A Cross-Cultural Tool To Identify Continuing Education Needs

Cost-controlled health reforms have created the need for training nurses to provide evidence-based care in new contexts. Planning for nurses' continuing education must thus target the appropriate personnel and simultaneously consider local healthcare needs and training requirements. To plan such educational programmes, a training needs analysis instrument was developed in the UK and used to compare the training needs of nurses in Australia, the USA and the UK. Below, the findings of this survey.     

Respiratory insufficiency in neuronopathic and neuropathic disorders

Twenty-nine patients with a neuronopathic or neuropathic disorder were referred for assessment of respiratory insufficiency between 1978 and 1994. Diagnoses included spinal muscular atrophy (6), chronic idiopathic demyelinating neuropathy (4), Vialetto-van Laere syndrome (3), hereditary motor and sensory neuropathy (3) and a miscellaneous group (5). We also describe seven patients with Guillain-Barre syndrome (GBS) who required long-term ventilatory support for over 6 months to 7 years after the initial illness. Respiratory insufficiency occurred as a consequence of respiratory muscle weakness, impaired bulbar function and restrictive lung defects. In some groups presentation was with progressive nocturnal hypoventilation culminating in acute respiratory failure. Five patients with GBS or chronic idiopathic demyelinating neuropathy were weaned from ventilatory support up to 18 months after the initial illness. The remaining 24 patients required continuous or nocturnal ventilatory support using intermittent positive-pressure ventilation (13), negative pressure ventilation (4), nasal-mask-delivered intermittent positive-pressure ventilation (4), nasal-mask-delivered continuous positive-pressure ventilation (3), mouthpiece-assisted ventilation by day (2) and rocking bed (1). None have been weaned from support after a period of ventilation ranging from one month to 10 years. Eight patients have subsequently died.      

Mycobacterial Infections After Renal Transplantation

Mycobacterial infections occurred in 11 of 633 (1.7 per cent)recipients of successful renal transplants. There were no casesof tuberculosis in patients receiving chemoprophylaxis, butamongst those who did not receive prophylaxis disease occurredin six of the 27 (22 per cent) high-risk patients. The majorcause of morbidity during treatment was renal allograft rejection,largely due to reduction in immunosuppressive drug therapy.     

What do midwifery mentors need? Priorities and impact of experience and qualification

Mentoring is a feature of most professional education programmes, although its purpose may vary. In some cases, a mentor performs solely a supporting role, while in others it may include assessment of practice competence. The aim of this study was to explore and prioritize the needs of midwifery mentors and investigate any relationship between these and duration of experience and/or level of qualification. A two-stage cross-sectional correlational study of 82 mentors was carried out in a maternity unit in the southwest of England. Content, univariate and bivariate analysis of the data were performed. The focus group identified 15 needs which formed the basis of the subsequent questionnaire. Overall ranking showed that 'guidance' and 'frequent shifts' were important to all mentors. Of least importance were 'choice in allocation' and 'involvement in selection'. Statistically significant findings emerged relating to mentors' academic level of qualification, background of direct entry or Registered Nurse, length of experience and place of work. The programme followed by the students also had an impact. Some of the conclusions were that mentors need more overt recognition of their role, breaks between students and consideration of their area of work and the type of student allocated. Tutors need to offer increased availability, support, guidance and feedback. Students should have frequent shifts rostered with their mentor and be encouraged to provide feedback. A 'mentor pyramid of needs' was developed which could be used by educators and managers to audit and prioritize mentor support. The findings of the study are of particular relevance in the context of recent regulatory body standards.