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A look back at our course for nurses

News | 19/06/2020

It has been 12 months since the first week of teaching for the implementation and improvement science course in Lilongwe, Malawi. Faculty members and participants were set to complete the course back in Malawi’s capital in May this year, but travel restrictions meant the course came to its conclusion remotely.

The Implementation Science course, which was designed specifically for nurses, has supported participants in their own research projects to establish positive and achievable change in their own burn units.

Why Nurses?

The need to integrate nurses in research has been highlighted by the nursing now campaign and WHO. The campaign recognises that nurses are at the heart of most health systems and should be integral to the integration of quality improvement research.

Nurses checking a chart

Participant nurses undertaking research  

Nurses working in low and middle income countries (LMIC’s) often lack the support to develop, undertake and lead their own research. This is due in part to the undervaluing of nurses’ contribution to research but also from a lack of resources, staff, training, education, and leadership.The implementation and improvement science course that was developed and run by the Centre for Global Burns and funded by NIHR sought to address this lack in knowledge and resources. Participants were given key training into quality improvement and were introduced to nurses who had successfully undertaken their own quality improvement projects. All nurses on the course were supported in developing their own quality improvement project addressing a real-life issue in their burn units.

The Projects

Below is a list of the projects that participants developed, undertook and led in their local hospitals, along with the key aims for quality improvement. (Some projects were undertaken in pairs).

  • Improving vital signs and fluid balance monitoring for HDU burns patients.Aim:  To improve vital signs and fluid administration documentation on patients that are in the burn HDU from 40% to 90% from September 2019 to January 2020.
  • Improving the decontamination process of surgical instruments.Aim:  To improve compliance with the decontamination processes for surgical instruments at Queen Elizabeth Hospital main theatres by January 2020.
  • Improving pain control for burns patients during dressing changes at Mzuzu Central Hospital  Aim:  To improve pain control in for burns patients during dressing changes from 10% to 70% during dressing changes by December 2019 in the male and female surgical wards.
  • Hand hygiene practice among health workers in the burns unit at Kamuzu Central Hospital.Aim:  To improve hand hygiene practice among healthcare workers in the burns unit from 5% to 50% by December 2019.
  • Improving documentation following dressing changes at Mzuzu Central Hospital. Aim:  To improve documentation following burns dressing changes in the male surgical ward at MCH from 5% to 50% by January 2020.
  • Keeping the privacy of male and female patients at the burns unit.Aim:  To improve privacy and dignity among male and female burn patients who have been admitted to the ward at the time of dressing using a patient screen from 15% to 50% by December 2020

Dissemination

Participants were due to present their projects in full at the end of the final week of training at a conference with fellow nurses, nurse leaders, hospital administrators and quality improvement directors. Further dissemination of their work was to come from international conferences that some participants were to attend. Unfortunately, due to COVID-19 these conferences were no longer possible, but we hope to share the projects in an upcoming eBook. To see our existing eBook which focuses on our 2019/20 highlights, click here.

Despite restrictions, participants have been holding events within their hospitals to share their ideas to the wider units.

As part of a course assignment, nurses have filmed elevator pitches addressed to their hospital directors. This is part of the training that helps nurses take leadership in securing necessary resources and support when implementing their quality improvement projects from their research. Below is an example video of these elevator pitches:

For the Future

We hope that within the local hospitals, participants of the course can train and encourage colleagues to undertake their own quality improvement research and place greater value on research as part of their role. The Centre will continue mentorship of LMIC nurses in the coming year with NIHR funding, inspiring  more nurses to become part of research led change in their field.

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