Skill training of inservice nurses in Delhi government: challenges and future interventions

Abstract

Qualified, competent skilled nurses are required to provide quality care. Pre-services and in-service training of nurse’s focused on enhancing knowledge and provides limited opportunities for proficiency in skills. Certain procedures like intra-venous/cannula insertion, collecting blood sample are not carried out by nurses in India. Statutory bodies do not allow nurses to perform these procedures independently. But today employer expects nurses to perform these procedures which were earlier carried out by medical officers. Therefore study was conducted to assess expected skill demanded by health department and challenges health department face to meet skill needs of in-service nurses in Delhi. Assessment of needs was done by discussion with administrators and nursing leaders. Curriculum and job responsibilities were analysed; further actual working of nurses was analysed. Secondary review on challenges faced by employers was done. Skill lab guidelines, Ministry of Health and Family Welfare, GOI were analysed for baseline. Few skills were identified by health department on priority; procedure guidelines, checklist prepared; trainers identified; monitoring formats designed for quality assurance. 60 nurses with 1 to 3 years in job were selected conveniently. Common theory session organised then group was divided into 4 sub-groups for skill training by 4 trainers. The Health Department expected nurses to perform intra-venous fluids, cannula insertion, collecting blood samples, as all nurses were qualified and registered with councils. 90% nurses had work experience in private sector before joining government; working in government since 1-3 years; 50% had performed intra-venous/Cannula insertion and collected blood samples in private sector. 80% need in-service training. Study helped in identifying methodology of training trainers and trainees i.e. in-service nurses using various methods like theory sessions through online or recoded sessions or manuals; practical sessions through demonstration, re-review of steps through manual and video or recording sessions; re-demonstrations and practice. Strategy was outlined for monitoring training for quality assurance.