Quality of maternal and newborn care could be improved if health care providers’ knowledge and competencies as well as system level constraints are addressed. However, due to several barriers staff nurses who form th...Quality of maternal and newborn care could be improved if health care providers’ knowledge and competencies as well as system level constraints are addressed. However, due to several barriers staff nurses who form the frontline of health care workforce have limited access to enhancing their clinical knowledge and competencies. To address this gap, a new cadre of nurse mentors (NMs) for the public health system were trained by specialists from a teaching hospital in a special 5-week training course. This included 54 hours of theory and 110 hours of practical in clinical obstetric and newborn care, apart from mentoring, quality improvement and health systems issues. The nurse mentors were assigned to support staff nurses in the primary health care centres (PHCs) in eight northern Karnataka districts. Each NM covered 6-8 PHCs monthly for 2 - 3 days and thus a total of 385 PHCs were reached. They received support in the field through supportive supervision visits done by the specialists who had trained them, as well as by refresher training and clinical postings to the district hospitals. This paper presents impact of the training program on change in immediate and long term knowledge and competency scores of nurse mentors. Their baseline knowledge scores changed from 44.3 ± 12.7 to 72.1 ± 13.8 immediately after the training in obstetric and from 18.2 ± 19.1 to 66.4 ± 14.9 in newborn (p p p > 0.05). Skills score soon after training increased from 62.2 ± 13.2 to 69.6 ± 12.5 in obstetric after a 1 year period and from 52.6 ± 9.3;63.5 ± 14.4 in newborn (p < 0.001) content areas respectively. These findings have implications for those interested in improving quality of maternal and child care through nurse-dependent health delivery systems.展开更多
Objective: (TVNOTES) [1], currently the most popular of the NOTES procedures being performed, offers the safest access point while avoiding a breach in the gastrointestinal tract to gain intraperitoneal access. But ar...Objective: (TVNOTES) [1], currently the most popular of the NOTES procedures being performed, offers the safest access point while avoiding a breach in the gastrointestinal tract to gain intraperitoneal access. But are women ready to embrace TVNOTES? Although similar studies have been conducted in developed nations, the authors aimed to seek the opinions of Indian women towards TVNOTES. Design: This study presents the results of a survey on attitudes of Indian women towards TVNOTES. 300 women attending a gynaecology out patients’ clinic were administered a questionnaire which sought out the percentage of Indian women concerned with surgical scars, their preference between TVNOTES and conventional laparoscopic surgery and apprehensions towards the vagina being used as an entry site for surgery. Results: 85.67% of the participants opted for scarless intra-abdominal surgery. Upon revealing that the surgery would be performed transvaginally (TV), reservations were unveiled, with 67.33% of all respondents being either unhappy or unsure about undergoing TV surgery. Results were initially equivocal when asked to choose between TVNOTES and conventional laparoscopic surgery, but when informed that TVNOTES may be as safe and efficacious as conventional laparoscopic surgery, the scales tipped in favour of TVNOTES, with three-fourths of the respondents opting for the latter. Conclusions: Although TVNOTES has captured the imagination and attention of surgeons, existing data suggest that the beneficiaries (i.e. women) remain to be convinced. This study suggests that Indian women will embrace TV surgery once its safety is proven, improved cosmesis being a predominant factor in making this choice.展开更多
文摘Quality of maternal and newborn care could be improved if health care providers’ knowledge and competencies as well as system level constraints are addressed. However, due to several barriers staff nurses who form the frontline of health care workforce have limited access to enhancing their clinical knowledge and competencies. To address this gap, a new cadre of nurse mentors (NMs) for the public health system were trained by specialists from a teaching hospital in a special 5-week training course. This included 54 hours of theory and 110 hours of practical in clinical obstetric and newborn care, apart from mentoring, quality improvement and health systems issues. The nurse mentors were assigned to support staff nurses in the primary health care centres (PHCs) in eight northern Karnataka districts. Each NM covered 6-8 PHCs monthly for 2 - 3 days and thus a total of 385 PHCs were reached. They received support in the field through supportive supervision visits done by the specialists who had trained them, as well as by refresher training and clinical postings to the district hospitals. This paper presents impact of the training program on change in immediate and long term knowledge and competency scores of nurse mentors. Their baseline knowledge scores changed from 44.3 ± 12.7 to 72.1 ± 13.8 immediately after the training in obstetric and from 18.2 ± 19.1 to 66.4 ± 14.9 in newborn (p p p > 0.05). Skills score soon after training increased from 62.2 ± 13.2 to 69.6 ± 12.5 in obstetric after a 1 year period and from 52.6 ± 9.3;63.5 ± 14.4 in newborn (p < 0.001) content areas respectively. These findings have implications for those interested in improving quality of maternal and child care through nurse-dependent health delivery systems.
文摘Objective: (TVNOTES) [1], currently the most popular of the NOTES procedures being performed, offers the safest access point while avoiding a breach in the gastrointestinal tract to gain intraperitoneal access. But are women ready to embrace TVNOTES? Although similar studies have been conducted in developed nations, the authors aimed to seek the opinions of Indian women towards TVNOTES. Design: This study presents the results of a survey on attitudes of Indian women towards TVNOTES. 300 women attending a gynaecology out patients’ clinic were administered a questionnaire which sought out the percentage of Indian women concerned with surgical scars, their preference between TVNOTES and conventional laparoscopic surgery and apprehensions towards the vagina being used as an entry site for surgery. Results: 85.67% of the participants opted for scarless intra-abdominal surgery. Upon revealing that the surgery would be performed transvaginally (TV), reservations were unveiled, with 67.33% of all respondents being either unhappy or unsure about undergoing TV surgery. Results were initially equivocal when asked to choose between TVNOTES and conventional laparoscopic surgery, but when informed that TVNOTES may be as safe and efficacious as conventional laparoscopic surgery, the scales tipped in favour of TVNOTES, with three-fourths of the respondents opting for the latter. Conclusions: Although TVNOTES has captured the imagination and attention of surgeons, existing data suggest that the beneficiaries (i.e. women) remain to be convinced. This study suggests that Indian women will embrace TV surgery once its safety is proven, improved cosmesis being a predominant factor in making this choice.
