Factors developing nursing students and novice nurses' ability to provide care in acute situations

Challenge or threat? A Q-methodological study into nursing students' perceptions on learning to collaborate under stress

INTRODUCTION

Nursing students will come across stressful situations during their internships and will continue to do so in future practice. Because of the impact stress can have on performance, nursing students need to be equipped to work and collaborate in such situations. Careful consideration of the needs and desires of nursing students should be taken in account, in order to create a training environment that fosters students' ability to learn to collaborate under stress.

AIM

The aim of this study is to identify viewpoints of undergraduate nursing students towards the learning of collaboration in stressful situations, to understand their needs and desires, and to improve educational designs for training to collaborate in stressful situations.

METHODS

We conducted a Q-methodology study, a mixed methods approach that studies and charts subjectivity, and uses a by-person factor analytical procedure to create profiles of shared viewpoints. The process of our Q-study is based on the following five steps: Q-set development (54 statements), participant selection (n = 29), Q-sorting procedure, data analysis, and factor interpretation.

RESULTS

Q-factor analysis resulted in two prevailing factors that answer our research question. Twenty-five students loaded on these two factors, and factor interpretation resulted in Profile 1 "Practice makes perfect, so let's do it" and Profile 2 "Practice is needed, but it scares me". Whereas Profile 1 regarded learning to collaborate in stress mainly as a challenge, Profile 2 appeared anxious despite feeling the necessity to learn this. An overarching consensus factor revealed the importance of a learning environment in which mistakes can be made.

DISCUSSION

The two described profiles align with the biopsychosocial model of challenge and threat, and could help to recognize and address the individual needs of nursing students when learning to collaborate in stressful situations. Incorporating these profiles in training may guide students towards a more challenge-like appraisal of stressful situations.

Factors Associated With Junior Nurses Ability to Recognise and Respond to Clinical Deterioration: A Cross-Sectional Study in Tertiary Hospitals in Malawi

RATIONALE

Recognising and responding swiftly to patient deterioration is critical for preventing adverse events. Junior nurses play a vital role in identifying the signs of clinical deterioration and initiating interventions. No prior studies have assessed junior nurses' abilities to manage clinical deterioration in Malawi.

OBJECTIVES

This study aimed to assess junior nurses' ability to recognise and respond to clinical deterioration in Malawian tertiary hospitals and identify associated factors.

METHODS

The institutional based cross-section study design was used which included 322 junior nurses across all departments of four tertiary hospitals in Malawi (November-December 2023). Data collection utilised a questionnaire for clinical deterioration recognition and response ability in junior nurses. Chi-square, Fisher's exact, and logistic regression tests were used for data analysis.

FINDINGS

Junior nurses achieved a median score of 71 with an interquartile range of 68-75 on the clinical deterioration questionnaire. According to the study, nurses with more work experience, those who worked in intensive care units, and those who participated in discussions about clinical deterioration had better scores. In contrast, nurses with less than 1 year of experience were 5.5 times more likely to struggle with recognising and responding to clinical deterioration than those with 5 years of experience (OR: 5.506, p = 007). Additionally, working in the paediatric department decreased junior nurses' ability to recognise and respond to clinical deterioration six times compared to working in the intensive care unit (OR: 6.068, p = 0.018). Furthermore, junior nurses who had never engaged in discussions related to clinical deterioration had a seven times higher likelihood of poor ability to recognise and respond to clinical deterioration (OR = 6.954, p = 0.005).

CONCLUSION

This study highlights the need for specialised training programmes related to clinical deterioration that incorporate active learning, such as clinical scenarios and practical applications, along with mentorship initiatives to enhance junior nurses' skills and confidence in recognising and responding to clinical deterioration.

Development and psychometric testing of the modeling scale for novice nurses: a cross-sectional survey design

BACKGROUND

Modeling is the learning of new patterns of behavior by observers through observation. In order for novice nurses to learn effectively in a busy, multi-tasking clinical environment, they need a learning strategy that is integrated into their daily work. Modeling is a necessary learning strategy for nurses because they learn skills, knowledge, and attitudes by observing senior nurses in action. In nursing, it is important to learn skills, knowledge, and attitudes by observing the behavior of senior colleagues. However, previous studies have shown that there are situations in which modeling is not done smoothly. Therefore, in this study, we decided to develop a modeling self-assessment scale to assist novice nurses in modeling.

METHODS

1,457 novice nurses from a random sample of 103 hospitals in Japan were selected, of which 337 novice nurses were surveyed from November 2019 to January 2020 by anonymous questionnaire. The questionnaire consisted of the draft Modeling Scale for Novice Nurses, The Scale Measuring a Sense of Generalized Self-Efficacy and a simplified version of the Scale of Self-Regulated Learning Strategy for Nurses for review of criteria-related relevance to the Modeling Scale for Novice Nurses, and personal background. Factor analysis was used for analysis, and correlation coefficients were calculated for criterion-related validity. For stability, the number of intraclass correlation coefficients were calculated for consenting subjects by retesting method 3 weeks after their responses.

RESULTS

The demographics of the participants were 316 women and 21 men, with a mean age of 22.7 ± 1.8 years. Item and factor analyses yielded 21 items with four subscales. Cronbach's α coefficient for the 21 items was 0.930. The correlation coefficients for the Modeling Scale for Novice Nurses and the Scale of Self-Regulated Learning Strategy for Nurses ranged from 0.266 to 0.480. In the retest method, the intraclass correlation coefficient ranged from 0.771 to 0.786.

CONCLUSIONS

The Modeling Scale for Novice Nurses can be used to obtain novice nurses' self-assessment of modeling and to assist novice nurses in modeling smoothly.

Perception of novice nurses in an emergency box: A qualitative approach to their experiences and needs

BACKGROUND

Nurses play an essential role in the care of emergency hospital patients, being the ones who have the most contact with the patient and the first to be able to detect their imminent deterioration. However, the literature shows the impact that this can have in terms of stress and insecurity among new nurses, with the consequent risk of resignation in the institution and in their learning process.

AIMS

To explore the process of incorporation of new nurses in the emergency room, as well as to identify and understand their emotions, difficulties, needs and proposals for improvement.

METHODS

Qualitative research aimed at emergency room nurses in a tertiary level university hospital in Catalonia, between April 2022 and March 2023. Twelve semi-structured interviews were conducted with content analysis.

RESULTS

Four categories emerged: identification of deficiencies, emotional dimension, competencies of the expert nursing professional, and needs and proposals for improvement, as main themes.

CONCLUSIONS

Insufficient training and deficit of interdisciplinary communication skills appear as main stressors. The analysis of the results suggests the need to create an intervention program that protects the mental and emotional health of new nurses and ensures the integrity of their patients. Innovative and multimodal training adapted to generational change is called for, with virtual, immersive, and contextualized simulation scenarios, together with the implementation of tools such as debriefing and nursing clinical sessions.

Improving recognition of early clinical decline: Determining reliability and validity of the Garvey clinical warning curves

BACKGROUND

New graduate nurses have difficulty recognizing and managing the early signs of clinical decline, resulting in a Failure to Rescue (FTR) event and preventable patient death. To address this gap, Garvey developed a series of Clinical Warning Curves as an instructional tool for new graduate nurses in an academic medical center. The Garvey Clinical Warning Curve models depict the progression of clinical changes in six body systems that occur before cardiac arrest.

AIMS

The purpose of this study was to establish the content validity, reliability, and usability of the Garvey Clinical Warning Curves among healthcare experts and new-graduate nurses.

METHODS

The current study was a cross-sectional, observational, validation survey design. Content experts used the content validity index (CVI) to evaluate the Curves.

RESULTS

All but the temperature curves were rated as "acceptable" (CVI >0.60) for relevance, clarity, and ambiguity. The new graduate nurses who reviewed the case studies and placed patients onto the Clinical Warning Curves did so similarly, generating high intraclass correlation (ICC) scores. The usability survey components measured the perceptions of acceptability, appropriateness, and feasibility for the use of the six Clinical Warning Curves in practice settings. All components of the Curves had an average score of 4.0 or greater except for the level of complexity which scored 3.88.

LINKING EVIDENCE TO ACTION

The Garvey Clinical Warning Curves emerged as valid and reliable tools that aid new graduate nurses in recognizing subtle signs of clinical decline. Because timely recognition and communication of clinical decline are key to preventing FTR events and avoiding patient deaths, it would be beneficial to provide the Clinical Warning Curves as a bedside resource for new graduate nurses during their orientation to the unit or within a nurse residency program.

Nursing Students' Perception of Just Culture and Development of Self-Confidence With Clinical Judgment: A Scoping Review

AIM

The aim of this study was to determine what is currently known about just culture's impact on nursing students' development of self-confidence with clinical judgment.

BACKGROUND

Graduates of nursing programs must execute sound nursing judgment to provide safe client care.

METHOD

The Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) guided the scoping review. The review elicited 1,411 sources and included 18 data sources.

RESULTS

Just culture was found to provide elements of trust, fairness, and psychological safety needed by nursing students to be self-confident in learning and executing clinical judgments that promote client safety.

CONCLUSION

Just culture promotes client safety in nursing education. Limited information exists on just culture's influence on student self-confidence with clinical judgment; more research is therefore required.

A cognitive task analysis of final year nursing students' situation awareness in simulated deteriorating patient events: A mixed methods study

AIM

The aim of this study was to: (1) use cognitive task analysis to describe final year nursing students situation awareness in recognising, responding and escalating care of deteriorating patients in ward settings; and (2) make recommendations for training and practice.

DESIGN

A mixed methods cognitive task analysis with a convergent triangulation design.

METHOD

Data collection involved observations of 33 final year nursing students in simulated deteriorating patient scenarios and retrospective cognitive interviews. A process tracing technique was applied to identify the cues to deterioration participants perceived; how cue perception altered as situational demands increased; the extent that participants made connections between perceived cues and reached a situational understanding; and the factors that influenced and constrained participants situation awareness. Qualitative and quantitative findings are woven together and presented using descriptive statistics, illustrative quotations and timeline extractions.

RESULTS

The median cue perception was 65.4% and 57.6% in the medical and surgical scenarios, respectively. Perception was negatively influenced by incomplete vital sign monitoring as situations escalated; limited physical assessments; passive scanning behaviours; poor task automaticity; and excessive cognitive demands. Incomplete perception, poor cue integration and underdeveloped mental models influenced situational understanding. Escalation calls did not always accurately reflect situations and a reporting mindset was evident. Clinical exposure to deteriorating patients was described as variable and opportunistic.

REPORTING METHOD

The study is reported in accordance with the Good Reporting of a Mixed Methods Study (GRAMMS) checklist.

PATIENT OR PUBLIC CONTRIBUTION

Patients and public were not involved in this research.

Translation and validation of the Persian version of the perception to care in acute situations (PCAS-P) scale in novice nurses

BACKGROUND

Novice nurses providing care in acute conditions should have satisfactory performance. Accurate and appropriate evaluation of the performance of novice nurses in providing care in acute situations is essential for planning interventions to improve the quality of patient care. This study was conducted to translate and evaluate the psychometric properties of the Persian version of the Perception to Care in Acute Situations (PCAS-P) scale in novice nurses.

METHODS

In this methodological study, 236 novice nurses were selected by the convenience sampling method. 17-item scale PCAS-P was translated into Persian by the forward-backward process. Then, this version was used for psychometric evaluation. For this purpose, face validity, content validity, and construct validity were assessed using confirmatory factor analysis. Internal consistency and stability reliability were calculated. The data were analyzed using SPSS and AMOS software.

RESULTS

The PCAS-P scale maintained the meaning of the original English version and was clear, explicit, and understandable for novice nurses. Confirmatory factor analysis showed that this Persian version is consistent with the proposed model and confirmed the fit of the three-factor model. The values of Cronbach's alpha coefficient, McDonald's omega, Coefficient H, and average inter-item correlation were excellent for the overall scale and its dimensions, and the three latent factors had good convergent and discriminant validity. Additionally, the average measurement size was 0.944 ICC (95% CI 0.909 to 0.969).

CONCLUSION

The PCAS-P scale is valid and reliable for measuring novice nurses' perception of acute situations.

Exploring the Frameworks, Needs, and Barriers of Interprofessional Education and Simulation in Emergency Medicine

SUMMARY STATEMENT

This manuscript focuses on interprofessional education (IPE) using simulation and its use between emergency department and emergency medical services personnel. It explores the theoretical frameworks behind IPE and applies them to simulation-based emergency medical services education. There is a notable lack of research on the use of IPE using simulation between these 2 professions. The need for IPE using simulation as well as barriers and recommendations to remove the barriers are discussed.

Early Prelicensure Nursing Students' Perceptions of Case Studies Through the Lens of the Clinical Judgment Measurement Model

BACKGROUND

Research indicates new nursing graduates struggle with clinical reasoning, despite some related skill development throughout their education. The question remains, "Could an earlier focus on clinical reasoning in nursing programs enhance nursing students' clinical reasoning?"

PURPOSE

This pilot study investigated how first-semester nursing students perceive the use of case studies in clinical reasoning skill development and the perceived benefits of case studies related to the NCSBN Clinical Judgment Measurement Model (NCJMM).

METHODS

Case studies and written reflections were introduced to a convenience sample (n = 45) of first-semester nursing students. Qualitative analysis was conducted on written reflections.

RESULTS

Students found case studies enhanced their knowledge and prepared them for clinical practice as a nurse.

CONCLUSIONS

Findings suggest early introduction of case studies is a meaningful teaching strategy to develop clinical reasoning aligned with the NCJMM.

When caring becomes an art - how clinical gaze are perceived to be developed

PURPOSE

This qualitative study describes nurses' experiences and perceptions of how they develop the clinical gaze.

METHODS

This qualitative study used an inductive approach and content analysis to assess the experiences of newly graduated nurses, nurse managers, and nursing teachers. Nineteen interviews were conducted. To achieve credibility, the study followed the guidelines of the Consolidated Criteria for Reporting Qualitative research (COREQ).

RESULTS

Two themes emerged: nurses' personal abilities and the learning culture. Learning culture was considered the foundation of the development of the clinical gaze. The clinical gaze was found to be developed in relationships with patients and when learning together with colleagues, in which the opportunities for reflection are central. To develop the clinical gaze, structures for learning activities, such as reflection, communication exercises, and simulation, are needed so that they become a natural part of daily work. This can also be achieved through supervision and skills training both at university and in a care context.

CONCLUSIONS

Prerequisites for the development of the clinical gaze include physical presence with the patient combined with learning activities such as conscious reflection with others in a safe learning culture.

Collaborative and Interprofessional Educational Program to Maintain Trauma-Focused Education During the COVID-19 Pandemic

Failure to rescue is prevalent among patients with traumatic injury who are admitted to medical-surgical units. These units are traditionally staffed by new graduate nurses who require mentorship and ongoing continuing education. The coronavirus disease 2019 (COVID-19) pandemic prompted nurse educators to develop and implement new methods of providing routine and just-in-time education in the hospital setting. This article describes a trauma-focused educational program with live sessions and online educational activities created with survey software. [J Contin Educ Nurs. 2023;54(6):275-280.].

Influence of workplace stress and social support on humanistic caring ability in Chinese nurses

AIM

This study aimed to examine the relationships between how workplace stress and social support affect the level of humanistic caring ability in Chinese nurses.

DESIGN

A cross-sectional study.

METHODS

The sample consists of 675 nurses working in major hospitals in China. Participants completed a set of self-reported measures, including the humanistic caring ability scale (HCAS), the Chinese nurse workplace stressor scale (CNWSS), the Chinese nurse stress response scale (CNSRS), and the Chinese nurse social support scale (CNSSS). Pearson's correlation analysis and structural equation modelling (SEM) were performed to investigate the relationships among studied variables.

RESULTS

The result showed that HCAS was negatively correlated with CNWSS (r = -0.427, p < 0.01) and CNSRS (r = -0.480, p < 0.01), and was positively correlated with CNSSS (r = 0.363, p < 0.01). Furthermore, a final model was conducted in which CNWSS has a strong direct effect on CNSRS (β = 0.54, p < 0.01) and an indirect effect on HCAS (β = -0.138, p < 0.01), which was mediated by CNSRS and CNSSS.

The value of simulation-based education in developing preparedness for acute care situations: An interview study of new graduate nurses' perspectives

AIM

This study aimed to explore how new graduated nurses experience a one-day simulation based education, contributing to providing care in acute situations two months after completion.

BACKGROUND

Simulation-based education is often offered to new graduated nurses as part of important workplace learning. Simulation-based education is a valid learning and teaching strategy and is suggested as a measure to improve nurses' ability in acute situations. However, studies are often conducted as pre-post evaluations immediately after completion of a simulation. Thus, knowledge of the clinical impact of simulation-based education on actual acute care situations could benefit both research and practice.

DESIGN/METHOD

During the winter of 2021-2022, 14 semi-structured interviews were conducted with newly graduated nurses two months after they completed the simulation-based education and the interviews were analyzed using thematic analysis.

RESULTS

The results are presented in three themes: a structured and shared strategy to handle acute situations, a developed role in acute situations and a more comprehensive understanding of acute situations. The results revealed that simulation-based education can contribute to the ability to care in acute situations in terms of action readiness and broad contextual understanding.

CONCLUSION

Simulation-based education can help develop the ability to care for patients in acute situations. However, differences in participant experiences must be acknowledged and processed in order for the implementation and outcome to be successful.

Effects of Blended Simulation on Nursing Students' Critical Thinking Skills: A Quantitative Study

Introduction

Critical thinking is regarded as imperative to healthcare quality and patient outcomes; therefore, effective strategies in nursing education are required to promote students' critical thinking abilities, leading to their success in clinical work. Accordingly, simulation-based education has been suggested as a measure for achieving this goal.

Objective

The aim of this study was to explore whether a nursing education course with blended simulation activities (hands-on simulations with high-fidelity manikins and a web-based interactive simulation program) could increase nursing students' critical thinking skills.

Method

A quasiexperimental, one-group pretest and post-test design was utilized. Data were collected through premeasurement and postmeasurement using a critical thinking questionnaire and were analyzed using paired sample t-tests, independent sample t-tests, and the nonparametric Wilcoxon signed-rank test. The effect size was calculated using Cohen's d formula.

Results

Sixty-one nursing students (57 women and four men, mean age 30 years) participated in the study. Findings of the paired sample t-test showed a significantly higher mean score for posteducation than pre-education, indicating a significant change in nurses' critical thinking capabilities (p < .001). The results for Cohen's d formula ( - 0.87) of the mean scores between pre-education and posteducation indicated a large effect size. The Wilcoxon signed-rank test also showed a statistically significant increase in the students' critical thinking abilities between pre-education and posteducation measures (p < .001). No statistically significant differences were found in the mean score according to age or sex.

Conclusion

This study concluded that blended simulation-based education can increase nursing students' critical thinking capabilities. As a result, this study builds on the use of simulation as a measure for developing and promoting critical thinking abilities during nursing education.

Transitioning a Graduate Nursing Physical Examination Skills Lab to an Online Learning Modality

BACKGROUND

Continued restrictions imposed on face-to-face learning related to the SARS-CoV-2 (severe acute respiratory syndrome coronavirus-2) pandemic resulted in a decision to permanently transition a graduate nursing education advanced assessment course from a hybrid to an online learning modality.

PURPOSE

The purpose of this article is to describe the transition of the physical examination skills lab from face-to-face to online, compare advanced practice nursing student performance outcomes, and evaluate faculty satisfaction and student satisfaction and confidence in learning.

METHODS

A retrospective comparison design was used to evaluate student outcomes. Surveys were used to evaluate faculty satisfaction and student satisfaction and confidence.

RESULTS

Academic performance, including the psychomotor performance proficiency of advanced assessment skills, was comparable between the modalities. Students were satisfied with and confident in their learning of skills. Faculty support online delivery despite increased workload.

CONCLUSIONS

Continued use of the online learning modality for teaching advanced physical examination skills is warranted.

Newly graduated Nurses' experiences of the intervention graduate guidance nurses: A qualitative interview study

AIMS

Describing newly graduated nurses' experiences of the intervention graduate guidance nurses.

BACKGROUND

Newly graduated nurses need support to become established in the profession. The intervention was initiated to empower and support in the professional role.

METHODS

A qualitative case study conducted with semi-structured interviews, using a thematic content analysis.

RESULTS

One overarching theme "Organizational prerequisites, consisting of three themes occurred: "Activator" involved that the graduate guidance nurse was the activator creating a clear structure and the wards became more attractive workplaces. "Supportive nursing" meant that the graduate guidance nurse constituted an important support function which ensured patient safety. "Professional development" created the opportunity for professional growth.

CONCLUSION

Newly graduated nurses' experiences shows that the creation of an organizational structure enabled the graduate guidance nurses to be an important support and contributed to professional development.

IMPLICATIONS FOR NURSING MANAGEMENT

In healthcare organizations, strategic decisions, management support, and clear goals are important to create the organizational conditions to improve safer care. Support from experienced nurses is a large enabler in supporting newly graduated nurses developing in their profession. The results of the current study can be transferred to other similar healthcare organizations and can be supporting managers who plan to initiate support to newly graduated nurses.

The Use of Simulation-Based Education With New Graduate Nurses in Emergency Department and Acute Care Settings: A Scoping Review

Background The literature questions if newly graduated nurses are truly ready to practice at the bedside. Simulation has been shown to bridge the gap between theory and practice. The purpose of this study was to investigate what is known about the use of simulation education with novice graduate nurses in critical care settings in the hospital. Method A scoping review was conducted using the PRISMA Extension for Scoping Reviews (PRISMA-ScR): Checklist and Explanation. Articles published in English between 2015 and September 2021 that focused on simulation education with novice graduate nurses in a critical care setting were included. Results The review yielded six articles. Conclusion The literature is scant on the use of simulation in critical care areas with novice graduate nurses. Additional inquiry is needed related to the role of learners, cost, timing, setting, and educational practices. More studies with stronger research designs and valid and reliable measurement instruments are also needed. Finally, there is a need to better understand the effects of simulation on novice nurse graduates' knowledge and skills as well as patient outcomes. [J Contin Educ Nurs. 2022;53(7):301-306.].

Student mental health nurses' understanding of recovery: A phenomenographic study

AIM

To explore the variation in mental health nursing students' understanding of recovery.

BACKGROUND

In mental health practice clinical understanding of recovery has been challenged with a new understanding based on the individualised experiences of the person, often referred to as personal recovery. Despite international policy endorsement, practice has been slow to embrace the principles of personal recovery and little is known about student nurses' understanding of the concept.

DESIGN

Qualitative phenomenographic study METHOD: In-depth semi-structured interviews including discussion of a clinical scenario, were conducted with 13 pre-registration student nurses. Data was analysed iteratively using a seven stage phenomenographic framework, identifying categories of description and the outcome space.

RESULTS

Analysis revealed a branched outcome space with four qualitatively distinct ways of understanding recovery. Branch one can be broadly aligned to clinical recovery and contains one category only, 'Recovery as Clinical Improvement'. It is distinctly different from branch two which contains three categories on a continuum, which represent more and less complete ways of understanding personal recovery: 'Recovery as Making Progress', 'Recovery as Managing to Live Well' and 'Recovery as Learning to Live Differently'. Most participants demonstrated understanding in the less sophisticated categories.

CONCLUSION

Recovery is central to mental health nursing, yet this study suggests it is a problematic concept for students. Features of personal recovery can be found in the second branch of the outcome space, with the most sophisticated category 'Learning to Live Differently' best representing the principles of recovery espoused in nursing literature and international policy. Phenomenography has allowed a more complex picture to emerge, replacing the dichotomy between clinical and personal recovery and enabling a differentiation between more and less complete ways of understanding personal recovery. This study addresses the lack of attention given to student nurse experiences of recovery. The insights support educators, both in clinical and academic settings, to address personal recovery in more explicit way where partial understanding can be explored.

A study of factors that predict novice nurses' perceived ability to provide care in acute situations

AIMS

To explore factors that predict novice nurses' trust in their ability to provide care in acute situations and identify factors that are related to their perceived ability to make clinical judgements in acute situations.

DESIGN

Exploratory cross-sectional study.

METHODS

Novice nurses employed within somatic care in Swedish hospitals completed an online survey. Univariate analysis facilitated exploration of the data and identification of predictor variables with the greatest association with: (1) trust in their own ability (one item) and (2) ability to make clinical judgements (four items). Multivariate binary logistic regression modelling was used to model the likelihood of outcomes based on each predictor variable.

RESULTS

The two most important predictors related to trust in ability to provide care were duration of work experience and participation in acute situations during nursing education. For clinical judgement, duration of work experience was significant in all four models and experience of acute situations post-graduation was significant in two models.

COVID-19 Disruption of Nursing Education and the Effects on Students' Academic and Professional Confidence

BACKGROUND

In spring 2020, the novel coronavirus prompted a sudden shift in nursing education. This study evaluated students' perceptions of their ability to adjust to these challenges.

METHODS

A cross-sectional survey of students (n = 286) in BSN programs throughout the United States was conducted via email to examine 3 areas of student confidence (academic success, NCLEX-RN success, and patient care delivery) and to determine how these were affected by the abrupt transition to remote learning.

RESULTS

Variables, including alignment of remote instruction styles with learning styles, ease of transition to distance learning, and educating children at home, were significantly associated with students' confidence in their ability to be successful academically, on NCLEX-RN, and in patient care.

CONCLUSIONS

With potential for ongoing challenges due to the coronavirus, faculty need to identify and support students at greater risk of experiencing difficulties and threats to success, thereby preventing attrition and ensuring preparation of a diverse workforce.

Predictors of caring ability and its dimensions among nurses in China: A cross-sectional study

BACKGROUND

Caring is an essential component of professional nursing practice, which directly affects the quality of patient care. Nurses' caring ability may not meet patients' demands for high-quality care. There are challenges in designing and implementing interventions to improve nurses' caring ability, especially in China. Understanding Chinese nurses' caring ability and related influential factors serves as the basis for effective interventions to improve their ability to care for patients.

AIM

To describe the caring ability of nurses and its potential predictors in China.

METHODS

From January to February 2018, a cross-sectional survey was conducted among 2304 Registered Nurses working at different levels of hospitals across 29 provinces in China. The structured online survey included socio-demographic information, Caring Ability Inventory, Caring Efficacy Scale and Professional Quality of Life. Descriptive statistics, univariate analyses and multivariate analyses were conducted.

RESULTS

Overall caring ability and its three dimensions of the participants were all significantly lower than the Nkongho' norm, an international scoring standard of nurse's caring ability. Age, employment type, workplace, caring efficacy, compassion satisfaction, burnout and secondary traumatic stress were predictors of knowing, explaining 41.8% of the variance. Predictors of courage were educational level, bereavement experience, caring efficacy, compassion satisfaction and burnout (31.7% of the variance). Educational level, workplace, exposure to critically ill patients, caring efficacy, compassion satisfaction, burnout and secondary traumatic stress were influencing factors of patience, accounting for 19.5% of the variance.

CONCLUSIONS

Chinese nurses' caring ability, with patience, knowing, and courage in descending order. Particular attention needs to be paid to the courage dimension of the nurses' caring ability. Further, the predictors of overall caring ability and each dimension were diverse. These results indicate that nurse educators and administrators need to identify training priorities and design targeted interventions based on the influencing factors.

Development and initial validation of an instrument to measure novice nurses' perceived ability to provide care in acute situations - PCAS

BACKGROUND

Novice nurses need to be better prepared to provide care in acute situations. There is currently no validated scale specifically measuring nurses' perception of their ability to provide care in acute situations. The aim of this study was to develop and examine the psychometric properties of a scale that measures novice nurses self-reported perception of ability to provide care in acute situations.

METHOD

Development and test of the psychometric properties of the Perception to Care in Acute Situations (PCAS) scale. Items were generated from interviews with novice nurses (n = 17) and validated using opinions of an expert panel and cognitive interviews with the target group.Two hundred nine novice nurses tested the final scale. Exploratory factor analysis (EFA) was used to test construct validity, item reduction and underlying dimensions between the measured variables and the latent construct.

RESULT

The PCAS scale contains 17 items grouped into three factors. EFA demonstrated a clean three factor logic construct solution with no cross-loadings, high correlation for the total scale in both Cronbach's alfa 0.90 and ordinal alpha 0.92.

CONCLUSIONS

The PCAS scale has proven to have acceptable validity. The factors," confidence in provision of care", "communication" and "patient perspective" are likely to be important aspects of providing care in acute situations. Additional testing of the PCAS is needed to conclude if it is sensitive enough to evaluate interventions aimed at improving novice nurses competence and suitable as a guide for reflection for novice nurses.

Factors influencing well-being in clinical nurses: A path analysis using a multi-mediation model

AIMS AND OBJECTIVES

To test a hypothetical path model estimating the influence of resilience and gratitude disposition on well-being in Korean clinical nurses and to verify the mediating effects of burnout, compassion satisfaction and job satisfaction using a multi-mediation model.

BACKGROUND

To improve the well-being of nurses, it is necessary to consider their personal and work-related characteristics comprehensively.

DESIGN

A descriptive cross-sectional design was used.

METHODS

A total of 310 clinical nurses participated in this study. A structured questionnaire was used to collect data. A path analysis using a multi-mediation model was performed using AMOS 23.0 to test the hypothetical path model. This study adhered to the STROBE guideline.

RESULTS

The model's fit indices were adequate. Resilience and gratitude disposition both had significant direct effects on well-being. Resilience and gratitude disposition had significant indirect effects on well-being through the effect of burnout, compassion satisfaction and job satisfaction. Resilience, gratitude disposition, burnout, compassion satisfaction and job satisfaction explained 68.3% of the total variance of well-being.

CONCLUSIONS

Intervention programmes considering these factors may be useful to improve nurses' well-being.

RELEVANCE TO CLINICAL PRACTICE

Nurses' well-being should be assessed along with resilience, gratitude disposition, burnout, compassion satisfaction and job satisfaction. To improve the well-being of clinical nurses, systematic and integrated intervention programmes need to be developed and applied, with consideration for a variety of factors related to well-being.