Background. Aspects of genetics/genomics are increasingly being incorporated into medicine. Nurses are crucial in helping transform healthcare through genomic nursing (Loud, 2010). However the integration of genetics/genomics into nursing education has been sporadic (Dodson and Lewallen, 2011). Influencing its uptake into practice may be via nurses who are already utilising genetics/genomics in their practice (adopters) and nurses who may lead the way and encourage others (opinion leaders) to do likewise. Identifying the characteristics of such adopters and opinion leaders within nursing may provide useful information for more wide-scale detection of these individuals to support a strategy for the inclusion of genetics/genomics into nursing practice. Methods. Five change behaviour theories were used to inform the study including the Theory of Planned Behaviour and the Diffusion of Innovations. A mixed methods approach was taken over two phases. In Phase 1 experts in the field of genetics/genomics and nursing were contacted to gain a consensus on four potential genetic indicators of adoption (GIAs), which would identify a nurse who had adopted genetics/genomics. In Phase 2, oncology nurses and practice nurses completed a questionnaire to identify the characteristics and demographic indicators of nurse genetic adopters and opinion leaders. Results. A consensus (>75%) was achieved for all four GIAs to be included as indicators of adoption of genetics/genomics within nursing practice (Phase 1). Individuals identified (in Phase 2) were subcategorised into six different groups, including genetic adopters and opinion leaders. There were 18 identifying features that defined an adopter, with some of the main features being Openness to Experience (p<0.001), seeing the relevance of genetics/genomics to their patient group (p<0.001) and talking to colleagues about genetics/genomics (p<0.001). There were six features that identified an opinion leader, including academic achievement (p=0.007), level of perceived influence over others (p<0.001) and being high on the opinion leadership scale (p<0.001). Two of the biggest barriers to incorporation by nurses were lack of time for adopters and a lack of local study sessions for opinion leaders. Conclusion. It has been identified that nurses can be categorised in terms of their relationship to genetics/genomics, through a number of distinguishing characteristics. It will be important to further identify and clarify these and other characteristics through the development of additional tools. These data can inform approaches to promote a greater integration of genetics/genomics into nursing practice, ultimately improving patient healthcare.

O Projeto de profissionalizaÃÃo dos trabalhadores da Ãrea de Enfermagem (PROFAE), lanÃado em 1999, pelo MinistÃrio da SaÃde, tinha como objetivo promover melhoria de qualidade da atenÃÃo à saÃde por meio da oferta de qualificaÃÃo profissional aos trabalhadores de enfermagem , empregados nas redes publicas e privadas, sem a devida formaÃÃo. A escola de SaÃde PÃbica do Cearà ( ESP-CE) atuou como operadora e executora das turmas do PROFAE, qualificando mais de cinco mil auxiliares e de 700 tÃcnicos de enfermagem, no perÃodo de 2002 a 2005.Considerada que, no CearÃ, poucas sÃo as pesquisas de avaliaÃÃo de cursos profissionalizantes, no Ãmbito do PROFAE estudo proposto teve como objetivo avaliar o Curso TÃcnico de Enfermagem, ofertado na parceria PROFAE/ESP-CE, sob a Ãptica dos egressos e supervisores acerca do desenvolvimento do curso; e quantitativa, como intuito de delinear o perfil socioeconÃmico dos egressos e relacionar o processo de trabalho com a formaÃÃo recebida no PROFAE. Foram realizados dois grupos focais com participaÃÃo, em media, de 10 egressos em cada, e um grupo focal com 10 supervisores, utilizando-se roteiros semi-estruturados. As falas foram categorizadas e analisadas à luz de Bardin. Aplicou-se um questionÃrio estruturado a 269 egressos procedentes de seis municÃpios beneficiados com o curso. Observou-se que o cursos promoveu melhoria dos conhecimentos e habilidades dos tÃcnicos de enfermagem constatada pela avaliaÃÃo satisfatÃria dos sujeitos, no que se refere à metodologia da ProblematizaÃÃo, a qualidade do material didÃtico, a atuaÃÃo do corpo tÃcnico-pedagÃgico e o sistema de avaliaÃÃo. Os aspectos polÃtico-institucionais nÃo foram bem avaliados. As dificuldades apontadas foram relacionadas essencialmente à logÃstica do curso, falta de apoio da gestÃo municipal, limitaÃÃo dos campos de estagio e gerenciamento de ajuda de custo. Quanto ao perfil dos egressos, houve reafirmaÃÃo do sexo feminino na Enfermagem (90%). A maioria (73%) pertencia à faixa etÃria entre 30 e 49 anos e era proveniente de famÃlias de baixo nÃvel socieconÃmico e de baixo instruÃÃo. Dos egressos, 97% permaneciam inseridos na saÃde, predominantemente no setor publico, atuando em serviÃos hospitalares. Verificou-se a tendÃncia dos egressos que permanecem da mesma forma. Quanto aos que atuam como tÃcnico, a qualidade, os resultados ressaltam, de maneira consistente, o efeito positivo do curso sobre o trabalho realizado. Conclui-se ,portanto, que o curso ampliou as possibilidades de inserÃÃo e permanÃncia de trabalhadores qualificados no setor saÃde; propiciou complementaÃÃo da qualificaÃÃo profissional e ampliaÃÃo do conhecimento tÃcnico fundamentais que permitirÃo apoiar a revisÃo da proposta do curso de tÃcnico de Enfermagem da ESP-CE, no que diz respeito aos aspectos pedagÃgicos e gerenciais, o que leva a reflexÃo acerca da importÃncia da avaliaÃÃo continua dos cursos / The professionalization of Project workers from the area of ​​Nursing (PROFAE), launched in 1999 by the Ministry of Health, aimed to promote quality improvement of health care by offering professional training to nursing staff, employed in public networks and private, without proper training. The School of Public Health of Cearà (ESP-CE) provider, and served as executor of PROFAE classes, qualifying more than five thousand auxiliaries and 700 nursing staff in the period 2002 to 2005.Considerada that, in CearÃ, few research evaluation of vocational courses within the PROFAE proposed study was to evaluate the Practical Nursing Course, offered in partnership PROFAE / ESP-EC, in terms of the graduates and supervisors about the course development, and quantitative, as in order to clarify the socioeconomic profile of graduates and to relate the process of working with the training received in PROFAE. Two focus groups were conducted with the participation, on average, of 10 graduates in each, and a focus group with 10 supervisors, using semi-structured. The statements were categorized and analyzed in the light of Bardin. We applied a structured questionnaire to 269 graduates coming from six municipalities benefit from the course. It was observed that the course improved the knowledge and skills of nursing staff noted the satisfactory completion of subjects, with regard to the methodology of Curriculum, the quality of materials, the performance of the technical-pedagogical and evaluation system. The political and institutional aspects have not been well evaluated. The difficulties mentioned were primarily related course logistics, lack of support of municipal management, limiting the fields of training and management expenses. The profile of graduates, there was reassurance in nursing females (90%). The majority (73%) belonged to the age group between 30 and 49 years old and came from families of low socioeconomic and low education. Of the graduates, 97% remained embedded in health, predominantly in the public sector, working in hospital services. There was a tendency of graduates who remain in the same way. As for those who act as technical quality, the results highlighted consistently, the positive effect on the course work. We conclude therefore that the course increased the possibilities for integration and retention of skilled workers in the health sector, provided completion of professional training and expansion of basic technical knowledge that will support the review of the proposed course of technical ESP-Nursing EC, with regard to pedagogical and managerial aspects, which leads to reflection on the importance of continuous evaluation of courses.

Philosophiae Doctor - PhD / Midwives play a critical role in the care of pregnant women from the first antenatal visit, through to the delivery and the postpartum period. The education of midwives has however become a concern, not only in South Africa but in many countries for a multitude of reasons. Evidence suggests that South Africa is devoted to reducing the maternal mortality rates as reflected in the Negotiated Service Delivery Agreement, signed in 2010, which identifies reductions in maternal and child/neonatal mortality rates as key strategic outcomes for the South African Health sector. However, by 2015 the set Millennium Development goals, specifically goal 4 (to reduce child mortality) and 5 (to improve maternal health) were not met and were replaced by Sustainable Development Goals, specifically goal 3 (to ensure healthy lives and promote wellbeing for all at all stages). This lag in meeting the indicators for improving the health of the population is associated in some respects to the education and training of health professionals.

The aim of this research is to identify the critical variables influencing the growth process in baccalaureate nursing programs, to establish the system structure of relationships between those variables, to incorporate the variables and their relationships into a dynamic decision-oriented simulation model of the growth process, and to investigate the validity and usefulness of the simulation model.

Palliative care is often not considered during care or is considered too late in the patient’s healthcare journey to provide much benefit. The underutilization of palliative care contributes to increased healthcare costs, poor patient outcomes, and decreased patient satisfaction. The practice-focused question guiding this evidence-based practice (EBP) project was whether an education program would increase nursing knowledge regarding palliative care criteria. The program was developed using Rogers’s diffusion of innovation model and a literature review to create educational tools and achieve a sustainable EBP change. An evidence-based decision tree was developed and used as a tool for teaching and learning. Other assessment tools included a pretest, posttest, and program evaluation. Twenty staff nurses from the same department participated in the education program. Registered nurses were selected based on the amount of regular face to face patient contact they have with patients. The education program increased knowledge of palliative care by 58% and validated the need for nursing education of palliative care criteria. The program might be beneficial to disseminate to all nurses who have patient contact. The potential for positive social change generated from findings of this project include improving satisfaction, quality of care, and outcomes of the patients and families benefiting from palliative care services.

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Indiana University-Purdue University Indianapolis (IUPUI) / Debriefing is the most significant component of simulation, yet the impact of debriefer training for this critical time of learning has not been reported. Although training of debriefers in the use of a structured debriefing method has been recommended by nursing organizations and regulating bodies, a description of the impact of training on the understanding and application of debriefing within nursing programs is largely unknown. Debriefing for Meaningful Learning© (DML) is a structured, evidencebased debriefing method that promotes the development of clinical reasoning among prelicensure nursing students. DML has been adopted for use across the curriculum throughout nursing education. However, little is known regarding how debriefers are trained in this method and how that training impacts their understanding and application of the method. The DML Inventory (DMLI), was developed and tested for this research study, and used to assess and document 234 debriefers’ understanding of the central concepts of DML and subsequent application of DML behaviors during simulation debriefing with prelicensure baccalaureate nursing students. Statistically significant differences were found between those debriefers who had and had not been trained in DML. Statistically significant differences were also found in the understanding of the DML central concepts, and in the application of DML based on the types of training the debriefers received. viii The data indicate that DML trained debriefers consistently apply more DML behaviors than those who had not received training, and that multiple sources of training resulted in a more consistent application of DML debriefing behaviors. Furthermore, understanding the central concepts of DML resulted in debriefers consistently applying more debriefing behaviors consistent with the DML design. This study contributes to the growing body of knowledge of debriefing in nursing education and training in evidence-based debriefing methods, by providing a tested instrument that can be used to assess debriefers using DML. The findings also demonstrate the impact of the type of training on how structured debriefing methods are then implemented in teaching-learning environments, which can be used to improve future training.

ABSTRACT Background: Community Health Workers are faced with challenges in the community when conducting home visits. The re-engineering of Primary Health Care services in South Africa brought a new cadre of Community Health Workers. The role of Community Health Workers relieved the workload and activities which were done by Primary Health Care nurses. Community Health Workers had to conduct home visits as one of the activities. The Community Health Workers experienced challenged during home visits. Aim: This study was conducted to describe and explore the challenges Community Health Workers perceived regarding home visits in the Tshwane district Method: Semi-structured interviews were undertaken with a purposive sample of fourteen Community Health Workers conducting home visits. The individual face to face interviews concentrated on the challenges perceived regarding home visits. All the interviews were transcribed verbatim and analysed using the tesch method. Findings: The challenges perceived were that of the community, logistical, occupational, human resource and managerial. The participants expressed the need for respect and acceptance by the community during home visits. Improved planning related to delegation of households by Outreach Leaders and provision of material resources. The support by managers for career development through training and education for various disease prevention. Conclusion: the findings suggest that training of Community Health Workers need to be formalised and in-service education related to home visits should be planned, structured and supported by the Department of Health. Key words Challenges, Perceived, Community Health Workers, Home visit. / Dissertation (MNurs)--University of Pretoria 2020. / Nursing Science / MNurs / Unrestricted

Introduction: Simulation-based learning is a teaching methodology, which provides the students with a learning opportunity in an environment that simulates the clinical settings, where mistakes and learning can happen without any risk of patient harm. However, despite of its importance, there is a lack of empirical studies about simulation-based learning in the United Arab Emirates. Aim: To explore and describe the perceptions of the nurse educators regarding simulation-based learning in the undergraduate nursing education and the hindering and facilitating factors for effective simulation-based learning in the United Arab Emirates in order to develop strategies for effective simulation-based learning. Research design: A complex mixed method design. Methods: The study design comprised four phases. • Phase one: qualitative exploratory, descriptive, and contextual design, in which purposive sampling was used to collect data from 18 nurse educators working in two nursing colleges in the United Arab Emirates through individual interviews. Data was analysed using thematic analysis with the assistance of NVivo QSR software version 12. • Phase two is a descriptive quantitative design, in which sampling for the entire population was used to collect data from 45 nurse educators working in two nursing colleges in the United Arab Emirates using a modified Simulation Culture Organizational Readiness Survey. Data was analysed with the assistance of the Statistical Package for Social Sciences Software using descriptive and inferential statistics. • Phase three is meta-inferences: where mixing of data from both phase one and phase two was done to guide the process of phase four. The first three phases represent the exploratory sequential mixed method. • Phase four is a modified e-Delphi technique: Purposive sampling was used among academic leaders and the nurse educators in the two nursing colleges, to develop a consensus on the strategies for effective simulation-based learning in the undergraduate nursing education. In this phase, data was collected through emails and online questionnaires. One hundred percent agreement on the proposed strategies granted, which indicated that the participants had reached the consensus. Results and conclusion: Based on the nurse educators and academic leaders’ needs and perceptions, the SBL strategic recommendation developed, these recommendations that are aligned with the international simulation-based learning recommendation and practices. There was evidence between the perceived influencing factors and the utilization of simulation-based learning in the nursing colleges. This study evolved in many implications and recommendation in regard to the strategies for effective simulation-based learning to benefit nursing education. Key terms / concepts: Simulation, Simulation-based learning, Undergraduate nursing education, Strategies, Nurse educators, Effectiveness, Academic leaders. / Thesis (PhD)--University of Pretoria, 2021. / Nursing Science / PhD / Unrestricted

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