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Jindal J, Launer D, France HS, Hey M, Song K, Portwood C, Richards G, Dernie F. Preventable deaths involving sepsis in England and Wales, 2013-2022: a systematic case series of coroners' reports. Infection 2024; 52:945-954. [PMID: 38079094 DOI: 10.1007/s15010-023-02140-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Accepted: 11/14/2023] [Indexed: 06/02/2024]
Abstract
PURPOSE Coroners' Prevention of Future Death (PFDs) reports are an under-utilized resource to learn about preventable deaths in England and Wales. We aimed to identify sepsis-related PFDs and explore the causes and concerns in this subset of preventable sepsis deaths. METHODS Four thousand three hundred five reports were acquired from the Courts and Tribunals Judiciary website between July 2013 and November 2022, which were screened for sepsis. Demographic information, coroners concerns and responses to these reports were extracted and analyzed, including a detailed paediatric subgroup analysis. RESULTS Two hundred sixty-five reports (6% of total PFDs) involved sepsis-related deaths. The most common cause of death in these reports was "sepsis without septic shock" (42%) and the most common site of infection was the respiratory system (18%) followed by gastrointestinal (16%) and skin (13%) infections. Specific pathogens were named in few reports (27%). Many deaths involved multimorbid patients (49%) or those with recent surgery (26%). Coroners named 773 individual concerns, the most frequent were: a failure to keep accurate records or notes (28%), failure in communication or handover (27%) or failure to recognize risk factors or comorbidities (20%). Paediatric cases frequently reported issues with sepsis screening tools (26%). Sepsis PFDs resulted in 421 individual reports being sent, of which 45% received no response. Most organisations who did respond acknowledged concerns and initiated a new change (74%). CONCLUSION Sepsis-related PFDs provide valuable insights into preventable causes of sepsis and identify important sources of improvement in sepsis care. Wider dissemination of findings is vital to learn from these reports.
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Affiliation(s)
- Jessy Jindal
- Medical Sciences Division, University of Oxford, Oxford, OX3 9DU, UK
| | - David Launer
- Medical Sciences Division, University of Oxford, Oxford, OX3 9DU, UK
| | - Harrison S France
- Medical Sciences Division, University of Oxford, Oxford, OX3 9DU, UK
| | - Molly Hey
- Medical Sciences Division, University of Oxford, Oxford, OX3 9DU, UK
| | - Kaiyang Song
- Medical Sciences Division, University of Oxford, Oxford, OX3 9DU, UK
| | - Clara Portwood
- Medical Sciences Division, University of Oxford, Oxford, OX3 9DU, UK
| | - Georgia Richards
- Centre for Evidence-Based Medicine, Nuffield Department of Primary Care Health Sciences, University of Oxford, Radcliffe Observatory Quarter, Woodstock Road, Oxford, OX2 6GG, UK
| | - Francesco Dernie
- Medical Sciences Division, University of Oxford, Oxford, OX3 9DU, UK.
- Oxford University Hospitals NHS Foundation Trust, Oxford, OX3 9DU, UK.
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Rios EM, Breda KL. Time Is Survival: Continuing Education on Sepsis for Neurosurgical Critical Care Nurses. J Contin Educ Nurs 2024; 55:224-230. [PMID: 38108815 DOI: 10.3928/00220124-20231211-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2023]
Abstract
BACKGROUND Early identification of sepsis among neurosurgical critical care patients is a significant challenge because of the many possible confounding variables that lead to altered mental status in this specific patient population. Nurses' knowledge, attitudes, confidence, and practices related to the early identification and management of sepsis are crucial to patients' survival. METHOD This evidence-based intervention project implemented continuing education for neurosurgical critical care nurses on the early signs and symptoms of sepsis and the management of sepsis according to the Surviving Sepsis Campaign (SSC) Guidelines. RESULTS Continuing education on sepsis increased neurosurgical critical care nurses' knowledge of the SSC 1-hour sepsis bundle, reported confidence in the management of sepsis, and likelihood of assessing for sepsis. CONCLUSION Continuing education for neurosurgical critical care nurses on the signs and symptoms of sepsis and the SSC Guidelines is necessary and may improve patient outcomes. [J Contin Educ Nurs. 2024;55(5):224-230.].
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Shakeshaft H, Bridge P. Evaluating the impact of training on therapeutic radiographer awareness of the signs and symptoms of neutropenic sepsis in patients undergoing concurrent chemoradiotherapy. Radiography (Lond) 2024; 30:500-503. [PMID: 38237466 DOI: 10.1016/j.radi.2024.01.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2023] [Revised: 12/21/2023] [Accepted: 01/09/2024] [Indexed: 03/08/2024]
Abstract
INTRODUCTION Neutropenic sepsis is a life-threatening combination of neutropenia and infection. Patients undergoing concurrent chemoradiotherapy are at a high risk of neutropenic sepsis and thus are likely to present in a clinical setting. This study aimed to evaluate levels of Therapeutic Radiographers' understanding of sepsis signs and response pathways along with the impact of a training session on this. METHODS A teaching session at the trust was conducted by the Sepsis Lead Nurse and utilised a range of active learning techniques including scenario-based questions and a sepsis game. Pre and post-training questionnaires were completed by participants which comprised of multiple-choice questions related to sepsis identification and response. Respondents were asked to rate their confidence in each answer. This enabled scoring to award penalties for higher levels of confidence in incorrect answers and reward high confidence in correct answers. Lower levels of confidence attracted or lost smaller marks. RESULTS There was a statistically significant (p < 0.0002) improvement in questionnaire scores after the training session from 42% to 66%. Lower scores on the pre-test responses mainly related to incorrect selection of responses to scenario questions. CONCLUSION This service evaluation has highlighted a lack of sepsis awareness amongst Therapeutic Radiographers. It also demonstrates that an active learning based training session can significantly improve understanding of sepsis. IMPLICATIONS FOR PRACTICE Sepsis training utilising scenario and response questions should be provided to Therapeutic Radiographers more frequently who are likely to work with patients undergoing concurrent chemoradiotherapy.
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Affiliation(s)
- H Shakeshaft
- School of Health Sciences, University of Liverpool, United Kingdom
| | - P Bridge
- School of Health Sciences, University of Liverpool, United Kingdom.
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Xia M, Dong GY, Zhu SC, Xing HM, Li LM. Sepsis one-hour bundle management combined with psychological intervention on negative emotion and sleep quality in patients with sepsis. World J Psychiatry 2024; 14:266-275. [PMID: 38464776 PMCID: PMC10921283 DOI: 10.5498/wjp.v14.i2.266] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Revised: 12/26/2023] [Accepted: 01/22/2024] [Indexed: 02/06/2024] Open
Abstract
BACKGROUND Sepsis is a serious infectious disease caused by various systemic inflammatory responses and is ultimately life-threatening. Patients usually experience depression and anxiety, which affect their sleep quality and post-traumatic growth levels. AIM To investigate the effects of sepsis, a one-hour bundle (H1B) management was combined with psychological intervention in patients with sepsis. METHODS This retrospective analysis included 300 patients with sepsis who were admitted to Henan Provincial People's Hospital between June 2022 and June 2023. According to different intervention methods, the participants were divided into a simple group (SG, n = 150) and combined group (CG, n = 150). H1B management was used in the SG and H1B management combined with psychological intervention was used in the CG. The changes of negative emotion, sleep quality and post-traumatic growth and prognosis were compared between the two groups before (T0) and after (T1) intervention. RESULTS After intervention (T1), the scores of the Hamilton Anxiety scale and Hamilton Depression scale in the CG were significantly lower than those in the SG (P < 0.001). Sleep time, sleep quality, sleep efficiency, daytime dysfunction, sleep disturbance dimension score, and the total score in the CG were significantly lower than those in the SG (P < 0.001). The appreciation of life, mental changes, relationship with others, personal strength dimension score, and total score of the CG were significantly higher than those of the SG (P < 0.001). The scores for mental health, general health status, physiological function, emotional function, physical pain, social function, energy, and physiological function in the CG were significantly higher than those in the SG (P < 0.001). The mechanical ventilation time, intensive care unit stay time, and 28-d mortality of the CG were significantly lower than those of the SG (P < 0.05). CONCLUSION H1B management combined with psychological intervention can effectively alleviate the negative emotions of patients with sepsis and increase their quality of sleep and life.
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Affiliation(s)
- Ming Xia
- Department of Intensive Care Unit, Henan Provincial Key Medicine Laboratory of Nursing, Henan Provincial People’s Hospital, Zhengzhou University People’s Hospital, Zhengzhou 450003, Henan Province, China
| | - Guang-Yan Dong
- Department of Intensive Care Unit, Henan Provincial Key Medicine Laboratory of Nursing, Henan Provincial People’s Hospital, Zhengzhou University People’s Hospital, Zhengzhou 450003, Henan Province, China
| | - Shi-Chao Zhu
- Department of Intensive Care Unit, Henan Provincial Key Medicine Laboratory of Nursing, Henan Provincial People’s Hospital, Zhengzhou University People’s Hospital, Zhengzhou 450003, Henan Province, China
| | - Huan-Min Xing
- Department of Intensive Care Unit, Henan Provincial Key Medicine Laboratory of Nursing, Henan Provincial People’s Hospital, Zhengzhou University People’s Hospital, Zhengzhou 450003, Henan Province, China
| | - Li-Ming Li
- Department of Nursing, Henan Provincial Key Medicine Laboratory of Nursing, Henan Provincial People’s Hospital, Zhengzhou University People’s Hospital, Zhengzhou 450003, Henan Province, China
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Zhao Y, Missbrenner N, Xu HD, Josephson J. Enhancing delirium assessment and management through nursing education interventions: A scoping review. Nurse Educ Pract 2024; 75:103887. [PMID: 38245939 DOI: 10.1016/j.nepr.2024.103887] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Revised: 12/21/2023] [Accepted: 12/29/2023] [Indexed: 01/23/2024]
Abstract
AIM/OBJECTIVE The purpose of this scoping review was to explore the characteristics and outcomes of education interventions for nurses focused on delirium assessment and management. BACKGROUND Delirium is a prevalent acute and reversible neuropsychiatric syndrome in hospitalized patients. Delirium can cause cognitive, psychiatric and physical impairments and result in prolonged hospital stay, increased risk of readmission and elevated morbidity and mortality rates. Nurses play an essential role in managing delirium. There is a lack of understanding of the existing nursing educational interventions on delirium management. DESIGN The study was a scoping review. METHODS In this scoping review, we used Arksey and O'Malley's (2005) scoping review framework. We searched articles published between 2019 and 2023 in Academic Search Premier, the Cumulative Index to Nursing and Allied Health Literature (CINAHL) and MEDLINE using the following CINAHL/MeSH suggested subject terms: "delirium" in conjunction with "education" "intervention" and "nurse", "nurses" or "nursing." Studies on improving nursing knowledge and practices regarding delirium were included while those focusing on nursing students were excluded. Initial screening involved evaluating article titles and abstracts for relevance from 164 identified articles, followed by a full-text review of 42 articles. Finally, 17 articles were selected for comprehensive analysis. We extracted relevant information from each article and charted the findings in an evidence table. RESULTS The 17 selected articles showcased a variety of interventions used to educate nursing staff, such as workshops, simulations, group discussions, online modules and one-on-one coaching. Educational interventions primarily focused on delirium definition, risk factors, assessment and management. These educational interventions enhanced nurses' perception of delirium, boosting their confidence and knowledge in managing delirium. These interventions also led to increased compliance with delirium assessment and management protocols, which ultimately resulted in improved documentation accuracy and patient outcomes. CONCLUSIONS Findings from this scoping review suggest that nursing administration need to provide support and education for delirium prevention and management to enhance nursing staff confidence and competence in assessing and managing delirium. The use of interactive educational techniques has demonstrated profound benefits in schema development, expertize promotion and critical thinking. These findings have significant implications for future research, including the identification of essential nursing competencies for educational interventions and the assessment of long-term knowledge retention and its application in nursing practice.
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Affiliation(s)
- Yunchuan Zhao
- School of Nursing, Boise State University, 1910 University Drive, Mail Stop 1840, Boise, ID 83725, United States.
| | - Nicolette Missbrenner
- School of Nursing, Boise State University, 1910 University Drive, Mail Stop 1840, Boise, ID 83725, United States
| | - H Daniel Xu
- Department of Political Science, East Carolina University, 1000 E 5th Street, Mail Stop 564, Greenville, NC 27858, United States
| | - Jayne Josephson
- School of Nursing, Boise State University, 1910 University Drive, Mail Stop 1840, Boise, ID 83725, United States
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Cuesta-Montero P, Navarro-Martínez J, Yedro M, Galiana-Ivars M. Sepsis and Clinical Simulation: What Is New? (and Old). J Pers Med 2023; 13:1475. [PMID: 37888086 PMCID: PMC10608191 DOI: 10.3390/jpm13101475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Revised: 09/22/2023] [Accepted: 10/06/2023] [Indexed: 10/28/2023] Open
Abstract
BACKGROUND Sepsis is a critical and potentially fatal condition affecting millions worldwide, necessitating early intervention for improved patient outcomes. In recent years, clinical simulation has emerged as a valuable tool for healthcare professionals to learn sepsis management skills and enhance them. METHODS This review aims to explore the use of clinical simulation in sepsis education and training, as well as its impact on how healthcare professionals acquire knowledge and skills. We conducted a thorough literature review to identify relevant studies, analyzing them to assess the effectiveness of simulation-based training, types of simulation methods employed, and their influence on patient outcomes. RESULTS Simulation-based training has proven effective in enhancing sepsis knowledge, skills, and confidence. Simulation modalities vary from low-fidelity exercises to high-fidelity patient simulations, conducted in diverse settings, including simulation centers, hospitals, and field environments. Importantly, simulation-based training has shown to improve patient outcomes, reducing mortality rates and hospital stays. CONCLUSION In summary, clinical simulation is a powerful tool used for improving sepsis education and training, significantly impacting patient outcomes. This article emphasizes the importance of ongoing research in this field to further enhance patient care. The shift toward simulation-based training in healthcare provides a safe, controlled environment for professionals to acquire critical skills, fostering confidence and proficiency when caring for real sepsis patients.
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Affiliation(s)
- Pablo Cuesta-Montero
- Department of Clinical Simulation (SimIA Lab), Dr. Balmis General University Hospital, Alicante Institute for Health and Biomedical Research (ISABIAL), 03010 Alicante, Spain
| | - Jose Navarro-Martínez
- Department of Clinical Simulation (SimIA Lab), Dr. Balmis General University Hospital, Alicante Institute for Health and Biomedical Research (ISABIAL), 03010 Alicante, Spain
| | - Melina Yedro
- Department of Clinical Simulation (SimIA Lab), Dr. Balmis General University Hospital, Alicante Institute for Health and Biomedical Research (ISABIAL), 03010 Alicante, Spain
| | - María Galiana-Ivars
- Department of Anesthesiology and Surgical Critical Care, Dr. Balmis General University Hospital, Alicante Institute for Health and Biomedical Research (ISABIAL), 03010 Alicante, Spain
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Lafon T, Baisse A, Karam HH, Organista A, Boury M, Otranto M, Blanchet A, Daix T, François B, Vignon P. SEPSIS UNIT IN THE EMERGENCY DEPARTMENT: IMPACT ON MANAGEMENT AND OUTCOME OF SEPTIC PATIENTS. Shock 2023; 60:157-162. [PMID: 37314202 DOI: 10.1097/shk.0000000000002155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
ABSTRACT Study hypothesis : Implementation of a new pathway dedicated to septic patients within the emergency department (ED) would improve early management, organ dysfunction, and outcome. Methods: During phase 1, all consecutive adult patients with infection and qualifying quick Sequential Organ Failure Assessment (qSOFA) score upon ED admission were managed according to standards of care. A multifaceted intervention was then performed (implementation phase): educational program, creation of a sepsis alert upon ED admission incorporated in the professional software, together with severity scores and Surviving Sepsis Campaign (SSC) bundle reminders, and dedication of two rooms to the management of septic patients (sepsis unit). During phase 2, patients were managed according to this new organization. Results: Of the 89,040 patients admitted to the ED over the two phases, 2,643 patients (3.2%) had sepsis including 277 with a qualifying qSOFA score on admission (phase 1, 141 patients; phase 2, 136 patients). Recommendations of SSC 3-h bundle significantly improved between the two periods regarding lactate measurement (87% vs. 96%, P = 0.006), initiation of fluid resuscitation (36% vs. 65%, P < 0.001), blood cultures sampling (83% vs. 93%, P = 0.014), and administration of antibiotics (18% vs. 46%, P < 0.001). The Sequential Organ Failure Assessment score between H0 and H12 varied significantly more during phase 2 (1.9 ± 1.9 vs. 0.8 ± 2.6, P < 0.001). Mortality significantly decreased during the second phase, on day 3 (28% vs. 15%, P = 0.008) and on day 28 (40% vs. 28%, P = 0.013). Conclusion: Systematic detection, education, and per protocol organization with a sepsis unit dedicated to the early management of septic patients appear to improve compliance with SSC bundles, organ dysfunction, and short-term mortality. These results warrant to be confirmed by prospective studies.
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Affiliation(s)
| | - Arthur Baisse
- Emergency Department, Limoges University Hospital Center, Limoges, France
| | - Henry Hani Karam
- Emergency Department, Limoges University Hospital Center, Limoges, France
| | | | - Marion Boury
- Emergency Department, Limoges University Hospital Center, Limoges, France
| | - Marcela Otranto
- Emergency Department, Limoges University Hospital Center, Limoges, France
| | - Aloïse Blanchet
- Emergency Department, Limoges University Hospital Center, Limoges, France
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Domínguez-Torres LC, Vega-Peña NV. Pyramids in medical education: Their conceptualization and utility summarized. REVISTA COLOMBIANA DE OBSTETRICIA Y GINECOLOGIA 2023; 74:163-174. [PMID: 37523683 PMCID: PMC10419883 DOI: 10.18597/rcog.3994] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Accepted: 05/25/2023] [Indexed: 08/02/2023]
Abstract
Objectives To examine the conceptual underpinnings of learning pyramids, their limitations and some proposed modifications, and to describe their utility. Materials and methods Starting with a selection of pyramids based on whether graphic design was part of their original design and on their conceptual description, we examined the criticisms they have received and the modifications derived from those observations, and the use given to the pyramids most commonly used in medical education. Results Five pyramids were included, namely, George Miller, Edgar Dale, Donald Kirkpatrick, Benjamín Bloom and Abraham Maslow. Pyramids describe different aspects of medical education evaluation, either of individuals or of training programs, including competencies, identity, reliability, learning, behavior, results, cognitive complexity and self-realization. Conclusions As theoretical models, the pyramids examined have contributed to support learning processes in health professions. Their practical utility extends to different specialties and education levels given that they can help faculty optimize curricular design, teaching and evaluation processes. It is important to conduct a local assessment of the effects on health science programs built on these theoretical models.
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Chua WL, Teh CS, Basri MABA, Ong ST, Phang NQQ, Goh EL. Nurses' knowledge and confidence in recognizing and managing patients with sepsis: A multi-site cross-sectional study. J Adv Nurs 2023; 79:616-629. [PMID: 36069994 PMCID: PMC10087790 DOI: 10.1111/jan.15435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Revised: 07/26/2022] [Accepted: 08/20/2022] [Indexed: 01/26/2023]
Abstract
AIMS (1) To examine registered nurses' knowledge and confidence in recognizing and managing to patients with sepsis and (2) identify nurse and workplace factors that influence their knowledge on sepsis. DESIGN A multi-site, cross-sectional survey. METHODS An online survey was developed and content validated. Data was collected from registered nurses working in the inpatient wards and emergency departments of three hospitals of a single healthcare cluster in Singapore during August 2021. Statistical analyses of closed-ended responses and content analysis of open-ended responses were undertaken. RESULTS A total of 709 nurses completed the survey. Nurses possessed moderate levels of knowledge about sepsis (mean score = 10.56/15; SD = 2.01) and confidence in recognizing and responding to patients with sepsis (mean score = 18.46/25; SD = 2.79). However, only 369 (52.0%) could correctly define sepsis. Nurses' job grade, nursing education level and clinical work area were significant predictors of nurses' sepsis knowledge. Specifically, nurses with higher job grade, higher nursing education level or those working in acute care areas (i.e. emergency department, high dependency units or intensive care units) were more likely to obtain higher total sepsis knowledge scores. A weak positive correlation was observed between sepsis knowledge test scores and self-confidence (r = .184). Open comments revealed that participants desired for more sepsis education and training opportunities and the implementation of sepsis screening tool and sepsis care protocol. CONCLUSION A stronger foundation in sepsis education and training programs and the implementation of sepsis screening tools and care bundles are needed to enhance nurses' knowledge and confidence in recognizing and managing patients with sepsis. IMPACT The findings of this study are beneficial to administrators, educators and researchers in designing interventions to support nurses in their role in recognizing and responding to sepsis.
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Affiliation(s)
- Wei Ling Chua
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore City, Singapore
| | - Chin Shim Teh
- Nursing Department, Alexandra Hospital, National University Health System, Singapore City, Singapore
| | | | - Shi Ting Ong
- Nursing Department, National University Hospital, National University Health System, Singapore City, Singapore
| | - Noel Qiao Qi Phang
- Nursing Department, Ng Teng Fong General Hospital, National University Health System, Singapore City, Singapore
| | - Ee Ling Goh
- Department of Emergency Medicine, Ng Teng Fong General Hospital, National University Health System, Singapore City, Singapore
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Hong S, Lee JY. Evaluation of therapeutic communication education for nursing students based on constructivist learning environments: A systematic review. NURSE EDUCATION TODAY 2022; 119:105607. [PMID: 36306635 DOI: 10.1016/j.nedt.2022.105607] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Accepted: 10/09/2022] [Indexed: 06/16/2023]
Abstract
OBJECTIVES Education on therapeutic communication has been emphasized in nursing education. However, few studies have used an educational framework to develop educational interventions, such as the instructional design model for Jonassen's Constructivist Learning Environments. Based on the model of Constructivist Learning Environments, this study aimed to analyze educational interventions on therapeutic communication for nursing students and propose a model for therapeutic communication education for nurse educators. DESIGN A systematic review. DATA SOURCES The terms "nursing," "students," "therapeutic," and "communication" were used to search for studies in English conducted between 2000 and 2022 in four databases (PubMed, Embase, Cumulative Index of Nursing and Allied Health Plus with Full Text, and Cochrane Library CENTRAL). REVIEW METHODS Two researchers independently screened the titles and abstracts of the original studies, followed by the full texts. The Cochrane Risk of Bias Tool 2.0 for randomized controlled trials and Risk of Bias Assessment Tool for Non-Randomized Studies for quasi-experimental studies were used to evaluate the eligible studies. This review adopted the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. RESULTS Twelve studies were included in this review. Among the six instructional components of the model for Constructivist Learning Environments, the most commonly used were question/case/problem, cognitive tool, and conversational/collaboration tool. Among the three instructional methods of the model, coaching was the most frequently used. Therefore, an instructional design model for effective therapeutic communication education for nursing students was proposed based on Constructivist Learning Environments. CONCLUSIONS Employing an instructional design, such as Constructivist Learning Environments, can effectively promote the therapeutic communication education of nursing students.
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Affiliation(s)
- Soomin Hong
- College of Nursing, Yonsei University, Seoul, South Korea
| | - Ji Yea Lee
- College of Nursing, Yonsei University, Seoul, South Korea.
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