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This study aims to explore the experiences and challenges faced by rural nurses in Botswana who manage births outside the hospital environment, providing insights into the impact of these experiences on maternal and neonatal health outcomes.
A qualitative descriptive design was employed to gain a comprehensive understanding of the participants' perspectives and experiences.
Twenty-six registered nurses from four remote health districts in Botswana were selected using a purposive convenience sampling technique. Semi-structured interviews were conducted to gather in-depth data regarding their experiences managing childbirth in rural settings.
The analysis revealed that nurses face significant emotional and practical challenges, including feeling unprepared for emergencies, lack of access to resources, and high levels of stress associated with managing complications without specialized training. Many participants reported a strong commitment to their communities despite the hurdles, underscoring their vital roles in maternal healthcare.
The findings indicate a pressing need for enhanced training programs and support systems for rural nurses to better equip them for the complexities of childbirth management outside hospital settings. Addressing these gaps is essential to improve clinical outcomes for mothers and infants and to minimize the risks associated with unsupervised births.
This study highlights the crucial role rural nurses play in maternal health and stresses the need for targeted training and policy interventions. By strengthening the capacity of these healthcare providers, we can work toward reducing maternal and neonatal morbidity and mortality rates in Botswana and similar rural settings worldwide.
To describe the development and implementation of evidence-based teaching strategies for assessing and classifying pressure injuries in older nursing home individuals ≥ 60 years old with darker skin tones.
Pressure injury assessment learning interventions based on pre- and post-test assessments.
The learning interventions were developed by experts in pressure injury education and were based on empirical evidence, international clinical practice guidelines, and underpinned by social constructivism theory and the integrated interactive teaching model. The teaching strategy was developed to educate research assistants in the assessment of pressure injuries in darker skin tone individuals. The content included requisite knowledge and skills for pressure injury assessment and classification in darker skinned individuals. Using evidence-based teaching strategies, the content was delivered through face-to-face lectures, small group discussions, and practical application sessions delivered using classroom and practical-based activities. Photographic images were used to assess their knowledge and skills in classifying pressure injuries. Four Bachelor of Nursing-qualified registered nurses in Sri Lanka were recruited as research assistants using the new education resource. Using scores from 1 to 20 points, mastery of the theory and practice components was assessed.
The mean pre-test score was 9 ± 1.6 (95% confidence interval 6.4–11.6), demonstrating that assessment and classification of pressure injury knowledge were lacking. The mean post-test score was 16 ± 0.8 (95% confidence interval 14.7–17.3) indicating an improvement in the participants' ability to assess and staging pressure injuries.
Early pressure injury detection among older individuals with darker skin tones is challenging. This evidence-based teaching approach can be used to educate clinical nurses and research assistants in assessing pressure injuries in individuals with darker skin tones.
This study contributes to the body of knowledge by improving the early detection and accurate classification of pressure injuries in older nursing home residents with darker skin tones, addressing a significant gap in current nursing practice.
To measure the prevalence and incidence of nursing home-acquired pressure injuries in older adults residing in Sri Lankan nursing homes.
Pressure injury prevalence and incidence are indicators of safety and quality of care. A significant portion of the global population has a skin color dominated by the presence of melanin. Yet, the number of nursing home residents with darker skin tones who develop pressure injuries in nursing homes is relatively unknown.
Prospective multisite cohort study conducted in nine nursing homes in Sri Lanka. The sample comprised 210 residents aged ≥60 years old.
Semi structured observations and chart audits were used to gather data from July to October 2023. Head-to-toe visual skin assessment to check for nursing home- acquired pressure injuries, Braden pressure injury risk scale and Fitzpatrick skin tone assessments were conducted on all recruited residents at baseline. All recruited residents were followed-up weekly for 12 weeks until detection of a new pressure injury, death, discharge, or transfer.
Pressure injury point prevalence at baseline was 8.1% (17/210). Cumulative incidence was 17.1% (36/210). Incidence density was 15.8 per 1000 resident weeks. Most nursing home-acquired pressure injuries were located on the ankle at baseline (29.4%; 5/17) and in the follow-up period (27.8%; 10/36). Stage I pressure injuries were most common: 58.8% (10/17) and 44.4% (16/36) at baseline and during follow-up respectively.
About one in six nursing home residents developed a new pressure injury over the 12-week follow-up period. Despite staff and resource constraints, there remains a need to focus on the prevention of pressure injuries in Sri Lankan nursing homes.
Studies on the burden of pressure injuries among darker skin tone nursing home residents are lacking and the current evidence available are predominantly from Western countries. The findings of this study highlight the need of targeted preventive measures for nursing home residents with darker skin tones.
Both nurses' well-being and quality of care are top priorities of the healthcare system. Yet, there is still a gap in understanding the extent and how authentic leadership influences them. This information is needed to inform the development of effective interventions, organizational practices, and policies. Thus, this study aimed to test the mechanism by which nurses' perception of their managers' authentic leadership impacts nurses' well-being and perception of quality of care, given the role of the nursing practice environment and nurses' psychological capital.
A cross-sectional design was used.
This study recruited a random sample of 680 nurses from six hospitals in Saudi Arabia. A final sample of 415 completed the surveys, with a response rate of 61%. Structural equation modeling was performed to test the hypothesized model.
The study showed that nurses' perceptions of authentic leadership in their managers positively and directly affect their perceptions of quality of care but do not directly affect nurses' well-being. Both the nursing practice environment and psychological capital fully mediated the relationship between authentic leadership and nurses' well-being. However, the nursing practice environment partially mediated the relationship between authentic leadership and perceptions of quality of care.
The findings contribute to understanding the crucial role of authentic leaders' style in nurses' well-being and quality of care through its positive impact on the nursing practice environment and psychological capital.
Designing interventions and policies that specifically target nursing managers' authentic leadership style has implications for enhancing nurses' well-being and the quality of patient care. Institutional measures are needed to help leaders practice an authentic leadership style to create a positive nursing practice environment and cultivate nurses' psychological capital, both of which contribute to nurses' well-being and attaining a better quality of care. Further work is required to highlight the outcomes of implementing an authentic leadership style relevant to other leadership styles.
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