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Ravik M, Bjørk IT. Influence of simulation and clinical settings on peripheral vein cannulation skill learning in nursing education: A qualitative study. INTERNATIONAL JOURNAL OF NURSING STUDIES ADVANCES 2023. [DOI: 10.1016/j.ijnsa.2023.100123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/29/2023] Open
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Nursing Students' and Preceptors' Experiences with Using an Assessment Tool for Feedback and Reflection in Supervision of Clinical Skills: A Qualitative Pilot Study. Nurs Res Pract 2021; 2021:5551662. [PMID: 34113465 PMCID: PMC8154278 DOI: 10.1155/2021/5551662] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Accepted: 05/07/2021] [Indexed: 12/02/2022] Open
Abstract
Background There is a need to improve students' learning in clinical practice. Undergraduate students need guidance when it comes to transferring knowledge from the classroom to clinical practice in community health services. Competence Development of Practical Procedures (COPPs), a simulation assessment tool, was used to explore students' and preceptors' experiences with feedback and reflection during the supervision of clinical skills in real practice. Method This was a pilot study with a qualitative exploratory and descriptive research design. Four students in their first year of a bachelor's programme in nursing and four preceptors participated. Data were collected from eight clinical skills performance assessments, audio recordings of supervision, and open-ended questionnaires. Data were systematized, categorized, and analysed using qualitative content analysis. Findings. Participants' experiences were divided into five categories: “learning environment, an atmosphere of respect, acceptance, and encouragement,” “students' reflections on their own personal learning,” “students' reflections on various care situations,” and “students' and preceptors' assessment and feedback.” Participants found COPPs easy to use and providing structure for assessment, feedback, and reflection during supervision. Concepts related to learning clinical skills became visible for both students and preceptors and helped students assess their performance of clinical skills. Through verbalization and reflection in supervision, participants established a consensus around what students knew and what they needed to learn. Conclusions The students and preceptors experienced the tool as a supportive structure to enhance feedback and reflection for the learning of clinical skills in municipal healthcare services. COPPs filled a gap in practice by providing a language for students and preceptors to articulate their knowledge and increasing students' awareness of what constitutes a good performance. The tool supported the coherence of concepts, enhanced clinical reasoning, and promoted deeper thinking and reflection, and the students gained insight into their own needs related to learning clinical skills.
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Leonardsen AL, Blågestad IK, Brynhildsen S, Olsen R, Gunheim‐Hatland L, Gregersen A, Kvarsnes AH, Hansen WC, Andreassen HM, Martinsen M, Hansen M, Hjelmeland I, Grøndahl VA. Nurses' perspectives on technical skill requirements in primary and tertiary healthcare services. Nurs Open 2020; 7:1424-1430. [PMID: 32802362 PMCID: PMC7424445 DOI: 10.1002/nop2.513] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2019] [Revised: 04/11/2020] [Accepted: 04/17/2020] [Indexed: 11/07/2022] Open
Abstract
Aim To explore nurses' perspectives on technical skill requirements in primary and tertiary healthcare services and their perspectives on where students should learn these skills. Design The study was conducted in Norway and had a cross-sectional, multicentre, descriptive design. Methods We used a questionnaire to explore registered nurses and intellectual disability nurses' perspectives on technical skill requirements and learning (N = 437). Results All the skills included in the university college curricula were reported to be required, and most skills should from the respondents' perspective be learned in the university college. There were significant differences between registered nurses and intellectual disability nurses about their perspectives on skill learning, but no significant differences between respondents in the interface between hospital and municipality wards. Conclusions Results from this study indicate that nurses need extensive technical skills in both primary and tertiary health care. Findings also indicate a need to modify the university college curricula.
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Affiliation(s)
| | | | | | - Richard Olsen
- Department of Competence and DevelopmentØstfold Hospital TrustGrålumNorway
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Improving Clinical Nurses' Development of Supervision Skills through an Action Learning Approach. Nurs Res Pract 2020; 2020:9483549. [PMID: 32148957 PMCID: PMC7049863 DOI: 10.1155/2020/9483549] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2019] [Revised: 12/19/2019] [Accepted: 01/04/2020] [Indexed: 11/17/2022] Open
Abstract
The aim of this study was to investigate action learning as an implementation method in a large-scale project with many participants in several autonomous and geographically spread groups. The focus of the implementation was the Model of Practical Skill Performance as a learning and supervision tool in the clinical education of nursing students. Nineteen action learning groups were established, and a total of 129 clinical supervisors and 13 facilitators were involved. To evaluate the implementation process, qualitative data were generated through three focus group interviews, questionnaires, and notes. Data illuminate clinical supervisors' perceptions of value, impact, and sustainability when they participate in an action learning group to become familiar with the Model of Practical Skill Performance. The deductive data analysis was guided by central concepts from action learning. Action learning proved to be an engaging and effective tool in the implementation where the main strength seemed to be the autonomous local group supporting collective reflections on actions. Clinical supervisors had the right competences to adopt a reflective process-oriented approach, which is the hallmark of action learning. This study shows the necessity of collaboration between stakeholders in practice, education, and management to implement large-scale projects in clinical practice. The findings imply that managers should choose participants on the basis of their motivation and their voluntary wish to participate and that nurses' immersion in the project over time aids implementation.
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Ravik M. Using "Knowing That" and "Knowing How" to Inform Learning of Peripheral Vein Cannulation in Nursing Education. Int J Nurs Educ Scholarsh 2019; 16:ijnes-2018-0078. [PMID: 31734657 DOI: 10.1515/ijnes-2018-0078] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2018] [Accepted: 10/31/2019] [Indexed: 11/15/2022]
Abstract
Background Peripheral vein cannulation is one of the most common invasive practical nursing skills performed by registered nurses. However, many registered nurses lack competence in this practical skill. Learning peripheral vein cannulation associated with successful placement and maintenance is not well understood. Framework Ryle's ways of knowing, "knowing that" and "knowing how", can be used during peripheral vein cannulation learning to guide development and competence in this practical skill. Aim The aim of the article was to provide an overview of Ryle's ways of knowing and to make recommendations for best practices for nurse teachers and nurses teaching students peripheral vein cannulation. Conclusion Ryle's ways of knowing can assist nursing students in their learning and development of peripheral vein cannulation.
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Affiliation(s)
- Monika Ravik
- University of South-Eastern Norway, Porsgrunn, Norway
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Ross J, Baker SR. Perceptions of foundation dentists on minor oral surgery teaching in dental foundation training. EUROPEAN JOURNAL OF DENTAL EDUCATION : OFFICIAL JOURNAL OF THE ASSOCIATION FOR DENTAL EDUCATION IN EUROPE 2019; 23:405-414. [PMID: 31108018 DOI: 10.1111/eje.12446] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/06/2019] [Revised: 05/08/2019] [Accepted: 05/16/2019] [Indexed: 06/09/2023]
Abstract
AIMS The aim of this service evaluation was to explore the experiences of foundation dentists (FDs) during their dental foundation year (DFT) in the field of oral surgery and surgical extractions. METHODS A phenomenological approach was taken aiming to explore the FDs' experiences through a qualitative design. All FDs in the region deemed eligible for the evaluation were invited to attend a semi-structured interview or answer a qualitative questionnaire when attending for their exit interview at the completion of DFT. The interviews were then transcribed and thematic analysis was undertaken. RESULTS 79 FDs took part in the evaluation, representing 86% of trainees eligible for inclusion. Findings showed that not all FDs had the opportunity to undertake surgical extractions independently during the year. Data was analysed and 4 main themes generated when evaluating FDs' experiences; specific learning encounters, influence of the educational supervisor, supportive learning environment and ready for independent practice. CONCLUSIONS This evaluation shows that there are a number of factors associated with FDs' experience during DFT, and not all FDs are leaving the training with a positive experience, with a query as to whether they are fulfilling the aims of training to become an "independent practitioner." It poses questions about what can be done to improve future training and what exactly does DFT need to achieve in terms of experience in surgical extractions.
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Affiliation(s)
- Jennie Ross
- Primary Dental Care, Charles Clifford Dental Hospital, Sheffield, UK
- Richmond Dental Care, Sheffield, UK
| | - Sarah R Baker
- Department of Psychology, Unit of Oral Health, Dentistry and Society, School of Clinical Dentistry, University of Sheffield, Sheffield, UK
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Differences in Psychomotor Skills Teaching and Evaluation Practices in Undergraduate Nursing Programs. Nurs Educ Perspect 2019; 41:83-87. [PMID: 31232871 DOI: 10.1097/01.nep.0000000000000515] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
AIM The purpose of this study was to understand the methods faculty use to teach and evaluate psychomotor skill performance in associate and baccalaureate nursing programs, resources available to students to master these skills, and policies and procedures related to summative evaluation of psychomotor skills. BACKGROUND Despite the importance of psychomotor skills competency in registered nursing programs, published methods for teaching and evaluating competency vary. The literature does not support a particular strategy for teaching or evaluation. METHOD In this primarily quantitative descriptive study, participants completed a 28-item questionnaire developed by the authors based on a review of the literature and personal teaching experience. RESULTS All respondents indicated that their institutions conducted summative assessment of psychomotor skills; however, the methods for teaching and evaluation varied widely. CONCLUSION Well-designed control studies and consensus guidelines from professional nursing education organizations would assist faculty in implementing consistent, effective, evidence-based strategies.
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Wighus M, Bjørk IT. An educational intervention to enhance clinical skills learning: Experiences of nursing students and teachers. Nurse Educ Pract 2018; 29:143-149. [PMID: 29353107 DOI: 10.1016/j.nepr.2018.01.004] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2016] [Revised: 12/05/2017] [Accepted: 01/04/2018] [Indexed: 11/24/2022]
Abstract
The simulation centre is a key setting for the acquisition of practical skills. However, pedagogical underpinnings of skills instruction in this setting are not always well founded. This study aimed to explore student and teacher experiences with an educational intervention to enhance clinical skills learning in the first semester of nursing education. The study had an exploratory design, where qualitative data were collected in focus group interviews involving 18 students and four teachers. The participants had generally positive experiences of the intervention. The findings showed that organisation, time usage, an observer role, re-training and structured reflection enhanced systematic feedback by students. We conclude that an educational intervention based on theoretically sound learning tools and pedagogical principles improved students' skills acquisition and gave the teachers a common educational platform.
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Affiliation(s)
- Marianne Wighus
- University College of Southeast Norway (HSN), Kjølnes Ring 56, N-3901 Porsgrunn, Norway.
| | - Ida Torunn Bjørk
- University College of Southeast Norway (HSN), Kjølnes Ring 56, N-3901 Porsgrunn, Norway; University of Oslo, Postboks 1130 Blindern, 0318 Oslo, Norway.
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Abstract
AIM The aim of the study was to realign how nurses view simulation in nursing education as a means of facilitating fluency in knowledge and action to promote expertise in practice. BACKGROUND Nursing expertise is attained by translating complex phenomena across multiple representations and by constructing meaning through experience. Simulation provides learners the experiences necessary to develop fluency in thought and action. METHOD Procedures outlined by Hupcey and Penrod (2005) and Walker and Avant (2011) were used to identify uses, defining attributes, philosophical assumptions, contextual factors, and values of the concept. RESULTS Use of simulation to promote representational fluency in other disciplines fosters deep conceptual understanding and skillfulness, which prepares learners to perform with fluidity and expertise. CONCLUSION The association between representational fluency and simulation introduces nurse educators to a way of thinking about how novices learn to think and act like experts. Further research is recommended.
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Ewertsson M, Bagga-Gupta S, Blomberg K. Nursing students' socialisation into practical skills. Nurse Educ Pract 2017; 27:157-164. [PMID: 28917136 DOI: 10.1016/j.nepr.2017.09.004] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2016] [Revised: 08/19/2017] [Accepted: 09/03/2017] [Indexed: 10/18/2022]
Abstract
Socialisation is a significant factor that shapes nursing students' learning in clinical settings. Little is known about the ways in which students learn practical skills during their clinical practice and how they are socialised into these skills. This knowledge is important for creating an optimal environment for ensuring a high standard of care and patient safety. This study aims to address this knowledge gap. An ethnographic approach was used. Data were collected by participant observations during nursing students' clinical practice in an emergency department at a university hospital in Sweden, and during informal conversations with students and their preceptors. In the analysis, four themes emerged: A reflective approach based on a theoretical framing; Multitasking situations; Shifts in an active role as a nursing student; and Styles of supervision. Students' socialisation into practical skills was shaped by several factors where preceptors played a key role. Teaching and learning styles and interactions between the preceptor and the student shaped the learning situations. A dominant discrepancy regarding whether and how reflections took place between preceptors and students was identified. This highlights the need for creating continuity between the ways that experiences are organised across the settings of learning (university-based and clinically based learning) to enhance nursing students' learning and socialisation into practical skills.
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Affiliation(s)
- Mona Ewertsson
- Faculty of Medicine and Health, School of Health Sciences, Örebro University, Örebro, Sweden.
| | | | - Karin Blomberg
- Faculty of Medicine and Health, School of Health Sciences, Örebro University, Örebro, Sweden
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Ewertsson M, Bagga-Gupta S, Allvin R, Blomberg K. Tensions in learning professional identities - nursing students' narratives and participation in practical skills during their clinical practice: an ethnographic study. BMC Nurs 2017; 16:48. [PMID: 28824335 PMCID: PMC5559829 DOI: 10.1186/s12912-017-0238-y] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2017] [Accepted: 08/01/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Clinical practice is a pivotal part of nursing education. It provides students with the opportunity to put the knowledge and skills they have acquired from lectures into practice with real patients, under the guidance of registered nurses. Clinical experience is also essential for shaping the nursing students' identity as future professional nurses. There is a lack of knowledge and understanding of the ways in which students learn practical skills and apply knowledge within and across different contexts, i.e. how they apply clinical skills, learnt in the laboratory in university settings, in the clinical setting. The aim of this study was therefore to explore how nursing students describe, and use, their prior experiences related to practical skills during their clinical practice. METHODS An ethnographic case study design was used. Fieldwork included participant observations (82 h), informal conversations, and interviews (n = 7) that were conducted during nursing students' (n = 17) clinical practice at an emergency department at a university hospital in Sweden. RESULTS The overarching theme identified was "Learning about professional identities with respect to situated power". This encompasses tensions in students' learning when they are socialized into practical skills in the nursing profession. This overarching theme consists of three sub-themes: "Embodied knowledge", "Divergent ways of assessing and evaluating knowledge" and "Balancing approaches". CONCLUSIONS Nursing students do not automatically possess the ability to transfer knowledge from one setting to another; rather, their development is shaped by their experiences and interactions with others when they meet real patients. The study revealed different ways in which students navigated tensions related to power differentials. Reflecting on actions is a prerequisite for developing and learning practical skills and professional identities. This highlights the importance of both educators' and the preceptors' roles for socializing students in this process.
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Affiliation(s)
- Mona Ewertsson
- Faculty of Medicine and Health, School of Health Sciences, Örebro University, S-70182 Örebro, Sweden
| | | | - Renée Allvin
- Faculty of Medicine and Health, School of Health Sciences, Örebro University, S-70182 Örebro, Sweden.,Clinical Skills Centre, Örebro University Hospital, Örebro, Sweden
| | - Karin Blomberg
- Faculty of Medicine and Health, School of Health Sciences, Örebro University, S-70182 Örebro, Sweden
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Johansen K, Persson K, Sonnander K, Magnusson M, Sarkadi A, Lucas S. Clinical utility of the Structured Observation of Motor Performance in Infants within the child health services. PLoS One 2017; 12:e0181398. [PMID: 28723929 PMCID: PMC5517004 DOI: 10.1371/journal.pone.0181398] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2017] [Accepted: 07/02/2017] [Indexed: 11/25/2022] Open
Abstract
AIM This study aimed to evaluate the clinical utility of the Structured Observation of Motor Performance in Infants (SOMP-I) when used by nurses in routine child healthcare by analyzing the nurses' SOMP-I assessments and the actions taken when motor problems were suspected. METHOD Infants from three child health centers in Uppsala County, Sweden, were consecutively enrolled in a longitudinal study. The 242 infants were assessed using SOMP-I by the nurse responsible for the infant as part of the regular well-child visits at as close to 2, 4, 6 and 10 months of age as possible. The nurses noted actions taken such as giving advice, scheduling an extra follow-up or referring the infant to specialized care. The infants' motor development was reassessed at 18 months of age through review of medical records or parental report. RESULTS The assessments of level of motor development at 2 and 10 months showed a distribution corresponding to the percentile distribution of the SOMP-I method. Fewer infants than expected were assessed as delayed at 4 and 6 months or deficient in quality at all assessment ages. When an infant was assessed as delayed in level or deficient in quality, the likelihood of the nurse taking actions increased. This increased further if both delay and quality deficit were found at the same assessment or if one or both were found at repeated assessments. The reassessment of the motor development at 18 months did not reveal any missed infants with major motor impairments. INTERPRETATION The use of SOMP-I appears to demonstrate favorable clinical utility in routine child healthcare as tested here. Child health nurses can assess early motor performance using this standardized assessment method, and using the method appears to support them the clinical decision-making.
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Affiliation(s)
- Kine Johansen
- Department of Women’s and Children’s Health, Uppsala University, Uppsala, Sweden
- Uppsala University Children’s Hospital, Uppsala, Sweden
| | - Kristina Persson
- Department of Women’s and Children’s Health, Uppsala University, Uppsala, Sweden
| | - Karin Sonnander
- Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
| | - Margaretha Magnusson
- Department of Women’s and Children’s Health, Uppsala University, Uppsala, Sweden
| | - Anna Sarkadi
- Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
| | - Steven Lucas
- Department of Women’s and Children’s Health, Uppsala University, Uppsala, Sweden
- Uppsala University Children’s Hospital, Uppsala, Sweden
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Bundgaard K, Sørensen EE, Delmar C. TIME - MAKING THE BEST OF IT! A Fieldwork Study Outlining Time in Endoscopy Facilities for Short-Term Stay. Open Nurs J 2016; 10:15-25. [PMID: 27347251 PMCID: PMC4894942 DOI: 10.2174/1874434601610010015] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2015] [Revised: 06/02/2015] [Accepted: 06/15/2015] [Indexed: 11/22/2022] Open
Abstract
Aim: This paper focus on nursing and time in endoscopy facilities for short-term stay aiming to explore aspects of time in this setting and how expectations from the healthcare organisation, patients and nurses are expressed and met when managing nursing time. Background: Former research primarily focuses on the subject of time in the understanding of duration where having more time is closely associated with the ability to deliver better quality nursing care. The main concern is the nurses’ increased number of tasks and the decreased length of time at their disposal. However, few studies describe nursing when time is sparse, and the possibility of providing individualised nursing within a very short span of time. Design: Inspired by practical ethnographic principles, a fieldwork study was performed in high technology endoscopy clinics during 2008-2010. Methods: Data triangulation included participant observation, participant reports and patients and nurses semi-structured interviews. Results/Findings: The issue of time was an interwoven part of life in the productive endoscopy units. The understanding of time related to the main category: ‘Time - making the best of it’, and the sub categories “Responsibility of time”, “Information and preparation”, and “Time wasters”. Conclusion: The study underlines the possibility of combining the health care systems, patients and the nurses’ perspectives on and expectations of how to spend nursing time in endoscopy settings. In successful patient pathways nursing maximize patient outcome, support the goals of the healthcare organisations, is reliable, assure, tangible, empathic and responsive, and is individually tailored to the patient’s needs. The study contributes by underlining the importance of discussing not how to get more time in clinical practice but instead how to spend the time in the best way possible.
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Affiliation(s)
| | - Erik E Sørensen
- Aalborg Hospital Science and Innovation Center (AHSIC), Aalborg University Hospital, Denmark
| | - Charlotte Delmar
- Department of Nursing Science, School of Public Health & Institute of Clinical Medicine Health, Aarhus, Denmark
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Johansen K, Lucas S, Bokström P, Persson K, Sonnander K, Magnusson M, Sarkadi A. 'Now I use words like asymmetry and unstable': nurses' experiences in using a standardized assessment for motor performance within routine child health care. J Eval Clin Pract 2016; 22:227-34. [PMID: 26489378 DOI: 10.1111/jep.12459] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/28/2015] [Indexed: 11/30/2022]
Abstract
RATIONALE, AIMS AND OBJECTIVES There is an increasing recognition that early intervention is important for children with motor disorders. The use of standardized assessment methods within the Swedish Child Health Services (CHS) may improve early identification of these children and thereby their development and quality of care. Given the key role of nurses within the CHS, we explored their experiences of using a structured assessment of motor performance (SOMP-I) in a clinical setting, and investigated possible barriers and facilitators for implementation of the method within the CHS. METHODS The study was conducted in 2013 in Uppsala County, Sweden. Ten child health nurses participated in two focus group interviews, which were analysed using systematic text condensation. RESULTS The analysis yielded three themes: (1) increased knowledge and professional pride - nurses described their desire to provide high-quality care for which SOMP-I was a useful tool; (2) improved parent-provider relationship - nurses felt that using SOMP-I involved both the parents and their infant to a greater extent than routine care; and (3) conditions for further implementation - nurses described that the time and effort needed to master new skills must be considered and practical barriers, such as lack of examination space, resource constraints and difficulties in documenting the assessment must be addressed before implementing the SOMP-I method in routine care. CONCLUSION Child health nurses felt that the SOMP-I method fitted well with their professional role and increased the quality of care provided. However, significant barriers to implementing SOMP-I into routine child health care were described.
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Affiliation(s)
- Kine Johansen
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Steven Lucas
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Pär Bokström
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Kristina Persson
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Karin Sonnander
- Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
| | - Margaretha Magnusson
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Anna Sarkadi
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
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Ewertsson M, Gustafsson M, Blomberg K, Holmström IK, Allvin R. Use of technical skills and medical devices among new registered nurses: A questionnaire study. NURSE EDUCATION TODAY 2015; 35:1169-74. [PMID: 26059922 DOI: 10.1016/j.nedt.2015.05.006] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/10/2015] [Revised: 04/14/2015] [Accepted: 05/10/2015] [Indexed: 05/27/2023]
Abstract
BACKGROUND One comprehensive part of nursing practice is performing technical skills and handling of medical equipment. This might be challenging for new registered nurses (RNs) to do in patient-safe way. OBJECTIVES The aim of this study was to describe and compare the extent to which new RNs perform various technical skills and handle medical devices in different settings, and to investigate their possibility for continued learning in this respect. A further aim was to describe their perceptions of incident reporting related to technical skills and medical devices. DESIGN A cross-sectional study with descriptive and comparative design. PARTICIPANTS RNs who recently graduated from a nursing programme at three Swedish universities and had worked as a RN for up to 1 year were included in the study (n=113, response rate 57%). METHOD Data were collected by means of a postal questionnaire. RESULTS Half of the RNs reported that they performed several of the listed tasks every day or every week, regardless of workplace. These tasks were most frequently performed in surgical departments. The majority of the participants (76%) stated a need of continued practical training. However, less than half of them (48%) had access to a training environment. Several participants (43%) had been involved in incidents related to technical skills or medical devices, which were not always reported. Nearly a third of the participants (31%) did not use the existing guidelines when performing technical skills, and reflection on performance was uncommon. CONCLUSIONS This study highlights the importance of shared responsibilities between nurse educators and health care employers to provide learning opportunities for new RNs in technical skills, to maintain patient safety. To increase the safety culture where nursing students and new RNs understand the importance of using evidence-based guidelines and taking a reflective approach in the performance of technical tasks is needed.
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Affiliation(s)
- Mona Ewertsson
- Faculty of Health and Medicine, School of Health and Medical Sciences, Örebro University, Örebro, Sweden.
| | - Margareta Gustafsson
- Faculty of Health and Medicine, School of Health and Medical Sciences, Örebro University, Örebro, Sweden
| | - Karin Blomberg
- Faculty of Health and Medicine, School of Health and Medical Sciences, Örebro University, Örebro, Sweden
| | - Inger K Holmström
- School of Health, Care and Social Welfare, Mälardalen University, Västerås, Sweden; Department of Public Health and Caring Science, Uppsala University, Uppsala, Sweden
| | - Renée Allvin
- Faculty of Health and Medicine, School of Health and Medical Sciences, Örebro University, Örebro, Sweden; Clinical Skills Centre, Örebro University Hospital, Örebro, Sweden
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Personnel's Experiences of Phlebotomy Practices after Participating in an Educational Intervention Programme. Nurs Res Pract 2014; 2014:538704. [PMID: 25530877 PMCID: PMC4230197 DOI: 10.1155/2014/538704] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2014] [Revised: 09/08/2014] [Accepted: 10/11/2014] [Indexed: 12/22/2022] Open
Abstract
Background. Blood specimen collection is a common procedure in health care, and the results from specimen analysis have essential influence on clinical decisions. Errors in phlebotomy may lead to repeated sampling and delay in diagnosis and may jeopardise patient safety. This study aimed to describe the experiences of, and reflections on, phlebotomy practices of phlebotomy personnel working in primary health care after participating in an educational intervention programme (EIP). Methods. Thirty phlebotomists from ten primary health care centres participated. Their experiences were investigated through face-to-face interviews. Findings were analysed using qualitative content analysis. Results. The participants perceived the EIP as having opened up opportunities to reflect on safety. The EIP had made them aware of risks in relation to identification procedures, distractions from the environment, lack of knowledge, and transfer of information. The EIP also resulted in improvements in clinical practice, such as a standardised way of working and increased accuracy. Some said that the training had reassured them to continue working as usual, while others continued as usual regardless of incorrect procedure. Conclusions. The findings show that EIP can stimulate reflections on phlebotomy practices in larger study groups. Increased knowledge of phlebotomy practices improves the opportunities to revise and maximise the quality and content of future EIPs. Educators and safety managers should reflect on and pay particular attention to the identification procedure, distractions from the environment, and transfer of information, when developing and implementing EIPs. The focus of phlebotomy training should not solely be on improving adherence to practice guidelines.
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Improving the quality of nursing students' clinical placements in nursing homes: An evaluation study. Nurse Educ Pract 2014; 14:722-8. [DOI: 10.1016/j.nepr.2014.09.004] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2013] [Revised: 07/25/2014] [Accepted: 09/21/2014] [Indexed: 11/21/2022]
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Kleinknecht-Dolf M, Grand F, Spichiger E, Müller M, Martin JS, Spirig R. Complexity of nursing care in acute care hospital patients: results of a pilot study with a newly developed questionnaire. Scand J Caring Sci 2014; 29:591-602. [PMID: 25251029 DOI: 10.1111/scs.12180] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2014] [Accepted: 08/01/2014] [Indexed: 01/27/2023]
Abstract
AIM The aim of this pilot study was to develop an instrument for measuring complexity of nursing care in hospitalised acute care patients as well as to examine its comprehensibility, its feasibility, the effort required for data collection, and its inter-rater reliability as well as its face validity. METHODS This pilot study was designed as a descriptive, explorative cross-sectional survey with multiple measurements of the patient-related complexity of nursing care and a supplemental qualitative questionnaire conducted on six units of a Swiss university hospital. The instrument to assess complexity of nursing care was developed on the framework of Perrow and encompasses on three subscales a total of 15 items with a 5-point Likert scale. ETHICAL CONSIDERATIONS The study was reviewed and approved by the Cantonal Ethics Committee. RESULTS In total, 866 assessments of complexity of nursing care were carried out on 234 patients. The variability of the results of the six units, from three different specialties, suggests that the sampling was suitable for capturing a wide spectrum of complexity. The results of the three subscales are consistent and the discussion of them with the participating units shows that they are also plausible. The verification of the inter-rater reliability has satisfactory to high intersubjective correlation of the values. There were also a few suggestions for improving comprehensibility as well as on how to support user application. The time expenditure for the assessment between 2 to 5 minutes per patient was accurately. CONCLUSION With the newly developed questionnaire to measure the complexity of nursing care in acute care hospitals it seems to be possible to assess and to quantify the complexity of nursing care in various acute care hospital settings. Based on the findings and the feedback of the participating users, the questionnaire needs to be improved for large-scale application.
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Affiliation(s)
| | - Francis Grand
- Directorate of Nursing, Medical-Technical and Medical-Therapeutic Areas, Inselspital, University Hospital, Berne, Switzerland
| | - Elisabeth Spichiger
- Directorate of Nursing, Medical-Technical and Medical-Therapeutic Areas, Inselspital, University Hospital, Berne, Switzerland.,Institute of Nursing Science, University of Basle, Basle, Switzerland
| | - Marianne Müller
- Institute for Data Analysis and Process Design, School of Engineering, Zurich University of Applied Sciences, Winterthur, Switzerland
| | - Jacqueline S Martin
- Department of Nursing and Allied Health Care Professions, University Hospital Basle, Basle, Switzerland
| | - Rebecca Spirig
- Institute of Nursing Science, University of Basle, Basle, Switzerland.,Department of Nursing and Allied Health Care Professions, University Hospital Zurich, Zurich, Switzerland
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Hinck G, Bergmann TF. Video capture on student-owned mobile devices to facilitate psychomotor skills acquisition: A feasibility study. THE JOURNAL OF CHIROPRACTIC EDUCATION 2013; 27:158-162. [PMID: 23957324 PMCID: PMC3791909 DOI: 10.7899/jce-13-12] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/28/2012] [Revised: 01/18/2013] [Accepted: 01/25/2013] [Indexed: 06/02/2023]
Abstract
Objective : We evaluated the feasibility of using mobile device technology to allow students to record their own psychomotor skills so that these recordings can be used for self-reflection and formative evaluation. Methods : Students were given the choice of using DVD recorders, zip drive video capture equipment, or their personal mobile phone, device, or digital camera to record specific psychomotor skills. During the last week of the term, they were asked to complete a 9-question survey regarding their recording experience, including details of mobile phone ownership, technology preferences, technical difficulties, and satisfaction with the recording experience and video critique process. Results : Of those completing the survey, 83% currently owned a mobile phone with video capability. Of the mobile phone owners 62% reported having email capability on their phone and that they could transfer their video recording successfully to their computer, making it available for upload to the learning management system. Viewing the video recording of the psychomotor skill was valuable to 88% of respondents. Conclusions : Our results suggest that mobile phones are a viable technology to use for the video capture and critique of psychomotor skills, as most students own this technology and their satisfaction with this method is high.
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Reierson IÅ, Hvidsten A, Wighus M, Brungot S, Bjørk IT. Key issues and challenges in developing a pedagogical intervention in the simulation skills center--an action research study. Nurse Educ Pract 2013; 13:294-300. [PMID: 23642302 DOI: 10.1016/j.nepr.2013.04.004] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2012] [Revised: 04/03/2013] [Accepted: 04/08/2013] [Indexed: 11/20/2022]
Abstract
Simulation skills centers (SSC) are considered important learning arenas for preparing and qualifying nursing students. Limited clinical placements and claims of diminished learning opportunities raise concerns that newly educated nurses lack proficiency in many psychomotor skills. Accordingly, there is an increased focus on learning in the SSC. However, it has been questioned if the pedagogical underpinning of teaching and learning in the SSC is missing or unclear. At a bachelor nursing education in Norway, there was a desire to change practice and enhance learning in the SSC by systematic use of The Model of Practical Skill Performance (Bjørk and Kirkevold, 2000). A participatory action research design was chosen. A pedagogical intervention was developed and implemented in 2010 in a cohort of eighty-seven first year bachelor nursing students during their basic nursing skill course. The intervention is shortly described. This article reports key issues and challenges that emerged during development of the new intervention. Data to inform the study were collected via thorough meeting minutes and the project leader's logbook, and analyzed using fieldnotes analysis. Six key issues and challenges were identified. These are presented and discussed consecutively in light of their importance for development and implementation of the new intervention.
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Affiliation(s)
- Inger Åse Reierson
- Telemark University College, Faculty of Health and Social studies, Institute of Health Studies, Kjølnes Ring 56, 3918 Porsgrunn, Telemark, Norway.
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Bjørk IT, Lomborg K, Nielsen CM, Brynildsen G, Frederiksen AMS, Larsen K, Reierson IÅ, Sommer I, Stenholt B. From theoretical model to practical use: an example of knowledge translation. J Adv Nurs 2013; 69:2336-47. [PMID: 23387968 DOI: 10.1111/jan.12091] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/22/2012] [Indexed: 11/28/2022]
Abstract
AIM To present a case of knowledge translation in nursing education and practice and discusses mechanisms relevant to bringing knowledge into action. BACKGROUND The process of knowledge translation aspires to close the gap between theory and practice. Knowledge translation is a cyclic process involving both the creation and application of knowledge in several phases. The case presented in this paper is the translation of the Model of Practical Skill Performance into education and practice. Advantages and problems with the use of this model and its adaptation and tailoring to local contexts illustrate the cyclic and iterative process of knowledge translation. DISCUSSION The cultivation of a three-sided relationship between researchers, educators, and clinical nurses was a major asset in driving the process of knowledge translation. The knowledge translation process gained momentum by replacing passive diffusion strategies with interaction and teamwork between stakeholders. The use of knowledge creates feedback that might have consequences for the refinement and tailoring of that same knowledge itself. With end-users in mind, several heuristics were used by the research group to increase clarity of the model and to tailor the implementation of knowledge to the users. IMPLICATIONS FOR NURSING This article illustrates the need for enduring collaboration between stakeholders to promote the process of knowledge translation. Translation of research knowledge into practice is a time-consuming process that is enhanced when appropriate support is given by leaders in the involved facilities. CONCLUSION Knowledge translation is a time-consuming and collaborative endeavour. On the basis of our experience we advocate the implementation and use of a conceptual framework for the entire process of knowledge translation. More descriptions of knowledge translation in the nursing discipline are needed to inspire and advise in this process.
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Affiliation(s)
- Ida Torunn Bjørk
- Department of Nursing Science, Institute of Health and Society, University of Oslo, Norway
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Nielsen C, Sommer I, Larsen K, Bjørk IT. Model of practical skill performance as an instrument for supervision and formative assessment. Nurse Educ Pract 2012; 13:176-180. [PMID: 23021010 DOI: 10.1016/j.nepr.2012.08.014] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2012] [Revised: 08/20/2012] [Accepted: 08/29/2012] [Indexed: 10/27/2022]
Abstract
There are still weaknesses in the practical skills of newly graduated nurses. There is also an escalating pressure on existing clinical placements due to increasing student numbers and structural changes in health services. Innovative educational practices and the use of tools that might support learning are sparsely researched in the field of clinical education for nursing students. This paper reports on an action research study that promoted and investigated use of The Model of Practical Skill Performance as a learning tool during nursing students' clinical placement. Clinical supervisors and two cohorts of nursing students placed in a hospital setting shared their experiences on the use of the model in six focus group interviews. Data was also generated through the supervisors' reflective logs. The model was viewed as highly applicable in the planning of learning situations as well as during practice, performance and formative assessment of practical skills learning. It provided a common language about practical skills and enhanced the participants' understanding of professionalism in practical nursing skill. In conclusion, the model helped to highlight the complexity in mastering practical skills, afforded help in sequencing a learning process that supported the novice, and contributed to a more nuanced feedback by supervisors.
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Affiliation(s)
- Carsten Nielsen
- VIA University College, Nurse education in Aarhus, Hedeager 2, 8200 Aarhus, Denmark.
| | | | | | - Ida Torunn Bjørk
- Department of Nursing Science, Institute for Health and Society, University of Oslo, Norway
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Houghton CE, Casey D, Shaw D, Murphy K. Staff and students' perceptions and experiences of teaching and assessment in Clinical Skills Laboratories: interview findings from a multiple case study. NURSE EDUCATION TODAY 2012; 32:e29-e34. [PMID: 22078867 DOI: 10.1016/j.nedt.2011.10.005] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/10/2011] [Revised: 09/28/2011] [Accepted: 10/12/2011] [Indexed: 05/31/2023]
Abstract
BACKGROUND The Clinical Skills Laboratory has become an essential structure in nurse education and several benefits of its use have been identified. However, the literature identifies the need to examine the transferability of skills learned there into the reality of practice. OBJECTIVE This research explored the role of the Clinical Skills Laboratory in preparing nursing students for the real world of practice. This paper focuses specifically on the perceptions of the teaching and assessment strategies employed there. DESIGN Qualitative multiple case study design. SETTING Five case study sites. PARTICIPANTS Interviewees (n=58) included academic staff, clinical staff and nursing students. METHODS Semi-structured interviews. RESULTS The Clinical Skills Laboratory can provide a pathway to practice and its authenticity is significant. Teaching strategies need to incorporate communication as well as psychomotor skills. Including audio-visual recording into assessment strategies is beneficial. Effective relationships between education institutions and clinical settings are needed to enhance the transferability of the skills learned. CONCLUSIONS The Clinical Skills Laboratory should provide an authentic learning environment, with the appropriate use of teaching strategies. It is crucial that effective links between educators and clinical staff are established and maintained.
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Affiliation(s)
- Catherine E Houghton
- School of Nursing and Midwifery Studies, National University of Ireland, Galway, Ireland.
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Khan BA, Ali F, Vazir N, Barolia R, Rehan S. Students' perceptions of clinical teaching and learning strategies: a Pakistani perspective. NURSE EDUCATION TODAY 2012; 32:85-90. [PMID: 21333417 DOI: 10.1016/j.nedt.2011.01.016] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/13/2010] [Revised: 01/19/2011] [Accepted: 01/19/2011] [Indexed: 05/30/2023]
Abstract
The complexity of the health care environment is increasing with the explosion of technology, coupled with the issues of patients' access, equity, time efficiency, and cost containment. Nursing education must focus on means that enable students to develop the processes of active learning, problem-solving, and critical thinking, in order to enable them to deal with the complexities. This study aims at identifying the nursing students' perceptions about the effectiveness of utilized teaching and learning strategies of clinical education, in improving students' knowledge, skills, and attitudes. A descriptive cross sectional study design was utilized using both qualitative and quantitative approaches. Data were collected from 74 students, using a questionnaire that was developed for the purpose of the study and analyzed using descriptive and non-parametric statistics. The findings revealed that demonstration was the most effective strategy for improving students' skills; reflection, for improving attitudes; and problem based learning and concept map for improving their knowledge. Students' responses to open-ended questions confirmed the effectiveness of these strategies in improving their learning outcomes. Recommendations have been provided based on the findings.
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Alnes RE, Kirkevold M, Skovdahl K. Marte Meo Counselling: a promising tool to support positive interactions between residents with dementia and nurses in nursing homes. J Res Nurs 2011. [DOI: 10.1177/1744987111414848] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Marte Meo Counselling (MMC) is an educational video-based counselling method developed to improve interactions between persons. This study aimed at investigating whether changes could be identified in the interactions between people with dementia and their nurses during morning care, following MMC. An intervention study based on video recordings before and after a MMC intervention was used. Thirteen nurses and 10 residents from six dementia-specific care units at six different institutions in Norway participated. Data were collected through video recording of six pairs (nurse and resident) in interaction before and after the staff received MMC. Four pairs participated as controls. The findings suggest that nurses who received MMC succeeded, to a greater degree than did the comparison nurses, in providing care consistent with promoting positive interactions. We found clearer indications of increased positive interactions and a reduction in inappropriate interactions in the intervention group. In the control group, the variation was greater, with both good and poor interactions present in the same cases. This study indicates that MMC can serve as a facilitator for positive interactions and can also lead to a reduction in inappropriate interactions. Further research is needed to evaluate the effect of MMC.
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Affiliation(s)
| | - Marit Kirkevold
- Institute of Health and Society, Department of Nursing Science, University of Oslo, Norway Institute of Public Health, Aarhus University, Denmark,
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Einang Alnes R, Kirkevold M, Skovdahl K. Insights gained through Marte Meo counselling: experiences of nurses in dementia specific care units. Int J Older People Nurs 2011; 6:123-32. [PMID: 21539717 DOI: 10.1111/j.1748-3743.2010.00229.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
AIM This study sought to uncover what nurses perceived to have learned, during their participation in video supported counselling, based on Marte Meo principles, in four dementia specific care units. METHODS This was a descriptive qualitative study. Data were collected through 12 individual and four focus group interviews. In addition, supplementary data from two video recordings and one written log were included. Findings emerged through content analysis and re-examination of the text based on the initial analysis. RESULTS The nurses experienced that they acquired new knowledge about the residents through Marte Meo Counselling (MMC), resulting in improved capability to interpret the residents` expressions, and increased awareness of the residents' competence. New knowledge about themselves as nurses also emerged; they recognised how their actions entailed consequences for the interaction, in turn making them conscious of the usefulness of taking time, pacing their interactions, maintaining eye contact and describing the situation in words when the interaction took place. This appeared to increase the resident's perception of being able to cope. CONCLUSIONS This study indicates that MMC helped the nurses to gain knowledge about how to improve interactions with residents suffering from dementia. Further research is warranted into the effectiveness of MMC.
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Affiliation(s)
- Rigmor Einang Alnes
- Department of Health Sciences, Aalesund University College, Aalesund, Norway.
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Paans W, Nieweg RM, van der Schans CP, Sermeus W. What factors influence the prevalence and accuracy of nursing diagnoses documentation in clinical practice? A systematic literature review. J Clin Nurs 2011; 20:2386-403. [PMID: 21676043 DOI: 10.1111/j.1365-2702.2010.03573.x] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
AIM To identify what determinants influence the prevalence and accuracy of nursing diagnosis documentation in clinical practice. BACKGROUND Nursing diagnoses guide and direct nursing care. They are the foundation for goal setting and provide the basis for interventions. The literature mentions several factors that influences nurses' documentation of diagnoses, such as a nurse's level of education, patient's condition and the ward environment. DESIGN Systematic review. METHOD MEDLINE and CINAHL databases were searched using the following headings and keywords: nursing diagnosis, nursing documentation, hospitals, influence, utilisation, quality, implementation and accuracy. The search was limited to articles published between 1995-October 2009. Studies were only selected if they were written in English and were primary studies addressing factors that influence nursing diagnosis documentation. RESULTS In total, 24 studies were included. Four domains of factors that influence the prevalence and accuracy of diagnoses documentation were found: (1) the nurse as a diagnostician, (2) diagnostic education and resources, (3) complexity of a patient's situation and (4) hospital policy and environment. CONCLUSION General factors, which influence decision-making, and nursing documentation and specific factors, which influence the prevalence and accuracy of nursing diagnoses documentation, need to be distinguished. To support nurses in documenting their diagnoses accurately, we recommend taking a comprehensive perspective on factors that influence diagnoses documentation. A conceptual model of determinants that influence nursing diagnoses documentation, as presented in this study, may be helpful as a reference for nurse managers and nurse educators. RELEVANCE TO CLINICAL PRACTICE This review gives hospital management an overview of determinants for possible quality improvements in nursing diagnoses documentation that needs to be undertaken in clinical practice.
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Affiliation(s)
- Wolter Paans
- Hanze University of Applied Sciences, Groningen, The Netherlands.
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Christiansen B, Bjørk IT, Havnes A, Hessevaagbakke E. Developing supervision skills through peer learning partnership. Nurse Educ Pract 2011; 11:104-8. [DOI: 10.1016/j.nepr.2010.11.007] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2010] [Revised: 11/04/2010] [Accepted: 11/20/2010] [Indexed: 11/29/2022]
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Hjälmhult E. Learning strategies of public health nursing students: conquering operational space. J Clin Nurs 2009; 18:3136-45. [DOI: 10.1111/j.1365-2702.2008.02691.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Wangensteen S, Johansson IS, Nordström G. The first year as a graduate nurse--an experience of growth and development. J Clin Nurs 2008; 17:1877-85. [PMID: 18578762 DOI: 10.1111/j.1365-2702.2007.02229.x] [Citation(s) in RCA: 94] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
AIM The aim of this paper was to illuminate how recently graduated nurses experience their first year as a nurse. BACKGROUND Graduate nurses are expected to identify themselves as members of an interdisciplinary team, to feel comfortable in chaos and to make and defend decisions. By graduation nurses expect to have the necessary competence to perform nursing. Recently graduated nurses lack competence, especially relating to leadership. DESIGN A qualitative design was chosen and 12 nurses working in hospitals and home care were individually interviewed. METHOD The interviews were transcribed verbatim and the texts were analysed using manifest and latent content analysis. RESULTS The nurses gave descriptions covering numerous experiences, interpreted and categorised in the following eight subcategories: uncertainty and chaos; need for induction; need for a supportive environment; need for recognition; awareness of responsibility; need for positive experiences; becoming experienced; and managing challenges. These subcategories gave reason for the three categories: experience of being new; gaining nurse experience; and gaining competence. The nurses described a tough start as a nurse, but they most of all gave descriptions interpreted as an experience of growth and development, which constituted the theme in this study. CONCLUSIONS Recently graduated nurses have a positive attitude to the challenges of being a new nurse. Although the initial period as a nurse was tough, the nurses appreciated their experiences because they learnt from them. RELEVANCE TO CLINICAL PRACTICE Recently graduated nurses should be spared from being the only nurse on duty. Employers both in hospital and home care should facilitate induction programmes for new graduate nurses.
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McKinley RK, Strand J, Ward L, Gray T, Alun-Jones T, Miller H. Checklists for assessment and certification of clinical procedural skills omit essential competencies: a systematic review. MEDICAL EDUCATION 2008; 42:338-349. [PMID: 18338987 DOI: 10.1111/j.1365-2923.2007.02970.x] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
OBJECTIVE To develop generic criteria for the global assessment of clinical procedural competence and to quantify the extent to which existing checklists allow for holistic assessment of procedural competencies. METHODS We carried out a systematic review and qualitative analysis of published clinical procedural skills assessment checklists and enumerated the contents of each. Source materials included all English-language papers published from 1990 to June 2005, identified from 18 databases, which described or referred to an assessment document for any clinical procedural skill. A pair of reviewers identified key generic themes and sub-themes through in-depth analysis of a subset of 20 checklists with iterative agreement and independent retesting of a coding framework. The resulting framework was independently applied to all checklists by pairs of reviewers checking for the emergence of new themes and sub-themes. Main outcome measures were identification of generic clinical procedural skills and the frequency of occurrence of each in the identified checklists. RESULTS We identified 7 themes ('Procedural competence', represented in 85 [97%] checklists; 'Preparation', 65 [74%]; 'Safety', 45 [51%]; 'Communication and working with the patient', 32 [36%]; 'Infection control', 28 [32%]; 'Post-procedural care', 24 [27%]; 'Team working', 13 [15%]) and 37 sub-themes, which encapsulated all identified checklists. Of the sub-themes, 2 were identified after the initial coding framework had been finalised. CONCLUSIONS It is possible to develop generic criteria for the global assessment of clinical procedural skills. A third and a half of checklists, respectively, do not enable explicit assessment of the key competencies 'Infection control' and 'Safety'. Their assessment may be inconsistent in assessments which use such checklists.
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von Krogh G, Nåden D. A Nursing-Specific Model of EPR Documentation: Organizational and Professional Requirements. J Nurs Scholarsh 2008; 40:68-75. [DOI: 10.1111/j.1547-5069.2007.00208.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Rischel V, Larsen K, Jackson K. Embodied dispositions or experience? Identifying new patterns of professional competence. J Adv Nurs 2008; 61:512-21. [DOI: 10.1111/j.1365-2648.2007.04543.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Ellefsen B, Kim HS, Ja Han K. Nursing gaze as framework for nursing practice: a study from acute care settings in Korea, Norway and the USA. Scand J Caring Sci 2007; 21:98-105. [PMID: 17428221 DOI: 10.1111/j.1471-6712.2007.00439.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
The aim of the study was to investigate the nature of nurses' clinical practice in terms of what frames their clinical engagement, and to examine how clinical constructions were made. The study is based on a descriptive design using a clinical field approach in acute care settings in Korea, the USA and Norway. A theoretical sample consisted of between four and six Registered Nurses in each country: up to three from medical wards and three from surgical wards. Data were collected through participant observation of and in-depth interviews with the nurses, as well as from nursing documentation about the patients. The result showed an overall model of a theory of nursing practice consisting of three processes: nursing gaze, clinical construction and clinical engagement. This first article outlines the overall descriptive theory of nursing practice and provides a detailed description of the first aspect: the nursing gaze. The model of the structuring of nursing gaze is set within the philosophy of nursing, consisting of the ontology of client and the ontology of practice. The dimensions of normality and needs constitute the ontology of client, and the dimension of clinical expectations constituted the ontology of practice.
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Affiliation(s)
- Bodil Ellefsen
- Institute of Nursing Science, University of Oslo, Blindern, Oslo, Norway.
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Currey J, Browne J, Botti M. Haemodynamic instability after cardiac surgery: nurses' perceptions of clinical decision-making. J Clin Nurs 2006; 15:1081-90. [PMID: 16911048 DOI: 10.1111/j.1365-2702.2006.01392.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND Cardiac surgical patients are distinguished by their potential for instability in the early postoperative period, highly invasive haemodynamic monitoring technologies and unique clinical presentations as a result of undergoing cardiopulmonary bypass. Little is known about nurses' perceptions of assuming responsibility for such patients. An understanding of nurses' perceptions may identify areas of practice that can be improved and assist in determining the adequacy of current decision supports. AIM The aim of this study was to describe critical care nurses' perceptions of assuming responsibility for the nursing management of cardiac patients in the initial two-hour postoperative period. DESIGN An exploratory descriptive study based on naturalistic decision-making. METHODS Thirty-eight nurses were interviewed immediately following a two-hour observation of their clinical practice. Content analysis and a systematic thematic analysis process called 'Framework' were used to analyse the interview transcripts. RESULTS Nurses described their perceptions of managing patients in terms of how they felt about making decisions for complex cardiac surgical patients and in terms of how clinical processes unique to the admission phase impacted their decision-making. Nurses felt either daunted or stimulated and challenged when making decisions. Nurses identified handover from anaesthetists, settling in procedures and forms of collegial assistance as important processes that impacted their decision-making. CONCLUSION Nurses' previous experiences with similar patients influenced how they felt about making decisions during the initial two-hour postoperative period, but did not alter their views about processes important for patient safety during this time. RELEVANCE TO CLINICAL PRACTICE Feelings expressed by nurses in this study highlight the need for clinical supervision and appropriate allocation of resources during the immediate recovery period after cardiac surgery. Nurses identified ways to improve clinical processes that impacted their decision-making during the immediate recovery of cardiac surgical patients.
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Affiliation(s)
- Judy Currey
- Alfred/Deakin Nursing Research Centre, Deakin University, Burwood, VIC, Australia.
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Goodman B, Girot EA, Latter S, Jackson D, Watkins M. A South West regional survey to identify education staff development needs in clinical skills and practice. J Res Nurs 2006. [DOI: 10.1177/1744987106063819] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
This paper reports tentative findings from a survey (undertaken in 2001) of education staff employed to teach nurses and midwives in four highereducation institutions in the South West of England, with specific focus on answers regarding clinical skills and practice within a wider aim of evaluating training needs. A 57 item self-administered postal questionnaire was sent out to 760 educators, 426 were returned with a response rate of 56%. The results were analysed using SPSS version 9, using descriptive statistics focusing on the responses of HE staff and lecturer practitioners on joint appointments. Findings suggest HE staff teach a limited range of (defined) clinical skills, they have varying and wide definitions of clinical skills, less confidence in teaching skills in practice, minimal experience in working in practice settings and difficulties in engagement in practice. They continue to experience role diversity and a wide variation in meeting clinical demands for clinical competence. Definitions of clinical practice and practice skill are explored in relation to the need for nurse teachers to have ‘recent and practical experience of nursing’. A range of education roles are explored.
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Abstract
AIMS AND OBJECTIVES The aim of the study was to contribute to increasing reliability of wound assessment. The objectives were to capture terminology used and to assess whether these words reflected personality preferences for information. BACKGROUND Wound assessment forms are expected to be used reliably by non-experts. This assumes that they mean the same thing to all practitioners. But many wound assessment forms are too complicated and do not necessarily show whether a wound is healing or not. Literature indicates that people have different information preferences that they use to aid judgement. DESIGN A correlational study investigating the relationship between word-preferences and assessor's personality type. METHOD Postregistration students (n = 45) and Tissue Viability Nurses (n = 16) suggested words or phrases to be used in an hypothetical wound assessment. Analysis was performed of how they preferred to describe healing, stasis and deterioration. They ranked the three most important signs they would look for in the three phases of wounds. Words were classified into categories (e.g. subjective, objective, value judgement), then matched with preferences seen in a personality type indicator. RESULTS Healing and deteriorating wounds were assessed relative to different signs or symptoms and static wounds were the most difficult to describe (mostly by absence of signs of healing). Personal types of approach to assessment could be identified: including subjectifiers and quantifiers. CONCLUSIONS In this preliminary study, statistically significant results support the view that wound assessment involves assessor preferences. Assessors judge by the absence rather than the presence of some signs and symptoms. RELEVANCE TO CLINICAL PRACTICE Wound assessment forms need to take account of assessor preferences for subjectivity or quantification if reliability is to be increased, also different wound assessment forms could suit different wound phases. Potentially, assessor types could seek agreement more on outcomes of assessment rather than input.
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Affiliation(s)
- Miles E Maylor
- School of Care Sciences, University of Glamorgan, Glyntaff Campus, Pontypridd, Rhondda Cynon Taff, Wales, UK.
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40
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Goldsmith M, Stewart L, Ferguson L. Peer learning partnership: an innovative strategy to enhance skill acquisition in nursing students. NURSE EDUCATION TODAY 2006; 26:123-30. [PMID: 16202483 DOI: 10.1016/j.nedt.2005.08.001] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/13/2004] [Accepted: 08/05/2005] [Indexed: 05/04/2023]
Abstract
The development of clinical skills for nursing students is a critical component of any undergraduate nursing program. Providing sufficient quality experience for students to develop competence has been recognised as a problem in skill acquisition. At the same time, peer learning has been identified as a valuable strategy for teaching and learning. Nurse academics at a Sydney university recognized these facts and implemented a peer learning strategy into existing first and third year nursing therapeutics units of study. This innovative approach linked the Australian Nursing Council Inc (ANCI) standards of practice to skills acquisition, resulting in third year students increasing their understanding of the relevance of these competency standards to practice. The peer learning strategy involved partnering first and third year students for clinical skills practice sessions. Evaluation of the peer learning approach indicated students valued the experience.
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Affiliation(s)
- Mary Goldsmith
- School of Nursing Family and Community Health, University of Western Sydney, Hawkesbury Campus, Penrith, South DC, NSW, Australia.
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41
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Lomborg K, Kirkevold M. Curtailing: handling the complexity of body care in people hospitalized with severe COPD. Scand J Caring Sci 2005; 19:148-56. [PMID: 15877640 DOI: 10.1111/j.1471-6712.2005.00330.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Assisted personal body care (APBC) tends to be regarded as an unproblematic nursing activity with little professional challenge. For severely ill patient diagnosed with chronic obstructive pulmonary disease (COPD) daily bathing and washing is, however, a significant self-preserving activity that requires substantial efforts on the part of both patients and nurses. The aim of this study was to report on the complex pattern of APBC in hospitalized patients with severe COPD and highlight significant characteristics that should be considered in clinical practice in order to support patients' comfort and well-being. The study used a grounded theory design with a generative and constant comparative approach. The sample consisted of 12 cases of nurse-patient interaction, based on data from participant observation of sessions of APBC, measures of patient's perceived degree of breathlessness and individual interviews with patients and nurses after the sessions. Findings show that APBC in hospitalized patients with severe COPD is a complex integrated pattern of body care activities that can proceed with a greater or lesser degree of success. The main problem is how to keep the patient's breathing under control while optimizing comfort and well-being. Curtailing addresses this problem. Curtailing is a subtle, purposeful balancing of protection from breathlessness and promotion of patients' present and future functional capacity in order to preserve their integrity. The idea that body care is a simple task belonging to patients' private daily lives may obscure the importance of determining a mutual nurse-patient agenda and the professional nurse responsibility may consequently be nebulous. Finding in this study will contribute to the development of a comprehensive and detailed understanding of the APBC and suggest the need for further investigation of the interaction perspective.
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Affiliation(s)
- Kirsten Lomborg
- Department of Nursing Science, Faculty of Health Sciences, Institute of Public Health, University of Aarhus, Aarhus, Denmark.
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42
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Abstract
BACKGROUND In their practice nurses constantly make decisions in a dynamic context including complex situations. Besides affecting elements related to the decision-maker and the task itself, the setting where the decision-making process takes place are of decisive importance to the quality of the decision-making outcome. AIM The aim of this study was to explore environmental elements related to the decision-making process in nursing practice. METHODS Six expert nurses, from three Swedish nursing settings, participated voluntarily in the study, which were designed of participated observations in everyday nursing practice. Permission to carry out the study was given by the clinics and an ethical committee. A content analysis was used to analyse the field notes where themes emerged which were found to be environmental elements affecting decision-making process of nurses. CONCLUSIONS The most striking theme, environmental elements, included the sub-themes interruptions and the work procedures are presented in this report. The implications of environmental elements, are discussed from a perspective of nurses' competence, where the elements could be seen as a facilitator or as a hindrance to developing nursing competence. It were concluded that environmental elements have to be well considered before knowledge can be reached about decision-making in practice. RELEVANCE TO CLINICAL PRACTICE Interpersonal and technological interruptions were features highlighted in the study, features which could jeopardize the decision-making outcome. Therefore, it is of greatest importance that nurses learn to use decision-making strategies to guarantee patient care security and patient care quality.
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Affiliation(s)
- Berith Hedberg
- Institute of Health Care Pedagogics, The Sahlgrenska Academy at Göteborg University, Göteborg, Sweden.
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