An International Nursing Exchange: The North Carolina/Republic of Moldova Nursing Collaborative

Monday, 30 October 2017: 3:05 PM

Julie O'Neal, MSN
Nursing Staff Education, Cone Health, Greensboro, NC, USA
Luba Louise Ivanov, PhD
College of Nursing, Chamberlain College of Nursing, Downers Grove, IL, USA

The State of North Carolina (NC) and the Republic of Moldova collaborative was created in 1999 as part of the North Atlantic Treaty Organization (NATO) Partnership for Peace. This collaborative was started with the goal to partner Euro-Atlantic countries and NATO to strengthen and improve relationships. In NC, the partnership includes, “civil emergency operations, expansion of markets, cultural, scientific and academic exchanges, and the coordination of humanitarian efforts” (NC Department of Secretary of State, 2015). This partnership is renewed every 5 years. Through this partnership, nurses in North Carolina and the Republic of Moldova, have collaborated to expand nursing practice and improve patient outcomes in the small Eastern European country of Moldova.

In October 2014, a delegation of Moldovan nursing leaders and a representative from the Ministry of Health visited hospitals, universities, and local health departments in Greensboro, NC. This visit identified the need for a collaborative effort to improve nursing education and practice. The key stakeholders that were instrumental in the success of this project included community resources, such as local rotary clubs, universities and colleges of nursing, and a Magnet designated health system. At the state level, the North Carolina Department of the Secretary of State and the North Carolina National Guard acknowledged their support of nursing projects. Sustainability of this project would not have been possible without international resources. The scope of nursing practice and nursing education curricula are governed by members of the Ministry of Health in the Republic of Moldova. As a result, it was crucial that support was obtained from key stakeholders in Moldova. Support was obtained from the International Rotary, Ministry of Health in the Republic of Moldova, Moldovan Nursing Association, College of Nursing and Pharmacy in Chisinau, the capital of Moldova, and various hospitals in Chisinau.

Working in collaboration with nurses, nursing faculty, and representatives from the Moldovan Ministry of Health, the need for assistance in improving nursing practice and development of a Bachelor of Science in Nursing Degree was identified. Currently, nurses in Moldova are taught at Colleges of Nursing for three years receiving a diploma upon graduation. To support the request for the development of a BSN program, two NC universities shared their curriculum with the College of Nursing in Chisinau. Opportunities to integrate the Moldova College of nursing curricula with elements of a BSN curricula were discussed to assist in moving to a BSN degree program.

 In May of 2015, North Carolina nurses provided education seminars on various topics to Moldovan nurses and nursing faculty. Sites of education included a national nursing conference, a college of nursing, several hospitals and a nursing education center. Education seminars on best practices in gerontology, oncology including safe practices in chemotherapy administration, infection prevention, palliative care, public health, and professional nursing was provided. In addition, information on nursing leadership and management, introduction of Shared Governance, and introduction of nursing documentation was also presented. One hundred twenty four nurses attended these seminars. An evaluation tool using a five point Likert scale was developed to evaluate the relevancy of the content presented to improving their nursing knowledge and practice. The tool was developed in Russian, by a nurse fluent in the Russian language which is one of their spoken languages. Ninety seven percent of participants responded either strongly agree or agree to the item, this session was valuable in adding to my understanding of nursing.

Approval for the project was required and received from the Guilford Rotary Club in Greensboro NC, the Moldovan Rotary in Chisinau and the International Rotary. After approval was received, funding was obtained from an International Rotary Global Grant, totaling $ 34,961.00. Additional funding was received from members of two Greensboro, NC rotary clubs and a fundraising event.

The outcomes of this project were significant and included the addition of a nurse leader on the Ministry of Health which had never been done before, improved staffing on nursing units by developing the nursing assistant role, development of a hospital based nurse leader role, safer practices for nurses including use of personal protective equipment with chemotherapy administration, and improved patient care related to improved hand hygiene practices, implementation of geriatric specific assessments and public health assessments, and increased efforts towards patient education regarding diagnoses. The development of a curriculum for a Bachelor of Science in Nursing degree was initiated. Outcomes in North Carolina for nursing staff in a Magnet Health System and a University School of Nursing included enhanced cultural competence and the opportunity to contribute to the body of nursing in another country.

 Through this collaboration in Moldova, nursing curriculum has been developed, new nursing leadership roles have been created and improved patient care practices have been initiated. The efforts of nurses in North Carolina and Moldova have contributed to the advancement of professional practice, enriched nursing education and expanded the Moldovan nurse’s knowledge to support improved patient care.