Volume 9, Issue 5, 2021

Effectiveness of the Validated Clinical Nursing Protocol for Vaccination Process Management
Original Research
Background: In Egypt, the routine training of the vaccinator nurses is not a part of ministry of health and population' continuous educational system. While, this system provides only short educational seminars for vaccinators, which are insufficiently control daily vaccinators' practice variation. Thus, the study aimed at providing a referenced protocol for vaccination process management after evaluating its effectiveness on the vaccinator nurses' knowledge and practices regarding obligatory childhood vaccination. Aim: This study aimed to evaluate the effectiveness of the validated clinical nursing protocol for vaccination process management. Method: A Quasi-experimental research design was utilized from the first of January 2020 to the end of December 2020 at Mansoura district primary health care facilities. Total sample size of 160 vaccinator nurses, as well as, 384 caregivers chosen by using convenient sampling technique. Data were collected.by using three tools; self-administrated vaccinator nurses' knowledge test; observation checklist for evaluating vaccinator nurses’ practice; and checklist to assess caregivers’ satisfaction related to the delivered vaccination services. Results: Mean scores for vaccinator nurses’ knowledge, and practice, as well as caregivers’ satisfaction post-protocol were significantly higher than the pre-protocol mean scores. A huge effect size of the vaccination protocol on the three targeted study outcomes was also observed. Conclusion: the validated vaccination protocol was fundamental in the skills’ acquisition of vaccinator nurses; variation reduction of vaccination practice; and enhancement of caregivers’ satisfaction. Recommendations: More in-service training and supportive supervision are requested for vaccinator nurses to effectively manage vaccination process. Furthermore, there is a need for including of a vaccination-training curriculum in health training institutions curriculums.
American Journal of Nursing Research. 2021, 9(5), 176-181. DOI: 10.12691/ajnr-9-5-4
Pub. Date: September 24, 2021
Effect of Web Based Health Education on Young Adults Weight Maintenance and Nutritional Knowledge
Original Research
Background: Lack of nutritional knowledge may lead to weight gain which led to several chronic disease as diabetes and hypertension. Therefore, the need to focus on the increasement of nutritional knowledge is essential. Aim: The aim of this study was to assess the effect of Web Based Health Education on Young Adults Weight and Nutritional Knowledge Design: A quasi-experimental research design was utilized to accomplish this study. Sample type: Purposive sampling technique was used to recruit Subjects and Setting: Total number of 132 young adults, who were invited through World Wide Web (WWW) for globalization. Anthropometric data were collected, and nutritional knowledge was evaluated. Tools: Three online self-administered questionnaires were used to assess nutritional health status of participants and their nutritional knowledge. Results: The present study revealed that the weight average decreased from 77.69(14.1) before the intervention to 68.84(13.3) 3 month after intervention and to 72.12(12.32) 6 months after intervention. There was statistically significant difference before and after 3 months of interventions (p=0.000) related to level of knowledge regarding nutrition. Conclusion: This study concluded that the majority of participants had higher score of knowledge after 3 and 6 months of intervention related to healthy nutrition which help in weight loss. Recommendation: This study was recommended to apply web-based health education for overweight and obese adults in different setting and worksite and integrate web-based education in all healthy promotion programs to enhanced healthy behavior.
American Journal of Nursing Research. 2021, 9(5), 171-175. DOI: 10.12691/ajnr-9-5-3
Pub. Date: September 17, 2021
Barriers Contributing to Policy Deviation: A Mixed Methods Study of Policymakers and Frontline Nurses
Original Research
Deviation from the policy at the point of care is frequently studied as a balancing act of health professionals, resulting in a lesser focus on barriers leading to such deviation. This study investigated practices of policy application or deviation with two aims. One, to assess if the frontline nursing staff is applying or deviating from the policy. Two, to understand the barriers that lead to policy deviation from the perspectives of policymakers and frontline staff. An explanatory sequential mixed methods design was applied, with a quantitative survey first (n=50) and then two qualitative focus group discussions. Data was collected in 2018 within a Local Health District (LHD) in New South Wales, Australia. Most respondents (96%) rated policy application to be the usual practice at work. Despite that, survey respondents (54%) agreed to have discretionally acted against policy requirements. Frontline nurses deviated from policy when they perceived a lack of functional merit. Examples of barriers that contributed to deviation from policy are unstructured policy review, inadequate support for policy writing and communication challenges during policy implementation. These barriers were jeopardizing appropriate policy development and implementation and often negatively influenced the functional merit of policy. A few known strategies, such as appointing policy champions and promoting policy messages through a combination of channels, should be considered to mitigate the identified barriers. Future studies can explore effective ways to manage policy deviation rather than relying on street-level bureaucracy.
American Journal of Nursing Research. 2021, 9(5), 164-170. DOI: 10.12691/ajnr-9-5-2
Pub. Date: August 11, 2021
Effect of Implementing Clinical Pathway among Pregnant Women with Pyelonephritis on Childbirth and Neonatal Outcome
Original Research
Aim of this study to determine the effect of implementing clinical pathway among pregnant Women with pyelonephritis on childbirth and neonatal outcomes. Design: A quasi –experimental design. Setting: The study was conducted at outpatient’s clinic of obstetric department at Shebin EL-Kom Teaching Hospital, Menoufia University hospital at Shebin EL-Kom. Subjects: Convenient sample was used all stuff nurses in the obstetric department (20 nurses) as well as 50 pregnant mothers will selected and divided into two equal groups; intervention group (25mothers who received clinical pathway during second trimester of pregnancy) and control group (25 mothers who not received clinical pathway). Instruments: interviewing questionnaire for pregnant mothers, & nurses and Observation checklist of neonatal outcomes. Results: The study revealed that there was highly significant improvement in women knowledge after implementing clinical pathway, there was significant improvement in nurse’s knowledge, childbirth, and neonatal outcomes. Conclusion: There was significant improvement was obvious among women relief of their reported symptoms and their knowledge about pyelonephritis and measures to relieve it. Recommendations: Improve the quality of health care provided through routine screening of pregnant women and applying workshops for nurses to improve their knowledge about pyelonephritis during pregnancy.
American Journal of Nursing Research. 2021, 9(5), 156-163. DOI: 10.12691/ajnr-9-5-1
Pub. Date: July 18, 2021