Background The quality of nursing education depends largely on the experience student receive in the clinical environment. The learning environment is complex with factors that may positively or negatively influence students learning. The current study aimed to explore the experiences and perceptions of diploma nursing students toward their clinical learning in Dodoma-Tanzania. Methods A qualitative descriptive study design was employed. The study was conducted in four nursing schools involving 32 nursing students who were purposively selected. Data was collected using focus-group discussions and analyzed using thematic analysis. Results Three main themes emerged during the discussions: experience on personal and technical support for clinical learning, the importance of the clinical environment in clinical learning, and insufficient clinical educational planning. The majority of students had negative experiences including poor clinical supervision, lack of equipment, congestion of students, and inability to meet clinical objectives. Few students had positive experiences related to exposure to a real clinical environment and great support from staff nurses. Conclusion Students had mixed experiences, both positive and negative on their clinical learning. The majority of students had negative experiences. This may have a serious impact on the student completing their education, the services they will offer to patients when employed, and nursing professional development.
Background: The quality of nursing education depends largely on the experience student receive in the clinical environment. The learning environment is complex with factors that may positively or negatively influence students learning. The study aimed to explore the experiences and perceptions of diploma nursing students toward their clinical learning and teaching. Methods: A qualitative phenomenological study design was employed. A purposive sampling using a criterion strategy was applied to enroll participants. Focus-group discussions were conducted to collect the data and a thematic analysis was done. Results: A total of 32 Participants were enrolled from 4 schools, 19 were females and the age ranged from 19 to 25 years. Four main themes emerged during the discussions, which were unsatisfactory clinical supervision and teaching, drawbacks to clinical learning and teaching, insufficient clinical educational planning, and confusion about nursing professional identity. Conclusion: From students' perspectives, the main challenges during clinical placements are unsatisfactory supervision, student congestion in wards, poor planning of rotations, and confusion about nursing professional identity. Regarding these challenges, students perceived negative impacts on clinical learning.
Despite the goal of eliminating new human immunodeficiency virus (HIV) infections in children, mother-to-child transmission is still common in resource-poor countries. The aims of this study were to assess the occurrence of mother-to-child transmission of HIV (MTCT) by age 18 months, risk factors for transmission, and the implementation of the national prevention of MTCT (PMTCT) program in a rural hospital in Tanzania. Data were collated from various medical registers and records. We included 172 children and 167 HIV-infected mothers. Among 88 children (51%) with adequate information, 9 (10.2%) were infected. Increased risk of MTCT was associated with late testing of the child (>2 months) [OR = 9.5 (95% CI: 1.8–49.4)], absence of antiretroviral therapy during pregnancy [OR = 9.7 (95% CI: 2.1–46.1)], and maternal CD4 cell count <200 cells/mm3 [OR = 15.3 (95% CI: 2.1–111)]. We were unable to determine the occurrence of MTCT transmission in 84 children (49%). The results from this study highlight that there is an urgent need for enhanced efforts to improve follow-up of HIV-exposed children, to improve documentation in registries and records, and to facilitate ease of linkage between these.
Documentation of fetal to neonatal heart rate (HR) transition is limited. The aim of the current study was to describe HR changes from one hour before to one hour after normal vaginal deliveries. We conducted a prospective observational cohort study in Tanzania from 1 October 2020 to 30 August 2021, including normal vaginal deliveries with normal neonatal outcomes. HR was continuously recorded from one hour before to one hour after delivery, using the Moyo fetal HR meter, NeoBeat newborn HR meter, and the Liveborn Application for data storage. The median, 25th, and 75th HR percentiles were constructed. Overall, 305 deliveries were included. Median (interquartile range; IQR) gestational age was 39 (38–40) weeks and birthweight was 3200 (3000–3500) grams. HR decreased slightly during the last 60 min before delivery from 136 (123,145) to 132 (112,143) beats/minute. After delivery, HR increased within one minute to 168 (143,183) beats/min, before decreasing to around 136 (127,149) beats/min at 60 min after delivery. The drop in HR in the last hour of delivery reflects strong contractions and pushing. The rapid increase in initial neonatal HR reflects an effort to establish spontaneous breathing.
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