Call For Neonatal Nursing Specialization in Developing Countries

Premji, Shahirose; Spence, Kenneth W.; Kenner, Carole

doi:10.1097/nmc.0b013e31829f2c94

Cited by 12 publications

(11 citation statements)

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“…Of these, 3 papers described development and evolution of clinical specialist and case management roles in which nurses facilitate interdisciplinary coordination of care and perform advanced assessments of adult and pediatric patients in intensive care, oncology and medical/surgical units [ 37 – 39 ]. International nursing associations endorsed differentiation of nursing in low-income countries into sub-specialties, such as dermatology and neonatology, as a means of enhancing quality of care [ 40 , 41 ]. Evidence pointed to parity between measures of patient outcomes and patient satisfaction obtained when specialized neurologic and obstetric care was delivered by trained nurses and physicians [ 42 , 43 ].…”

Section: Resultsmentioning

confidence: 99%

Professional practice models for nurses in low-income countries: an integrative review

Ng’ang’a

Byrne

2015

BMC Nurs

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BackgroundAttention is turning to nurses, who form the greatest proportion of health personnel worldwide, to play a greater role in delivering health services amidst a severe human resources for health crisis and overwhelming disease burden in low-income countries. Nurse leaders in low-income countries must consider essential context for nurses to fulfill their professional obligation to deliver safe and reliable health services. Professional practice models (PPMs) have been proposed as a framework for strategically positioning nurses to impact health outcomes. PPMs comprise 5 elements: professional values, patient care delivery systems, professional relationships, management approach and remuneration. In this paper, we synthesize the existing literature on PPMs for nurses in low-income countries.MethodsAn integrative review of CINAHL-EBSCO, PubMed and Scopus databases for English language journal articles published after 1990. Search terms included nurses, professionalism, professional practice models, low-income countries, developing countries and relevant Medical Subject Heading Terms (MeSH).ResultsSixty nine articles published between 1993 and 2014 were included in the review. Twenty seven articles examined patient care delivery models, 17 professional relationships, 12 professional values, 11 remuneration and 1 management approach. One article looked at comprehensive PPMs.ConclusionsAdopting comprehensive PPMs or their components can be a strategy to exploit the capacity of nurses and provide a framework for determining the full expression of the nursing role.

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Section: Resultsmentioning

confidence: 99%

Professional practice models for nurses in low-income countries: an integrative review

Ng’ang’a

Byrne

2015

BMC Nurs

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“…Health providers, especially midwives and specialist nurses, play a critical role in neonatal care [ 6 , 8 , 36 - 38 ]. Specially trained neonatal nurses may not be available in all health facilities, but previous studies show it is important to monitor who, if anyone, cares for newborns in the absence of specialised staff [ 8 ].…”

Section: Discussionmentioning

confidence: 99%

Service readiness for inpatient care of small and sick newborns: what do we need and what can we measure now?

Moxon

Guenther

Gabrysch

et al. 2018

Journal of Global Health

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BackgroundEach year an estimated 2.6 million newborns die, mainly from complications of prematurity, neonatal infections, and intrapartum events. Reducing these deaths requires high coverage of good quality care at birth, and inpatient care for small and sick newborns. In low- and middle-income countries, standardised measurement of the readiness of facilities to provide emergency obstetric care has improved tracking of readiness to provide care at birth in recent years. However, the focus has been mainly on obstetric care; service readiness for providing inpatient care of small and sick newborns is still not consistently measured or tracked.MethodsWe reviewed existing international guidelines and resources to create a matrix of the structural characteristics (infrastructure, equipment, drugs, providers and guidelines) for service readiness to deliver a package of inpatient care interventions for small and sick newborns. To identify gaps in existing measurement systems, we reviewed three multi-country health facility survey tools (the Service Availability and Readiness Assessment, the Service Provision Assessment and the Emergency Obstetric and Newborn Care Assessment) against our service readiness matrix.FindingsFor service readiness to provide inpatient care for small and sick newborns, our matrix detailed over 600 structural characteristics. Our review of the SPA, the SARA and the EmONC assessment tools identified several measurement omissions to capture information on key intervention areas, such as thermoregulation, feeding and respiratory support, treatment of specific complications (seizures, jaundice), and screening and follow up services, as well as specialised staff and service infrastructure.ConclusionsOur review delineates the required inputs to ensure readiness to provide inpatient care for small and sick newborns. Based on these findings, we detail where questions need to be added to existing tools and describe how measurement systems can be adapted to reflect small and sick newborns interventions. Such work can inform investments in health systems to end preventable newborn death and disability as part of the Every Newborn Action Plan.

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“…A worldwide nursing shortage exists in both high and low resource settings [ 24 , 25 ]. For small and sick newborns this is not simply a shortage of qualified individuals; there is a critical human resource gap for a neonatal nursing cadre, with almost no neonatal nursing training programmes outside of high income countries (Figure 6 ).…”

Section: Discussionmentioning

confidence: 99%

Inpatient care of small and sick newborns: a multi-country analysis of health system bottlenecks and potential solutions

Moxon

Lawn

Dickson

et al. 2015

BMC Pregnancy Childbirth

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171

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BackgroundPreterm birth is the leading cause of child death worldwide. Small and sick newborns require timely, high-quality inpatient care to survive. This includes provision of warmth, feeding support, safe oxygen therapy and effective phototherapy with prevention and treatment of infections. Inpatient care for newborns requires dedicated ward space, staffed by health workers with specialist training and skills. Many of the estimated 2.8 million newborns that die every year do not have access to such specialised care.MethodsThe bottleneck analysis tool was applied in 12 countries in Africa and Asia as part of the Every Newborn Action Plan process. Country workshops involved technical experts to complete the survey tool, which is designed to synthesise and grade health system "bottlenecks" (or factors that hinder the scale up) of maternal-newborn intervention packages. For this paper, we used quantitative and qualitative methods to analyse the bottleneck data, and combined these with literature review, to present priority bottlenecks and actions relevant to different health system building blocks for inpatient care of small and sick newborns.ResultsInpatient care of small and sick newborns is an intervention package highlighted by all country workshop participants as having critical health system challenges. Health system building blocks with the highest graded (significant or major) bottlenecks were health workforce (10 out of 12 countries) and health financing (10 out of 12 countries), followed by community ownership and partnership (9 out of 12 countries). Priority actions based on solution themes for these bottlenecks are discussed.ConclusionsWhilst major bottlenecks to the scale-up of quality inpatient newborn care are present, effective solutions exist. For all countries included, there is a critical need for a neonatal nursing cadre. Small and sick newborns require increased, sustained funding with specific insurance schemes to cover inpatient care and avoid catastrophic out-of-pocket payments. Core competencies, by level of care, should be defined for monitoring of newborn inpatient care, as with emergency obstetric care. Rather than fatalism that small and sick newborns will die, community interventions need to create demand for accessible, high-quality, family-centred inpatient care, including kangaroo mother care, so that every newborn can survive and thrive.

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Call For Neonatal Nursing Specialization in Developing Countries

Cited by 12 publications

References 11 publications

Professional practice models for nurses in low-income countries: an integrative review

Professional practice models for nurses in low-income countries: an integrative review

Service readiness for inpatient care of small and sick newborns: what do we need and what can we measure now?

Inpatient care of small and sick newborns: a multi-country analysis of health system bottlenecks and potential solutions

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