Medium-term outcomes of a program to upgrade the nursing faculty in Cambodia: A qualitative study

Continuous professional development is important for improving professional competencies, such as cognitive knowledge, technical skills, behaviors, and attitudes. Trainees who complete training programs can have a positive influence on their workplaces. However, it is challenging to establish a process that can facilitate individual learning and help achieve training outcomes in educational and clinical workplaces. In Cambodia, a tumultuous history has played a part in the deficit of adequately prepared nursing faculty. Since the faculty development is vital to ensuring the quality of education, the application of upgraded nursing programs has started in 2011. After the completion of upgraded program, an immediate post-training study was conducted in 2014. Results showed that some faculty members did not accept trainees because they lacked an understanding about nursing concepts. The current study aimed to evaluate the medium-term outcomes of an established program that can improve nursing education and to identify relevant factors in light of the institutional development of educational and clinical facilities in Cambodia. A qualitative study incorporating focus group discussions, key-informant interviews, and teaching document reviews was performed with a thematic analysis using the four-level training evaluation model of Kirkpatrick. Finally, factors influencing outcomes were assessed based on the Bronfenbrenner's ecological system theory. Five themes for behavior and three themes for results were identified as medium-term outcomes from an institutional development aspect. The major enabling factors for the above-mentioned themes were the support of institutional managers, continuous networking among trainees, and supportive national policy. Compared with the immediate post-training study findings, the perceived medium-term outcomes became more strategically focused. Then, the impact of training at a considerably broader scale within the workplace was discussed. The findings highlighted the importance of medium-term program delivery and monitoring if one understands the role played in stimulating outcomes. Moreover, the importance of contextual factors including the influence of managers and policy environment were emphasized

Infection control teams for reducing healthcare-associated infections in hospitals and other healthcare settings: a protocol for systematic review

Introduction Healthcare-associated infections (HCAIs) are a worldwide problem. Infection control in hospitals is usually implemented by an infection control team (ICT). Initially, ICTs consisted of doctors, nurses, epidemiologists and microbiologists; then, in the 1980s, the infection control link nurse (ICLN) system was introduced. ICTs (with or without the ICLN system) work to ensure the health and well-being of patients and healthcare professionals in hospitals and other healthcare settings, such as acute care clinics, community health centres and care homes. No previous study has reported the effects of ICTs on HCAIs. This systematic review aims to assess the effectiveness of ICTs with or without the ICLN system in reducing HCAIs in hospitals and other healthcare settings.Methods and analysis We will perform a comprehensive literature search for randomised controlled trials in four databases: PubMed, Embase, CINAHL and the Cochrane Library. The primary outcomes are: patient-based/clinical outcomes (rate of HCAIs, death due to HCAIs and length of hospital stay) and staff-based/behavioural outcomes (compliance with infection control practices). The secondary outcomes include the costs to the healthcare system or patients due to extended lengths of stay. Following data extraction, we will assess the risk of bias by using the Cochrane Effective Practice and Organization of Care risk of bias tool. If data can be pooled across all the studies, we will perform a meta-analysis.Ethics and dissemination We will use publicly available data, and therefore, ethical approval is not required for this systematic review. The findings will be submitted for publication in peer-reviewed journals.Trial registration number CRD42020172173

Perceived barriers to utilization of maternal health services in rural Cambodia

Objective The aim of this study was to identify the underlying causes of Cambodian women's non-use of maternal health services provided by skilled birth attendants.Method A qualitative study of 66 reproductive-age women was conducted in Kampong Cham Province, Cambodia. Data were collected through 30 semi-structured interviews and 6 focus groups.Results We identified 5 barriers to the utilization of maternal health services: (i) financial barriers; (ii) physical barriers; (iii) cognitive barriers; (iv) organizational barriers; and (v) psychological and socio-cultural barriers.Conclusions The Cambodian Ministry of Health and its development partners should take these barriers into account when promoting the use of maternal health services. These barriers should be addressed proactively. A successful approach to increasing use of maternal health services should involve changes to both service programs and public education.Cambodia Maternal health services Health seeking behaviour Barriers to health services Qualitative study

Effectiveness of Infection Control Teams in Reducing Healthcare-Associated Infections: A Systematic Review and Meta-Analysis

The infection control team (ICT) ensures the implementation of infection control guidelines in healthcare facilities. This systematic review aims to evaluate the effectiveness of ICT, with or without an infection control link nurse (ICLN) system, in reducing healthcare-associated infections (HCAIs). We searched four databases to identify randomised controlled trials (RCTs) in inpatient, outpatient and long-term care facilities. We judged the quality of the studies, conducted meta-analyses whenever interventions and outcome measures were comparable in at least two studies, and assessed the certainty of evidence. Nine RCTs were included; all were rated as being low quality. Overall, ICT, with or without an ICLN system, did not reduce the incidence rate of HCAIs [risk ratio (RR) = 0.65, 95% confidence interval (CI): 0.45–1.07], death due to HCAIs (RR = 0.32, 95% CI: 0.04–2.69) and length of hospital stay (42 days vs. 45 days, p = 0.52). However, ICT with an ICLN system improved nurses’ compliance with infection control practices (RR = 1.17, 95% CI: 1.00–1.38). Due to the high level of bias, inconsistency and imprecision, these findings should be considered with caution. High-quality studies using similar outcome measures are needed to demonstrate the effectiveness and cost-effectiveness of ICT

Mission Data Processor Aboard the BepiColombo Mio Spacecraft: Design and Scientific Operation Concept

International audienceBepiColombo Mio, also known as the Mercury Magnetospheric Orbiter (MMO), is intended to conduct the first detailed study of the magnetic field and environment of the innermost planet, Mercury, alongside the Mercury Planetary Orbiter (MPO). This orbiter has five payload groups; the MaGnetic Field Investigation (MGF), the Mercury Plasma Particle Experiment (MPPE), the Plasma Wave Investigation (PWI), the Mercury Sodium Atmosphere Spectral Imager (MSASI), and the Mercury Dust Monitor (MDM). These payloads operate through the Mission Data Processor (MDP) that acts as an integrated system for Hermean environmental studies by the in situ observation of charged and energetic neutral particles, magnetic and electric fields, plasma waves, dust, and the remote sensing of radio waves and exospheric emissions. The MDP produces three kinds of coordinated data sets: Survey (L) mode for continuous monitoring, Nominal (M) mode for standard analyses of several hours in length (or more), and Burst (H) mode for analysis based on 4-20-min-interval datasets with the highest cadence. To utilize the limited telemetry bandwidth, nominal- and burst-mode data sets are partially downlinked after selections of data based on L- or L/M-mode data, respectively. Burst-mode data can be taken at preset timings, or by onboard automatic triggering. The MDP functions are implemented and tested on the ground as well as cruising spacecraft; they are responsible for conducting full scientific operations aboard spacecraft