Formação de Enfermeiros em Hemodiálise - Pluribus II Internacional

Hemodialysis Nurses Training Program and On-Job Integration in teams (Angola)

Abstract

Nursing Training

Number of trainees

Training Hours

Year	2012	2013	2014	2015	2017	2019	Total
Started Training	29	38	2	47	47	57	220
Approved in Module 1	29	17	2	47	30	35	160
Approved in Module 2	18	14	2	24	26	33	118
Integrated in the Team (On Job)	8	5	2	17	18	12	62
Training Hours	9600	7880	800	14200	12560	15360	60400

Activity Report

1 – Introduction

The Hemodialysis Training Course for Nurses were developed with the general objective of increasing theoretical and practical knowledge in nephrology, to prepare our employees for the exercise of specialized functions in hemodialysis at Hemodialysis Clinic of Benguela and at Lobito Hemodialysis Clinic.

2 – Selection of Applications

The trainees selected to attend the Training Course in Hemodialysis for Nurses had medium and/or higher education in Nursing.

Candidates had to fill out a specific form, attach their CV, diploma, and a document certifying that they were registered with the local Nurses Association.

From all the applications received, only candidates who possessed the necessary qualifications to attend the training were selected. An internal application process for Nursing Technicians (Medium level) was also opened at General Hospital of Lobito.

3 – Planning

The training plan was divided into different Modules: Module 1 had 12 theoretical subjects (Annex 1), Module 2 included 7 theoretical and practical subjects (Annex 2) and Module 3 put candidates providing direct healthcare to users in a regular dialysis program. It was mandatory to attend all Modules. Module 1 had a duration of 6 weeks, Module 2 from 4 to 6 weeks and Module 3 lasted 12 weeks.

A textbook was given to each trainee with the contents of the 12 theoretical subjects of Module 1, and the planning of the training sessions.

Candidates were evaluated through a written exam at the end of Module 1. It had 25 multiple-choice questions.

Module 2 classes were lectured to all trainees that passed Module’s 1 exam. To complete Module 2, trainees had to pass a practical exam.

The content of both Modules was explained to the trainees in the Hemodialysis Clinic of Lobito Training Room, using slides.

Trainees who completed Modules 1 and 2 with the best grades were selected to participate in Module 3. For 12 weeks, they provided healthcare in collaboration with the nursing staff of Benguela Hemodialysis Clinic.

4 – Trainees’ features

4.1 – Candidates

We received 60 applications for the Hemodialysis Training Course for Nurses, and we selected 43 candidates: 28 came from Lobito Municipal Hospital – who for this reason were preferred – and the other 15 were external candidates.

4.2 – Features

4.2.1 – Gender

In what concerns gender, 79% were women (34 candidates) and 21% were men (9 candidates), which follows the same gender ratio of the Nursing Course.

4.2.2 – Academic Degree

All selected candidates were Medium Level Nurse Technicians (43 candidates), 9% were enrolled in a Nursing High Degree (4 candidates), and 28% were enrolled in other high degrees (12 candidates). The rest, 63%, did not reveal their educational background or were not students. Most of the selected candidates were Medium Level Nurse Technicians because the Nursing Degree was only created in 2010, in Benguela. Moreover, at the time, that was the university level required to be hired to the Hospital staff.

5 – Course Attendance

From all the selected candidates, 5 renounced before the beginning of the course, reducing the number of trainees to 38.

Module 1 classes began on May 14, 2013, and ended on June 17, of the same year. 12 subjects were presented in a total of 16 training sessions. 2 subjects were too large and had to be given in two training sessions.

Module 1 written exam was done on June 25, 2013: 17 trainees passed (45%), 19 did not pass (50%) and 2 had their exam annulled for multiple answers.

Module 2 classes began on June 24, 2013, and ended on July 19, of the same year. It lasted 4 weeks. The first 3 weeks were focused on skill acquisition and the last week was composed of theoretical and practical training sessions.

From July 24 to 28, 2013, the 17 trainees were divided into 4 groups and were evaluated according to the evaluation skills grid (annex 3). The trainees acquired basic knowledge on how to use the hemodialysis monitor, on nursing records, on infection control and preparation of anticoagulation therapies.

14 trainees were approved (82%) and 3 were rejected (18%).

From the 14 approved trainees, 71% (10 trainees) stated they were not available to attend Module 3 classes, for personal and professional reasons. They also added they attended this Course to obtain more knowledge. Only 4 trainees wished to proceed to Module 3.

One of the trainees who failed the exam, said she had technical skills, but on the evaluation day she was nervous, and therefore required to carry out a new assessment. Her requirement was analyzed, and a new practical exam was made to all trainees who had not been approved.

Consequently, 2 trainees failed the exam once again and 1 was approved.

Module 3 began on August 11, 2013, and ended on November 19, 2013, in Benguela Hemodialysis Clinic, with 5 trainees, who were integrated into the nursing team as interns: they provided direct healthcare to patients on regular hemodialysis program, (3 shifts per week where they could apply and improve the knowledge and techniques acquired in the previous modules).

6 – Conclusion

Some of the theoretical content of Module 1 will have to be changed because they are too complex for these trainees, who as we previously mentioned do not possess a university degree.

During Module 2 training sessions, it was necessary to speak about some basic content that we supposed to be already known by the trainees. This extended the duration of module’s 2 classes.

The 12-week period defined for the conclusion of Module 3 proved to be sufficient for the integration into the HD classroom dynamics. However, it was necessary to establish 5 or 6 shifts per week, as it was noticed that with weekly shifts trainees asked about concepts acquired in the previous shift.

As verified, the trainees who successfully finished the training were not always available and motivated to start working. Some mentioned they attended this training because it was free and offered them a Training Diploma.