CONSENSUS ON THE DEFINITION AND ATTRIBUTES OF PERSON-CENTRED TEAMWORK: AN e-DELPHI STUDY:Person-centred Teamwork

Background: Effective health care relies on person-centeredness and teamwork, which are known to improve outcomes. These two concepts have been defined individually, but we could not find a definition of the combined concept. A preliminary definition was developed through a concept analysis; however, consensus on the concept has not been reached.Aim: The aim of this study was to reach consensus on the definition and attributes of person-centered teamwork.Methods: A consensus design allowed experts to collaborate and share their experience and wisdom to refine and reach consensus on the definition and attributes of person-centered teamwork. An e-Delphi was used to engage the experts.Results: Three rounds of online engagement with 12 experts were needed to reach consensus on the definition and attributes of person-centered teamwork. The attributes reached consensus of 82% after the first round. The definition had 82% consensus after the three rounds. The definition had been adjusted and refined according to the expert input. The newly adjusted definition was established.Linking Evidence to Action: We successfully used the e-Delphi method to obtain consensus on the attributes and definition of person-centered teamwork. The definition of person-centered teamwork can be further developed and included in clinical practice to guide improved clinical outcomes. The consensus definition of person-centered teamwork provides a clear understanding of the meaning thereof, which may in turn enrich the usability thereof in clinical practice. Person-centered teams improve outcomes for persons receiving care in hospitals. Building person- centered teams are now better understood and the foundation of building these teams defined. We engaged with 12 experts in the academic and clinical field of person- centeredness and teamwork. The use and value of the Delphi method to obtain consensus is now better understood and can assist future research development

Process of development of a contemporary curriculum in advanced midwifery

Background: We identified the need for a contemporary curriculum to enhance education in advanced midwifery. Midwifery education needs to address the changing health needs, meet the requirements of the educational framework in South Africa and align with international trends.   Aim: The aim was to describe the development of a contemporary curriculum for advanced midwifery.   Setting: The curriculum development took place at a South African university.   Method: We used a situational analysis to create a contemporary curriculum based on the Research Development and Diffusion Model.   Results: We described the process followed for the situation analysis towards the development of a contemporary curriculum in advanced midwifery which is aligned with global trends.   Conclusion: A situation analysis of the existing curriculum, the community and country’s maternal and neonatal needs, educational framework and global trends should be used to develop the intended contemporary curriculum

Becoming the mother of a child with disabilities : a systematic literature review

The transition to motherhood starts early in pregnancy and is completed when the mother feels competent in caring for the infant. Becoming the mother of a child with disabilities is demanding as their needs are complex. The aim of the review was to appraise completed qualitative and quantitative reports on the challenges of mothers of children with disabilities regarding their own transition to motherhood. A review of the literature was carried out through, first, a computerized search strategy to identify relevant studies from selected databases and, second, quality appraisal and thematic analysis of selected studies. The transition to motherhood of children with disabilities takes place in the inside world at home, the outside world external to home and the ‘going-between’ world of travelling between the two worlds. The mothers are challenged at home to integrate basic infant care with technical care of their children. In the outside world they often struggled to ensure that their children got the necessary professional care. Travelling between their homes and healthcare services posed many problems.La transition vers la maternité commence au début de la grossesseet la transition s’estterminéquand la mèreestcompétente pour être capable de soigner pour l’enfant. De devenir la mère d’un enfant handicapéestexigeantparcequeleursbesoinssont complexes. L’objectif de l’étudeétaitd’évaluer à la fin les rapports qualitativesetquantitativessur les défis de mèresd’enfantshandicapés en ce qui concerneleurpropre transition vers la maternité. Une revue de la littérature a étéréalisée par le biais, d’abord, unestratégie de rechercheinformatisé pour identifier les étudespertinentes à partir de bases de donnéessélectionnées et, deuxièmement, l’évaluation de la qualité et de l’analysethématique des étudessélectionnées. La transition vers la maternité des enfantshandicapés a lieu dans le monde dans la maison, le monde dehors de la maison et dans le monde »qui se trouve entre cesdeuxmondes » c.a.d. le monde de voyage entre cesdeuxmondes. Les mèressontcontestées à la maison pour intégrer les soins de bases comme les nourrissons avec unsoin technique de leursenfants. Dans le monde dehors de la maison, ilsontsouventlutté de donner la securité à cequeleursenfantsontobtenu les soinsnécessaires qui doiventêtreprofessionnels. De voyager entre leur domicile et les services de soins de santé a posé beaucoup de problèmes.http://www.tandfonline.com/loi/ccwf202017-08-16hb201

Consensus on the content of an instrument to measure person-centred teamwork : an e-Delphi study

AIMS AND OBJECTIVES : To establish consensus on items to be included in an instrument to measure person-centred teamwork in a hospital setting. The objective was to identify the items through a methodological literature review. Refine the items and obtain consensus on the items. BACKGROUND : A definition and related attributes of person-centred teamwork have been agreed upon. An instrument is needed to measure and monitor person-centred teamwork in hospital settings. DESIGN : Consensus, electronic Delphi design. METHODS : Items were identified through a methodological literature review. These items were included in three electronic Delphi rounds. Using purposive and snowball sampling, 16 international experts on person-centred care, teamwork and/or instrument development were invited to participate in three electronic Delphi rounds via Google Forms. Descriptive statistics were used to demonstrate their agreement on the relevance and clarity of each item. Items were included if consensus was 0.75. Content analysis was used to analyse written feedback from experts. RESULTS : The response rate was 56% (n = 9/16). Nine experts participated over an 8-week period to reach consensus on the items to be included in an instrument to measure person-centred teamwork in hospital settings. The experts' responses and suggestions for rephrasing, removing and adding items were incorporated into each round. CONCLUSION : A Delphi consensus exercise was completed, and experts reached agreement on 38 items to be included in an instrument that can be used to evaluate person-centred teamwork in hospital settings. RELEVANCE TO CLINICAL PRACTICE : We engaged with nine international experts in the academic and clinical field of person-centeredness, teamwork and/or instrument development. An online platform was used to allow the experts to give input into the study. The experts engaged from their own environment with full autonomy and anonymity. Person-centred teamwork, aimed at improving practice is now measurable. Person-centred teams improve outcomes of patients. Person-centred teamwork was specifically developed to assist low compliance areas in hospitals.http://www.wileyonlinelibrary.com/journal/jocnhj2024Nursing ScienceNon

A rapid-cycle evaluation and adjustment of paediatric tonsillectomy primary caregiver education : qualitative research in implementation science

BACKGROUND : Tonsillectomies are generally performed on paediatric patients in ambulatory settings. The children are discharged after a short post-operative period of three to four hours which results in their parents becoming the primary caregivers at home. It is imperative that they receive extensive preparation and guidance on how to prevent, identify and manage complications related to the surgery at home. In this study, rapid-cycle evaluation and adjustment in combination with qualitative research in implementation science were used to show how health education can be revised during implementation. AIM: The study aimed to evaluate and adjust the paediatric tonsillectomy primary caregiver health education at a designated ambulatory hospital. DESIGN : A rapid cycle evaluation and adjustment of paediatric tonsillectomy health education was done through qualitative research in implementation science. It was guided by the contextual and interventional facilitators and barriers of the Consolidated Framework for Implementation Research. Two rounds of semi-structured interviews were conducted with parents as the primary caregivers of children and nurses who was directly involved with the health education. RESULTS : The process of evaluation and adjustment provided the researcher with valuable information that were applied to create a more compressive piece of primary carer health education. A guideline was created with current information to manage pain, eating practices and to limit post-operative haemorrhaging. CONCLUSION : Rapid-cycle evaluation and adjustment in combination with qualitative research in implementation science is effective to revise health education processes and material.https://www.elsevier.com/locate/ijanshj2024Nursing ScienceSDG-03:Good heatlh and well-bein

Caregivers’ and nurses’ perceptions of the responsibilities of community nurses in the management of infant developmental needs in a primary healthcare clinic in South Africa

By virtue of their access to infants and their families, community nurses in South Africa are provided with an important window of opportunity to assess and positively influence infant health and development. Hence, developmental surveillance should be incorporated into the ongoing healthcare of the child. Such routine child development services are not consistently provided by community nurses and if at all these services are provided, significant inadequacies hamper the delivery thereof. A single holistic case study design was used to explore the perceptions of caregivers and community nurses about the responsibilities of community nurses regarding the management of infant developmental needs in a primary healthcare clinic in one of the provinces in South Africa. Semi-structured interviews were conducted with five nurses and eleven caregivers of infants. Data were analysed by means of content analysis. Community nurses do not focus adequately on infant development, as stipulated in their scope of practice. The caregivers indicated that they receive limited emotional and appraisal support. The only interventions indicated by the community nurses were that of referral and limited anticipatory guidance. This study highlights the importance of community nurses living up to their responsibility regarding the management of infant developmental needs to ensure optimal outcomes for both the infant and the family.http://www.ajol.info/journal_index.php?jid=153&ab=ajpherd2017-12-31am201

Strategies for Nurses in Antiretroviral Clinics to Mitigate Symptoms of Compassion Fatigue.

Compassion fatigue has a negative impact on the well-being of healthcare professionals. Compassion fatigue affects nurses physically, emotionally and psychologically, as well as their behaviour towards others. Factors that increase nurses’ risk to develop compassion fatigue include an overwhelming workload, being a secondary witness to their patients’ traumatic experiences, emotional involvement with patients, especially children, lack of managerial support, and dealing with the deaths of their patients. The purpose of this paper is to describe strategies that nurses who work in antiretroviral (ARV) clinics use to mitigate the symptoms of compassion fatigue. A qualitative single embedded case study, utilising semi-structured interviews to collect data in ARV clinics in a tertiary hospital in the Gauteng province of South Africa was used. The process of content analysis as described by Elo and Kyngäs was utilised to analyse the data. The knowledge gained from the research findings contributed towards the identification of strategies that nurses use to prevent and manage compassion fatigue ‒ strategies such as debriefing, management support, psychological support, self-care, collegial support, and celebrating patients’ lives. If compassion fatigue is not recognised early and managed properly, it will have a negative impact on the quality of care and can result in an increase in the turnover rate of staff ‒ therefore the need for strategies that will mitigate the symptoms of compassion fatigue.Health Studie

Development of guidelines for the assessment of abuse in women living with HIV/AIDS in Malawi

The aim of the study was to develop guidelines for the assessment of abuse in women living with HIV/AIDS in Malawi. In phase one of the research, the experiences of these women were explored through a descriptive phenomenological study that involved 12 women living with HIV/AIDS who had encountered abuse. In phase 2, guidelines for the assessment of abuse were developed. Information from the interviews and a review of the literature was used to compile the draft guidelines. The guidelines were refined through a Delphi study carried out by nurses in the field of HIV/AIDS and gender-based violence. The guidelines could assist nurses to identify and address the abuse of women living with HIV/AIDS in a timely manner. Since the guidelines are inclusive of the actions nurses should take to encourage women to talk about their experiences, it is foreseen that their implementation could improve the quality of care rendered to the women.Government of Malawi and the Community-Oriented Nursing Education Project for Women and Child Health of the University of Pretoria.http://www.ajol.info/journal_index.php?jid=153&ab=ajpherd2016-09-30hb201

Do pregnant women know how to correct inverted nipples?

Inverted nipples occur in an estimated 9 to 10 percent of women globally, contributing to the number of women who are not exclusively breastfeeding their infants. Women with inverted nipples may want to breastfeed, but infants may be unable to latch to the breast. Inverted nipples can be corrected, but it is unclear if women know about suitable interventions. This study assessed if pregnant women knew about the available techniques to correct inverted nipples. We conducted individual interviews with nine pregnant women with inverted nipples in a tertiary hospital in South Africa. Data were analysed using an inductive content analysis. Most of the women had very limited knowledge of exclusive breastfeeding or inverted nipples and knew very little about correcting devices. These women thought that their infants would be unable to latch and that exclusive breastfeeding would be impossible. Pregnant women with inverted nipples should be educated about methods to correct their nipples.http://www.journals.co.za/content/journal/ajpherd1am2017Nursing Scienc

Healthcare needs of displaced women : Osire refugee camp, Namibia

AIM : The aim of this study was to explore and describe the experiences of health care needs of displaced women in the Osire refugee camp in Namibia. BACKGROUND : Namibia is a country where displaced people from other African countries seek refuge as a result of their own country‟s political instability. All displaced people are hosted in the Osire camp, which is a highly protected area. There are more women than men in the camp and their health is often compromised. METHODS : In a descriptive phenomenological study the natural dimension of the experiences of the participants of their health care needs were explored through in-depth interviews and reflected upon through transcendental processes to formulate the phenomenological dimension thereof. FINDINGS : The essence of displaced women´s health care needs was “the need for the restoration of hope and human dignity”. Their needs refer to measures to enhance their autonomy and freedom; skills training; certainty about their future; security with aid distribution; protection against stigmatisation due to Human Immuno-deficiency Virus (HIV) infection; protection against abuse; and participation in reproductive health care. DISCUSSION : When displaced women are admitted in a camp they lose their freedom to make decisions about everyday functioning and future. They thus develop feelings of insecurity and vulnerability. CONCLUSION : The participants referred to several factors that were detrimental for their wellbeing. The essence of their needs was “the need for the restoration of hope and human dignity” that could only be achieved when their needs are addressed. IMPLICATIONS FOR NURSING : As nurses are in close contact with displaced women in refugee camps they should negotiate opportunities for the women to discuss their concerns with the camp officials. IMPLICATIONS FOR HEALTH AND SOCIAL DEVELOPMENT POLICY : Policies should make provision for the involvement of displaced people in all aspects that relate to their everyday and future living arrangements.http://onlinelibrary.wiley.com/journal/10.1111/(ISSN)1466-76572017-03-31hb2016Nursing Scienc