Disaster and Nurse’s Role

India is vulnerable to a large number of disasters.More than 58.6%of the landmass is prone to earthquakes of moderate to high intensity;over 40 million hectares(12%)of its land is prone to floods and river erosion;close to 5.700 km,out of the 7.516 km long coastline is prone to cyclones and tsunamis;68%of its cultivable area is vulnerable to droughts;and,its hilly areas are at risk from landslides and avalanches.The WHO defines disaster as any occurrence that causes damage,ecological disruption,loss of human life,deterioration of health,and health services,on a scale sufficient to warrant an extraordinary response from outside the affected community or area.Roles of nurse during disaster management include to determine the magnitude of the event,define and understand the health needs of the affected groups,prepare the priorities and objectives,identify actual and potential public health problems at the earliest,and estimate resources needed to respond to the needs identified.

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.

Infection Control Measures among Healthcare Workers: Knowledge, Attitude and Practice

Background: Nosocomial infections are some of public health problems globally and continue to be increased regardless of the hospital’s efforts on infection control measures and are contributing significantly to morbidity, mortality and cost. The absence of infection control policies, guidelines and trained professionals also contributes to the magnitude of the problem. The aim of this study was to assess the Knowledge, attitude and practices towards infection control measures among healthcare workers at Old Mutare Hospital. Methods: A cross-sectional survey design was used to acquire information. A purposive sampling method was used to select 22 nurses, 15 nurse Aids and 2 laboratory technicians (Lab Tech). A self-administered questionnaire with four components addressing demographic data, knowledge, attitudes and practices was used to collect data that was completed by a checklist. Results: The study findings revealed a poor knowledge of infection control measures among the nurse’s aide. The attitude and practices among participants were impartially good in all variables. The participants had scored over 50% towards their attitude and their practices on infection control. A significant statistical difference was found between the professional status of the participants and the ability to explain how one can get Hospital Acquired Infections (HAIs) and awareness of infection control programs in their hospital (rs = 0.640, 0.645) with P < 0.05 (0.01, 0.01) respectively. Conclusion: Despite of having a fair attitude and practice towards infection control, the participants had presented poor knowledge;therefore, it had been recommended that in service training and workshop should be planned by the administration to update their knowledge and attain full compliance towards their practice.

Pregnancy related issues in inflammatory bowel disease: Evidence base and patients' perspective

Inflammatory bowel disease (IBD) affects women of childbearing age and can influence fertility, pregnancy and decisions regarding breastfeeding. Women with IBD need to consider the possible course of disease during pregnancy, the benefits and risks associated with medications required for disease management during pregnancy and breastfeeding and the effects of mode of delivery on their disease. When indicated, aminosalicylates and thiopurines can be safely used during pregnancy. Infliximab and Adalimumab are considered probably safe during the first two trimesters. During the third trimester the placenta can be crossed and caution should be applied. Methotrexate is associated with severe teratogenicity due to its folate antagonism and is strictly contraindicated. Women with IBD tend to deliver earlier than healthy women, but can have a vaginal delivery in most cases. Caesarean sections are generally recommended for women with active perianal disease or after ileo-anal pouch surgery. While the impact of disease activity and medication has been addressed in several studies, there are minimal studies evaluating patients' perspective on these issues. Women's attitudes may influence their decision to have children and can positively or negatively influence the chance of conceiving, and their beliefs regarding therapies may impact on the course of their disease during pregnancy and/or breastfeeding. This review article outlines the impact of IBD and its treatment on pregnancy, and examines the available data on patients' views on this subject.