1. GLOBAL RESEARCH NURSES’ NETWORK RESEARCH AS A TOOL FOR QUALITY CARE IMPROVEMENT. PRESENTATION BY: John Nepiyala; RNM Monitoring, Evaluation and Investigations Officer. BLANTYRE- MALAWI.

2. Nurses and Midwives Council secretariat- Lilongwe

3. PRESENTATION OUTLINE Nurses and Midwives Council of Malawi(NMCM) mandate Roles and functions of NMCM Activities by NMCM Findings during supportive supervision activities in health facilities Importance of research in the Nursing and midwifery profession Need for nursing and midwifery research in Malawi What NMCM has done so far The focus on NMCM research committee Challenges in the implementation of research committee activities What nurses need to do Whose responsibility to make it happen

4. NMCM MANDATE It exists to regulate nursing and midwifery training, education and practice as enshrined in the Nurses and Midwives Act No 16 of 1995. It is a symbol of professional nursing and midwifery in Malawi.

5. FUNCTIONS OF NMCM To assist in the promotion and improvement of health of the population of Malawi To control and exercise authority affecting the nursing and midwifery profession To exercise disciplinary control over professional conduct of nurse/midwives To promote liaison of the education and training and practice here and beyond

6. FUNCTIONS OF NMCM cont. To advise the minister of health on any matters falling within the scope of nursing and midwifery profession To communicate to the minister any information acquired by the council relating to matters of health.

7. SOME ACTIVITIES BY NMCM Accreditation, monitoring and evaluation of training institutions Examination and registration Monitoring and Evaluation(supportive supervision) of health facilities Investigations of all cases regarding nursing and midwifery reported

8. FINDINGS DURING MONITORING AND EVALUATION ACTIVITIES Improved dressing code Improved infection prevention practices Monitoring of patient condition especially in HDUs, ICUs Inadequate provision of basic nursing and midwifery care Poor or no documentation of nursing and midwifery care given

9. FINDINGS DURING MONITORING AND EVALUATION ACTIVITIES cont. Inadequate material and human resource Inadequate support systems Health education given only in programmatic areas. Inadequate monitoring of patient condition Inadequate student supervision Inadequate supervision at all levels Poor attitudes of health care providers

10. IMPORTANCE OF NURSING AND MIDWIFERY RESEARCH Florence Nightingale first discussed the importance of applying research based nursing practice during the Crimean war. To expand the practice of nursing For the nursing profession to identify itself as a unique discipline To properly understand the health care of patients

11. IMPORTANCE OF NURSING AND MIDWIFERY RESEARCH cont. To modify existing and generate knew knowledge To create information to explain the unique responsibility of the nurse in the profession To depict a sense of responsibility if care is based on research evidence To reduce unnecessary health costs To enable the nurse take proper decisions at every phase of the health care process Helps to plan the nursing process, to predict what could be the possible result of nursing care and avoid undesirable outcomes

12. WHY NURSING AND MIDWIFERY RESEARCH IN MALAWI(CONTEXT OF HEALTH STATISTICS) High disease burden, high maternal and neonatal(infant) mortality rates; HIV/AIDS, malaria, pneumonia, gastrointestinal diseases malnutrition etc 13.1 million people 5.7 Total Fertility Rate 10.6% HIV prevalence 42% Contraceptive Prevalence Rate 5.7 Total Fertility Rate, (MDH 2010, 2008 census )

13. WHY NURSING AND MIDWIFERY RESEARCH IN MALAWI cont. MMR: 675/100,000 live births (UN 460). U5MR: 112/1000 live births (MDHS 2010) IMR: 66/1000 live births NMR: 31/1,000 live births 40% infant deaths occur during 1 st month of life Cause: sepsis, asphyxia, LBW, prematurity 20% newborns LBW: below 2500 gm Against nurse/midwife population of 10,400 (NMCM; 2011)

14. WHY NURSING AND MIDWIFERY RESEARCH IN MALAWI cont. Growing demand and expectation of nursing and midwifery care by society Resource constraint health care delivery setting The health care is changing at unprecedented pace and nursing has to assume a posture which will enable it withstand that change.

15. WHAT NMCM HAS DONE ON RESEARCH SO FAR Inclusion of research activities in its 2010 to 2014 strategic plan Recruitment of research officer in August, 2012. Establishment of research committee within the structures of NMCM on 1 st April, 2010 with the following individual membership composition: – FPAM; chair – Kamuzu College of Nursing – College of Medicine – Kamuzu Central hospital – Bunda College of Agriculture – National Organization of Nurses in Malawi – NMCM secretariat

16. THE FOCUS OF RESEARCH COMMITTEE AT NMCM Research activities designed to assess and document the effectiveness of health care services as stimulated by the need for cost-effective care that achieves positive outcomes without compromising quality Promotion of research utilization- efforts to translate research findings into practice and nurse/midwives at all levels will be encouraged to engage in evidence based care

17. THE FOCUS OF RESEARCH COMMITTEE AT NMCM cont. Need for improvement both in the quality of nursing studies and in nurse/midwives skills in understanding, critiquing and utilizing study results Development of stronger knowledge base through multiple confirmatory strategies achieved through deliberate replication of studies with different clients in different settings and at different times to ensure that the findings are robust.

18. THE FOCUS OF RESEARCH COMMITTEE AT NMCM cont. Need for expanded dissemination of research findings i.e. diversify modes of dissemination of research information which in turn may help to promote research utilization. Championing utilization of operational research findings

19. CHALLENGES IN THE IMPLEMENTATION OF RESEARCH ACTIVITIES Inadequate numbers of research minded nurses Inadequate skills, material resource to support operational research activities

20. CHALLENGES IN THE IMPLEMENTATION OF RESEARCH ACTIVITIES cont. Low interest in doing operational research by nursing and midwifery fraternity Most nurses and midwives do not have a reading culture

21. WHAT NURSE/MIDWIVES NEED TO DO Learn to evaluate nursing/midwifery literature critically ; developing the ability to read nursing literature as a means of discovering gaps in knowledge and evaluating the findings of research study. Learn how valid research results can be applied to nursing practice and develop ideas about how scientific knowledge can be used in caring of patients

22. WHAT NURSE/MIDWIVES NEED TO DO cont. Begin to generate hunches and pose questions that could form basis for future research Need to become involved in research investigations that lead to contribute to new knowledge.

23. WHOSE RESPONSIBILITY TO MAKE IT HAPPEN Nursing and midwifery research Training institutions Development partners Regulatory bodies You and me Professional associations Service providers(MOH, CHAM,PVT)

24. WHOSE RESPONSIBILITY TO MAKE IT HAPPEN cont. We need to unite as stakeholders in the nursing and midwifery research with NMCM focus on operational research.

26. Thank you very much. ZIKOMO KWAMBIRI!