Stanford University School of Medicine, Stanford, California, USA.
ReSurge International, Sunnyvale, California, USA.
BMJ Glob Health. 2020 Feb 6;5(2):e001981. doi: 10.1136/bmjgh-2019-001981. eCollection 2020.
Continued nursing education and development can reduce mortality and morbidity of patients and can alleviate the shortage of healthcare workers by training of nurses for high-demand skill sets. We reviewed patterns of educational interventions and strategies in initiating behaviour change, improving patient outcomes or knowledge for nurses in low- and middle-income countries (LMICs).
The study searched the MEDLINE (PubMed), Embase, CINAHL, Google Scholar and Web of Science databases. The study included interventional studies on continued nursing education from 2007 to 2017. Of the 6216 publications retrieved, 98 articles were included and analysed by three independent reviewers.
Of the 98 studies that met inclusion criteria, five were randomised controlled trials, two were qualitative in design and the remaining 91 were quasi-experimental, before-and-after studies. Of these studies, the median sample size of participants was 64, and the majority were conducted in Asia (53.1%). During the 10-year study period, 20.4% was conducted in 2015, the highest proportion, with a general increase in number of studies over time from 2007 to 2017. Main themes that arose from the review included train-the-trainer models, low-dose/high-frequency models, use of multiple media for training, and emphasis on nurse empowerment, strong international partnerships, and the integration of cultural context. Overall, the studies were limited in quality and lacked rigorous study design.
Continued nursing education in LMICs is essential and effective in improving nurses' knowledge base, and thus patient outcomes and quality of care. Long-term, randomised studies are needed to understand how training strategies compare in impact on nurses and patients.
持续的护理教育和发展可以降低患者的死亡率和发病率，并通过培训护士掌握高需求技能来缓解医疗保健人员的短缺。我们回顾了在中低收入国家（LMICs）中启动行为改变、改善患者结局或护士知识的教育干预措施和策略模式。
该研究在 MEDLINE（PubMed）、Embase、CINAHL、Google Scholar 和 Web of Science 数据库中进行了检索。该研究包括 2007 年至 2017 年期间针对持续护理教育的干预性研究。在检索到的 6216 篇文献中，有 98 篇文章被 3 位独立评审员纳入并进行了分析。
在符合纳入标准的 98 项研究中，有 5 项为随机对照试验，2 项为定性设计，其余 91 项为准实验、前后对照研究。这些研究中，参与者的中位数样本量为 64 人，大多数研究在亚洲进行（53.1%）。在 10 年的研究期间，20.4%的研究是在 2015 年进行的，这是比例最高的一年，研究数量随着时间的推移从 2007 年到 2017 年呈总体增长趋势。从综述中出现的主要主题包括培训师模式、低剂量/高频率模式、多种媒体培训的使用，以及强调护士赋权、强大的国际伙伴关系和文化背景的融合。总体而言，这些研究的质量有限，缺乏严谨的研究设计。
在 LMICs 中进行持续护理教育对于提高护士的知识库，从而改善患者结局和护理质量至关重要。需要进行长期的、随机的研究，以了解培训策略对护士和患者的影响如何进行比较。
