Spousal participation in labor and delivery in Nigeria

A male companion at antenatal care is unusual and spousal participation during labor and delivery in Nigeria is poor. This can be attributed to amongst other things the beliefs that labor is exclusively a women affair. Although there are few studies about male involvement in maternity care in Nigeria, no review has been conducted regarding spousal participation in labor and delivery. Therefore, majority of women desire their spouses as birth companions and attest to having emotional comfort and support when their spouses participate in their labor and delivery, the status and acceptability of spousal participation in labor and delivery in Nigeria is quite low due in part to socio-cultural drawbacks. This narrative review looks at existing research literatures identified through electronic sources such as Google Scholar, PubMed and EBSCO published in English between 1995 and 2013. The aim of this narrative review is to extract from these literatures the level of participation of Nigerian spouses in labor and delivery. Keys words used for the search include spouse, labor, delivery, Nigeria, maternal; childbirth and only English papers were included. Although presently weak, the spousal participation in labor and delivery in Nigeria should be encouraged and promoted as a deliberate health-care policy through the creation of an enabling environment and dissemination of information highlighting the pivotal role that spouses could play in labor and delivery

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Background: Evidence from a nursing conference convened in Nigeria in 1973 amongst other things implied that Nigerian nurses are not adequately educated and ill-equipped with prerequisite research skills. Four decades after the first and only initiative that examined the capacity and contribution of Nigerian Nurses to health care research, it is therefore pertinent to revisit the state of nursing research in the country.Aim: To review the academic and research preparedness of Nigerian nurses in conducting research and utilizing research results in healthcare practices. Methods: Literature review of seven published articles on nursing education and research in Nigeria, identified through online data bases; Google Scholar, CINAHL and PubMed. Findings: The findings revealed that majority of nurses in Nigeria had only diploma degree in nursing education. Also, nurses’ involvement and utilization of research was limited and poor even though nursing research was perceived as very important in nursing practice by majority of the nurses. Conclusion: Most nurses are not academically equipped with research skills in Nigeria due to minimal educational qualifications not sufficient for conducting nursing research. There is a compelling need to reassess nursing education and research policies in Nigeria.Key words: Nurses, nursing education, nursing practices, nursing research, research utilization, research skil

Factors contributing to reported medication administration incidents in patients' homes - A text mining analysis

AIMS: To describe the characteristics of medication administration (MA) incidents reported to have occurred in patients' own homes (reporters' profession, incident types, contributing factors, patient consequence, and most common medications involved) and to identify the connection terms related to the most common contributing factors based on free text descriptions. DESIGN: A retrospective study using descriptive statistical analysis and text mining. METHODS: Medication administration incidents (N = 19,725) reported to have occurred in patients' homes between 2013-2018 in one district in Finland were analysed, describing the data by the reporters' occupation, incident type, contributing factors, and patient consequence. SAS® Text Miner was used to analyse free text descriptions of the MA incidents to understand contributing factors, using concept linking. RESULTS: Most MA incidents were reported by practical (lower level) nurses (77.8%, N = 15,349). The most common category of harm was 'mild harm' (40.1%, N = 7,915) and the most common error type was omissions of drug doses (47.4%, N = 9,343). The medications most commonly described were Marevan [warfarin] (N = 2,668), insulin (N = 811), Furesis [furosemide] (N = 590), antibiotic (N = 446), and Panadol [paracetamol] (N = 416). The contributing factors most commonly reported were 'communication and flow of information' (25.5%, N = 5,038), 'patient and relatives' (22.6%, N = 4,451), 'practices' (9.9%, N = 1,959), 'education and training' (4.8%, N = 949), and 'work environment and resources' (3.0%, N = 598). CONCLUSION: There is need for effective communication and clear responsibilities between home care patients and their relatives and health providers, about MA and its challenges in home environments. Knowledge and skills relating to safe MA are also essential. IMPACT: These findings about MA incidents that have occurred in patients' homes and have been reported by home care professionals demonstrate the need for medication safety improvement in home care

Factors Related to Medication Administration Incidents in England and Wales Between 2007 and 2016: A Retrospective Trend Analysis

OBJECTIVES The aims of the study were to describe medication administration incidents reported in England and Wales between 2007 and 2016, to identify which factors (reporting year, type of incident, patients' age) are most strongly related to reported severity of medication administration incidents, and to assess the extent to which relevant information was underreported or indeterminate. METHODS Medication administration incidents reported to the National Reporting & Learning System between January 1, 2007, and December 31, 2016 were obtained. Characteristics of the data were described using frequencies, and relationships between variables were explored using cross-tabulation. RESULTS A total of 517,384 incident reports were analyzed. Of these, 97.1% (n = 502,379) occurred in acute/general hospitals, mostly on wards (69.1%, n = 357,463), with medicine the most common specialty area (44.5%, n = 230,205). Medication errors were most commonly omitted doses (25.8%, n = 133,397). The majority did not cause patient harm (83.5%, n = 432,097). When only incidents causing severe harm or death (n = 1,116) were analyzed, the most common type of error was omitted doses (24.1%). Most incidents causing severe harm or death occurred in patients aged 56 years or older. For the 10-year period, the percentage of incidents with “no harm” increased (74.1% in 2007 to 86.3% in 2016). For some variables, data were often missing or indeterminate, which has implications for data analysis. CONCLUSIONS Medication administration incidents that do not cause harm are increasingly reported, whereas incidents reported as severe harm and death have declined. Data quality needs to be improved. Underreporting and indeterminate data, inaccuracies in reporting, and coding jeopardize the overall usefulness of these data

Spousal Presence as a Nonpharmacological Pain Management during Childbirth: A Pilot Study.

Background. Measures of spousal effect during parturient pain should take a tripartite approach involving the parturients, spouses, and midwives. Aim. To develop and validate three questionnaires measuring spousal presence in management of parturient pain in Nigeria. Methods. There are two phases: (1) development of questionnaires, Abuja Instrument for Midwives (AIM), Abuja Instrument for Parturient Pain (AIPP), and Abuja Instrument for Parturient Spouses (AIPS), utilizing literatures, Kuopio instrument for fathers (KIF) and expertise of health professionals, and (2) pilot study to validate the questionnaires which were administered in two hospitals in Nigeria: midwives (n = 10), parturients (n = 10), and spouses (n = 10).  Results. Internal consistency for the three questionnaires indicated Cronbach's alpha coefficient of 0.789 (AIM), 0.802 (AIPP), and 0.860 (AIPS), while test-retest reliability was r = 0.99 (AIM), r = 0.99 (AIPP), and r = 0.90 (AIPS). Conclusions. AIM, AIPP, and AIPS provide a means of investigating the effectiveness of spousal presence in management of parturient pain in Nigeria. However, further testing of each instrument is needed in a larger population to replicate the beneficial findings of AIMS, AIPP, and AIPS which can contribute rigor to future studies

Revisiting Nursing Research in Nigeria

Background: Evidence from a nursing conference convened in Nigeria in 1973 amongst other things implied that Nigerian nurses are not adequately educated and ill-equipped with prerequisite research skills. Four decades after the first and only initiative that examined the capacity and contribution of Nigerian Nurses to health care research, it is therefore pertinent to revisit the state of nursing research in the country. Aim: To review the academic and research preparedness of Nigerian nurses in conducting research and utilizing research results in healthcare practices. Methods: Literature review of seven published articles on nursing education and research in Nigeria, identified through online data bases; Google Scholar, CINAHL and PubMed. Findings: The findings revealed that majority of nurses in Nigeria had only diploma degree in nursing education. Also, nurses’ involvement and utilization of research was limited and poor even though nursing research was perceived as very important in nursing practice by majority of the nurses. Conclusion: Most nurses are not academically equipped with research skills in Nigeria due to minimal educational qualifications not sufficient for conducting nursing research. There is a compelling need to reassess nursing education and research policies in Nigeria

Medication administration errors and mortality: Incidents reported in England and Wales between 2007 ̶ 2016

Background Medication administration errors may contribute to patient mortality, thus additional understanding of such incidents is required. Objectives To analyse medication administration errors reported in acute care resulting in death, to identify the drugs concerned, and to describe medication administration error characteristics (location of error, error type, patient's age) by drug group. Methods Medication administration errors reported in acute care in 2007 ̶ 2016 (n = 517,384) were obtained from the National Reporting and Learning System for England and Wales. Incidents reported as resulting in death (n = 229) were analysed. Drugs were classified by two researchers using the British National Formulary. Drug categories were described by medication administration errors' year, location, patient age, and error category based on the incidents’ original classification. Results Errors were most often reported on wards (66.4%, n = 152), and in patients aged over 75 years (41.5%, n = 95). The most common error category was omitted medicine or ingredient (31.4%, n = 72); most common drug groups were cardiovascular (20.1%, n = 46) and nervous system (10.0%, n = 23). Most errors in patients under 12 years concerned drugs to treat infection; cardiovascular drugs were most common among other age groups. Conclusions In order to prevent these most serious of medication administration errors, interventions should focus on avoiding dose omissions, and administration of drugs for patients over 75 years old, as well as safe administration of parenteral anticoagulants and antibacterial drugs

Nurses' perceptions on pain behaviours among burn patients : a qualitative inquiry in a Ghanaian tertiary hospital

Background Pain sustained from burns is usually quite severe and has been linked to extreme distress, preventing patients from contributing to their care. Nurses have legal and professional obligations to promptly assess burns pain by using pain assessment tools and by relying on the patient’s behaviour and expressions. Objectives To explore nurses' perceptions on pain behaviours among burn patients in a Ghanaian tertiary hospital. Methods A qualitative descriptive design was used. A total of 11 nurses were recruited through a purposive sampling technique from a burns unit of a tertiary facility in Ghana. Semi-structured face-to-face interviews were conducted. Analysis was done using thematic content analysis, from which two major themes and nine subthemes were identified. Findings Patients express their pain by adopting both verbal and non-verbal communication means. However, due to the subjective nature of pain, nurses’ perceptions of pain were not sufficient to effectively assess the degree of pain. Verbal indicators that nurses perceived to be pain behaviours of burn patients were screaming, crying, praying and groaning, while frowning, reduced sense of humour, and body language were some non-verbal indicators nurses used to confirm the existence of burns pain. Nurses in Ghana must adopt the use of objective pain assessment tools, in conjunction with perceived pain behaviours, for optimal pain management outcomes. Conclusions Patients with burns experience intense pain from both the burns and the procedures that are done for them to aid in their healing. A systematic pain assessment by nurses, as part of the health care team, is a vital guide to pain management. To ensure consistency in the assessment of pain, there is a need to design protocols and policies to guide all nurses in the assessment of burns pain in the burns unit

Burns pain management in Ghana : the role of nurse–patient communication

Background: Nursing is an embodiment of knowledge, clinical work, and interpersonal communication. Effective nursing care has a distinct influence on the overall satisfaction and experience of the patient. Communication is said to be indispensable in the delivery of quality healthcare. Effective communication between nurses and patients has proven to yield better results with pain control and improved psychological status of patients. Objectives: The aim of the study is to explore nurses’ perceptions on the role of communication in the management of burns pain. Methods: A qualitative design with purposive sampling was carried out to recruit 11 registered nurses from a Reconstructive Plastic Surgery and Burns Center in Ghana. To identify the participants’ perception on the role of nurse–patient communication in the management of burns pain, a face to face semi-structured interviews were conducted using an interview guide to collect data. Results: Thematic analysis was done with various themes emerging. Helping patients manage pain, early detection of patient’s distress, improved patient participation in their care were some of the positive effects of nurse–patient communication whiles reduced level of cooperation during caregiving, and endurance of pain by the patient were the results of poor nurse–patient communication. Language and time facto were the barriers that were identified to hinder effective communication between nurses and patients. Conclusions: Due to the subjective nature of pain, the current study highlights the need for increased communication for an effective assessment and management of pain among patients with burns. It is, therefore, imperative that nurses be well trained in communication with an emphasis on patient-centered communication

Adverse perinatal outcomes among practical nurses : the Finnish medical birth register study

Work as a practical nurse (nurse assistant) may have an effect on pregnancy outcomes. Exposure to chemical, physical and biological hazards are common among hospital personnel. Stressful work conditions such as shift work, prolonged standing and long working hours have been reported among practical nurses. The aim of this study was to examine whether working as a practical nurse is associated with adverse perinatal outcomes. Data were obtained from the Finnish Medical Birth Register of 1997-2014. We included 58512 singleton newborns of practical nurses as cases, and 8765 and 39485 newborns of secretaries and housewives, respectively, as controls. Outcomes included preterm birth (<37 weeks), low birthweight (<2500 g), perinatal death (stillbirth or neonatal death within the first seven days), SGA (<2.5th percentile), and breech presentation, among others. Logistic regression analysis was performed and adjusted for confounders such as maternal age, parity, smoking, and diabetes. Being a practical nurse had lower likelihood of low birthweight (OR=0.88; 95% CI: 0.81-0.96), perinatal death (OR=0.77; 95% CI: 0.62-0.96), SGA (OR=0.79; 95% CI: 0.72-0.86) and episiotomy (OR=0.90; 95% CI: 0.86-0.94). Practical nursing was significantly related to higher odds of instrumental delivery (OR=1.08; 95% CI: 1.00-1.17), but not with preterm birth, breech presentation, shoulder presentation, or caesarean section. After adjusting for confounding variables, working as a practical nurse was associated with higher likelihood of instrumental delivery, particularly vacuum delivery. The risk for shoulder presentation was nearly two-fold compared to controls. Further studies to determine when mothers started their maternity leave and the consequent effect on pregnancy outcome is highly recommended. [Abstract copyright: © 2021 Kwegyir-Afful E. et al.