Influence of Technology in Supporting Quality and Safety in Nursing Education

Perceptions and Attitudes of Registered Nurses and Nursing Students Toward Advanced Technology and Artificial Intelligence: A Review of Literature

The use of technology in healthcare and healthcare education settings has increased rapidly across the United States and accelerated due to the COVID-19 pandemic. However, perceptions of new technologies in clinical nursing and nursing education are not well understood. Yet, understanding perceptions of registered nurses and nursing students toward advanced technology and artificial intelligence in clinical care and education is crucial if we are to implement these care delivery and educational innovations. This literature review investigates existing literature on registered nurses' and nursing students' attitudes toward advanced technology and artificial intelligence in nursing, including nursing education. Ten peer-reviewed studies published between 2017 and 2022 were reviewed. Findings revealed positive perceptions, such as improved patient care, efficiency, and reduced human error, but also concerns about job displacement, loss of human touch, and ethical/legal issues. Challenges in implementation, adequate training in technologies, and how technologies may reduce the human connection aspect of nursing care were identified. By recognizing the attitudes and perceptions of registered nurses and nursing students toward these advanced technologies, we can better ensure that it is ethically, effectively, and responsibly integrated into nursing practice and education.

Technologies to support nursing students in learning Standardized Nursing Languages: A systematic literature review

AIM

This review identifies technologies used to teach Standardized Nursing Languages and their impact on nursing students' educational outcomes.

METHODS

A literature review, updated to June 14, 2024, was conducted by consulting the PubMed, CINAHL, Scopus, and Cochrane databases. The main inclusion criterion was primary studies in which technology was used to educate students on Standardized Nursing Languages.

RESULTS

Three types of technology were addressed: Computerized Aids and Electronic Devices, Decision Support Systems, and Diagnostic Reasoning Software. Most of these technologies were found to positively impact knowledge, performance, application of the nursing process, diagnostic accuracy, and clinical reasoning.

CONCLUSIONS AND IMPLICATIONS FOR NURSING EDUCATION

Integrating technology into nursing education enhances nursing students' skills and equips them to handle the digital aspects of modern health care. Technologies must support all stages of the nursing process, reinforce clinical reasoning, and offer timely feedback. Additionally, the presence of teachers during technology training is crucial to ensure proper functioning, provide technical support, manage the learning environment, and verify students' skills. Nursing students with technological skills will become nurses capable of producing complete and quality clinical documentation and supporting their professional achievements.

Development of a novel instrument to measure Japanese psychiatric nurses' technological competency as caring in nursing

Background

To effectively advance person-centered care (PCC) practice, it is important to equip healthcare providers with person-centered values and beliefs while simultaneously transforming their work environment to align with PCC. Thus, instruments to measure caring practice status in nursing competency for psychiatric-specific behavioral limitations, ethico-moral behavior, technology use, and PCC need to be developed.

Objective

This study developed the Technological Competency as Caring in Psychiatric Nursing Instrument (TCCNPNI) to measure practice status and test its content and construct validity.

Methods

Five different phases were followed: 1) Literature Review; 2) Operational definition of the construct and development of items; 3) Two-round Delphi method; 4) Validity measure; and 5) Reliability measure. The online survey was conducted in 2024.

Results

The developed instrument comprises 22 items with a 4-factor structure: competency to practice caring and person-centered care (Factor 1); competency to recognize and respond to ethical issues in psychiatry (Factor 2); competency to utilize technology in psychiatry (Factor 3); and competence to practice care for the preservation of human dignity and shared decision making (Factor 4). Cronbach's alpha for the entire scale was 0.864, while that for factors 1-4 was 0.911, 0.814, 0.773, and 0.64, respectively. Cumulatively, these four factors contributed 49.6% and explained nearly 50% of the total data. Item-total correlation values were 0.6 or higher among factors 1-3. However, factor 4, for which items were Q30, Q33, Q34, and Q35 (r = 0.03, 0.04, 0.21, 0.11, respectively), were inverted items and had low I-T correlation values. These low correlations suggest that these items capture different concepts. The developed TCCNPNI allows for the measurement of the practice of nursing as caring in psychiatry, the state of ethico-moral behavior, and the practice status of technological competency as caring in psychiatric nursing.

Conclusion

This study demonstrated satisfactorily and efficiently evaluated the practice status of technological competency in psychiatric nurses' caring. Measuring technological competency as caring in psychiatric nursing can be an important adjunct for in-service education in psychiatric hospitals or formalized nursing education in nursing universities.

The impact of The Quality and Safety Education (QSEN) program on the knowledge, skills, and attitudes of junior nurses

BACKGROUND

The quality and safety education for nurses (QSEN) competency program represents a valuable initiative in nursing practice and education, equipping nurses with the essential knowledge, attitude, and skills (KAS) required to deliver safe, efficient, and patient-centered care.

PURPOSE

This study aims to determine the impact of QSEN competency on the KAS of nurses in Palestine.

METHOD

A quasi-experimental pre-test and post-test design with two groups was used utilizing a questionnaire to collect data from 164 Junior nurses in two governmental hospitals within the period of 25th, January to the 10th February 2024. Patricia Benner's theory suggests that a strong educational foundation and diverse experiences enable nurses to enhance their patient care knowledge and abilities over time.

RESULTS

The findings indicate that nurses in Palestine can benefit from targeted interventions and QSEN educational programs aimed at improving their patient-centered care competence, as post-test scores show a significant rise over pre-test scores. Junior nurses who participated in the QSEN program experienced a 57% increase in knowledge, a 57% increase in skills, and a 64% increase in attitudes. The intervention significantly improved knowledge (77.02 vs. 49.19, p < 0.001), quality and safety skills (70.16 vs. 44.61, p < 0.001), and attitudes (75.47 vs. 46.16, p < 0.001) among participants post-procedure, indicating a substantial positive impact on these areas, demonstrating the effectiveness of the educational intervention.

CONCLUSION

The study demonstrates that an educational intervention improves junior nurses' KSAs for six QSEN competencies, leading to higher average scores in quality and safety competence subscales, thereby enhancing staff satisfaction, and reducing medical errors, and patient safety.

Innovating clinical nursing education using virtual technology to combat the effects of COVID-19: A qualitative study

BACKGROUND

At the beginning of the COVID-19 pandemic, social distancing effects halted in-person clinical placements in nursing programs at all Canadian universities. To mitigate educational disruption, clinical practicums were pivoted to online delivery, despite knowledge gaps on the perspectives of nursing students and community liaisons on using virtual technology to facilitate clinical placements.

OBJECTIVE

Accordingly, we explored the impact of using innovative virtual technology to combat the social distancing effects of the COVID-19 pandemic on students' and community liaisons' experiences in a clinical community health nursing course.

METHODS

Using a descriptive qualitative research approach, we evaluated an innovative online clinical placement approach which we implemented to combat the disruptions of social distancing guidelines. Forty-five nursing students were grouped and paired with five community health organizations to create community-led health promotion projects using online videoconferencing. Upon completion of their practicum, six nursing students and four community liaisons participated in virtual individual interviews. Data was analyzed using a thematic analysis approach.

RESULTS

Three themes were developed: 1) Openness to change, 2) Effective virtual communication, and 3) Creation of learning spaces that foster nurturing relationships. On the theme of 'Openness to Change,' participants voiced the need to shift focus from common learning approaches to new, untested options. On the theme of 'Effective virtual communication,' participants valued the critical role of thorough virtual communication in online learning. On the theme of 'Creation of learning spaces that foster nurturing relationships,' participants appreciated the role of relationships, careful planning, and organization of virtual learning spaces for program success.

CONCLUSION

The success and viability of virtual technology in clinical education are strongly related to individual and systems approach and adaptations to support students' access to learning opportunities. Our findings could be used to enhance access to virtual clinical education for students from disadvantaged and vulnerable populations.

Examining patient safety protocols amidst the rise of digital health and telemedicine: nurses' perspectives

BACKGROUND

Integrating digital health and telemedicine technologies is transforming healthcare delivery. In light of this transition, it is critical to ascertain the efficacy of patient safety protocols and evaluate the awareness of healthcare professionals, particularly nurses, regarding the integration of digital health technologies.

AIM

This study examines the factors influencing the successful adoption of digital health and telemedicine technologies from the nurses' perspective, focusing on ensuring patient safety and enhancing organizational readiness for digital health integration.

METHODS

A cross-sectional study included 246 nurses from outpatient healthcare centers in Egypt. The data collected included demographic information and responses to a series of questionnaires, namely the Patient Safety Culture Survey (PSCS), the Telemedicine Risk Assessment and Mitigation Matrix (TRAMM), the Digital Health Adoption Readiness Assessment (DHARA), and the Digital Health Impact Assessment Tool (DHIA). The descriptive statistical analyses were conducted using the IBM SPSS Statistics software, version 26.

RESULTS

The sample was predominantly composed of nurses aged 18-35 (40.65%) and 36-55 (44.72%), with a near-equal gender distribution (48.78% male, 51.22% female). Most nurses held college degrees (73.17%) and were familiar with telemedicine (73.17%). The PSCS indicated positive scores for Communication Openness (4.5), Leadership Support (4.2), Teamwork (4.3), and Organizational Learning (4.1), with an overall mean score of 4.275. The TRAMM scores were notably high (total mean score 4.9), indicating effective risk management. The DHARA demonstrated considerable preparedness, as evidenced by a Total Mean Score of 7.85. The DHIA further substantiated this readiness, indicating a robust anticipated impact, particularly in Patient Engagement (9.0) and Usability (8.2).

CONCLUSION

The favorable assessment scores indicate a strong awareness of integrating digital health and telemedicine, suggesting the potential for enhanced patient care and healthcare delivery. It is recommended that healthcare organizations prioritize providing ongoing training and support for nurses, enabling them to utilize digital health tools and thereby enhance patient safety effectively.

CLINICAL TRIAL NUMBER

Not applicable.

Simulation learning: exploring its transformative influence on nursing practice

Simulation in nursing education enables nursing students to develop and practise their clinical, critical thinking and decision-making skills within the safety of a realistic learning environment. Evidence suggests that this method of learning can enhance nursing students' confidence, enabling them to navigate the current challenges in healthcare and consider new ways of working. This article outlines the benefits and challenges of simulation and discusses the implications of the use of this learning technique in nurse education for future nursing practice.

Navigating ethical considerations in the use of artificial intelligence for patient care: A systematic review

AIM

To explore the ethical considerations and challenges faced by nursing professionals in integrating artificial intelligence (AI) into patient care.

BACKGROUND

AI's integration into nursing practice enhances clinical decision-making and operational efficiency but raises ethical concerns regarding privacy, accountability, informed consent, and the preservation of human-centered care.

METHODS

A systematic review was conducted, following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Thirteen studies were selected from databases including PubMed, Embase, IEEE Xplore, PsycINFO, and CINAHL. Thematic analysis identified key ethical themes related to AI use in nursing.

RESULTS

The review highlighted critical ethical challenges, such as data privacy and security, accountability for AI-driven decisions, transparency in AI decision-making, and maintaining the human touch in care. The findings underscore the importance of stakeholder engagement, continuous education for nurses, and robust governance frameworks to guide ethical AI implementation in nursing.

DISCUSSION

The results align with existing literature on AI's ethical complexities in healthcare. Addressing these challenges requires strengthening nursing competencies in AI, advocating for patient-centered AI design, and ensuring that AI integration upholds ethical standards.

CONCLUSION

Although AI offers significant benefits for nursing practice, it also introduces ethical challenges that must be carefully managed. Enhancing nursing education, promoting stakeholder engagement, and developing comprehensive policies are essential for ethically integrating AI into nursing.

IMPLICATIONS FOR NURSING

AI can improve clinical decision-making and efficiency, but nurses must actively preserve humanistic care aspects through ongoing education and involvement in AI governance.

IMPLICATIONS FOR HEALTH POLICY

Establish ethical frameworks and data protection policies tailored to AI in nursing. Support continuous professional development and allocate resources for the ethical integration of AI in healthcare.

Hybrid Education in Remote Nursing Placements in Australia: A Descriptive Qualitative Study

BACKGROUND

Rural and remote areas offer unique opportunities for undergraduate nurses. Extended placements boost work readiness, improve assessment skills, and increase likelihood of practicing in these areas post-registration. However, hybrid delivery of curriculum content in not well understood. Undergraduate Extended Nurse Placement Program (ENPP) and on campus students, and academics were recruited from a major tertiary institution to understand impact of hybrid delivery for nursing curriculum.

METHOD

Data were obtained from descriptive qualitative design and focus group interviews. A process of thematic analysis generated themes and findings.

RESULTS

There were 12 participants: academics (n = 4), ENPP students (n = 7), and 1 on campus student. The main theme was "Bridging the Hybrid Gap," with two sub-themes: (1) separation, describes ENPP students emotional, experiential, and academic disconnect from on-campus students; and (2) adaptation, describes strategies used to adjust to hybrid learning.

CONCLUSION

Technology has evolved and presents opportunities for nursing education. We must continue to enhance education design in the nursing curriculum context. [J Nurs Educ. 2024;63(11):755-763.].

Exploring the nurse-patient relationship in caring for the health priorities of older adults: qualitative study

BACKGROUND

Person-centered care (PCC) is critical in addressing the diverse health priorities of older adults. Nurses play a pivotal role in implementing PCC, yet the nuances of the nurse-patient relationship in outpatient settings remain underexplored. This study aimed to gain insights into nurses' experiences, challenges, and strategies in caring for older adults through the lens of PCC.

METHODS

A qualitative descriptive design was employed, involving semi-structured interviews with 12 registered nurses from outpatient clinics serving older adults. Thematic analysis was conducted following the principles of trustworthiness and credibility.

RESULTS

Five main themes emerged: (1)Understanding and Implementing Person-Centered Care (PCC) (2) Experiences in Older Adult Care, highlighting the significance of trust-building, adapting care approaches, interdisciplinary collaboration, and emotional rewards; (3) Challenges in Care Delivery, including resource constraints, navigating family dynamics, keeping up with medical advances, and emotional strain; (4) Impact on Care Quality, encompassing consistency in care, patient satisfaction, professional development, and ethical considerations; and (5) Coping Strategies, such as peer support, work-life balance, reflective practice, and resilience building.

CONCLUSIONS

The study underscores the complexities and rewards of the nurse-patient relationship in caring for older adults in outpatient settings. Nurses face formidable challenges but employ various coping strategies to maintain high-quality, person-centered care. Findings have implications for nursing practice, education, policy, and future research, emphasizing the need for supportive environments, continuous professional development, and recognition of the critical role nurses play in addressing the health priorities of the aging population.

Effect of digital based nursing intervention on knowledge of self-care behaviors and self-efficacy of adult clients with diabetes

BACKGROUND

In recent years, there has been growing interest in the use of Digital Based Nursing Intervention to support diabetes management. This study aimed to evaluate the effect of digital based nursing intervention on knowledge of self-care behaviors and self-efficacy of clients with diabetes.

METHODS

Employing a quasi-experimental design, a sample of 120 adult participants diagnosed with type 2 diabetes, aged more than 18 years with focus on older adults was drawn from outpatient clinics at Cairo University Hospital. The intervention was approved and registered by the ethical committee of the faculty of nursing with IRB number: RHDIRB2019041701. The intervention group (n = 60) received a digital-based nursing intervention, while the control group (n = 60) received standard care. Data were collected using adopted standardized tools including the Diabetes Knowledge Test, the Diabetes Self-Efficacy Scale, and the Summary of Diabetes Self-Care Activities. Demographic characteristics were analyzed, and pre- and post-intervention scores were compared using paired t-tests were statistical methods.

RESULTS

The digital-based nursing intervention resulted in significant enhancements in participants with diabetes knowledge and self-efficacy levels. Moreover, the intervention group demonstrated marked improvements in various self-care behaviors encompassing diet, exercise, medication adherence, blood glucose testing, and foot care. While the control group also exhibited some progress, the effects were less pronounced. Regression analyses highlighted age as a consistent factor associated with knowledge, self-efficacy, and specific self-care behaviors.

CONCLUSION

This study underscores the potential of tailored digital nursing interventions to complement traditional care approaches, empowering patients with type 2 diabetes to actively engage in self-management. The findings suggest that digital-based nursing interventions hold promise for enhancing patient knowledge, confidence, and proactive health behaviors. Nevertheless, limitations, including the relatively short intervention duration and a sample from a single clinic, warrant consideration. Future research should address these limitations to bolster the validity and applicability of the study's conclusions.

The influence of heart failure high-fidelity simulation education based on NLN Jeffries simulation framework in the prelicensure nursing program: A quasi-experimental study

Objectives

To examine the influence of heart failure high-fidelity simulation education based on the National League for Nursing (NLN) Jeffries Simulation Framework in prelicensure nursing education.

Methods

A heart failure high-fidelity simulation (HFHFS) education pilot project was carried out at Carrington College Sacramento. Twenty-three students participated in the study. This study used a quasi-experimental design. Students' Self-Efficacy, Satisfaction, and Knowledge in Heart Failure Clinical Knowledge were measured pre- and post-HFHFS education.

Results

The results of the high-fidelity simulation education for heart failure showed that students achieved a mean score of 45.39 (SD = 7.88) in self-efficacy, 18.70 (SD = 3.38) in satisfaction, and 64.09 (SD = 10.86) in knowledge after the intervention. The paired-sample t-test significantly improved between the pre- and post-intervention scores (P < 0.001). The students highly rated self-efficacy, student satisfaction, and knowledge because of the positive impact on the teaching effectiveness of simulation design (i.e., objectives, problem-solving, student support, fidelity, debriefing) activity that included the application of quality safety education for nurses (QSEN) three competencies safety, patient-centered care, and teamwork and collaboration during nursing care for patients with acute heart failure. The teaching effectiveness of the heart failure high-fidelity simulation education is closely correlated with student satisfaction, self-efficacy, and improvement of participant knowledge in clinical nursing skills performance and critical thinking.

Conclusion

A heart failure high-fidelity simulation education established upon the National League for Nursing (NLN) Jeffries framework enhanced student knowledge, satisfaction, self-efficacy, application of safety, patient-centered care, and teamwork and collaboration. Nurse educators should consider simulation planning to include the five simulation design characteristics, i.e., objectives, problem-solving, student support, fidelity, and debriefing, while integrating safety, patient-centered care, and teamwork and collaboration to bring about education effectiveness.