WhatsApp-Delivered Intervention for Continued Learning for Nurses in Pakistan During the COVID-19 Pandemic: Results of a Randomized-Controlled Trial

Levels of nurse disaster preparedness: A systematic review and meta-analysis

AIM

To evaluate nurses' disaster preparedness and the impact of publication year, departments, disaster response experience and disaster training on nurses' level of disaster preparedness.

BACKGROUND

With the frequent occurrence of global disaster events. As key medical relief members, nurses' preparedness has a significant impact on disaster response effectiveness.

DESIGN

Systematic review and meta-analysis METHOD: CNKI, Wanfang, VIP, SinoMed, PubMed, Embase, CINAHL, Web of Science and the Cochrane Library. The search period was from the creation of the database to December 4, 2024. A random effects model was used to summarize the total mean scores for the three sub-dimensions of the Disaster Preparedness Evaluation Tool. Subgroup analyses were performed to explore sources of between-study heterogeneity.

RESULTS

A meta-analysis of 21 studies with 9222 nurses from three countries. The total mean DPET score (3.95, 95 % CI [3.81,4.10], P = 0.000), with scores on the disaster knowledge, disaster skills and disaster management dimensions were (4.06, 95 % CI [3.92,4.21], P = 0.000), (3.89, 95 % CI [3.73,4.05], P = 0.000), (3.83, 95 % CI [3.65,4.00], P = 0.000). Subgroup analyses showed an increase in nurses' total mean DPET scores after COVID-2019; the average total DPET score of emergency department nurses and nurses without disaster relief experience or training was relatively weak.

CONCLUSIONS

Nurses' disaster preparedness was moderate and disaster skills and management abilities needed strengthening. In the emergency department, nurses without disaster response experience and training had relatively low levels of disaster preparedness. These findings may guide nursing educators in educating nurses about disaster care.

A Mixed-methods Systematic Review of Just-in-time Training Interventions During Health Emergencies: Types of Interventions and Development Processes

AIMS

The World Health Organization (WHO) Health Emergency Programme funded three systematic reviews to inform development of guidance for emergency preparedness in health emergencies. The current review investigated the type of learning interventions that have been developed and used during health emergencies, and how they were developed.

METHODS

We searched PubMed, CINAHL, Communication and Mass Media Complete (EBSCO), and Web of Science. Study quality was appraised by WHO-recommended method-specific checklists. Findings were extracted using a narrative summary approach.

RESULTS

187 studies were included. Studies were split between online, in-person, and hybrid modalities, conducted mostly by hospitals and universities, and most frequently training nurses and doctors. Studies emphasized experiential learning to develop and reinforce skills; online learning for knowledge dissemination; multi-sectoral partnerships, institutional support and carefully constructed planning task forces, rapid training development and dissemination, and use of training models.

CONCLUSION

It Most studies evaluated only knowledge or self-confidence of trainees. Relatively few assessed skills; evaluations of long-term outcomes were rare. Little evidence is available about comparative effectiveness of different approaches, or optimum frequency and length of training programming. Based on principles induced, six recommendations for future JIT training are presented.

Effectiveness and uptake of WhatsApp-based HIV microlearning for healthcare workers in remote South African clinics: A pragmatic, mixed-methods, cluster-randomised trial

AIM/OBJECTIVE

To design and test the usability of case-based HIV microlearning lessons using WhatsApp groups. This paper reports on effectiveness and uptake.

BACKGROUND

South Africa has the largest antiretroviral treatment program globally. National guidelines are regularly updated. Ongoing training of healthcare workers is vital but complicated by infrastructural, financial and human resource shortages. Innovative solutions are needed.

DESIGN

A pragmatic, mixed methods, parallel group, cluster randomised trial.

METHODS

Nurses and community health workers (CHWs) at 50 clinics in the Eastern Cape were invited to participate. Online questionnaires tested knowledge and retention of knowledge; retrospective folder reviews measured changes in patient care. Patient folders were sampled purposively pre-/post-intervention for clinical points learned. Descriptive and inferential analyses were performed.

RESULTS

Uptake and participation were good: 232 (79 %) nurses and 207 (76 %) CHWs participated. 96 % of nurses and 88 % of CHWs read the lessons within two weeks. There was a significant intervention effect on knowledge, based on the online questionnaires: nurses (0.5 units; 95 % CI 0.11-1.0; p = 0.0499) and CHWs (0.7 units; 95 % CI 0.2-1.3; p = 0.004). 1083 patient folders were reviewed to compare changes in patient care between the study arms. Adjusting for pre-care differences between the arms, the intervention increased correct patient care by 21 % ( 95 % CI 10 %-32 %; p < 0.001) in the year after the training.

CONCLUSIONS

WhatsApp-based microlearning improves knowledge and patient care. This, with the companion paper's data showing that it is well received and accepted, makes it a valuable option for simple, accessible, scalable continuing medical education for HCWs.

Emergency infection prevention and control training in fragile, conflict-affected or vulnerable settings: a scoping review

BACKGROUND

It is uncertain what could be the best training methods for infection prevention and control when an infectious disease threat is active or imminent in especially vulnerable or resource-scarce settings.

METHODS

A scoping review was undertaken to find and summarise relevant information about training modalities, replicability and effectiveness of IPC training programmes for clinical staff as reported in multiple study designs. Eligible settings were conflict-affected or in countries classified as low-income or lower-middle income (World Bank 2022 classifications). Search terms for LILACS and Scopus were developed with input of an expert working group. Initially found articles were dual-screened independently, data were extracted especially about infection threat, training outcomes, needs assessment and teaching modalities. Backwards and forwards citation searches were done to find additional studies. Narrative summary describes outcomes and aspects of the training programmes. A customised quality assessment tool was developed to describe whether each study could be informative for developing specific future training programmes in relevant vulnerable settings, based on six questions about replicability and eight questions about other biases.

FINDINGS

Included studies numbered 29, almost all (n = 27) were pre-post design, two were trials. Information within the included studies to enable replicability was low (average score 3.7/6). Nearly all studies reported significant improvement in outcomes suggesting that the predominant study design (pre-post) is inadequate to assess improvement with low bias, that any and all such training is beneficial, or that publication bias prevented reporting of less successful interventions and thus a informative overview.

CONCLUSION

It seems likely that many possible training formats and methods can lead to improved worker knowledge, skills and / or practice in infection prevention and control. Definitive evidence in favour of any specific training format or method is hard to demonstrate due to incomplete descriptions, lack of documentation about unsuccessful training, and few least-biased study designs (experimental trials). Our results suggest that there is a significant opportunity to design experiments that could give insights in favour of or against specific training methods. "Sleeping" protocols for randomised controlled trials could be developed and then applied quickly when relevant future events arise, with evaluation for outcomes such as knowledge, practices, skills, confidence, and awareness.

Learning interventions and training methods in health emergencies: A scoping review

BACKGROUND

Keeping the health workforce and the public informed about the latest evolving health information during a health emergency is critical to preventing, detecting and responding to infectious disease outbreaks or other health emergencies. Having a well-informed, ready, willing, and skilled workforce and an informed public can help save lives, reduce diseases and suffering, and minimize socio-economic loss in affected communities and countries. Providing "just in time" support and opportunities for learning in health emergencies is much needed for capacity building. In this paper, 'learning intervention' refers to the provision of ad-hoc, focused, or personalized training sessions with the goal of preparing the health workers for emergencies or filling specific knowledge or skill gaps. We refer to 'training methods' as instructional design strategies used to teach someone the necessary knowledge and skills to perform a task.

METHODS

We conducted a scoping review to map and better understand what learning interventions and training methods have been used in different types of health emergencies and by whom. Studies were identified using six databases (Pubmed/Medline, Embase, Hinari, WorldCat, CABI and Web of Science) and by consulting with experts. Characteristics of studies were mapped and displayed and major topic areas were identified.

RESULTS

Of the 319 records that were included, contexts most frequently covered were COVID-19, disasters in general, Ebola and wars. Four prominent topic areas were identified: 1) Knowledge acquisition, 2) Emergency plans, 3) Impact of the learning intervention, and 4) Training methods. Much of the evidence was based on observational methods with few trials, which likely reflects the unique context of each health emergency. Evolution of methods was apparent, particularly in virtual learning. Learning during health emergencies appeared to improve knowledge, general management of the situation, quality of life of both trainers and affected population, satisfaction and clinical outcomes.

CONCLUSION

This is the first scoping review to map the evidence, which serves as a first step in developing urgently needed global guidance to further improve the quality and reach of learning interventions and training methods in this context.

Designing and implementing a training program on surgical hand scrubbing, wearing surgical cap and surgical mask, gowning, and gloving using HMD-based virtual reality technologies for nursing students: an exploration of student perceptions

Objective

The aim of this study is to determine the steps of a training program utilizing Head-Mounted Display (HMD) based Virtual Reality Technology to enhance nursing students' skills in surgical hand scrubbing, wearing surgical cap and surgical mask, gowning and gloving, and to evaluate students' perceptions toward the program.

Methods

The study aimed to investigate the potential applications of HMD-Based Virtual Reality Technology in Surgical Hand Scrubbing, Wearing Surgical Cap and Surgical Mask, Gowning and Gloving Program for nursing students, as well as students' perceptions toward this technology. The research was conducted with a focus group consisting of second-year nursing students in Osmaniye/Turkey, between January and June 2022, and the training program was implemented in five stages: Analysis, Design, Development, Implementation, and Evaluation. The program was evaluated with a focus group of nursing students. Focus group discussions were conducted to provide insights into students' experiences, feedback, and perceptions of the program.

Results

A vast majority of participants (92.5%) reported feeling fully immersed in the operating room environment during the virtual reality (VR) experience. Notably, all students acknowledged the potential of HMD-Based Virtual Reality Technology to enrich their understanding of surgical hand scrubbing, wearing surgical cap and surgical mask, gowning and gloving procedures, surpassing conventional instructional models. While many participants found the experience exhilarating (85.1%), a considerable portion reported a decline in engagement after repeated exposures (88.8%). Overall, participants welcomed the integration of VR technology into education, expressing optimism about its capacity to facilitate additional instructional modules (74.4%). Moreover, they conveyed satisfaction with the opportunity to engage with the VR application, emphasizing its significant educational value (81.4%).

Conclusion

Based on these findings, we can suggest that virtual reality technology has the potential to have an impact on nursing students' education. The majority of students expressing a sense of presence in the operating room highlights the value of this method in education. However, the reported boredom after repeated experiences by most participants underscores the importance of diversifying the program and introducing innovative approaches to keep students engaged.

Training a Continent: A Process Evaluation of Virtual Training on Infection Prevention and Control in Africa During COVID-19

BACKGROUND

Strengthening infection prevention and control (IPC) capacity was identified as a key intervention to prepare African Union member states to curb the COVID-19 pandemic. As part of the Africa Taskforce for Coronavirus, which helped implement the Africa Joint Continental Strategy for COVID-19 Outbreak response, the IPC Technical Working Group (IPC TWG) was convened to coordinate the development of IPC core components for preparedness, response, and recovery from COVID-19. As part of the IPC TWG's work, the Africa Centres for Disease Control and Prevention, in collaboration with the Infection Control Africa Network, delivered virtual IPC training sessions targeted to African Union member states. We aimed to undertake a process evaluation of this training to inform and improve both ongoing and future programming.

METHODS

The scope of the evaluation was agreed upon through discussion with the training organizers and advisory members and a design workshop. A mixed-methods approach was used; data collection was partly prospective and partly retrospective due to the rapid start of some of the training activities. Existing available data included: usage analytics, the content of questions posed during the webinar and community of practice, and participant feedback survey results. In addition, in-depth qualitative interviews were conducted with a sample of webinar participants.

RESULTS

The rapid development of this training was efficient and responsive. The training reached more than 3,000 participants across the 2 rounds, but the numbers varied substantially by location. Participants engaged well during the question period during each webinar, but the asynchronous community of practice was less utilized during the evaluation time frame. Many participants appreciated the African focus of the webinars and gave positive feedback on the practical and context-specific content.

CONCLUSIONS

The move toward online training provides an important opportunity to improve IPC across the African continent.

Building capacity of primary health care workers and clients on COVID-19: Results from a web-based training

BACKGROUND

Health care workers (HCWs) in the first line of care play critical roles in providing the correct information about the coronavirus disease to the community. The objective of the study was to determine the effect of virtual training on the knowledge, attitude, and preventive practices among PHC workers and their clients in the prevention and control of coronavirus disease.

METHODS

A quasi-experimental intervention virtual training, using a before and after design amongst HCWs and clients was conducted at primary health care facilities in two Local Government Areas of Lagos State. The study instruments were pre-tested questionnaires for both HCWs and their clients. which investigated knowledge of symptoms, modes of disease transmission, methods of prevention, and preventive practices. Changes in knowledge, attitudes, and practices were compared pre-and post-intervention. The level of significance was set at p < 0.05.

RESULTS

Sixty-three HCWs (out of 100 recruited at baseline) and 133 clients (out of the initial 226) completed the study. The mean ages of the HCWs and clients were 39.2±9.9 and 30.9±5.0 years respectively. At the baseline, the HCW's knowledge was good in the domains of symptoms, modes of transmission, and preventive measures. The training led to a higher but not significant (p> 0.05) increase in the level of knowledge. Contact with trained HCWs was found to lead to significantly (P < 0.001) higher levels of knowledge, attitudes, and preventive practices. amongst clients.

CONCLUSION

The training was effective in improving the knowledge of both the trained HCWs and their clients.

Factors and optimizations of healthcare workers' perception in alternative care facilities

Background

Diverse measures have been carried out worldwide to establish Alternative Care Facilities (ACFs) for different ends, such as receiving, curing or isolating patients, aiming to cope with tremendous shock in the urban medical system during the early passage of the COVID-19 epidemic. Healthcare workers always felt anxious and stressed during multiple major public health emergencies in medical facilities. Some active measures to improve healthcare workers' perceptions, such as temporary training, workflow improvement, and supplementary facilities, were proved insufficient in several past public health emergencies. Therefore, this study aims to analyze the contributing factors of the healthcare workers' perceptions of the ACFs in this pandemic, which can help find an innovative path to ensure their health, well-being and work efficiency.

Method

This paper conducted semi-structured in-depth interviews with the world's first batch of healthcare workers who have worked in ACFs through a qualitative study based on Grounded Theory. The healthcare workers interviewed from Heilongjiang, Shandong, Fujian, and Hubei provinces, have worked in one of the four different ACFs built in Wuhan. The results are obtained through the three-level codes and analyses of the interview recordings.

Results

The factors affecting the perception of healthcare workers in ACFs during the epidemic situation can be summarized into five major categories: individual characteristics, organization management, facilities and equipment, space design, and internal environment. The five major categories affecting the composition of perception can be further divided into endogenous and exogenous factors, which jointly affect the perception of healthcare workers in ACFs. Among them, individual characteristics belong to endogenous factors, which are the primary conditions, while other categories belong to exogenous factors, which are the decisive conditions.

Conclusion

This paper clarifies factors affecting the perception of healthcare workers in ACFs and analyzes the mechanism of each factor. It is posited that the passive strategies are a promising solution to protect healthcare workers' health, improve their work efficiency, and help reduce the operation stress of ACFs. We should train multidisciplinary professionals for future healthcare and enhance collaborations between healthcare workers and engineers. To sum up, this paper broadens new horizons for future research on the optimization of ACFs and finds new paths for alleviating healthcare workers' adverse perceptions of ACFs.