Showing papers in "Journal of Nursing Education and Practice in 2019"
TL;DR: In this paper, the authors survey the perceptions of faculty members towards utilizing Blackboard in the teaching system at Hafr Al-Batin University and find that perceived usefulness, enjoyment, satisfaction, and challenges were the most highly mean scores.
Abstract: Background and objective: The faculty members’ perceptions regarding Blackboard as the pedagogical management tool plays a vital role in learning and teaching process. Aim: To survey the perceptions of faculty members towards utilizing Blackboard in the teaching system at Hafr Al-Batin University. Methods: Design: Quantitative descriptive design was utilized depending on online surveys. Setting: The study was conducted in all Colleges of Hafr Al-Batin University. Participants: 174 faculty members from different colleges at the University of Hafr Al-Batin. Tools: Questionnaire consisted of two parts; the first includes the faculty demographic information and the second describes faculty perception in four sections; usefulness, enjoyment, satisfaction, and challenges. Results: The study demonstrated that perceived “usefulness” and “enjoyment” were the most highly mean scores. Conclusions: The faculty members have a positive attitude towards the implementation of the Blackboard system. Recommendations: A great need for training of both faculty members and students in the Blackboard system regularly.
15 citations
TL;DR: Students in Beni-Suef University, Egypt lacked the required knowledge about breast and cervical cancers, in particular, knowledge scores of students about screening for both cancers were the lowest.
Abstract: Background and objective: Breast and cervical cancers represent a public health concern since they result in high mortality and disability rates. The aim of our study was to assess the knowledge of nursing students in Beni-Suef University about both Breast and cervical. Subjects and methods: A total of 500 students representing all scholastic years from the Technical Institute of Nursing (both 2 years of post-high school nursing education), Beni-Suef University, Egypt, participated in this study that was conducted during the 1st semester of the academic year 2017/2018. The knowledge of the students was assessed using a self-administered questionnaire. The assessment included knowledge of students about 4 aspects; risk factors, manifestations, screening, and management of breast and cervical cancers. Results: The mean age of the students was 19.2 ± 0.7 years, and most of them (77.6%) were females. Precisely, 43% had optimal knowledge about breast cancer; 43.8% risk factors, 52.4% manifestations, 27.8% screening, and 48% management, while only 29% of students had optimal knowledge about cervical cancer; 21.8% risk factors, 38.2% manifestations, 12.4% screening, and 43.6% management. None of the studied personal characteristics showed association with the knowledge of students whether regarding breast or cervical cancers ( p > .05). Healthcare givers, TV, and the Internet were the most commonly reported sources of knowledge about breast and cervical cancers: 42%, 33.2%, and 21.2%, respectively. Conclusion and recommendations: Students lacked the required knowledge about breast and cervical cancers. In particular, knowledge scores of students about screening for both cancers were the lowest. Further studies should focus on improving the knowledge of nursing students using awareness programs or educational modules.
11 citations
TL;DR: The results showed that the undergraduate nursing students at Medical-Surgical training, Faculty of Nursing, Alexandria University, have a high satisfaction level about the clinical learning environment concerning all components of the clinical placement and have ahigh competency self-efficacy level in all nursing activities and tasks in the clinical training.
Abstract: Competency self-efficacy (CSE) in clinical nursing practice is necessitated to be attained by the undergraduate nursing students. It is a significant indicator of the work's acceptance and commitment to nursing roles. Self-efficacy in nursing experience enhances nursing student's abilities to achieve the clinical tasks independently, mainly in wide range field of care like Medical-Surgical Nursing. Some factors are affecting competency self-efficacy in the clinical nursing practice; the most evident factor is the nursing student’s impressions with their clinical learning environment (CLE). In the light of educational preparation for nursing undergraduates, the Faculties of Nursing emphasize to preserve a high quality of clinical learning environment for clinical nursing essentials. The clinical learning environment has an apparent function in building up students' confidence, and competency self-efficacy, particularly, during clinical skills achievement. The current paper aimed to determine undergraduate nursing student's satisfaction about the clinical learning environment and their competency self-efficacy, and then investigate the relationship between both variables. Thus, the study conducted through a descriptive, correlative research design with all nursing students who enrolled in third and fourth academic semesters (second year) during their clinical training in Medical-Surgical Nursing course, Faculty of Nursing, Alexandria University, Egypt. A triple-section questionnaire was used for data collection: First; nursing student’s sociodemographic profile, Second: Clinical Learning Environment Inventory (CLEI) which was constructed by Chan in 2002. Third: Nursing Competency Self Efficacy Scale (CSES) which was developed by Kennedy in 2013. The results showed that the undergraduate nursing students at Medical-Surgical training, Faculty of Nursing, Alexandria University, have a high satisfaction level about the clinical learning environment concerning all components of the clinical placement. As well, they have a high competency self-efficacy level in all nursing activities and tasks in the clinical training. Further, there is an obvious parallel correlation between nursing student's satisfaction about clinical learning environment and their competency self-efficacy which is significant. Conclusion & Recommendations: Adequate and planned arrangements should be settled in the nursing curricula for the nursing clinical training setting. Too, the clinical instructors should encourage students' trials to do difficult nursing tasks in a successful manner which tends to increase the student's competency self-efficacy. Further researches are required to investigate the factors affecting clinical learning environment satisfaction and competency self-efficacy among nursing students in their clinical placement. Additionally, another research is necessary about; developing an educational program about student's competency self-efficacy to guide nursing instructors in clinical training.
9 citations
TL;DR: Developing breathing technique and forward leaning position in COPD patients help to improve physiological outcomes, dyspnea symptoms and anxiety status after implementing of program.
Abstract: Background and objective: Chronic obstructive pulmonary disease (COPD) remains a significant burden for health. It is one of the most common respiratory disease and leads to limitation of airflow as well as deteriorating health status. The aim of the study was to determine the effects of positioning and pursed lip breathing exercise on dyspnea and anxiety status in patients with chronic obstructive pulmonary disease. Methods: The study was carried in the outpatient clinics in Mansoura University Hospital & Chest Hospital at Mansoura region, utilizing a quasi-experimental study design on sixty patients diagnosed COPD. Participation was randomized into both groups (study group and control group). Pretest, posttest and follow-up evaluation was done using Dyspnea Assessment Scale, Anxiety Assessment Scale and Demographic and Medical History Questionnaires (MHQ). The researcher established exercise program aimed at effecting dyspnea and anxiety in chronic obstructive pulmonary disease patients to help improve breathing and control anxiety. The research was accomplished over four steps namely assessment, planning, implementation and evaluation. Each patient was evaluated at baseline, immediately and three months after implementation of program. Results: There were statistically significant improvements after intervention of program on dyspnea symptoms and anxiety status at post and follow-up test ( p < .05). There was a statistically significant improvement in temperature (T), heart rate (HR), blood pressure (BP) and respiratory rate (RR) throughout study ( p < .05) after intervention. Also there are positive relation between anxiety and dyspnea after intervention. Conclusions: Developing breathing technique and forward leaning position in COPD patients help to improve physiological outcomes, dyspnea symptoms and anxiety status after implementing of program. It is recommended to implement exercise training program as a part of treatment by health professionals in the clinical setting.
9 citations
TL;DR: Findings of this study would be beneficial for nursing programs to strategize effectively for students who are at risk of failing and support them in their NCLEX-RN preparation.
Abstract: Background: First time National Council Licensure Examination-Registered Nurses (NCLEX-RN) pass rates and successful student progression in a program are considered key indicators of quality of nursing programs. The purpose of this study was to investigate the predictors of first-attempt NCLEX-RN success among multiple factors, and to explore the students’ perception for NCLEX-RN. Methods: A retrospective descriptive design was used including a total of 671 students who were admitted as a junior to the program between spring 2012 and fall 2015. Descriptive statistics and multiple logistic regression models were conducted to find significant predictors of first time NCLEX-RN success. Results: Course grades for adult health, family health, critical care health, and the repeated course history, and HESI scores for adult health, family health, and the EXIT exam were significant predictors of NCLEX-RN success. Students perceived that the review course and practice test were helpful in passing NCLEX-RN. Conclusions: Findings of this study would be beneficial for nursing programs to strategize effectively for students who are at risk of failing and support them in their NCLEX-RN preparation.
8 citations
TL;DR: It is extensively proven that stress among NMs affects their general health as well as patient safety and quality of care and senior managers of hospitals should create a favourable working environment for nurses and the appointment of NMs should be based on experience and competence.
Abstract: Background: The role of Nurse Managers (NMs) is dynamic, multifaceted and complex thus, exposing NMs to high levels of work-related stress which seriously impact general wellbeing, and organizational outcomes. Methods: A quantitative cross-sectional approach was employed to examine the phenomenon of stress among NMs in 38 selected hospitals. Census approach was used to collect data from 267 NMs. Descriptive and inferential statistics were performed to describe the sample and established the predictors of stress. Results: The main causes of stress among NMs are a shortage of staff (94.4%), poor working conditions (91.8%), inadequate management support (89.9%) and heavy workload (89.15%). NMs experienced all the types of stress (psychological, emotional and physical). The major stress coping mechanisms are time management (91.8%), effective communication (91%) and delegation of duties (89.5%) while excessive eating (18.4%) is the least strategy used. Sociodemographic characteristics together explained 6.4% of stress among NMs [ R 2 = .064, F(6,241) = 2.676, p = .016]. Conclusions: Senior managers of hospitals should create a favourable working environment for nurses and the appointment of NMs should be based on experience and competence. Implication for Nursing Practice: Stress among healthcare managers especially, NMs is very common. This current study has extensively proven that stress among NMs affects their general health as well as patient safety and quality of care. Training on stress management should be organized regularly for hospital staff particularly, NMs to enable them to cope better with stress.
8 citations
TL;DR: It was found that there was significant negative correlation between burn out and job satisfaction, the highest frequency of nurses had high burnout and had low level of job satisfaction.
Abstract: Objective: One of the core concerns in psychiatric nursing is job burnout among nurses, because burnout had harmful impacts on both nurses’ health and their ability to cope with job demands. Moreover, long term job stress can cause burn out and reduce their level of satisfaction. Aim: The aim of the study was to explore the relationship between burnout aand job satisfactions among psychiatric nurses. Methods: Descriptive correlation design was utilized. The study was conducted at Psychiatric Department in Tanta University Hospital and Tanta Mental Health Hospital. The study sample consisted of 50 staff nurses. Tools were utilized for collection of data: First, the Burnout Inventory by Maslach; Second, the Job Satisfaction scale. It measured the general job satisfaction of the nursing staff. This scale has five domains: Personal factors, Work organization, Content and amount of work, Working unit and Leadership. Results: It was found that the majority of nurses had job dissatisfaction. In relation to staff nurses’ burnout, staff nurses’ job burnout and its components were found. It was observed that the majority of nurses had high burnout. Regarding burnout components, specifically, in relation to emotional exhaustion, it was found that the majority of nurses experienced high emotional exhaustion and depersonalization compared low accomplishment. It was found that there was significant negative correlation between burnout and job satisfaction, the highest frequency of nurses had high burnout and had low level of job satisfaction. Conclusions: The highest frequency of nurses had high burnout and had low level of job satisfaction. It recommended newly developed interventions to alleviate nurses’ burnout and increase job satisfaction, thereby enhancing the quality of healthcare. So, further support of managers in the prevention of burnout is a necessity. Thus, it will enhance creativity, job satisfaction, self-worthiness, and service quality.
7 citations
TL;DR: Comparison of simulation to case-based learning on nursing students’ perceived cultural competence, awareness, and sensitivity shows integration of cultural learning opportunities into nursing education provides a foundation for continued development of cultural competence.
Abstract: Background: Cultural competence encompasses knowledge, skills, and comfort in caring for patients from diverse cultures and is a core competency in providing patient-centered care. Simulation provides an opportunity to expose students to diverse cultures. Case-based learning has been effective in improving nursing student communication and problem-solving skills, but no research describes its use in cultural education. The purpose of this study was to compare the effect of simulation to case-based learning on nursing students’ perceived cultural competence, awareness, and sensitivity. Methods: Eighty baccalaureate nursing students were randomly assigned to a simulation experience or case-based learning exercise. The Cultural Competence Assessment Survey was used to measure perceived cultural competence, awareness, and sensitivity. Results: Both simulation and case-based learning improved nursing student perceived cultural awareness and sensitivity. Case-based learning improved perceived cultural competence. Conclusions: Integration of cultural learning opportunities into nursing education provides a foundation for continued development of cultural competence.
7 citations
TL;DR: The most important clinical supervision factors which had the positive correlations were between finding time and ward atmosphere with age & years of experience with importance and value of clinical supervision among the studied first line nurse managers, while there was a negative significant correlation between age and trust and rapport & leadership style of the ward manager.
Abstract: Objective: Assess clinical supervision factors as perceived by nurses and first line nurse managers at Assiut University Hospital, and explore the relationships among personal characteristics and clinical supervision factors of studied nurses and first line nurse managers. Methods: A descriptive design was utilized in Medical and Surgical departments at Assiut University Hospital for A convenience sample of first line nurse managers (N = 30) and nurses (N = 151) by using study tools for nurses included two parts: 1) personal characteristics data sheet; 2) clinical supervision factors, and Study tool for first line nurse managers included two parts: 1) personal characteristics data sheet; 2) clinical supervision factors. Results: The highest mean scores were in trust and rapport & Supervisor advice and support of clinical supervision factors among the studied nurses. While among first line nurse managers' the highest mean scores were in improved care and skills & personal issues and reflection of clinical supervision factors. Conclusions: The most important clinical supervision factors which had the positive correlations were between finding time and ward atmosphere with age & years of experience with importance and value of clinical supervision among the studied first line nurse managers, while there was a negative significant correlation between age and trust and rapport & leadership style of the ward manager among the studied nurses. Nurse Managers should direct, monitor and evaluate the staff nurses through scientific standards of supervision as recommendation for the study results.
7 citations
TL;DR: This study confirmed the feasibility of conducting a pharmacovigilance module for nursing students in Nepal and found students had better attitude/practice scores, but a poor knowledge score at baseline.
Abstract: Objective: This study evaluated the impact of a pharmacovigilance education module for nursing students. Methods: In this prospective, pre-post interventional study, the 2nd year diploma in Nursing students (n = 38) were the ‘test’ group (who received intervention), and the 1st and 3rd year students were the control group (n = 78); total n = 116. Knowledge Attitude Practice (KAP) responses were taken at baseline (0 day), 30 days, 90 days and 180 days from both the groups. Improvements in the KAP scores following the intervention was analyzed using Wilcoxon signed rank test at alpha = .05, and the feedback was obtained using a ‘Likert scale’ having 20 questions; maximum possible score was 100. Results: The median (IQR) overall baseline scores of knowledge were 11 (10-12), the attitude/practice scores were 22 (20.25-22.00) and the total scores was 32.5 (31-34); the maximum possible score was 40. Almost all (n = 113; 97.4%) of them felt adverse drug reactions reporting was necessary and were interested in learning about adverse drug reactions. The baseline KAP scores were significantly higher among the second- and third-year students compared to the first year ( p < .001). Upon intervention, a significant improvement was seen in knowledge scores between the baseline and first follow-up ( p = .018) and between second and third follow-up ( p = .001) in the test group. The median (IQR) feedback score was 85 (80.7-88.2). Conclusions: Students had better attitude/practice scores, but a poor knowledge score at baseline. This study confirmed the feasibility of conducting a pharmacovigilance module for nursing students in Nepal.
7 citations
TL;DR: Providing nurses with Master’s level knowledge and skills can make a difference for them in clinical practice, however, knowledge is still needed on how the MSN qualification can have an impact on patient care.
Abstract: Objective: To describe and compare the development of Master of Science in Nursing graduates’ utilization and improvement of nursing research-related tasks and knowledge in daily clinical practice, six months and twelve months after graduation. Methods: A longitudinal cohort study of 65 Master of Science in Nursing (MSN) graduates from a Danish university was conducted from 2016 to 2017. Data were collected six and twelve months after graduation using a purposive-constructed questionnaire based on four validated questionnaires. Data were analyzed using descriptive statistics and STATA software (12.0). Results: The overall results of the longitudinal cohort study showed a positive impact 12 months after graduation on the MSN graduates’ development and improvement of their utilization of nursing research-related tasks and knowledge in clinical practice. The results also showed a development in the MSN graduates’ employment in academic positions, as well as an increase in the number of hours per week spent on nursing research-related tasks. Conclusions: Providing nurses with Master’s level knowledge and skills can make a difference for them in clinical practice. However, knowledge is still needed on how the MSN qualification can have an impact on patient care: Future research must focus on practical observations of how the Msn graduates use their academic knowledge and skills to improve patient care, using specific outcomes and observable criteria.
TL;DR: Reorienting critically ill patients through recorded messages is an effective strategy to reduce the incidence of delirium, and using a familiar family sound is more effective in reducingDelirium as proved by the number ofdelirium free days.
Abstract: Background: About 50%-80% of critically ill patients develop delirium during their intensive care unit (ICU) stay. Adverse events associated with delirium can range from functional disability, cognitive and psychological impairment, dementia and even death. Removal of invasive lines, self-extubation, prolonged sedation and ventilation therapies which delay the ICU liberation, and increase the overall hospital length of stay are also negative squeals of delirium. Delirium has series of adverse events that are not limited to the associated morbidies and mortality, but also extended to include the burden placed on caregivers, families and healthcare services, in addition to increasing the cost of care. Using auditory stimulation as a non-pharmacological intervention can stimulate the affected neural networks, accelerate brain plasticity and avoid sensory deprivation that could induce pain, agitation, and delirium and slow down the patients' recovery. It is evident that familiar auditory stimuli by a familiar voice is eliciting more responses to auditory tones as it can grasp patients' attention without much effort and disrupts ongoing cognitive activities. Accordingly, multicomponent family reorientation strategy has recently been proposed to achieve better outcomes. Methods: A quasi experimental research design was used in this study in which one tool was used for data collection: “Confusion Assessment Method-intensive care unit (CAM-ICU)”. Results: During the five-day intervention period, the delirium free days was all the days in the family voice group, four days in the unfamiliar voice group and no free days in the control group which indicates a significant difference among groups on number of delirium free days ( MC p < .001*). Conclusion: Reorienting critically ill patients through recorded messages is an effective strategy to reduce the incidence of delirium. Furthermore, using a familiar family sound is more effective in reducing delirium as proved by the number of delirium free days. During the five-day intervention period, the family voice group shows more delirium free days than the unfamiliar voice group. The intervention used in this study is easy, costless and effective strategy in prevention of delirium among critically ill patients.
TL;DR: The offering of an adequate nursing work scale (adequate number of professionals for the care), as a function of the nursing workload measured by the NAS, could be effective in the reduction of VAP, hospital stay time and hospital costs.
Abstract: Objective: Evaluate the relation of nursing workload, evaluated by the Nursing Activities Score (NAS), with the occurrence of Ventilator-associated Pneumonia (VAP) in an Intensive Care Unit (ICU) and the impact of VAP on hospitalization costs. Methods: Retrospective cohort study in Adult ICU of a high complexity Brazilian university hospital. The profile, outcomes, costs, and daily NAS from patients were collected. We also proposed some workload indicators based on NAS daily evaluation. Results: The study included 195 patients, 27.17% diagnosed with VAP. VAP was more prevalent in patients diagnosed with trauma on admission. The total costs of care were higher for VAP patients. In all multivariate models tested were predictive for VAP: the patient's intubation that occurs in days prior of the ICU admission day (higher risk if occurs in days prior the ICU admission day) and ventilation time prior ICU (higher risk if higher time). We found others predictors, but these were dependent on the model tested. Additional risk predictors were tracheostomy, propofol use, neuromuscular blocker use and the higher NAS from admission. The protective factors found were the percentage of adequacy of the assignment based in NAS that measure if the workload measured by the NAS was offered and the increment in NAS during the ventilation time. Conclusions: The offering of an adequate nursing work scale (adequate number of professionals for the care), as a function of the nursing workload measured by the NAS, could be effective in the reduction of VAP, hospital stay time and hospital costs.
TL;DR: The results of this systematic literature review showed risk factors for developing peristomal skin complications are multidimensional and suggest that prevention and early identification of risk factors related to peristom skin complication are very important.
Abstract: Surgical intervention of colorectal cancer often includes formation of ostomy Irrespective of the type of stoma, many ostomy patients suffer from peristomal skin complications Identifying risk factors related to peristomal skin complications is one of the crucial factors in maintaining peristomal skin health The purpose of this integrative review is to identify the risk factors associated with the development of peristomal skin complications Whittmore and Knafl’s (2005) framework for integrative literature review guided this study The results of this systematic literature review showed risk factors for developing peristomal skin complications are multidimensional Leakage of stoma output, type and structure of stoma, stoma site marking and nature of surgery, ostomy education, ostomy appliances, mechanical trauma, and demographic factors are the most commonly identified risk factors in the development of peristomal skin complications The development of peristomal skin complications is closely associated with skin contact with ostomy effluent In all settings ostomy patients requires specialized care and management to prevent development of peristomal skin complications and promote quality of life The findings of this focused study suggest that prevention and early identification of risk factors related to peristomal skin complications are very important
TL;DR: The study demonstrates that this relatively brief intensive program for health professionals working in cardiac rehabilitation significantly improves health professionals’ confidence in a range of areas related to establishing, running, maintaining and evaluating a CR program, with immediate improvements sustained four months later.
Abstract: We developed an intensive five-day training program for health professionals working in cardiac rehabilitation (CR). The training covers topics related to establishing, running, maintaining and evaluating a CR program. The aim of this study was to assess the impact of the training on health professionals’ self-efficacy regarding the effective delivery of CR. From 2014 to 2018, 167 health professionals participated in one of five training programs. Participants completed a 28-item pre- and post-training self-efficacy scale. For a sub-group, self-efficacy was re-assessed 4 months later. Factor analysis was used to identify self-efficacy domains. Paired sample t-tests compared pre- and post-training self-efficacy scores; repeated measures analysis of variance investigated change over the three time points. Variations in self-efficacy across profession, role in CR, and years of CR practice were investigated. Factor analysis identified three domains: Operational aspects of CR; Medical aspects of heart disease; and Psychosocial aspects of CR. Health professionals’ self-efficacy increased significantly after training participation, across the three domains and for the total score. Effects were sustained in the 4-month follow-up. Few variations in self-efficacy trajectories by participant characteristics were identified. The study demonstrates that our health professional CR training significantly improves health professionals’ confidence in a range of areas related to establishing, running, maintaining and evaluating a CR program, with immediate improvements sustained four months later. The pattern of findings was largely consistent regardless of participants’ role and experience in CR. Findings highlight the benefits of this relatively brief intensive program on enhancing the capacity of the CR workforce.
TL;DR: Findings highlight need for nurse managers to have greater visibility and managerial influence to enable them create opportunities for implementation of EBP in nursing.
Abstract: Background and objective: Evidence-based practice (EBP) is widely acknowledged as an essential aspect of healthcare delivery. Nurse managers are expected to contribute to the development of organisational cultures promoting EBP. However, there are indications that nurse managers are not necessarily empowered to drive implementation due to hierarchical constraints. This study explores how nurse manager’s position in the hospital hierarchy influences EBP implementation in nursing, in the Nigerian acute care settings. Methods: A qualitative case study methodology is utilised to gather data from two large acute care settings in Nigeria. Drawing on semi-structured interview, twenty-one ward managers and two nurse managers were interviewed. Data were transcribed and inductively analysed to generate four overarching themes. Results: Nurse managers were hugely constrained by lack of autonomy to mobilise resources for EBP related activities. The hierarchical structure of the settings promoted top-down decision-making processes which in turn, limited nurse manager’s visibility in the boardroom. Consequently, nurse managers were excluded from key strategic planning within the organisation and could not drive EBP implementation. Conclusions: Findings highlight need for nurse managers to have greater visibility and managerial influence to enable them create opportunities for implementation of EBP in nursing. Implications for nursing management: Administratively, there is need for nurses to have greater involvement in management. Adequate authority and leadership visibility as well as managerial influence would enable nurse managers create opportunities for successful implementation.
TL;DR: Debriefing is a central element that can be applied as a teaching strategy during simulation and is a critical learning component and ought to be applicably focused in nursing education.
Abstract: Background and objective: The development of self-confidence is an essential element of a nurse in the clinical setting. Nursing educators discuss the addition of simulation and debriefing into learning activities, which play a central role in identifying the fundamental elements of safety and clinical efficiency. Methods: Quality and Safety Education for Nurses (QSEN) competencies are used to examine the data supporting the effectiveness of simulation debriefing in nursing students registered in a fast-tracked baccalaureate program. This novel approach allows one to quantitatively measure the relationship between simulation debriefing, self-confidence and reduced anxiety. Results: Univariate Spearman Rho regression displays a significant positive correlation between reduced anxiety, self-confidence, and debriefing. The feedback received is encouraging, productive, and effective to learning. Logistic multivariate regression reveals debriefing mechanisms predict developing self-confidence and reducing anxiety, allowing the likeness on student’s clinical judgement and methodology to patient care (χ 2 = 34.249, p = .011), sufficient time being provided to reflect and review clinical performance (χ 2 = 0.68, p = .30) and identifying the justification for the actions and responses (χ 2 = 119.365, p = .001). Conclusions: Debriefing is a central element that can be applied as a teaching strategy during simulation. This study offers further understanding of the role of debriefing in enhancing self-confidence and reducing anxiety in nursing students. This is a critical learning component and ought to be applicably focused in nursing education.
TL;DR: There is a need to enhance and promote the motivational strategies within the current study setting by providing satisfactory remuneration, equitable benefits increase the chances of promotion and encourage supportive supervision.
Abstract: Background and aim: Nurses are working in different healthcare organizations; each healthcare organization has different organizational resources. Therefore, factors affecting nurses’ work motivation are varied among nurses. This study aimed to identify factors affecting nurses’ work motivation levels at a governmental hospital in Saudi Arabia. Methods: A cross-sectional design was conducted by recruiting registered nurses (n = 280) who worked for at least one year of experience. The survey was distributed among registered nurses working in one governmental hospital in the Kingdom of Saudi Arabia to assess nurses' work motivation level and to identify the affecting factors. Results: This study showed that nurses' work motivation level is affected by several personal and organizational factors. A positive relationship was found between higher order need strength and shared values and nurses' work motivation (intrinsic and extrinsic). This study revealed that there is a positive relationship between pay, promotion, supervision, fringe benefits, contingent rewards, co-workers, nature of work, communication and working conditions and nurses' work motivation level. Conclusions: There is a need to enhance and promote the motivational strategies within the current study setting by providing satisfactory remuneration, equitable benefits increase the chances of promotion and encourage supportive supervision. Additionally, there is a need to create healthy workplace environment that support co-workers relationship.
TL;DR: A learning outcomes assessment rubric was developed to support self-regulated learning and assessment during presimulation preparation and debriefing and perceived that integration of learning outcome assessment rubrics into simulation design enhanced senior nursing students' self- regulated learning and presimulations preparation.
Abstract: Background: Few studies have examined effective methods to prepare learners to participate in simulation-based learning experiences. Similarly, there is limited literature on valid, reliable assessment methods to determine whether clinical simulation learning outcomes have been met. We developed a learning outcomes assessment rubric to support self-regulated learning and assessment during presimulation preparation and debriefing. Methods: Fourth-year undergraduate nursing students enrolled in a critical care nursing course participated in two deteriorating patient simulations, one delivered in a traditional format, and the other using a new format incorporating a learning outcomes assessment rubric into presimulation preparation and debriefing. A descriptive survey evaluated learner perceived competence with deteriorating patients and satisfaction with the two simulations formats. Learner self-assessment data using the rubric was collected pre and post simulation. Results: Learner satisfaction with the deteriorating patient scenario and accompanying assessment rubric was very high. Learners were significantly more satisfied with the simulation scenario delivered using the new format which included the assessment rubric than with the standard format without the assessment rubric ( p < .001). Learners valued the opportunity to identify their own learning needs, and reported increased competence in management of a deteriorating patient following the simulation ( p < .001). Conclusions: Senior nursing students perceived that integration of learning outcomes assessment rubrics into simulation design enhanced their self-regulated learning and presimulation preparation. Further research is needed to explore presimulation preparation strategies and to validate rubrics used for summative assessment.
TL;DR: It is concluded that infection prevention and control topics in undergraduate nursing education may be insufficient and need to be updated, as well as the need for reviewing the intended learning outcomes of nursing program to ensure the addition and implementation of infection control guidelines in all undergraduate and graduate nursing students.
Abstract: Undergraduate nursing education plays a vital role in acquiring the necessary competency for patient safety. Infection prevention and control is a very critical topic for providing patient safety so, undergraduate and graduate nursing students should be competent in infection prevention and control. The aim of this study was to measure the undergraduate nursing program effectiveness in improving knowledge and practice of infection prevention and control of internship nursing students and to identify their learning needs. A descriptive research design was used. Students were selected using convenience sampling which included 400 internship nurses. Data was collected using a self-reported questionnaire. The results of the current study displayed that more than half (59.5%) of the intern nurses had poor knowledge and also 43.2% of them had poor practice. In addition, it was found that more than half of them reported that infection control program is neither irrelevant nor meaningful, and 48.5% of the students suggested that participation in infection prevention and control training is most important for the improvement of nursing program. This study concluded that infection prevention and control topics in undergraduate nursing education may be insufficient and need to be updated, as well as the need for reviewing the intended learning outcomes of nursing program to ensure the addition and implementation of infection control guidelines in all undergraduate in the last academic year of nursing program as well as internship. The students also are in need for continued training and education regarding guidelines of infection prevention and control practice.
TL;DR: The aim of this article is to critique the mechanical way telemedicine is being implemented in the health sector, and to present the basic ideas of empowerment and user involvement behind teleMedicine, exemplifying them with a case of user resistance to telemedics.
Abstract: Objective: Telemedicine is a rapidly expanding area, and this article discusses the implications of patient empowerment and user involvement in relation to frail patients. Our aim is to critique the mechanical way telemedicine is being implemented in the health sector. Methods: We present the basic ideas of empowerment and user involvement behind telemedicine, exemplifying them with a case of user resistance to telemedicine. Four logics of empowerment are employed to identify the underlying rationale in specific cases of telemedicine. The case comes from a large evaluation of new welfare technology products. The data consist mainly of written documents and an interview. Results: Telemedicine is often considered a way to increase empowerment and user involvement in healthcare. The majority of the geriatric patients in the described case refused to engage in telemedicine, preferring instead to be hospitalized. The case appeared to be driven primarily by a professional logic of empowerment. User involvement and empowerment are discussed in terms of their demands and implication for users, such as 1) intrusion on the private sphere, i.e., the home and 2) the question of the responsibility for treatment and 3) the expectation, that the capabilities and resources of patients and relatives may increase. Conclusions: Although telemedicine is acknowledged as relevant, a mechanical approach too often hampers empowerment for the patient. Some patient groups may not feel safe using telemedicine, in which case user involvement and empowerment are not possible.
TL;DR: This article explored the experiences of midwives in Ghana who have worked in diverse settings over time, and explored how midwives' personal experiences across time, place and in diverse contexts impact their care for women during childbirth.
Abstract: Objective: This paper focuses on exploring the experiences of midwives in Ghana who have worked in diverse settings over time. It explores how midwives’ personal experiences across time, place and in diverse contexts impact their care for women during childbirth. The paper describes the forms of knowledge held by midwives. It presents how the experiences of midwives reflect their professional and personal practical knowledge landscape. Methods: Using narrative inquiry, the experiences of four midwives working in private maternity homes were explored. Being guided by the three-dimensional narrative inquiry space of temporality, sociality and place, and the concept of relational ethics, a meaningful relationship was built with participants over a period of five months. Several tape-recorded conversations were held with each participant, multiple other interactions were recorded as field notes and in a journal. Each tape-recorded conversation was transcribed and used to construct narrative accounts that reflected participants’ experiences as lived and told. Interim narrative accounts were shared with participants to ensure that the accounts reflected their experiences. Analysis: To identify resonant threads across all four narrative accounts, each account was read multiple times with intentionality and with the research objectives in mind. Results: Three distinct professional knowledge landscapes for midwives were identified. These were the professional knowledge landscape of working in rural communities, urban communities, and private maternity homes. Two concepts of knowledge: knowledge for midwives and midwives’ knowledge, were identified on each of these professional knowledge landscapes. Conclusions: Education of midwives should consciously take into consideration the different knowledge landscapes in which midwives in Ghana practice.
TL;DR: The findings of this study support the use of reflective journals as a pedagogical intervention to decrease nursing students’ anxiety associated with the first clinical experience.
Abstract: Objective: Many nursing students experience anxiety in the clinical setting. Increased anxiety impairs students’ ability to learn and can negatively affect patient safety. To promote student learning and patient safety, it is imperative that nurse educators identify and implement strategies to decrease nursing students’ anxiety. The purpose of this qualitative study was to determine how undergraduate nursing students perceive the impact of writing reflective journals on their anxiety level associated with their first clinical rotation experience early in their program of study. Methods: Participants were randomly assigned by their clinical group to either write guided reflective journals, non-guided reflective journals, or no reflective journals during their first clinical rotation where they provided patient care. Five individuals from each intervention group were randomly selected to participate in an interview. Themes related to the participants’ perceptions of the impact of writing reflective journals on their anxiety were determined through qualitative analysis. Results and implications: Participants who wrote guided or non-guided reflective journals experienced decreased anxiety associated with their first clinical rotation. Participants in the non-journaling group expressed that they would have benefitted from having a journal assignment. Four themes were identified related to experiences with writing journals: allowed time, identified feelings, assisted with processing, and increased confidence. The findings of this study support the use of reflective journals as a pedagogical intervention to decrease nursing students’ anxiety associated with the first clinical experience. Additional benefits of the reflective journaling included taking time to identify and process feelings and increased confidence in future clinical experiences.
TL;DR: The findings from this study revealed that heads of private nursing institutions perceived the accreditation by nursing ETQA as a tool used to promote quality outcomes in nursing education, and it increases trust, confidence, and reinforcement of uniformity across the nursing education sector.
Abstract: Background and objective: Nursing education throughout the world is striving for international competitiveness and accountability for effectiveness, quality, and trust to the students, patients, and the community, thus making the issue of institutional accreditation increasingly important. The aim of this paper was to explore the perceptions of heads of private nursing institutions on the benefits of school accreditation by nursing education and training quality assurance (ETQA) in KwaZulu-Natal region, South Africa. Methods: The study adopted a qualitative approach. Data were collected from seven heads of private nursing institutions. In-depth interviews were used to explore the perceived benefits of the accreditation of nursing institutions by Nursing ETQA. Thematic content analysis was used in this study to analyse the collected data. The study adhered to all ethical principles. Results: The findings from this study revealed that heads of private nursing institutions perceived the accreditation by nursing ETQA as a tool used to promote quality outcomes in nursing education. Results from this study further revealed that accreditation is a mechanism of ensuring high standards of performance, and it increases trust, confidence, and reinforcement of uniformity across the nursing education sector. In this study, several challenges were reported to hinder the accreditation process including as a disjoint and an inconsistent process of accreditation, unclear criteria for accreditation, the high cost of accreditation, accreditation being detrimental to teaching the outcome, lack of uniformity in the recommendations; and a lengthy process of accreditation. Conclusions: Accreditation is an important tool to ensure that programs and degrees meet the highest standards of education. In nursing education, the accreditation process is associated with several challenges, and there is a need for collaborative and well-coordinated accreditation of nursing schools nationally and globally.
TL;DR: Nursing staffs’ perceptions about and the factors related to the actualization of safety checks, monitoring and documentation in the medication process in long-term elderly care indicate that some safety checks and monitoring guidelines are often violated during the medication administration process.
Abstract: Objective: Elderly people often use several medicines, which increases risks for side effects and adverse effects. Moreover, most reported adverse events in healthcare are associated with medication. The aim was to describe nursing staffs’ perceptions about and the factors related to the actualization of safety checks, monitoring and documentation in the medication process in long-term elderly care. Methods: This was a cross-sectional quantitative, questionnaire-based study. The response rate, among all nurses working in long-term elderly care wards in a Finnish healthcare district, was 39.4% (n = 492). Results: The results indicate that some safety checks and monitoring guidelines are often violated during the medication administration process, but most nurses self-reportedly maintained good practice in medication documentation. Conclusions: The results suggest needs to review training in pharmacology, infection control, and medication calculations during pre-qualification and continuing education, and to ensure nurses’ awareness of attitudes and ethical considerations for medication safety.
TL;DR: The use of debriefing may help nurses gain self-awareness of MD and it may offer nurses strategies to build moral resilience, according to a pilot project.
Abstract: Objective: Moral distress (MD) is a problem for nurses that may cause despair or disempowerment. MD can have consequences like dissatisfaction or resignation from the nursing profession. Techniques such as evidence-based debriefing may help nurses with MD. Creating opportunities for critical care nurses to debrief about their MD might equip them with the tools needed to overcome it. Measuring MD by using the Moral Distress Thermometer (MDT) could provide insight into how debriefings help nurses. The purpose of this pilot project was to examine the impact of evidence-based debriefing sessions on critical care nurses’ sense of MD. Methods: This pilot project used a quasi-experimental, one-group, before-during-after design. Critical care nurses (N = 21) were recruited from one unit at a large academic medical center. Four debriefing sessions were held every 2 weeks. Participants completed the MDT 2 weeks before the first session, at the end of each session they attended, and 1 month after the debriefing sessions. Results: In the pilot project, participants felt that debriefing was helpful by increasing their self-awareness, giving them time to commune with colleagues, and encouraging them to improve self-care habits; however, MDT scores did not change significantly when comparing pre with post intervention scores ( t (12) = 0.78, p = .450). Conclusions: The use of debriefing may help nurses gain self-awareness of MD and it may offer nurses strategies to build moral resilience.
TL;DR: The diabetes self-management education is an effective measure in improving glycemic control and other clinical parameters among patients with type 2 Diabetes Mellitus and needs to be implemented among clinic patients with T2DM for the better outcome and the preventions of complications.
Abstract: This study was aimed to assess the effectiveness of diabetes self-management education (DSME) in the improvement of glycemic control among patients with type 2 Diabetes Mellitus (T2DM) in Batticaloa District, Sri Lanka. The study was a prospective interventional study and conducted as a preliminary study at medical clinic, Base hospital, Kaluwanchikudy, Batticaloa. Thirty patients with T2DM were included based on inclusion and exclusion criteria. A structured individual diabetes self-management education for 10 hours (one hour per week) was delivered to diabetic patients by the trained Nurse Health Educator. Glycosylate hemoglobin (HbA1c) was assessed as a main outcome measure and Fasting Blood Sugar (FBS), Body Mass Index (BMI) of each patient were also measured and recorded before and after the intervention. The respondent rate was 96.7% (n = 29). Majority of them were females (n = 25, 86.2%). A Wilcoxon signed rank test showed that DSME had a statistically significant reduction in HbA1c [8.60 (IQR 2.60) vs. 7.40 (IQR 2.10), p = .000] and FBS level [159.00 (IQR 77.50) vs. 134.00 (IQR 40.50), p = .002] at 3 months of intervention. The mean BMI at baseline was higher compared to 3 months of intervention [24.88 (SD ± 3.06) vs. 24.19 (SD ± 2.79)] which was statistically significant ( p = .000). Majority of participants (n = 22, 75.9%) had improved their HbA1c level by ≥ 0.5% in 3 months. The diabetes self-management education is an effective measure in improving glycemic control and other clinical parameters among patients with T2DM. Thus, DSME needs to be implemented among clinic patients with T2DM for the better outcome and the preventions of complications.
TL;DR: Application of the nursing guidelines has a positive outcome on improving nurses’ knowledge and performance regarding to prevention of ventilator associated pneumonia in neonates.
Abstract: Background: Ventilator Associated Pneumonia (VAP) is a common syndrome in pediatrics primarily in infants and early childhood. Mechanical ventilation is one of the leading supportive modalities of management in the intensive care unit, but it conveys a lot of threats and complications. This study aimed to assess the impact of nursing guidelines on nurses’ knowledge and performance regarding to prevention of ventilator associated pneumonia in neonates through the following: 1) Assessment of nurses’ knowledge and performance regarding to prevention of ventilator associated pneumonia in neonates. 2) Designing, implementing and evaluating the impact of nursing guidelines on nurses’ knowledge and performance regarding to prevention of ventilator associated pneumonia in neonates. Methods: Research design: A quasi-experimental design was utilized to conduct this study. Settings: The study was convoyed at Maternity & Gynecological and Children’s Hospitals affiliated to Ain shams University Hospitals from neonatal intensive care units. Sample: A convenient sample method of forty three (43) nurses, and fifty (50) neonates’ infants on mechanical ventilation was included in the study as a single study group. Tools: The questionnaire format, the observation checklist and implementation of nursing guidelines was assessed the nurses’ knowledge and performance regarding to prevention of ventilator associated pneumonia in neonates. The implementation of nursing guidelines was premeditated as reference guidelines for nurses. Results: There were statistically significant differences between mean scores of the pre and post test as regards nurses’ knowledge and performance regarding to prevention of ventilator associated pneumonia in neonates. Conclusions: Application of the nursing guidelines has a positive outcome on improving nurses’ knowledge and performance regarding to prevention of ventilator associated pneumonia in neonates. Recommendations: The current study recommended that directing a written protocol for prevention of ventilator associated pneumonia in neonates to support satisfactory knowledge, and competent practices are actually required at neonatal intensive care units.
TL;DR: The results illustrated that the majority of students enjoyed their clinical experience in ICUs, however, students highlighted many factors that hindered their clinical practice such as the stressful intensive care setting, fear of making mistakes, complex patients’ conditions, theory-practice gap, overburdening with documentation and lack of coordination between clinical placements.
Abstract: Providing nursing students with quality clinical experience in intensive care units (ICUs) is a major concern for nursing educators in Egypt. Understanding nursing students' perception of their critical care experience is important in future planning of successful clinical placements in ICUs. The purpose of this study was to investigate undergraduate nursing students' perception of their clinical practice in ICUs. The study involved 306 nursing students who were registered in critical care nursing course. Data were collected using a self-administered survey which addressed nursing students' perception of three domains including clinical practice environment, clinical teaching and learning and factors hindering clinical practice in intensive care setting. The results illustrated that the majority of students enjoyed their clinical experience in ICUs. However, students highlighted many factors that hindered their clinical practice such as the stressful intensive care setting, fear of making mistakes, complex patients’ conditions, theory-practice gap, overburdening with documentation and lack of coordination between clinical placements. Supportive learning environment is needed to enhance students' clinical learning, improve collaboration between students, demonstrators and critical care nursing staff, and reduce theory-practice gap.
TL;DR: A European model that refers for healthcare leadership, highlighting the key principles of culturally competent and compassionate health care leadership, is described, aiming to improve the quality of care within a cultural framework.
Abstract: Objective: This paper aims to describe the development of a European model that refers for healthcare leadership. The model promotes the values of cultural competence and compassion. Methods: The development of this model is part of the IENE 4 EU funded project with participating countries: United Kingdom, Spain, Cyprus, Romania, Italy, Denmark, Turkey. Its development is based on a) a needs assessment survey among healthcare leaders in the partner countries (N = 199), b) two round Delphi study with 14 experts and c) a focus group with healthcare leaders after the development of the model. Results: The components of this model include the basic principles, values and skills that a health care leader should have as a role model and a coach of his/her staff in delivering compassionate and culturally competent care. This model was further used within the IENE 4 project, as a tool for creating learning tools, aiming to improve the quality of care within a cultural framework. Fourteen such learning tools were developed and piloted in all partner countries. Conclusions: Health care leaders need to guide, mentor and support their staff and collaborate among them and with patients and families, as to provide quality care within a safe, compassionate and culturally appropriate environment. This model highlights the key principles of culturally competent and compassionate health care leadership.