Impact of structured refresher training on clinical competence of primary healthcare nurses in Karachi, Pakistan: A quasi-experimental study

Document Type

Article

Department

Medical College Pakistan; Internal Medicine; School of Nursing and Midwifery, Pakistan

Abstract

Background: In resource-limited primary healthcare (PHC) settings, nurses often have limited opportunities for refresher training and capacity-building. This study evaluates a structured nursing refresher training program implemented in slum-based PHC clinics, focusing on changes in clinical competence, patient safety practices, and adherence to healthcare protocols.
Methodology: A single-group pre-post quasi-experimental study was conducted among 250 nurses from 40 primary health clinics. Knowledge and practice skills were assessed before and after the training. Data were analyzed using STATA version 15.0. Descriptive statistics and paired t-tests were applied, and mean differences with 95% confidence intervals (CIs) were reported. Generalized Estimating Equations (GEE) with an exchangeable correlation structure were also used to examine associations between independent variables and changes in knowledge and practice scores.
Results: Of the 250 participants, 231 completed the study. The mean age was 31.6 years (± 6.67), with an average of 5.63 years (± 4.21) of job experience. The mean knowledge score increased from 11.91 to 15.62, with a mean difference of 3.71 (95% CI: 3.15-4.27). Similarly, mean practice scores increased from 19.53 (95% CI: 19.29-19.77) to 26.11 (95% CI: 25.87-26.35), with a mean difference of 6.58 (95% CI: 6.26-6.90).
Conclusion: The findings indicate improvements in knowledge and practice scores following the training intervention. However, due to the absence of a control group, causal interpretations should be made with caution. The results highlight the potential value of continuous education and capacity-building initiatives for healthcare providers in similar settings.

Comments

Volume, Issue and Pagination was not provided by author/publisher

Publication (Name of Journal)

BioMed Central nursing

DOI

10.1186/s12912-026-05096-8

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