Web-delivered research-based nursing staff education for seeking Magnet status

Evaluation of the Premature Infant Pain Profile-Revised (PIPP-R) e-Learning Module: Immediate and Sustained Competency

BACKGROUND

Electronic health (e-health) learning is a potential avenue to educate health professionals about accurately using infant pain assessment tools, although little is known about the impact of e-health interventions on clinical competence.

PURPOSE

To evaluate whether an e-health learning module for teaching the accurate use of the Premature Infant Pain Profile-Revised (PIPP-R) pain assessment tool results in immediate and sustained competency to assess infant pain.

METHODS

Neonatal intensive care unit (NICU) nurses who participated in a larger study across 2 tertiary NICUs in Canada examining the implementation and clinical utility of the PIPP-R e-learning module completed 2 follow-up evaluations at 1 week and 3 months. Participants were asked to view a video recording of an infant undergoing a painful procedure and to assess the infant's pain intensity response using the PIPP-R measure. Immediate and sustained competency was assessed via interrater consensus of participant-reported PIPP-R scores compared with those of an experienced trained coder.

RESULTS

Of the 25 eligible nurses, 22 completed 1-week and 3-month follow-up evaluations. At the 1-week follow-up, 84% of nurses scored the video accurately compared with 50% at 3 months. Behavioral pain indicators were more likely to be scored incorrectly than physiological indicators.

IMPLICATIONS FOR PRACTICE

Follow-up training after completion of the initial e-learning module training may improve competency related to the clinical use of the PIPP-R tool to assess infant pain over time.

IMPLICATIONS FOR RESEARCH

Additional study regarding the need and timing of e-health training to optimize sustained competency in infant pain assessment is warranted.

Comparison between Virtual and Traditional Learning Methods for Orthodontic Knowledge and Skills in Dental Students: A Quasi-Experimental Study

A gradual transition from traditional face-to-face learning to online learning has been observed globally following the COVID-19 pandemic. The aim of the study was to compare online and traditional learning methods in relation to orthodontic knowledge and skills acquired in undergraduate courses. A quasi-experimental design was used with two consecutive year classes of 198 dental students at Jazan University, Saudi Arabia. The experimental (virtual) group of 92 students received the content of a clinical orthodontic course virtually using the Blackboard Collaborate™ platform. The control (traditional) group consisted of a previous cohort of 106 students who enrolled in the same course but received traditional classroom education. The students were evaluated through a semester, and both groups obtained the same content and exam questions. The students in the virtual group scored higher in the final theory exam than the traditional group (p-value < 0.05). However, no significant difference in the overall orthodontic knowledge and skills was observed between the groups at the end of the course. Both learning methods showed moderate positive correlation between orthodontic knowledge and skills. In conclusion, virtual learning can serve as an effective alternative to traditional face-to-face learning for teaching orthodontic knowledge and skills to the dental students.

Effect of virtual versus traditional education on theoretical knowledge and reporting skills of dental students in radiographic interpretation of bony lesions of the jaw

BACKGROUND

This study aimed to compare the effect of virtual and traditional education on theoretical knowledge and reporting skills of dental students in radiographic interpretation of bony lesions of the jaw.

METHODS

This experimental study evaluated 39 dental students who had not received any instruction regarding radiographic interpretation of bony lesions of the jaw. They were randomly divided into two groups of virtual (n = 20) and traditional education (n = 19) and matched in terms of their grade point average (GPA). The virtual group received a virtual learning package while the traditional group received traditional classroom instruction for 6 one-hour sessions. Similar contents were taught to both groups by the same mentor. All students participated in a theoretical test with multiple-choice questions and an objective structured clinical examination (OSCE). Similar exams were also held 2 months later to assess knowledge retention. Data were analyzed using independent sample t-test and repeated measures ANOVA.

RESULTS

The mean scores of theoretical test (P < 0.05) and OSCE (P > 0.05) in the virtual education group (16.60 ± 0.91 and 15.13 ± 0.78) were higher than those in the traditional education group (14.89 ± 0.99 and 14.71 ± 0.92). In both methods of instruction, the mean scores of theoretical test and OSCE at 2 months were lower than the scores acquired immediately after instruction but this difference was not statistically significant (P > 0.05). Type of education had a significant effect on the theoretical test score (P < 0.001) but had no significant effect on the clinical score (P = 0.072).

CONCLUSIONS

Virtual learning was superior to traditional lecture-based method for enhancement of knowledge acquisition in radiographic interpretation of bony lesions of the jaw. However, to improve our students' reporting skills, we need to revise our virtual educational program so that the students have more opportunities to engage in reporting skills.

Barriers and enablers to the implementation of the 6-PACK falls prevention program: A pre-implementation study in hospitals participating in a cluster randomised controlled trial

Evidence for effective falls prevention interventions in acute wards is limited. One reason for this may be suboptimal program implementation. This study aimed to identify perceived barriers and enablers of the implementation of the 6-PACK falls prevention program to inform the implementation in a randomised controlled trial. Strategies to optimise successful implementation of 6-PACK were also sought. A mixed-methods approach was applied in 24 acute wards from 6 Australian hospitals. Participants were nurses working on participating wards and senior hospital staff including Nurse Unit Managers; senior physicians; Directors of Nursing; and senior personnel involved in quality and safety or falls prevention. Information on barriers and enablers of 6-PACK implementation was obtained through surveys, focus groups and interviews. Questions reflected the COM-B framework that includes three behaviour change constructs of: capability, opportunity and motivation. Focus group and interview data were analysed thematically, and survey data descriptively. The survey response rate was 60% (420/702), and 12 focus groups (n = 96 nurses) and 24 interviews with senior staff were conducted. Capability barriers included beliefs that falls could not be prevented; and limited knowledge on falls prevention in patients with complex care needs (e.g. cognitive impairment). Capability enablers included education and training, particularly face to face case study based approaches. Lack of resources was identified as an opportunity barrier. Leadership, champions and using data to drive practice change were recognised as opportunity enablers. Motivation barriers included complacency and lack of ownership in falls prevention efforts. Motivation enablers included senior staff articulating clear goals and a commitment to falls prevention; and use of reminders, audits and feedback. The information gained from this study suggests that regular practical face-to-face education and training for nurses; provision of equipment; audit, reminders and feedback; leadership and champions; and the provision of falls data is key to successful falls prevention program implementation in acute hospitals.

Impact of a multifaceted education program on implementing a pediatric palliative care guideline: a pilot study

BACKGROUND

A national clinical practice guideline for pediatric palliative care was published in 2013. So far there are only few reports available on whether an educational program fosters compliance with such a guideline implementation. We aimed to test the effect of the education program on actual compliance as well as documentation of compliance to the guideline.

METHODS

We performed a prospective study with pre- and post-intervention evaluation on compliance to the guideline of the nurse specialists of a pediatric palliative care team for case management at a children's university hospital. Eleven quality indicators were selected from 192 recommendations from the pediatric palliative care guideline, based on frequency, measurability and relevance. The multifaceted education program included e-learning and an interactive educational meeting. Four e-learning modules addressed 19 patient cases on symptoms, diagnostics and treatment, and a chart-documentation exercise. During the interactive educational meeting patient cases were discussed on how to use the guideline. Documentation of compliance to the guideline in the web-based patient-charts as well as actual compliance to the guideline through weekly web-based parent reports was measured before and after completion of the e-learning.

RESULTS

Eleven quality indicators were selected. The educational program did not result in significant improvement in compliance for any of these indicators. The indicators "treatment of nausea", "pain medications two steps ahead" and "pain medication for 48 h present", measured through parent reports, scored a compliance beyond 80 % before and after e-learning. The remaining indicators measuring compliance, as well as six indicators measuring documentation by chart review, showed a compliance below 80 % before and after e-learning.

CONCLUSIONS

The multifaceted education program did not lead to improvement in documentation of compliance to the guideline. Parent reported outcome revealed better performance and might be the more adequate assessment tool for future studies.

Computer-assisted resilience training to prepare healthcare workers for pandemic influenza: a randomized trial of the optimal dose of training

BACKGROUND

Working in a hospital during an extraordinary infectious disease outbreak can cause significant stress and contribute to healthcare workers choosing to reduce patient contact. Psychological training of healthcare workers prior to an influenza pandemic may reduce stress-related absenteeism, however, established training methods that change behavior and attitudes are too resource-intensive for widespread use. This study tests the feasibility and effectiveness of a less expensive alternative - an interactive, computer-assisted training course designed to build resilience to the stresses of working during a pandemic.

METHODS

A "dose-finding" study compared pre-post changes in three different durations of training. We measured variables that are likely to mediate stress-responses in a pandemic before and after training: confidence in support and training, pandemic-related self-efficacy, coping style and interpersonal problems.

RESULTS

158 hospital workers took the course and were randomly assigned to the short (7 sessions, median cumulative duration 111 minutes), medium (12 sessions, 158 minutes) or long (17 sessions, 223 minutes) version. Using an intention-to-treat analysis, the course was associated with significant improvements in confidence in support and training, pandemic self-efficacy and interpersonal problems. Participants who under-utilized coping via problem-solving or seeking support or over-utilized escape-avoidance experienced improved coping. Comparison of doses showed improved interpersonal problems in the medium and long course but not in the short course. There was a trend towards higher drop-out rates with longer duration of training.

CONCLUSIONS

Computer-assisted resilience training in healthcare workers appears to be of significant benefit and merits further study under pandemic conditions. Comparing three "doses" of the course suggested that the medium course was optimal.

E-Learning education program for registered nurses: the experience of a teaching medical center

The aim of this study was to describe registered nurses' experiences with an e-learning education program (ELEP) conducted at a 776-bed teaching medical center in Taipei. The study was completed in three stages: planning, implementation, and evaluation. Nurses who were registered were randomly assigned either to the ELEP or traditional in-classroom program (TICP). Data were analyzed using descriptive and inferential statistics. Forty-two nurses participated (22 in the ELEP and 20 in the TICP). Scores for participants were all > 70 points (out of 100) for both programs. Of the five courses, only teaching and learning and communication showed significant statistical difference between the two groups (p = .001). Nearly all participants (97.6%) felt satisfied with their program (both ELEP and TICP). All nurses passed the nursing care skill tests. Findings should help guide efforts to popularize e-learning education in Taiwan and help create alternative learning methods for future continuing nursing education programs.

Developing an E-learning education programme for staff nurses: processes and outcomes

OBJECTIVE

To describe the Instructional System Design Processes (analysis, design, development, implementation, and evaluation) used to develop an e-learning education programme for staff nurses at a 700-bed teaching medical center in Taiwan.

BACKGROUND

Evidence has shown that education via e-learning improves knowledge and skills; however, with cost constraints and limited resources, finding effective alternatives is critical for health professionals.

METHODS

Five courses required for N2 to N3 level nurses were designed for both e-learning and traditional in-classroom programmes. Multiple-choice written test questions and a satisfaction questionnaire were used to compare outcomes between programmes. Nursing care skills were rated as pass or fail. Both programmes were begun at the same time and completed within a 3-month period.

RESULTS

Forty-two staff nurses participated in this study. All nurses' knowledge scores were >70 points (out of 100) and all passed nursing care skills. In five courses, only teaching and learning and communication were statistically significantly different (p=0.001). Nearly all nurses (97.6%) felt satisfied or very satisfied with the programmes.

CONCLUSIONS

Instructional System Design Processes provide an alternative delivery system for in-service nursing education which allows for individualized leaning.

Use of the internet in staff development and its application in helping critical care nurses to lower family stress

A systematic review evaluated use of the Internet in nursing staff development and the feasibility of using the Internet to teach critical care nurses how to help families. Use of the Internet to provide staff development had varying success. The keys to success are careful development of the program according to needs and capabilities of the users, strong education pedagogical principles, and constant evaluation for success in order to make alterations as they are needed.

The hospital library as a "magnet force" for a research and evidence-based nursing culture: A case study of two magnet hospitals in one health system

When Baptist Hospital of Miami, then South Miami Hospital, became Magnet award-winning hospitals, their libraries' challenges increased. Could their librarians ease the transition of research and evidence-based practice into the "real world" of nursing? Did library services have a role in the ongoing Magnet re-credentialing process? This case study defines hospital library magnet force strategies that worked in the quest for this prestigious award for nursing excellence at two hospitals at Baptist Health South Florida.