Showing papers in "Journal of Nursing Education and Practice in 2014"
TL;DR: Nurses in the hematology/oncology unit reported lowest burnout and highest job satisfaction, which may be due to the educational and mentoring support from a unit-based end-of-life care program.
Abstract: Aims: The aims of the study were to: assess job satisfaction, burnout, compassion satisfaction, and work-related stress among pediatric nurses at surgical, medical, critical care, and hematology/oncology units in a tertiary acute care hospital; and identify the predictors of job satisfaction, burnout, compassion satisfaction, and work-related stress. Methods: A cross-sectional study was conducted at a children’s hospital in southern California from February 2013 to March 2013. A convenience sample of registered nurses working in four different units (N = 240) completed the Professional Quality of Life, Brief Index of Affective Job Satisfaction, and demographic questionnaire. One-way Analysis of Variance (ANOVA) and simultaneous multiple regression procedures were performed. Results: Nurses in the hematology/oncology unit reported the lowest level of burnout and highest levels of job satisfaction and compassion satisfaction. In contrast, nurses in the surgical unit reported the opposite. Among surgical unit nurses, those with 5-9 years of RN experience reported highest burnout as well as lowest job satisfaction and compassion satisfaction. The combination of demographic variables explained a large fraction of the variance in job satisfaction ( R 2 = 0.251) and positive predictors were white ethnicity (β = 0.33) and hematology/oncology unit (β = 0.16), whereas negative predictors were surgical unit (β = -0.32) and critical care unit (β = -0.20). Conclusions: Nurses in the hematology/oncology unit reported lowest burnout and highest job satisfaction, which may be due to the educational and mentoring support from a unit-based end-of-life care program. A focused strategy targeting a specific group of nurses in a unit may help to reduce work-related stress and burnout.
48 citations
TL;DR: Enthusiasm from patients and caregivers in new technologies to aid in adherence was tempered by potential burden, and should be considered when designing interventions to promote adherence.
Abstract: Background: Reducing the rate of rehospitalization among heart failure patients is a major public health challenge; medication non-adherence is a crucial factor shown to trigger rehospitalizations. Objective: To collect pilot data to inform the design of educational interventions targeted to heart failure patients and their caregivers to improve medication adherence. Methods: Heart failure patients with an implantable cardioverter defibrillator and their family caregivers were recruited from an outpatient electrophysiology clinic at an urban university medical center (N = 10 caregiver and patient dyads, 70% race/ethnic minority, mean patient age = 63 years). Quantitative and qualitative research methods were utilized. Semi-structured individual interviews were conducted to assess patients’ and caregivers’ individual interest in, and access to, new medication adherence technologies. Patient adherence to medications, medication self-efficacy, and depression were assessed by validated questionnaires. Medication adherence and hospitalization rates were assessed among patients at 30-days post-clinic visit by mailed survey. Results: At baseline, 60% of patients reported sometimes forgetting to take their medications. The most common factors associated with non-adherence included forgetfulness (50%), having other medications to take (20%), and being symptom-free (20%). At 30-day follow-up, half of patients reported non-adherence to their medications, and 1 in 10 reported being hospitalized within the past month. Dyads reported widespread access to technology, with the majority of dyads showing interest in mobile applications and text messaging. There was less acceptance of medication-dispensing technologies; caregivers and patients were concerned about added burden. Conclusions: The majority of etiologies of medication non-adherence were subject to intervention. Enthusiasm from patients and caregivers in new technologies to aid in adherence was tempered by potential burden, and should be considered when designing interventions to promote adherence.
46 citations
TL;DR: The findings of current study confirm that occupational stress has negative relationships with the faculty members’ emotional intelligence and self-efficacy, and suggest that the Faculty of Nursing should keep the stress level of their faculty members lower and help them to stay healthier by holding training courses on emotional intelligence.
Abstract: Background/Aim: Different studies, in international context, have linked occupational stress to emotional intelligence or self-efficacy of faculty members. However, investigating the relationship between these three constructs in this context was limited. So, the researchers investigated the relationship between occupational stress, emotional intelligence and self-efficacy among faculty members. Method: The study was conducted at the Faculty of Nursing, Zagazig University using a descriptive correlational design. A convenience sample of 91 faculty members working in Faculty of Nursing Zagazig University during the academic year 2011-2012 were recruited for the study. Four tools were used for data collection: Questionnaire about demographic data, Emotional Intelligence Scale, General Self-Efficacy Scale, and Occupational Stress Scale. Results: The study findings indicate that the majority of faculty members experience a high level of occupational stress, while they have a low level of emotional intelligence and self-efficacy. The occupational stress was negatively related with faculty members’ emotional intelligence and self-efficacy. Conclusion and Recommendation: The findings of current study confirm that occupational stress has negative relationships with the faculty members’ emotional intelligence and self-efficacy. Therefore, we suggest that the Faculty of Nursing should keep the stress level of their faculty members lower and help them to stay healthier by holding training courses on emotional intelligence improving their social skills and increase their efficiency at work. Moreover, the perceived self-efficacy can be improved among the faculty members through training programmes and courses this would help the faculty members enhance their stress bearing capacity and also improve their productivity.
42 citations
TL;DR: Effective ways for nursing faculty to teach spiritual care will help to advance spiritually educated nurses who can rise above obstacles to providing spiritual care to clients, and enhance the delivery of this vital aspect of holistic nursing.
Abstract: Since Florence Nightingale, spiritual care has been embraced in professional nursing as the integration and promotion of purpose and meaning in life. Research reports that nurses have a prominent regard for spiritual care and acknowledge that it is part of their role. The intention of this literature review is to explore effective ways for nursing faculty to teach spiritual care. This in turn will help to advance spiritually educated nurses who can rise above obstacles to providing spiritual care to clients. During the nursing formation process, spiritual care must be integrated into the nursing curricula throughout the didactic and clinical nursing education. Numerous nurses today consider themselves underprepared to meet the spiritual needs of their clients, despite nursing’s past dedication to spiritual care. Research further supports the appeal of clients to have their spiritual needs addressed while hospitalized. Given the suitable resources and education, nurses can be positioned to address the spiritual care of clients. Relevant nursing education on more effective ways to teach spiritual care will enhance the delivery of this vital aspect of holistic nursing. The focus of holistic patient care is based on the Neuman systems model, where the spiritual variable considerations are necessary for a truly holistic perspective and caring concern for the patient. As part of a successful pedagogy, a course of action and theory-based approach must be translated into preparing student nurses to incorporate spiritual care into their emerging practices.
39 citations
TL;DR: High-fidelity simulation using a computer-controlled human patient simulator has potential to support the development of clinical judgment in nursing students, and tutors are challenged to enhance students' intrinsic motivation for learning, and encourage them to continue their efforts in learning.
Abstract: Background : Improving students’ decision making and judgment skills becomes an essential part of nursing education. The purpose of this Quasi-experimental study was to assess nursing students’ clinical judgment in high-fidelity simulation based learning using observational measures. Method : Based on Tanner’s clinical judgment model, a single group repeated-measures design was used with a purposive sampling at one nursing school in Macao. A total of 113 baccalaureate nursing students (49 in year two, 64 in year three) completed five simulation sessions within a 36 hour period. Two tutors used the Clinical Judgment Rubric to assess s tudents’ clinical judgment at the end of each simulation session. The inter-rater reliability for the sessions ranged from 0.833 to 0.910. Results: The scores for clinical judgment increased from the first simulation scenario to the last scenario. Compared with third-year students, second-year students had significantly higher scores of clinical judgment in scenarios two, three, four and five. The debriefing was essential to preparing students for improving their thinking and reasoning skills. Students perceived that simulation strengthened their theoretical knowledge and helped them to notice, interpret, and respond appropriately to contingencies and emergencies. Tutors’ comments indicated that second-year students valued the newly learned knowledge and used it to analyze the simulated scenarios while third-year students presented less knowledge and skill preparation. Conclusions: High-fidelity simulation using a computer-controlled human patient simulator has potential to support the development of clinical judgment in nursing students. Tutors are challenged to enhance students' intrinsic motivation for learning, and encourage them to continue their efforts in learning. Further research is needed to explore whether senior students have better performance in clinical judgment than junior students.
39 citations
TL;DR: In this article, the debriefing phase in human patient simulation is considered to be crucial for learning and debriefs are considered to offer excellent opportunities for transferable learning, and activity, predictability and preparedness were deemed essential.
Abstract: The debriefing phase in human patient simulation is considered to be crucial for learning. To ensure good learning conditions, the use of small groups is recommended, which poses a major challenge when the student count is high. The use of large groups may provide an alternative for typical lecture-style education and contribute to a more frequently and repeated training which is considered to be important for achieving simulation competency. The purpose of the present study was to describe nursing students’ experiences obtained during the debriefing conducted in small and large groups with the use of a qualitative descriptive approach. The informants had participated in a human patient simulation situation either in large or small groups. Data was collected through the use of five focus-group interviews and analysed by content analysis. The findings showed that independent of group-size the informants experienced the learning strategies to be unfamiliar and intrusive, and in the large groups to such an extent that learning was hampered. Debriefing was perceived as offering excellent opportunities for transferable learning, and activity, predictability and preparedness were deemed essential. Small groups provided the best learning conditions in that safety and security were ensured, but were perceived as providing limited challenges to accommodate professional requirements as a nurse. Simulation competency as a prerequisite for learning was shown not to be developed isolated in conjunction with simulation, but depends on a systematic effort to build a learning community in the programme in general. The faculty needs to support the students to be conscious and accustomed to learning as a heightened experience of learning out of their comfort zone.
36 citations
TL;DR: Testing a communication intervention with baccalaureate student nurses to examine its effect on empathy revealed an increase in empathy and incorporation of NVC into nursing education could feasibly prevent future hardship as students advance their nursing careers.
Abstract: Background: Ineffective communication among healthcare team members is associated with decreased collaborative efforts and adverse patient outcomes. The impact of empathy on collaboration with colleagues and patient interaction has been previously demonstrated. Studies have yet to measure the impact of (Nonviolent Communication [NVC]) on empathy in nursing students. Purpose: The purpose of this mixed methods study was to test a communication intervention (NVC) with baccalaureate student nurses to examine its effect on empathy. Methods: A mixed methods single group pre/post test design incorporating the Interpersonal Reactivity Index (IRI) to measure empathy was used. A paired samples t test was calculated to compare means scores pre and post intervention. One-way ANOVA was used to examine between group differences. Interpretive methods were used to analyze qualitative data collected via journal entries during the training and focus groups immediately following and 2 years post intervention. Results/Findings: Quantitative results revealed an increase in empathy (69.1 to 71.4, p = .037) post training. Qualitative analyses demonstrated positive impact of NVC in empathizing with self and others. Clinical impact was especially noted when working with psychiatric patients. Conclusion: Incorporating NVC into nursing education could feasibly prevent future hardship as students advance their nursing careers. Further research may be needed to capture the larger impact that NVC could have on nurses and nursing students.
35 citations
TL;DR: Investigating whether the blended learning model adopted by a UNP could yield the same, if not better academic achievement as compared with the traditional classroom learning found no significant difference in terms of academic performance before and after the courses adopted blended learning.
Abstract: As more and more undergraduate nursing programs (UNP) adopt the blended learning model, which combines traditional face-to-face learning and e-learning, how it impacts on students’ academic performance comes into educators’ mind. The purpose of this study was to investigate whether the blended learning model adopted by a UNP could yield the same, if not better academic achievement as compared with the traditional classroom learning. Students enrolled in two undergraduate nursing courses in fall 2008 and spring 2009 semesters were taken as a convenient sample. Students’ academic achieve- ments were compared before and after the two undergraduate nursing courses adopted blended learning. Faculty members who taught those courses before and after the adoption were interviewed for insights on students’ complains and their corresponding solutions. The statistic results showed that there was no significant difference in terms of academic performance before and after the courses adopted blended learning. Interviews from the faculty members suggested that there was some initial resistance from the students on taking the online content outside of class. Pop quizzes at the beginning of each face-to-face class helped motivate students to complete the online portion at home prior coming to the class.
34 citations
TL;DR: The authors examined the experience of men "training" to be registered nurses within a regional New Zealand context and identified four key themes were identified: a career with flexibility and promise; perceived gender inequality in providing care; developing professional boundaries with female colleagues and being unique has its advantages.
Abstract: Background: Surprisingly, opinion about whether men are suitable within the profession continues to be a divided issue. Men enter the profession for a multitude of reasons, yet barriers whether emotional, verbal or sexual are still present. Aim: The aim of this study was to examine the experience of men “training” to be registered nurses within a regional New Zealand context. Design: A Narrative Analysis approach was used. Participants: Five New Zealand men currently undertaking their bachelor of nursing degree at a regional tertiary institute were interviewed as to their experiences of what it meant to be a man in “training”. Method: A thematic analysis was undertaken and guided by an understanding of the way personal narratives informs the human sciences especially within the context of nursing praxis. Four key themes were identified. Results: Four key themes were identified: A career with flexibility and promise; perceived gender inequality in providing care; developing professional boundaries with female colleagues and being unique has its advantages. Conclusion: The men in this study were attracted to the profession by career stability and advancement; the opportunities for travel also figured highly. At times they felt excluded and marginalised because of their minority status within their group and the feminine nature of the curriculum. The men attempted to dispel the myth around male nurse sexual stereotypes. Some of the students behaved in a manner to exert their heterosexualness. The students in this study sensed their vulnerability in choosing nursing as a career. However, all the participants saw nursing as viable and portable career in terms of advancement and travel.
33 citations
TL;DR: Findings support the view that nursing student incivility is becoming more widespread on college campuses and can have devastating effects on nursing faculty members and suggest the importance of identifying contributing factors of incvility present in nursing students and implementing new and more effective policies and strategies to address and prevent this increasingly prevalent problem.
Abstract: 120 Student incivility against nursing faculty is recognized as an area of increased concern in nursing education. The negative experience that this may potentially have on nursing faculty is disturbing. The purpose of this study was to elicit an understanding of the experiences and impact nursing faculty encountered with nursing student incivility using a phenomenological research design. Twelve nursing faculty members from seven mid-western universities provided rich descriptions of their experiences with student incivility. Colaizzi’s analysis method was used to create clusters that resulted in six identified themes, including: (a) Faculty are subjected to a variety of unacceptable student behaviors; (b) Dealing with incivility is time consuming; (c) An aftermath of incivility can tarnished one’s reputation; (d) Support from others is beneficial; (e) Can cause harm to one’s health and well-being; and (f) May result in questioning the future. Findings support the view that nursing student incivility is becoming more widespread on college campuses and can have devastating effects on nursing faculty members. This information strongly suggests the importance of identifying contributing factors of incivility present in nursing students and implementing new and more effective policies and strategies to address and prevent this increasingly prevalent problem. Normal 0 false false false EN-US X-NONE X-NONE
33 citations
TL;DR: One-third of the studied elderly was suffering insomnia which was associated with worse quality of life in older adults, and Insomniac elderly had significantly lower scores in allquality of life domains, except the social functioning domain.
Abstract: Background: Insomnia is a highly prevalent complaint among elderly; it is associated with significant morbidity and is often a persistent problem, particularly in older adults . Aim of the study: The present study aimed to dete rmine the prevalence and risk factors of insomnia and its effect on quality of life among elderly. Design : a cross-sectional descriptive design was utilized to conduct this study . Sample: a stratified random sample of 107 elderly subjects attending the two geriatric social clubs in Zagazig city. Tools: Fo ur tools were used in the present study; a structured interview questionnaire, Athens insomnia scale, The Geriatric Depression Scale: short form, and The Medical Outcomes Study Short Form Health Survey (SF-36). Results: The prevalence of insomnia among the studied elderly was 33.6%, while difficulty initiating sleep was the most prevalent insomnia symptoms among them. Unmarried status, depressive status, smoking, eating before bedtime, daytime long naps, irregular sleep hours were significantly associated with insomnia. Suffering from asthma, nocturia, apnea, and total number of daily medications were significantly associated with insomnia. Insomniac elderly had significantly lower scores in all quality of life domains, except the social functioning domain. Conclusion : One-third of the studied elderly was suffering insomnia which was associated with many different factors. Insomnia was associated with worse quality of life in older adults. Recommendations: Healt h instructions and educational programs should be conducted for elderly individuals with insomnia to improve their sleeping pattern and quality of life .
TL;DR: Workplace violence is not new to nursing, or has it changed from generation to generation, but why is this serious condition still occurring and decreasing the authors' moral on units and even reducing their workforces?
Abstract: Workplace violence is not new to nursing, or has it changed from generation to generation. We are still seeing intolerable situations in nursing and in most cases; we have not made changes to our organizations to eliminate our tolerance to workplace violence. It used to be called “nurses who eat their young” now we call it “horizontal workplace violence” or just “bullying”. Why is this serious condition still occurring and decreasing our moral on units and even reducing our workforces?
TL;DR: Strategic Management Simulations (SMS) is explored as an educational strategy for enhancing the development of critical thinking skills among undergraduate nursing students and includes assessment, feedback, and training, which are not included in other strategies.
Abstract: Critical thinking is a skill required by nurses in order for sound clinical decisions to be made with optimal patient outcomes. Previous nursing education specific strategies, aimed at developing critical thinking, include high-fidelity simulation, case study discussions, concept-mapping, and reflective writing. Post-graduation nurse residency programs have had some success in preparing the new graduate nurse to take on the challenges and demands of the profession. These strategies have had varied success in developing critical thinking skills and are, at times, costly. The purpose of this article is to explore Strategic Management Simulations (SMS) as an educational strategy for enhancing the development of critical thinking skills among undergraduate nursing students. SMS includes assessment, feedback, and training, which are not included in other strategies.
TL;DR: Effective coping aids the successful management of heart failure, specifically the management of associated physical symptoms and psychological sequelae that may result, and nurses should include problem-focused coping strategies in patient and family education.
Abstract: Background: The incidence of heart failure continues to rise in the United States, with more than 600,000 new cases diagnosed each year. The progressive nature of heart failure predisposes individuals to physical and psychological sequelae, including physical activity intolerance and depressive symptoms. Coping is beneficial in assisting individuals to live with heart failure. Evidence suggests that how individuals cope with heart failure may influence heart failure-related outcomes, such as psychological well-being, self-care, health-related quality of life, and mortality. Thus, a better under- standing of coping styles can assist clinicians and researchers to develop interventions that improve heart failure outcomes. Purpose: To provide a systematic review and synthesis of evidence regarding the influence of coping styles in HF. A conceptualization of coping commonly used in heart failure-related literature within the context of stress and cognitive appraisal of stress is described. In addition, this review will identify what is known about: (1) individual factors that influence coping styles in heart failure; (2) the influence of coping styles on heart failure-related outcomes; and (3) interventions that promote effective (e.g., problem-focused) coping in heart failure. Methodological issues associated with this empirical literature and implications for clinicians and research also were discussed. Methods: This article provides a systematic review of current empirical evidence regarding the influence of coping styles on heart failure-related outcomes. Results: This review of empirical literature revealed several factors that may influence coping style in individuals with HF, including co-morbidities, personality, illness knowledge and beliefs, and sense of coherence. Additionally, the use of problem-focused coping strategies was found to be related to positive HF outcomes, such as psychological well-being, enhanced self-care, and improved health-related quality of life. Whereas, the use of emotion-focused coping strategies was found to be associated with negative HF outcomes, such as psychological distress, decreased health-related quality of life, and increased HF-related mortality. Although limited, experimental work in this area suggests that problem-focused coping strategies may be beneficial in improving HF-related outcomes. Conclusions: Effective coping aids the successful management of heart failure, specifically the management of associated physical symptoms and psychological sequelae that may result. Problem-focused strategies may be more beneficial than emotion-focused strategies in assisting individuals to cope with heart failure and improve heart failure outcomes, such as psychological well-being, self-care, and health-related quality of life. Conversely, emotion-focused strategies may nega- tively influence heart failure outcomes, such as psychological distress, decreased health-related quality of life, and heart failure-related mortality. Therefore, nurses should include problem-focused coping strategies in patient and family education. Research on the effectiveness of problem-focused strategies is sparse, thus more experimental studies, particularly longitudinal designs, is warranted to determine the efficacy of problem-focused interventions throughout the progression of heart failure.
TL;DR: Evidence is provided that graduate transition programs are essential, with Graduate Nurse Program Coordinators performing a crucial role in providing appropriately planned strategies to support graduates through this vulnerable time.
Abstract: Aims : This research explores the challenges that new nursing graduates experience whilst adapting to their new role in their first year of practice. These challenges are presented from the perspectives of Graduate Nurse Program Coordinators in the state of Victoria, Australia, previously not described in the literature. Background : Each year, thousands of new nursing graduates join the workforce in Australia, with many suffering major stressors and dissatisfaction in their first year of practice. Much has been written about challenges faced by this group from their own perspectives, yet nothing has been heard from the perspectives of those who support them; that is, the coordinators of year-long graduate nurse transition programs. Methods : This descriptive qualitative study used individual, semi-structured interviews to access information and perceptions from sixteen Graduate Nurse Program Coordinators about the challenges experienced by nursing graduates in their first year of practice. Transcripts were thematically analysed to reveal reoccurring themes and sub-themes. Results : The interviews provided an insight into various challenges that nursing graduates experience in relation to role adaptation in their first year of practice. Nursing graduates found difficulties with reality shock, work-life balancing and having unrealistic assumptions in their capacity to work, assuming they should be at a higher level despite being a beginner practitioner. Conclusions: This study reinforces the need for education providers to maintain currency in their undergraduate nursing programs and to work closely with health care services in providing a quality clinical experience to all nursing students. It also provides evidence that graduate transition programs are essential, with Graduate Nurse Program Coordinators performing a crucial role in providing appropriately planned strategies to support graduates through this vulnerable time.
TL;DR: It is revealed that nursing staffs’ knowledge and practice about pressure ulcer preventive measures could be improved and continues education and in service training program for the nursing staff, which is necessary for the continuously advancing care for patients in this area.
Abstract: Background: Pressure ulcers are common problems in healthcare system and produce a significant burden on patients and care providers. Hospital Acquired Pressure Ulcers is a leading cause of preventable harm. It is associated with a significant increase in treatment cost, length of stay, and poor patients’ satisfaction. The aim of this study is to determine the effect of implementing educational program about pressure ulcer control on nurses' knowledge and safety of immobilized patients. Methods: A quasi-experimental design was used to conduct the study on 40 nurses working in the critical care units at Mansoura University Hospital, in addition to 40 patients were randomly assigned from these units previous. A structured questionnaire to collect data related to socio-demographic data for nurses, pressure ulcer nurses' knowledge questionnaires, observational checklist and patient assessment sheet that include Sciodemographic data related to patients, and Braden scale sheet. Results: The present study revealed that: (a) The mean total knowledge scores of nurses were increased immediately after implementation of a program with statistical significant difference compared to pre implementation. (b) The mean total practice scores of nurses were higher immediately after implementing program with a higher statistical significant difference compared to pre implementation. (c) There were a positive correlation between nurses' knowledge and practices with a high statistical significant difference. (d) There were a positive safety immobilized patients as evidence by less incidence of pressure ulcers among study group after received intervention than pre received intervention. Conclusion: This study revealed that nursing staffs’ knowledge and practice about pressure ulcer preventive measures could be improved. Participants in the study reported that they could use the educational program effectively and easily in the prevention of pressure ulcers among their immobilized patients, which decreases the occurrence of pressure ulcers and as well as improved patient outcome. Recommendations: The present study recommended that continues education and in service training program for the nursing staff, which is necessary for the continuously advancing care for patients in this area.
TL;DR: Low-fidelity simulation was found both to be effective, as it provided familiarity with equipment used in theclinical setting, and inadequate due to lacking opportunity to discern differences encountered in the clinical setting.
Abstract: Background: It is assumed that practical skills learned through simulation can be transferred to the clinical setting, but little is known about students’ skill performance on real patients after simulation-based learning. The literature shows that newly qualified nurses lack proficiency in skill performance, implying that transfer of learning is challenging. The aim is to explore practical skill transfer from skill centre to clinical setting. Method: A qualitative descriptive observational study of five undergraduate nursing students practicing peripheral venous cannulation (PVC) in the skills centre and clinical setting. Performances were compared using content analysis. Findings: There were similarities and differences in the students’ performance accuracy in the skills centre and the clinical setting. Many steps were performed correctly, though some were performed incorrectly, and several were not performed or not relevant to perform in either setting. Practicing on a mannequin and on actual patients gave different learning opportunities. Practicing on a mannequin gave the students the opportunity to perform most of the PVC steps even if the vein was missed. When students missed the vein on real patients, they had to terminate the attempt, with no opportunity to perform subsequent steps of the skill. Conclusion: Low-fidelity simulation was found both to be effective, as it provided familiarity with equipment used in the clinical setting, and inadequate due to lacking opportunity to discern differences encountered in the clinical setting. The simulation must be improved to ensure that students learn what is needed for safe practice on real patients in the clinical setting.
TL;DR: Stakeholders’ perceptions of the new graduates not being ready for practice call for the collaboration of academia, service and the regulatory body in establishing quality assurance mechanisms for clinical education and in providing structured support for new graduates at service entry to enhance easier and safer transition.
Abstract: Background : Employers and educators of nurse s expect that, upon graduation, they will have acquired a basic set of scientific knowledge, clinical skills and professional attitudes. In Swaziland, however, these expectations remain unmet. Methods : We explored the perceptions of stakeholders in nurs ing education of how new graduates cope and perform at service entry and the factors influencing their clinical competence. From 31 purposively recruited participants, audio-recorded focus group discussions were held with registered nurses and semi-structured interviews with lecturers and nurse managers. Data were analyzed thematically. Results: Results showed that although the graduates indicated their willingness to learn and become autonomous in their practice, stakeholders felt that most new graduates were not ready for practice upon graduation. Factors contributing to this discrepancy were associated with inadequate preparation and lack of support upon service entry. Conclusions: Stakeholders’ perceptions of the new graduates not being ready for practice call for the collaboration of academia, service and the regulatory body in establishing quality assurance mechanisms for clinical education and in providing structured support for new graduates at service entry to enhance easier and safer transition.
TL;DR: The findings indicate that when preceptors and preceptees have the benefit of formal preceptorship programs that are well supported, and when the preceptors’ efforts are rewarded, satisfaction is enhanced for both participants and the preceptee has a foundation for strong clinical performance.
Abstract: Background: Retention of newly graduated nurses is becoming a costly challenge regardless of efforts such as orientation and residency programs. Satisfaction with the preceptorship relationship is important if the preceptor is to remain committed to fulfilling the role and if the preceptee is to complete the experience and then exhibit satisfactory clinical performance. Most studies have focused on describing either preceptor or preceptee perspectives regardless of the fact that both parties impact the outcomes. The purpose of this study was to describe what factors are associated with preceptors’ commitment to, and satisfaction with, the preceptor role; with preceptees’ satisfaction with the preceptorship experience and with their nursing performance; and with preceptors’ and preceptees’ job satisfaction. Methods: This study used a descriptive correlational design with a convenience sample of preceptors (n = 85) and preceptees (n = 85) from a tertiary medical center in the north-eastern U.S. Subjects were surveyed within six months of a preceptorship experience. Data were analysed for associations between preceptors’ experience and perceptions of the preceptorship role; and with multiple regression for predictive models of the preceptorship relationship. Results: Total job satisfaction was rated “high” or “quite high” by 99% of preceptors and 97% of preceptees, with intrinsic factors rated higher than extrinsic factors. Preceptors ranked “assisting new staff to integrate into the unit” and “teaching and sharing knowledge” as the greatest benefits to the preceptorship program. Preceptees ranked interpersonal relationships, communication, and professional development as their strongest skills, and teaching and collaboration and critical care as their least strong skill set. Positive correlations were found between the preceptors’ perceptions of benefits and rewards and their perceptions of support (r = .448, p < .01) and commitment to the role (r = .652, p < .01). The preceptors’ perceptions of support predicted extrinsic, intrinsic and total job satisfaction; and explained 36%, 48%, and 50% of the variability in the outcome, respectively. The total score on the preceptee satisfaction scale was the only variable predicting extrinsic, intrinsic, and total job satisfaction; with 45%, 39%, and 20% explained by the model. Conclusions: Our findings suggest that systems should be established so that preceptors perceive that their preceptorship role is rewarded and supported. Preceptee satisfaction with the preceptorship experience was correlated with favorable evaluation of the relationship between the preceptee and preceptor. Beyond experience and competence, precepting requires considerable teaching skill. Experience is a necessary, but not sufficient, condition for a good preceptor. These findings indicate that when preceptors and preceptees have the benefit of formal preceptorship programs that are well supported, and when the preceptors’ efforts are rewarded, satisfaction is enhanced for both participants, preceptors’ commitment to the role is reinforced, and the preceptee has a foundation for strong clinical performance. Ultimately, the patient is the direct beneficiary of a well-designed preceptorship program.
TL;DR: There is a strong congruence between the groups concerning core tasks of nursing, and competitions with low scores, differences between groups, management’s support, and factors influencing competence need further research for planning interventions to enhance competence development.
Abstract: Background/objective: Nurse managers have an important impact on nurses’ competence. However, research on managers’ and nurses’ competence assessments using the same criteria is scarce. For quality care it is important that these assessments align. This study compared nurses’ and their managers’ competence assessments. Methods: A cross-sectional, descriptive, comparative correlation design was applied. Participants were 1656 manager-nurse pairs conducting self-assessments and manager assessments respectively in a university hospital in Finland. The Nurse Competence Scale which measures nurses’ generic level professional competence was used to collect the data. Means, range, frequencies, and standard deviations, and Mixed Models with Repeated Measures were used in data analysis. Results: Both managers and nurses assessed the competence level as good, but managers assessed the level significantly higher than nurses themselves. However, the overall competence profiles between the groups aligned. Higher competence level and smaller Visual Analogy Scale (VAS) score differences between the groups were related to individualized patient care, and ethically committed and flexible action in care situations. Lower competence level and bigger VAS score differences between groups concerned consultation, guiding, and evaluation activities within care team, developmental tasks, and use of research knowledge. Conclusions: Although the difference between managers’ and nurses’ competence assessments was significant in favour of managers, there is a strong congruence between the groups concerning core tasks of nursing. Competences with low scores, differences between groups, management’s support, and factors influencing competence need further research for planning interventions to enhance competence development. Use of multiple assessment methods is recommended to add validity and reliability of the measurements.
TL;DR: Findings could enhance research develop ment in this field of studies and suggest multilevel approach in order to detect the most effective organizational level to improve educational intervention.
Abstract: Background: Clinical learning in nursing education is workplace-based and it involves both learning and organizational factors. Students could experience these factors both at individual and at group level. This study aimed to assess clinical learning environment as a multilevel phenomenon, by grouping students’ perceptions at different organizational levels. Method: A cross-sectional multilevel design has been conducted. 3 Italian Universities, 6 Hospitals and 73 wards have been involved in the study during 2013. Wards with at least 3 attending nursing students have been included. The sample involved 597 nursing students (average age 23.1 years, SD = 4.67 years; 72.6% females; 27.2% attending first year; 31.7% second year; 41.1% third year). Clinical Learning Environment and Supervision plus Nurse teacher ( CLES+T ) scale has been administered. Intraclass Correlation Coefficients (ICC) have been estimated at ward, at hospital and at University level. Results: All ICCs scores were above 0.10 and they indicated clinical learning environment as a multilevel phenomenon. The most pertinent level to multilevel research was the ward level. The nurse teacher scale was pertinent to Hospital and University level. Conclusions: Clinical learning environment is a multilevel phenomenon. These findings could enhance research develop ment in this field of studies. Practical implications suggest multilevel approach in order to detect the most effective organizational level to improve educational intervention.
TL;DR: Detailed accounts of the activities surrounding simulation that support student learning in multiple domains are provided by providing detailed description of learning activities surrounding a simulation experience with a deteriorating cardiac patient.
Abstract: Background: Educational advantages of simulation have been widely reported. Pre-briefing and debriefing support simulation methods. However, few detailed accounts of how the learning activities surrounding simulation are implemented exist. Objectives: This case example provides a detailed description of learning activities surrounding a simulation experience with a deteriorating cardiac patient. The educational sequence integrates Benner et al. ’s goals for transforming nursing education. The study objectives were to design and evaluate an educational sequence using narrative, games, and simulation to teach students how to manage and anticipate the care of a deteriorating patient. Design: A case example with descriptive quantitative and qualitative evaluation is presented. Setting: The study took place on multiple days in a university simulation laboratory. Participants: All study participants (n = 43) were senior students enrolled in a Bachelor of Science in Nursing program. Methods: Students experienced an educational sequence and then rated and ranked educational activities. Results are reported with descriptive statistics. Students and faculty responded to the question, “What will you take from this experience?” Their responses were evaluated using constant comparison and expert review for themes. Results: Students identified ‘knowing how’, ‘increasing confidence’ and ‘understanding roles’ as what they took from the experience. Students ranked the simulation itself as the most helpful. Conclusions: Incorporating Benner et al .’s transformational educational goals informed the educational sequence and engaged students in the learning experience. This paper adds uniquely to the nursing literature by providing detailed accounts of the activities surrounding simulation that support student learning in multiple domains.
TL;DR: Six strategies for giving effective feedback to preceptors at Sultan Qaboos University Hospital emerged, among them providing feedback that is regular and timely; clear and focused; empha- sising preceptees’ performance and progress, as well as respecting preceptee feelings, views and privacy.
Abstract: Introduction: Providing effective feedback during preceptorship is essential to advance learning in the clinical area. However in Oman, at present, there is no published data on strategies for giving effective feedback despite the high number of non-Omanis involved in clinical teaching. This study explored the different strategies preceptors at Sultan Qaboos University Hospital use to provide effective feedback. Methods: A qualitative research design was employed using focus groups, with data collection occurring in November 2012. The focus group discussions were recorded, transcribed and analysed thematically. Results: Six strategies emerged, among them providing feedback that is regular and timely; clear and focused; empha- sising preceptees’ performance and progress, as well as respecting preceptee feelings, views and privacy. Other strategies include listening to preceptees and starting with positive remarks during feedback sessions. Conclusion: Feedback during preceptorship provides preceptors with an excellent opportunity to explain to preceptees where and how they are moving along the continuum of meeting expected goals in relation to attainment of professional knowledge, skills and behaviour, and includes specific suggestions for further improvement. The contextual realities in the clinical environment require preceptors to provide timely, regular, clear and focused feedback that emphasises preceptees’ performance, respect their feelings, privacy and opinions. Such feedback techniques when appropriately implemented enable preceptees to improve their performance, by making use of preceptors’ constructive criticism, which in turn enables them to rate their clinical practice in a more realistic way, leading them to seek opportunities for further self-improvement.
TL;DR: Mothers of infants in the NICU who experienced higher depressive symptoms also reported greater stress and experienced poorer sleep; altogether, this may compromise one’s ability to learn and care for a child inThe NICU.
Abstract: Objective: To compare the level of self-reported perceived global and situational stress, sleep disturbance, and the level of wellness between mothers with an infant in Neonatal Intensive Care Units (NICU) who are categorized as having high or low depressive symptoms. Methods: Cross-sectional comparative design which included 55 first-time mothers who were in their second postpartum week and had a preterm infant admitted to the NICU of three urban hospitals in the southeastern United States. Participants wore wrist actigraphy and completed sleep diary for 2-3 days, in addition to completing self-report questionnaires for depressive symptoms, stress, perceived sleep disturbance, and well-being. Participants were categorized as having high (≥ 13) or low (< 13) depressive symptoms by using the total score of Edinburgh Postnatal Depression Scale. Results: Approximately 62% of the study participants reported high depressive symptoms. Mothers with high depressive symptoms reported greater stress and less well-being compared to those with less depressive symptoms. With the exception of wake after sleep onset, there was no statistically significant difference in the sleep between the two groups; all of the mothers had clinically significant poor sleep. Conclusions: Mothers of infants in the NICU who experienced higher depressive symptoms also reported greater stress and experienced poorer sleep; altogether, this may compromise one’s ability to learn and care for a child in the NICU. Nurses and members of the healthcare team should be attuned to signs and symptoms of depression, perhaps incorporating more formal screening of mothers, educational and support resources, and referral systems.
TL;DR: Students’ assessments of their level of nursing skills should be taken into account when planning orientation and mentorship programmes for practical work to ensure safe and qualified patient care.
Abstract: Objective: To evaluate the level of nursing skills at the point of graduation based on students’ self-assessments and to identify possible related factors. Background: Nursing skills have been identified as one of the key factors in enhancing patient safety. Maintaining patient safety is a major concern for nurses, which is why the level of graduating nurses’ skills needs to be evaluated. Also, little is known about factors related to students’ nursing skills. Methods: Evaluation is based on graduating nursing students’ (n = 154, response rate 51%) self-assessments during final clinical placements in Finnish university hospitals in 2011. Descriptive statistics and inferential statistics such as paired T -test, Multifactor Analysis of Covariance and Pearson/Spearman correlation coefficients were used to analyse the data. Results: The overall level of nursing skills was self-assessed as good (75.4; VAS 0-100). Nursing skills related to the care of a dying patient was the only category assessed to be on moderate level (63.1; VAS>57-66.8). The more positively the students self-assessed their readiness for practice based on nurse education and the supervisory relationship in clinical placement, the higher was the self-assessed level of nursing skills. Conclusions: Students’ assessments of their level of nursing skills should be taken into account when planning orientation and mentorship programmes for practical work to ensure safe and qualified patient care. Nurse educators should ensure that students can practice nursing skills related to care of a dying person during nurse education. A knowledge test, observation, or comparing the students’ evaluations to assessments by mentors could provide a more comprehensive picture of the level of students’ nursing skills.
TL;DR: The Academic Performance of 3rd and 4th year BS Nursing students of Omar Al-Mukhtar University College of Nursing correlates well with their Clinical Performance, indicating that an academic performer rates as well in their clinical focus and may be attributed to their increased appreciation of nursing as they reach a higher year level.
Abstract: Background: Theoretical knowledge acquired in the classroom setting is necessary to enhance the clinical performance of nursing students in the same way that the latter reinforces what is learned in the classroom. However academic grade does not always reflect the competence of students in clinical setting. This study was conducted to determine a possible correlation between student academic performance in the nursing specialization subjects and their clinical performance. Design and Method: The research employed a descriptive non-experimental approach using existing data sets. The grades of three batches of Omar Al-Mukhtar University College of Nursing (Libya) students were retrieved from the Office of the College Registrar and subjected to statistical analysis. Pearson Product Moment Coefficient was utilized to determine the relationship in the changes and movement of the two variables, Academic and Clinical Performance. Result: Positive correlation between academic and clinical performance was observed from the three groups of students considered in this study. Correlation was noted to consistently increase from the third to the fourth year for the two most recent batches of students suggesting enhanced appreciation of theoretical and clinical nursing among students. Students who perform well in the classroom setting performed similarly well in the clinical setting. Conclusion: The Academic Performance of 3rd and 4th year BS Nursing students of Omar Al-Mukhtar University College of Nursing correlates well with their Clinical Performance. This indicates that an academic performer rates as well in their clinical focus and may be attributed to their increased appreciation of nursing as they reach a higher year level.
TL;DR: In this paper, the authors evaluated the effect of cooperative learning on undergraduate nursing students' self-esteem, as well as assessing their attitude regarding cooperative learning, which is an important quality and an attribute considered as specific requirement for better performance and interpersonal success.
Abstract: Background: Cooperative learning means method which learners work in a small group member and take advantages of each other’s expertise to achieve a common goal, and promote higher self-esteem which is an important quality and an attribute considered as specific requirement for better performance and interpersonal success. Objective: Evaluate effect of cooperative learning on undergraduate nursing students’ self-esteem, as well as assessing their attitude regarding cooperative learning. Methods: Quasi-experimental study was conducted along the second semester, academic year 2012/2013, at college of applied medical sciences, king Khalid University, Saudi Arabia. Total number of 61 female nursing students enrolled in growth& development course divided into two groups experimental group (32 students) and control group (29 students) was the study sample. Three tools of data collections were used: Preliminary sheet, Rosenberg’s self-esteem scale with high reliability (Cronbach’s alpha coefficient r = 0.844) and Likert rating attitude scale, its reliability (Cronbach’s alpha coefficient r = 0.771). Results: Students’ mean age was 20.8±.983. Total students’ self-esteem pretest was low. The results indicated improvement of the experimental group self-esteem and presence of highly statistical significant differences between experimental and control group posttest p < .001. 62.5% and 68.8% of the experimental group strongly agree that cooperative learning enhanced students’ social skills and responsibility . Conclusion: The study findings reflected low self-esteem between nursing students. Cooperative learning method is an effective teaching approach improved their self-esteem and it is highly recommended instructional pedagogy prepared students for lifelong learning.
TL;DR: This study demonstrated the usefulness of active participation in simulation learning for an analytic- intuitive approach to decision making, however active Participation in debrief was a more important influencing element than role-playing.
Abstract: Background: The continued use of high fidelity full sized human patient simulation manikins (HF-HPSMs) for developing decision making skills of nursing students has led to growing research focusing its value on student learning and decision making skills. Methods: In October 2012, a cross-sectional survey using the 24-item Nurse Decision-Making Instrument was used to explore the decision making process of 232 pre-registration nursing students (age 22.0 + 5.4; 83.2% female) in Singapore. Results: The independent samples t-tests demonstrated three significant predictive indicators. These indicators include: prior experience in high fidelity simulation based on pre-enrolled nursing course (t = 70.6, p = .001), actual hands-on practice (t = 69.66, p < .005) and active participation in debrief (t = 70.11, p < .005). A complete experience based on role-playing followed by active discussion in debrief was a significant contributor to the decision making process (t = 73.6667, p < .005). However, the regression model indicated active participation in debrief as a significant variable which explained its development (t = 12.633, p < .005). Conclusions: This study demonstrated the usefulness of active participation in simulation learning for an analytic- intuitive approach to decision making, however active participation in debrief was a more important influencing element than role-playing. In situations where resources are limited for students to experience hands-on role-playing, peer reviewing and feedback on others’ experiences could benefit students, just as much. However, further study is warranted to determine the development of HF-HPSMs as a pedagogic tool for enhancing the decision making process of nursing students.
TL;DR: A grounded theory study to explore the process that nursing faculty use when working with students whose preceptors have reported them as unsafe in their final year of the undergraduate program finds promoting student success emerged as the core variable or main concern.
Abstract: Sherry Arvidson 12.00 Background: To ensure safe practice, educational programs are regulated by academic and legal guidelines to prepare graduates who are at the very least competent novice nurses. The preceptorship model is widely used in Canadian nursing programs as an effective strategy in the clinical education of students who are preparing to transition to professional practice. For nursing faculty who are responsible for the final determination of student success in a clinical rotation, a challenge arises when a preceptor identifies a student as unsafe in practice. Method: The authors conducted a grounded theory study to explore the process that nursing faculty use when working with students whose preceptors have reported them as unsafe in their final year of the undergraduate program. Data were collected primarily through individual semi-structured interviews with six nursing faculty and the constant comparative method was used to analyze the data. Results: ‘Promoting student success’ emerged as the core variable or main concern, with six inherent major categories: (a) recognizing red flags of unsafe practice, (b) strategies for managing students with unsafe practice, (c) evaluation strategies for success, (d) decision to fail a student, (e) guidance and support for student and preceptor, and (f) guidance and support for faculty. In this article the authors focus on three of these categories: (a) strategies for managing students with unsafe practice, (b) evaluation strategies for success, and (c) decision to fail a student. Conclusion: The findings have implications for ongoing support for faculty involved in the preceptorship program. Administrators in nursing education programs need to reflect on these findings and support faculty in preparing for and engaging in their role in the preceptorship experience. Normal 0 false false false EN-CA X-NONE X-NONE MicrosoftInternetExplorer4
TL;DR: The strength of the practice educator role is that it bridges the worlds of university and practice, resulting from social processes that required a sustained presence in practice to engage in the reality of everyday practice and gain the shared social identity of a practitioner.
Abstract: High quality, supportive practice learning experiences are crucial for ensuring that student nurses and midwives develop into competent practitioners who are fit for practice. The practice educator role is one model of practice learning support but the role is relatively new and has been little investigated. This paper reports on an appreciative inquiry that explored the current practice educator role at one university in England, with the aim of reaching a consensus for how the role could be enhanced. The first phase involved in-depth interviews with 18 participants: practice educators (n = 10); student nurse representatives (n = 5) and practice based education leads (n = 3). The interviews were analysed thematically. Three themes related to social processes involved in the role: being a bridge, being there, and social identity. The other themes described contributions to the practice learning environment: safeguarding, support, critical thinking. The second phase used a modified Delphi technique. Participants ranked trigger statements, related to the themes, in order of importance. Two consensus workshops were held where the statements were reviewed by practice educators, students and learning environment leads, following which principles and practices of the practice educator role were agreed. In conclusion, the strength of the practice educator role is that it bridges the worlds of university and practice. This bridging resulted from social processes that required a sustained presence in practice to engage in the reality of everyday practice and gain the shared social identity of a practitioner.