The case for international collaboration among nurses

An Iraqi nurse checks the chart for a pre-​​mature baby. Photo via Flickr.

In 2005 4 mil­lion infants died during their first 28 days of life. Despite the World Health Organization’s Mil­le­nium Devel­op­ment Goals to reduce that number sig­nif­i­cantly by 2010, the number had only dropped to 3.6 mil­lion in those next five years.

In an article in this month’s issue of the Amer­ican Journal of Maternal and Child Nursing, School of Nursing dean Carole Kenner argues that the WHO’s goals could be met if we give more autonomy to nurses across the globe and pro­vide an inter­na­tional plat­form for them to col­lab­o­rate. “One strong voice for neonatal nursing care and edu­ca­tion will help to improve health out­comes,” she writes, along with Marina Boykova, a doc­toral stu­dent at Uni­ver­sity of Oklahoma’s Col­lege of Nursing.

The three main fac­tors con­tributing to the 2010 neonatal deaths were infec­tions, child­birth and delivery com­pli­ca­tions and preterm births, write the authors. In the US alone, preterm births grew 20% between 1990 and 2006 and is only now slowly declining. But the biggest issue gov­erning all of this might be patient edu­ca­tion and nurses’ edu­ca­tion. The latter, write the authors, has been shown to be inti­mately linked to better patient out­comes. When nurses are edu­cated in things like neonatal sta­bi­liza­tion (appar­ently not stan­dard for all nursing pro­grams world­wide) and resus­ci­ta­tion, neonatal deaths can be reduced by 30%, and an addi­tional 20%  when com­mu­nity health workers receive sim­ilar training.

But nurses don’t always receive the sup­port they need, due to things like eco­nomic status of the hos­pi­tals they work in or even just the stan­dard pro­to­cols of var­ious coun­tries’ edu­ca­tional pro­grams. For instance, there is simply no oppor­tu­nity for increased nursing training in some regions, write the authors: “the only way is to become a physi­cian.” Nurses have a unique oppor­tu­nity to pro­vide both care and patient edu­ca­tion, and with ade­quate training that care could include pro­ce­dures crit­ical to main­taining neonatal health and survival.

Kenner was instru­mental in estab­lishing the Council of Inter­na­tional Neonatal Nurses and this article seeks to reestab­lish how impor­tant that organization’s mis­sion is. The needs are the same for neonatal nurses and care “whether in Nepal or the United States.”

By sharing infor­ma­tion and col­lab­o­rating across inter­na­tional boarders, which are much easier to over­come today through modern com­mu­ni­ca­tion tech­nolo­gies, nurses can help improve the sit­u­a­tion for neonatal mor­tality. For example, a col­lab­o­ra­tion between nurses in Oak­land, Cal­i­fornia and Russia suc­ceeded in reducing the mor­tality rate at St. Petersburg’s Children’s Hos­pital #1 from 33% to 5.7%.

A nurse does not have to write health policy to effect change,” write the authors. “Change occurs by one nurse influ­encing, teaching and men­toring another one or another health­care professional.”