Experiences of Early and Enhanced Clinical Exposure for Postgraduate Neonatal Nursing Students at the University of Zambia, School of Nursing Sciences: Lessons and Implications for the Future

Background and Objectives: Early and Enhanced Clinical Exposure immediately places postgraduate students in a clinical setting and incorporates continual hands-on instruction throughout their studies. It aims to motivate students by strengthening their academics, improving clinical and communication skills, and increasing their confidence. The underlying principles are to provide a clinical context and to ensure that the patient remains the centre of learning. The School of Nursing Sciences implemented this model in 2021 to produce hands-on Masters-level neonatal practitioners who can work in multidisciplinary clinical contexts. Therefore, this study explored the experiences of postgraduate nursing students on the Early and Enhanced Clinical Exposure model and draw implications for the future. Methods: A phenomenological study design was utilized at the University of Zambia, School of Nursing Sciences and comprised of eight Master of Science Neonatal Nursing students in their second year. Convenience sampling was used to select the study site and participants. Data was collected between 15th January 2023 and 31st January 2023 using an in-depth interview guide. Audio recording and notes were transcribed immediately after data collection. Data analysis was conducted using thematic analysis and codes and themes were constructed from the coded data. Ethical clearance and permission were sought before conducting the study. Results: Four major themes emerged from the study: identity and role confusion, challenging and hectic experiences, positive educational experiences, and personal and professional growth. These themes contributed to the promotion of evidence-based practice by helping students to assess, diagnose, and treat various conditions, as well as gain interest, experience, knowledge, and exposure. Conclusion: The model has a significant impact on motivation to learn, as evidenced by reported increased skill level with potential for use in clinical practice. It is recommended that it be implemented in all postgraduate programs for full-time students.

Prevalence and Social Demographic Factors Associated with Secondary Traumatic Stress, Burnout and Compassion Satisfaction among Nurses at Selected Teaching Hospitals in Lusaka, Zambia

Introduction: Nurses’ constant exposure to severe human suffering within constrained health care environments places them at risk for developing Secondary Traumatic Stress and Burnout. The current study therefore sought to establish the prevalence and social demographic factors associated with Secondary Traumatic Stress, Burnout and Compassion Satisfaction among Nurses working at selected Teaching Hospitals in Lusaka, Zambia. Methods: A correlational design employing a self-administered questionnaire adapted from version five of the Professional Quality of Life scale was used to collect data from 250 nurses drawn using proportional stratified sampling method. The resulting data were analyzed using version 23 of the Statistical Package for Social Sciences (SPSS). Hierarchical multiple linear regression analysis was used to identify predictors of Secondary Traumatic Stress and Burnout. Findings: Whilst the majority of respondents reported average levels of Secondary Traumatic Stress and Burnout, about a quarter reported high Secondary Traumatic Stress and Burnout scores at 23% and 26% respectively. Only 81 (32.4%) scored high on Compassion Satisfaction. Social demographic factors including;working in the main Intensive Care Unit, and being married accounted for the greatest variance in Secondary Traumatic Stress (R2 = 0.237, p Conclusion: Findings of the current study signify a need to institute measures to help nurses cope with the deleterious psychological effects of constant engagement with those in distress and to foster Compassion Satisfaction.

Strengthening Post-Operative Pain Assessment in Patients with Major Abdominal Surgery, University Teaching Hospitals, Zambia

Systematic, routine pain assessment using standardized clinical guidelines is the foundation of effective pain management for patients who are unable to self-report pain. In Zambia, there are no context appropriate standardised clinical guidelines for post-operative pain observations. This study sought to develop such a clinical guideline in form of an assessment tool. The study adopted an exploratory sequential mixed method through a three-phased approach and an adapted Clinical Decision Making Survey instrument was used. Snowball sampling was employed and in phases II and III, purposive sampling was used. The study was conducted at the University Teaching Hospitals where 120 participants were enrolled in the study. Phases II and III provided preliminary internal validation processes of the developed tool, where discussions, orientation and trial implementation of the tool were done. In phase II of the study, 47 participants comprising of nurses participated while in phase III, there were 11 nurses and 32 participants. The results yielded the first ever standardised post-operative pain assessment tool for patients with major abdominal surgery in Zambia. The tool is made up of six dimensions of the identified nonverbal indicators of post-operative pain in patients with major abdominal surgery namely: facial expressions, mobility, activity intolerance, behavioural disturbance, communication ability and vital signs. The present study showed that the developed post-operative pain assessment tool for Zambia is acceptable for use among patients who have had major abdominal surgery and can facilitate improved post-operative pain management for most patients.