Effect of a comprehensive geriatric assessment nursing intervention model on older patients with diabetes and hypertension

BACKGROUND The Comprehensive Geriatric Assessment(CGA)was introduced late in China and is primarily used for investigating and evaluating health problems in older adults in outpatient and community settings.However,there are few reports on its application in hospitalized patients,especially older patients with diabetes and hypertension.AIM To explore the nursing effect of CGA in hospitalized older patients with diabetes and hypertension.METHODS We performed a retrospective single-center analysis of patients with comorbid diabetes mellitus and hypertension who were hospitalized and treated in the Jiangyin Hospital of Traditional Chinese Medicine between September 2020 and June 2022.Among the 80 patients included,40 received CGA nursing interventions(study group),while the remaining 40 received routine nursing care(control group).The study group's comprehensive approach included creating personalized CGA profiles,multidisciplinary assessments,and targeted inter-ventions in areas,such as nutrition,medication adherence,exercise,and mental health.However,the control group received standard nursing care,including general and medical history collection,fall prevention measures,and regular patient monitoring.After 6 months of nursing care implementation,we evaluated the effectiveness of the interventions,including assessments of blood glucose levels fasting blood glucose,2-h postprandial blood glucose,and glycated hemoglobin,type A1c(HbA1c);blood pressure indicators such as diastolic blood pressure(DBP)and systolic blood pressure(SBP);quality of life as measured by the 36-item Short Form Survey(SF-36)questionnaire;and treatment adherence.RESULTS After 6 months,the nursing outcomes indicated that patients who underwent CGA nursing interventions experienced a significant decrease in blood glucose indicators,such as fasting blood glucose,2-h postprandial blood glucose,and HbA1c,as well as blood pressure indicators,including DBP and SBP,compared with the control group(P<0.05).Quality of life assessments,including physical health,emotion,physical function,overall health,and mental health,showed marked improvements compared to the control group(P<0.05).In the study group,38 patients adhered to the clinical treatment requirements,whereas only 32 in the control group adhered to the clinical treatment requirements.The probability of treatment adherence among patients receiving CGA nursing interventions was higher than that among patients receiving standard care(95%vs 80%,P<0.05).CONCLUSION The CGA nursing intervention significantly improved glycemic control,blood pressure management,and quality of life in hospitalized older patients with diabetes and hypertension,compared to routine care.

Assessing the Levels of Clinical Reasoning Skills Using Self-Assessment of Clinical Reflection and Reasoning in Undergraduate Nursing Students: A Descriptive Comparative Study

Background: Clinical reasoning is a critical cognitive skill that enables undergraduate nursing students to make clinically sound decisions. A lapse in clinical reasoning can result in unintended harm to patients. The aim of the study was to assess and compare the levels of clinical reasoning skills between third year and fourth year undergraduate nursing students. Methods: The study utilized a descriptive comparative research design, based on the positivism paradigm. 410 undergraduate nursing students were systematically sampled and recruited into the study. The researchers used the Self-Assessment of Clinical Reflection and Reasoning questionnaire to collect data on clinical reasoning skills from third- and fourth-year nursing students while adhering to ethical principles of human dignity. Descriptive statistics were done to analyse the level of clinical reasoning and an independent sample t-test was performed to compare the clinical reasoning skills of the student. A p value of 0.05 was accepted. Results: The results of the study revealed that the mean clinical reasoning scores of the undergraduate nursing students were knowledge/theory application (M = 3.84;SD = 1.04);decision-making based on experience and evidence (M = 4.09;SD = 1.01);dealing with uncertainty (M = 3.93;SD = 0.87);reflection and reasoning (M = 3.77;SD = 3.88). The mean difference in clinical reasoning skills between third- and fourth-year undergraduate nursing students was not significantly different from an independent sample t-test scores (t = −1.08;p = 0.28);(t = −0.29;p = 0.73);(t = 1.19;p = 0.24);(t = −0.57;p = 0.57). Since the p-value is >0.05, the null hypothesis (H0) “there is no significantno significant difference in clinical reasoning between third year and fourth year undergraduate nursing students”, was accepted. Conclusion: This study has shown that the level of clinical reasoning skills of the undergraduate nursing students was moderate to low. This meant that the teaching methods have not been effective to improve the students clinical reasoning skills. Therefore, the training institutions should revise their curriculum by incorporating new teaching methods like simulation to enhance students’ clinical reasoning skills. In conclusion, evaluating clinical reasoning skills is crucial for addressing healthcare issues, validating teaching methods, and fostering continuous improvement in nursing education.

Evaluation of the Effect of Assessment Method Reform in “Nursing Research” Course

Objective:This paper aims to evaluate the implementation effect of the diversified course assessment method reform.Methods:A diversified assessment method was implemented for 196 undergraduate nursing students.Students’mastery of key knowledge in“Nursing Research”was assessed through group reports on topic selection and literature retrieval,as well as the proposition level of the final examination.Results:81.6%of the students agreed with the course assessment method,and 97.9%believed studying“Nursing Research”would be helpful for future scientific research applications.Conclusion:Diversified assessment methods can help improve undergraduate nursing students’scientific research skills and comprehensive quality.

Application Effect of Stratified Nursing Intervention for ICU Mechanically Ventilated Patients in the Context of Aspiration Risk Assessment

Objective:To explore the application effect of stratified nursing intervention based on the background of misinspiration risk assessment in mechanically ventilated patients in intensive care unit(ICU).Methods:100 cases of mechanically ventilated patients who were admitted to the ICU of our hospital from March 2022 to March 2023 were selected and divided into an observation group and a control group according to the random number table method,with 50 cases in each of the two groups.The control group was given routine care in ICU,and the observation group was given stratified nursing interventions based on the background of the risk of aspiration assessment on the basis of the control group,and both groups were cared for until they were transferred out of the ICU,and the mechanical ventilation time,ICU stay time,muscle strength score,complication rate,adherence,and satisfaction were observed and compared between the two groups.Results:The mechanical ventilation time and ICU stay time of the observation group were shorter than that of the control group after the intervention;the muscle strength score,compliance and satisfaction of the observation group were higher than that of the control group after the intervention;and the complication rate of the observation group was lower than that of the control group after the intervention,all of which were P<0.05.Conclusion:The application of stratified nursing intervention based on the background of misaspiration risk assessment in ICU mechanically ventilated patients can improve the patient's muscle strength,shorten the time of mechanical ventilation,promote the patient's recovery,reduce the occurrence of complications,and improve the patient's compliance and satisfaction.

The effects of applying an assessment form based on the health functional patterns on nursing student's attitude and skills in developing the nursing process

Objectives: Comprehensive nursing assessment,as the first step in the nursing process,involves the systematic and constant data gathering to facilitate the development of the patient-specific nursing process.The aim of this study is to determine the effects of applying an assessment form based on the health functional patterns on nursing student's attitude and skills in developing nursing process.Methods: A randomized controlling design was conducted.Of 84 undergraduate nursing students,42 students were allocated to the intervention or control group.In clinical education,a patient assessment form based on Gordon's functional health patterns was applied to help students in the intervention group to develop nursing process,while the control group received traditional methods.The data were gathered using a demographic information questionnaire,skills in nursing process development checklist,and attitudes towards nursing process questionnaire.Results: The average scores for students' attitude and skills in developing nursing process in the intervention group were greater than those of the control group.Conclusion: Applying nursing assessment using the patient assessment form based on Gordon's functional health patterns can improve the students' learning in developing nursing process.

Barriers in performing physical assessment among nursing students:An integrative review

Objectives:This study aimed to identify barriers in performing physical assessments among nursing students through integrative review study.Methods:The literature were searched in Medline,CINAHL,ScienceDirect,Web of Science,ProQuest,and Taylor&Francis Online using the descriptors barrier,physical assessment,nursing student et al.Only English-language and peer-reviewed journal articles were included,and there were no year restrictions.Results:Twelve articles were selected for review.Two aspects were extracted:the barriers included personal challenges,challenges related to nursing education,challenges related to clinical practice;establishing competency-based education learning as a method to reduce physical assessment barriers.Student competencies and experiences were influenced by various factors that collectively hindered their successful performance of physical assessments.Conclusions:The review findings provide valuable insights into the complex issues involved in the performance of physical assessments and guidance for improvement in practice.A collaborative effort should be made to address the issues often faced by nursing students in performing routine physical assessments.Also,more constructive and competency-based teaching methods should be integrated into academic and clinical settings.

The Potential of Simulation to Enhance Nursing Students’ Preparation for Suicide Risk Assessment: A Review

Suicide risk assessment is a critical skill in preventing suicide. Yet most nurses do not feel confident in assessing suicide risk. Development of this potentially life-saving skill needs to begin at the undergraduate nursing level. As simulation is an effective pedagogical tool utilised within nursing education, the aim of this paper was to explore the potential of simulation in preparing student nurses’ for suicide risk assessment. Literature was examined to identify what simulation modalities were employed within nursing education and the outcomes associated with these. The findings suggest that to varying degrees all simulation modalities have the potential to decrease student anxiety, and increase student confidence, knowledge and communication skills when working with people at risk of suicide. However the use of Standardised Patient (SP) simulation adds an authenticity to the experience and allows for the assessment of a wider range of human responses, including key nonverbal communication skills. The sense of realism provided by SP allows for more in-depth understanding into the person’s experiences, which is critical in the assessment of a person’s mental health needs and risk of suicide. The majority of simulations identified were located within a mental health setting. Given that student nurses may encounter a person who is suicidal in any clinical setting, further research is needed on simulation which integrates mental health assessments and suicide risk assessment into a variety of clinical areas.

Application of Criterion-Meeting Assessment Method in Fundamentals of Nursing

To investigate the results of criterion-meeting assessment method used for the operation test in fundamentals of nursing, 101 nursing undergraduates who entered Nursing College, Beihua University in 2007, were randomly divided into experimental group and control group. The students in the control group were examined with the traditional assessment method, namely, the points were given the students one-time and estimated in a way of quantitative analysis. The students in the experimental group were examined with criterion-meeting assessment methods. The average score of students in the experimental group was higher than that in the control group (P <0.001), the difference was statistically significant, and 100% students in the experimental group got 90-100 points of the assessment standards. Our studies suggest that the method is not only conducive to fully mobilizing the enthusiasm of the students and students’ establishing critical thinking, but also gives help to improve the overall quality of teachers. It can strengthen the experimental teaching, improve teachers’ and students’ senses of responsibility in teaching and learning and contribute to the good teaching result.

Barriers and Promoting Strategies to Sexual Health Assessment for Patients with Coronary Artery Diseases in Nursing Practice: A Literature Review

Background: Sexual health is an important and integral part of human health. Patients often voice their concerns regarding their sexual health after experiencing coronary artery diseases. Nurses face many barriers to conduct sexual health assessment. Although many sexual health instructions have been developed, nurses still pay little attention to sexual health assessment. Purpose: The purpose of this literature review was to identify the barriers and strategies that promoted sexual health assessment in clinical nursing practice. Design: A comprehensive search of the recent literature related to barriers and promoting strategies to sexual health assessment was undertaken. Methods: A review of literature published over the last 10 years on a wide variety of recent studies in nursing and related discipline in the field of sexual health was performed. Findings: Most studies indicated that sexual health was poorly addressed in clinical settings. Barriers to addressing sexual health are multifactorial;we classified them into four categories: patients related barriers, nurses related barriers, organizational related barriers and value related barriers. Many strategies to enhance sexual health assessment and counseling in clinical setting are summarized. Conclusion: Overall, it is evident that nurses encounter many barriers to sexual health assessment. Therefore, investigating these barriers and developing appropriate interventions are recommended.

Assessment of Clinical Learning Environment, Supervision (CLES) among Nursing Students, Hyderabad, Sindh, Pakistan

Background: In nursing education for better teaching and essential professional skills, the clinical practice plays a substantial role. Practice at clinical settings permits students to convert theoretic knowledge into the knowledge of the skills mandatory for the care of the patient. Clinical learning environment (CLE) is an important part in education of nursing and has a sizable influence on the students’ learning. Objective: The purpose of this study is to examine perception and satisfaction of nursing students with their CLEs in Hyderabad, Pakistan. Methods: This cross-sectional study was conducted at three nursing institutes of Hyderabad from December 2018 to January 2019 among 342 nursing students. Clinical Learning Environment, Supervision and Nurse Teacher (CLES + T) assessment tool was used as the instrument to identify the students’ perception about the learning environment in clinical setting. Results: The mean age of the participants was 25.6 ± 4.93 with majority of them male (70.7%). Three domains, pedagogical atmosphere, supervisory relationship and nurse teacher role in clinical practice showed good reliability of more than 70%. Highest domains vise mean score was obtained for nursing premises on the ward (3.315) whereas lowest for nurse teacher role in clinical practice (NT) (3.062). Analysis of variance revealed that three domains supervisory relationship, leadership style of the ward manager and premises of nursing showed significant mean score difference among supervisor title. Conclusion: It was found that students valued positive supervision, ward manager leadership style premises of nursing on the ward as positive CLE. Learning environment varies between gender, clinical settings and supervision. Medicine ward appeared to deliver the finest learning situations for the nursing program.

Evaluation of undergraduate students’nursing assessment and communication skills through an objective structured clinical examination within a high-fidelity simulation using a student-simulated patient

Objective:To evaluate nursing students’assessment and communication skills through an objective structured clinical examination(OSCE)within a high-fidelity simulation using a student-simulated patient(SSP)and analyze the validity,reliability,degree of difficulty,and discriminability of the OSCE.Methods:A descriptive study was conducted at one nursing school in Macao.All scenarios were designed using a high-fidelity simulator combined with SSPs.A convenience sample of 54 baccalaureate nursing students completed the OSCE.The nursing assessment OSCE checklist(NAOC)and the communication evaluation rubric(CER)were used as observational measurements with three-point Likert scales(2=Achieved,1=Partly achieved,0=Not completed/Incorrect).Results:Difficulty coefficients of the exam were 0.63 for nursing assessment skills and 0.56 for communication skills.The discrimination index of the majority items of the NAOC(86.4%)was>0.20,showing a better to good discriminability.The items of the CER had satisfactory indexes of item discrimination(from 0.38 to 0.84).Students received high scores in conducting blood oxygen saturation and cardiac and lung auscultation but low scores in vomiting and diarrhea assessment.Students presented good communication skills in eye contacting and listening,but culture assessment needs to be improved.The students with experiences in simulation or simulated patient(SP)interactions had better assessment and communication skills than students without those experiences.There was a positive relationship between nursing assessment and communication skills(r=0.67,P=0.000).Conclusions:SSPs were involved in enhancing the realism of interactions in simulated scenarios.Nursing students can conduct nursing assessments specific to patient conditions,explain the conditions to the patient,and ensure that the patient remains informed at all times of the precautions to be taken.However,students’cultural awareness and some communication skills need further training.With moderate difficulty and high discrimination index,OSCE showed satisfactory reliability and validity.

Assessment tools of nursing work environment in magnet hospitals: A review

In the 1990s,the American Nurses Association established a certification program called the Magnet Recognition Program through the American Nurses Credentialing Centre(ANCC)to complement the quality care provided to patients by hospitals.After the program was recognised,hospitals were identified as magnet hospitals[1].Some studies show that magnet hospitals provide a healthier working environment for nurses,accompanied by higher nurse satisfaction and better patient prognosis than non-magnet hospitals[2e5].The nursing work environment is the sum of various elements that directly or indirectly affect the patient care system[6].Improving the nursing work environment is a focal point and challenge for nursing administrators.Therefore,administrators in magnet hospitals usually apply a variety of assessment tools for effective evaluation of the nursing work environment to maintain and improve the health of the environment.

Prioritizing Patient Assessment Data (PAD) Using the Japanese Psychiatric Nursing Assessment Classification System (PsyNACS)©

The study identified priorities of the Patient Assessment Data (PAD) using the Japanese Psychiatric Nursing Assessment Classification System (PsyNACS&copy;) derived from 644 psychiatric nurses’ responses who were practicing in specific units: Acute Care Units (ACU), General Care Units (GCU), Long-term Care Units (LCU), physically Complicated Disease Care Units (CDCU), and Dementia Care Units (DCU). Secondary analysis of the PsyNACS&copy;on-line survey data using four levels of “importance” was used to determine the priorities: 1) unnecessary;2) quite important;3) important and 4) very important. The Mean Factor Points (MFP) and the Welch’s ANOVA were calculated. PsyNACS&copy;score of 3 or higher indicates the PAD as priority. The results showed that in the ACU PAD1, “Psychological symptom”, “Stress coping”, and “Mood disorder and aggression”, and PAD2 “Information of adherence”, and “Information of the psychiatry rehabilitation”, and PAD7 “Situation of the family and social life”, “Relationship to the health care providers”, and “Relationships with others” are high priority (high importance). Other PADs showed results below PsyNACS&copy;score of 3. The GCU had PAD 3 “Balance of water”, the LCU had PAD 4 “Intention/Point of view”, and “Thoughts of the patient” and PAD 7 “Disease and family”. The CDCU showed PAD 2 “Blood test”, PAD 3 “Excretion situation”, and PAD 5 “General health condition”, “Respiratory and chest symptom”, and “Vital signs”, and the DCU had PAD 1 “Cognition function”, and “Delirium and derangement capacity to register failure”, PAD 3 “Function of eating”, PAD 6 “Egestion and cleanliness” and PAD 8 “Activity and sleeping”, and “Mobility capability”. These classifications indicated levels of importance in the CAD comprising the PAD below the score of “2”. Japanese psychiatric hospitals specify assessments according to functional areas. By prioritizing the CAD for each PAD, more effective and efficient assessments can be performed according to practice unit.

Thought Processes of Nurses in Nursing Assessment: Analysis of Nursing Problems and Patient Strengths, Patient Information

Aims: The purpose of this study was to clarify the thought processes of nurses in performing nursing assessment. Methods: The participants comprised 20 nurses working in a surgery ward. Patient information on a case, including presenting illness, vital signs, and other findings from admission until 09:00 on the day after surgery, was shown to the participants. After reading the case report, the nurses presented their assessments. Based on these assessments, nursing problems, patient strengths, and patient information were identified. Nursing problems and patient strengths were described by various words and sentences, and were classified according to similar content. Results: The number of nursing problems ranged from 1 to 8 and patient strengths from 0 to 6 for each nurse. The mean number of nursing problems was 4.7 ± 1.8, and the mean number of patient strengths was 2.2 ± 1.4. The main nursing problems were respiratory complications, postoperative wound pain, and anxiety, and the main patient strength was family cooperation. Patient information as evidence of respiratory complications included history of smoking, chest radiography results, postoperative vital signs, sputum color and properties. Patient information as evidence of postoperative wound pain included complaints of pain, epidural anesthesia, use of patient-controlled anesthesia and its effect. Patient information indicating family cooperation included family structure, preoperative visits by family, and presence of family while providing informed consent. Significant differences were seen in the number of nursing problems and patient strengths according to cognitive style. Conclusions: Postoperative complications were the nursing problems most commonly extracted by nurses. To clarify nursing problems and patient strengths, the nurses made assessments on the basis of information such as patient complaints, vital signs, and test results. However, extracted nursing problems and patient strengths were diverse, suggesting that nursing problems and patient strengths as determined by nurses differed between individual nurses.

Nursing culture assessment tool (NCAT): Empirical validation for use in long-term care

Background:Capturing general aspects of the occupational subculture of nursing is needed in long-term care(LTC)given its latent influence on the quality of care that residents receive and on the ability of nursing staff(licensed nurses and certified nursing assistants)to implement evidence-based practice innovations.The psychometrically validated Nursing Culture Assessment Tool(NCAT)provides a comprehensive assessment using six dimensions(teamwork,communication,satisfaction,professional commitment,behaviors,and expectations),and evaluation of these dimensions could help positively reshape the culture before any change implementation.Purpose:Aims were to:(1)assess the validity and reliability of the NCAT across nursing staff in a single type of clinical setting e LTC facilities,and(2)present a refined theoretical model of the interaction of culture and practice implementation.Methods:A cross-sectional,exploratory investigation of the NCAT in LTC settings was conducted.Empirical construct validity of the 19-item NCAT's six subscales was investigated by confirmatory factor analysis using a sample of licensed nurses and certified nursing assistants(n?318).Results:The model fit was judged using the comparative fit index(0.94)and standardized root mean-square residual(0.05).Cronbach's alpha correlation coefficients of items in each subscale and in the overall scale ranged from 0.76 to 0.94.Conclusion:A summary of the NCAT development and report on its psychometric properties when administered in LTC settings is provided,extending previous findings of the NCAT's enhanced stability when used in assessing nursing staff perceptions in LTC and by demonstrating that the NCAT is a reliable and valid psychometric screening tool for nursing culture.

Problem-Based Learning <i>in Situ</i>Applied to Students in the Assessment of Nursing Process

Background: Nursing is considered a science in the making that recognizes the nursing process (NP) as the scientific and methodological tool to provide care. The NP is composed of five stages of which the assessment is the first and fundamental to identify the health problems of the people. This research aimed to evaluate a pedagogical didactic strategy that is based on situated constructivism, the Based-Problem Learning (BPL), in order to improve significant learning. Methods: Quantitative research with an explanatory scope, was transversal, and it was applied to 30 students of the first year of the nursing career at the Faculty of Higher Studies Iztacala, National Autonomous University of Mexico. The sample was chosen considering the inclusion criteria. Data were collected using a Likert-type instrument validated in a previous investigation. Results: The average value obtained from the Likert scale to evaluate the intervention was 103.4, the highest score was 135 and the lowest was 83, which reflects that it was evaluated as good and particularly good. The grade given to the teacher as an agent of the ZPD, was between agree and totally agree, the highest percentages scored at 93%, since it provoked challenge in their thinking, and favored interaction among classmates. Conclusions: The application of the in situ teaching strategy, BPL favored significant learning of the assessment stage, the students were able to carry out the assessment in the hospital, the experience contributed to generate significant learning when students face real scenarios, which showed the effectiveness of the method.

The Development of the Japanese Psychiatric Nursing Assessment Classification System (PsyNACS©)

The purpose of this study was to develop the Japanese Psychiatric Nursing Assessment Classification System (PsyNACS)©. This study used the on-line survey method from February to April 2015. There were 644 respondents comprised of professional nurses with minimum qualification of 3 years’ experience being in a psychiatric unit of a stand-alone 200-bed or more Psychiatric Hospital in Japan. Assessment items were derived from 211 specific items selected from nursing textbooks, excluding the North-American-Nursing-Diagnosis-Association (NANDA). The questionnaire contained Cover Letter, Demographic Data Sheet, and the PsyNACS© questionnaire. There were 644 questionnaires accessed but only 435 were completed and valid. Item levels of importance were evaluated: 1) Unnecessary, 2) Not very important, 3) Important and 4) Very important. Data analysis used descriptive and multivariate statistics. Factor analysis (principal factor analysis, varimax rotation), the Kaiser-Meyer-Olkin (KMO) and the Bartlett’s test of Sphericity assessed the adaptive validity of the factor analysis. Factor loadings were set at 0.4 or more for the configuration of items. Internal consistency and reliability were established using Cronbach’s alpha coefficient. Mean factor points were calculated, including standard deviation, range, and confidence interval at 95%. Statistical significance was at 0.05 level. Nine Patient Assessment Data (PAD) with 2 to 5 Cluster Assessment Data (CAD) each were categorized. Thirty one CADs comprised the Patient Assessment Data: (PAD1) Psychological symptom and stress, (PAD2) Information about treatment, (PAD3) Function of eating and balance of water, (PAD4) Life and value, (PAD5) Vital signs and health assessment, (PAD6) Self-care, (PAD7) Social support, (PAD8) Activity, sleeping and mobility capability, and (PAD9) Sexual function and sexual behavior. The PsyNACS© is a classification of items assessing health care needs within the Japanese psychiatric nursing care environment, and also can be used in various psychiatric patient care situations in all psychiatric units.

Clinical nursing competency assessment:a scoping review

Objective:To ensure that only competent graduates are licensed to practice nursing,councils conduct licensing examinations,which may include among others clinical competency assessment.This review explored current practices in clinical competency assess­ment of nursing students as part of a larger study aimed at developing an evidence-based,context-specific framework for clinical competency assessment in a sub-Saharan African(SSA)country.Methods:A scoping guided by the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews(PRISMA-ScR)was conducted.Results:Findings from 28 out of 1151 studies identified from Scopus,PubMed,CINAHL,Wiley Online Library,and ProQuest were included and synthesized.Results show that a good assessment system must be valid,reliable,transparent,feasible,fair,objective,and must provide feedback and continually improve to have an educational impact.Clinical competency assessment systems must be developed on sound empirical evidence,pilot tested,and involve thorough training and evaluation of the examiners.Continuous evaluation of the assessment system is also essential to ensure the quality and relevance of the assessment system.Only one of the included studies was conducted in Africa.Conclusions:The paucity of clinical competency assessment research in sub-Saharan Africa may lead to benchmarking assessment systems on research conducted outside the context.Sub-Saharan Africa has a set of circumstances that demand a context-specific clinical competency assessment framework to guide clinical competency assessment.

The Impact of Repeated Death Conference Participation on Nurses’ Terminal Care and Nursing in Death Conference Using the Death Conference Nursing Self-Assessment Sheet

Background: Increasing the number of DC (Death Conference) experiences, nurses are expected to improve the quality of nurses’ terminal care and developing nursing minds. Therefore, there is a need for further evidence on the impact of repeated DC experiences on nurses’ terminal care. Aim: This study aims to clarify the impact of repeated DC experiences on nurses’ terminal care and nursing in DC using the prepared Death Conference Nursing Self-Assessment Sheet. Method: The study is approved by the Ethics Review Board of St. Mary’s College, Chukyo Gakuin University, and the hospital where the survey was conducted. This study was an observational and cross-sectional study using an anonymous, self-completed questionnaire composed of the newly created Death Conference Nursing Self-Assessment Sheet. Its evaluation items in the Death Conference Nursing Self-Assessment sheet consist of four categories (Cooperation, Future direction of nursing, Specific measures for nursing, and Feeling of the nurse) and 14 questions. The questionnaires were conducted on 144 nurses in the ER, ICU, and Palliative Care Ward (Hospice Ward) in a general hospital in Japan. For analysis, JMP ver.14.2 was used to perform Fisher’s exact test, Wilcoxon/Mann Whitney test, univariate, and multivariate logistic regression analysis. Results: Thirty-four participants (23.6%) who answered the number of DC experiences were included in the final analysis. Seventeen nurses had DC experiences, and 17 had no experience. There were significant differences in all of the above categories impacting nurses’ terminal care and nursing in DC. Conclusion: Repeated DC affected nurses’ terminal care and nursing in DC using the Death Conference Nursing Self-Assessment Sheet. In the future, verification of the reliability, validity of the questionnaire, and more evidence of the way of terminal concerns by raising the quality of DC for developing nursing minds will be needed.

Assessment of strategic management practice of malaria control in the dangme west district, GhanaArticle submitted to the west african college of nursing for the award of a fellow

Strategic management (SM) practice was as-sessed in all HCFs both in the public and private and some chemical shops within the Dangme West district using semi-structured question-naires. In-depth interviews were carried out with healthcare managers in their clinical setting. The study utilized both qualitative and quantitative methods in describing the SM practice. Healthcare managers were using all the elements of SM in the management of malaria but these were not holistically coordinated. Present were short ranged informal planning based on the objectives of NMCP and day-to-day operation of the HCFs especially with Ghana Health Service facilities. Due to homogenous nature of Dangme West district, management of culture wasn’t given much attention by healthcare managers though healthcare providers were acutely aware of its importance to quality service delivery. Competition was woefully absent in the healthcare environment. No formal structure has been created for the management of malaria control activities with the exception of the involvement of Community Based agents. The district was widely implementing all the strategies of the NMCP with favourable outcomes.