Factors that optimise the impact of continuing professional development in nursing: A rapid evidence review

Data-Driven Implementation Strategy to Optimise Clinician Behaviour Change at Scale in Complex Clinical Environments: A Multicentre Emergency Care Study

AIM

To develop an evidence-driven, behaviour change focused strategy to maximise implementation and uptake of HIRAID (History including Infection risk, Red flags, Assessment, Interventions, Diagnostics, communication and reassessment) in 30 Australian rural, regional and metropolitan emergency departments.

DESIGN

An embedded, mixed-methods study.

METHODS

This study is the first phase of a step-wedge cluster randomised control trial of HIRAID involving over 1300 emergency nurses. Concurrent quantitative and qualitative data were collected via an electronic survey sent to all nurses to identify preliminary barriers and enablers to HIRAID implementation. The survey was informed by the Theoretical Domains Framework, which is a synthesis of behavioural change theories that applies the science of intervention implementation in health care to effect change. Quantitative data were analysed using descriptive statistics and qualitative data with inductive content analysis. Data were then integrated to generate barriers and enablers to HIRAID implementation which were mapped to the Theoretical Domains Framework. Corresponding intervention functions and Behaviour Change techniques were selected and an overarching implementation strategy was developed through stakeholder consultation and application of the APEASE criteria (Affordability, Practicability, Effectiveness and cost-effectiveness, Acceptability, Side-effects/safety and Equity).

RESULTS

Six barriers to HIRAID implementation were identified by 670 respondents (response rate ~58%) representing all 30 sites: (i) lack of knowledge about HIRAID; (ii) high workload, (iii) lack of belief anything would change; (iv) not suitable for workplace; (v), uncertainty about what to do and (vi) lack of support or time for education. The three enablers were as follows: (i) willingness to learn and adopt something new; (ii) recognition of the need for something new and (iii) wanting to do what is best for patient care. The 10 corresponding domains were mapped to seven intervention functions, 21 behaviour change techniques and 45 mechanisms. The major components of the implementation strategy were a scaffolded education programme, clinical support and environmental modifications.

CONCLUSIONS

A systematic process guided by the behaviour change wheel resulted in the generation of a multifaceted implementation strategy to implement HIRAID across rural, regional and metropolitan emergency departments. Implementation fidelity, reach and impact now require evaluation.

IMPACT

HIRAID emergency nursing assessment framework reduced clinical deterioration relating to emergency care and improved self-confidence and documentation in emergency departments in pilot studies. Successful implementation of any intervention in the emergency department is notoriously difficult due to workload unpredictability, the undifferentiated nature of patients and high staff turnover. Key barriers and enablers were identified, and a successful implementation strategy was developed. This study uses theoretical frameworks to identify barriers and enablers to develop a data-driven, behavioural-focused implementation strategy to optimise the uptake of HIRAID in geographically diverse emergency departments which can be used to inform future implementation efforts involving emergency nurses.

REPORTING METHOD

The CROSS reporting method (Supporting Information S3) was used to adhere to EQUATOR guidelines.

PATIENT OR PUBLIC CONTRIBUTION

No Patient or Public Contribution.

TRIAL REGISTRATION

Australian New Zealand; Clinical Trials Registry (ANZCTR) number: ACTRN12621001456842, registered 25/10/2021.

Impacts of an online asynchronous continuing professional development toolkit supporting primary care nurses to engage in shared decision-making: a single-group pre-post study

BACKGROUND

Shared decision-making (SDM) is central to person-centred care and professional nursing practice. Some primary care nurses must become more comfortable and prepared to use SDM in their practice, especially with patients having complex care needs.

METHODS

We conducted a single-group pre-post study with primary care nurses to assess the relevance and impacts of the online continuing professional development (CPD) toolkit. Using the New World Kirkpatrick model, we assessed the toolkit's relevance (level-1, reaction) and nurses' confidence and commitment (level-2, learning). We collaborated with the virtual community of practice for nurses in family medicine groups in Quebec to reach out to as much nurses as possible. We sent hard copies of the toolkit to 42 primary care establishments. We used descriptive statistics and the student t-test to treat quantitative data and analyzed open-ended questions with qualitative content analysis.

RESULTS

One hundred sixty-five nurses used the toolkit, and 69 completed the pre- and post-training survey. Most were female (94.2 %), aged between 31-45 years old (55.1 %), and held a first university degree (91.3 %). Ninety-six percent (96 %) agreed or strongly agreed that the toolkit would improve their practice. The toolkit significantly increased nurses' confidence (p ≤ 0.001) and intention (p ≤ 0.01) to engage in SDM with patients having complex care needs. Nurses appreciated the relevance of video vignettes and accessibility, amongst others.

CONCLUSIONS

Primary care nurses felt better able to include SDM in their practice with patients with complex care needs and understand their roles better. A CPD toolkit by and for primary care nurses is relevant and increases learning.

The relationship between practical skills confidence and readiness for transition to practice among nursing internship students: Exploring the mediating role of preceptorship

BACKGROUND

The transition from nursing student to practitioner can be a difficult and stressful period marked by a lack of confidence and practical skills. To bridge this theory-practice gap and ensure successful integration into the workforce, preceptorship programs are essential. By providing experienced mentors and role models, preceptors can equip new nurses with the necessary skills, boost their confidence, and ultimately contribute to a smoother transition and a more prepared nursing workforce.

AIM

Examine the relationship between practical skills confidence and readiness for transition to practice among nursing internship students through exploring the mediating role of preceptorship.

DESIGN

This was a descriptive correlational study.

PARTICIPANTS

A convenience sample of 100 internship nursing students from College of Nursing at a selected governmental University in Riyadh were included in the study.

METHODS

The study participants responded to an electronic Casey-Fink Graduate Nurse Experience Survey validated survey. Descriptive and inferential statistics were used to explore results and examine the relationships between study variables.

RESULTS

About half of the study sample (53 %) had low level of perception regarding the role transition experience with a mean score of 3.01 ± 0.39. As well as more than two thirds of the participated internship nursing students (62 %) had a moderate level of perception regarding the preceptorship role with a mean score of 3.13 ± 0.57. Furthermore, more than half of the study participants (57 %) had high confidence in their practical skills with a mean score of 2.12 ± 0.48. In addition, the study results verified that there was a highly significant correlation between the internship nursing students' practical skills confidence, their readiness for transition to practice and role of preceptorship (P < 0.001). According to the SEM, internship nursing students' perception regarding preceptorship role accounted for 98 % of the variance in internship nursing students transition to practice and 88 % of the variance in their confidence level of their practical skills.

CONCLUSION

Internship nursing students' perception regarding the role of preceptorship regarding is an important predictor of the success of their transition to practice and it affect on improving their confidence level of their practical skills.

Evaluation of Geriatric Care Competencies Among Nurses Working in Home Health Care in Saudi Arabia

PURPOSE

To assess geriatric care competencies of nurses in home health care (HHC) settings in Saudi Arabia and explore the factors influencing these competencies.

METHOD

A cross-sectional design was used. Data were collected using the Gerontological Nursing Competence Scale among 393 RNs working in HHC units in the Riyadh and Qassim regions.

RESULTS

Nurses demonstrated high competence in ensuring safe living environments and addressing nutritional needs. However, weaker competencies were noted in supporting older adults' sexuality and managing ethical challenges. Specialized training and shorter work hours were significantly associated with higher self-perceived competency levels. This finding may suggest that reduced working hours allows nurses to engage in continuing education, skill development, and quality-focused care, rather than indicating lack of clinical experience.

CONCLUSION

Findings highlight strengths and gaps in geriatric care competencies among HHC nurses, emphasizing the need for targeted training to address weaknesses in sensitive areas, including sexual health, ethical dilemmas, and communication challenges in end-of-life care. [Journal of Gerontological Nursing, xx(xx), xx-xx.].

A Mixed-Methods Evaluation of a Maternal Child Health Nurse Education Programme Using Moore's Outcomes Framework for Continuing Medical Education

AIM

Maternal Child Health Nurses (MCHN) play an integral role in child health in the community yet lack professional development opportunities. A tertiary hospital sought to fill this gap and developed an online MCHN education programme. This study aimed to assess the impact of the programme on MCHN confidence, knowledge and practice and to understand the factors influencing its impact.

METHODS

MCHN enrolled in the programme were invited to participate in a mixed method study based on Moore's Outcomes Framework for continuing medical education. Quantitative data from surveys collected pre and post live webinars and at 6 months post programme implementation assessed participant knowledge and confidence, and the quality of the programme. Qualitative data from individual semi-structured interviews was analysed inductively to understand impact.

RESULTS

Reported knowledge and confidence improved after each webinar (for knowledge from 2.60 out of 4 (95% CI 2.54-2.66) to 3.45 out of 4 (95% CI 3.40-3.59) post-webinar (p < 0.001) and for confidence from 2.58 out of 4 (95% CI 2.52-2.64) to 3.42 out of 4 (95% CI 3.38-3.47) post-webinar (p < 0.001)). Four themes emerged which facilitated the programme impact: filling a continuing education void, supporting diverse learning styles and needs, enhancing practice and advocacy through empowerment and fostering connections and respect.

CONCLUSION

We demonstrated that a well-designed online education programme led to increased knowledge, confidence and changes in practice. It facilitated connection and respect and reinforced MCHN value and contribution. It highlighted and addressed an educational gap within the MCHN continuing education landscape and has proven to be sustainable and impactful.

Latent profile analysis of nurses' moral courage: a professional values perspective

INTRODUCTION

Nurses' moral courage (NMC) enhances care quality and patient safety. Nurses' professional values promote ethical adherence, moral obligation fulfillment, and compliance to prevent ethical violations. It is necessary to explore the current status and influencing factors of moral courage from the perspective of professional values.

AIM

To investigate the current situation of nurses' moral courage, analyze the latent profiles of nurses' moral courage, and explore the influencing factors from the perspective of professional values.

RESEARCH DESIGN

A cross-sectional design was employed.

PARTICIPANTS AND RESEARCH CONTEXT

Data were collected through convenient sampling at a tertiary hospital during May 2023 in Wuhan, Hubei province, China. A self-designed web-based questionnaire consisting of demographic characteristics, the Chinese Nurses' Professional Values Scale-Revised Version (NPVS-R-CV) and the Nurses' Moral Courage Scale (NMCS) were used for the cross-sectional survey. Latent profile analysis was conducted using the results of 3 explicit indexes of NMCS, and multivariate logistic regression was used to analyze the influencing factors of NMC.

ETHICAL CONSIDERATIONS

Research ethics approval (with the code of TJ- IRB 20220543) was obtained from Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology.

FINDINGS

This study included 966 nurses, predominantly female and under 30 years old, with 91.10% holding a bachelor's degree. Latent profile analysis identified three moral courage profiles: low-level (31.5%), medium-level (47.2%), and high-level (21.3%). Multivariate logistic regression analysis showed significant positive correlations between professional values and moral courage, with head nurses being significantly more likely to exhibit high moral courage (OR = 3.586, p = 0.013).

CONCLUSIONS

The moral courage of nurses can be classified into 3 subgroups. Nurses' professional values positively correlate with moral courage, with head nurses showing significantly higher levels of moral courage. Strengthening professional values through training can enhance ethical behavior in nursing, potentially improving patient care and safety.

Core competency in palliative care among intensive care unit nurses: A latent profile analysis

BACKGROUND

Intensive care unit (ICU) nurses play a leading role in integrating palliative care into ICU practices, which requires them to possess professional and comprehensive palliative care core competencies.

AIM

To explore the current status of ICU nurses' palliative care core competency and to examine the factors influencing different subgroups of core competency.

STUDY DESIGN

A quantitative, cross-sectional study. A random sampling of 342 ICU nurses from five hospitals participated in this study from March to April 2024. A latent profile analysis (LPA) was conducted to identify subgroups based on the Palliative Care Nurses' Core Competences (PCNCC) scale. Differences between the variables, including sociodemographic characteristics, autonomous learning capacity, job satisfaction and subgroups, were explored using multivariate logistic regression. This cross-sectional study used the STROBE checklist.

RESULTS

The mean score for palliative care core competency among ICU nurses was (58.96 ± 21.56). There were three different subgroups of palliative care core competency, namely, the 'low palliative care core competency group (31.2%)', the 'medium palliative care core competency group (47.2%)' and the 'low palliative care core competency group (21.6%)'. Professional title (odds ratio [OR] = 0.161, 95% confidence interval [CI]: 0.038-0.673, p = .012), position (OR = 0.111, 95% CI: 0.013-0.975, p = .047), work experiences (OR = 0.169, 95% CI: 0.030-0.965, p = .046) and autonomous learning capacity (OR = 3.298, 95% CI: 1.390-7.822, p = .007) were significant factors affecting the medium-level group, while position (OR = 0.101, 95% CI: 0.011-0.918, p = .042) and autonomous learning capacity (OR = 3.878, 95% CI: 1.447-10.396, p = .007) significantly influenced the low-level group.

CONCLUSIONS

The majority of ICU nurses were categorized in the low and medium-level palliative care core competency group; professional title, position, work experience and autonomous learning capacity were the main influencing factors.

RELEVANCE TO CLINICAL PRACTICE

ICU nurses should receive specific knowledge and training on palliative care, especially young nurses with limited work experience. Nursing managers and educators should provide targeted intervention strategies for nurses with different autonomous learning capacities to improve their core competencies in palliative care.

Continuing Professional Development Among Nurses in Jordan: Perceptions, Importance, Motives, and Barriers

BACKGROUND

Continuing professional development (CPD) is a type of lifelong learning and a means of gaining career security and personal development and assuring the public that professional knowledge is up-to-date. This study assessed Jordanian nurses' perceptions of the importance of CPD, their motives for obtaining CPD, and barriers to receiving CPD.

METHOD

A descriptive cross-sectional design was used. Data collected included demographic information and responses to a questionnaire about CPD for nurses.

RESULTS

The findings showed that the motives subscale had the highest mean score (M = 4.09, SD = 0.58), and the CPD activities subscale had the lowest mean score (M = 2.96, SD = 0.75).

CONCLUSION

Nurses understand the importance of CPD to improve nursing qualifications, enhance nursing practice, and promote health care quality. However, there are differences in how nurses perceive and engage in CPD. Addressing barriers and aligning intentions with actions could improve CPD participation. [J Contin Educ Nurs. 2025;56(3):111-117.].

Assessment of the Educational Needs of Spanish Nurses in the Care and Management of Patients with Diabetes

Introduction: The rising prevalence of chronic diseases such as diabetes poses significant challenges to healthcare systems globally, requiring specialized care and management. Nurses play an essential role in educating and caring for patients, but current continuing education programs often fail to meet the practical needs of clinical settings. Methods: This study used a qualitative descriptive-interpretative approach, conducting semi-structured interviews with 24 nurses working in primary care and hospital settings across Spain. The interviews focused on their experiences, perceptions, and educational needs in diabetes care. A thematic analysis was performed to identify key trends and insights. Results: Nurses emphasized the importance of ongoing education in building professional confidence and improving patient care outcomes. However, they reported significant barriers, including limited time, high costs, and a lack of practical focus in existing training programs. Participants favored hybrid learning models, which combine the flexibility of online training with the hands-on experience of in-person sessions. Nurses in rural areas highlighted the value of virtual training to overcome geographic constraints, while those in urban environments preferred hybrid approaches. Additionally, nurses called for accessible and concise resources, such as digital libraries and clinical simulations, to support decision making in real time. Conclusions: To be effective, diabetes- and ostomy-focused continuing education must align with nurses' clinical realities and individual needs. Combining digital tools with practical in-person learning can enhance accessibility and foster the practical application of skills. These findings provide actionable insights for designing education programs that advance both patient care and nurses' professional development.

Nurses retention: the impact of transformational leadership, career growth, work well-being, and work-life Balance

BACKGROUND

Nurse retention is critical for healthcare systems worldwide, as high turnover rates adversely affect patient care and organizational stability.

AIM

Examines the impact of transformational leadership, career growth opportunities, work well-being, and work-life balance on nurse retention.

METHODS

A cross-sectional study was conducted with 297 nurses employed in inpatient wards at Mansoura University Hospital. The study measured variables using the Nursing Retention Index, Global Transformational Leadership Scale, Career Growth Scale, Work Well-Being Scale, and Work-Life Balance Scale.

RESULTS

A linear regression analysis identified significant predictors of nurse retention. Work-life balance was found to be a strong predictor, with an unstandardized coefficient (B) of 0.255 (p < 0.001) and a standardized coefficient (β) of 0.426, indicating a positive relationship with retention, transformational leadership also significantly influenced retention, with a B of 0.082 (p = 0.002) and a β of 0.171. In contrast, Career Growth and Work-Life Balance did not significantly predict retention, showing coefficients of -0.082 (p = 0.154) and -0.042 (p = 0.482). The model explained 23.4% of the variance in nurse retention (R-squared = 0.234) and demonstrated statistical significance (F = 22.294, p < 0.001).

CONCLUSION

This study highlights the critical role of transformational leadership and work-life balance in enhancing nurse retention. However, career growth and work well-being did not significantly predict retention in this study. Healthcare institutions should focus on transformational leadership and work-life balance to enhance nurse retention. Future studies should explore factors related to career growth and work well-being to determine their potential impact on retention.

Career Growth as a Mediator Between Scope of Practice, Importance of Practice and Emergency Nursing Competency Among School Nurses

BACKGROUND

School nurses are sometimes the sole healthcare professionals in schools, highlighting their significant role in delivering emergency care and the vital necessity of their competence in emergency nursing care. The scope of practice and ongoing professional development are hypothesized to play significant roles in enhancing these competencies.

AIM

Investigate the direct and indirect effects of the scope of current practice and the importance of training on the emergency nursing care competency of school nurses, with career growth serving as a potential mediator.

METHODS

A multi-center cross-sectional study was conducted with a convenient sample of 219 school nurses. Data were collected using the career growth of nurses' scale, the emergency nursing care competency scale for school nurses and the scope of school nursing practice tool. Mediation analysis was used to explore the direct and indirect effects of studied variables.

RESULTS

Mediation analysis indicated that the scope of current practice had a significant direct effect on career growth (β = 0.179) and emergency nursing care competency (β = 0.389). The importance of practice also had significant direct effects on career growth (β = 0.164) and emergency nursing care competency (β = 0.220). Additionally, career growth significantly mediated the relationship between both the scope of current practice (β = 0.110) and the importance of practice (β = 0.120) with emergency nursing care competency.

CONCLUSIONS

The findings emphasis the critical role of career growth as a mediator between the scope and importance of practice and emergency nursing care competency among school nurses. Expanding the scope of practice and emphasising the importance of professional activities can enhance career growth and improve emergency nursing care competencies.

IMPLICATIONS

Nurses scope of practice and clear career advancement through mentorship, advanced certifications, further education and enforcing policies mandating regular emergency care is crucial. Establishing a regulatory framework to define and expand the scope of practice for school nurses is also important.

PATIENT OR PUBLIC CONTRIBUTION

No patient or public contribution.

Healing Through Humanized Care: Lessons from a Patient-Centered Perinatal Loss Protocol

Background/Objectives: Perinatal loss is a challenging experience that significantly impacts families and healthcare professionals. This study aimed to explore the perceptions and experiences of the nursing team in the gynecology unit at a Spanish hospital regarding the implementation of a new protocol for perinatal bereavement care. Methods: A qualitative descriptive study was conducted involving a focal group interview with nursing staff from the gynecology unit. Participants were selected through purposive sampling, and data were analyzed using thematic analysis to identify recurring patterns and insights. Results: The findings revealed a disparity in attitudes toward perinatal bereavement care, with some nurses demonstrating empathy and understanding, while others expressed discomfort and avoidance behaviors. Barriers to effective care included a lack of formal training, insufficient emotional support, and practical challenges in implementing the protocol. Participants suggested improvements such as enhanced communication training, the appointment of a bereavement coordinator, and earlier psychological interventions to support both families and staff. Conclusions: The study highlights the need for continuous education and emotional support to facilitate the adoption of perinatal bereavement protocols. Involving nursing staff in protocol development and addressing systemic barriers can improve the quality of care for bereaved families while supporting healthcare professionals' emotional well-being.

Physicians' perception towards continuing professional development in government teaching hospitals of Addis Ababa, Ethiopia-mixed method design

BACKGROUND

Continuing professional development has been mandatory for healthcare professionals to renew their licenses. However, there is a shortage of information regarding physicians' perceptions of continuing professional development. Therefore, it is timely to assess the perception of physicians and barriers toward continuing professional development.

METHODS

An institution-based quantitative design triangulated with a qualitative research design was conducted. A total of 367 and 6 study participants were included in the quantitative and qualitative study, respectively. Simple random and purposive sampling strategies were employed to select participants for the quantitative and qualitative parts. Quantitative Data was inserted in EPI-INFO version 7 and cleaned and analyzed using the Statistical Package for the Social Sciences,version 25 statistical program. Binary-dependent categorical variables were analyzed using binary logistic regression. Multiple logistic regression analysis was assessed to observe the association between perception and various explanatory variables. Thematic content analysis was conducted to develop items from transcribed qualitative information.

RESULT

This study involved 367 participants from three government teaching hospitals in Addis Ababa, Ethiopia. Being younger (20-30) had significantly higher odds of positively perceiving continuing professional development. It also showed that the department of healthcare Professionals had a statistically significant association with the perception of continuing professional development. Those working in Internal Medicine and Obstetrics and Gynecology departments and healthcare professionals had significantly higher odds of perceiving continuing professional development as good. The interviews revealed that the barriers to continuing professional development are divided into Individual and health system barriers. The Individual barriers include awareness gap, Motivation Issues and Family size, whereas the health system-related barriers include recognition, infrastructure, time, place, and accessibility. CONCLUSION AND RECOMMENDATION: The study identified the department of the healthcare professional as significantly associated with perception of continuing professional development. Improving patient care collaboration and career progression influenced physicians' perception of continuing professional development. The study findings suggest the need for effective strategies to enhance physicians' engagement in continuing professional development and improve the quality of healthcare services in Ethiopia.

Comparison of student nurses' expectations and newly qualified nurses' experiences regarding clinical practice: A secondary analysis of a cross-sectional survey

AIM

To compare student nurses' expectations and newly qualified nurses' experiences regarding clinical practice in Switzerland 1 year after graduation.

DESIGN

A secondary explorative analysis of a cross-sectional survey.

METHODS

The data were sourced from the Swiss National Graduate Survey of Health Professionals covering six universities of applied sciences between 2016 and 2019, with information on three cohorts of bachelor student nurses, with a 1-year follow-up between each year. The participants were 533 bachelor-prepared nursing graduates.

RESULTS

The student nurses' overall expectations included the following top two prioritized aspects: 'contributing to something important' and 'adequate time to spend with patients'. Newly graduated nurses' clinical practice experiences demonstrated that not all expectations were met 1 year after graduation. The largest gaps were found in 'adequate time to spend with patients', 'work-life balance' and experiencing 'good management'.

CONCLUSION

The most crucial expectation gaps are related to having sufficient time to spend with patients and a good work-life balance. The most important result is whether there is a shortage of places for nurses to work rather than the oft-cited shortage of nurses.

IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE

The expectations of Swiss newly qualified nurses can be better met by an assessment in the first year about which individual perceptions of workplace characteristics cause them to make choices to change something about their work, affect their job satisfaction or influence their intention to stay.

IMPACT

Few of the student nurses' expectations were met 1 year after graduation, therefore Swiss healthcare institutions should improve needs assessments to strengthen the nurse workforce starting early in employment. The results underscore the importance of a constructive management culture, such as that in magnet hospitals in the United States which underpins the philosophy of changing in nursing. The results can be used internationally as a benchmark and as a basis for introducing potential interventions for nurse retention.

REPORTING METHOD

This study was reported following the Standardized Reporting of Secondary Data Analyses Checklist.

PATIENT OR PUBLIC CONTRIBUTION

There were no patient or public contributions.

TRIAL AND PROTOCOL REGISTRATION

This study has not been registered.

The Essentials: Upskilling a National Health Workforce in the Identification and Treatment of Eating Disorders

OBJECTIVE

Health practitioners report limited skills and lack of confidence in managing and treating people with eating disorders. The purpose of this study was to evaluate the national rollout of comprehensive basic training in identification, assessment, treatment, and management of people with eating disorders to clinicians.

METHODS

The Essentials: Training Clinicians in Eating Disorders is a core competency eLearning program. As part of a nation-wide multidisciplinary workforce training strategy, 7500 course places were provided free of charge to public and private health care professionals across all jurisdictions of Australia between January 2020 and March 2022.

RESULTS

A total of 7370 health professionals enrolled during the study period. All learning outcomes showed improvement with large effect (Cohen's d = 1.2-2), with the largest improvements for self-reported knowledge of requirements for working with children and adolescents. Effects did not depend on years of working with eating disorders suggesting that the training was beneficial across levels of experience. Those who started with very low knowledge of eating disorders or higher willingness to treat eating disorders were most likely to complete the course. Most participants reported that the course was relevant to their clinical practice, that they expected their clinical practices to change, and that they would recommend the course to other health professionals.

DISCUSSION

The strategy to provide government-funded core competency training in eating disorder care to healthcare professionals met key objectives by reaching health professionals eligible to provide government-rebated services in public and private settings across all jurisdictions including regional and remote areas.

A 2-Day Postpartum CBT-Based Training for Nurses

BACKGROUND

Public health nurses (PHNs) are often a first point of contact for postpartum individuals seeking mental health support, but report limited training related to mental health.

PURPOSE

To determine whether a two-day cognitive behavioral therapy (CBT)-based training program focused on postpartum maternal mental health can improve PHN perceptions of their ability to deliver CBT techniques, their confidence working with distressed clients, and with managing client resistance to treatment recommendations.

METHODS

A convenience sample of 45 PHNs working in the Family Health Division of Niagara Region Public Health in Ontario, Canada were assessed before and after they received a two-day CBT-based training program. Before attending training, PHNs reported their current professional position, years of experience working in public health, and any previous mental health training. Their confidence in delivering CBT techniques, working with distressed clients, and with managing client resistance to treatment recommendations was assessed pre- and post-training. Participants also rated their satisfaction with the training.

RESULTS

Statistically significant improvements were seen in confidence using CBT techniques, and in supporting and managing distressed or resistant clients. The two-day training was highly rated overall by participants. Medium to large effect sizes were found for changes in confidence-related questions.

CONCLUSIONS

Providing PHNs with brief CBT-based mental health-related training can increase their confidence in this aspect of their practice, and could potentially improve the quality of care they provide.

Level of knowledge of nurses and healthcare technicians regarding soft skills: An exploratory study

OBJECTIVE

To assess the knowledge level of nurses and healthcare technicians regarding soft skills (SS) and to identify the most crucial SS.

METHOD

This is a quantitative exploratory study with an analytical focus, encompassing 350 nurses and healthcare technicians in the Souss-Massa region.

RESULTS

Approximately half of participants (49.7%) exhibited some understanding of SS, with only 12.3% having received any training on the subject. According to participants, the top 10 SS are communication, teamwork, stress management, problem-solving, conflict management, honesty, decision-making, adaptability, lifelong learning, and confidence. Additionally, the prediction model indicates a significant association between SS knowledge and experience (p < 0.001), academic level (p < 0.001), and SS training (p < 0.001).

CONCLUSION

Nurses and healthcare technicians possess knowledge of SS despite the absence of formal training. Identifying the most important SS in this field is, therefore, invaluable for integration into training programmes for both healthcare professionals and students. Furthermore, additional studies are recommended on SS development and assessment.

Exploring challenges and enablers for community pharmacists using electronic prescriptions (Wasfaty) in Makkah region, Saudi Arabia: a qualitative study using the theoretical domains framework

Background

Transition to electronic prescribing (e-prescribing) systems, such as Wasfaty, represents a significant advancement in healthcare. Introduced by the Saudi Arabian Ministry of Health in 2019, Wasfaty aims to enhance medication availability and streamline healthcare delivery. This study explores the challenges and enablers community pharmacists face when using the Wasfaty system in Saudi Arabia. This study uses the Theoretical Domains Framework (TDF) to analyse behavioural and contextual factors influencing pharmacists' adoption of electronic prescriptions. TDF identifies key challenges and enablers across multiple behavioural domains, making it well-suited for understanding complex healthcare implementation processes.

Methods

A qualitative study design was employed using the Theoretical Domains Framework (TDF) to understand factors affecting Wasfaty use. Participants were purposively sampled, focusing on community pharmacists experienced with Wasfaty prescriptions. Recruitment and interviews occurred from June to August 2024. Data saturation was achieved at 18 interviews. Transcripts were coded and mapped into TDF domains to identify barriers and enablers.

Results

Five key TDF domains influenced Wasfaty use: environmental context and resources; social influences; beliefs about capabilities; social/professional role and identity; and knowledge. Challenges included high prescription volumes, medication shortages, technical difficulties, resistance from elderly patients, and inconsistent training. Some pharmacists reported inadequate training as a barrier, while others highlighted effective programs as enablers.

Conclusion

Significant barriers, such as insufficient training and high prescription volumes, impede effective Wasfaty use. However, continuous training, prior experience with electronic systems, and organisational support were crucial enablers. Addressing these challenges through targeted interventions can enhance e-prescription efficiency, improving patient care and outcomes. Findings underscore the importance of ongoing professional development and supportive work environments in fostering pharmacists' competence in electronic systems.

Rainbow within and beyond: A qualitative study on the experiences of lesbian, gay, bisexual, and transgender staff nurses in the Philippine hospital settings

Background

An individual's sexual orientation plays a fundamental role in their self-identity, relationships, and health. Years have shown both progressive and regressive responses to the LGBT community's social acceptance, particularly observable in various areas. Yet existing literature overlooks the Filipino healthcare settings, particularly with lesbian, gay, bisexual, and transgender (LGBT) staff nurses. Exploring their perspectives and experiences, whether challenges or successes, is crucial for gaining insights into occupational matters, workplace dynamics, and policy development.

Objective

The research aimed to explore the lived experiences of LGBT staff nurses in the hospital settings.

Methods

Husserl's Transcendental Phenomenology research design was utilized in this study. Participants included LGBT staff nurses with at least a year of experience at any hospital department. Individualized unstructured interviews were conducted with three participants interviewed face-to-face and five through online video conferencing platforms from March to April 2024. All interviews were transcribed, coded, themed, and analyzed using Colaizzi's approach. Data saturation was achieved with eight participants.

Results

Seven themes emerged, including: Recognizing Gender Stereotypes, Optimizing Nursing Care, Yearning for Acceptance, Generating Meaningful Relationships, Battling Heteronormative Gender Norms, Inspiring Potentials beyond Gender and Profession, and Valuing the Progress of LGBT Inclusivity.

Conclusion

The study revealed that LGBT staff nurses had multifaceted experiences with patients, colleagues, and superiors in the hospital settings as their workplace. They faced gender stereotyping and battled against limits on expression but fought to defend their authentic identities. They built relationships with colleagues and strived to be defined beyond societal perceptions. As they yearn for amplified LGBT acceptance in the workplace and society, they expressed gratitude for progress towards acceptance of the LGBT community.

New Nurse Turnover Intention and Related Factors in Japan and China: Focusing on Nursing Practice Environment and Burnout

BACKGROUND

With rapidly declining birth rates and aging populations worldwide, the demand for nursing care has increased in recent years. High turnover, an important cause of nurse staffing shortages, directly affects the quality of nursing care. However, no comparison studies on turnover intention in East Asia have been published.

PURPOSE

The purpose of this study was to clarify the relationships among turnover intention, the work environment, and related factors among new nurses in Japan and China.

METHODS

A self-administered questionnaire survey was used to collect data from nurses employed for < 2 years. This questionnaire included participant characteristics, assessment of desire to become a nurse at the start of employment, current turnover intention, the Practice Environment Scale of the Nursing Work Index, and the Maslach Burnout Inventory-Human Services Survey. The relationship between current turnover intention and, respectively, number of hospital beds, strength of desire to become a nurse at the start of employment, level of participation in hospital affairs, emotional exhaustion (EE), personal achievement, and demographic variables was assessed.

RESULTS

The number of nurses who intended to leave the hospital was higher in Japan (74.1%) than in China (42.4%). However, of those expressing intention to leave, 46.6% of the nurses in China and only 5.0% of those in Japan indicated intention to quit the nursing profession altogether. In Japan, collegial nurse-physician relations and EE were related to turnover intention, whereas in China, number of hospital beds, strength of desire to become a nurse at the start of employment, participation in hospital affairs, EE, and personal achievement were all related to turnover intention.

CONCLUSIONS

To enhance retention and reduce turnover intention among nurses, the strength of desire to become a nurse in China and the nurse-physician relationship and EE in Japan should be taken into particular consideration when designing retention strategies and nurse education programs.

Collaborative learning linking nursing practice and education - Interview study with master's students and teachers

BACKGROUND

Collaborative and innovative educational approaches are essential to building nurses' competencies in responding to healthcare challenges and to enhance high-quality nursing practice. Nurses are increasingly learning in various contexts, and thus, the understanding and organising of collaborative learning needs further exploration.

AIM

To describe collaborative learning in nursing practice and education from the point of view of nurses, involved as students and teachers in master's education in nursing.

DESIGN AND METHODS

Qualitative study using semi-structured focus groups involving 33 nurses as master's students and teachers from Estonia and Norway. The data were analysed using inductive content analysis.

FINDINGS

The essence of collaborative learning in the context of nursing practice and education was identified as the aggregation of diverse learners' skills and reflections while working towards shared aims. This fostered the development of workplace competencies, professional attitudes, and personal growth. Organising collaborative learning requires careful planning and synchronisation between clinical and educational organisations.

CONCLUSIONS

Collaborative learning is an inclusive method, aiding nurses at different phases of their career to gain knowledge and enhance their soft skills, and potentially reducing professional hierarchies. Further research is needed to develop methods for evaluating the outcomes of collaborative learning.

Investigating the Possibility of Nurse Prescribing Training Development in Nursing Education System in Iran

PURPOSE

Adequate medical knowledge and skills are fundamentals for nurse prescribing authority development. This study will explore the potential for developing nurse prescribing training in Iran, where nurses currently lack prescribing authority despite their strong academic nursing education.

METHODS

This is a study with two phases. At first, in a conventional qualitative content analysis method, with purposive and snowball sampling, from June 2021 to March 2023, 20 participants, including 16 nurses in different clinical, managerial, educational, and policy-making settings, three physicians, and one clinical pharmacist were interviewed. Unstructured interviews were conducted face-to-face or virtually as the situation required during the pandemic period due to Coronavirus disease, 2019 (COVID-19). Qualitative content analysis as developed by Elo and Kyngäs in 2008 was used for data analysis. In the second comparative analysis phase, four masters of science and one doctor of nursing curricula analyzed in the existence of the nurse prescribing prerequisite courses and these five curricula and two potential masters of science in community health and critical care nursing curricula were compared with John Hopkins University curricula.

RESULTS

In the qualitative phase, two themes emerged: nursing education challenges and the potential for nurse prescribing training development. These were further broken down into four subthemes: inadequate nurses' knowledge in prerequisite nurse prescribing courses, unprepared educational infrastructure, treatment sector potentials, and educational potentials, with a total of 12 concepts identified. During the comparative phase, it was found that none of the nursing curricula had adequate prerequisite courses for nurse prescribing. However, the Community Health and Critical Care nursing curricula showed potential for developing nurse prescribing training.

CONCLUSIONS

In the nursing education system, there are some challenges and potentials for prescribing training, and the community health and critical care nursing curricula have the potential capacity to prepare the graduated nurses to prescribe. It needs educational and managerial policies. More developmental research and pilot studies are recommended.

Nurse managers' managerial innovation and it's relation to proactivity behavior and locus of control among intensive care nurses

BACKGROUND

The nursing profession is undergoing rapid transformation, requiring innovation in management approaches and proactive behaviors among staff. Nurse Managers play a vital role through managerial innovation, but its impacts on intensive care nurses' proactivity and locus of control remain underexplored.

OBJECTIVES

This study aimed to assess the levels of Nurse Managers' managerial innovation and relate it to proactivity behaviors and locus of control orientations among intensive care nurses.

METHODS

A cross-sectional correlational design was adopted, recruiting 242 intensive care nurses from Tanta University Hospital, Egypt. Participants completed standardized questionnaires measuring perceived managerial innovation, proactivity behavior, and locus of control.

RESULTS

Nurse Managers demonstrated moderately high innovation across all dimensions, especially in continuous learning and development (mean = 4.65) and advanced technology use (mean = 4.56). Nurses exhibited sound proactivity levels, particularly in adaptability (mean = 4.40) and planning (mean = 4.35). The majority of nurses showed an internal locus of control (64.5%). Managerial innovation had significant positive correlations with nurses' proactivity (r = 0.45, p < 0.001) and internal locus of control (r = 0.42, p < 0.001). Regression analysis revealed age, gender, experience, education, and ICU type as significant predictors of proactivity and locus of control.

CONCLUSION

Innovative nursing leadership positively influences staff's proactivity levels and perceived control over their practice. This underscores the vital role of nurse managers in creating empowering environments in intensive care.

An exploration of organizational climate in community-based opiate prescribing services; a mixed methods study

INTRODUCTION

Assessing the internal dynamics of organizations has been shown to provide information that can help planners and policymakers improve service delivery. A good organizational climate, which in this study incorporates mission clarity, team cohesion, staff autonomy, communication, levels of stress, and openness to change has been shown to be of particular importance. Still, there is a dearth of evidence in this area, and while relationships between organizational factors have been identified, little is known about the mechanisms that might underpin these relationships, and there is little understanding of how to address deficits once they are identified. The objective of this study was to identify relationships between program factors that influence organizational climate and to explore which mechanisms might underpin these relationships.

METHODS

This paper reports on a cross-sectional, concurrent, mixed-methods study design, across twelve discrete community-based prescribing service providers (organizations) in Ireland. Data was obtained using a staff survey [n = 132] which utilized measurements of organizational readiness to change and one-to-one interviews [n = 12]. Quantitative data was analyzed using multivariate linear regression modeling which assessed relationships between variables, while interviews were analyzed using an abductive approach, both types of data were synthesized at the interpretation stage.

RESULTS

A range of interdependent factors were considered to affect the climate of organizations. Surveys identified that specific types of resources, such as physical infrastructure, training, and staffing resources were important for supporting a good organizational climate, while programs with greater needs had a poorer climate. Opportunities for professional growth, the skill sets of staff, and having access to e-communication were also significant. Interviewees reported that rigid organizational hierarchies and bureaucracy, philosophical views of addiction, stress, and staff turnover were influenced by the provision of fewer resources. Interdependent factors such as leadership, supervision, staff relationships, and collective training, also thought to be influenced by resources, were considered to positively influence programs. Resources were not the only challenge identified, and practices within programs and how existing resources are used were also thought to contribute both positively and negatively to the internal dynamics of services.

CONCLUSION

Key findings in this study identified that the organization of effective services is influenced by a range of specific factors, some of which can be addressed without additional resources. Overall, staff views of organizations can provide us with valuable information to support service improvement. Using a mixed methods approach can not only identify where relationships between organizational variables exist but can also help us to understand the mechanisms that underpin these relationships and, importantly, how to address deficits once they are identified. In order to improve how substance misuse services work, the need for a long-term systemic approach to program development, which incorporates some of the findings from this study, is required.

A Randomized Trial Assessing the Effectiveness of High-fidelity Simulation Training in Managing Maternal Cardiac Arrest among Emergency Medical Professionals in India

Introduction

Maternal cardiac arrest is a rare but critical event that poses significant risks to both the mother and the fetus. As majority of population in India lives in the rural areas, Emergency Medical Professionals assist in childbirth in transit in ambulances. This timely assistance ensures the safe transportation of both mother and new born baby to the hospital. The aim of this study was to assess the effectiveness of high-fidelity simulation training in the management of maternal cardiac arrest among emergency medical professionals.

Methods

The randomized simulation study aimed to assess the effectiveness of high-fidelity simulation in managing maternal cardiac arrest. Two hundred and fifty emergency medical professionals were randomly assigned to 50 groups. Participants underwent a prebriefing session before engaging in simulation scenarios. After the initial scenarios, participants received a debriefing session emphasizing the standardized algorithm for maternal cardiac arrest management. A week later, participants engaged in a second simulation scenario, and their adherence to the algorithm was assessed. The data were analyzed using statistical tests, and the entire simulation session was video recorded for reliability.

Results

The results showed that participants demonstrated an improvement in managing both maternal and obstetric interventions in the posttraining scenario compared to the pretraining scenario. The successful implementation of the advanced cardiac life support algorithm and the debriefing session were key factors in improving participants' performance. However, continuous exposure and practice are necessary to maintain and enhance these skills.

Conclusion

Health-care professionals should actively seek opportunities for ongoing training and education to stay updated with the latest guidelines and advancements in managing maternal cardiac arrest.

Evolution of Chatbots in Nursing Education: Narrative Review

Background

The integration of chatbots in nursing education is a rapidly evolving area with potential transformative impacts. This narrative review aims to synthesize and analyze the existing literature on chatbots in nursing education.

Objective

This study aims to comprehensively examine the temporal trends, international distribution, study designs, and implications of chatbots in nursing education.

Methods

A comprehensive search was conducted across 3 databases (PubMed, Web of Science, and Embase) following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) flow diagram.

Results

A total of 40 articles met the eligibility criteria, with a notable increase of publications in 2023 (n=28, 70%). Temporal analysis revealed a notable surge in publications from 2021 to 2023, emphasizing the growing scholarly interest. Geographically, Taiwan province made substantial contributions (n=8, 20%), followed by the United States (n=6, 15%) and South Korea (n=4, 10%). Study designs varied, with reviews (n=8, 20%) and editorials (n=7, 18%) being predominant, showcasing the richness of research in this domain.

Conclusions

Integrating chatbots into nursing education presents a promising yet relatively unexplored avenue. This review highlights the urgent need for original research, emphasizing the importance of ethical considerations.

Challenges and opportunities for competency-based health professional education in Bangladesh: an interview, observation and mapping study

BACKGROUND

Bangladesh has a shortfall of health professionals. The World Health Organization states that improving education will increase recruitment and retention of health workers. Traditional learning approaches, in medical education particularly, focus on didactic teaching, teaching of subjects and knowledge testing. These approaches have been superseded in some programmes, with a greater focus on active learning, integrated teaching and learning of knowledge, application, skills and attitudes or values and associated testing of competencies as educational outcomes. In addition, some regions do not have continuous professional development or clinical placements for health worker students, contributing to difficulties in retention of health workers. This study aims to explore the experiences of health professional education in Bangladesh, focusing on what is through observation of health professional education sessions and experiences of educators.

METHODS

This mixed method study included 22 observations of teaching sessions in clinical and educational settings, detailed analysis of 8 national curricula documents mapped to Global Competency and Outcomes Framework for Universal Health Coverage and 15 interviews of professionals responsible for health education. An observational checklist was created based on previous literature which assessed training of within dimensions of basic clinical skills; diagnosis and management; professionalism; professional development; and effective communication. Interviews explored current practices within health education in Bangladesh, as well as barriers and facilitators to incorporating different approaches to learning.

RESULTS

Observations revealed a variety of approaches and frameworks followed across institutions. Only one observation included all sub-competencies of the checklist. National curricula documents varied in their coverage of the Global Competency and Outcomes Framework domains. Three key themes were generated from a thematic analysis of interview transcripts: (1) education across the career span; (2) challenges for health professional education; (3) contextual factors and health professional education. Opportunities for progression and development post qualification are limited and certain professions are favoured over others.

CONCLUSION

Traditional approaches seem to predominate but there is some enthusiasm for a more clinical focus to education and for more competency based approaches to teaching, learning and assessment.

The effectiveness of continuing professional development for the residential long-term care workforce: A systematic review

OBJECTIVES

To investigate the effectiveness of continuing professional development in residential long-term care.

DESIGN

Systematic review.

DATA SOURCES

PubMed, Cumulative Index to Nursing & Allied Health (CINAHL), and Web of Science.

REVIEW METHODS

Empirical studies published between 2003 and 2023 describing the effectiveness of continuing professional development in long-term care were selected according to PRISMA guidelines. The type, topic, and effectiveness of continuing professional development activities in long-term care were analysed, in addition to facilitators and barriers. The protocol of this review is registered in PROSPERO.

RESULTS

A total of 155 studies were selected, including over 17,000 participants the majority of whom were nurses. The most common topics were 'dementia care' (n = 22; 14.2 %), and restraint use (n = 14; 9 %). The impact of continuing professional development was mainly evaluated in terms of 'participant satisfaction with continuing professional development' (n = 5; 3 %), 'staff knowledge' (n = 57; 37 %), 'staff competencies and skills' (n = 35; 23 %), 'resident outcomes' (n = 45; 29 %), and 'staff wellbeing' (n = 12; 8 %). A total of 64 (41 %) studies evaluated if impact of continuing professional development was sustained over time. 'Good organisation', 'a supportive learning environment', 'expressing personal preferences', and 'management support' were described as facilitators of continuing professional development.

CONCLUSIONS

Increasing numbers of long-term care residents with complex health conditions require nurses with advanced skills, such as dementia care. To improve the effectiveness of continuing professional development, support from managers, who adopt relational leadership styles, is instrumental to integrate new knowledge and skills into practice. This needs to be linked to career progression, and consequently increase the attractiveness of working in the long-term care sector. This could meet the dual goal of improving outcomes for residents and nurses' job satisfaction.

Health and social care managers' perceptions of factors affecting the competence of managers in knowledge management: A qualitative study

AIM

To describe health and social care managers' perceptions of the factors affecting the competence of managers in knowledge management.

DESIGN

A qualitative descriptive study.

METHODS

A semi-structured interview was conducted with 15 managers from three public health and social care organizations in Finland. Data were collected in the spring of 2022 and analysed using inductive content analysis.

RESULTS

Health and social care managers perceived that the competence of managers working in knowledge management is affected by managers' behavioural and attitudinal characteristics, their interactive network competence in knowledge management, the dimensions of their competence in knowledge management, the knowledge management infrastructure with which they work and the organizational learning culture within which they work.

CONCLUSIONS

The competence of health and social managers in knowledge management is influenced by various factors, including their personal characteristics, management competence and the infrastructure and culture of the organization for which they work. However, their competence is constrained by an absence of clear processes, structures and resources in knowledge management as well as a lack of systematic support and training for managers working in knowledge management.

IMPACT

The study provides valuable information for improving the competence of managers working in knowledge management in health and social care organizations. The competence of managers working in knowledge management is instrumental for successful implementation and sustaining of knowledge management practices and thus, such competence has a positive impact on the overall performance of an organization.

IMPLICATIONS

Clarifying the roles and responsibilities of health and social care managers, as well as establishing organizational structures, is essential for effective knowledge management in organizations.

REPORTING METHOD

Consolidated Criteria for Reporting Qualitative Research (COREQ) checklist has been used in the reporting.

PATIENT OR PUBLIC CONTRIBUTION

No patient or public contribution.

Effectiveness of an educational intervention to increase professional nurses' person-centred care competence in long-term care of older people-Quasi-experimental study

BACKGROUND

Based on previous evidence person-centred care (PCC) as a quality indicator is important in long-term care (LTC) settings for older people. Effective ways to increase nurses' person-centred care competence are missing.

AIM

To evaluate the effectiveness of a continuing education (CE) intervention named 'Person First-Please' (PFP) for improving nurses' PPC competence and its connection to PPC climate.

METHODS

Quasi-experimental cluster design with intervention and control groups was carried out in LTC settings for older people. The intervention group (n = 77) received a 10-week CE intervention, with control group (n = 123) working as usual. The primary outcome was professional nurses' PCC competence. Secondary outcome was the PCC climate as perceived by nurses and, residents with their next of kin. Measurements were conducted pre-/post-intervention and after 6 weeks using the validated, Person-centred Care Competence scale and the Person-centred Care Climate questionnaire, staff and patient versions. Data was analysed with descriptive and inferential statistics.

RESULTS

PCC competence was significantly increased in the intervention group and remained after 6 weeks of follow-up. PCC climate increased in the intervention group in total score and also in all sub-scales, across residents with their next of kin. The control group did not show any significant change. Comparisons of PCC competence and PCC climate in time between intervention and control groups confirmed that changes seen between groups were statistically significant in intervention group.

LIMITATIONS

Measurements were self-assessments, which may have been affected by bias, especially in context of competence assessment.

CONCLUSION

The intervention was effective in increasing professional nurses' PCC competence and on person-centred care climate in long-term care settings for older people.

Self-reported competence among advanced practice nursing students in Denmark, Finland and Norway: a cross-sectional multicentre study

BACKGROUND

The health care systems in the Nordic countries and worldwide are under pressure due to increased longevity and a shortage of nurses. Providing nurses with a high level of education, such as advanced practice nursing, is of great importance to ensure effective, safe and high-quality care.

AIM

The aim of this study was to investigate self-reported competence using the Nurse Professional Competence Scale Short-Form for the first time among master's students of advanced practice nursing in the Nordic countries and to relate the findings to age, work obligations, child-rearing responsibilities, level of education and clinical nursing experience.

METHODS

A multicentre, cross-sectional design was used in this study conducted at five universities in Denmark, Finland and Norway. The Nurse Professional Competence Scale Short-Form consisting of six competence areas was used with a maximum score of 7 per item for the analysis of single items and a transformed scale from 14.3 to 100 for analysing the competence areas (higher score equals higher self-reported competence). Descriptive and comparative statistics were used to analyse the data.

RESULTS

The highest mean score was found for the competence area 'Value-based nursing care'. Students living with home-dwelling children (≤ 18 years) reported significantly higher competence in 'Nursing care', while students ≥33 years reported significantly higher competence in 'Nursing care' and 'Value-based nursing care'. No significant differences were found between students working and those not working alongside their studies, between students with and without further nursing-related education, or between students with long and short experience as nurses.

CONCLUSIONS

The findings from this study might help to further develop curricula in advanced practice nursing master's programmes to ensure high-quality nursing and sustainable health care in the future. Future high-quality master's programmes might benefit from systematic collaboration between Nordic higher education institutions as also Sweden is planning master's programme. Higher age, having children at home and working while studying should not be considered causes for concern.

Educational interventions and their effects on healthcare professionals' digital competence development: A systematic review

INTRODUCTION

The digitalisation of healthcare requires that healthcare professionals are equipped with adequate digital competencies to be able to deliver high-quality healthcare. Continuing professional education is needed to ensure these competencies.

OBJECTIVE

This systematic review aimed to identify and describe the educational interventions that have been developed to improve various aspects of the digital competence of healthcare professionals and the effects of these interventions.

METHODS

A systematic literature review following the Joanna Briggs Institute's guidelines for Evidence Synthesis was conducted. Five electronic databases (CINAHL, PubMed, ProQuest, Scopus and Medic) up to November 2023 were searched for studies. Two researchers independently assessed the eligibility of the studies by title, abstract and full text and the methodological quality of the studies. Data tabulation and narrative synthesis analysis of study findings were performed. The PRISMA checklist guided the review process.

RESULTS

This review included 20 studies reporting heterogeneous educational interventions to develop the digital competence of healthcare professionals. The participants were mainly nurses and interventions were conducted in various healthcare settings. The length of the education varied from a 20-minute session to a six-month period. Education was offered through traditional contact teaching, using a blended-learning approach and through videoconference. Learning was enhanced through lectures, slide presentations, group work, case studies, discussions and practical exercises or simulations. Educational interventions achieved statistically significant results regarding participants' knowledge, skills, attitudes, perception of resources, self-efficacy or confidence and output quality.

CONCLUSIONS

The findings of this review suggest that digital competence education of nurses and allied health professionals would benefit from a multi-method approach. Training should provide knowledge as well as opportunities to interact with peers and instructors. Skills and confidence should be enhanced through practical training. Adequate organisational support, encouragement, and individual, needs-based guidance should be provided.

An exploration of how specialist dementia nurses perceive and maintain the skills and competencies that frame their specialism: A qualitative survey

Background

UK policy for complex and long-term health conditions including dementia has recommended that specialist nursing intervention is offered across the trajectory of the condition, but there is a lack of agreement regarding the skills and competencies that specialist nurses are expected to possess. Admiral Nurses are the largest UK group of specialist dementia nurses.

Objective

To explore how Admiral Nurses met and were supported to meet competencies as defined in the Admiral Nurse Competency Framework, and to develop and maintain skills as dementia specialists.

Design

Cross-sectional, semi-structured survey.

Setting

Online national survey.

Participants

Admiral (specialist dementia) Nurses.

Methods

We co-designed our survey with Admiral Nurses; then invited Admiral Nurses to complete it in 2022-23 Data were analysed thematically.

Results

68 (20% of all Admiral Nurses) completed the survey; most were female (85.2%), from a white ethnic group (88.2%); they reported on average 24 years of nursing experience. We identified three themes in responses: 1.Having time and skills for meaningful support, explored how participants were resourced with time and skills to understand and address family carer client needs by active listening, tailoring person-centred support, and "walking alongside" families. 2.Partnering family carers, concerned how they co-designed interventions with family carers, learning from these collaborative partnerships where expertise was shared. 3.Practice and peer-based learning, explored how participants took responsibility for using available training, peer learning and self-reflection to develop their practice.

Conclusions

Admiral Nurse roles enabled respondents to develop as autonomous practitioners and to access resources that supported them to build and sustain their dementia specialist practice. Learning was practice based, through partnerships with family carer clients, peer support and self-directed learning. Specialist nursing models may help address the global health workforce emergency, through enabling creative practice development and valued roles that support retention of experienced nurses.

Factors influencing early career nurses to adopt leadership roles: a literature review

Effective nursing leadership has been shown to improve patient outcomes, but there has been little exploration of the factors that influence early career nurses to develop their leadership skills and adopt leadership roles. This article presents a rapid review of the literature on these factors, integrating data from 25 articles. Findings suggest that improving leadership confidence and self-efficacy, particularly in relation to system leadership, can increase nurses' motivation for adopting leadership roles. Supportive organisations that value leadership and give nurses opportunities to exercise it are equally important. Training and education, preceptorship, peer-to-peer shadowing, modelling and mentoring can all be useful in improving leadership skills and inspiring the next generation of nurse leaders.

Examining the Outcomes of Project ECHO® as an Interprofessional Community of Practice for Pediatric Feeding Clinicians

Project ECHO® is a virtual, interprofessional, cased-based peer-learning model. To date, no studies have explored ECHO as a model for pediatric feeding education. This study examined the outcomes of establishing a pediatric feeding ECHO network. Using a prospective, mixed-methods design, two cohorts of allied health professionals were recruited. Each cohort participated in eight, 90-min videoconference sessions incorporating a didactic presentation and clinical case presentation. The case was presented by a participant, with questions and recommendations provided by the ECHO network. Participants completed: (1) a learning needs analysis before the ECHO series, (2) a self-reported confidence questionnaire pre, post, and 3-month post, (3) a satisfaction questionnaire after each session, and (4) an overall satisfaction questionnaire post-ECHO series. Time spent by hospital allied health clinicians providing impromptu phone/email feeding support to external clinicians was recorded for 8 weeks prior to and 8 weeks during the ECHO series. Forty-seven participants were included in the study, attending an average of 5.8 sessions. Significant improvements in self-reported confidence were observed across the three time points (p < 0.01) with less experienced participants demonstrating greater improvements. Participants reported high satisfaction with ECHO, with 93% (40/43) wanting continued access to ECHO in future. The multidisciplinary format, interactivity, structure, and case-based nature of ECHO were considered beneficial. A 75% reduction in requests for support from clinicians in the same catchment area was noted during the ECHO series. Results demonstrated that Project ECHO is a viable model for pediatric feeding education for clinicians working in the field. Further research is needed to investigate the long-term effects and impacts on clinical care.

Developing effective In-Service Education for intensive care nurses: Exploring the views of clinical stakeholders in the Kingdom of Saudi Arabia

BACKGROUND

Evidence-based in-service education (ISE) in the intensive care unit (ICU) is essential to maintaining nurse skill and competence in this complex clinical area. However, there has been limited research that has focused on developing and optimising the specialised training required by ICU nurses working in trauma care.

OBJECTIVES

To explore the perspectives of ICU clinical stakeholders regarding their needs and preferences for ISE to inform the future development and implementation of effective educational interventions.

DESIGN

A qualitative, multiple-case study supported by the "Empowering Education" theoretical framework, which emphasises the importance of stakeholder involvement in education development.

SETTINGS

Adult ICUs in three major hospitals located in two geographical areas in Saudi Arabia.

PARTICIPANTS

Forty clinical nurses, twelve nurse managers, nine nurse leaders and seven clinical educators participated.

METHODS

Data were collected through semi-structured interviews followed by focus groups. Framework analysis was used for data analysis.

FINDINGS

Stakeholders wanted ISE and training by subject experts characterised by: (i): relevant educational content; (ii): a range of educational techniques and (iii) flexible delivery and format. Nurses also identified factors that encouraged them to participate in ISE including adequate resources and a supportive work environment, whilst heavy workloads, cost and scheduling issues hindered engagement.

CONCLUSION

This paper highlights the importance of considering staff needs and local context when developing in-service ICU education to support nurses' competence. Further recommendations and a proposed framework to develop future ISE in the ICU are provided.

TWEETABLE ABSTRACT

The key to effective in-service education for ICU nurses is understanding stakeholders' needs and motivational drivers, whilst addressing barriers to successful implementation.

Pharmacists' perceptions and delivery of health behaviour change recommendations: Mapping the COM-B model

BACKGROUND

Pharmacists are trusted and accessible healthcare professionals who are well-positioned to deliver brief health behaviour change technique-based interventions for chronic health conditions. However, little is known about the factors influencing pharmacists' use of behaviour change techniques and their capacity to deliver these interventions within community pharmacy.

OBJECTIVES

This study employed the COM-B model to explore the factors that explain pharmacists' delivery of behaviour change techniques in practice. A secondary objective was to ascertain whether capability, opportunity, and motivation are associated with and explain significant variance in the use of behaviour change techniques during patient interactions.

METHODS

Two-hundred and eleven Australian pharmacists (mean age = 36.1, SD = 10.7) completed a survey on their capability, opportunity, and motivation to deliver behaviour change techniques, and their delivery and frequency of use in practice.

RESULTS

Most pharmacists (91.3%) use behaviour change techniques during patient interactions. Results from a simple linear regression showed that a composite COM score was associated with pharmacists' behaviour change technique use F(1,195) = 47.12, β = 0.44, 95 % CI [0.09, 0.16], p < .001, and their frequency of use (F(1,198) = 44.19, β = 0.43, 95 % CI [0.02, 0.06], p < .001). While capability, opportunity, and motivation were individually associated with the range and frequency of behaviour change technique used, motivation was the only significant variable in the composite model for range (β = 0.35, 95 % CI [0.11, 0.41], p < .001) and frequency of behaviour change technique use (β = 0.22, 95 % CI [0.01, 0.09], p < .05).

CONCLUSIONS

Pharmacist motivation was the most important construct explaining behaviour change technique use. Interventions should seek to foster pharmacist motivation and may benefit from adopting COM-B as a behaviour change framework, to understand the factors influencing the delivery of behaviour change interventions.

Reviewing the influence of positive leadership on worker well-being: A comprehensive analysis

The study provides a review of existing empirical studies on the impact of positive leadership on worker well-being. The aim it to integrate current knowledge and provide directions for future research. The study analyses the content of 118 articles retrieved mainly from Google Scholar and Scopus database published between 2004 and 2022. Findings revealed that most of the studies are atheoretical with the dominant theory applied being conservation of resource theory. Furthermore, most of the studies were cross-sectionally designed, used convenient sampling and self-reported questionnaire. A conceptual framework is presented which synthesizes findings from prior works and shows the various dimensions of positive leadership practices and worker well-being. Additionally, a comprehensive future research agenda for theoretical and empirical advancement is suggested. The study offers a comprehensive framework that synthesizes and integrates the existing literature on positive leadership and worker well-being. The findings offer researchers in leadership a common platform for discourse.

Insights from defining nurses' career success: An integrative review

AIMS

To review the literature and identify factors that make sense of and influence nurses' career success. We sought to provide insights into achieving nurses' career success.

DESIGN

An integrative review conducted in May 2022 using Whittemore and Knafl's methodology of integrative review.

METHODS

The databases searched were PubMed, Web of Science, Scopus, and CINAHL. Search criteria included the keywords "nurs*" and "career success" in the title and abstract. The quality of the reviewed papers was assessed using the JBI Critical Appraisal Tool for cross-sectional studies and qualitative research. We extracted five types of information from quantitative studies: the definition of career success, factors of career success instruments, reliability or validity of career success instruments, and factors influencing nursing career success. Furthermore, we extracted two types of information from qualitative studies: themes that imply career success and factors that influence nurses' career success. Primary data were categorized into two perspectives: (1) what nurses' career success means and (2) what influences nurses' career success. Categorized data were unified into similar contents. Themes were developed from unified subgroups.

RESULTS

Fourteen studies were included in the analysis. Seven themes were integrated into the factors that make sense of nurses' career success: satisfaction, positive attitude towards work, quality work in nursing, continuation of career and professional development, positive interaction at work, person-organization fit, and enrichment of an individual's life. Three themes were integrated into the factors influencing nursing career success: personal resources, positive behavior toward nursing work and research, and job resources and environment.

NO PATIENT OR PUBLIC CONTRIBUTION

Patients or members of the public were not involved in this review.

Preparing Staff Nurses to Be Preceptors on a Dedicated Education Unit Through an Interactive Bulletin Board

Nursing professional development (NPD) specialists are tasked with providing pertinent education to staff members. Many barriers exist in providing education to nurses. Through an academic-practice partnership, an interactive bulletin board was trialed to provide staff education with overwhelmingly positive results. An increased percentage of staff participated in this learning activity. In addition, the mean score from the content knowledge quiz was 88%. NPD specialists may increase staff participation employing interactive bulletin boards as an educational method.

Self-Perceived Clinical Competence of Nurses in Different Working Experiences: A Cross-Sectional Study

BACKGROUND

Competence is an essential concept for measuring nurses' performance in terms of effectiveness and quality. To this end, our analysis highlighted the process of acquiring competencies, their self-evaluation into clinical practice, and how their proficiency levels change throughout the nursing career. In detail, this research explored nurses' perceived level of competence and the factors that influence it in different contexts.

METHODS

A cross-sectional survey using a structured questionnaire to assess the nursing participants' perception of their competencies in different clinical settings was accomplished.

RESULTS

A descriptive and bivariate analysis was performed on 431 nurses. Most respondents assessed their level of competence to be higher than their roles required. The Kruskal-Wallis test confirmed that nursing experience was a relevant factor influencing nursing competencies.

CONCLUSIONS

We suggest improving the competence of practicing nurses, using experience as a measurable effect of their development.

Self-reported continuing professional development needs of medical laboratory professionals in Ghana

BACKGROUND

Because of the essential nature of the work of medical laboratory professionals, continuing development in knowledge and skills is indispensable. The study aimed at identifying and prioritizing the development and training needs of medical laboratory professionals in Ghana. This is expected to help in developing focused continuing professional development (CPD) that meets the needs of practitioners as well as the changing medical trends.

METHODS

An online cross-sectional survey in February 2022 using a structured questionnaire was conducted. Respondents were asked questions that collected demographic and work-related data about them, their participation, preference, and challenges in being part of CPDs. Finally, a list of topics based on (i) quality management systems, (ii) technical competence, (iii) laboratory management, leadership, and coaching, (iv) pathophysiology, and (iv) data interpretation and research were asked with the option to rate them on a 3-point scale (most, moderate, and least) in order of importance.

RESULTS

A total of 316 medical laboratory professionals participated in the study. Overall, the most frequently selected topics for training based on domains for CPD training and ranking as most important were (i) quality management systems, (mean = 80.59 ± 9.024; 95% CI = 73.04-88.13); (ii) pathophysiology, data interpretation, and research (mean = 78.0 ± 6.973; 95% CI = 73.97-82.03); (iii) technical competence (mean = 73.97 ± 10.65; 95% CI = 66.35-81.59); and (iv) laboratory management, leadership, and coaching (mean = 72.82 ± 9.719; 95% CI = 67.44-78.2). The factors affecting the choice of training needs included the medical laboratory professionals' current place of work, years in service, the reason for attending CPD activities, the period for attending the last CPD, being in a supervisory role, and the number of staff being supervised. Face-to-face presentations, training workshops, and hands-on workshops were the most preferred modes of CPD delivery with financial implications and workload/time constraints being the main challenges impeding CPD participation.

CONCLUSION

The identified needs will help in developing CPD programs that address what medical laboratory professionals prioritize as training needs. Stakeholders should incorporate these training needs into future programs and address the challenges highlighted in this study to have more relevant training for medical laboratory professionals.

Barriers and Enablers to Nurses' Engagement With Continuing Professional Development: A Survey

BACKGROUND

Continuing professional development (CPD) is perceived as a pivotal component of building and maintaining nursing skill and capacity. Exploring motivators for CPD engagement can aid program adaptation and improvement. The goal of this study was to survey the barriers, enablers, and changes of Australian RNs' engagement with CPD in general during the coronavirus disease 2019 (COVID-19) pandemic. An additional goal was to understand factors influencing the interest of participants to engage with programs focused on care for people with intellectual disability and/or autism.

METHOD

This study was a cross-sectional exploratory survey.

RESULTS

Most of the sample had engaged with CPD in the previous 12 months, and the most reported topics were related to COVID-19. Sixty percent of nurses saw a change in volume of CPD. Younger nurses, with fewer years of experience, and practicing in major cities, were significantly more likely to report less CPD.

CONCLUSION

It is pivotal that the design and promotion of CPD curricula consider the motivators and barriers for nurses' engagement with them. [J Contin Educ Nurs. 2023;54(9):405-412.].

Relationship between Nurses Reflection, Self-efficacy and Work Engagement: A Multicenter Study

Introduction

Reflection is considered an essential element in nurses' practice with different positive outcomes, we decided to determine the level of nurses' reflection and then assess the relationship between nurses' reflection with their self-efficacy and work engagement.

Methods

In this cross-sectional study, a total of 240 nurses were selected from seven educational hospitals affiliated with Tabriz University of medical sciences (Iran). The stratified random sampling method was used to select the participants from hospitals. Data were collected through three questionnaires including Groningen Reflection Ability Scale (GRAS), Sherer's General Self-Efficacy Scale (SGSES), and Utrecht Work Engagement Scale (UWES). Data were analyzed using SPSS version 13.

Results

According to the results, the mean (SD) score of nurses' reflection was calculated as 86.51 (8.17) out of 115. The mean (SD) score of nurses' self-efficacy was 60.89 (11.11) out of 85. Moreover, the mean (SD) total score of nurses' work engagement in a possible range of 0 to 6 was 3.39 (1.36). There was a positive and significant relationship between the total reflection score with work engagement and self-efficacy scores.

Conclusion

According to the results, nurses working in different units showed different scores of reflection. Moreover, the results of the present study showed that nurses' reflection is associated with nurses' work engagement and self-efficacy. Therefore, nurse managers and nurse educators should improve nurses' skills in reflection and they should support the reflective practice in clinical settings.

Middle Eastern nurses' views/experiences of work and well-being with the support measures during past disease outbreaks and COVID-19: a qualitative systematic review

BACKGROUND

The potential psychological health impact of pandemics on nurses has been increasingly widely recognised, as have recommendations to establish support measures for nurses' well-being. Despite the availability of support measures significant number of nurses still experienced burnout and mental distress during Covid-19. Few efforts have been made in the wider literature to understand how nurses experience well-being support or how they perceive it affects their well-being during pandemics. In the Middle East, understanding and exploring well-being support measures during pandemics from nurses' perspectives has not received significant attention.

OBJECTIVE

To investigate nurses' perspectives and experiences of well-being support measures during prior pandemics and the Covid-19 pandemic in the Middle East.

METHODS

A systematic qualitative review was undertaken utilising the JBI model as a framework. Searches were carried out in databases comprised CINAHL, MEDLINE, NUsearch Library of Nottingham University and Google Scholar. Moreover, a manual search through reference lists for relevant studies were carried out.

DATA EXTRACTION AND SYNTHESIS

Eleven studies were included in the review. The findings from the included qualitative studies were extracted using the JBI-QARI data extraction tool for qualitative research. The results were synthesised using a meta-synthesis in line with the JBI approach.

RESULTS

The included studies yielded an aggregate of 111 findings and were categorised into 14 categories, followed by four synthesised findings. These were: [1] nurses experienced challenges during MERS, yet different strategies were implemented by leaders and nurses to manage these challenges; [2] some well-being support measures were unfulfilled during Covid-19; [3] additional aspects compounded negatively on nurses' well- being; and [4] nurses showed maturity during Covid-19.

CONCLUSION

In comparison to prior health emergencies, well-being support measures during Covid-19 were not sufficiently adopted. Nurse policymakers and managers should consider these support measures to correspond with nurses' needs and explore the contextual factors that affect their implementation.

TRIAL REGISTRATION

PROSPERO (CRD42022344005).

Trailblazing New Paths to e-Learning Engagement

E-learning modules are a common component of orientation and other education initiatives, but their usefulness can be limited by poor engagement. This article presents the results of an experimental cohort study testing interventions designed to improve learner engagement with e-learning modules.

Effectiveness of transition programs on new graduate nurses' clinical competence, job satisfaction and perceptions of support: A mixed-methods study

AIM

To assess the effectiveness of two graduate nurse programs on new graduate nurses' overall competence at 3, 6, 9 and 12 months. Secondary aims were to assess new nurses' job satisfaction at 12 months and explore their experiences of support.

BACKGROUND

Most clinical settings have implemented transition programs to help new nurses to adapt to their new environments and expand their competences. To this day, very few studies have assessed the effectiveness of these programs.

DESIGN

Longitudinal mixed-methods study.

METHODS

The study was conducted at two teaching hospitals in Australia. New nurses were recruited during orientation. Data were collected at baseline (T0; n = 88), 3 (T1; n = 29), 6 (T2; n = 15), 9 (T3; n = 11) and 12 months (T4; n = 9). At each time point, the questionnaire included demographic and the Nurse Competence Scale. At T4, the questionnaire also included the Nurse Satisfaction Scale. Semi-structured interviews were conducted from T1 to T4. This study conforms to the STROBE guidelines.

RESULTS

Competence increased significantly at T1, with participants stating that they learned by "getting out" of student mode. At T2, despite no significant difference in competence, participants expressed they were more confident and in control, because they felt supported. Again, at T3, there was no significant increase in competence. Finally, at T4, competence increased significantly, with participants acknowledging that they still had a lot to learn.

CONCLUSION

This study supports that 12-month transition programs are necessary for NGNs to expand their competence. One major factor influencing NGNs during their first year was how well they felt supported and encouraged to seek help when they needed it.

RELEVANCE

There is a need to understand how new NGNs enrolled in transition programs expand their competences. Their professional development depends on a supportive environment where NGNs feel confident in asking questions or for help.

Evidence for continuing professional development standards for regulated health practitioners in Australia: a systematic review

BACKGROUND

Health practitioner regulators throughout the world use continuing professional development (CPD) standards to ensure that registrants maintain, improve and broaden their knowledge, expertise and competence. As the CPD standard for most regulated health professions in Australia are currently under review, it is timely that an appraisal of the evidence be undertaken.

METHODS

A systematic review was conducted using major databases (including MEDLINE, EMBASE, PsycInfo, and CINAHL), search engines and grey literature for evidence published between 2015 and April 2022. Publications included in the review were assessed against the relevant CASP checklist for quantitative studies and the McMaster University checklist for qualitative studies.

RESULTS

The search yielded 87 abstracts of which 37 full-text articles met the inclusion criteria. The evidence showed that mandatory CPD requirements are a strong motivational factor for their completion and improves practitioners' knowledge and behaviour. CPD that is more interactive is most effective and e-learning is as effective as face-to-face CPD. There is no direct evidence to suggest the optimal quantity of CPD, although there was some evidence that complex or infrequently used skills deteriorate between 4 months to a year after training, depending on the task.

CONCLUSIONS

CPD is most effective when it is interactive, uses a variety of methods and is delivered in a sequence involving multiple exposures over a period of time that is focused on outcomes considered important by practitioners. Although there is no optimal quantity of CPD, there is evidence that complex skills may require more frequent CPD.

Continuing professional development needs in pain management for Canadian health care professionals: A cross sectional survey

Background

Continuing professional development is an important means of improving access to effective patient care. Although pain content has increased significantly in prelicensure programs, little is known about how postlicensure health professionals advance or maintain competence in pain management.

Aims

The aim of this study was to investigate Canadian health professionals' continuing professional development needs, activities, and preferred modalities for pain management.

Methods

This study employed a cross-sectional self-report web survey.

Results

The survey response rate was 57% (230/400). Respondents were primarily nurses (48%), university educated (95%), employed in academic hospital settings (62%), and had ≥11 years postlicensure experience (70%). Most patients (>50%) cared for in an average week presented with pain. Compared to those working in nonacademic settings, clinicians in academic settings reported significantly higher acute pain assessment competence (mean 7.8/10 versus 6.9/10; P < 0.002) and greater access to pain specialist consultants (73% versus 29%; P < 0.0001). Chronic pain assessment competence was not different between groups. Top learning needs included neuropathic pain, musculoskeletal pain, and chronic pain. Recently completed and preferred learning modalities respectively were informal and work-based: reading journal articles (56%, 54%), online independent learning (44%, 53%), and attending hospital rounds (43%, 42%); 17% had not completed any pain learning activities in the past 12 months. Respondents employed in nonacademic settings and nonphysicians were more likely to use pocket cards, mobile apps, and e-mail summaries to improve pain management.

Conclusions

Canadian postlicensure health professionals require greater access to and participation in interactive and multimodal methods of continuing professional development to facilitate competency in evidence-based pain management.