BackgroundThis study sought to better understand the drivers of skilled health professional migration, its consequences, and the various strategies countries have employed to mitigate its negative impacts. The study was conducted in four countries—Jamaica, India, the Philippines, and South Africa—that have historically been “sources” of health workers migrating to other countries. The aim of this paper is to present the findings from the Indian portion of the study.MethodsData were collected using surveys of Indian generalist and specialist physicians, nurses, midwives, dentists, pharmacists, dieticians, and other allied health therapists. We also conducted structured interviews with key stakeholders representing government ministries, professional associations, regional health authorities, health care facilities, and educational institutions. Quantitative data were analyzed using descriptive statistics and regression models. Qualitative data were analyzed thematically.ResultsShortages of health workers are evident in certain parts of India and in certain specialty areas, but the degree and nature of such shortages are difficult to determine due to the lack of evidence and health information. The relationship of such shortages to international migration is not clear. Policy responses to health worker migration are also similarly embedded in wider processes aimed at health workforce management, but overall, there is no clear policy agenda to manage health worker migration. Decision-makers in India present conflicting options about the need or desirability of curtailing migration.ConclusionsConsequences of health work migration on the Indian health care system are not easily discernable from other compounding factors. Research suggests that shortages of skilled health workers in India must be examined in relation to domestic policies on training, recruitment, and retention rather than viewed as a direct consequence of the international migration of health workers.

Health policy-makers in India need to take a serious look at the growing migration of nurses to foreign countries. While such migration leads to inflow of foreign exchange, it also implies the loss of medical personnel vital for the fulfilment of national goals.

Background Objective Structured Practical Examination (OSPE) is a method of assessment of clinical competence. The examination is conducted at multiple stations. Besides practical and problem-solving skills, theoretical knowledge is also tested. OSPE can be traced back more than 40 years. OSPE has been included more than two decades, as a part of assessment in the College of Nursing, All India Institute of Medical Sciences (AIIMS), New Delhi. Objectives This study was carried out to determine nursing students' attitudes towards OSPE as an assessment tool. Participants The responses of all the 252 Undergraduate nursing students studying at the College of Nursing, AIIMS were obtained for this study (77 from B.Sc.(H) Nursing first year, 61 from the second year, 69 from the third year and 45 from the fourth year). Methods The students attitudes towards OSPE were assessed by using a validated questionnaire containing 28 item statements on Likert's 5-point scale (LS) and 11 bipolar adjectives on Osgood's 7-point Semantic' Differential Scale (OSDS). Result Most of the students approved of OSPE and felt that it was fair, useful, good, effective, exciting, interesting, practical, skill oriented but also taxing. The study also revealed that amongst the second years' students there was a strong correlation between Overall Rank in the Class and Assessment of OSPE. Conclusion The study supports the introduction of OSPE as one of the methods of assessment of B.Sc. (Hons.) Nursing students.

Incontinence is a common problem among hospitalised patients and has been associated with multiple health complications, including incontinence-associated dermatitis (IAD) and hospitalacquired pressure ulcers (HAPUs). IAD is one of the clinical manifestations of moisture- associated skin damage (MASD). IAD is a common problem in aged patients with faecal and/or urinary incontinence. In this study it was sought to reduce the incidence of IAD among critically ill patients admitted in ICU from 5.94 rate to <2.00 by implementing Nursing Interventions of IAD protocol. A one group pre-test post-test design was selected using consecutive sampling technique. The data was obtained by using an audit checklist prior and post-interventions. Results showed that the compliance to IAD protocol increased from 37.94 percent to 77.33 percent. Incidence of IAD reduced from 5.94 to 2.02 in the last 3 months. Healing status of IAD was 100 percent in June & July 2017. Thus nursing interventions are effective in the prevention and healing of IAD among critical care patients. To conclude incontinence associated dermatitis is a prevalent but under-recognised form of skin damage in the critically ill patients with urinary or fecal incontinence. Prevention and treatment focus on treatment of underlying incontinence and protection of skin exposed to urine or stool-based on a structure skin care regimen.