Professional practice models for nurses in low-income countries: an integrative review

Ng’ang’a, Njoki; Byrne, Mary Woods

doi:10.1186/s12912-015-0095-5

BMC Nursing

Table 1 Summary of selected articles

From: Professional practice models for nurses in low-income countries: an integrative review

Author	Year	Country	Aspect of PPMs^f	Study design and sample	Study aims and context
Akinsola et al. [29]	2001	Botswana	Professional values	Literature review	Explore ethical dilemmas faced by nurses
Akinsola et al. [29]	2001	Botswana	Professional values	Peer-reviewed journal articles, international and national grey literature	Rural settings
Botes [28]	1999	South Africa	Professional values	Case study	Explore ethical dilemmas faced by nurses
Botes [28]	1999	South Africa	Professional values	Case study	Low-resource settings
Donkor et al. [25]	2011	Ghana	Professional values	Cross-sectional survey	Describe nurses’ approach to ethical dilemmas
				Nurses attending an international conference (n = 200)	Describe nurses’ approach to ethical dilemmas
				Purposive sampling	Various practice settings in Ghana
Donkor et al.^d [30]	2011	Ghana	Professional values	Literature review	Describe the challenges of nursing practice in Ghana
Donkor et al.^d [30]	2011	Ghana	Professional values	Peer-reviewed journal articles, international and national grey literature	Describe the challenges of nursing practice in Ghana
Harrowing et al. [26]	2011	Uganda	Professional values	Critical ethnography	Describe the impact of moral distress amongst providers of HIV/AIDS care
				Focus groups, interviews and participant observation
				Acute care and public health nurses (n = 24)	1 tertiary care facility
Jewkes et al. [31]	1998	South Africa	Professional values	Ethnography	Explore health seeking practices of pregnant women
				Focus groups, interviews and participant observation	Explore health seeking practices of pregnant women
				Midwives, nurses, family planning advisor (n = 13)	Public maternal health facilities
				Patients utilizing maternal health services (n = 90)	Public maternal health facilities
Kaeswarn et al. [27]	2003	Thailand	Professional values	Cross-sectional survey	Examine impact of nurses’ beliefs about postpartum care on nursing practice
Kaeswarn et al. [27]	2003	Thailand	Professional values	Nurses (n = 372)
Mill et al. [34]	2013	Jamaica	Professional values	Participatory action research	Explore the role of stigma on nursing care delivered to People Living with HIV/AIDS
		Kenya		Interviews and focus groups
		South Africa		Purposive sampling
		Uganda		Nurses and midwives (n = 84)
Pelzang et al. [35]	2010	Bhutan	Professional values	Mixed methods	Explore understanding and implementation of patient-centered care
				Cross-sectional survey and open-ended questionnaire
				Purposive sample
				Nurses (n = 87)	Secondary and tertiary facilities
Shields et al.^e [32]	2003	Indonesia	Professional values	Literature review	Describe the context of nursing practice in Indonesia
Shields et al.^e [32]	2003	Indonesia	Professional values	Peer-reviewed journal articles, international and national grey literature	Describe the context of nursing practice in Indonesia
Shields [33]	2005	Multiple	Professional values	Editorial	Discuss the ethical dilemmas faced by nurses practicing in under-resourced settings
Tschudin et al. [36]	2003	Multiple	Professional values	Literature review	Examine the ethical implications of war and conflict on nursing practice
Tschudin et al. [36]	2003	Multiple	Professional values	Peer-reviewed journal articles, international and national grey literature
Alberto et al. [37]	2014	Argentina	Patient care delivery systems	Medical record review	Describe the role of the ICU liaison nurse
				Content analysis of nursing exemplars	Describe the role of the ICU liaison nurse
				Intensive care unit (ICU) liaison nurses (n = 5)	Intensive care unit in 1 tertiary care facility
Alquidimat et al. [39]	2009	Jordan	Patient care delivery systems	Case study	Describe the role of the clinical nurse coordinator
Alquidimat et al. [39]	2009	Jordan	Patient care delivery systems	Case study	Pediatric cancer center
Araya et al.^a,c,d [53]	2009	Ethiopia	Patient care delivery systems	Cross-sectional survey	Describe the experience of mental health nurses and perceptions of mental health service provided by nurses amongst interdisciplinary colleagues
				Nurses (n = 42) and their interdisciplinary colleagues (n = 55)
					18 hospitals and 4 health centers
Barrett et al. [54]	2009	Multiple	Patient care delivery systems	Open-ended questionnaire	Identify key issues encountered by mental health nurses
				Qualitative thematic analysis
				Subscribers to an online forum coinciding with the release of the Nurses in Mental Health Atlas (n = 615)
					80 countries
Choromanski et al. [62]	2012	Multiple	Patient care delivery systems	Tool development	Develop an International Classification of Nursing Practice® subset for documenting nursing care provided to children with HIV/AIDS
Choromanski et al. [62]	2012	Multiple	Patient care delivery systems	Tool development	Low-income country settings
Colquhoun et al. [46]	2012	Solomon Islands	Patient care delivery systems	Qualitative thematic analysis	Describe the role and context of pediatric nursing
				Semi-structured interviews	Primary, secondary and tertiary facilities
				Pediatric nurses (n = 21)	Primary, secondary and tertiary facilities
Day et al.^a,c [47]	2008	Guatemala	Patient care delivery systems	Review of medical records, policies, procedures and job descriptions	Evaluate quality of nursing practice based on Joint Commission International standards
					St. Jude’s Children’s Research Hospital international outreach site
				Interviews and participant observation
Day et al.^a,c [64]	2013	Guatemala	Patient care delivery systems	Review of medical records, policies, procedures and job descriptions	Evaluate quality of nursing practice based on Joint Commission International standards
					St. Jude’s Children’s Research Hospital international outreach site
				Interviews and participant observation
De Silva et al. [50]	2010	Sri Lanka	Patient care delivery systems	Ethnography	Explore nursing management of cancer pain
				Qualitative thematic analysis
				Interviews, participant observation and journal/field notes
				Interviews, participant observation and journal/field notes	1 medical/cancer ward
				Nurses (n = 10)	1 medical/cancer ward
Ersser et al. [41]	2000	Multiple	Patient care delivery systems	Literature review	Outline the vision of the International Skin Care Nursing Working Group to promote global skin health
Ersser et al. [41]	2000	Multiple	Patient care delivery systems	Peer-reviewed journal articles, international and national grey literature
Hoyt [65]	2006	Multiple	Patient care delivery systems	Program description	Describe the experience of implementing Problem Solving for Better Health Nursing methodology
Hoyt [65]	2006	Multiple	Patient care delivery systems	Program description	15 countries
Jejeebhoy et al. [43]	2011	India	Patient care delivery systems	2-sided equivalence study	Compare level of safety and efficacy between manual vacuum aspiration (MVA) performed by nurses and MVA performed by physicians
Jejeebhoy et al. [43]	2011	India	Patient care delivery systems	Nurses (n = 10) and physicians (n = 10)	5 non-governmental reproductive health clinics
Kep [52]	2012	Papua New Guinea	Patient care delivery systems	Editorial	Perspective on changes in nursing practice over 30 years
Lu [61]	2007	China	Patient care delivery systems	Cross-sectional survey	Explore perceptions of the nursing role
Lu [61]	2007	China	Patient care delivery systems	Nurses (n = 512)	Medical/surgical departments in 2 teaching hospitals
Miles et al. [55]	2006	Multiple	Patient care delivery systems	Literature review	Describe issues surrounding medication prescribing by nurses
				Peer-reviewed journal articles, international and national grey literature
					Low-income countries
Miles et al. [56]	2007	Botswana	Patient care delivery systems	Case study	Highlight the case of anti-retroviral roll-out in Botswana to make the case for shifting to nurse-led models in HIV/AIDS care
				Literature review
				Peer-reviewed journal articles, international and national grey literature
Mweemba [44]	2003	Zambia	Patient care delivery systems	Editorial	Perspective on the challenges encountered by acute care and public health cardiovascular nurses
Nankumbi et al.^a,c,d [57]	2011	Uganda	Patient care delivery systems	Mixed methods	Evaluate a new model of HIV/AIDS care
				Cross-sectional survey
				Key informant interviews
				Qualitative thematic analysis	6 urban government clinics
				Nurses (n = 20) and nurse managers (n = 6)	6 urban government clinics
Paul et al. [42]	2013	India	Patient care delivery systems	Mixed methods	Compare efficacy of and patient satisfaction with nurse-led epilepsy follow-up care to that of a physician
				Cross-sectional survey
				Semi-structured interviews
				Nurse (n = 1) and physician (n = 1)	Outpatient neurology clinic
Plager et al. [59]	2009	Madagascar	Patient care delivery systems	Needs assessment	Describe strategies to improve nursing education and advance the profession
Plager et al. [59]	2009	Madagascar	Patient care delivery systems	Interviews and site visits
Premji et al. [40]	2013	Multiple	Patient care delivery systems	Literature review	Examine the state of neonatal nursing in low-income countries
Premji et al. [40]	2013	Multiple	Patient care delivery systems	Peer-reviewed journal articles, international and national grey literature
Rukanuddin [63]	2005	Pakistan	Patient care delivery systems	Tool development	Describe the process of developing and testing International Classification of Nursing Practice® subsets for documenting maternity and cardiology nursing care
Scott et al. [45]	2012	South Africa	Patient care delivery systems	Key informant interviews and focus groups	Explore perspectives of nurses and middle managers on new staffing procedures
				Qualitative thematic analysis	6 primary care clinics
				Nurses (n = 42) and managers (n = 12)
				Purposive selection of facilities
Sharma et al. [58]	2013	India	Patient care delivery systems	Grounded theory	Describe the scope of nursing practice in obstetric settings
				Semi-structured interviews and participant observation
				Nurses (n = 10), Physicians (n = 9), Midwives (n = 4), Nursing and midwifery faculty (n = 4), Student (n = 1)
					1 tertiary, 1 secondary and 3 primary facilities
				Purposive selection of facilities	1 tertiary, 1 secondary and 3 primary facilities
Squires et al.^c [48]	2012	Mexico	Patient care delivery systems	Qualitative content analysis	Examine nurses’ perspective of their work environment
				Semi-structured interviews	Examine nurses’ perspective of their work environment
				Semi-structured interviews	Diverse practice settings (acute care, community, academia)
				Nurses (n = 46)
				Geographic locations selected purposively
Uebel et al. [51]	2013	South Africa	Patient care delivery systems	Meta-ethnography of 3 studies	Explore factors driving integration of HIV/AIDS services into primary care clinics
				In-depth interviews, focus groups and participant observation
				Nurses (n = 44), other stakeholders (n = 32) and patients (n = 27)	More than 40 clinics
Walani [38]	2006	Pakistan	Patient care delivery systems	Case study	Describe the nurse case manager role in medical/surgical units
Walani [38]	2006	Pakistan	Patient care delivery systems	Case study	1 university medical center
Bender et al. [74]	2011	Ethiopia	Professional relationships	Case study	Describe Ethiopian-Canadian collaborative research project examining intimate partner violence
Brown et al. [73]	2013	Indonesia	Professional relationships	Case study	Describe Indonesian-Australian collaborative program to enhance clinical skills
Coverston et al. [70]	2004	Guatemala	Professional relationships	Qualitative content analysis	Explore factors that attract and retain nurses to the profession
Coverston et al. [70]	2004	Guatemala	Professional relationships	Nurses (n = 5)
El-Jardali et al.^d [68]	2011	Lebanon	Professional relationships	Mixed methods	Explore the relationship between nursing work environment and intention to leave
				Cross-sectional survey
				Open ended questionnaire
				Qualitative thematic analysis	69 hospitals with at least 20 beds
				Nurses (n = 1793)	69 hospitals with at least 20 beds
George et al. [81]	2013	Multiple	Professional relationships	Systematic literature review	Evaluate the degree of collaboration between counterparts in low- and high-income countries
George et al. [81]	2013	Multiple	Professional relationships	Peer-reviewed journal articles (n = 9)
Hendel et al. [80]	1996	Multiple	Professional relationships	Case study	Describe networking and training program in Israel for perioperative nurses from low-income countries
Jones et al. [60]	2000	Vietnam	Professional relationships	Case study	Describe nursing practice and education
Lasater et al. [76]	2012	Cambodia	Professional relationships	Case study	Describe United States-Cambodia collaborative program to boost professional nursing
McInerney [71]	1993	Uganda	Professional relationships	Editorial	Perspective from a short-term international volunteer experience
Mosby et al. [77]	2008	Central America	Professional relationships	Case study	Describe Central American-United States collaboration to address nutritional management of children with cancer
Papastavrou et al.^e [69]	2012	Turkey	Professional relationships	Cross-sectional survey	Examine perceptions of the professional practice environment
				Convenience sampling
				Nurses (n = 156)
				Nurses (n = 156)	Orthopedic surgical wards in 7 tertiary or private facilities
Schaepe et al. [82]	2011	Uganda	Professional relationships	Ethnography	Describe the role of palliative care nurses
				Semi-structured interviews, participant observation and field notes
				Nurses (n = 20)
Silinzieds et al. [79]	2012	Nepal	Professional relationships	Case study	Describe Nepalese-Australian collaborative program to improve the quality of nursing care of patients undergoing plastic and reconstructive surgery
Sudhaker [83]	2008	India	Professional relationships	Letter to the editor	Describe participatory research project aimed at empowering nurses to curb hospital acquired infections in acute care facilities
Thomson et al. [78]	2008	Sri Lanka	Professional relationships	Case study	Describe Sri Lankan-United Kingdom collaborative program to improve quality of diabetes care
Walusimbi et al. [72]	2002	Uganda	Professional relationships	Editorial	Describe Ugandan-United States collaborative program to improve HIV/AIDS care
Wraa [75]	2013	Nepal	Professional relationships	Case study	Describe Nepalese-United States collaborative program to improve quality of post-anesthesia nursing care
Anonymous [88]	2010	India	Remuneration	Editorial	Speech delivered by the vice-President of India during national nursing award ceremony
Anonymous [89]	2010	India	Remuneration	Editorial	Speech delivered by the Indian Minister of Health & Family Welfare during national nursing award ceremony
Delobelle et al.^a [66]	2010	South Africa	Remuneration	Cross-sectional survey	Examine the relationship between demographic characteristics, job satisfaction and intent to leave
				Nurses (n = 137)
				Convenience sample
				Convenience sample	20 fixed and 6 mobile primary health clinics
Du Toit et al. [91]	2011	Western Pacific Islands	Remuneration	Qualitative situation assessment	Describe organizational elements contributing to quality of ophthalmic care delivered by nurses
				Semi-structured interviews
				30 nursing graduates of an ophthalmology program
El-Jardali et al. [85]	2013	Lebanon	Remuneration	Cross-sectional survey	Explore factors influencing nursing retention
				Non probability sampling	Explore factors influencing nursing retention
				Non probability sampling	63 facilities serving underserved areas
				Nurses (n = 857)	63 facilities serving underserved areas
Hamid et al. [49]	2014	Pakistan	Remuneration	Qualitative narrative analysis	Compare perceptions of job satisfaction between nurses in public and private facilities
				In-depth interviews
				In-depth interviews	2 tertiary, teaching facilities
				Purposive sampling
				Nurses (n = 41)
Hollup [92]	2012	Mauritius	Remuneration	Qualitative thematic analysis	Explore factors attracting and retaining nurses to the profession
				Semi-structured interviews and participant observation
				Convenience sampling
				Nurses (n = 47)
Lu et al.^a,c [67]	2007	China	Remuneration	Cross-sectional survey	Examine elements of the nursing work environment
Lu et al.^a,c [67]	2007	China	Remuneration	Nurses (n = 512)	Medical/surgical departments in 2 teaching hospitals
Nasrabadi et al. [90]	2004	Iran	Remuneration	Literature review	Describe education, practice and research issues encountered by nurses
Nasrabadi et al. [90]	2004	Iran	Remuneration	Peer-reviewed journal articles, international and national grey literature
Rockers et al. [87]	2013	Laos	Remuneration	Discrete choice experiment	Identify preferences for job characteristics amongst practicing nurses and nursing students
				Nurses (n = 249) and nursing students (n = 256)
				Nurses (n = 249) and nursing students (n = 256)	Primary, secondary and tertiary facilities in 3 rural provinces
Zarea et al. [86]	2009	Iran	Remuneration	Literature review	Examine factors contributing to the nursing shortage
Zarea et al. [86]	2009	Iran	Remuneration	Peer-reviewed journal articles, international and national grey literature	Examine factors contributing to the nursing shortage
Gulzaret et al. [84]	2011	Pakistan	Management approach	Qualitative content analysis	Explore perceptions of the community health nurse assistance manager role
				Semi-structured interviews
				Community health stakeholders (n = 13)
				Purposive sampling
Ng’ang’a et al. [93]	2011	Multiple	Comprehensive PPMs^f	Editorial	Promote professional practice models for nurses in low-income countries

^aAlso addresses management approach
^bAlso addresses professional values
^cAlso addresses professional relationships
^dAlso addresses remuneration
^eAlso addresses patient care delivery systems
^fProfessional practice models

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ISSN: 1472-6955

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