i-manager's Journal on Nursing (JNUR)


Volume 9 Issue 2 May - July 2019

Research Paper

The Effect of Early Skin to Skin Contact in Term Neonates After C-Section on Breastfeeding Choice at the Time of Discharge

Batool Pouraboli* , Mahdieh Estabraghi **, Younes Jahani ***
* Department of Pediatric and neonatal nursing, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran.
** NICU Nursing, Nursing and Midwifery Kerman School of Razi, University of Medical Sciences, Kerman, Iran.
*** Research Center for Social Determinant of Health, Institute of Futures Studies in Health University of Medical Sciences, Kerman, Iran.
Pouraboli, B., Estabraghi, M., and Jahani, Y. (2019). The Effect of Early Skin to Skin Contact in Term Neonates After C-Section on Breastfeeding Choice at the Time of Discharge. i-manager's Journal on Nursing, 9(2), 1-8. https://doi.org/10.26634/jnur.9.2.15981

Abstract

The events happening in the early hours of life are very effective on the survival and development of the child, and the separation of the newborn from the mother after birth, even for a short term, can disrupt successful breastfeeding at this important time. The current study aimed to determine the effect of skin-to-skin contact of mother and newborn immediately after the cesarean section on breastfeeding choice at the time of discharge. This randomized controlled interventional study was performed on 80 mothers and newborns after the cesarean section with spinal anesthesia in two groups of skin-to-skin contact and routine care. The type of feeding selected by the mother was asked at the time of admission and discharge, and it was compared between the two groups. Data were analyzed using SPSS 22 for, logistic regression, Chi-square and Fisher tests. The results showed that the selection of breastfeeding at the time of discharge in the skin-to-skin contact group was slightly higher than that of the routine care group, but there was no statistically significant difference between the two groups regarding the significance level of the study (p-value >0.05),. 96.3% of the mothers of the skin contact group reported that the skin-to-skin contact was effective in choosing exclusive breastfeeding for their newborns. The results of this study show that although a high percentage of mothers tends to breastfeed their newborns, in practice almost half of them do not succeed in breastfeeding their newborns exclusively. According to the results of the study, and since the selection of breastfeeding in the skin contact group was at a higher level, skin-to-skin contact did not have a significant effect on the selection of breastfeeding. It seems that a study with a larger sample size will produce more positive results.

Research Paper

Nurses’ Job Dissatisfaction and Associated Factors at Public Sector Tertiary Care Hospital in Pakistan: A Qualitative Study

Shazia Bano* , Nousheen Akber Pradhan**, Narjis Rizvi***, Farid Midhet****
*-*** Community Health Sciences, Aga Khan University, Karachi, Pakistan.
**** Qassim University College of Medicine, Saudi Arabia.
Bano, S., Pradhan, N. A., Rizvi, N., and Midhet, F. (2019). Nurses’ Job Dissatisfaction and Associated Factors at Public Sector Tertiary Care Hospital in Pakistan: A Qualitative Study. i-manager's Journal on Nursing, 9(2), 9-19. https://doi.org/10.26634/jnur.9.2.16352

Abstract

Nurses, the mainstay of the healthcare system, occupy a significant position at all tiers of health care. Inadequate number of nursing staff affects the quality of nursing care and also elevate the burden of workload on existing staff. This study aimed to assess factors influencing nurses' job satisfaction and retention in a public sector tertiary care hospital in Pakistan. An exploratory qualitative study was used to explore nurses' perception of job satisfaction at work. Study was carried out during July to September, 2016 at public sector tertiary care hospital of Pakistan using purposive sampling technique. Study participants were nurses, providing direct patient care and head nurses in 10 different units of hospital. Focus Group Discussions were conducted with staff nurses from eleven different clinical units. In-depth interviews with head nurses and Human Resource/Administration personnel. Human Resource policy related documents were also reviewed. Lack of career growth prospects and in-service education and trainings, professional discrimination between physicians and nurses, high work load and shortage of staff were the important factors indicated by participants for job dissatisfaction. Nurses also expect recognition for their work and respect from their co-workers. Job satisfaction among nurses can potentially increase quality of nursing care. The study highlighted the need to implement fair and equitable policies for nursing workforce at hospital. Simple measures for better management practices could significantly improve the working conditions and hence retention of nurses in the longer run.

Research Paper

Experiences of Undergraduate Nursing Students about Reflective Journaling

Nafisa Iqbal * , Muhammad Ishtiaq **, Hawa Gul ***, Khalil Ahmed Jatt ****
*-*** Shifa college of Nursing, University of ShifaTameer-e MillatUniversity, Islamabad, Pakistan.
**** Pakistan Institute of Medical Sciences, Islamabad, Pakistan.
Iqbal, N., Ishtiaq, M., Gul, H., and Jatt, K. A. (2019). Experiences of Undergraduate Nursing Students about Reflective Journaling. i-manager's Journal on Nursing, 9(2), 20-25. https://doi.org/10.26634/jnur.9.2.16379

Abstract

To explore the experiences of undergraduate nursing students about reflective journaling. A qualitative descriptive study was carried out in a private nursing college. A Convenience sample consisted of all the PRN (Latin term: pro re nata) extended first year students were selected. In depth interviews were carried out in the month of November, 2018 by the trained data collector. The three major categories emerged from data “Benefits of writing reflective journaling”, “challenges faced by the students in writing reflective journaling” and “Future implementation of the strategy”. Benefits that has been highlighted such as post-reading at the end of the session, remembrance of the content, improvement in writing skills etc. Challenges were reported as: time limitation and difficulty in writing the log. Application of this strategy in different subjects with providing feedback was recommended by the students. The reflective journaling was found to be more beneficial for undergraduate nursing students with few manageable challenges. The findings of the research will help the nursing educator to adopt reflective journaling as a teaching learning strategy in class room setting during teaching of different subjects.

Research Paper

Effectiveness of Structured Teaching Programme on Behavioral Problems and Toilet Training Among the Mothers of Toddlers

Rashmi Negi* , Shweta Handa**
*-** Faculty of Nursing, SGT University, Gurugram, Haryana, India.
Negi, R., and Handa, S. (2019). Effectiveness of Structured Teaching Programme on Behavioral Problems and Toilet Training Among the Mothers of Toddlers. i-manager's Journal on Nursing, 9(2), 26-35. https://doi.org/10.26634/jnur.9.2.16131

Abstract

Behavioral problems among the toddlers are common and result from the child's need for autonomy and exploration. Toddler might like to continue to excrete whenever tension in the bowel or bladder occurs. An important part of dealing with the issue of toilet training is to educate parents about the signs of readiness for their child to begin. A pre experimental research approach and one group pre test post test design was adopted to find out the effectiveness of structured teaching programme on behavioral problems and toilet training. This study was conducted on mothers of toddlers admitted in pediatric wards at RMMCH, Chidambaram. Data were collected through structured questionnaire. The total sample comprises of 50 mothers of toddlers who full fill the inclusion criteria. This study assessed the knowledge and attitude among mothers of toddlers regarding behavioral problems and toilet training, and found that the mothers had inadequate knowledge related to behavioral problems and toilet training. The study concluded that the structured teaching programme was effective in improving knowledge and attitude of mothers regarding behavioral problems and toilet training.

Review Paper

Using an Acuity Tool that Interfaces with the Electronic Health Record to Balance Nursing Workload

Mary Hawkins* , Amber Messier**, Kimberly Myers***, Ashley Nihsen****, Sobia*****
* Nebraska Methodist Health System in Omaha, Nebraska.
**,*** Methodist Hospital, Omaha, Nebraska.
**** Methodist Jennie Edmundson Hospital, Council Bluffs, Iowa.
***** Nebraska Methodist College, Omaha, Nebraska.
Hawkins, M., Messier, A., Myers, K., Nihsen, A., and Kniewel, M. (2019). Using an Acuity Tool that Interfaces with the Electronic Health Record to Balance Nursing Workload, i-manager's Journal on Nursing, 9(2), 36-42. https://doi.org/10.26634/jnur.9.2.16250

Abstract

Matching nursing resources with patient needs and acuity while maintaining patient safety and quality of care has become increasingly difficult due to the increase in nursing shortage. Nurses have growing concerns about equity and satisfaction regarding patient assignments. The purpose of this project was to discover the effects of utilizing an acuity tool that interfaces with the Electronic Health Record (EHR) to accurately assess patient acuity and balance the nursepatient workload. A search plan was developed to identify keywords within several article databases. Existing literature identified evidence on how an electronic acuity-based staffing tool balances nurse-to-patient workload and allows for consistent, high-quality patient care while managing healthcare costs. An acuity measurement tool interfaced with the EHR can be an excellent resource for optimizing nurse staffing and workload. Electronically predicting a patient's acuity provides a powerful tool for healthcare managers to allocate resources. Such estimations and predictions on patient's acuity can be produced from vast amounts of electronic healthcare data, information technology, and computational intelligence techniques. Using tactical decision-making and resource allocation with different mathematical optimization models will support acuity predictions and help to balance nurse workloads.

Review Paper

A Prevalence of Hepatitis C in Pregnant Women of Pakistan: A Systematic Review

Shiyam Sunder Tikmani* , Sumera Aziz Ali**, Sayyeda Reza***, Prashant Tikmani****
*-*** Department of Community Health Sciences, Aga Khan University, Karachi, Pakistan.
**** Shaheed Zulfiqar Ali Bhutto Institute of Science and Technology, Karachi, Pakistan.
Tikmani, S. S., Ali, S. A., Reza, S., and Tikmani, P. (2019). A Prevalence of Hepatitis C in Pregnant Women of Pakistan: A Systematic Review, i-manager's Journal on Nursing, 9(2), 43-49. https://doi.org/10.26634/jnur.9.2.16341

Abstract

Hepatitis C is a major public health problem affecting 3% of the population around the world. However, worldwide prevalence of hepatitis C in pregnant women is variable. In Pakistan alone prevalence of hepatitis C in pregnant women varies from 0.7% to 36%. Unfortunately, a rising prevalence of Hapatitis C Virus (HCV) in pregnant women is making them vulnerable to complications. Therefore, the purpose of this analysis is to estimate a prevalence rate that represents the actual burden of hepatitis C in pregnant women; by pooling the prevalence of hepatitis C in pregnant women reported in 17 studies from Pakistan. Pakmedinet, PubMed through the National Center for Biotechnology Information (NCBI), MEDLINE and Google Scholar search engines were employed for literature search. Studies published in the English language from the year 2001 and onwards have been included in this review. Since there is a paucity of studies related to this topic, no literature were excluded from the published literature fulfilling inclusion criteria. The quality of each study was assessed using the Newcastle–Ottawa Scale. Paper review was done by two reviewers with data extracted and compiled in MS Excel. The registration number of the study is CRD42016042341. A total of 17 studies from Pakistan reported prevalence of hepatitis C in pregnant women; 3 each were conducted in Islamabad and Khyber Pakhtunkhwa respectively, 5 in Punjab and 6 studies were conducted in Sindh province. From 17 studies, 1,24,635 pregnant women screened for hepatitis C were pooled and of them, 8342 women were found to be positive for Anti-HCV. The overall prevalence of hepatitis in pregnant women of Pakistan was 6.7% (95% CI: 6.5-6.8) while its range varied from 0.7% to 36%. In Pakistan, the overall prevalence of hepatitis C in pregnant women was 6.7%. Nonetheless these findings cannot be disregarded and should be used by policymakers for considering the antenatal screening of hepatitis C in pregnant women.

Case Study

Missing Identity: To Whom Do I Belong?

Mamoona Iram* , Saleema Khowaja**
*-** Aga Khan University School of Nursing and Midwifery, Karachi, Pakistan.
Iram, M., and Khowaja, S. (2019). Missing Identity: To Whom Do I Belong?.i-manager's Journal on Nursing, 9(2), 50-53. https://doi.org/10.26634/jnur.9.2.16350

Abstract

The trends of pregnancy by using third party sperms are being popular to deal with the challenges of infertility that raise different ethical questions. Keeping into consideration of ethical points, it is important to examine the psycho-social wellbeing and rights of the donor-conceived child. The aim of this study was to identify a scenario related to some ethical issue and analyze and comment on it. The scenario was analysed in light of ethics, social, legal and Muslim context. The analysis revealed that the sperm donor should ponder over the wellbeing of the unborn child before sperm donation and parents should respect the child's right before taking a decision. It is recommended that healthcare professionals should consider the entire dimensions of the patient's contexts before proposing such controversial treatment modalities.