Lynda Wilson

Global Health Competencies for Nurses in the Americas

This article reports the findings from an online survey of nursing faculty from the United States, Canada, Latin America, and Caribbean countries to identify their perceptions about global health competencies for undergraduate nursing students. A list of global health competencies for medical students developed by the Association of Faculties of Medicine of Canada Resource Group on Global Health and the Global Health Education Consortium was adapted for nurses and translated from English to Spanish and Portuguese. The competencies were divided into six subscales, and respondents rated each competency on a 4-point Likert scale, with high scores reflecting strong agreement that the competency was essential for undergraduate nursing students. E-mail invitations and links to the online survey were distributed using a nonprobability convenience sampling strategy. This article reports findings only from the respondents to the English and Spanish surveys. The final sample included 542 responses to the English survey and 51 responses to the Spanish survey. Cronbachs alpha reliability coefficients for the subscales ranged from .78 to .96. The mean values for all 6 subscales and for each of the 30 items were greater than 3.0 for the respondents to the Spanish survey, and the mean values for 27 of the items were greater than 3.0 for the respondents to the English survey. These findings suggest that respondents perceived the competencies as essential global health competencies for undergraduate nursing students in the Americas. Narrative comments written by respondents indicate additional competencies and specific concerns about adding additional content to an already full curricula. Results of this study can be used to guide faculty deliberations about global health competencies that should be incorporated in the nursing curricula.

Identifying Interprofessional Global Health Competencies for 21st-Century Health Professionals

BACKGROUND At the 2008 inaugural meeting of the Consortium of Universities for Global Health (CUGH), participants discussed the rapid expansion of global health programs and the lack of standardized competencies and curricula to guide these programs. In 2013, CUGH appointed a Global Health Competency Subcommittee and charged this subcommittee with identifying broad global health core competencies applicable across disciplines. OBJECTIVES The purpose of this paper is to describe the Subcommittees work and proposed list of interprofessional global health competencies. METHODS After agreeing on a definition of global health to guide the Subcommittees work, members conducted an extensive literature review to identify existing competencies in all fields relevant to global health. Subcommittee members initially identified 82 competencies in 12 separate domains, and proposed four different competency levels. The proposed competencies and domains were discussed during multiple conference calls, and subcommittee members voted to determine the final competencies to be included in two of the four proposed competency levels (global citizen and basic operational level - program oriented). FINDINGS The final proposed list included a total of 13 competencies across 8 domains for the Global Citizen Level and 39 competencies across 11 domains for the Basic Operational Program-Oriented Level. CONCLUSIONS There is a need for continued debate and dialog to validate the proposed set of competencies, and a need for further research to identify best strategies for incorporating these competencies into global health educational programs. Future research should focus on implementation and evaluation of these competencies across a range of educational programs, and further delineating the competencies needed across all four proposed competency levels.

Global health diplomacy: An integrative review of the literature and implications for nursing

Abstract The increasing interconnectedness of the world and the factors that affect health lay the foundation for the evolving practice of global health diplomacy. There has been limited discussion in the nursing literature about the concept of global health diplomacy or the role of nurses in such initiatives. A discussion of this concept is presented here by the members of a Task Force on Global Health Diplomacy of the American Academy of Nursing Expert Panel on Global Nursing and Health (AAN EPGNH). The purpose of this article is to present an integrative review of literature on the concept of global health diplomacy and to identify implications of this emerging field for nursing education, practice, and research. The steps proposed by Whittemore and Knafl (2005) were adapted and applied to the integrative review of theoretical and descriptive articles about the concept of global health diplomacy. This review included an analysis of the historical background, definition, and challenges of global health diplomacy and suggestions about the preparation of global health diplomats. The article concludes with a discussion of implications for nursing practice, education, and research. The Task Force endorses the definition of global health diplomacy proposed by Adams, Novotny, and Leslie (2008) but recommends that further dialogue and research is necessary to identify opportunities and educational requirements for nurses to contribute to the emerging field of global health diplomacy.

Teaching Chilean mothers to massage their full-term infants: effects on maternal breast-feeding and infant weight gain at age 2 and 4 months.

The purpose of this study was to evaluate the effects of massage on infant weight gain and exclusive maternal breast-feeding of an intervention that involved teaching mothers to massage their full-term infants. The sample included 100 healthy newborn infants who were receiving primary healthcare at 3 health centers in a low-income neighborhood of Santiago, Chile. The control group included 65 infants and the massage group included 35 infants. During their second well-child clinic visit, clinic nurses provided instruction to massage-group mothers about how to massage their infants, based on the methods of the Babys First Massage program (http://www.babysfirstmassage.com/Scripts/default.asp). Mothers were encouraged to massage their infants for 10 to 15 minutes at least once a day, starting when their infants were 15 days old. There was no difference in the mean weights of the infants between the massage and control groups at baseline, but at age 2 months, massage group infants weighed significantly more than control-group infants. There were no weight differences between the 2 groups at age 4 months. There were no differences between the 2 groups on the incidence of exclusive maternal breast-feeding at age 2 or 4 months. The findings suggest that teaching mothers to massage their newborn infants may have a beneficial effect on the infants early weight gain. There is a need for additional studies to evaluate the effect of maternal massage on other health and welfare outcomes for both mothers and infants.

Supporting and retaining preceptors for NNP programs: results from a survey of NNP preceptors and program directors.

Preceptors are vital resources for the clinical education of healthcare providers, especially neonatal nurse practitioners (NNPs). With the increasing number of NNP programs, including distance accessible programs, there is a need for research to identify effective strategies for recruiting, preparing, and supporting preceptors in their roles. This article presents a review of existing literature and describes findings from a survey of NNP program directors in the United States and from a survey of preceptors for a distance-based NNP program in an Academic Health Sciences Center in the southern United States. The survey focused on current practices in recruiting and supporting preceptors and on perceptions of strategies that would facilitate success and enhance preceptor satisfaction with their roles. The article concludes with presentation of a model based on survey findings and recommendations from the literature that can guide NNP faculty and researchers in identifying effective strategies for recruiting, preparing, and supporting clinical preceptors.

Identifying global health competencies to prepare 21st century global health professionals: report from the global health competency subcommittee of the consortium of universities for global health.

As universities increase their focus on global health-related professional education, the need for specific competencies and outcomes to guide curriculum development is urgent. To address this need, the chair of the Education Committee of the Consortium of Universities for Global Health (CUGH) appointed a Subcommittee to determine if there is a need for broad global health core competencies applicable across disciplines, and if so, what those competencies should be. Based on that work, this paper (a) discusses the benefits of developing interprofessional and discipline-specific global health competencies; (b) highlights themes that emerged from a preliminary review of existing related literature; and (c) reviews the process used to identify two levels of interprofessional global health competencies.

Research nurse manager perceptions about research activities performed by non-nurse clinical research coordinators

OBJECTIVES There has been limited research to document differences in roles between nurses and non-nurses who assume clinical research coordination and management roles. Several authors have suggested that there is no acknowledged guidance for the licensure requirements for research study coordinators and that some non-nurse research coordinators may be assuming roles that are outside of their legal scopes of practice. There is a need for further research on issues related to the delegation of clinical research activities to non-nurses. METHODS This study used nominal group process focus groups to identify perceptions of experienced research nurse managers at an academic health science center in the Southern United States about the clinical research activities that are being performed by non-nurse clinical research coordinators without supervision that they believed should only be performed by a nurse or under the supervision of a nurse. RESULTS A total of 13 research nurse managers volunteered to be contacted about the study. Of those, 8 participated in two separate nominal group process focus group sessions. The group members initially identified 22 activities that they felt should only be performed by a nurse or under the direct supervision of a nurse. CONCLUSIONS After discussion and clarification of results, activities were combined into 12 categories of clinical research activities that participants believed should only be performed by a nurse or under the direct supervision of a nurse.

The Zambian HIV Nurse Practitioner Diploma Program: Preliminary Outcomes from First Cohort of Zambian Nurses

This article describes the implementation and evaluation of a program to prepare HIV Nurse Practitioners in Zambia. Thirty nurses from all nine Zambian provinces participated in this program. Data on a variety of indicators were collected at baseline and throughout the one-year program including student and supervisor assessments, student performance on pre- and post-tests, clinical and case study assessments, documentation of care in patients’ health records, and their performance on final oral and written examinations. Findings indicated that the students were able to achieve the identified competencies and that their supervisors perceived that they would be able to implement their expanded skills to improve care for patients with HIV and AIDS in Zambia. Lessons learned from this initial pilot project will be used to expand the program in order to ensure successful task-shifting to address the critical shortage of health workers in Zambia in the context of the HIV/AIDS epidemic.

Teaching of the Integrated Management of Childhood Illness strategy in undergraduate nursing programs

Objetivo: se describio y analizo la ensenanza de la estrategia Atencion Integrada a las Enfermedades Prevalentes de la Infancia en la formacion de licenciados en enfermeria en Brasil. Metodo: estudio transversal que integro una investigacion internacional multicentrica. Fueron invitados a acceder al cuestionario electronico, 571 cursos identificados en el pais. La recoleccion de datos fue realizada de mayo a octubre de 2010. Resultados: 142 cursos respondieron al cuestionario, siendo tres cuartos privados. La estrategia Atencion Integrada a las Enfermedades Prevalentes de la Infancia integraba el contenido teorico de 64% y practico de 50% de los cursos. La practica ocurria principalmente en servicios de atencion primaria. El modulo tratamiento era el menos ensenado y pocos cursos poseian los manuales de la estrategia. Todos evaluaban los estudiantes con pruebas; y en las privadas si valoraba ademas la participacion en clase. Las instituciones publicas tenian mas docentes capacitados en la estrategia. Conclusion: a pesar de su relevancia en el cuidado al nino, la estrategia Atencion Integrada a las Enfermedades Prevalentes de la Infancia no esta incorporada en todos los cursos de licenciatura en enfermeria en Brasil y falta capacitacion docente y material didactico para hacerlo.Descriptores: Atencion Integrada a las Enfermedades Prevalentes de la Infancia; Salud del Nino; Enfermeria; Educacion Superior.OBJETIVO: descrever e analisar o ensino da Estrategia Atencao Integrada as Doencas Prevalentes na Infância, praticado na graduacao em enfermagem no Brasil. METODO: estudo transversal que integrou pesquisa internacional. Foram convidados a acessar o questionario eletronico 571 cursos de graduacao identificados no pais. A coleta de dados foi realizada de maio a outubro de 2010. RESULTADOS: responderam ao questionario 142 cursos, sendo 3/4 (tres quartos) privados, com algumas diferencas do ensino entre as instituicoes publicas e privadas. A estrategia Atencao Integrada as Doencas Prevalentes na Infância integrava o conteudo teorico de 64% dos cursos e o conteudo pratico de 50%. Unidades basicas de saude eram os locais mais usados para ensino pratico. O modulo tratamento era o menos ensinado e poucos cursos possuiam os manuais da estrategia. Todos utilizavam provas para avaliacao, mas a participacao em aulas era mais considerada nas privadas. Houve diferenca somente quanto a capacitacao docente na estrategia, com maioria nas instituicoes publicas. CONCLUSAO: apesar da relevância da estrategia Atencao Integrada as Doencas Prevalentes na Infância no cuidado a crianca, seu conteudo nao e abordado em todos os cursos de graduacao e constatam-se falta de capacitacao docente e de material didatico.

Perspectives of nursing faculty in Africa on global health nursing competencies

BACKGROUND It is important to define global health competencies for health professionals. To date, we know little about perspectives of nurses in Africa where environments are particularly challenging. PURPOSE The purpose was to describe perceptions of nursing faculty in Africa about global health competencies and compare those to faculty from the Americas. METHODS A 32-item online survey with a convenience sample of nursing faculty. RESULTS Data from 63 nurses in 21 African countries and 618 in the Americas were analyzed. Competencies related to Social and Environmental Determinants of Health were awarded relatively higher scores. Competencies related to globalization of health and health care were ranked relatively lower. This was similar across regions. DISCUSSION Nursing education should address the social implications for health. CONCLUSION Participants in all three regions considered Social and Environmental Determinants of Health as a priority. These data help set educational priorities in a setting where educational and training resources are limited.