An education intervention to improve nursing students' understanding of medication safety

The mediating role of pediatric nursing competence in the relationship between pediatric drug administration self-efficacy and medical error tendency in nursing students

AIM

This study was conducted to determine the mediating role of pediatric nursing competence in the relationship between self-efficacy in pediatric drug administration and medical error tendency in nursing students.

BACKGROUND

The self-efficacy of nursing students towards drug administration knowledge and practices is one of the determinants of achieving the goals of nursing education programs related to drug administration.

DESIGN

The sample of the descriptive and correlational study consisted of a total of 303 3rd and 4th-year students taking the Pediatric Health and Diseases Nursing course at the Department of Nursing. Data were collected using the Pediatric Nursing Competency Scale (PNCS), the Medication Administration Self-Efficacy Scale in Children for Nursing Students (MASSC) and the Medical Errors Tendency Scale (METS). Pearson correlation analysis, linear regression analysis, independent groups t-test, one-way analysis of variance (ANOVA) and post hoc (Tukey, LSD) test were used to analyze the data. In addition, hierarchical regression analyses regarding the mediation effect were performed using PROCESS Model 4 developed by Hayes (2013) for SPSS.

RESULTS

When the correlation levels between the total scores of MASSC, PNSC and METS were analyzed, a positive moderate correlation was found between PNSC and MASSC total scores, a positive weak correlation was found between METS and MASSC total scores and a positive weak correlation was found between METS and PNSC total scores (p<0.05). As a result of the analysis, the model was found to be significant and the total change in METS was explained by 17.3 % of the total change in METS (F=63.289;p=0.000). It was found that PNSC was a partial mediator variable between MASSC and METS.

CONCLUSION

As a result of the study, it was determined that pediatric nursing competence had a partial mediating role in the relationship between pediatric drug administration self-efficacy and medical error tendency in nursing students.

Pediatric nursing students' self-efficacy regarding medication administration and clinical comfort and worry: A pre-posttest comparative study of nurse mentoring versus peer mentoring

AIM

This study aimed to examine the effect of mentoring practice by graduate nursing students and clinical nurses on students' self-efficacy in pediatric medication administration, clinical comfort and worry levels of students taking pediatric nursing courses.

BACKGROUND

Children are a highly sensitive group against medication administration errors. Improving the self-efficacy of student nurses who will work with this group toward medication administration is essential. Mentoring programs can increase students' skills and self-efficacy by reducing their stress levels during clinical practice.

DESIGN

The research is a two-group pretest-posttest randomized controlled experimental research design.

SETTINGS

The study was conducted in the pediatric units of a training and research hospital located in the Western Black Sea region of Turkey between October 1, 2022 and December 30, 2022, as part of the clinical practice of the Pediatric Nursing course in the fall semester of 2022-2023.

PARTICIPANTS

The study sample consisted of 143 students (peer mentoring group=73, nurse mentoring group=70) who were 3rd-year students taking the pediatric nursing course.

METHODS

Participant information form, Medication Administration Self-Efficacy Scale in Children for Nursing Students (MASSCNS) and Pediatric Nursing Students Clinical Comfort and Worry Tool (PNSCCWT) were administered to the students before the clinical practice. Then, the groups received mentoring practice in the clinical practice area for 14 weeks. At the end of the practice, MASSCNS and PNSCCWT were administered to the students again.

RESULTS

The groups were homogeneously distributed when compared according to descriptive characteristics (p > 0.05). The self-efficacy scores of the students in both groups after clinical practice were significantly different from those before clinical practice (tnurse=-4.724, pnurse=0.000 <0.05; tpeer=-3.742, ppeer=0.001 <0.05).

CONCLUSIONS

This study's results indicate that nurse mentoring and peer mentoring effectively increase nursing students' self-efficacy during pediatric clinical practice. While nurse mentors decreased students' worry, peer mentors increased students' clinical comfort levels.

Understanding complexity in a safety critical setting: A systems approach to medication administration

'Medication errors' are a significant concern and are associated with a higher incidence of adverse events and unintentional patient harm than any other aspect of healthcare. While much research has focused on adverse medication errors, limited studies have specifically examined 'normal' medication delivery performance and the interactions between tasks, agents, and information within the medication administration system. This article describes a study that applied the Event Analysis of Systemic Teamwork (EAST) model to study the hospital medication administration system to identify opportunities to optimise performance and patient safety. Key findings of this study demonstrate that this is a highly complex system, comprising many social agents and a relatively closely linked series of tasks and information. However, most of the workload relies on a small proportion of healthcare professionals. Significantly, the patient has a minimal role in the medication administration system during their hospital stay. The research has shown that this approach enables mapping networks and their interdependencies to optimise the system as a whole rather than its parts in isolation.

Engaging Nursing Students in Quality Improvement: Teaching Safe Medication Administration

BACKGROUND

Safety and reduction of errors during medication administration is a prominent focus in nursing and nursing education. Developing simulated medication administration experiences that include opportunities for nursing students to manage interruptions in a realistic environment can help improved critical thinking and reasoning for safe administration practices.

METHOD

Sophomore nursing students voluntarily participated in a quality improvement project examining nursing management of interruptions during medication administration. Students observed medication administration activities for episodes of interruptions and conducted surveys in a real-time format that encouraged decision-making dialogue.

RESULTS

After the project, student learning outcomes included improved identification of interruptions, prioritization, critical reasoning skills, and development of management techniques for better safety.

CONCLUSION

Incorporating real-world experiences that allow nursing students to identify and manage interruptions during medication administration foster development of critical thinking and interruption management techniques. [J Nurs Educ. 2022;61(5):268-271.].

Nursing Student Medication Administration Practice in the Clinical Setting: A Descriptive Study

BACKGROUND

Nurses are instrumental in preventing medication errors that cause patient harm. Increased practice and educational interventions are suggested to prepare nursing students to safely administer medications. However, a quantified account of the reality of nursing student medication administration practice in the clinical setting is unknown.

METHOD

This cross-sectional descriptive study assessed the frequency and quality of nursing student medication administration practice in the clinical setting. A convenience sample of prelicensure nursing students (n = 222) completed an electronic Nursing Student Medication Administration Survey after each clinical day for one semester.

RESULTS

Overall, participants on average had one medication administration experience, administered two drugs, and administered medications to one patient. Most medication administration experiences were supervised by bedside RNs.

CONCLUSION

Medication administration opportunities in the clinical setting are unpredictable and vary by facility and nursing program policy. Further investigation is necessary. [J Nurs Educ. 2022;61(3):137-142.].

The Role of Education in Developing a Culture of Safety Through the Perceptions of Undergraduate Nursing Students: An Integrative Literature Review

OBJECTIVE

This integrative literature review seeks to examine research-based knowledge about the role of education in developing a culture of safety through the perspectives of undergraduate nursing students.

METHODS

An integrative literature review of nursing and health databases was conducted and literature from 2009 to 2018 were reviewed. Studies focusing on patient safety education in undergraduate nursing students were analyzed to identify the current state of safety education in academia. The results and findings from the articles reviewed were included in the final synthesis of the literature.

RESULTS

A total of 336 articles were identified from the onset and 14 were selected for inclusion in the review. There were 3 qualitative studies, 8 quantitative studies, and 3 mixed-methods research studies included. Four themes emerged: students perceive patient safety education is important, safety education in the curriculum is important, students are afraid to speak up, and students perceive a lack of knowledge and support for speaking up.

CONCLUSIONS

The results of this integrative literature review demonstrate that nursing education plays an integral role in creating a culture of safety among nursing students. Nursing students lack a strong understanding of their role in patient safety. This translates into a need for dedicated patient safety curriculum to establish a culture of safety in nursing education.

NurseVR: Development of a Serious Virtual Reality Game for Medication Preparation and Administration Training

The use of simulation for nursing education has several advantages. The present study aimed to develop and validate a serious virtual reality game for medication preparation and administration training. This is a methodological study in which a serious virtual reality game named NurseVR was developed and evaluated by teachers and students of a nursing course. In NurseVR, the player presents himself or herself in a simulated hospital environment to prepare and administer a medication. From then on, all the steps to be taken are the player's free choice according to what was learned in the classroom, making the game the closest to reality. High levels of positive agreement to statements concerning the validity of the game were found between students and teachers. The virtual immersion proposal was an innovative tool, and the validation results of the final version of NurseVR allow its use for nursing training.

Artificial Intelligence for Identifying the Prevention of Medication Incidents Causing Serious or Moderate Harm: An Analysis Using Incident Reporters' Views

The purpose of this study was to describe incident reporters’ views identified by artificial intelligence concerning the prevention of medication incidents that were assessed, causing serious or moderate harm to patients. The information identified the most important risk management areas in these medication incidents. This was a retrospective record review using medication-related incident reports from one university hospital in Finland between January 2017 and December 2019 (n = 3496). Of these, incidents that caused serious or moderate harm to patients (n = 137) were analysed using artificial intelligence. Artificial intelligence classified reporters’ views on preventing incidents under the following main categories: (1) treatment, (2) working, (3) practices, and (4) setting and multiple sub-categories. The following risk management areas were identified: (1) verification, documentation and up-to-date drug doses, drug lists and other medication information, (2) carefulness and accuracy in managing medications, (3) ensuring the flow of information and communication regarding medication information and safeguarding continuity of patient care, (4) availability, update and compliance with instructions and guidelines, (5) multi-professional cooperation, and (6) adequate human resources, competence and suitable workload. Artificial intelligence was found to be useful and effective to classifying text-based data, such as the free text of incident reports.

Nurses' perceptions toward factors that cause medication errors in Jordan: A qualitative study

AIMS

The aim of this study was to investigate nurses' experiences related to medication errors (MEs) from the perspective of Jordanian nurses. This article reports the findings concerning the factors that cause MEs from the perspectives of Jordanian nurses.

BACKGROUND

MEs are critical issues facing healthcare providers and health institutions. Most of the studies on MEs were conducted in Western countries. However, there is little research that seeks to understand this issue in the developing countries and Jordan is one of these countries.

DESIGN

A qualitative descriptive approach was used in three hospitals in different clinical settings in Jordan.

METHODS

Individual semi-structured face-to-face interviews were conducted with 24 nurses.

RESULTS

The data that emerged from the interviews was arranged and contextualized in two major themes, individual and systemic factors, that explained the main causes of MEs. From the individual side, lack of knowledge and experience ranked as the highest concerns, and from the systematic side workload was the most important factor.

CONCLUSION

This study provides an opportunity for stakeholders and Jordanian managers to increase their awareness of these factors and address them in the future, thereby increasing the level of care provided in their health organizations.

Validation of the attitudes to patient safety questionnaire for nursing students in the Spanish context

Background

There are different instruments to assess the attitudes of nursing students towards patient safety. However, no questionnaire validated in Spanish with this objective was identified. The objective of this study was to validate the Attitudes to Patient Safety (APS) questionnaire for nursing students in Spain and to study the attitudes towards patient safety of nursing students at the Universitat Jaume I (Spain).

Design

Cross-sectional psychometric study developed in a sample of 177 undergraduate nursing students. The study was carried out in the second semester of 2016.

Methods

First, a nominal group was created to perform cross-cultural adaptation and determine content validity of the Attitude to Patient Safety Questionnaire (APQS-III). Second, a cross-sectional study was conducted to determine the psychometric properties of the questionnaire and to study nursing student attitudes towards patient safety.

Results

Exploratory factorial analysis explained 53.82 % of the variance, with good internal consistency (α = 0.808), and confirmatory factor analysis indicate an adequate fit between the model and the data (χ2 = 366; p < 0.001; χ2/df = 1.886; RMSEA = 0.07; IC95 %=0.059–0.081; CFI = 0.885). Intra-observer reliability was good (ICC = 0.792, p < 0.001). The mean overall score of the questionnaire was 3.92 (95 % CI = 3.88–4.03). Significant differences were observed regarding whether the students had completed a clinical practicum (p = 0.012) and the academic year (p = 0.25).

Conclusions

The psychometric properties of the APS questionnaire adapted for Spanish nursing students are adequate. Students show an adequate attitude towards patient safety; however, it is necessary to develop a strategy to guarantee the acquisition of competency for patient safety as well as to design and evaluate specific educational interventions.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12912-021-00634-y.

The impact of online synchronous simulated clinical immersions on nursing students' pharmacology self-efficacy: A pre-test post-test intervention pilot study

BACKGROUND

Medication errors are fatally significant, posing considerable threats to patient safety. To date, there is a lack of literature and no consistent recommended nursing pharmacology curriculum design to improve nursing students' pharmacology self-efficacy.

PURPOSE

The purpose of this pilot study is to examine the effects of nursing pharmacology synchronous online scrabbling active learning classroom design with simulated clinical immersion experiences on the students' self-efficacy and perceived pharmacology knowledge acquisition.

METHODS

A pretest-posttest intervention design was used with a convenience sample of (n = 34) accelerated nursing students. The intervention included an online synchronous scrabbling active learning classroom design with simulated clinical immersion experiences for eight weeks. The Motivated Strategies for Learning Self-Efficacy Subscale (MSLQ-SE) questionnaire was applied before and after the intervention. The Survey for Knowledge Acquisition and Application (SKAA) was used post-intervention. The students also provided narrative, open-ended responses regarding their perceptions of the synchronous simulated clinical experiences.

RESULTS

The results of the simulated clinical immersions presented an improvement in self-efficacy scores. A one tailed paired t-test presented a significant increase from MSLQ-SE pre-test scores (M = 31.2, SD = 4.8) to MSLQ-SE post-test scores (M = 32.9, SD = 4.3); (t(33) = -2.1, p = .02). The SKAA results presented that the students perceived that simulated clinical immersions were promoting authentic learning and confidence.

CONCLUSION

The finding of this study is significant to nursing pharmacology education. The online synchronous simulated clinical immersion experiences improved overall self-efficacy scores and provide an authentic teaching approach to connect pharmacology theory to the clinical practice.

Psychometric design and validation of a tool to assess the medication administration process through simulation in undergraduate nursing students

BACKGROUND

Medication errors account for 38% of adverse events reported among undergraduate nursing students. Simulation provides training for nursing students in the medication administration process. However, there is a lack of reliable and valid instruments to measure its assessment.

OBJECTIVES

To design and validate a new tool (MEDICORRECT) to assess undergraduate nursing students in the medication administration process using a high-fidelity simulation scenario.

DESIGN AND METHODS

Study participants were fourth year undergraduate nursing students at the University of Barcelona. Phase 1 consisted of tool design and drafting, and content validity and feasibility analyses. Phase 2 covered construct validity and interrater reliability. A factor analysis was conducted, involving a principal component analysis and varimax rotation.

FINDINGS

Of 21 initial items, 11 were eliminated because of low content validity ratio, 4 of which assessed cognitive skills such as administering the right medicine at the right dose, which were impossible to observe in the simulation scenario. The final version of MEDICORRECT contained 10 items. The exploratory factor analysis identified a four-factorial model explaining 67.3% of the variance. Interrater agreement measured with Kappa was greater than 0.70 for 80% of items.

CONCLUSIONS

The 10 items in MEDICORRECT are relevant and feasible, have suitable psychometric properties and reflect the practical skills identified in the medication administration process. The tool excludes cognitive skills, which should be included and assessed during prebriefing.

Attitudes of Undergraduate Nursing Students towards Patient Safety: A Quasi-Experimental Study

Improving nursing students' attitudes towards patient safety is a current and relevant topic. This study aims to evaluate the effectiveness of an educational intervention based on critical incident and root cause analysis (RCA) techniques regarding attitudes towards patient safety in nursing students. A quasi-experimental before and after study was developed between January 2018 and December 2019 in a sample of 100 nursing students at Universitat Jaume I (Spain). The intervention was developed in two phases. Phase I was at university, where students applied the RCA technique in a real case. Phase II took place during clinical practice. Students used critical incidents to identify a risk situation for the patients and applied RCA to detect its root causes. The measurement of attitudes was performed with the Attitudes to Patient Safety Questionnaire (APSQ-III). The global score of the questionnaire in the baseline measurement was 3.911 (±0.335), in the intermediate measurement it was 4.031 (±0.337) and in the final measurement it was 4.052 (±0.335), with significant differences (p = 0.03). However, intra-group differences were observed in the final measurement (p = 0.021). The teamwork dimension had the highest mean score on all three measures and the notification dimension had the lowest mean scores. An educational intervention combining critical incident and RCA techniques can improves nursing students' attitudes toward patient safety.

PRN Medicines Optimization and Nurse Education

Medicines management is a high-risk and error prone process in healthcare settings, where nurses play an important role to preserve patient safety. In order to create a safe healthcare environment, nurses should recognize challenges that they face in this process, understand factors leading to medication errors, identify errors and systematically address them to prevent their future occurrence. ''Pro re nata'' (PRN, as needed) medicine administration is a relatively neglected area of medicines management in nursing practice, yet has a high potential for medication errors. Currently, the international literature indicates a lack of knowledge of both the competencies required for PRN medicines management and the optimum educational strategies to prepare students for PRN medicines management. To address this deficiency in the literature, the authors have presented a discussion on nurses' roles in medication safety and the significance and purpose of PRN medications, and suggest a model for preparing nursing students in safe PRN medicines management. The discussion takes into account patient participation and nurse competencies required to safeguard PRN medication practice, providing a background for further research on how to improve the safety of PRN medicines management in clinical practice.

Contextualising numeracy skill development and assessment in a first year undergraduate nursing subject: A mixed methods research study

BACKGROUND

Undergraduate nursing students continue to perform poorly on clinically-related numeracy tasks, making errors that betray fundamental misconceptions about the underlying mathematics. Graduate nurses are also prone to error in this area but they have the benefit of performing their calculations in a real-world setting with the assistance of colleague nurses if required. These conditions are difficult to simulate in a classroom environment, but when effort is made in this direction the effects can be rewarding for students and educators.

OBJECTIVES

To investigate the effect on undergraduate nursing students' learning experience and test performance of a practical, clinically contextualised numeracy workshop featuring individual and collaborative modes of assessment.

DESIGN

A mixed methods study using pre and post tests and a survey.

SETTINGS

Clinical practice classrooms at an Australian university.

PARTICIPANTS

First year undergraduate nursing students undertaking a subject whose curriculum features medication safety and clinically-related numeracy.

METHODS

Administration of individual and collaborative short-answer pre and post tests, a survey, and facilitation of team-based, clinically-related numeracy activities over a 1.5 h workshop. All test marking, data collection and analysis were performed by the authors.

RESULTS

Positive responses to survey questions probing students' judgement of the effect of contextualised learning on their confidence, engagement and proficiency in nursing numeracy, as well as the value of working in a clinical setting. Significant improvement in students' performance in pre/post tests.

CONCLUSIONS

Contextualised, practical and collaborative learning and assessment of nursing numeracy is valued by students and has a positive effect on their experience and performance in the content area.

Development of a Medication Safety Science Curriculum for Nursing Students

BACKGROUND

Medication errors, now thought to be 4 times greater than previous estimates, harm patients, families, health care institutions, and nurses themselves, who are second victims of their mistakes.

PROBLEM

Current nursing education may lack coherent medication safety frameworks other than the classic Five Rights construct.

APPROACH

This project piloted an educational intervention with senior associate degree nursing students based on high-reliability organization (HRO) safety principles.

OUTCOMES

Subjects evaluated the HRO safety concepts learning experience positively and improved pretest to posttest scores by 74%.

CONCLUSIONS

This study demonstrates subjects' ready acceptance and comprehension of HRO safety theory as applied to medication safety, an alternative to the Five Rights construct.

First year undergraduate nursing students' perceptions of the effectiveness of blended learning approaches for nursing numeracy

The ability to safely calculate and administer medications are indispensable, core nursing skills in nursing education and practice. Therefore, it is imperative that nursing students are adequately prepared with the necessary numeracy skills during their undergraduate nursing studies. The focus of this study, conducted at a single multi-campus university in the western Sydney region of Australia, was to determine the effectiveness of a suite of blended learning approaches on numeracy self-efficacy from the students' perspective. Surveys were administered as part of the study and included open-ended questions. 525 students provided open-ended responses that were analysed by the research team. Four main themes were identified from the open-ended responses: (i) Self-realisation; (ii) Practice, practice, practice; (iii) Boosting confidence; and (iv) Wanting more. The themes captured students' perceptions of the benefits of having a rigorous learning design in blended learning approaches. The study showed that a structured pedagogical approach to nursing numeracy in undergraduate programs improved students' self-reported self-efficacy with mathematics and assisted students in realising the importance of learning and applying these skills as nursing clinicians.

Characterization of adverse events occurring during nursing clinical rotations: A descriptive study

INTRODUCTION

Patient safety is a pillar of quality health care. Nursing students may commit errors during clinical practice, compromising patient safety.

OBJECTIVE

Analyze the adverse events, as well as the factors associated with the errors, reported by students from a private university in Santiago, Chile during nursing clinical rotations.

METHODS

Quantitative cross-sectional descriptive study. A total of 68 errors by first- through fifth-year nursing students were reported between 2012 and 2018. The data collection instrument was the Adverse Events Notification Form from the School of Nursing. This form documented information about the study as well as about the event.

RESULTS

After this reporting system was established in 2012, the number of events reported increased steadily each year. The greatest numbers of reported errors were committed by fifth-year students (73.5%), and the most common type of error was associated with medication administration (94.2%), including incorrect dose (27.9%) and incorrect medication (17.6%). The major factors contributing to errors were failure to review the "10 rights of medication administration" (85.3%) or lack of critical judgment (7.4%). Most of the errors occurred in public institutions (72.1%).

CONCLUSION

The results suggest that it would be beneficial to re-evaluate how safety and quality of care are taught at the school of nursing, with an emphasis on understanding the learning styles of students and teaching strategies of instructors. It is crucial that the academic institution remain actively involved in teaching safety-related skills to future nursing professionals. Furthermore, we suggest modifications to the adverse events reporting system that would avoid the need for personal interpretations of the event by the student.

Medication error encouragement training: A quasi-experimental study

BACKGROUND

Medication errors are the most common clinical errors in healthcare practice and can lead to serious consequences. Medication error encouragement training (MEET) brings students face-to-face with potential errors in the medication process, in a safe environment where they are encouraged to understand both the error and the context in which it occurred.

OBJECTIVES

The study aimed to examine the effects of a MEET intervention on medication safety confidence among nursing undergraduates.

DESIGN

This was a quasi-experimental study with a nonequivalent control group design.

PARTICIPANTS

Our sample was recruited from the nursing education department of a university, with 47 participants randomly assigned to the experimental group, and 50 to the control group.

METHODS

Both groups received theoretical training, followed by applied training. The experimental group received the MEET intervention developed specifically for this study, while the control group received traditional error avoidance training. Participants' medication administration confidence was measured pre- and post-intervention.

RESULTS

Following training, the experimental group's confidence was significantly higher than that of the control group. With regard to individual medication administration procedures, the experimental groups' medication safety confidence increased significantly after training compared to the control group in patient identification, drug information confirmation, and drug preparation.

CONCLUSIONS

Introducing MEET into nursing curricula could reduce medication errors and related complications in healthcare institutions. Further studies are needed to investigate the long-term effects of MEET interventions, as well as the generalizability of our findings.

Evaluation of Swedish nursing students' experience of a web-based platform for drug calculation

Safe drug calculation is important in nursing as insufficient skills pose a risk to patient safety. Therefor solid education in mathematics for undergraduate nursing students must be provided. To support nursing students' skills in drug calculation, a web-based learning platform for drug calculation was created. The aim of this study was to investigate nursing students' experiences of a web-based learning platform for drug calculation in terms of usability and learning support. The study was a cross-sectional comparative study. Ninety-five nursing students participated, out of which 46 students were in semester one and 49 students were in semester six. A questionnaire was used to evaluate the nursing students' experiences of a web-based learning platform for drug calculation in terms of usability and learning support. The findings were informed by statistical and thematic analyses. The majority of the participants evaluated the platform positively. The platform was deemed useful, and it was a support for the nursing students' learning. These findings provide that a web-based learning platform for drug calculation can be used as a complement to traditional lectures. Nevertheless, further research is required focusing teaching strategies facilitating different learning styles and level of computer skills.

Literature review of audiovisual practices in Nursing education

ABSTRACT Objective: to carry out a literature review to characterize the production in the Nursing area about the use of movies and videos in Nursing education, related to underlying communication assumptions and contents taught. Method: integrative bibliographic review carried out in the PUBMED databases, CAPES journal portal, and SCIELO online library, with studies from 2007 to 2016. Results: 36 articles were included, in which audiovisual resources are part of the research subject. There are predominance of validation and effectiveness studies, in which audiovisual resources are used mostly as a reproduction of reality, mainly to develop clinical skills, with the purpose of illustrating procedures or bringing students closer to real contexts of action. Final considerations: the results point to a weak theoretical support of most of the studies. It is suggested that more empirical research be conducted to offer more consistent contributions to Nursing teaching.

Nursing students' errors in clinical learning. Qualitative outcomes in Mixed Methods Research

ABSTRACT Objective: to analyze factors associated with nursing students' errors during clinical learning, and their perceptions regarding these events and the opportunity for learning and development provided by them. Method: Convergent Mixed Method design according Creswell and Clark. Qualitative dimension included face to face and internet interviews. Data analysis followed Miles and Huberman method. Results: Nursing student's errors were revealed according to their perceptions. They occurred in all phases of the nursing process and in transversal skills. Errors were acknowledged as learning and developmental opportunities. Final considerations: Students acknowledged their errors and ascribe to themselves reasons and what could have prevented what happened. Mixed Method was a very adequate design to study phenomena. Qualitative dimension was essential to reveal and achieve the objectives. Suggestions founded on the findings are presented.

Contemporary issues: The pre-licensure nursing student and medication errors

In Modern health care, the creation of cultures of safety for patients is of the upmost importance. Impacting the institutional stabilization of health care facilities safety initiatives, is the preparation of pre-licensure nursing students to safely administer medications to patients. Therefore, preparation of the pre-licensure nursing student must be evidence-based practice focused and incorporate innovative ways to reduce the potential for medication errors.

Factors affecting nursing students' intention to report medication errors: An application of the theory of planned behavior

BACKGROUND

Medication errors are common among nursing students. Nonetheless, these errors are often underreported.

OBJECTIVES

To examine factors related to nursing students' intention to report medication errors, using the Theory of Planned Behavior, and to examine whether the theory is useful in predicting students' intention to report errors.

DESIGN

This study has a descriptive cross-sectional design.

SETTINGS

Study population was recruited in a university and a large nursing school in central and northern Israel.

PARTICIPANTS

A convenience sample of 250 nursing students took part in the study.

METHODS

The students completed a self-report questionnaire, based on the Theory of Planned Behavior.

RESULTS

The findings indicate that students' intention to report medication errors was high. The Theory of Planned Behavior constructs explained 38% of variance in students' intention to report medication errors. The constructs of behavioral beliefs, subjective norms, and perceived behavioral control were found as affecting this intention, while the most significant factor was behavioral beliefs. The findings also reveal that students' fear of the reaction to disclosure of the error from superiors and colleagues may impede them from reporting the error.

CONCLUSIONS

Understanding factors related to reporting medication errors is crucial to designing interventions that foster error reporting.

Problem-Based Learning for Didactic Presentation to Baccalaureate Nursing Students

Nursing judgment is an essential component in the delivery of safe, quality patient care. Nurses must have the knowledge and skills to question authority, make judgments, substantiate evidence, and advocate for the patient. Traditional pedagogy in content-laden courses remains primarily lecture based. Incorporating active strategies to strengthen professional practice is essential. A pilot study assessed senior baccalaureate nursing students' perceptions of problem-based learning (PBL) and their readiness for self-directed learning. In addition, the authors analyzed the relationship between readiness for self-directed learning and course content mastery using PBL. Students completed the Self-directed Learning Readiness Scale, the Problem-Based Learning Environment Inventory, and course content mastery exams. Students reported positive experiences with PBL and readiness for self-directed learning. Readiness for self-directed learning and 2 of 5 exam scores were inversely, significantly related. Students' perceptions of their readiness for self-directed learning did not always correspond with course content mastery. Specifically, some students who perceived themselves as ready for self-directed learning did not perform well on course content exams. This inverse relationship has not been reported by other researchers and brings an interesting perspective to student perceptions and actual performance. Four themes emerged from students' narrative responses: Prepared Me for Real Life Professional Situations, Stimulated My Critical Thinking, Promoted Independent Problem Solving, and Supported Learning Retention. PBL as a pedagogical approach provides opportunities for nursing students to explore their professional independence while attempting to master content.

Reducing medication errors: Teaching strategies that increase nursing students' awareness of medication errors and their prevention

Medication errors are a patient safety and quality of care issue. There is evidence to suggest many undergraduate nursing curricula do not adequately educate students about the factors that contribute to medication errors and possible strategies to prevent them. We designed and developed a suite of teaching strategies that raise students' awareness of medication error producing situations and their prevention.

Surveying the experiences and perceptions of undergraduate nursing students of a flipped classroom approach to increase understanding of drug science and its application to clinical practice

Patient harm from medication error is a significant issue. Individual failures by health professionals including knowledge deficits and poor communication have been identified as increasing the likelihood of medication administration errors. In Australia, the National Strategy for Quality Use of Medicines in 2002 compels health professionals to have the knowledge and skills to use medicines safely and effectively. This paper examines nursing students' perceptions of the effectiveness of a flipped classroom approach to increase understanding of pharmacology principles and the application of this knowledge to medication practice. An internet-based self-completion questionnaire was used in 2013 (n = 26) after the flipped classroom approach was implemented, and pre- (n = 6) and post-flipping (n = 25) in 2014. Students who engaged with digitally recorded lectures (eLectures) prior to face-to-face workshops stated that they had greater understanding of the subject and enhanced critical thinking skills. The replay function of the eLecture was perceived by some students as most beneficial to independent learning. However, for some students, time constraints meant that they relied on eLectures alone, while others preferred traditional teaching methods. Although limited by sample size and potential participant bias, the results provide insights about the flipped classroom experience from a student perspective.