A modified systematic review of research evidence about education for pre-registration nurses in palliative care

Background: We undertook a modified systematic review of research regarding educational approaches to and effectiveness of pre-registration palliative care nursing, to inform the development of a short course in palliative care for pre-registration nursing students in Cameroon. The aim of this review was to examine educational approaches applied to pre-registration palliative care nursing education and their effectiveness, and to discuss implications for the development of palliative care curricula in resource-poor countries. Method: A modified systematic review of research on palliative care educational interventions, conducted with pre-registration student nurses was undertaken. Relevant literature was gathered from CINAHL, EMBASE, MEDLINE and PsychINFO databases for the period 2000–2013. Inclusion was limited to studies of educational interventions evaluating the effectiveness and outcomes of palliative and end of life care education with pre-registration student nurses. Results: 17 studies were found, all of which were conducted in resource-rich countries: United States of America, Canada, Australia, and United Kingdom. Palliative care nursing education at pre-registration level is either delivered as a discrete course within the curriculum or palliative care content is embedded into other nursing specialty courses throughout the wider curriculum. Palliative care education is delivered to students at a variety of stages in their nursing program, using a mix of both didactic and experiential educational strategies. Course facilitators span palliative care specialists, educators who have attended ‘train-the-trainer’ courses in palliative care, and nurses with hospice experience. Education is underpinned by transformative and experiential learning theories and reported as effective in improving students’ attitudes towards care of the dying. Conclusion: The educational strategies identified in this review may be applicable to resource-poor countries. However, there are challenges in transferability because of the lack of availability of specialist palliative care practitioners who can serve as educators, specialist palliative care units/institutions for experiential learning, funds to design and use high fidelity simulations, and palliative care textbooks and other educational materials. There is thus a need for innovative educational strategies that can bridge these barriers in resource-poor countries. There is also a need for further research into how palliative care education impacts on pre-registration student nurses’ knowledge and practice

Current antibiotic susceptibility profile of the bacteria associated with Surgical wound infections in the Buea health district in Cameroon

Background: Most surgical wounds seen in clinical practice in the Buea Health District, Cameroon are infected prior to arrival or while they are in the hospital. Sometimes the infection necessitates a combination of local wound site measures and systemic antibiotherapy to properly manage the patient.Objective: To identify the current antibiotic susceptibility profile of the common germs that cause surgical wound infections in the Buea Health District of Cameroon.Methods: A total of 2120 specimens comprising swabs from burns, ulcers, open or post-operative wounds were collected from hospitalized patients attending health institutions in Buea. The samples were collected from different anatomic sites of the patients. Cultures were effected from the specimens and bacteria isolated from infected wounds using standard microbiological techniques. Antibiotic susceptibility of the different isolates was determined.Results: Majority (79.8%) of the wounds were infected with pathogenic bacteria. The germs globally showed multi resistant patterns to commonly used antibiotics in the study area, especially to co-trimoxazol, doxycycline, chloramphemicol, ampicilline and aztreonam. However appreciable sensitivity was noted to ofloxacillin, perflacin, and ceftriazone.Conclusion: This study has revealed ofloxacin as the only antibiotic to which all the isolated bacteria from infected wounds were sensitive in the study area.Keywords: Wound infection, Antibiotic susceptibility profile, Buea Health District, Cameroo

A qualitative evaluation of the impact of a palliative care course on preregistration nursing students' practice in Cameroon

Background Current evidence suggests that palliative care education can improve preregistration nursing students’ competencies in palliative care. However, it is not known whether these competencies are translated into students’ practice in the care of patients who are approaching the end of life. This paper seeks to contribute to the palliative care evidence base by examining how nursing students in receipt of education report transfer of learning to practice, and what the barriers and facilitators may be, in a resource-poor country. Methods We utilised focus groups and individual critical incident interviews to explore nursing students’ palliative care learning transfer. Three focus groups, consisting of 23 participants and 10 individual critical incident interviews were conducted with preregistration nursing student who had attended a palliative care course in Cameroon and had experience caring for a patient approaching the end of life. Data was analysed thematically, using the framework approach. Results The results suggest that nursing students in receipt of palliative care education can transfer their learning to practice. Students reported recognizing patients with palliative care needs, providing patients with physical, psychosocial and spiritual support and communicating patient information to the wider care team. They did however perceive some barriers to this transfer which were either related to themselves, qualified nurses, the practice setting or family caregivers and patients. Conclusion The findings from this study suggest that nursing student in receipt of palliative care education can use their learning in practice to provide care to patients and their families approaching the end of life. Nevertheless, these findings need to be treated with some caution given the self-reported nature of the data. Demonstrating the link between preregistration palliative care education and patient care is vital to ensuring that newly acquired knowledge and skills are translated and embedded into clinical practice. This study also has implications for advocating for palliative care policies and adequately preparing clinical placement sites for students’ learning and transfer of learning

Preregistration nursing students' experiences of a palliative care course in a resource-poor setting

Palliative care education for non-specialist health professionals is an important strategy for widening access to palliative care. To describe Cameroonian nursing students' experiences and perceptions of the strengths and weaknesses of a palliative care course, with a view to refining the course. Three focus groups were conducted with 23 students, and data were analysed thematically using the framework approach. The students reported connecting with their past personal and professional experiences in the care of patients with palliative care needs during the course. The main course strength reported was its use of a variety of interactive educational strategies, such as role plays, group discussions and case studies. The course's main reported weakness was the lack of supervised clinical practice in palliative care. The use of a variety of interactive educational strategies-including supervised clinical practice-is considered by nursing students as vital to enhancing learning in palliative care education. However, the lack of supervised palliative care clinical practice opportunities is a challenge in Cameroon