Ridge Laura Jean, Liebermann Erica Jean, Stimpfel Amy Witkoski, Klar Robin Toft, Dickson Victoria Vaughan, Squires Allison Patricia
New York University Rory Meyers College of Nursing, New York, New York, USA.
J Adv Nurs. 2022 Sep;78(9):3000-3011. doi: 10.1111/jan.15282. Epub 2022 May 9.
To explore the resources supporting current nurse practice in the post-emergency country of Liberia, using the nursing intellectual capital framework, as nurses work to meet the targets set by Government of Liberia's Essential Package of Health Services.
Case study.
Data were collected in Liberia February-June 2019. Direct observation, semi-structured interviews and photographs were used to investigate how nurse practice is supported. Field notes, transcripts and photographs were coded using both directed and conventional content analysis. Reports were then generated by code to triangulate the data.
Thirty-seven nurses at 12 health facilities participated. The intellectual capital supporting inpatient and outpatient nurse practice differs in important ways. Inpatient nurse practice is more likely to be supported by facility-based protocols and trainings, whereas outpatient nurse practice is more likely to be supported by external protocols and trainings, often developed by the Liberian government or non-governmental organizations. This can lead to uneven provision of inpatient protocols and trainings, often favouring private facilities. Similarly, inpatient nurses rely primarily on other nurses at their facilities for clinical support while outpatient nurses often have external professional relationships that provided them with clinical guidance.
Much has been accomplished to enable outpatient nurses to provide the primary- and secondary-care target services in the Essential Package of Health Services. However, as the Liberian government and its partners continue to work towards providing certain tertiary care services, developing analogous protocols, trainings and clinical mentorship networks for inpatient nurses will likely be fruitful, and will decrease the burden on individual facilities.
Nurses are often expected to meet new service provision targets in post-emergency states. Further research into how best to support nurses as they work to meet those targets has the potential to strengthen health systems.
在利比里亚这个经历过紧急状态后的国家，利用护理智力资本框架探索支持当前护士执业的资源，因为护士们致力于实现利比里亚政府基本卫生服务包设定的目标。
案例研究。
2019年2月至6月在利比里亚收集数据。采用直接观察、半结构化访谈和照片来调查护士执业是如何得到支持的。使用定向和常规内容分析法对实地记录、访谈记录和照片进行编码。然后根据编码生成报告以对数据进行三角验证。
12家医疗机构的37名护士参与了研究。支持住院和门诊护士执业的智力资本在重要方面存在差异。住院护士的执业更有可能得到基于机构的规程和培训的支持，而门诊护士的执业更有可能得到外部规程和培训的支持，这些规程和培训通常由利比里亚政府或非政府组织制定。这可能导致住院规程和培训的提供不均衡，往往有利于私立机构。同样，住院护士主要依靠所在机构的其他护士提供临床支持，而门诊护士通常有外部专业关系为他们提供临床指导。
在使门诊护士能够提供基本卫生服务包中的初级和二级护理目标服务方面已经取得了很大成就。然而，随着利比里亚政府及其合作伙伴继续努力提供某些三级护理服务，为住院护士制定类似的规程、培训和临床指导网络可能会取得成效，并将减轻各个机构的负担。
在经历紧急状态后的国家，护士常常被期望实现新的服务提供目标。进一步研究如何最好地支持护士实现这些目标，有可能加强卫生系统。
