May 2022
Greetings from the Nurse Education Team at Connaught Hospital, Freetown! Rachel and Rhoda have been working hard in the first half of this year as the project has gone from strength to strength. New equipment has been distributed, education activities have been ongoing, and links with the Ministry of Health have been established.
Vital Signs Equipment Distribution and SLEWS
We have bolstered this equipment distribution with another SLEWS mentorship drive to ensure that learning is applied in the clinical setting. We have been visiting the wards during vital signs rounds and supporting our education lead nurses to monitor the implementation of the SLEWS score. We have also provided posters to each ward outlining the ‘action pathway’ providing a reminder to the nurses what actions should be taken as a result of elevated SLEWS scores.
The beginning of the year kicked off with a distribution of blood pressure monitors and thermometers to all wards and units at Connaught Hospital. We were also able to provide the Accident and Emergency departments with standing monitors to enable them to closely monitor their acutely unwell patients. This formed part of our continuous professional development activities to strengthen the use of the Sierra Leone Early Warning Score (SLEWS) system and the early detection of deteriorating patients.
During our ward-based mentorship that we conduct on the wards following the formal SLEWS trainings, we noticed that even though nurses were now equipped with knowledge, they were facing challenges with the availability of equipment. Blood pressure machines were often faulty or not available at all, making regular and comprehensive monitoring of patients almost impossible. With the support we receive from The Burdette Trust for Nursing, we were able to procure semi-automated blood pressure monitors that are specifically designed for low resource settings. Already in use in other healthcare facilities in Sierra Leone, the CRADLE vital signs alert monitor is lightweight and rechargeable and has been well received on the wards. We have supplied each ward with two monitors and have provided the Matron’s Office with some replacement parts to ensure the equipment can be easily maintained and is sustainable.
The distribution of this equipment also provided us with an opportunity to deploy our education lead nurses. This team are embedded within each of the wards in Connaught and were trained to cascade training to their peers. They delivered bedside training to their colleagues to ensure correct operation and care of the devices. Since the rollout, we have been visiting the wards regularly to offer support and it has been great to see nurses motivated by the equipment as well as seeing our education champions teaching and training their peers. They are now the point of contact on the ward for any challenges that may arise, and although there have so far not been too many, we are happy that they are able to approach the nurse education team for help and support.
We have bolstered this equipment distribution with another SLEWS mentorship drive to ensure that learning is applied in the clinical setting. We have been visiting the wards during vital signs rounds and supporting our education lead nurses to monitor the implementation of the SLEWS score. We have also provided posters to each ward outlining the ‘action pathway’ providing a reminder to the nurses what actions should be taken as a result of elevated SLEWS scores.
Educational Activities at Connaught Hospital
The nurse education team is proud to have cemented its role within the Matron’s Team in so far that that it has become the first port of call for any educational initiative that is implemented at Connaught. This means that training can be standardised both in content and quality. Our aim for the CPD framework at Connaught is that all activities are relevant to the Sierra Leone hospital setting and are delivered at a high standard. We have been able to achieve this so far by supporting trainings in nursing care planning and emergency burns care. This year, we have continued to support colleagues in training delivery. We provided facilitator mentorship to a multi-disciplinary team of Connaught staff who were cascading training they had received whilst on an exposure visit to Ghana. They trained 40 nurses, physiotherapists and junior doctors in the principles of stroke care in preparation for the opening of a stroke unit at Connaught Hospital.
We not only offered support in the planning of the training but also facilitated de-brief sessions for the team, giving them a chance to reflect on their own practice. We were so pleased to see how the healthcare staff, some of whom had not facilitated training amongst their peers before, gained an awareness of their learners’ needs and improved their own facilitation skills to create an excellent environment for learning. As the Stroke Unit becomes functional, we hope to be able to support the MDT further to provide on the job mentorship to their peers including being able to assess skills competency and facilitate case-based discussions.
Connections to further CPD amongst nurses across Sierra Leone
The CPD framework for nurses at Connaught Hospital has embedded itself within the Matron’s team and it is our hope to seek recognition from the Ministry of Health. This support from the Nursing Directorate would help to ensure sustainability of the nurse education team as the project draws to a close. In light of this, we have been able to meet with the Chief Nursing and Midwifery Officer (CNMO) at the Ministry of Health to outline our work. We are grateful for her support and the fact that creation of CPD activities for nurses aligns with the objectives of the ministry. In follow up to this meeting, we are looking forward to meeting the Registrar of the Nurses’ Board where we will present our training materials and seek accreditation from them.
In addition to this, we have met with other partners who are implementing similar nursing education programmes in other hospitals in Freetown and, further afield, in Tonkolili District. This has been really encouraging for the nurse education team as we have been able to share successes and ways of working as well as talk about the challenges that we face. Moving forward, we hope to maintain these links to see that nurses across Sierra Leone can benefit from professional development to ultimately enhance care for patients across the country.
In March, some of the senior nurses from Connaught were able to attend the inaugural Research Conference for Nurses in Sierra Leone. This was a fantastic opportunity for nurses to gather together to learn from evidence-based presentations and panel discussions. The conference showed how nurses in Sierra Leone are motivated to elevate their profession and served to boost the enthusiasm of the team from Connaught. The Nursing for Welbodi team were pleased to support the team by giving them access to these CPD activities.
Moving Forward
The month of June will see the arrival of a new nurse volunteer from the UK. There will be a period of handover in-country to ensure a smooth and easy transition between the volunteers.
As we enter the final phase of this project, we hope to consolidate CPD activities by transitioning the physical presence of the nurse education team to a space within the Matron’s Office. This space has already been allocated by the nursing management and we are currently working together with Senior Matron to develop a proposal as to how we can make this space accessible for all nurses at Connaught as well being a base for the Training Coordinator, education lead team and nurse facilitators.
