Effects of a mixed media education intervention program on increasing knowledge, attitude, and compliance with standard precautions among nursing students: A randomized controlled trial

Exploring the impact of collaborative learning on the development of critical thinking and clinical decision-making skills in nursing students: A quantitative descriptive design

This study aims to introduce collaborative learning as a method in the Mental Health and Diseases Nursing course for actively enrolled fourth-year nursing students. The objective is to assess the impact of collaborative learning on critical thinking and clinical decision-making among nursing students. Collaborative learning involves the use of small groups to help students identify effective ways of working together to enhance their learning outcomes. A quantitative research methodology was employed in this study. To evaluate the effectiveness of the collaborative learning program, a within-subject repeated-measures design was implemented. This study was conducted in the nursing department of a university in Turkey. The study included 96 female students (92.3 %) and 8 male students (7.7 %). Data collection involved the sociodemographic data form, the California Critical Thinking Disposition Inventory (CCTDI), and the Clinical Decision-Making in Nursing Scale (CDMNS). The students' pre-program CDMNS median score was 146.00 (117.00-177.00), and the post-program CDMNS median score was 147.50 (115.00-175.00). While there was an increase in the students' clinical decision-making scores after the program, this increase was not statistically significant (p > 0.05). The pre-program median score for CCTDI was 223.26 (176.87-296.02), and the post-program median score was 227.88 (188.87-359.00). The students' critical thinking disposition scores showed a statistically significant increase after the program (p < 0.05). The study results revealed notable enhancements among students who participated in courses utilizing the collaborative learning method. These enhancements included heightened academic performance, elevated levels of critical thinking, increased self-confidence, and improved clinical decision-making abilities.

Impact of and strategies to address negative role models and adherence of nursing students to standard precautions: An integrative review

BACKGROUND

Negative role models can significantly impact nursing students' adherence to standard infection control precautions (SP) but there has been limited research on impacts and relevant strategies.

PURPOSE

This review examined the impact of negative role models on nursing students' adherence to SP and explored strategies that nursing instructors could use to help students effectively manage the influence of negative role models.

METHODS

An integrative review was conducted, guided by Whittemore and Knafl's methodology (2005). PubMed, CINAHL, and Scopus were searched for articles from 2008-2023. Research studies were critically appraised using appropriate tools.

RESULTS

Fourteen articles met the inclusion criteria and were included in this review. The literature indicates that nursing students frequently encounter negative role models during their clinical placements and that such negative encounters detrimentally impact their adherence to SP. Five strategies to potentially mitigate the impact of negative role models were identified.

CONCLUSION

To address the issue of negative role models, nursing instructors can help students learn specific strategies to manage encounters with negative role models, promote discussion of role modeling with students and clinical staff, and act as role models themselves. Further research is needed to inform specific strategies.

Compliance of healthcare workers in a psychiatric inpatient ward to infection control practices during the COVID-19 pandemic: a participant observation study supplemented with a self-reported survey

BACKGROUND

As an emerging infectious disease with a heterogenous and uncertain transmission pattern, coronavirus disease 2019 (COVID-19) has created a catastrophe in healthcare-associated infections (HAIs) and posed a significant challenge to infection control practices (ICPs) in healthcare settings. While the unique characteristics of psychiatric patients and clinical settings may make the implementation of ICPs difficult, evidence is lacking for compliance with ICPs among healthcare workers (HCWs) in a psychiatric setting during the COVID-19 pandemic.

METHODS

A cross-sectional multi-method study based on participant unobtrusive observation coupled with the completion of a self-administered ICP survey was conducted to assess compliance with ICPs among HCWs in a psychiatric inpatient ward in a regional hospital. An online checklist, called eRub, was used to record the performance of HCWs in hand hygiene (HH) and other essential ICPs. Furthermore, a well-validated questionnaire (i.e., Compliance with Standard Precautions Scale, CSPS) was used to collect the participants' self-reported ICP compliance for later comparison.

RESULTS

A total of 2,670 ICP opportunities were observed from January to April 2020. The overall compliance rate was 42.6%. HCWs exhibited satisfactory compliance to the wearing of mask (91.2%) and the handling of clinical waste (87.5%); suboptimal compliance to the handling of sharp objects (67.7%) and linen (72.7%); and poor compliance to HH (3.3%), use of gloves (40.9%), use of personal protective equipment (20%), and disinfection of used surface/area (0.4%). The compliance rates of the nurses and support staff to HH were significantly different (χ2 = 123.25, p < 0.001). In the self-reported survey, the overall compliance rate for ICPs was 64.6%.

CONCLUSION

The compliance of HCWs in a psychiatric inpatient ward to ICPs during the COVID-19 pandemic ranged from poor to suboptimal. This result was alarming. Revisions of current ICP guidelines and policies that specifically target barriers in psychiatric settings will be necessary.

Factors Associated with Exclusive Use of Hygienic Methods during Menstruation among Adolescent Girls (15-19 Years) in Urban India: Evidence from NFHS-5

Background

Menstrual hygiene is a critical public health concern for adolescent girls in urban India. However, there is a paucity of research on this subject, particularly on a national scale. To the best of our knowledge, this study diverges from previous research, as the majority of prior investigations in India have centered on rural locales, married individuals, and those aged between 15 and 24 years. Thus, this study aims to fill this gap by investigating the factors associated with the exclusive use of hygienic methods during menstruation among urban adolescent girls (15-19 years) in India.

Method

A total of 25136 samples were included in this analysis from the National Family Health Survey 5 (NFHS-5). The Binary logistic regression model has been administered to determine the associated factors of the exclusive use of hygienic methods among adolescent girls.

Results

The results of the multivariate model revealed significant positive associations between higher education levels and usage of menstrual hygiene management products (AOR: 1.860; 95 % CI: 1.418-2.439), (AOR: 2.110; 95 % CI: 1.553-2.867). Additionally, individuals in higher wealth quintiles were more likely to use MHM products, with the richest quintile showing the highest likelihood (AOR: 5.310; 95 % CI: 4.494-6.275). Attendance at cultural events such as cinema or theater was positively associated with MHM product utilization (AOR: 1.338; 95 % CI: 1.181-1.517).Conversely, Lack of access to sanitation facilities was inversely associated with MHM product utilization (AOR: 0.742; 95 % CI: 0.628-0.877). Muslim girls had lower odds than Hindus (AOR: 0.576; 95 % CI: 0.520-0.637). Substantial regional variations were evident, with the Western (AOR: 0.879; 95 % CI: 0.759-1.019), Eastern (AOR: 0.747; 95 % CI: 0.654-0.854), Central (AOR: 0.349; 95 % CI: 0.313-0.388), and North-eastern regions (AOR: 0.597; 95 % CI: 0.490-0.727) displaying diminished odds of MHM product usage relative to the southern region. General caste had higher odds compared to scheduled caste (AOR: 1.255, 95 % CI: 1.103-1.429), while other backward caste had lower odds (AOR: 0.858, 95 % CI: 0.771-0.955).

Conclusion

These findings underscore the importance of addressing inequalities in access to menstrual hygiene products among urban adolescent girls in India. Targeted interventions and educational programs are essential to ensure equitable access and promote overall health and well-being.

Enhancing collaborative learning in health management education: an investigation of Padlet-mediated interventions and the influence of flexible thinking

This study had three primary goals. First, it aimed to craft an intervention program centered around collaborative learning enabled by Padlet. Second, it aimed to gauge the perceptions of health management students regarding this intervention and how it affected their collaborative learning experiences. Additionally, the third objective of the study aimed to investigate how students' flexible thinking within the learning process might shape their perceptions of the advantages derived from this instructional activity within the domain of online collaborative learning. Data for the analysis were gathered from 100 Israeli undergraduate students by two measurements: Flexible thinking in learning and Student perceptions of collaborative learning via Padlet. The intervention program included several stages. First, the students discussed the pedagogic objective of using Padlet. In the second stage, the students were presented with ill-structured problems related to the course content. Each group had to choose one problem and analyze it from three perspectives discussed in the course-healthcare provider, patient, and organization. Next, the students presented and explained their solutions employing the shared knowledge base. The final work was presented in different formats using various technologies. The PLS-SEM analysis has corroborated our hypothesis that students' flexible thinking might positively contribute to their perception of Padlet utilization. According to the empirical model, in general, students who perceived themselves as more flexible were found more receptive to utilizing the proposed technological tool (Padlet) and hence tended to appreciate its function as a collaborative learning platform enabler. This study mainly underscores the important role flexible thinking plays in motivating managers and medical professionals to embrace innovative technologies or methods for teamwork, that could enable them to weigh arguments, seek alternative solutions to authentic problems, and adjust their approaches effectively and collaboratively as new challenges emerge.

Interventions to Enhance Nursing Student Compliance With Infection Control: A Systematic Review

AIM

The purpose of this review was to identify effective strategies for improving infection control practices among prelicensure nursing students.

BACKGROUND

Infection control practices are fundamental skills taught to prelicensure nursing students. The most effective teaching strategy to support infection control behaviors has yet to be determined.

METHOD

A systematic search of peer-reviewed English literature published before October 2021 was conducted in three databases, followed by critical appraisal. Outcomes included either observed or self-reported infection control behaviors.

RESULTS

Twelve eligible studies met inclusion criteria for qualitative synthesis. Studies with integrated simulation or multimodal interventions generally achieved higher infection control compliance than those with greater emphasis on traditional education. The appraisal noted intervention/instrument heterogeneity and limited control.

CONCLUSION

Didactic infection control education should be supplemented with other modalities, but further controlled studies are needed to identify which specific approach is most effective.

Nurses' intention to care for patients with infectious disease: a content analysis study

OBJECTIVE

This present study was designed to explain the concept of nurses intention to care of patients with infectious diseases.

METHODS

This study is a deductive content analysis study that was performed from May 2022 to Jun 2022 in three hospitals in Iran. In total 21 nurses were chosen by purposive sampling and for deta collection used semi-structured interviews. Data analysis was done using Elo and Kingas method.

RESULTS

This study have revealed the formation of seven distinct themes, namely Job satisfaction, Professional ethics, Personal values, Standard precautions, Preserving health, Support, and Attitude of patients and their families. These themes are comprised of 17 categories and 59 subcategories.

CONCLUSION

By comprehending the dimensions of nurses' intentions to care for patients with infectious diseases, it is possible to develop suitable planning and strategies to meet the healthcare requirements of such patients. Managers can take action by examining the issues and demands of nurses, and by providing job security, they can establish a Healthcare service systems with high security that can effectively respond during an outbreak of infectious diseases. Additionally, Nursing managers can prevent nurses from leaving their jobs by taking appropriate intervention, increasing their motivation, and enhancing their satisfaction.

Effects of blended learning on undergraduate nursing students' knowledge, skills, critical thinking ability and mental health: A systematic review and meta-analysis

AIM

This study aimed to evaluate the effects of blended learning on nursing students. The primary outcomes include knowledge and skills, and the secondary outcomes include critical thinking ability, mental health, blended learning design, and nursing students' attitudes toward blended learning.

BACKGROUND

Blended learning combines the advantages of online learning and traditional face-to-face learning, and makes up for the disadvantages of simple online learning or traditional learning. The effects of blended learning on the knowledge, skills, critical thinking ability, and mental health of nursing students were unknown.

DESIGN

Systematic review and meta-analysis.

METHODS

The present systematic review and meta-analysis was applied according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) statement. Publications were searched in PubMed, Web of Science, EMBASE, ERIC, CINAHL and the Cochrane's Library before February 2023. Two researchers independently retrieved articles and evaluated quality. The meta-analysis was performed using Stata 12.0 software according to PRISMA guidelines. The risk of bias in the selected studies was evaluated using the Revised Cochrane risk-of-bias tool for randomized trials. Heterogeneity was assessed by I2 and P statistics. Standardized mean difference (SMD) and 95% confidence intervals (CIs) were used as effective indicators.

RESULTS

A total of 26 studies involving 2823 nursing students were included in the present study. The results showed that blended learning courses were designed based on learning theory. Blended learning was more effective on the knowledge (SMD = 0.73, 95%CI [0.37, 1.09]) and skills (SMD = 0.86, 95% CI [0.35, 1.37]) compared with non-blended learning for nursing students. Critical thinking ability improved significantly through BL (SMD = 2.23, 95% CI [0.85, 3.61]). In addition, blended learning had a positive impact on nursing students' mental health. Nursing students were very satisfied with blended learning.

CONCLUSIONS

The results of this study indicated that blended learning had a positive impact on nursing students. In the future, the optimal ratio of online to offline learning in blended learning should also be explored.

Effectiveness of educational and training intervention for improving hand hygiene compliance amongst nurses: a systematic review and meta-analysis of randomised controlled trials

BACKGROUND AND AIMS

Developing and implementing an educational and training programmes for improving hand hygiene compliance of the nursing personnel might help in increasing their knowledge, promoting positive attitude and follow adequate practice measures.

MATERIAL AND METHODS

Systematic search was done in PubMed, SCOPUS, CENTRAL, EMBASE, ScienceDirect, Clinicaltrials.gov and Google Scholar databases for articles published between 1964 and December 2022. Meta-analysis was carried out using a random-effects model, and the results were reported as pooled risk ratio (RR) with 95% confidence intervals (CIs), pooled standardised mean differences (SMD) or risk ratios (RR).

RESULTS

Eight studies were included in the analysis. Most studies had higher risk of bias. Nurses receiving educational and training programmes had significantly higher compliance to hand hygiene practices (pooled RR of 1.69 [95% CI: 1.23-2.31; I2  =  99.1%], p  =  0.001). The pooled analysis based on studies reporting the compliance to hand hygiene as continuous outcome has reported the pooled SMD as 1.28 with 95% CI: 0.62 to 1.95 and I2  =  74.5%. There were no single-study effects with respect to this outcome, since the sensitivity analysis showed no difference in either direction or strength of effect estimate.

CONCLUSION

Educational and training programmes are effective in improving the hand hygiene compliance amongst the nursing professionals.

Barriers to Learning Healthcare-Associated Infections Prevention and Control during Clinical Practicum among Nursing Students in Korea: A Focus Group Study

Healthcare-associated infections (HAI) refer to infections that patients may acquire from healthcare facilities through nursing activities. Nursing students involved in patient care are regularly exposed to an array of pathogens and clinical practicum is essential for them to appropriately practice HAI prevention and control. This study aimed to explore the barriers to learning HAI prevention and control experienced by nursing students during their clinical practicum. A qualitative study was performed using focus group interviews. A total of 12 nursing students from South Korea, consisting of six third-year students and six fourth-year students, were enrolled. Both groups had taken clinical practicum courses. Data were collected using semi-structured questions and analyzed with conventional content analysis. Barriers experienced by the participants when learning HAI prevention and control were limited learning opportunities, inadequate infection control-related knowledge, inadequate practicum experience, and passive learning attitudes. Addressing the identified barriers would allow nursing students to effectively acquire infection control competencies during their clinical practicum.

Online collaborative Padlet-mediated learning in health management studies

Introduction

The Padlet interactive platform constitutes a virtual online board on which users can post various types of multimedia content, such as documents, questions, comments, images, video clips, and audio clips. This platform has gained popularity in higher education yet remains ancillary in the fields of medical education and medical management.

Methods

This case study sought to initially design an intervention program that employs online collaborative learning enabled by Padlet and to assess how Health Management students perceived the activity and its ramifications for their learning. 85 students’ reflective journals were content analyzed.

Results

five main categories stood out: (1) user experience of the platform; (2) visuality and visibility of the platform; (3) collaborative learning and OCL; (4) active online learning and student engagement; and (5) cognitive flexibility.

Discussion

This study emphasizes the importance of incorporating digital tools in education, particularly the use of the Padlet platform to facilitate collaborative learning and improve the quality of teaching and learning. It demonstrates that Padlet-mediated online collaborative learning can be an effective digital learning tool because of its ease of use and ability to accommodate both pedagogical and technological challenges.

Can online learning be a reliable alternative to nursing students' learning during a pandemic? - A systematic review and meta-analysis

OBJECTIVES

To compare online learning with traditional face-to-face and blended learning, based on randomized controlled trials, to determine the impact of online learning on nursing students' learning outcomes.

DESIGN

A systematic review and meta-analysis.

DATA SOURCES

A systematic search was conducted via English (PubMed, ERIC, Embase, CENTRAL, and CINAHL) and Korean databases (RISS, DBpia, and KISS).

REVIEW METHODS

Studies published up to the first week of April 2022 were reviewed with a focus on the participants, intervention, comparison, outcome, and study design format. Following a primary screening of titles and abstracts, and secondary screening of full texts, 10 randomized controlled trial studies were selected, of which eight were included in the meta-analysis. Two researchers independently reviewed the literature, and the final selection was made in consensus.

RESULTS

Online learning had a statistically significant positive effect on nursing students' knowledge, compared with no educational intervention (standardized mean difference (SMD) = 1.63; 95 % confidence interval (CI): 1.31 to 1.95). However, there was no significant difference in the impact of online learning on knowledge compared with blended learning (SMD = -0.14; 95 % CI: -0.70 to 0.41) and face-to-face learning (SMD = 0.37; 95 % CI: -0.32 to 1.06). Furthermore, compared with blended learning (SMD = -0.18; 95 % CI: -0.43 to 0.06) and face-to-face learning (SMD = 0.05; 95 % CI: -0.31 to 0.41), there was no significant difference in the impact of online learning on attitudes toward learning.

CONCLUSIONS

Online learning in nursing education is not significantly different from blended or face-to-face learning in terms of its impact on knowledge acquisition and attitudes toward learning. The results of this review and meta-analysis highlight the need for selective application of learning methods, taking into account learning environments as well as curricular subjects and topics.

Exploring the activities and outcomes of digital teaching and learning of practical skills in higher education for the social and health care professions: a scoping review

Higher education for health care professionals faces numerous challenges. It is important to develop and apply methods supporting education, especially the practical skills. This scoping review aimed to explore the activities and learning outcomes of digital technology in practical skills teaching and learning in higher education for the social and health professions. Scoping review recommendations and the PRISMA-ScR checklist were applied. Randomized controlled trials published between 2016 and 2021 involving students in higher education who were taking courses in the social sciences and health care and reported interventions with digital technology activities and practices in practical teaching and learning were included. The CINAHL Plus, PubMed, Scopus, ERIC, and Sociological Abstracts/Social Services Abstracts databases were searched. Teaching methods were blended, e-learning or other online-based, and digital simulation-based activities. Teaching and learning environments, methods, resources, and activity characteristics varied, making a summary difficult. Interventions were developed in a face-to-face format prior to digitalization. The outcomes were measured at the knowledge level, not at the performance level. One-third of the studies showed a significant improvement in practical skills in the intervention group in comparison to the control conditions. The use of digital technology in the learning and teaching process have potential to develop of students' skills, knowledge, motivation, and attitudes. The pedagogy of technology use is decisive. The development of new digital methods for teaching and learning practical skills requires the engagement of students and teachers, in addition the researchers.

Effectiveness of game-based virtual reality phone application and online education on knowledge, attitude and compliance of standard precautions among nursing students

Game-based virtual reality phone applications can create a realistic environment to prepare for clinical applications and improve students’ knowledge of and compliance with standard precautions. An experimental study was performed among 126 nursing students’ from the third and fourth nursing levels to determine the effect of online education and game-based virtual reality phone applications related to standard precautions. Students were divided randomly into two groups; the experimental group used online education and game-based virtual reality phone applications, while the control group used traditional education. The study was performed between July and August 2019 to prevent clashes with lectures and midterm and final examinations. A tool package including knowledge, attitude, and compliance with standard precautions was used in pre-and post-tests among nursing students. The results showed that the knowledge of, attitudes towards, and compliance with standard precautions differed between the two groups. The performance of the experimental group of nursing students significantly improved with online instruction and game-based virtual reality phone applications. This study demonstrated the effectiveness of online education and game-based virtual reality phone application among nursing students.

Protocol for educational programs on infection prevention/control for medical and healthcare student: A systematic review and meta-analysis

During the COVID-19 pandemic, infection protection/control education has become increasingly important for not only healthcare professionals but also students undertaking medical, nursing, physical therapy, occupational therapy, and other related courses. A review of the literature on infection control education reveals that the target participants often comprise healthcare workers, and very few studies of infection control education focus on students. We have developed a protocol for the systematic review of the literature on simulation-based infection prevention/control education for students undertaking medical, nursing, rehabilitation, and other related courses. The protocol for the systematic review and meta-analysis has been drafted in alignment with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) statement. Systematic literature search will be performed for the period between 1990 (January) and 2022 (September) using the CENTRAL, MEDLINE, and Scopus databases. We will qualitatively and quantitatively examine the effects of simulation-based infection education for students in this systematic review and meta-analysis. Two investigators will independently search the databases according to the defined search strategy. The full-text of the selected articles will be screened independently keeping in mind the inclusion criteria by a pair of reviewers. Descriptive data will be extracted from each study regarding: study design, methods, participants, and outcomes. A meta-analysis will be performed if the quantitative data is suitable. Heterogeneity will be assessed using the standard χ². Odds ratio for categorical data and weighted mean differences for continuous data and their 95% confidence intervals will be calculated and used for analysis. Where statistical pooling is not possible, the findings of the quantitative papers will be presented in narrative form. The qualitative aspect will employ narrative (descriptive) synthesis. Our review will make a valuable contribution to the domain of simulation-based infection prevention/control for students enrolled in medical and/or related courses.

Utilizing educational technology in enhancing undergraduate nursing students' engagement and motivation: A scoping review

BACKGROUND

Modern educational technology (Edtech) combines technological tools with educational theories. Over the years, Edtech has been adopted in nursing education to address student needs and expectations, institutional resources, community stakeholder expectations, and healthcare trends. However, regardless of the technologies used, keeping students engaged in learning is still challenging. As intrinsic motivation is significantly related to academic achievement, ensuring student engagement and motivation for learning becomes crucial.

AIMS

This scoping review aims to explore the types and features of modern Edtech that have impacted on undergraduate nursing students' engagement and motivation.

DESIGN

This scoping review is based on the five-stage approach following Arksey and O'Malley's framework, and the Engagement theory framework for technology-based teaching and learning.

METHODS

A systemic search was conducted across 10 electronic databases (PubMed, EMBASE, CINAHL, PsycINFO, ProQuest, Web of Science, Cochrane, Engineering Village, and IEEE Explore). The titles, abstracts, and full texts were screened and reviewed based on the inclusion criteria of undergraduate nursing students, using innovative Edtech, and outcomes of engagement and motivation. Studies published in non-peer reviewed journals, or not in English were excluded. Study characteristics were summarized and quantified. Descriptions of educational technology characteristics from selected studies were coded and categorized as follows: "Facilitating collaboration", "Stimulating problem-solving", and "Pursuing authentic focus".

RESULTS

Majority of the studies utilised gamification over other types of Edtech such as virtual reality or smart glasses, successfully engaging and motivating students through the features of collaboration, competition, and challenge. Despite the high technology aspect of the interventions used, the human presence as an authentic focus was perceived to be important in engaging students in learning experience. Moreover, attaining meaningful achievements also improves engagement and motivation.

CONCLUSIONS

Edtech can promote positive engagement and motivation of undergraduate nursing students. Educators should emphasize an authentic focus in students' learning experience with Edtech.

What is the impact of video as a teaching method on achieving psychomotor skills in nursing? A systematic review and meta-analysis

OBJECTIVES

The aim of this systematic review (SR) is to establish if video is a beneficial teaching method when teaching psychomotor skills in nursing.

DESIGN

Systematic review.

DATA SOURCES

A database search of CINAHL, MEDLINE, EMBASE and Cochrane was performed with search terms 'video', 'nurse' 'RCT' and 'practical skills' resulting in seventy-four research articles.

REVIEW METHOD

All research articles yielded from the searches from the specified databases were scanned while considering the research question, and the inclusion and exclusion criteria. Data were assessed by two independent reviewers on the title and abstract content initially, papers then considered at this point had the full text studied. Data extraction and table were compiled with headings of interest considering the research question. A narrative piece was written on the extraction table. Quality appraisal was performed by using RevMan software Version 5.3 to assess the internal validity of all eight studies.

RESULTS

This systematic review supports the use of video as a teaching method when achieving psychomotor skills. Nine different practical clinical skills have been taught throughout the papers and six out of the eight research papers concluded that video is a beneficial teaching method.

CONCLUSION

Video can be communicated via many modes, including mobile devices, making it very accessible to the user while facilitating guidance at their fingertips while providing current evidence-based care to the patient. This review suggests that making video accessible to the learner, is a positive addition when teaching and learning psychomotor skills.

Exploring nursing students' learning experiences and attitudes toward older persons in a gerontological nursing course using self-regulated online enquiry-based learning during the COVID-19 pandemic: A mixed-methods study

BACKGROUND

During the COVID-19 pandemic, universities adopted online teaching as the primary teaching and learning method. Most of the online teaching, however, has been limited to the broadcasting of asynchronous lectures and sharing of teaching materials.

OBJECTIVES

To explore undergraduate nursing students' self-regulated learning experiences, satisfaction, and attitudes toward older persons in a gerontological nursing course using online self-regulated enquiry-based learning (EBL) during the COVID-19 pandemic.

DESIGN

A mixed-methods design was adopted.

SETTING

A university in Hong Kong providing pre-registration nursing programmes.

PARTICIPANTS

155 students studying in the fourth year in a five-year Bachelor of Nursing programme participated in the quantitative study in which 18 joined the focus groups (4 groups with group size of 4-5).

METHODS

Five video-based scenarios along with two interactive online workshops, a mind-map development exercise, gamified assessments, reading materials, group discussions, and presentations were adopted in a gerontological nursing course offered in 2019-2020 to enhance the students' learning, driven by a process of enquiry. Attitudes toward older people were measured at baseline and one week after the course (post-test). Information on self-regulated learning experiences, satisfaction, and confidence were collected at post-test only. Paired t-tests and descriptive statistics were used to analyse the data. Focus groups were conducted through semi-structured interviews and transcribed verbatim for inductive content analysis.

RESULTS

A significant improvement was demonstrated in the students' attitude toward older people. The students appreciated the opportunities provided by the online EBL to apply key concepts of gerontology in the teaching and learning activities and to enhance their critical thinking skills. Three major themes were revealed from the focus group: Perception of the teaching pedagogy, Improvement of cognitive skills, and Positive and negative aspects of the learning experience.

CONCLUSIONS

The online self-regulated EBL improved the students' online learning experience in a gerontological nursing course during the pandemic and improved their attitudes toward older people.

Effect of infection control training course on knowledge and practices of medical interns in a large academic hospital in Egypt: an intervention study

Health care-associated infections are reported among the top causes of hospital deaths worldwide. Their prevention is a first priority for patient safety in acute care hospitals. Education and training is recommended as a core component for effective infection prevention and control programs. This study aimed to assess the effect of an infection control training course on the knowledge and practices of medical interns in a large academic hospital in Egypt. The study included 268 medical interns who were getting their practical training at Tanta University Hospitals, Egypt during the study period. Knowledge and practices regarding infection control measures were assessed using a predesigned questionnaire sheet and an observational checklist before and after intervention by infection control training course based on Egyptian national guide for infection control. The data have been analyzed through the application of descriptive frequency, percentages, mean of scores, and the inferential analysis that includes paired t test and Monte Carlo test. The level of statistical significance was adopted at p≤0.05. There was a statistically significant (p < 0.0001) increase in total knowledge score (65.4±13.9 versus 80.2 ±13.2) and total practices score (65±11.3 versus 108±7.9) of infection control measures among studied participants before intervention compared with after intervention. A significant strong positive correlation was detected (r= 0.8, p= 0.0001) between total knowledge and practice scores after intervention by training course. There is a strong positive correlation between knowledge and practices so intervention by infection control training course using teaching multimedia and role play significantly improves the knowledge and practice levels of the studied medical interns.

The Awareness and Empowerment Aspects of the Needlesticks and Other Sharps Injuries and Reporting in Nursing Education: A Cross-Sectional Survey

BACKGROUND

Occurrence and underreporting of needlesticks and other sharps injuries (NSIs) are still immediate concerns among nursing students. This study examined the relationship between occupational health and safety (OHS) awareness and empowerment levels of nursing students and the occurrence and reporting of NSIs.

METHODS

This cross-sectional study was conducted among purposively selected 840 students in a nursing school in 2018-2019. A self-report questionnaire was used to collect data about students' sociodemographic characteristics, OHS awareness and empowerment levels, and NSIs characteristics. After bivariate analyses, multivariate logistic regression was used.

RESULTS

The number of evaluated questionnaires was 469, for a response rate of 55.8%. Participants, 21.2% (n = 99), had suffered NSIs, and 47.8% had reported their injuries. The NSIs were statistically related to age, academic year, working night shift, OHS awareness level of students, and the number of clinical placements completed by students. The odds of experiencing NSIs was 2.3 (95% confidence interval [CI] = [1.0, 5.3]) times higher in male students, 4.3 (95% CI = [2.4, 7.4]) times higher in those beyond the second academic year, and 2.5 (95% CI = [1.4, 4.4]) times higher in those who had received OHS training for a shorter period than the average duration.

CONCLUSION/APPLICATION TO PRACTICE

The levels of awareness and empowerment were higher in students who received OHS and NSIs prevention training and those who received OHS training for the above-average duration. Increasing awareness and empowerment levels of nursing students through training can reduce the occurrence and the underreporting of NSIs.

Interventions promoting uptake of water, sanitation and hygiene (WASH) technologies in low- and middle-income countries: An evidence and gap map of effectiveness studies

Background

Lack of access to and use of water, sanitation and hygiene (WASH) cause 1.6 million deaths every year, of which 1.2 million are due to gastrointestinal illnesses like diarrhoea and acute respiratory infections like pneumonia. Poor WASH access and use also diminish nutrition and educational attainment, and cause danger and stress for vulnerable populations, especially for women and girls. The hardest hit regions are sub-Saharan Africa and South Asia. Sustainable Development Goal (SDG) 6 calls for the end of open defecation, and universal access to safely managed water and sanitation facilities, and basic hand hygiene, by 2030. WASH access and use also underpin progress in other areas such as SDG1 poverty targets, SDG3 health and SDG4 education targets. Meeting the SDG equity agenda to "leave none behind" will require WASH providers prioritise the hardest to reach including those living remotely and people who are disadvantaged.

Objectives

Decision makers need access to high-quality evidence on what works in WASH promotion in different contexts, and for different groups of people, to reach the most disadvantaged populations and thereby achieve universal targets. The WASH evidence map is envisioned as a tool for commissioners and researchers to identify existing studies to fill synthesis gaps, as well as helping to prioritise new studies where there are gaps in knowledge. It also supports policymakers and practitioners to navigate the evidence base, including presenting critically appraised findings from existing systematic reviews.

Methods

This evidence map presents impact evaluations and systematic reviews from the WASH sector, organised according to the types of intervention mechanisms, WASH technologies promoted, and outcomes measured. It is based on a framework of intervention mechanisms (e.g., behaviour change triggering or microloans) and outcomes along the causal pathway, specifically behavioural outcomes (e.g., handwashing and food hygiene practices), ill-health outcomes (e.g., diarrhoeal morbidity and mortality), nutrition and socioeconomic outcomes (e.g., school absenteeism and household income). The map also provides filters to examine the evidence for a particular WASH technology (e.g., latrines), place of use (e.g., home, school or health facility), location (e.g., global region, country, rural and urban) and group (e.g., people living with disability). Systematic searches for published and unpublished literature and trial registries were conducted of studies in low- and middle-income countries (LMICs). Searches were conducted in March 2018, and searches for completed trials were done in May 2020. Coding of information for the map was done by two authors working independently. Impact evaluations were critically appraised according to methods of conduct and reporting. Systematic reviews were critically appraised using a new approach to assess theory-based, mixed-methods evidence synthesis.

Results

There has been an enormous growth in impact evaluations and systematic reviews of WASH interventions since the International Year of Sanitation, 2008. There are now at least 367 completed or ongoing rigorous impact evaluations in LMICs, nearly three-quarters of which have been conducted since 2008, plus 43 systematic reviews. Studies have been done in 83 LMICs, with a high concentration in Bangladesh, India, and Kenya. WASH sector programming has increasingly shifted in focus from what technology to supply (e.g., a handwashing station or child's potty), to the best way in which to do so to promote demand. Research also covers a broader set of intervention mechanisms. For example, there has been increased interest in behaviour change communication using psychosocial "triggering", such as social marketing and community-led total sanitation. These studies report primarily on behavioural outcomes. With the advent of large-scale funding, in particular by the Bill & Melinda Gates Foundation, there has been a substantial increase in the number of studies on sanitation technologies, particularly latrines. Sustaining behaviour is fundamental for sustaining health and other quality of life improvements. However, few studies have been done of intervention mechanisms for, or measuring outcomes on sustained adoption of latrines to stop open defaecation. There has also been some increase in the number of studies looking at outcomes and interventions that disproportionately affect women and girls, who quite literally carry most of the burden of poor water and sanitation access. However, most studies do not report sex disaggregated outcomes, let alone integrate gender analysis into their framework. Other vulnerable populations are even less addressed; no studies eligible for inclusion in the map were done of interventions targeting, or reporting on outcomes for, people living with disabilities. We were only able to find a single controlled evaluation of WASH interventions in a health care facility, in spite of the importance of WASH in health facilities in global policy debates. The quality of impact evaluations has improved, such as the use of controlled designs as standard, attention to addressing reporting biases, and adequate cluster sample size. However, there remain important concerns about quality of reporting. The quality and usefulness of systematic reviews for policy is also improving, which draw clearer distinctions between intervention mechanisms and synthesise the evidence on outcomes along the causal pathway. Adopting mixed-methods approaches also provides information for programmes on barriers and enablers affecting implementation.

Conclusion

Ensuring everyone has access to appropriate water, sanitation, and hygiene facilities is one of the most fundamental of challenges for poverty elimination. Researchers and funders need to consider carefully where there is the need for new primary evidence, and new syntheses of that evidence. This study suggests the following priority areas:Impact evaluations incorporating understudied outcomes, such as sustainability and slippage, of WASH provision in understudied places of use, such as health care facilities, and of interventions targeting, or presenting disaggregated data for, vulnerable populations, particularly over the life-course and for people living with a disability;Improved reporting in impact evaluations, including presentation of participant flow diagrams; andSynthesis studies and updates in areas with sufficient existing and planned impact evaluations, such as for diarrhoea mortality, ARIs, WASH in schools and decentralisation. These studies will preferably be conducted as mixed-methods systematic reviews that are able to answer questions about programme targeting, implementation, effectiveness and cost-effectiveness, and compare alternative intervention mechanisms to achieve and sustain outcomes in particular contexts, preferably using network meta-analysis.

Posters as a Tool to Improve Hand Hygiene among Health Science Students: Case-Control Study

(1) Background: Numerous educational interventions have been conducted to improve hand hygiene (HH) compliance and effectiveness among nursing students, with mixed results. The aim is to evaluate the effectiveness of posters as a teaching tool and factors associated with HH quality. (2) Methods: A pre-post experimental intervention study was conducted with a total of 293 nursing students randomly assigned to two groups (experimental and control) who, before and after HH, took cell culture samples from their non-dominant hands. Only the experimental group was exposed to the poster. (3) Results: In the experimental group, significant differences were observed among students older than 22 years (p = 0.017; V = 0.188), with a higher percentage of failures (15.7% vs. 3.6%). Poster displaying was associated with passing, other variables being equal, although without statistical significance (ORa = 2.07; 95% CI = 0.81-5.26). Pre-practice hand contamination was weakly associated with lower HH quality (ORa = 0.99, 95% CI = 0.99-0.99). (4) Conclusions: The use of posters as a teaching method shows indications of efficacy. Prior hand contamination slightly affects the quality of HH. Further evaluation of teaching methods is needed to ensure good technical performance of HH to prevent the spread of infectious diseases during the COVID-19 pandemic.

Applying interprofessional simulation to improve knowledge, attitude and practice in hospital- acquired infection control among health professionals

BACKGROUND

This study aimed at determining the effectiveness of an innovative approach using interprofessional simulation scenarios (IPSS) in improving knowledge, attitude, and practice (KAP) of hospital-acquired infection control (HAIC) among health professionals.

METHODS

The interventional study was conducted in a teaching hospital in Malaysia. Purposive sampling was used to recruit participants from surgical, intensive care, and other units. Thirty-six health professionals in the experimental and forty in the control group completed the study. All subjects participated in an interactive lecture and demonstrated four IPSS on HAIC i.e. (i) taking blood specimen (ii) bedsore dressing (iii) collecting sputum for acid-fast bacilli and (iv) intermittent bladder catheterization. Each team consisted of a doctor and a nurse. A self-administered questionnaire on KAP on HAIC was completed by respondents during the pre-, immediately and, post-intervention. An independent t-test was conducted to measure the significance between the experimental and control group.

RESULTS

The mean scores for KAP among the experimental group increased following the intervention. Significant differences in scores were seen between the two groups post-intervention (p < 0.05). Overall, using the four procedures as surrogates, the interprofessional learning approach in HAIC intervention showed improvement among the participants in the experimental group following structured instructions. The IPSS approach in HAIC clearly shows its relevance in improving learning outcomes.

CONCLUSIONS

Well-designed interprofessional simulated scenarios can be effective in skills training in improving KAP in HAIC among health professionals.

The Effectiveness of Interventions in Improving Hand Hygiene Compliance: A Meta-Analysis and Logic Model

Background

Despite the availability of various guidelines, rules, and strategies, hand hygiene adherence rates among healthcare workers are reported significantly lower than expected. The aim of this meta-analysis is to determine the most effective interventions to improve hand hygiene and to develop a logic model based on the characteristics of the most effective interventions.

Methods

A literature search was conducted on PubMed, ProQuest, Web of Knowledge, Scopus, Cochrane Library, and ScienceDirect databases up to December 21, 2019, with no time limit. Randomized clinical trials which had designed interventions to improve hand hygiene were reviewed. Data were extracted independently by two authors. All statistical analyses were performed using Comprehensive Meta-Analysis (CMA) software (version 2.0). A random-effects model was used to estimate odds ratios.

Results

Although 14 studies were initially reviewed, only 12 studies entered the meta-analysis, since they had identified percentage rates of hand hygiene compliance. The most effective intervention (odds ratio 18.4, 95% CI (13.6–24.8)) was a multilevel strategy that influenced the determinants of hand hygiene behavior at individual, interpersonal, and organizational levels. Following this, a theory-driven logic model was mapped out to promote hand hygiene, based on situational analysis.

Conclusion

This study suggests that designing integrated interventions based on a multilevel socioecological approach has the greatest potential to improve hand hygiene compliance in healthcare workers. The logical model proposed in this study can thus provide a useful guide for designing and conducting future experimental research.

Hand-hygiene-related clinical trials reported between 2014 and 2020: a comprehensive systematic review

BACKGROUND

There is general consensus that hand hygiene is the most effective way to prevent healthcare-associated infections. However, low rates of compliance amongst healthcare workers have been reported globally. The coronavirus disease 2019 pandemic has further emphasized the need for global improvement in hand hygiene compliance by healthcare workers.

AIM

This comprehensive systematic review provides an up-to-date compilation of clinical trials, reported between 2014 and 2020, assessing hand hygiene interventions in order to inform healthcare leaders and practitioners regarding approaches to reduce healthcare-associated infections using hand hygiene.

METHODS

CINAHL, Cochrane, EMbase, Medline, PubMed and Web of Science databases were searched for clinical trials published between March 2014 and December 2020 on the topic of hand hygiene compliance among healthcare workers. In total, 332 papers were identified from these searches, of which 57 studies met the inclusion criteria.

FINDINGS

Forty-five of the 57 studies (79%) included in this review were conducted in Asia, Europe and the USA. The large majority of these clinical trials were conducted in acute care facilities, including hospital wards and intensive care facilities. Nurses represented the largest group of healthcare workers studied (44 studies, 77%), followed by physicians (41 studies, 72%). Thirty-six studies (63%) adopted the World Health Organization's multi-modal framework or a variation of this framework, and many of them recorded hand hygiene opportunities at each of the 'Five Moments'. However, recording of hand hygiene technique was not common.

CONCLUSION

Both single intervention and multi-modal hand hygiene strategies can achieve modest-to-moderate improvements in hand hygiene compliance among healthcare workers.

The Effect of Distance Learning on Knowledge Acquisition in Undergraduate Second-Degree Nursing Students: A Systematic Review

AIM

The aim of the study was to determine the effect of distance learning on knowledge acquisition in undergraduate second-degree nursing students, a growing population of nursing students.

BACKGROUND

Distance learning is a convenient way of attaining professional training.

METHOD

The study was conducted by critical appraisal and data extraction using Joanna Briggs Institute tools for quasi-experimental, qualitative systematic reviews and research synthesis and randomized control research. Risk for bias was determined using the Cochrane collaboration tool.

RESULTS

Eleven studies from five countries are included in the review: four quantitative, two qualitative, one mixed-method, and four integrative review. Dates range from 2015 to 2018.

CONCLUSION

The evidence suggests that knowledge acquisition is not impacted by educational setting alone. Flipped classroom and mixed-method instruction were found to positively impact knowledge acquisition. Distance learning, coupled with traditional face-to-face instruction, has a greater impact on knowledge acquisition than either method alone. Online methodologies improve clinical skill acquisition more than face-to-face instruction.

Controlling nosocomial infection in adult intensive treatment unit: A quality improvement project

BACKGROUND

Nosocomial infection is a significant burden on healthcare facilities. Its multifactorial nature renders it challenging to control. However, quality healthcare necessitates a safer service that poses no harm to the patient.

OBJECTIVE

The aim of this project was to reduce the infection rates in the adult ITU to the benchmark levels.

METHOD

We conducted an internal audit as a result of the high infection rates in the adult ITU. The audit started with root cause analysis using the fishbone quality tool. FOCUS-PDCA quality tool was used to design the framework. We introduced a change in the staff uniform laundry and organized a campaign to improve hand hygiene compliance using a multimodality approach. Moreover, we conducted training on aseptic techniques in ventilation, urinary catheter, and central lines insertion. Finally, we changed the ventilator filter to a higher quality brand which meets the standard specifications. Infection rates were monitored before and after the proposed changes.

RESULTS

There was a marked reduction in ventilator-associated pneumonia; however, it did not reach the benchmark rates. Catheter line-associated bloodstream infection declined from above to below the benchmark. Catheter-associated urinary tract infection rates were below the benchmark; however, they showed a noticeable reduction. Hand hygiene adherence showed an improvement from 80% to 84%. However, this was below the predetermined target level of 90%.

CONCLUSIONS

In-hospital laundry of staff uniforms is safer to control nosocomial infections. A multimodal approach is necessary to improve hand hygiene adherence and adoption of aseptic techniques. Quality improvement is a continuous process.

Adaptation and validation of the Compliance with Standard Precautions Scale amongst nurses in Turkey

AIMS

To adapt and psychometrically test the Compliance with Standard Precautions Scale for use by Turkish nurses.

BACKGROUND

Measurement of standard precautions compliance is important to manage the safety of both patients and health care teams.

METHODS

This two-phase methodological study employed a correlational design with repeated measures. In phase one, the scale's adaptation, including translation, semantic equivalence, content and face validity, was implemented. In phase two, internal consistency and stability were used to examine the reliability of the scale. Construct validity was tested using the Rasch rating scale model. This study was conducted by recruiting 411 nurses from three different hospitals between September 2015 and September 2016.

RESULTS

Adaptation results showed that the Turkish version of the Compliance with Standard Precautions Scale (CSPS-T) is adequate for linguistic and content validation. The content validity index and comprehensibility of the scale were similarly satisfactory. The reliability of the CSPS-T was examined by Cronbach's alpha, corrected item-total correlations and intraclass correlation coefficient, and good results were obtained. The Rasch model showed that all items were compatible with the model. Whereas Item 4 was the most difficult, Item 10 was the easiest.

CONCLUSION

The CSPS-T is a reliable and valid tool for assessing compliance with standard precautions amongst Turkish nurses.

Hand Hygiene Teaching Strategies among Nursing Staff: A Systematic Review

Background: Patient safety is a priority of any healthcare system, and one of the most effective measures is hand hygiene. For this, it is important that health staff have correct adherence and perform the technique properly. Otherwise, the incidence of nosocomial infections can increase, with consequent complications. The aim here was to analyze hand hygiene training and the effectiveness of different methods and educational strategies among nurses and whether they maintained correct adherence over time. Methods: A systematic review was conducted in the sources CINAHL (Cumulative Index to Nursing and Allied Health Literature), Dialnet, Lilacs (Latin American and Caribbean Health Sciences Literature), ProQuest (Proquest Health and Medical Complete), Medline, SciELO (Scientific Electronic Library Online), and Scopus. The search equation with Medical Subject Headings (MeSH) descriptors was “Nurs* AND (handwashing OR hand hygiene) AND clinical trial”. The review was performed following the recommendations of the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. Results: n = 17 clinical trials were included, with a total of 5747 nurses and nursing students. Strategies such as reminder sounds, practical simulations, videos, and audiovisual media improved handwashing compliance. Adherence overtime increased by up to 60%. The greatest effectiveness was related to the use of povidone–iodine, which reduced colony formation compared Hand hygiene teaching strategies among nursing staff: a systematic review to soap. Conclusions: The strategies that go beyond teaching techniques such as lectures may be more effective at increasing hand hygiene compliance. Combined approaches to learning/instruction improve user satisfaction by enabling self-management, flexibility, and repetition.

Skills for generalist and specialist nurses working in the prevention and control of infections in Brazil

Objective

to define the competencies for the prevention and control of healthcare-related infections that should be developed by the generalist nurse and the specialist nurse in infection control in Brazil.

Method

the Delphi technique, developed in four rounds, was used. Thirty-one nurses and eight physicians participated in the study, with expertise in infection prevention and control. Data were collected using open-ended questionnaires, whose answers were treated using the content analysis technique. Structured instruments were used to evaluate the importance of each competency using a Likert scale. Data were analyzed and presented in a descriptive way, use of median and coefficient of variation.

Results

the competences were organized in 4 core, 14 generic and 17 specific, with name and description of each competency.

Conclusion

the definition of competencies for the prevention and control of healthcare-related infections is the first step to begin the rethinking of the teaching and learning process in the initial training of nurses. The data found in the present study may help to restructure education and support permanent education programs in health.

Effects of a multi-component educational intervention on nurses' knowledge and adherence to standard precautions in intensive care units

Background

The standard precautions (SPs) should be disseminated and implemented by healthcare providers. This study aimed to examine the effects of a multi-component educational intervention on nurses' knowledge and adherence to the SP guidelines in intensive care units (ICUs).

Methods

This small-scale study consisted of a cluster randomised trial. Two ICUs, located in different hospitals, participated in the study. Nurses (n = 15) in one ICU received the multi-component educational intervention. The intervention involved an educational (with multiple instructional media) and a behavioural (with hands-on practice) component. Nurses' knowledge and adherence were assessed at pre-test and two and six weeks after the intervention.

Results

Results showed significant group by time interaction effects for both outcomes: a large improvement was found in the experimental group over time, but not in the control group. The experimental nurses' knowledge improved from 15 ± 2.47 at pre-test to 19 ± 2.65 and 19.53 ± 0.92 at follow-ups. Similarly, their adherence increased from 19.87 ± 4.44 at pre-test to 29.20 ± 5.00 and 28.40 ± 4.37 at two and six weeks post-test, respectively.

Conclusions

The multi-component educational interventions had demonstrated initial effectiveness in enhancing ICU nurses' knowledge and adherence to the SPs guidelines. The intervention is a promising approach for designing effective continuing education initiatives aimed to improve nurses' practice.