ICP/EDS/OO7
ENGLISH ONLY
REPORT OF THE WORKSHOP ON EDUCATIONAL TECHNOIDGY IN NURSING/MIDWIFERY IN THE SOUTH PACIFIC
Sponsored by the
WORLD HEALTH ORGANIZATION REGIONAL OFFICE FOR THE WESTERN PACIFIC Suva, Fiji 13 - Zl May 1980
Not for Sale Printed and Distributed by the Regional Office for the Western Pacific of the World Health Organization Manila, Philippines August 1980
/
NOTE
The views expressed in this report are those of the persons who participated in the workshop and do not necessarily reflect the policies of the Organization.
"
This report has been prepared by~he Weatern Pacific Regional Office of the World Health Organization for Governments of Member States in Manila and for those who participated in the Workshop on Educational Technology in Nursing(Midwifery in the South Pacific which was held in Suva, Fiji, from 13 to 27 May 1980.
CON'l'ENTS
1.
INTRODUCTION
.................................................................................................. ............................................................................
1 1
2.
PRE-WORKSHOP ACTIVITIES PARTICIPANTS
3.
..................................................................................................
2 2
4.
AIM AND OBJECTIVES
...................................................................................... ...................................................................................... . ........................................................................ .
4.1
4.2
Aim .............. . . .. . .. . .. '" ...................................................................... .
Objectives
2 2
5.
CONDUCT OF THE WORKSHOP
3 3 3 3 4
Opening of workshop ...................................................................... 5.1 Organization of workshop ••........•••••...•.•........• 5.2 5.2.1 Orientation ......................................................................................
5.2.3 Socio-cultural factors ................................................................ 5.2.4 Instructional technology ............................................. .. Closure of workshop .................................................................... .. 5.3 o. , EVAWATION .................................................................................................... ..
5.2.2
Learning process
............................................................................
4 4
5 5
6.1 6.2 6.2.1 6.2.2
Midworkshop instruction .............................................................. Final evaluation .............................................................. . . .. .. .. .. .. ...................................... 6 .................................................... ..
Instrument for evaluation Results
..........................................................
5 6 6 6 9 9 10
CONCLUSIONS AND RECOMMENDATIONS
............................................................
7.1 7.2 ANNEXES
Conclusions ...................................................................................... Recommendations ..............................................................................
ANNEX 1 - LIST OF PARTICIPANTS AND CORRESPONDING LEARNERCEN'rRED PR.OORAJIrfJIE.S DEVEIDPED ............................................ .. ANNEX 2 AGENDA .......................................................................................... MODULES: MANAGEMENT OF FIRST STAGE LABOUR ••••••••• ANNEX 3 OO.RD CARE .............................................................. ..
13 15 19 32
1.
INTRODUCTION
This the South introduce midwifery and
Workshop on Educational Technology 1n Nursing/M!dwifery in Pacific is an initial activity of a four-year project to the production and use of relevant technologies in nursing/ education.
This programme was designed to orient faculty to the principles concepts of instructional methodology and will be followed by individual collaboration with schools. 2. PRE-WORKSHOP ACTIVITIES
The World Health Organization informed the governments of the different countries and areas in the South Pacific about the workshop objectives. partiCipants were subsequently nominated. Preparatory activities included the following: (1) A two-day briefing and consultation conference in the Regional Office for the Western Pacific in Manila (28-29 February 1980). Tentative plans for the workshop were discussed. A five-day visit to Suva, Fiji (3-7 March 1980). afforded the opportunity to do the following: •
(2)
This visit
(al (bl
consultation/conference with the co-operational officer of the workshop; Study of the curriculum of South Pacific schools of nursing/midwifery to ensure that the workshop would be appropriate to the South Pacific Region; Visits to three programmes and conferences with faculty and administrators on the workshOp objectives: post-basic midwifery course Fiji School of Nursing post-basic public health nursing course
(e)
(d)
Discussion with prospective participants to the workshop via satellite (based at the University of the South Pacific) of workshop objectives, the importance of sharing, pre-workshop materials with peers and administration and identification of an area to be developed as a project. All arrangements were then made for use of the satellite communication system during the workshop so that partiCipants could discuss their project and thereby ensure support from their colleagues and administrators.
- 2 -
(e)
Identification of audiovisual equipment and materials needed for the workshop. An inventory of available audiovisual equipment/aids was made.
(3)
Preparation and circulation of a print package to participants. This package contained: Ca) a comparison of the characteristics of a school using conventional methods of teaching and a school using learner-centred instructional methods; abstracts on information about audiovisual equipment! materials; form to enter data on available audiovisual equipment/ materials; guide in collecting data and articles to be used in the workshop; guide in selecting an area of content from the subJect taught, which could be used as a proJect.
(b) (c) (d) (e)
(4) Designing of the workshop syllabus in collaboration with the operational and co-operational officers •
.
,
..
3.
PARTICIPANTS
The workshop was attended by 12 nurse educators from selected countries and areas in the South Pacific (see Annex 1). 4. AIM AND OBJECl'IVES
4.1
Aim
To introduce to the faculty of nursing/midwifery schools in the South Pacific principles of learner-centred educational systems, with emphasis on instructional technology. 4.2 ObJ ect! ves (1) (2) To exchange information on the extent to which current
nursing education programmes are learner-centred. To identify and explore instructional methodologies Which increase and sustain students' motivation with potential for maximizing retention of learning.
(3)
To develop a proJect in instructional technology for future testing in the partiCipant's home school.
5. 5.1 Opening of workshop
}
-
CONDUCT OF THE WORKSHOP
The workshop was opened by the WHO Regional Nursing Adviser, Manila (Operational Officer), who gave an overview of the activities pertaining to nursing education in the South Pacific. She further cited the· proposal for a South Pacific Regional Nursing/Midwifery Training and Research Centre, which could be a strategy for closer collaboration and cooperation among nurses as well as for strengthening nursing education and services in the South Pacific. The greetings of the Regional Director, Dr H. NakaJima, were read by Dr Y.T. Kuo. Dr Nakajima challenged the participants to explore the wide arena of instructional technology and to select the most appropriate ones for learners in the South Pacific. Ms Kuini Naqaslma, Controller of Nursing Services for the Ministry of Health, Suva, acknowledged the sincere intention of the participants in seeking and sharing knowledge to be utilized in further development of their nursing curriculum. She encouraged the participants to learnercentred proJects which consider the socio-cultural factors influencing learning. 5.2 Organization of workshop The workshop was divided as follows: (1) (2) (}) (4) (5) 5.2.1 orientation; learning process; socio-cultural factors influencing learning in the South PaCific; instructional technology; evaluation.
Orientation The orientation included: (1) (2) Discussion related to administrative aspects of the workshop. Clarification of the objectives and activities outlined in the provisional agenda (Annex 2) and the opportunity to challenge the sequencing of events. It was stressed that the focus of the workshop was on the learner and on leamer-centred activities. Flexible scheduling would therefore be an ongoing aspect of the daily plan.
- 4 -
5.2.2
Learning process
Learning was introduced as an experience that indiv1duals seek throughout life - and from this reference point began the exploration of learning from the learner's point of view. Self-direction was encouraged. Modular learning was introduced as one method by which a project could be developed. This method was introduced early since all of the components of this method supported learner-centred concepts. Two of the participants had previous experience in developing modules and it was felt that they might wish to develop an audio-visual component of modules that had been developed, as well as be a resource person to others wishing to use this method. The print component that accompanied the module on module learning initiated active inquiries about self-pacing, pre-testing, learning activities, post-testing and evaluation. (These discussions continued throughout the workshop as scheduled or on request by individuals.) Objectives - specif1cally behaVioural objectives - were explored and identified as a critical component of learner-centred programmes. 5.2.3 Socio-cultural factors Dr T. Saba, University of the South Pacific, discussed socio~ cultural factors influencing learning. His research pointed out the life styles of the different cultural groups in the South PacifiC and the implications for teaching. He cited differences in the performance of students, which are closely related to certain family groupa, beliefs and practices. He encouraged the participants to be cognizant and respectful of that which was traditional in a society before considering the need for change. The understanding of a learner's needs must begin with an underst~ding of that learner's culture. 5.2.4 Instructional technology
,
,
The aim Was to bring machines, techniques and materials together to become instructional technology for educational purposes. Various mediated materials were explored with the intention of triggering a creative response that could be applied to project planning. These ranged from abstract and subliminal concepts to the viewing of simple programmed materials. Examples of programmed materials were displayed. Graphics expanded on the theme of instructional technology to include writing styles and printed images of a wide variety.
- 5 A group participation in the production of a simple mediated programme was initiated to tie together all workshop content presented up to this point. Other methods of instruction were demonstrated: the laboratory clin1cal experience case method simulation. While there were 16 hours for independent work on projects, partiCipants utilized extra time in order to complete them. Individual projects were presented (see Annex 3 which contains two examples of participant's independent work.). Suggestions for strengthening were made. A satellite exchange was held where participants were able to share the experiences of the workshop and seek advice from their colleagues at home. The use of the satellite as a means of commun1cation among nurses in the South Pacific was discussed. The highlights of the workshop were videotaped at the South Pacific satellite centre.
5.3
Closure of workshop
The workshop was closed with a recapitulation of the workshop activities, a message from the WHO Programme Coordinator for the South Pacific received by Dr Y.T. Kuo and SUIIIIISry statements about the workshop by a Tongan partiCipant, Ms Tupoumiua.
6. 6.1 Midworkshop instruction
EVAWATION
At the end of the first week, participants were invited to assess the conduct and coverage of the workshop and to suggest ways in which this could be made more appropriate to meet their needs, particularly on instructional methodology. Responses from the partiCipants did not indicate a need for change and/or modification of the plans for the workshop as scheduled.
- 6 -
6.2 6.2.1
Final evaluation Instrument for evaluation
The instrument for the final evaluation of the workshop was developed based on the format recommended by the Organization. It determined the educational gains derived by the participants from the workshop, an appraisal of the process and outcome, organization and administrative aspects, as well as the participants' overall conclusions, plans and recommendations for follow-up activities by respective governments, WHO and other agencies. 6.2.2 Results The results of the evaluation are herein summarized. 6.2.2.1 Educational gains (al The development of a project on instructional technology for future testing was fully attained as claimed by lO~ of the participants while the objective, which was to exchange information on the extent to which current nursing education programmes were learner-centred, was perceived to be attained by 75~ of the group. Four (3~l participants remarked that the time alloted for this purpose was very limited. New skills or concepts were learnt by 11 participants. One said that there were no new skills/concepts gained but different approaches were learnt in using audio-visual materials/equipment more effectively. These new skills or concepts were perceived as appropriate for the respective countries considering their socio-cultural factors. 25~ of the participants anticipated difficulty in applying the new skills or concepts acquired at the workshop because of inadequate audiovisual equipment and teaching materials.
"
(b)
(cl
(d)
6.2.2.2
Process and outcome Cal The majority of the participants felt that they were able to express their ideas/problems as well as having had the opportunity to exchange knowledge and experience within the workshop schedule as well as outside of the workshop time.
(b)
'(
-
The working papers, references and audiovisual materials were found satisfactory by the participants (9~, 85~, 85~, respectively). Methods of instruction and presentation of the different topics were found to be satisfactory by 10 out of the 12 participants. Generally, 92-100~ of the participants were fully satisfied with discussions during the planning sessions, group discussions and individual consultations. Time allotment and materials/resources available in relation to independent work in developing learnercentred materials were appraised as not satisfactory by 33~ of 12 participants. In regard to the assistance during independent work, 11 participants said they were fully satisfied about this. The variety and technical data on instructional technology were also perceived as satisfactory by 11 participants. As to beginning skill development, '75~ of the participants expressed satisfaction in this area.
(c)
(d)
(e)
(f) (g) 6.2.2.3
Organization of workshop (a) The participants were equally divided in their opinions about the duration of the workshop. Half of the group felt that the two weeks' duration was realistic in achieving the workshop objectives. Only one participant in the other half felt that two weeks was too long while the rest felt that it was short. A three to four weeks' duration was recommended. The majority (11) said that scheduling of activities reflected flexibility and logical sequencing •.
(b) 6.2.2.4
Administrative aspect
All participants were pleased with the travel arr.angements made, the meeting room used and the secretarial SUPP<r t provided. 6.2.2.5 Overall conclusion and plans (a) All partiCipants felt that their attendance at the workshop was worthwhile. When asked whether their participation was worthwhile to their respective country, 11 participants responded positively.
- tl -
(b) (c)
A similar workshop was viewed as valuable to other nurse educators by 11 participants. All participants were optimistic about the feasibility of close collaboration/communication among South Pacific nurses.
6.2.2.6 Follow-up activities Participant~recommendations
for follow-up activities were as follows:
(a)
By national government (i) (11)
Logistic support for library, audiovisual equipment and implementation of the project. Commitment to develop and maintain collaboration and communication among nurses in the South Pacific. Sponsorship in the conduct of similar workshops for other faculty, health and education staff; sponsorship of faculty training in other countries. Inclusion of nursing/midwifery education in the educational system of the country; inclusion of postgraduate courses for nurse educators in the university. Setting up of an audiovisual aid department. Identification of priority areas in the training of faculty. Seeking of consultant services on modularization of the learning programme.
(11i)
(iv)
(v) (iv) (Vii) (b)
By WHQ (i) (ii) (iii) Follow-up of partiCipants via the satellite, questionnaires anq/or visits by conSUltants. Provision of references. Holding of workshops (Suggested number of participants: two per country) (a) (b) (c) Evaluation and assessment of students'performance Similar workshop for other faculty FPllow-up to discuss project implementation.
- 9 (c) By
other agencies Civic organizations, commercial establishments and embassies should be approached for logistic support as well as for other assistance in faculty development and in building up the learning resources of the schools. Assistance from the education departments should be sought in studying current nursing and midwifery education programmes and inolusi.n of nurse educators in in-service programmes for educators. 7. CONCWSIONS AND RECOMMENDATIONS
(i)
(11)
7.1
Conclusions
The objectives of the workshop were attained. Given two weeks more, learner-centred programmes would have been developed in more depth. The missing components of the programmes such as the production of Visuals, designing of evaluation instruments (classroom and clinical performance of stUdents), validation and redesigning of programmes could have been accomplished. The areas Where most participants met difficulty were: (1) (2) selection of the subject which lent itself for learnercentred programme designing; formulation of behavioural objectives and validation; selection of appropriate learning activities to achieve objectives; development of evaluation instruments for assessing performance of students (classroom and olinioal).
(3) (4)
The discussion on socio-cultural factors influencing learning and the status of nursing education in the South Pacific pointed to the need for the inclusion of the arts and humanities and strengthening of the scientifio base of the nursing/midwifery curriculum. An adverse faculty/student ratio in nursing/midwifery schools in the South Pacific is a perennial problem owing to the small number of prepared faoulty and high attrition rate among this group. There are also limited resouroes and expertise in the preparation and current use
- 10 -
of audiovisual materials for basic and post-basic nursing/modwifery education. This workshop on educational technology, therefore, is one step taken in strengthening nursing/midwifery education in the South Pacific. 7.2 Recommendations (1) To encourage continuation of the interest that has been engendered by the workshop, it is recommended that participants be followed-up in order to determine the implementation of projects. Consultants should be provided to participating schools to collaborate in additional programme designing, establishment of a learning resource unit, designing of a mechanism for development, production, storage, distribution and retrieval of learner-centred programmes, and assessment of the effectiveness and use of learner-centred packages. To encourage the sharing of those accomplishments that
(2)
serve to further nursing education, an ongoing communication medium should be devised. The sharing of general knowledge, programmed materials, teaching methods and strategies should be encouraged. This could be done through: (a) Publication of a South Pacific Nursing Newaletter. Initially published on a bimonthly basis, the responsibility for compiling a specifiC issue could be rotated among the nurses associations of countries in the South Pacific. I t is proposed that funding for the first two years should come from the educational technology project (ICP/EDS/OO7). Satellite. I f the satellite health education programme for the South Pacific materializes into a more structured format, this type of medium could be used for such activities as round-table discussions of current issues/ problems in nursing education; information-giving sessions on new trends in health care; follow-up sessions of earlier seminars and workshops; and pre-pl·anning exercises for future seminars.
(b)
())
The quality control of all facets of programme planning and production is of prime concern. It is recommended therefore,that nursing faculty wishing to design and produce learner-centred programmes should seek assistance from audiovisual technicians where they are available. The resulting team would enhance creativity while utilizing the expertise of individuals. Fellowships should be provided for faculty on the preparation of audiovisual materials to complement existing manpower resources available in the country.
(4)
The successful implementation of this initial activity hinges on the continued deSign, evaluation and use of learner-centred programmes; WHO should therefore,promote and support suitable activities and continued technical collaboration in the folloWing areas:
- 11/12 (a) evaluation of learning effectiveness, cost effectiveness and acceptability of learnercentred programmes to the faculty, students and administration; curriculum designing to strengthen or enrich nursing/midwifery curriculum. The planning of student's clinical instruction programmes and the designing of evaluation instruments are critical areas of concern; faculty preparation for specialty areas such as community health nursing; prepara t10n of a group of faculty 1n research.
(b)
(c) (d) (5)
To avoid needless duplication in the designing of learnercentred programmes, regional coordination is suggested. It is also necessary to first identify learner-centred programmes which can be exchanged between countries. The question 1s one of cross-cultural as well as cross-national transference. Some form of coordination such as the proposed regional training and research centre for nursing and midwifery in the South Pacific will have to be instituted to ensure the rational use of financ1al and expert resources.
- 13 ANNEX 1
LIST OF PARTICIPANTS AND CORRESPONDING IEARNER-CENTRED PROGRAMMES DEVELOPED
Participants
Programme Helping Mothers to Breastfeed
1.
Judy Aralleo Nurse Tutor Vila Base Hospital Vanuatu Margaret Beckett Senior Nursing Officer (Education) Solomon Islands Sela1 Cati Senior Nursing Officer, Tutorial Kiribati Marie Crisostomo Instructor University of Guam Guam Colonial War Memorial Hospital Suva, Fiji
2.
Complications of Diabetes
3.
Care of the Patient with Intravenous Infusion
4.
Administering Perenteral Pre-op Meds
5. Emily Driver
Pre-eclamptic Toxaemia
6.
Mengyor Emesiochl Instructor Community College of Micronesia Saipan, Mariana Islands Anna Fruean Acting Principal Post-basic Nursing School Apia, Western Samoa Mari ca Narawa Colonial War Memorial Hospital Suva, Fiji
Cord Care
7.
Samoa CUltural Groups
8.
Nursing Assessment of the Newborn
- 111 Annex 1 cont'd. Participants Programme Estimation of Expected Date of Confinement
9.
Nasa1an N-Draku Principal School of Nursing Wewak Papua New Guinea Sabina Taro Instructor Community College of Micronesia Saipan Mariana Islands Blenoa K. Tupoumiua Acting Supervising Tutor Sister c/o Ministry of Health Nuku'alofa Tonga Jellilah A. Unla Officer-in-Charge Diploma Nursing Education Department of Health Konedobu Papua New Guinea
10.
Teaching Diabetic Patients How to Self Administer Insulin Injection
11.
Management of First Stage of Labour
12.
How to Teach Attitudes
AOIIIGlA WORIISIIOP OR J!lXlCATlONAL mcJM)IDGY IN IIlRSllIO/MIMlIBRY IN 'l'II8 SOU'l'JI PACme . 1}-27 1107 1980. SUv.. FiJi (.
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1, 1107 Tueeday
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10.00 - 10.30 10.30
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12.00 - 1.30 1.30
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- 2 -
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Graphics (cont'd.)
: Simulation (coot'd.) Independent lAboratory R Wor~
Inc\ependent Work/ lAboratory
ot Project.
I
Group cU.sw •• 1m
f
Sharing of proJ ect.
(cant'd.)
."
on satellite use
(cant'd. )
" 10.00 - 10.}O 10.)0 B
E
A
~
K I
Feedback on Mid-workshop evaluation Independent work
b. satellite u•• d1tto ditto Orientation to
III
Sharing of proJects (cant'd. )
d1tto Pinal evaluation of worbhop
aatell1 te use
'-
12.00 ~
1.)0
L
u d1tto
N
C
l.}O Independent work
V PROJECT PlU!Sl!liTATION AND PIANS IIOR IMPIl!JII!N'l'ATION
satellite - a.una •
. •• ." ~
H
for cloae
collabor~·
c. Videotaping a8s81on
hedback on evaluation ot the workshop
tion/cooaun1catiOll
•
•• Sharlna of proJects
I
e. Plana for 1.plalentatlon d. Rilcapltulatlon
• 3.00 - 3.)0 B ft
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e. Simulation
f. CaBe method
ditto
ditto
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Closing Ceremony c/o Participant.
.
•
- 17 ANNEX
3
THIS MODUIE WAS PREPARED DURING WHO WORKSHOP ON EDUCATIONAL TECHNOIDGY IN
NURSING/MIIltllFERY . IN THE SOUTH PACIFIC
13-27
May
1980
GRAND PACIFIC HOTEL SUVA, FIJI
- 18 Annex 3 cont'd.
AUDIENCE:
PRIMARY
This
MODUIE
is
intended during Block Year of of
to Normal for
be
taught Obstetric First
the
Nursing
Students School
~een
Sa10te
Nursing.
Tonga
SECONDARY -
INSERVICE EDUCATION FOR STAFF NURSES
- 19 Annex 3 cont'd. "MANAGEMENT OF FIRST STAGE lABOUR" 1. Statement of purpose
A pregnant mother has been carrying her unborn child for nine months. During these long months of waiting, she is really looking forward to a time or seeing and nursing her baby. In her eagerness, any sign of labour will make her think that she has reached the time to unlOad her long expected passenger, but it could be a false alarm. Labour is divided in four stages but this module is focussed on the learner to understand the "Management of a pregnant woman admitted to hospital in the First Stage of Labour". 2. Review skills giving enema sharing of the perineum abdominal palpation monitoring - pulse
- B/p - foetal heart
3.
Learning objectives At the end of this module, the learner will be able to:
3.1
Name four signs that often indicate labour is about to begin.
~
3.2 Explain the following: 3.2.1 3.2.2 3·2·3 3.2.4 ).2.5 Show Contractions Intervals Frequency Intensity
3.2.6 Membranes - Intacts 3.2.7 3.2.8 Dilatation and effacement
em
on fingers
- 20 -
Annex 3 cont'd.
3.3 Differentiate false from true labour. 3.4 Identify factors influencing the length of labour.
3.5 Explain the possible effects on foetus when membranes rupture before labour begins. 3.6 Demonstrate skills in: Providing physical and emotional comfort. Assessing maternal and foetal conditions. Interpreting observations and findings. Recording and reporting maternal and foetal abnormalities. Preventing infection by using proper aseptic technique. Determining time when delivering is imminent. Preparing delivery bundle. Setting of delivery room.
3.6.1 3.6.2 3.6.3 3.6.4 3.6.5 3.6.6 3.6.7 3.6.8
- ;'>1 -
Annex 3 cont'd. POST TEST ON "MANAGEfo'ENT OF FIRST STAGE OF IAl3OUR" Candidate's No.: Date: No. of items: Results: __________ Cri teria for mastery: ______
1.
TRUE or FALSE (16 marks). if statement is false.
Encircle T if the statement is true, F
For either answers, defend or explain for why. 1.1 T.F. Mele Finau B/p on last check-up was 130/70. On admission her B/p was 130/90. Mele's B/p is normal.
Reason: 1.2 T.F. A foetal heart rate of 160 is abnormal.
Reason: 1.3 T.F. Passing of meconium-stained liquor is normal.
Reason: 1.4 T.F. A woman admitted in First stage of labour has defecated well at home before coming to hospital. Therefore, there is no need to give an enema. Reason: 1.5 T.F. Encouraging a woman in labour to eat plenty of good food will make her strong to push out her baby. Reason: 1.6 T.F. When the membranes rupture - encourage the patient to walk about. Reason: 1. 7 T.F. If the head of the foetus is fully flexed - the brain will be presenting part. Reason: 1.8 T.F. If membranes rupture before labour begins, it is good for the baby. Reason:
- 22 -
Annex 3 cont'd. II. 12.
MATCHING (10 marks). Match ColuDUl A with ColuDUl B. of the correct answers in space before the number. show oontraction false labour interval delatation effacement "membranes intact" CM
Enter the letter
a. b. c.
Will be found at the level of xiphisternum. Time between contractions. Discharge of blood stained ~cus flow vagina and is considered as one of the signs of labour. The taking up of the cervix due to shortening and thickening of muscle fibres during contraction. The patient shows painful rhythmic uterine oontractor, the cervix is dilated and she had show. Is the relationship of the foetal parts to each other. Temporary shortening and thickening of uterine muscle. Labour is not progressing. Patient had only few moderate contractions yesterday and none today. There is no show and so is still closed. This means the widening of the cervix. The rate of occurrences of contractions within a given time. Indicates Size/diameter of the cervix which helps to determine how soon the delivering will be expected. There is no liquor seen because they are not ruptured.
3· 4.
5. 6. 7. -
d.
e.
8. ,\
f. g. h.
9. 10.
true labour frequency
1. j.
k.
1.
- 23 Annex 3 cont'd.
III
ESSAY
3.1
List the line~articles that comprise the delivery bundle (15 marks).
3.2 List the articles needed for artificial rupturing of membranes (ARM) (6 marks),
3.3 Compare true and false labour (8 marks).
True labour Duration of contraction Interval of contraction Intensity of contraction OS
False labour
3.4 Five measures in protecting the patient from injeotion (5 marks). a. b. c. d. e.
- 24 -
Annex 3 oont'd. 3.5 Ana Vi delivered within 2 hours after labour started. Fane Vea had her baby 16 hours after. Why this differenoe? What are the faotors that influenoe length of labour. Name 5 (5 marks). a.
b.
c. d. e.
3.6 List 5 measures that can promote physical and emotional comfort to the patient (5 marks). a. b.
c. d.
e.
- 25 HOPIJI,I'; 1';VilJ.1IJI'I'LON 1"01111
Annex 3 cont'd.
Ple"se "'t"tc whether the followin\f helped your learning, in terfer.!!d with it or did nc,t affec t at all. Conunents would be very much appreciateJ.
HELPED
INTERFERED-
NO CHANGE
1·
STATEMENT OF PURPOSE '.
,
2.
OBJECTIVES
3.
ACTIVITIES
4.
POST...'!'EST
5.
THE HANDOUTS ON "MANAGEMENT OF FIRST STAGE LABOUR"
Further suggestions on activity:-
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- 26 Annex ~ cont'd.
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- 28 Annex
3 cont'd,
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WORKSHOP ON EDUCATIONAL TECHNOLOGY IN NURSING/MIDWIFERY IN THE SOUTH PACIFIC 13-27 May 1980, Suva, Fiji 21 May 1980 CORD CARE
1.
Statement of purpose 1.1 During faetal. life the cord had an important function, for example, to carry nutrients and oxygen to foetus and eliminate waste products. With the birth of the baby, this function WAS terminated. If the cord stump is not well taken care of, bleeding and infection may result. 1.2 Care of cord is one aspect of nursing the newborn baby. module explains the importance and steps of cord care. Th1s
2.
Audience Target: Nursing students taking Maternity Nursing. Public health nurse - for review New nursing personnel - on orientation. Review foetal circulation Upon completion of this module you will be able to:
Secondary: 3. 4.
Pre-requis1te:
Learning objectives: 4.1 4.2 4.2.1 4.2.2 4.2.3 4.2.4 4.2.5
Differentiate a normal cord stump from an infected cord stump. Demonstrate skill in Assembling the materials needed for cord care. Identify Signs/symptoms indicating infection of the cord stump. Dressing the cord aseptical.ly. Carrying out measures in caring for an infected cord. Recording and re~ting
observations.
.•
- 33 Annex 3 cont'd.
5.
criteria for mastery 5.1 8o~
performance in post test.
5.2 Satisfactory return demonstration on cord care. 6. Learning activities 6.1 Study nursing activity A (cord oare) 6.2 View the transparency and listen to audio tape on cord care 6.3 Observe demonstration on cord care 6.4 Study Nursery Prooedure Book, p. 15 Proceed to Nursing Art Room and do the following: 6.5 Prepare a cord care tray containing materials recommended on Nursing Activity A. Practice the nursing actions.
6.6 When you have mastered the skill, call on your instructor for return demonstration. ',. Post-test 7.1 What would you do 1f there is an 1ndication of bleeding from the cord stump? 7.2 How to get rid of an unpleasant odour from an infeoted cord.
- ~Armex 3 cont'd. LEARNING IICTIVI'lY II
THE CORD CARE TRAY CUL'lVRE 'lUBE ANTISEPTIC PHYSOHEX 1 BETADINE 2 · HYDROGEN PEl/OXIDE 3 ALCOHOL SWAB 4
SPECIAL INSTRUCTIONS
· · ·
~ ~
ONE OF THESE IF THERE IS AN EXISTING INFECTION OTHERWISE ALCOHOL IS THE ANTISEPTIC OF CHOICE
•
OINTMENT NEOMYCIN • BACITRICIN GAUZE - 4 x 4 ONE OF THESE WHEN INFECTION PRESENT OR FOR DIRECT PRESSURE DRESSING IN TIlE EVENT OF BLEEDING
NURSING ACTION 1. CHECK THE DRESSING TABLE TO MAKE SURE ALL MA TERIALS AilE AVAILABLE i. e. diapers, clothinG CHECK THE CORD CARE TRAY
NURSING PRINCIPLES
2.
3. 4.
WASH HANDS BRING the inf an t to dressing table, undre:;s him and remove diaper. Inspect the cord for sign of infection or bleeding. Careful handling prevents Trauma. • Do not leave him unattended !iafety.
5.
., .../4
- 35 Annex) cont'd
.
SIC:NS & SYMPTOMS OF INf'ECTION r-
One or more oE the following:
.
dischiU'~e
.
redness
.
unpleasant odour
r
The presence of BLOOD is an indication of - the CORD TIE HAS LOOSENED. or the cord stump has been irritated.
NURSING ACTION
NURSING PRINCIPLES
~
6.
Swab the discharge around the cord stem to obtain a specimen Eor culture and sensi tivi ty. TAKE TEMPERATURE RECORD
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7.
--
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8.
4 x 4 GAUZE FROM . USING TRAY, APPLY GENTLE PRESSURE
. ENSURE
PROMPT REPORTING
9.
IE no si2n of inEection begin using Alcohol Swab cleanse gently UNDER & AROUND TIlE DRY CORD STUMP GIVE 13AlN A SPONGE BATII SEE MODUI.E BATlfING 11lE NEWBORN
Gentle handling of the unhealed cord - prevents irritation which could result in bleeding. A tub bath should not be given beEore the cord falls oEE.
10.
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- 36 Annex 3 cont'd.
•
NURSING ACTION 11.
NURSING PRINCIPLES FECAL MATERIAL and/or urine could cause irri ta-, .'
When the cleansing hils been completed, secure the diaper below the cord stump. NO dressing is applied to
tion of the stwnp. A -
12.
the cord s twnp •
can become wet cord stump that has been kep t dry rill drop off in the first week of life. dre~sing
a
, ,
,
13.
Record the condition of the cord stwnp in the nurses notes and on the chart. Dress the baby to his crib. ~d
,
14.
return To provide warmth & comfort
bundle him snugly.
Plan:
prepare post-test key student's evaluation of module clinical evaluation sheet
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