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Malawi Medical Journal
College of Medicine, University of Malawi and Medical Association of Malawi
ISSN: 1995-7262
Vol. 31, No. 2, 2019, pp. 138-143
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Bioline Code: mm19024
Full paper language: English
Document type: Research Article
Document available free of charge
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Malawi Medical Journal, Vol. 31, No. 2, 2019, pp. 138-143
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Contextual issues that influence preparedness of nurses for critical care nursing practice in Malawi
Gundo, Rodwell; Mearns, Gael; Dickinson, Annette & Chirwa, Ellen
Abstract
Background
There are no critical care nurse training programs in Malawi despite the high burden of diseases which culminate in critical illness.
This paper presents contextual issues that influence preparedness of nurses for critical care nursing practice in Malawi. The qualitative
findings presented are part of a larger mixed methods study which explored learning needs of critical care nurses as a way of informing
the development of a training program for the critical care nurses in Malawi.
Methods
Interpretive descriptive design was used. Data were gathered through 10 key informant interviews with nurse leaders (n=8) and
anaesthetists (n=2); and two focus group discussions with registered nurses and nurse midwife technicians working in intensive care
and adult high dependency units at two tertiary hospitals. Transcribed data were analyzed manually and through the use of NVivo data
management software utilizing Thorne’s steps of analysis1.
Results
Being unprepared to work in intensive care and high dependency units was a dominant theme. Factors that contributed to this sense
of unpreparedness were lack of educational preparation, organisational factors and workforce issues. The consequences of nurses’
perceptions of being unprepared were fearfulness, a change of nurses’ attitudes and elevation of risk to patients. The nurses managed
unpreparedness by relying on other health professionals and learning on the job.
Conclusion
The findings illuminated contextual issues to be considered when developing programs for upskilling nurses in hospitals within Malawi
and contributes to the developing body of knowledge related to nursing education and practice development within developing countries.
Keywords
Critical Care Nursing; Critical Illness; Developing Countries; Malawi; Education; Nursing; Qualitative Research; Critical Care
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