Heart Failure as an Entry Point for Severe Cardiovascular Disease in Sub-Saharan Africa: 10-Year Experience With Nurse-Led Diagnosis and Treatment at District Hospitals in Rural Rwanda

Eberly, Lauren A.; Rusingiza, Emmanuel; Park, Paul; Ngoga, Gedeon; Dusabeyezu, Symaque; Mutabazi, Francis; Harerimana, Emmanuel; Mucumbitsi, Joseph; Nyembo, Philippe F.; Borg, Ryan; Gahamanyi, Cyprien; Mutumbira, Cadet; Ntaganda, Evariste; Kwan, Gene F.; Bukhman, Gene

doi:10.1016/s0735-1097(18)31197-5

Cited by 2 publications

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“…An integrative review study identified knowledge deficits as a barrier to nurses participating in diagnosis and prognosis-related communication as full members of the clinical team and recommended interprofessional training focused on diagnosis discussions as essential to promoting diagnostic collaboration (Newman, 2016). With further education and support, nurses have been found to be safe and effective diagnosticians in the area of eye-led lesions, chronic obstructive pulmonary disease, health failure, and delirium (Mohite et al, 2016;Strong et al,2014;Eberly, 2018;Wand et al, 2014). Strengthening instruction on the diagnostic process in the didactic and clinical nursing curriculum will better prepare nurses to participate on the diagnostic team and ultimately achieve better diagnostic outcomes for patients.…”

Section: Introductionmentioning

confidence: 99%

The critical need for nursing education to address the diagnostic process

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The National Academy of Medicine recently concluded that diagnostic errors represent an urgent national concern. Their first recommendation to address this issue called for promoting the key role of the nurse in the diagnostic process. Registered nurses across clinical settings significantly contribute to the medical diagnostic process, though their role in diagnosis has historically gone unacknowledged. In this paper, we review the history and current state of diagnostic education in pre-licensure registered nurse preparation, introduce interprofessional individual-and team-based competencies to improve diagnostic safety, and discuss the next steps for nursing education. Nurses educated and empowered to fully participate in the diagnostic process are essential for achieving better, safer patient outcomes.

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Section: Introductionmentioning

confidence: 99%

The critical need for nursing education to address the diagnostic process

et al. 2021

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Task-sharing to support paediatric and child health service delivery in low- and middle-income countries: current practice and a scoping review of emerging opportunities

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Background Demographic and epidemiological changes have prompted thinking on the need to broaden the child health agenda to include care for complex and chronic conditions in the 0–19 years (paediatric) age range. Providing such services will be undermined by general and skilled paediatric workforce shortages especially in low- and middle-income countries (LMICs). In this paper, we aim to understand existing, sanctioned forms of task-sharing to support the delivery of care for more complex and chronic paediatric and child health conditions in LMICs and emerging opportunities for task-sharing. We specifically focus on conditions other than acute infectious diseases and malnutrition that are historically shifted. Methods We (1) reviewed the Global Burden of Diseases study to understand which conditions may need to be prioritized; (2) investigated training opportunities and national policies related to task-sharing (current practice) in five purposefully selected African countries (Kenya, Uganda, Tanzania, Malawi and South Africa); and (3) summarized reported experience of task-sharing and paediatric and child health service delivery through a scoping review of research literature in LMICs published between 1990 and 2019 using MEDLINE, Embase, Global Health, PsycINFO, CINAHL and the Cochrane Library. Results We found that while some training opportunities nominally support emerging roles for non-physician clinicians and nurses, formal scopes of practices often remain rather restricted and neither training nor policy seems well aligned with probable needs from high-burden complex and chronic conditions. From 83 studies in 24 LMICs, and aside from the historically shifted conditions, we found some evidence examining task-sharing for a small set of specific conditions (circumcision, some complex surgery, rheumatic heart diseases, epilepsy, mental health). Conclusion As child health strategies are further redesigned to address the previously unmet needs careful strategic thinking on the development of an appropriate paediatric workforce is needed. To achieve coverage at scale countries may need to transform their paediatric workforce including possible new roles for non-physician cadres to support safe, accessible and high-quality care.

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Heart Failure as an Entry Point for Severe Cardiovascular Disease in Sub-Saharan Africa: 10-Year Experience With Nurse-Led Diagnosis and Treatment at District Hospitals in Rural Rwanda

Cited by 2 publications

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The critical need for nursing education to address the diagnostic process

The critical need for nursing education to address the diagnostic process

Task-sharing to support paediatric and child health service delivery in low- and middle-income countries: current practice and a scoping review of emerging opportunities

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