Showing papers by "Caroline Larue published in 2018"

Learning theories and tools for the assessment of core nursing competencies in simulation: A theoretical review

Abstract: Aim To identify the theories used to explain learning in simulation and to examine how these theories guided the assessment of learning outcomes related to core competencies in undergraduate nursing students. Background Nurse educators face the challenge of making explicit the outcomes of competency-based education, especially when competencies are conceptualized as holistic and context-dependent. Design Theoretical review. Data Sources Research papers (N=182) published between 1999 - 2015 describing simulation in nursing education. Review Methods Two members of the research team extracted data from the papers, including theories used to explain how simulation could engender learning and tools used to assess simulation outcomes. Contingency tables were created to examine the associations between theories, outcomes and tools. Results Some papers (N=79) did not provide an explicit theory. The 103 remaining papers identified one or more learning or teaching theories; the most frequent were the National League for Nursing/Jeffries Simulation Framework, Kolb's theory of experiential learning and Bandura's social cognitive theory and concept of self-efficacy. Students’ perceptions of simulation, knowledge and self-confidence were the most frequently assessed, mainly via scales designed for the study where they were used. Core competencies were mostly assessed with an observational approach. Conclusion This review highlighted the fact that few studies examined the use of simulation in nursing education through learning theories and via assessment of core competencies. It also identified observational tools used to assess competencies in action, as holistic and context-dependent constructs. This article is protected by copyright. All rights reserved.

A pilot study of "post-seclusion and/or restraint review" intervention with patients and staff in a mental health setting.

Abstract: Purpose To develop and evaluate a “post-seclusion and/or restraint review” (PSRR) intervention implemented in an acute psychiatric care unit. Design and Methods Twelve staff members and three patients were enrolled in a participatory case study. To evaluate PSRR intervention, qualitative analysis was carried out. Seclusion and restraint use 6 months before and after the PSRR implementation was compared. Findings Nurses reported that they were able to explore the patient's feelings during the PSRR intervention with patients, which led to restoration of the therapeutic relationship. PSRR with the treatment team was perceived as a learning opportunity, which allowed to improve the therapeutic intervention. Both the use of seclusion and the time spent in seclusion were significantly reduced 6 months after the implementation of PSRR intervention. Practice Implication Our results suggest the efficacy of PSRR in overcoming the discomfort perceived by both staff and patient and, in the meantime, in reducing the need for coercive procedures. Systematic PSRR could permit to improve the quality of care and the safety of aggressiveness management.

Identification and Analysis of Factors Contributing to the Reduction in Seclusion and Restraint for a Population with Intellectual Disability.

Abstract: Background A cohort of 11 patients with an intellectual disability and a psychiatric diagnosis present severe behavioural disorders in psychiatric hospital of Quebec in 2009. Control-measure use for this clientele has now been reduced. How do management personnel, families and care teams explain the changes? What clinical interventions did management and care providers implement that contributed to the reduction? Method A retrospective case study was conducted. Five focus groups were held with people involved in their care, and the patient files were examined. Results The factors contributing to this change were the cohesion of the care providers, the involvement of the families and the efforts to determine the function of the behaviour. Implications This study may inspire other care teams to try new approaches in dealing with patients with severe behavioural disorders. Also, the model of factors and interventions supporting a reduction in seclusion and restraint measures may inspire future studies.

A Case Study: Seclusion and Restraint in Psychiatric Care:

Abstract: A wide breadth of research has recognized that seclusion and restraint affects patients, staff, and organizations alike. Therefore, it is essential to understand the viewpoints of all stakeholders to improve practices. The study aimed to understand the context in which seclusion and restraint practices are employed based on the perceptions of staff and inpatients in a psychiatric ward. A case study was performed using a participatory approach. Methods included a 56-hr immersion in the practice setting and individual interviews with staff and patients ( n = 17). The main themes discussed were patient characteristics (etiology of the violence, difficult experience), staff characteristics (feelings of safety, rationalization of seclusion use), and environmental characteristics. Both explicit (e.g., hospital protocol) and implicit (e.g., ward rules) standards seem to influence seclusion and restraint management. Our results point toward the potential for developing post-seclusion and restraint review in which both patient and staff perspectives are taken into account.