Organizational Vs Individual Efforts to Help Manage Stress and Burnout in Healthcare Professionals

Stress and burnout continue to impact the thoughts, behaviors, and careers of healthcare professionals. Solutions will require a multidimensional approach that focuses on both individual and organizational efforts geared to build resilience and help providers better adjust to the pressures of medical practice. Individual efforts can only go so far. Since most of the issues are system related, solutions will require an empathetic pro-active approach form the affiliated organizations in which staff practice to provide effective resources and support to help them succeed. The article outlines a series of suggested strategies designed to help staff better adjust to the pressures of medical practice.

Effects of COVID-19 on Maternity Services in Selected Public Health Facilities from the Priority MNCH Counties in Kenya

Background: Covid-19 is a rapidly evolving pandemic, affecting both developed and developing countries. Maternity services in low resource countries are adapting to provide antenatal and postnatal care midst a rapidly shifting health system environment due to the pandemic. Objectives: The objective of the study was to determine the effect of COVID-19 on maternity services in selected levels III and IV public health facilities within five MNCH priority counties in Kenya. Method: A two-stage sampling approach was used to select health facilities. The study employed cross-sectional and observational retrospective approaches. Data was collected from Maternity facilities managers and registers in a total of 28 levels III and IV facilities. Open Data Kit (ODK) formatted tools were used to collect data. Data was analysed using STATA Version 15. Descriptive statistics, Chi-square and fishers exact tests were used to analyse data. For all tests, a p-value <0.05 was taken as statistically significant. Results: A total of 31 midwifery managers were interviewed and a total of 801 maternity records (400 before COVID and 401 during COVID-19 pandemic) were reviewed from levels III (66%) and IV (34%) facilities. The managers indicated that Antenatal Care (ANC) visits had reduced (67.9%), referrals of mothers with complications got delayed (29%), mothers feared delivering in hospitals (64.5%). The managers reported that New-born care services were most affected by the pandemic (54.8%) followed by ANC services (45.2%). Facility records revealed a 19% higher ANC attendance before COVID than during the pandemic. Neonatal deaths increased significantly during Covid-19 period ((P=0.010) by 38%. Live births significantly increased during the pandemic (p <0.0001). Significant increases also observed in mothers who developed labour complications (p=0.0003) and number of mothers that underwent caesarean sections (p <0.001) during the pandemic period. Conclusion: The fear of the Covid-19 pandemic had a cross-cutting effect on utilisation of maternity services.

Peer Mentorship: Implementation of a Resident Registered Nurse Anesthetist Mentorship Program

Nurse anesthesia residents experience high levels of stress while being enrolled in a post-baccalaureate nurse anesthesia program. Elevated levels of stress have been proven to limit one’s ability to learn and commit new material to memory, all while inhibiting their academic and clinical performance. This study represents a quality improvement project that implements a Peer Mentorship Program (PMP) into a major University in the New England area of the United States. The study utilizes descriptive statistics to determine if implementation of a peer mentorship program can help to decrease nurse anesthesia resident’s stress, while simultaneously increasing academic and clinical performance. Data gathered by the investigators of this study was composed of a Critical Action Point Checklist (CAPC); a set of objectives that were meant to be completed by the participants in order to help run a successful mentorship program. Additional data was collected using a Peer Mentorship Reflection Questionnaire at the end of the study to receive feedback about the Peer Mentorship Program. 56% of participants agreed that the Peer Mentorship Program helped to decrease stress during the study and 83.4% of participants agreed that they would like to see the Peer Mentorship Program continue for future cohorts at their nurse anesthesia program. The findings of this study suggest that more Nurse Anesthesia Programs should work to incorporate a Peer Mentorship Program for their nurse anesthesia residents to help develop safe, high-quality anesthesia providers for the future.

The Epistemology of Swarming in Patient Care: An Innovative Approach to Admitting Patients into Intensive Care Units

Epistemology is the branch of philosophy that addresses cognitive sciences, the history of science and cultural studies. It investigates the origin, methods, nature and limits of knowledge and seeks to determine what we know and how we know it. It is also used to determine truth or falsehoods as we strive to acquire knowledge. This review examined the epistemology of Swarming in patient care, following the SQUIRE guidelines. No best practices exist on how to SWARM patients, yet this process is performed by frontline nurses daily. Four examples of Swarming were examined and a systematic approach on how to SWARM critically ill patients in the admission process into ICUs was recommended. Tasks needed once the patient arrives into the ICU suite are for the primary RN to receive bedside report from the healthcare team and log into the Electronic Health Record to start the admission note. A checklist was introduced to streamline tasks with the goal to reduce the number of chores to be performed by the primary RN, thus freeing up time for assessments of the critically ill patient. This work strives to improve efficiency in the workflow of the ICU admission process, by improving communication amongst the team via practice and a consistent approach to admitting critical patients.

Economic Evaluation of School Health Programmes: A Mapping Review (2005-2015)

The economic evaluation has gained popularity in recent years but, to be useful, it must be conducted and reported accurately. The aim of this study was to perform a mapping review identifying published articles about economic evaluation of school health programmes, characterizing and qualifying what has been published, and discussing how these studies were conducted. The review was carried out in PubMed for studies published in the past decade. The search strategy included "cost", "economic evaluation", "school health services", "school health", "school health promotion" and "school health program”. Thirty-five studies were assessed. The studies addressed ten different countries and cost-effectiveness was the most economic evaluation used. The narrative synthesis gathered the selected studies in nine groups, demonstrating a high heterogeneity of methods and results in the economic analyzes performed. There is evidence that school health programmes can bring benefits to the target population and society. The gathered information in this article can contribute to performing economic evaluation studies and improving programmes

Social Customs and Practices Associated with Pregnancy and Child Bearing in Low Socio-Economic Communities

Child birth is a very significant event in a married woman’s life. She is filled with fear and anxiety mixed with a feeling of joy and expectation of the coming child. Apart from physical care psychological care and assurance are equally important. Present study deals with the women of poor workers of the factories who have to undergo deliveries either at home or ill equipped hospitals causing much suffering and even mortality. Detailed history of such 250 women was taken in a questionnaire proforma prepared for the study. A history of age, caste, education, para, occupation, husband’s income and knowledge about pre and post-natal care was recorded. Thus 21 tables were made of each case and analyzed in detail. It is a practice to marry girls at an early age as they feel it ensures their safety. Husband’s income was quite low and 50% of them were uneducated. 30.8% could only read and only 8.8% were graduate. Illiteracy was a major problem in safe delivery of the child. Old traditional customs were followed some which were not hygienic. Only 19% were employed. Rest were only house wives. Ground delivery was preferred in 74% cases, squatting position in 71.2% and 56% preferred sand in place of mattress. All these are not preferred methods currently. In the second stage of labor birth canal was lubricated in only 8.8% cases. In 76% cases massage of abdomen was done to hasten the delivery. The cord was cut mainly by knife after delivery. Placentas were mainly buried after delivery (74.8%). 56% of women remained lying in for about a week after delivery. 78% mothers took their first bath 3 to 6 days after delivery.

The Impact of Attitudes and Behaviors on Nurse Satisfaction, Well-being, and Outcomes of Patient Care

Healthcare is a complex multidimensional system that depends upon effective communication and collaboration amongst all members of the health care team as the key ingredient for best patient care. In the current health care environment all health care providers are feeling the growing pressures on care delivery and the changing health dynamics which in many instances has negatively impacted their attitudes and behaviors toward medical care. Nursing is a key part of this process. In order to provide best patient care, affiliated organizations need to recognize how important staff satisfaction and engagement is to care continuity and provide the necessary resources and support to maintain staff physical, emotional, and behavioral well- being. The aim of the article is to review key literature findings to help organizations recognize the causes and consequences of stress and burnout and the importance of providing the appropriate support and resources to help nurses succeed.

A Campaign to Improve Seasonal Influenza Immunization Compliance in a University Nursing Health and Wellness Clinic: A Case Study

Seasonal influenza can result in enormous physical and economic burdens. Healthy People 2020 report that substantially fewer than the recommended 70% in most age groups actually receive the immunization (Bekkat-Berkani & Romano-Massotti, 2018). The purpose of this study was to ascertain whether the WTAMU Nursing Health and Wellness Clinic seasonal flu campaign was considered effective and advantageous to those who received it on campus. A brief survey was developed for distribution to those who received the influenza immunization during the 2018-2019 flu seasons. Making the flu vaccine convenient and inexpensive/free has been an effective mechanism to improve immunization acceptance in our community. Response rate for the survey was 61% or 106 individuals with 44%, reporting that they would not have sought out the seasonal flu immunization had it not been made available on the university campus. More importantly, when the 106 participants were asked where on campus they received their immunization, only 41% physically came to the nursing clinic, while 59% were provided the vaccine in their office or departmental workplace. Of those individuals receiving immunization in their office or workplace, 38% reported that had it not been provided in this setting, they would not have gone to the nursing clinic or elsewhere to be immunized. Of those responding to the survey, 61% reported having received an influenza immunization during the 2017-2018 seasons. The remaining 39% of respondents either could not recall or denied receiving the vaccine. However, when asked about their intentions to be immunized in the 2019-2020 season, 90% of the participants related positive intention to receive the seasonal flu immunization.

Tolerance in Preterm Infants Fed Exclusively with Human Milk. Prospective Analytic Study

Human milk is the best feeding for premature infants. When Own Mother’s Milk (OMM) is insufficient or unavailable, the alternative is represented by the Donor Milk (DM). OMM and DM must be fortified to support the adequate growth. Objectives: Evaluation of the food tolerance on preterm fed exclusively with fortified Human Milk (HM). Materials and Methods: This prospective analysis has been performed on a sample of 48 preterm with GA ≤ 32 weeks. Gastric Residual (GR), Vomiting (V) and Feeding Suspension (FS) are the parameters performed. We identified two categories (OMM/DM) and 4 groups: newborns fed exclusively with OMM (EOMM), with prevalent OMM (POMM), with exclusively DM (EDM) and with prevalent DM (PDM). Results: The overall incidence of GRs was 18%, the incidence of bilious residuals was 4%, the incidence of Vs was 4.5%, there was no indication of blood in the stool, the total percentage of days of FS was 12.7%. There was no statistical correlation between the incidence of GR, V, FS in the two categories (OMM/DM). The relationship between the kind of feeding and the GA or the BW was not statistically significant. Conclusions: The study highlights the irreplaceability of the OMM in feeding the preterm and that the DM is a valid substitute of OMM.

Effect of Communication Skills Training Program on Nurses-Cancer Patient Communication

Background: Effective communication between nurses and patients in cancer is central element of care. There is a lack of understanding of the value of interpersonal communication between the cancer patients and the professional. Purposes: this study was conducted to assess the effectiveness of Communication Skills Training Program (CSTP) for undergraduate nursing students in caring for cancer patients. Method: One group pretest and posttest quasi experimental design was used to assess the effectiveness of Communication Skills Training Program for undergraduate nursing students in caring for cancer patients. A sample of thirty three students was participated. Students' knowledge was assessed by using a knowledge test. Students' communication skills were observed and evaluated pre- and post-intervention by using Checklist observation sheet namely communication skills observation checklist (SEGUE). Results: there was a significant difference between the students’ level of knowledge pre-and post-intervention (t=–10.12, p=0.001). A significant difference between the students’ level of communication pre-and post-intervention (t=-4.67, p=0.001) was found. Conclusions and Implications: communication skills among undergraduate nursing students were improved by the training program. Different teaching aid such as role playing, open discussion, and bedside demonstration were effective in increasing the level of knowledge and skills. Findings indicate that having specific communication skills program is effective in increasing nurses’ knowledge and developing communication skills also.