Neonatal circumcision: profile of neonates with complications resulting from the use of plastibell

Introduction. Circumcision is one of the most performed surgical procedures in neonates. Aim. The aim of this study was to evaluate our experience with neonates who developed complications following the use of plastibell for circumcision. Material and methods. This was a retrospective study of male neonates who were managed for complications resulting from circumcision (performed with plastibell) over a 5-year period at the pediatric surgery unit of a teaching hospital in Enugu, Nigeria. Ethical approval was obtained from the ethics and research committee. Results. Out of the 1794 neonatal circumcisions (using plastibell) performed during the study period, 134 (7.5%) neonates had complications. Sixty percent (1074) of the circumcisions were performed in the teaching hospital while 40% were referred cases. The ages of the patients ranged from 7 to 27 days with a median of 10 days and their mean weight was 2.5 kilograms. Majority of the plastibell circumcisions that developed complications was performed by unregistered (auxiliary) nurses. Retained plastibell was the most common complication and its removal was the most performed procedure. No mortality was recorded. Conclusion. Complications following circumcision with plastibell vary widely. Retained plastibell was the most common in the present study. The most complications occurred when the circumcision was performed by auxiliary (unregistered) nurses.

Trends and risk factors for infant mortality in the Lao People’s Democratic Republic

A high infant mortality rate (IMR) indicates a failure to meet people’s healthcare needs. The IMR in Lao People’s Democratic Republic has been decreasing but still remains high. This study aimed to identify the factors involved in the high IMR by analyzing data from 53,727 live births and 2189 women from the 2017 Lao Social Indicator Survey. The estimated IMR decreased from 191 per 1000 live births in 1978–1987 to 39 in 2017. The difference between the IMR and the neonatal mortality rate had declined since 1978 but did not change after 2009. Factors associated with the high IMR in all three models (forced-entry, forward-selection, and backward-selection) of multivariate logistic regression analyses were auxiliary nurses as birth attendants compared to doctors, male infants, and small birth size compared to average in all 2189 women; and 1–3 antenatal care visits compared to four visits, auxiliary nurses as birth attendants compared to doctors, male infants, postnatal baby checks, and being pregnant at the interview in 1950 women whose infants’ birth size was average or large. Maternal and child healthcare and family planning should be strengthened including upgrading auxiliary nurses to mid-level nurses and improving antenatal care quality.

Maternal health training priorities for nursing and allied professions in Haiti

Objectives. This study summarizes the findings of a training needs and priority assessment completed in Haiti. Its objective is to describe the characteristics of nursing and allied professions providing first level maternal health care and identify training needs and priorities to inform planning of Human Resources for Health interventions. Methods. A cross-sectional survey was completed between October 2016 and March 2017 by the Pan American Health Organization/World Health Organization Haiti office in collaboration with national health authorities. Participants reached consensus to submit one finalized version of the survey. Data were collected on composition, capacities, and training needs and priorities of traditional birth attendants, community health workers, registered nurses, professional midwives, and auxiliary nurses. Results. Haiti relies heavily on community level workers including community health workers, auxiliary nurses, and traditional birth attendants. Traditional birth attendants attend the majority of Haiti’s births, despite having low education levels and not being regulated by the Ministry of Public Health and Population. All professional categories prioritize preventive capacities such as timely identification of complications, while none are trained to manage postpartum hemorrhage, preeclampsia, or eclampsia. Management of obstetric emergencies is a training priority for Haiti but is not part of the scope of work of the nursing and allied health professions included in this study. Conclusions. Community level health workers are key in providing preventive care and referral of complicated pregnancies, but lack of access to providers qualified to treat obstetric complications remains a challenge to reducing maternal mortality.

Resilience of auxiliary nurses providing nursing care to patients with intellectual disabilities at a public mental healthcare institution

Background: Although mental health is regarded by the International Council of Nurses as a very important element of wellness, healthcare to patients with intellectual disabilities still remains neglected and under-resourced in most societies. Auxiliary nurses are crucial in providing nursing care to patients with intellectual disabilities. These nurses may not be prepared to handle challenges in providing nursing care to these patients, but their resilience can help them to manage these challenges. Limited research is available with regard to the resilience of auxiliary nurses providing nursing care to patients with intellectual disabilities.Objectives: To explore and describe the perceptions of auxiliary nurses providing nursing care to patients with intellectual disabilities on their resilience and protective mechanisms and vulnerability factors that influence their resilience when providing nursing care to these patients.Method: A qualitative, descriptive inquiry approach was used. The population comprised approximately 220 auxiliary nurses providing nursing care to patients with intellectual disabilities at a mental healthcare institution. Auxiliary nurses were selected through purposive sampling with the assistance of a mediator. The sample size was determined by data saturation. The data were collected through four focus group interviews with altogether 32 participants.Results: Five main themes emerged from the data. Practical wisdom was applied by the participants. They also made use of different forms of interactions, including the application of strategies such as utilising induction programmes and being willing to learn, in order to remain resilient. Protective mechanisms and vulnerability factors influence their resilience.Conclusions: Recommendations to strengthen the resilience of auxiliary nurses caring for patients with intellectual disabilities were formulated from the research findings, including recommendations for nursing practice, education and nursing research. Informal peer support, as well as addressing ethical issues, improving nurse–patient communication, training to handle adverse working conditions, and continuing education and further research on the practical wisdom of auxiliary nurses, is recommended.

Experiences of auxiliary nursing trainees of poverty alleviation programme regarding nursing and nursing profession in Vhembe District, Limpopo Province

Background: The Limpopo Department of Health and Social Development introduced a system to train children from poor families as auxiliary nurses as a poverty alleviation strategy in 2003. The programme targeted the needy families, those who depended on social grants, orphaned or child-headed families. The programme has been implemented for more than 10 years and the experiences of trainees were never explored.Objectives: The purpose of this study was to explore the experiences of auxiliary nurse trainees of the poverty alleviation programme regarding nursing and the nursing profession.Methods: A qualitative approach was used. Purposive sampling was used to sample 15 auxiliary nurses who were trained under poverty alleviation programme in four of the seven hospitals of Vhembe District. Data were collected through in-depth individual interviews. One central question ‘As a beneficiary of poverty alleviation programme, could you describe your experiences of training as a nurse and of the nursing profession in this hospital’. Data were collected until no new information emerged. Note taking and a voice recording was performed to capture all the information reported by the participants. Open coding method was used to analyse data.Results: Two themes emerged, namely experiences of being a nurse and about nursing as a profession, and interpersonal relationships between auxiliary nurses and the ward staff.Conclusions: The Department of Health in Limpopo Province was commended and to be encouraged to develop other programmes as poverty alleviation strategy for other government departments, so that the affected children can have a wider career choice. The managers and supervisors in the wards to have moral and legal obligations to support initiatives that foster effective mentoring of neophyte nurses in the nursing profession.

Helsevesenet trenger vår kompetanse- hvorfor ikke bruke den? En kvalitativ studie av filippinske sykepleieres opplevelse av veien til autorisasjon i Norge

The healthcare system need our competence - why not use it? A qualitative study of Filipino nurses experience of their way to accreditation in Norway Healthcare professionals educated outside the EU/EEA are an important source of labor in the Norwegian healthcare system, where nurses and auxiliary nurses from the Philippines constitute the largest group. Complicated authority requirements are attached to accreditation in Norway. The study explores how Filipino nurses with three different approvals in the authorization process, experience the process of accreditation in Norway, using qualitative research interviews. The results show that nurses face challenges related to the authorization process in Norway, which they experience as unworthy, unfair, baffling and economically burdensome, but also with experiences of hope for good prospects. A predictable and a dignified authorization process for Filipino nurses should be developed, so that their knowledge and competence can be included and appreciated in the Norwegian health care services.

Time Utilisation Pattern of Front Line Health Workers in India – A Case Study from Mangalore District

Sustainable development goal 3: Ensure healthy lives and promote well-being for all at all ages reports that most of populations are living healthier than before but there are many suffering from many disease and its prevalence and targets to achieve all them. Health workers are the core of the health care service system to deliver the care to the community. World Health Organization section of Nurse and Midwifery states that they comprised of more than 50% of the total health workforce, and there is a global shortage but the largest need based shortage in the Africa and South East Asia regions (https://www.who.int/news-room/fact-sheets/detail/nursing-andmidwifery). WHO statistics consists of Auxiliary nurses midwife (ANM, two years of training), registered nurses and midwifes (it varies from 3 -4 years of education).