Searching for collaboration in international nursing partnerships: a literature review

GEORGE E.K. & MEADOWS‐OLIVER M. (2013) Searching for collaboration in international nursing partnerships: a literature review. International Nursing Review 60 , 31–36 Background: Nurses from low‐income countries (LICs) face extreme nursing shortages, faculty shortages and a lack of professional development opportunities. Nurses from high‐income countries (HICs) can leverage their wealth of resources to collaborate with nursing colleagues in LICs to expand clinical, education and research capacity. In turn, nurses from HICs gain stronger competency in the care they provide, improved communication skills and an increased understanding of global health issues. Aim: The purpose of this literature review is to identify international nursing clinical, education and research partnerships among nurses from LICs and HICs and to analyse the degree of collaboration involved in each partnership using DeSantis' counterpart concept. Methods: We conducted a systematic review of international nursing partnerships in the scientific literature from January 2001 to July 2012. A total of nine articles met inclusion criteria for analysis. Findings: All of the articles discuss lessons learnt in building international nursing partnerships among nurses from HICs and LICs. However, the articles failed to meet the criteria set forth by DeSantis' counterpart concept to achieve fully collaborative nursing partnerships. Conclusions: International nursing partnerships require more foresight and planning to create partnerships in which the benefits derived by nurses from LICs equal those of their colleagues from HICs. By striving for such collaboration, international nursing partnerships can help build nursing clinical, education and research capacity in LICs.     

The Alfred Trauma Team Training Program in India and Sri Lanka

Injury is a major global health problem. India suffers more deaths from vehicle collisions than any other country. Since 2004 The Alfred Hospital in Melbourne, Australia has established strong linkages with Christian Medical College (CMC) in Ludhiana, the Punjab, India and Teaching Hospital Karapitiya (THK) in Galle, Sri Lanka, supporting trauma care capacity‐building. In response to the demand for a systematic approach to trauma care in India and Sri Lanka, The Alfred Trauma Team Training Program was developed, funded by the Australian Agency for International Development, The Alfred and its participating staff, CMC and THK. The aim of the programme was to enhance the understanding and skill in reception and resuscitation of critically injured patients in a cohort of providers of emergency care. Participants were selected from nine sites: CMC, five government hospitals across the Punjab, Delhi, THK and Teaching Hospital Peradeniya in Kandy, Sri Lanka. The programme was conducted at CMC, with follow‐up visits to THK and Teaching Hospital Peradeniya, and focused on team‐based scenarios. The faculty included emergency clinicians from The Alfred. Participants showed improvement in the knowledge and skills of trauma reception and resuscitation. Observed programme challenges included the variety of health systems from which the participants were sourced. The Trauma Team Training Program allowed Australian emergency clinicians to impart some skills towards improving the level of trauma reception and resuscitation by 26 participants from nine sites. The team‐based systematic approach to the delivery of emergency trauma care was valued by the participants.     

Reaching across the pond: a global exchange between health systems

AIM: This article describes a unique programme begun in 2001 through a partnership between the historic St Bartholomew's Hospital and the London National Health Service Trust, in London, England and Valley Health in Winchester, Virginia, USA. Dubbed the RN International Exchange Program, selected registered nurses have the opportunity to experience first-hand healthcare delivery in another country and participate in a creative way of expanding knowledge about nursing. BACKGROUND: Professional nurses are persistent in seeking new ways to enhance nursing practice and improve patient care. This happens in several ways, including academic study, research, continuing education and dialogue with other healthcare professionals. One method to advance nursing practice is through the sharing of knowledge between nurses, both at home and across the globe. CONCLUSION: Participating nurses see this type of global educational opportunity as a once-in-a-lifetime experience that could never be duplicated in the traditional classroom setting.     

Understanding partnership practice in child and family nursing through the concept of practice architectures

A significant international development agenda in the practice of nurses supporting families with young children focuses on establishing partnerships between professionals and service users. Qualitative data were generated through interviews and focus groups with 22 nurses from three child and family health service organisations, two in Australia and one in New Zealand. The aim was to explore what is needed in order to sustain partnership in practice, and to investigate how the concept of practice architectures can help understand attempts to enhance partnerships between nurses and families. Implementation of the Family Partnership Model (FPM) is taken as a specific point of reference. Analysis highlights a number of tensions between the goals of FPM and practice architectures relating to opportunities for ongoing learning; the role of individual nurses in shaping the practice; relationships with peers and managers; organisational features; and extra‐organisational factors. The concept of practice architectures shows how changing practice requires more than developing individual knowledge and skills, and avoids treating individuals and context separately. The value of this framework for understanding change with reference to context rather than just individual’s knowledge and skills is demonstrated, particularly with respect to approaches to practice development focused on providing additional training to nurses.     

Evaluation of a programme to train Russian émigré nurses

Baj PA. International Journal of Nursing Practice 1997; 3: 40–46
Evaluation of a programme to train Russian émigré nurses
This project evaluates a curriculum model designed to specifically help Russian émigré nurses overcome major barriers to employment in the United States of America. Training cycles included: vocational English, basic nursing skills, socialization theory, transcultural care theory, clinical preceptorships, job search workshops and NCLEX-RN preparation. Specific learning objectives and outcome criteria were developed, evaluated and adapted for subsequent training cycles based on pilot programme testing.     

Focus on communication: increasing the opportunity for successful staff-patient interactions

mcgilton k., sorin‐peters r., sidani s., rochon e., boscart v. & fox m. (2010) Focus on communication: increasing the opportunity for successful staff–patient interactions. International Journal of Older People Nursing 6 , 13–24
doi: 10.1111/j.1748‐3743.2010.00210.x Objectives. This study reports on a pilot study examining the feasibility of a Patient‐Centred Communication Intervention. Aims of this study include: assessing the implementation of the communication care plans; identifying staff perceptions of the intervention; exploring changes in patients’ perceptions of care and psychosocial functioning; and exploring changes in nurses’ knowledge of and attitude towards communication with patients. Background. More than 50% of stroke survivors have speech and language impairments. Many nurses lack the specialized skills to effectively communicate with patients and therefore have difficulties understanding the patients’ needs. Design. A one‐group pre‐ post‐test design supplemented with a focus group session with nursing staff was used. The intervention consisted of developing individualized communication plans; attending at a workshop; and implementing a system to support nurses when using the plans. The plans were used over a 2‐month period. Focus groups were held with seven nurses. Results. The pilot study demonstrated feasibility. There was an excellent response rate and nurses adhered to the intervention. Conclusion. The Patient‐Centred Communication Intervention is feasible and has demonstrated potential for a larger‐scale study. Relevance to clinical practice. Providing tailored approaches to communication‐enhancement education may be necessary for changes in practice to occur.     

21st century nursing practice in Ghana: challenges and opportunities

DONKOR N.T. & ANDREWS L.D. (2011) 21st century nursing practice in Ghana: challenges and opportunities. International Nursing Review 58 , 218–224 Aim: This article is intended to stimulate critical thinking and generate fruitful discussion on nursing practice in Ghana as experienced by the authors. Its rationale is to promote exchange of ideas and creative partnerships to ensure that right decisions are made in preparing competent, adaptable and resourceful nurses who can contribute to health for all in the 21st century. The problem: The challenges of nursing education, practice and migration in Ghana seem grim. There is inadequate capacity of training institutions, low staff morale, poor distribution and serious workforce shortages. Methods: Government reports and policy documents on nursing were sourced from official websites and reviewed and discussed in the context of the international scholarly published literature. Opportunities: The authors note that despite the severe crises, a number of opportunities such as improved home‐based training, international nursing education partnerships and welfare and human resource development could foster effective nurse retention and managed migration. Conclusions: To address the issues with nursing health service delivery and nursing shortages in Ghana requires all stakeholders to move beyond the traditional stereotypes and be flexible and forward‐looking. Needed policy options include expansion of local nursing education and training capacity, collaborative training opportunities, improving the welfare and retention rates of current staff and international exchange of nurse resources that is mutually beneficial to both source and sink countries.     

Mental health nurses in primary care: Qualitative outcomes of the Mental Health Nurse Incentive Program

The Mental Health Nurse Incentive Program (MHNIP) is a government‐funded programme, which, since 2007, has enabled mental health nurses to work in primary care settings in Australia in collaboration with general practitioners (GPs) or private psychiatrists. To date, small‐scale qualitative studies have explored outcomes of the programme from the point of view of nurses, consumers, and the perceptions of GPs. This study reports on an on‐line survey of credentialed mental health nurses perceptions of outcomes of the MHNIP. Two hundred and twenty five nurses who worked in MHNIP provided detailed narrative responses that were examined using thematic content analysis. The most commonly‐cited outcomes were reductions in symptoms or improved coping, improved relationships, and enhanced community participation. Other reported outcomes included reduced hospitalization or use of state‐funded mental health services, better use of health services, the continuation or establishment of meaningful occupation, improved physical health and medication management, less use of coercive interventions, and greater independence.     

The mental health nurse: contributing to improved outcomes for patients in the emergency department.

Fundamental changes to health-care policy in Australia have led to an increase in the extent to which emergency department staff come into contact with patients experiencing mental health problems. This has been problematic for nurses, many of whom perceive themselves as lacking the skills and expertise to provide appropriate care and treatment to this client group. Psychiatric/mental health consultation-liaison nursing within the emergency department is becoming established as a means to overcome some of the problems identified. Despite this growth there is a paucity of literature evaluating the effectiveness of this position. This paper presents the results of an evaluation of the mental-health consultation-liaison nurse role in an inner city teaching hospital in Sydney Australia. The survey involved a three stage approach to data collection. The data collected at the commencement of the position included focus groups to ascertain the needs of emergency department nurses and a questionnaire designed to measure the skills, confidence and perceived knowledge of emergency department nursing and medical staff. An evaluation of the satisfaction of nurses and doctors was conducted towards the end of the three month pilot programme. The results confirmed the need for positions of this type and suggested a high level of satisfaction with the service provided.     

Australian rural remote registered nurses' experiences of learning to provide antenatal services in general practice: A pilot study

Mills J, Birks M, Francis K, Miles M, Jones J. International Journal of Nursing Practice 2010; 16 : 319–325
Australian rural remote registered nurses' experiences of learning to provide antenatal services in general practice: A pilot study This article reports on a pilot vocational study programme for provision of antenatal services in the general practice environment. The concurrent evaluation study assessed practice nurses' experiences of undertaking the pilot programme, the level and applicability of the content, and the mode of delivery. General practitioners' understanding of the role of the nurse in providing antenatal services, and the actual and potential impact of this new role on models of service delivery and care were also investigated. Women receiving care from practice nurses within this new model of service delivery and care were also of interest in this study. Findings showed that the current role of the general practice nurse in caring for pregnant women is restricted to assisting the general practitioner to complete their assessment of clients. Organizing clinical placement with a midwife was a major barrier to completing the pilot programme.     

An education–service partnership: analysis of the development of a satellite baccalaureate nursing programme

An education service partnership: analysis of the development of a satellite baccalaureate nursing programme ¶The development of a satellite education partnership between the School of Nursing at the University of Wisconsin Eau Claire and St Joseph's Hospital in Marshfield, Wisconsin, is reported. The factors which were identified as key to this successful partnership are compared to the antecedent conditions and defining attributes of the concept of collaboration as described by Henneman, Lee and Cohen. These factors include: (a) enlisting organizational support; (b)␣identifying anticipated benefits to all parties; (c) scrutiny regarding the necessity of the project; (d) communication skills and trust among partners; (e)␣a␣contract including not only how to proceed but how to disband; and (f)␣assessment of the risks of failure and whether they can be endured. The defining attributes of collaboration were met in this satellite baccalaureate programme partnership. The consequences of this collaboration are discussed and support the conceptual literature. The success of this collaboration is evidence that partnerships between nursing service, education and research are not only worth the risks but necessary for our full participation in the health care system.     

Reshaping a school health nursing service

Faced with staff shortages and a recognition that the core health surveillance system in schools could not be sustained, school nurses in one area decided to pool their skills and target surveillance to children with identified needs. Following completion of a pilot programme in October 2002, the school health nursing service has been restructured and now operates in teams who manage a corporate caseload. The core programme includes a targeted health surveillance programme, a programme of health promotion and a referral system that were modelled on the pilot project.     

Mental Health Nurse Incentive Program: contributing to positive client outcomes

Mental health conditions are likely to affect almost half of the population at some stage in their lives. Despite the magnitude and potentially serious consequences of mental illness and disorders, access to services is a significant problem. In 2007, the Mental Health Nurse Incentive Program (MHNIP) was implemented to improve access to mental health care in Australia. Mental health nurses are engaged under the MHNIP to work with general practitioners, psychiatrists, and other mental health professionals to treat clients experiencing a mental health condition. This paper presents findings from a qualitative exploration of nurses working under the MHNIP in Australia. In-depth interviews were conducted with 10 nurses currently working under the MHNIP to gain an understanding of their roles and their perceptions of the effectiveness of this new programme. Data were analysed using NVivo. Four major themes emerged: developing the role, a holistic approach, working collaboratively, and benefits to clients. The findings suggest that mental health nurses have the potential to make a significant contribution to enhancing access to, and the quality of, mental health care through flexible and innovative approaches.     

The better sleep better well‐being programme: Educating and training community healthcare nurses in developing interventions for families of infants with moderate sleep problems: a pilot study

The main aim of this pilot study was to evaluate the benefit of the Better Sleep Better Well‐being (BSBW) educational and training intervention programme regarding infants sleep problems for Community Health Care (CHC) nurses, on their perceptions on their family nursing practice skills and on their job demand, control and support. There were 6 CHC nurses who participated in the BSBW programme, and 26 nurses in the comparison group. The programme consisted of 4 sessions (8 hours per session) of lectures on the aetiology of infants sleep problems as well as on evidence‐based and family relational practices and on 20 sessions of clinical cases, scenarios, discussions and reflections. The main finding indicated that the nurses in the intervention group reported significantly higher family nursing practices skills compared to the nurses in the comparison group. The findings are promising, since they offered additional resources to the CHC nurses, in their clinical practices.     

Divergence and convergence in nursing and health care among six countries participating in ICN's 2010 Global Nursing Leadership Institute

ZITTEL B., EZZEDDINE S.H., MAKATJANE M., GRAHAM I., LUANGAMORNLERT S. & PEMO T. (2011) Divergence and convergence in nursing and health care among six countries participating in ICN's 2010 Global Nursing Leadership Institute. International Nursing Review 59 , 48–54 In 2009 the International Council of Nursing (ICN) launched, with support from Pfizer External Medical Affairs, a Global Nursing Leadership Institute (GNLI) which was again repeated in the fall of 2010. The programme, provided in English, at a location near ICN headquarters in Geneva, Switzerland, provided the opportunity for senior and executive level nursing leaders throughout the world to acquire new knowledge and skills about national and global leadership within a supportive and stimulating learning environment. Once selected for participation, GNLI members are requested to complete a country profile – a two to three page précis providing information regarding health and nursing specific to their respective country encompassing the following: the country's health system and how it is funded; identification of current or proposed changes in the health system; national demographic data such as population, gross national income, average life expectancy, number of nurses and physicians, and the top three causes of deaths; and key issues facing the health system and nursing in the country. On arrival at the Institute, participants were divided into leadership development teams, small groups of six persons each, which met throughout the week to discuss the ways in which health challenges and nursing in their respective countries both converged and diverged. Shared insights learned are presented from one such 2010 GNLI team representing nursing leaders from the countries of Australia, Bhutan, Lebanon, Lesotho, Thailand and the USA. A comparative analysis of the health profiles of their respective countries is also provided.     

Psychotherapeutic skills training for nurses on an acute aged mental health unit: A mixed‐method design

This study examines the need for, and outcomes of, a psychotherapeutic skills training programme, within an acute psychogeriatric unit. Nursing staff were surveyed to explore their training needs in psychotherapeutic skills with inpatients diagnosed with depressive, anxiety, or neurocognitive disorders. Staff were then invited to participate in a focus group (n = 6) to identify content of such training, possible barriers, and an implementation strategy. Next, to ascertain the feasibility and acceptability of such training, materials and schedules were developed and piloted with a small group of nurses (n = 8), before being administered to nurses across the unit (n = 23). Impacts of training on the confidence and competence of nurses to use such skills were investigated. Of nurses surveyed (n = 20), 80% wanted to use psychotherapeutic skills in routine practice, but only 35% had received training in such skills in the last 5 years. Focus group results identified that nurses wanted training in skills related to engaging patients, responding to resistance from patients, problem solving, reminiscence, relaxation, and cognitive behaviour therapy. Nurses who underwent the pilot training reported increases in confidence and competence in using such skills. These findings were replicated in the unit‐wide training programme and were found to be durable across a 3‐month follow‐up period. This study highlighted the training needs of nurses working in an inpatient psychogeriatric setting, approaches to implementing new skills, and benefits of training for nurses’ levels of confidence and competence in using psychotherapeutic skills.     

Educational preparation for maternal, child and family health nurses in Australia

KRUSKE S. & GRANT J. (2012) Educational preparation for maternal, child and family health nurses in Australia. International Nursing Review 59 , 200–207 Aim: The study aims to map and critique the current postgraduate educational nursing programmes offered to nurses and midwives in maternal, child and family health in Australia. Background: Nursing specialties that focus on the early years of child health and development are based on international recognition of the developmental needs of the growing infant and of the social, health and economic consequences of failing to support families to raise their children in optimal environments. Little is known whether the educational programmes that prepare maternal, child and family health nurses (MCFHNs) for practice in Australia have kept up with new knowledge and understanding of the early years of life. Methods: A survey of all maternal, child and family health education programmes offered in Australia was undertaken. Findings: Marked variations in course titles, length, content, clinical exposure and award exist across the 12 institutions offering such programmes in Australia. Many institutions provide inadequate preparation in some of the core skills required of the workforce. Conclusion: The establishment of minimum standards for the education of MCFHNs across Australia is required. This study also highlights the need for further research around the scope of practice of MCFHNs, and the role of midwives who are not nurses, in this specialty area.