The intellectual capital supporting nurse practice in a post-emergency state: A case study

Aim To explore the resources supporting current nurse practice in the post-emergency country of Liberia, using the nursing intellectual capital framework, as nurses work to meet the targets set by Government of Liberia\u27s Essential Package of Health Services. Design Case study. Methods Data were collected in Liberia February–June 2019. Direct observation, semi-structured interviews and photographs were used to investigate how nurse practice is supported. Field notes, transcripts and photographs were coded using both directed and conventional content analysis. Reports were then generated by code to triangulate the data. Results Thirty-seven nurses at 12 health facilities participated. The intellectual capital supporting inpatient and outpatient nurse practice differs in important ways. Inpatient nurse practice is more likely to be supported by facility-based protocols and trainings, whereas outpatient nurse practice is more likely to be supported by external protocols and trainings, often developed by the Liberian government or non-governmental organizations. This can lead to uneven provision of inpatient protocols and trainings, often favouring private facilities. Similarly, inpatient nurses rely primarily on other nurses at their facilities for clinical support while outpatient nurses often have external professional relationships that provided them with clinical guidance. Conclusion Much has been accomplished to enable outpatient nurses to provide the primary- and secondary-care target services in the Essential Package of Health Services. However, as the Liberian government and its partners continue to work towards providing certain tertiary care services, developing analogous protocols, trainings and clinical mentorship networks for inpatient nurses will likely be fruitful, and will decrease the burden on individual facilities. Impact Nurses are often expected to meet new service provision targets in post-emergency states. Further research into how best to support nurses as they work to meet those targets has the potential to strengthen health systems

Outcomes from an Interprofessional Educational Model for Teaching Community Health

Interprofessional team work is widely recognized as an essential component of our health care delivery system. At UMass, an interprofessional educational partnership was established with the goal of promoting interprofessional teaching to medical and nursing students in the area of community health. Presented at the UMMS Commonwealth Medicine Academic Conference, Worcester, Mass. in 2006

Simulated Basic Skills Training: Graduate Nursing Students Teaching Medical Students: A Work in Progress

For a number of years, Advanced Practice Nursing (APN) students have taught interested 1st year medical students to perform intramuscular injections prior to their participation in community flu clinics. When several 4th year medical students needed documentation of competency in intravenous (IV) cannulation prior to participating in an elective rotation at another institution, the Medical School\u27s Dean of Students called the Director of Interdisciplinary Partnerships in the Graduate School of Nursing to request assistance. In fact, all medical students need IV therapy training prior to graduation, not just those who seek out visiting clerkships at other medical schools. Integration of IV training into the Undergraduate Medical Education Surgery Clerkship Curriculum supports the clinical objectives of the Surgery Clerkship along with the developing use of simulation within in the medical school. This need led to the development of this interdisciplinary simulation education initiative. Presented at the 2008 Society on Simulation in Healthcare Conference

Working hard: women\u27s self-care practices in Ghana

Women\u27s health care providers have noted an increased infant mortality rate among Ghanaian immigrants. We conducted focus groups with 17 women in Ghana. We asked them how they maintained their health both before and during pregnancy. When discussing their health, women repeatedly described the conditions or context of their daily lives and the traditional practices that they used to stay healthy. Knowledge of women\u27s lives, the health care system that they previously used, and their cultural practices can be utilized by health care providers to more fully assess their patients and design more culturally appropriate care for this group of women

Macrocognition in the Healthcare Built Environment (mHCBE): A Focused Ethnographic Study of Neighborhoods in a Pediatric Intensive Care Unit

OBJECTIVES: The objectives of this research were to describe the interactions (formal and informal), in which macrocognitive functions occur and their location on a pediatric intensive care unit, to describe challenges and facilitators of macrocognition using space syntax constructs (openness, connectivity, and visibility), and to analyze the healthcare built environment (HCBE) using those constructs to explicate influences on macrocognition. BACKGROUND: In high reliability, complex industries, macrocognition is an approach to develop new knowledge among interprofessional team members. Although macrocognitive functions have been analyzed in multiple healthcare settings, the effect of the HCBE on those functions has not been directly studied. The theoretical framework, macrocognition in the healthcare built environment (mHCBE) addresses this relationship. METHOD: A focused ethnographic study was conducted including observation and focus groups. Architectural drawing files used to create distance matrices and isovist field view analyses were compared to panoramic photographs and ethnographic data. RESULTS: Neighborhoods comprised of corner configurations with maximized visibility enhanced team interactions as well as observation of patients, offering the greatest opportunity for informal situated macrocognitive interactions (SMIs). CONCLUSIONS: Results from this study support the intricate link between macrocognitive interactions and space syntax constructs within the HCBE. These findings help increase understanding of how macrocognition in the HCBE can improve physical space by designing new spaces, refining existing spaces, or adapting interprofessional team practices to maximize formal and informal SMI opportunities to improve safety and quality for interprofessional teams, patient, and family care