The Safer Surgery Saves Lives pilot project partnership between ZUNO and RCN, aimed at improving knowledge and skills in using the WHO surgical checklist, concluded after training 296 staff over two years. Speeches highlighted the importance of safety in healthcare, especially surgery, and continuing this work. The WHO checklist is a 19-item tool to decrease errors and increase communication among surgical teams. Additionally, ARC held its second learning session in Rwanda to strengthen nursing and midwifery project management skills. Finally, a clinical audit found increased use of the partograph among midwives, though some still do not use it properly.

1. ZUNO E- NEWSLETTER/ Monthly Issue# 19 March 2017
P A G E | 1
On March 31st
2017, the Safer Surgery
Saves Lives pilot project, a partnership
between the Zambia Union of Nurses
Organisation (ZUNO) and the Royal
College of Nursing (RCN) funded by the
Tropical Health & Education Trust (THET)
under the United Kingdom Department
For International Development came to a
close.
The Safer Surgery Saves Lives pilot
project, aimed at improving the
knowledge and skills of theatre teams in
the use of the World Health Organisation
(WHO) Surgical Checklist in their work,
commenced in April 2015.
Between July 2015 and February 2017,
ZUNO conducted eleven training
sessions in the two pilot sites (Lusaka and
Kabwe) reaching a total of 296 different
categories of staff.
Speaking at the event to mark the close
of the project and dissemination of the
evaluation report, Ministry of Health
Permanent Secretary for Health Services
Dr Jabbin Mulwanda in a speech read on
his behalf by the Deputy Director Nursing
Services Mrs Emily Chipaya noted that
safety is an essential element of health-
care provision and even more so in the
area of surgery.
Dr Mulwanda said recognizing the
importance of surgical care, the Zambian
government has stayed committed to
improving operating theatres across the
country.
And RCN Chief Executive Janet Davis
noted that national nurse organisations
have a huge role to play in improving
patient care and population health across
the world. Ms Davis disclosed that RCN
will be continuing to work with ZUNO
into phase II in rolling-out the program
further and consolidate it.
ZUNO President Mr Liseli Sitali called on
theatre staff, hospital management,
Members of Parliament and other
political leaders, relevant government
institutions and the media to play a role
in advocating for safer surgery and
ensuring that it is a norm in Zambia.
And Zambia operating theatre nurses
interest group (ZOTNIG) Chairperson Ms
Judith Munthali noted that the project
has helped strengthen peri-operative
nursing professionalism through the use
and implementation of the WHO safe
surgery tool adding that the gains from
the Safer Surgery Saves Lives pilot
project should be sustained.
The WHO Surgical Safety Checklist is a 19
item tool developed after extensive
consultation aiming to decrease errors and
adverse events, and increase teamwork and
communication among surgical teams.
###
Also In this issue
 ARC holds 2nd learning session
in Kigali
 Call for increased awareness and
implementation of the new
Gender Equity and Equality ACT
 Clinical audit reveals increased
use of the partogragh among
midwives in Zambia
Chreso University School of Nursing Cultural Group
presenting the report to Ministry of Health Deputy Director
Nursing Services Mrs Chipaya and ZUNO General Secretary
Mr Michelo during the official closing of the Safer Surgery
Saves Lives Pilot Project at Cresta Golf View Hotel in
Lusaka© ZUNO
ZUNO/RCN Safe Surgery Saves Lives Pilot Project comes to a close.

2. ZUNO E- NEWSLETTER | Monthly Issue#19 MARCH 2017 PAGE2
The African Health Professions Regional Collaborative for Nurses and
Midwives (ARC) held its second learning session from 21 -23 March 2017 in Kigali
Rwanda.
The 10 countries that attended are: Ethiopia, Kenya, Lesotho, Malawi,
Mozambique, Rwanda, Swaziland, Tanzania, Zambia and Zimbabwe.
The purpose of the meeting, was to strengthen the ability of nursing and
midwifery leaders to successfully implement, monitor, and evaluate national
quality improvement projects.
Speaking during the meeting Commonwealth Nurses and Midwives Federation
executive secretary Jill Iliffe encouraged the participants to continue applying
and upskilling their knowledge in project management
All the four pillars of nursing and midwifery, that is Administration, Education,
Professional, and Regulatory were represented to as issues specific to their area
of responsibility were discussed.
The third learning session will be held in Lusaka Zambia from 6-8 July 2017. The
first learning session was held in Entebbe Uganda 7-9 November 2016.
ARC works across eighteen (18) countries in sub-Saharan Africa to facilitate
nurse- and midwife-led HIV care for pregnant women and children; improve the
quality of nursing practice; and enhance national nursing policy and regulation.
ARC is funded by the President's Emergency Plan for AIDS Relief (PEPFAR)
through the US Centers for Disease Control and Prevention (CDC) and
implemented by Emory University School of Nursing in partnership with the
Lillian Carter Center for Global Health and Social Responsibility at Emory
University, the Commonwealth Nurses and Midwives Federation, and the East,
Central and Southern Africa Health Community.
ARC representatives from Zambia after receiving their certificates during the ARC
meeting in Kigali, Rwanda
ARC holds 2nd learning session in Kigali Call for increased awareness
and implementation of the new
Gender Equity and Equality
ACT
On March 8th 2017 Zambia Union of Nurses
Organisation (ZUNO) joinedt the rest of Zambia
in observing the International Women’s Day under
the theme “Promoting inclusiveness in economic
participation as a means of attaining sustainable
development.”
Zambia’s Republican President Mr Edgar Lungu
graced the event calling for practical measures in
promoting women empowerment in Zambia. Mr
Lungu said this would be possible through creating
awareness and implementing the new Gender
Equity and Equality ACT, 2015.
The President noted that the Act is aimed at
promoting gender equity and equality as a cross
cutting issue in all spheres of life while seeking to
stimulate productive resources and opportunities
for both men and women.
Internationally, International Women's Day 2017,
focused on the theme #BeBoldForChange.
The theme is a call to help forge a better working
world - a more gender inclusive world in 2017 and
beyond.
###

3. ZUNO E- NEWSLETTER | Monthly Issue#19 MARCH 2017 PAGE3
Arecent Clinical audit conducted at University Teaching Hospital
for Women and New- Born and Mansa General Hospital has revealed
that the number of Midwives who are able to use the partograph is
improving, but that some midwives still do not pay attention to it.
A partograph, which is an essential tool for decision making, is a
graphical record of the observations made of a women in labour.
The audit was conducted by Lugina Africa Midwives Research Network
(LAMRN) Zambia which is part of a regional LAMRN grouping aimed at
improving and increasing midwifery research and evidence-based
midwifery practice in the Eastern, Central and Southern African region.
The clinical audit conducted at the two hospitals from 2015, to
determine the level of knowledge and practices that skilled attendants
had on utilization of the partograph, also revealed that utilization of
the partograph is a challenge.
While at least 95% of midwives in labor ward are expected to be able to
plot the partograph correctly, the initial audit indicated that only 7.5%
of the skilled attendants were able to interpret and plot correctly on
the partograph. 47.5% of the skilled attendants failed to plot on the
partograph and 45% did not attempt to plot on the partograph.
However, when the re-audit was conducted it revealed a significant
improvement. The percentage number of the skilled attendants who
were able to interpret and plot correctly on the partograph rose above
the standard to 95.5 %.
The initial audit further indicated that only 29.5 % of midwives
monitored and recorded foetal heart every 30 minutes, 65.9% did not
monitor and record foetal heart rate every 30 minutes, while 4.6%
gave Intrauterine Fetal Death (which refers to the death of a baby in
the uterus, during pregnancy and before birth) as the reason for not
monitoring and recording foetal heart rate every 30 minutes. When the
re-audit was done however, the percentage rose to 70.5%.
Table indicating standard and performance gap: audit & re-audit
Fig.1
The clinical audit revealed that there are some factors that are
hindering the use of the partograph among skilled attendants which
include unavailability of partographs, attending to emergencies or
simply no attempt to use it.
Factors hindering the use of the partograph among skilled
attendants (n=40)
Fig.2
Discussing the recommendations during the audit findings
dissemination meeting held in Lusaka from 23rd to 24th March 2017,
the meeting endorsed the need to ensure that midwives adhere to
WHO prescribed 5 year in-service training on partograph. The meeting
further recommended a roll out training on partograph utilization and
the need to integrate auditing in the nursing curriculum.
LAMRN plans to conduct a re-audit December 2017 and intends to
integrate the audit in the 2017-2021 Ministry Of Health strategic plan
so that audit is budgeted for as hospital activities.
The Clinical audit was conducted to improve quality of care by
providing decision makers with evidence based practice needed to
improve maternal and new-born health.
###
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A midwife providing Antenatal care to a pregnant women
Clinical audit reveals increased use of the
partogragh among midwives in Zambia

4. ZUNO E- NEWSLETTER/ Monthly Issue# 19 March 2017
P A G E | 4
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registered with the General Nursing Council of Zambia
(GNCZ), and employed both in the public and private sectors.
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through ZUNO membership, as the organisation creates an
effective platform for networking and capacity building with
local and international stakeholders.
Benefits include;
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(CPD)
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committees
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QUOTE
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that counts.”
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