Study Protocol on Stroke Management: Role of Nurses and Physiotherapists at the Adult University Teaching Hospital, Lusaka Zambia

Background: Management of stroke patients requires a multidisciplinary approach. Literature presents unequivocal evidence of improved outcomes when patients are treated in a stroke unit by multi-disciplinary teams made up of medical doctors, nurses, physiotherapists and occupational therapists. Among the multidisciplinary team members, physiotherapists and nurses are the largest professional workforce working with both stroke patients and survivors. This study, therefore, aims at investigating the role of nurses and physiotherapists in the management of stroke patients at the Adult University Teaching Hospital. Methodology: This study shall utilize a convergent parallel mixed method design where both quantitative and qualitative data will be collected at the same time resulting in two data sets which will eventually be merged at the point of discussion. The quantitative component shall utilize an analytical cross-sectional approach while the qualitative component shall use a qualitative case study approach. The study will be conducted at the Adult University Teaching Hospital in Lusaka. Data will be collected from all the 287 nurses and 37 physiotherapists working in the Emergency Department, Medical Wards, Adult Intensive Care Unit and the Department of Physiotherapy. Quantitative data will be analyzed using Statistical Package for social sciences. Descriptive statistics shall be computed on the role of nurses and physiotherapists in stroke care. In addition, chi-square and fisher’s exact tests will be used in the test for associations between variables while binary logistic regression will be used in identifying predictors of the various roles played by nurses and physiotherapists in the management of stroke patients. Qualitative data will be analyzed using thematic analysis in order to generate new concepts and a substantive model of care for stroke patients. Conclusion: Despite research evidence of improved outcomes when stroke patients are managed by a multi-disciplinary team, data on the role of different members of the multidisciplinary care team in stroke management is almost non-existent from the Zambia context. It is therefore hoped that information obtained from this study will be used as a basis for recommending the streamlined role of the nurse and physiotherapist in both acute care and rehabilitation.

Role of physical activity in renal rehabilitation: narrative review

Background:Renal rehabilitation is a process that consists of a series of activities that are intended to improve the health of people with chronic kidney disease.A person with chronic kidney disease requires intensive nursing care,support from other healthcare providers,and an interdisciplinary team of professionals.Objective:This article aims to teach these aspects of renal nursing rehabilitation,highlight the effect of rehabilitation in patients with chronic kidney disease to avoid renal complications,and improve self-care activities.Conclusion:Rehabilitation of renal patients is a multidisciplinary task that the medical team must perform.Physiotherapy teams are crucial to the development of patients’exercise programs.Support from family and renal nurses and care teams is of great importance.All parties play an important role,and integrated team approaches can make rehabilitation very effective.Recommendation:Clinicians should counsel patients with chronic kidney disease;increasing physical activity levels in vulnerable older people,including older people,promotes health through regular physical activity,including exercise and endurance.

Pediatric Nursing Care and Its Practices in Three Health Care Facilities

Introduction: Pediatric nursing cares are among the most important care needed referring to the category of patients. A gap of the best practice in Pediatric Nursing Care (PNC) had been publically a major problem of health and raises the rate of morbidity and mortality. The lack of nursing guidelines, low level of studies, experience at work and low economic status of Health Care Facilities (HCFs) were the main problems assessed in these three HCFs (HUCK, VNC and MHK) in this study. The purpose of this study is to assess the knowledge of nurses during their practices in Pediatric Wards of HCFs and to provide a better contribution. Method: A descriptive study design was used in this study during the period of one month. 43, 25 and 30 nurses were selected among 98 nurses by using Dilman formula. A questionnaire with 5 parameters was distributed. Data were typed using Microsoft ward and analyzed using Statistical Package for Social Scientists version 16 software (SPSS). Results: The current study found that the majority of nurses don’t know to make the best nursing diagnosis neither the factors related to the implementation of EBP in PNC. The nurses have shown different barriers often met during their practices. The all process of nursing diagnosis was not recognized with the average of 97.6% of nurses. Conclusion: Even if the nurses have some experience at work they express their weakness based on low level of study, lack of knowledge and trained professionals on work and the pediatric nursing guidelines.

Second-order problem solving:Nurses'perspectives on learning from.near misses

Objectives:Near misses happen more frequently than actual errors,and highlight system vulnerabilities without causing any harm,thus provide a safe space for organizational learning.Second-order problem solving behavior offers a new perspective to better understand how nurses promote learning from near misses to improve organizational outcomes.This study aimed to explore frontline nurses’perspectives on using second-order problem solving behavior in learning from near misses to improve patient safety.Methods:A qualitative exploratory study design was employed.This study was conducted in three tertiary hospitals in east China from June to November 2015.Purposive sampling was used to recruit 19 frontline nurses.Semi-structured interviews and a qualitative directed content analysis was undertaken using Crossan’s 4I Framework of Organizational Learning as a coding framework.Results:Second-order problem solving behavior,based on the 4I Framework of Organizational Learning,was referred to as being a leader in exposing near misses,pushing forward the cause analysis within limited capacity,balancing the active and passive role during improvement project,and promoting the continuous improvement with passion while feeling low-powered.Conclusions:4I Framework of Organizational Learning can be an underlying guide to enrich frontline nurses’role in promoting organizations to learn from near misses.In this study,nurses displayed their pivotal role in organizational learning from near misses by using second-order problem solving.However,additional knowledge,skills,and support are needed to maximize the application of second-order problem solving behavior when near misses are recognized.