Barreras y facilitadores en la práctica de la Enfermería Basada en la Evidencia en Medellín, Colombia

ABSTRACT: To identify and describe the perceptions of nursing researchers, educators, and graduate students regarding the barriers to, and facilitators for, EBN in Medellín, Colombia.Methodology. Using a qualitative descriptive design, in-depth-semi-structured interviews were conducted with 12 participants associated with a large university faculty of nursing in Medellín,and one member of the National Association of Nurses. Qualitative content analysis was used to analyze the interview transcripts.Results. Several barriers to EBN were reported, including: lack off recognition of nursing as an autonomous profession; a lack off incentives for nurses to pursue advanced education or engage in research; limited availability and utility of nursing evidence;and a lack of communication between academic and clinical practice environments. Perceived facilitators included an increase in nurses pursuing advanced education opportunities; the current healthcare accreditation process; access to international research and research collaborations; and clinical and research partnerships between universities and clinical institutions.Conclusion. Effective implementation of evidence-based nursing practices is a necessity to translate the vast amount of health related research, knowledge, and experience into positive changes in healthcare quality.Key words: evidence-based nursing; education, nursing; research,nursing; information dissemination.RESUMEN: Identificar y describir las percepciones de los enfermeros investigadores, educadores y estudiantes de postgrado sobre las barreras y elementos facilitadores para la práctica de la Enfermería Basada en la Evidencia (EBE), en Medellín, Colombia. Metodología. En 2012, se realizó un estudio descriptivo cualitativo en el que se realizaron entrevistas semiestructuradas a 12 participantes de una Facultad de Enfermería de una universidad pública de Medellín, y de un miembro de la Asociación Nacional de Enfermeras. Se utilizó el análisis de contenido cualitativo para estudiar las transcripciones de las entrevistas. Resultados. Se informaron algunas barreras para la práctica de la EBE, entre ellas: la falta de reconocimiento de la enfermería como una profesión autónoma, la falta de incentivos para cursar estudios avanzados o dedicarse a la investigación, la limitada disponibilidad y baja utilización de la evidencia en enfermería, y la falta de comunicación entre la academia y los entornos de práctica clínica. Los facilitadores incluyeron, entre otros, el aumento de enfermeras quienes buscan oportunidades de educación avanzada, el actual proceso de acreditación en salud, el acceso a la investigación internacional y a las redes de colaboración en investigación, y a la unión de esfuerzos para la investigación entre las instituciones clínicas y las universitarias. Conclusión. La aplicación efectiva de la práctica de la enfermería basada en la evidencia es la necesidad de traducir la gran cantidad de investigación relacionada con la salud, el conocimiento y la experiencia en el mejoramiento de la calidad asistencial

Development of the Migrant Friendly Maternity Care Questionnaire (MFMCQ) for migrants to Western societies: an international Delphi consensus process

Background Through the World Health Assembly Resolution, ‘Health of Migrants’, the international community has identified migrant health as a priority. Recommendations for general hospital care for international migrants in receiving-countries have been put forward by the Migrant Friendly Hospital Initiative; adaptations of these recommendations specific to maternity care have yet to be elucidated and validated. We aimed to develop a questionnaire measuring migrant-friendly maternity care (MFMC) which could be used in a range of maternity care settings and countries. Methods This study was conducted in four stages. First, questions related to migrant friendly maternity care were identified from existing questionnaires including the Migrant Friendliness Quality Questionnaire, developed in Europe to capture recommended general hospital care for migrants, and the Mothers In a New Country (MINC) Questionnaire, developed in Australia and revised for use in Canada to capture the maternity care experiences of migrant women, and combined to create an initial MFMC questionnaire. Second, a Delphi consensus process in three rounds with a panel of 89 experts in perinatal health and migration from 17 countries was undertaken to identify priority themes and questions as well as to clarify wording and format. Third, the draft questionnaire was translated from English to French and Spanish and back-translated and subsequently culturally validated (assessed for cultural appropriateness) by migrant women. Fourth, the questionnaire was piloted with migrant women who had recently given birth in Montreal, Canada. Results A 112-item questionnaire on maternity care from pregnancy, through labour and birth, to postpartum care, and including items on maternal socio-demographic, migration and obstetrical characteristics, and perceptions of care, has been created - the Migrant Friendly Maternity Care Questionnaire (MFMCQ) – in three languages (English, French and Spanish). It is completed in 45 minutes via interview administration several months post-birth. Conclusions A 4-stage process of questionnaire development with international experts in migrant reproductive health and research resulted in the MFMCQ, a questionnaire measuring key aspects of migrant-sensitive maternity care. The MFMCQ is available for further translation and use to examine and compare care and perceptions of care within and across countries, and by key socio-demographic, migration, and obstetrical characteristics of migrant women

Influenza vaccination for immunocompromised patients: systematic review and meta-analysis from a public health policy perspective.

Immunocompromised patients are vulnerable to severe or complicated influenza infection. Vaccination is widely recommended for this group. This systematic review and meta-analysis assesses influenza vaccination for immunocompromised patients in terms of preventing influenza-like illness and laboratory confirmed influenza, serological response and adverse events

Public Health Legal Preparedness in Indian Country

American Indian/Alaska Native tribal governments are sovereign entities with inherent authority to create laws and enact health regulations. Laws are an essential tool for ensuring effective public health responses to emerging threats

HIV and Pregnancy Intentions: Do Services Adequately Respond to Women's Needs?

Too little is known about how an HIV diagnosis and access to care and treatment affect women's childbearing intentions. As access to antiretroviral therapy improves, greater numbers of HIV-positive women are living longer, healthier lives, and many want to have children