Senior Nursing Studentsʼ Perceptions of Their Readiness for Oral Medication Administration Prior to Final Year Internship: A Quantitative Descriptive Pilot Study

Evaluating student understanding of core pharmacokinetic concepts

Both educators and graduates have expressed concern about a perceived pharmacology knowledge gap that includes difficulty applying fundamental principles to clinical and research problems. Consequently, we sought to determine the extent to which current students can explain the meaning of, and appropriately apply, a subset of core concepts, and to identify any misconceptions arising from the responses. Of the twenty-four pharmacology core concepts arising from the recent international collaboration, four pharmacokinetic concepts were chosen, namely drug bioavailability, drug clearance, volume of distribution, and steady-state concentration. A total of 318 students from 11 universities across seven countries chose to participate in this study. Expert analysts identified the essential elements for each concept, then independently assessed each student's response. Teams of two experts compared their evaluations to reach a consensus and grouped misconceptions thematically. For each core concept, less than 30% of students provided responses that encompassed all essential elements. Participants found drug clearance most challenging, generally conflating it with the rate of elimination, whereas they demonstrated a better understanding of drug bioavailability. There were 34 misconception themes coded in a total of 813 statements, with volume of distribution and drug clearance producing the highest numbers (13 and 12, respectively). Overall, results suggest that students found it easier to apply the concept than to explain its meaning, which might reflect the shift from didactic to active learning approaches. These findings may be useful for educators who are developing introductory pharmacokinetic courses by providing conceptual focus and revealing common misconceptions to explicitly address.

A psychometric appraisal of a revised preparedness for medication administration questionnaire in final-year undergraduate nursing students: a secondary analysis

BACKGROUND

Students must be prepared for the transference of medication administration (pharmacology knowledge and clinical skills) to clinical practice. The Preparedness for Medication Oral Administration questionnaire has been used in several studies and demonstrated strong internal reliability and consistency. The questionnaire has been revised to align with updated medication competencies. The factor structure or dimensionality of the questionnaires has not been examined.

AIM

To examine the psychometric properties of the Preparedness for Medication Administration (Revised) Questionnaire.

METHOD

Data from a previous study were used to determine the psychometric properties of the Preparedness for Medication Administration (Revised) Questionnaire. Three new items were added to the revised questionnaire, and the focus shifted from the oral route of medication administration. An exploratory factor analysis was conducted to assess the reliability and dimensionality of the revised questionnaire, using principal axis factoring and Oblique rotation on the 20 items.

RESULTS

Two hundred fourteen final-year undergraduate nursing students completed the questionnaire; the Kaiser-Meyer-Olkin measure confirmed sampling adequacy (.96) and Bartlett's test of sphericity χ2(214) 3003.534 p < .001 adequate sample size-to-variable ratio and inspection of the correlation matrix for loadings > 0.30. The 20 items produced a 2-factor solution, which was also confirmed by parallel analysis, with the deletion of 4 items not meeting item loadings of > 0.4. The final revised version of the questionnaire titled the Preparedness for Medication Administration Revision2 (PMAR2) contained 16 items loading onto one of the 2 factors titled Clinical Reasoning and Confidence to Practice Safely. Cronbach alpha coefficients for the factors were .89 to .95, respectively.

CONCLUSION

This research provides information for a psychometrically sound tool to assess students' preparedness for medication administration once they graduate and become independent practitioners.

Newly qualified general nurses' experiences of pre-registration internship: A Republic of Ireland cross-sectional study

Aim

The aim of this study was to examine Newly Qualified General Nurses' (NQGNs') experiences of and the value of the internship period.

Background

Internship was introduced as the final part of the undergraduate nursing degree in Ireland in 2002. The aim was to provide students with clinical experience, whereby they work more independently and in doing so, seamlessly progress their transition to the role of registered nurse.

Design

A cross-sectional, quantitative, descriptive study.

Setting and Participants

Newly Qualified General Nurses who completed their undergraduate degree in general nursing and graduated from Higher Education Institutions (HEIs) in the Republic of Ireland between 2018 and 2020 were eligible for inclusion in the study.

Methods

Participants were recruited using snowball sampling. Data were collected anonymously using the electronic Experience of Internship Questionnaire. Analysis was undertaken using the Statistical Package for Social Sciences (SPSS 27).

Results

Pre-internship preparation experiences differed across hospitals. The NQGNs would have preferred more support with their caseloads and help with understanding the rationale for care delivery. However, internship provided good opportunities to link theory to practice and was considered valuable by most in preparing them for practicing as a registered nurse.

Conclusion

Internship assists intern nursing students to link theory to practice. Further, support in internship is crucial when managing a caseload and to enhance understanding of the care provided. The value of internship was identified with suggestions on ways to strengthen the experience of internship.

Final year nursing students' preparedness for medication administration during COVID-19: A multi-site survey study

AIM

To examine final-year undergraduate nursing students' characteristics and their perceived preparedness for medication administration across three universities during COVID-19.

BACKGROUND

Medication administration is a complex process and medication errors can cause harm to the patient. Nurses are at the frontline of medication administration; therefore, nursing students must be well-prepared to administer medicines safely before graduation. Little is known about final-year undergraduate nursing students' perceived medication administration preparedness during COVID-19.

DESIGN

A multi-site study using a cross-sectional survey of student demographics, the 'Preparedness for Medication Administration' (Revised) tool and an open-ended question.

METHODS

The questionnaire was distributed to nursing students in their final semester of the program in 2022 across two universities in Australia and one in New Zealand. Completed surveys n=214. Descriptive statistics were used to analyse the demographic data. Differences in demographic data and preparedness scores between the three universities were analysed using ranked means, correlation coefficient, Chi-Square, Mann- Whitney U and Kruskal- Wallace H. Directed content analysis was used to analyse the data from the open-ended question.

RESULTS

Overall, students reported high preparedness scores for medication. International students reported significantly higher preparedness scores (Md =119, n=29) compared with domestic students (Md=112.00, n=164), U=1759.50, z=-2.231, p=02, r=.16. Mean ranked scores for each item were above average across the three universities. The impact of COVID-19 on curriculum and students' opportunity to practice may be one explanation for the difference in preparedness scores between universities. International participants reported significantly higher scores on the Preparedness for Medication Administration (Revised) tool than domestic participants. Older students were more confident in applying principles of pharmacology to practice. Students' comments generated three major categories and five subcategories indicating preparedness gaps.

CONCLUSION

This study provides insights into students' medication management preparedness during restrictions and before transitioning to the role of Registered Nurse. It highlights the need to provide integrated and comprehensive medication education and assessments throughout the curriculum and the need for additional support for newly graduated nurses in medication management due to the restrictions.

Readiness levels of intern nursing students during the transition to professional practice within the Al Jouf Region in Saudi Arabia

BACKGROUND

The transition of newly graduated nurses into the workforce is recognized as a complex undertaking and has been examined extensively in the literature.

OBJECTIVE

This study aimed to assess the readiness levels of intern nursing students and investigate the factors affecting their transition to professional practice within the Al Jouf region in Saudi Arabia.

METHODS

The study employed a combination of descriptive, correlational, and qualitative methodologies to conduct its investigation. Data were acquired via an online questionnaire that included demographic information, the Nursing Practice Readiness Scale (NPRS), and two open-ended questions. A total of 135 nursing intern students were recruited to participate in the study. Benner's "novice-to-expert" theory of clinical competence was utilized to guide the theoretical underpinning of the study.

RESULTS

Findings revealed that most intern nursing students (63.7%) exhibited a moderate level of readiness. Furthermore, 70.4% and 55.6% of the students showed moderate readiness in terms of their professional attitudes and patient-centeredness, respectively. More than one-third of the students demonstrated a high level of readiness in the self-regulation domain (36.3%), while a similar proportion indicated a high level of readiness in the domain of collaborative interpersonal relationships (33.3%). The students underscored their reliance on the education system as pivotal in enhancing their preparedness for clinical practice.

CONCLUSION

Nursing internship programs contribute to a more comprehensive readiness of nurses for active participation in clinical practice as compared to traditional educational programs.

Nursing students' and faculty's experiences of first medication administration: A phenomenological inquiry

BACKGROUND

Learning medication administration is essential for nursing students, but the first time can be stressful and shape their clinical development. Previous research primarily focused on student knowledge and technical aspects.

PURPOSE

This phenomenological study helped explore the lived experiences of nursing students and faculty during student's first medication administration in the clinical setting to gain a deeper understanding of their thoughts, feelings, and perspectives.

METHOD

Semi-structured interviews were conducted with female student and faculty informants (N = 12). Using a phenomenological study, data were analyzed using van Manen's hermeneutic six-step research activity method.

RESULTS

Five overarching themes were found: administrating medication, (un)preparedness for complexities in the clinical environment, transformative experience, overcoming fears, and reaping the rewards.

CONCLUSION

First-time medication experiences are greater than an exercise in skill proficiency and may be improved if faculty provides more structured learning experiences and take sufficient time for student preparation in relating medication knowledge to the skill, technology usage, and supporting students' attitudes toward nurse-patient interactions. These are essential aspects of the medication administration learning process as nursing programs shift toward competency-based education. Clinical faculty also need support in their role as educators and to be facilitated to find this time, considering their multiple responsibilities.

Factors related to readiness for practice among undergraduate nursing students: A systematic review

AIM

This systematic review identifies the factors and effective strategies related to nursing students' readiness for practice.

METHOD

A search was conducted from 2012 to 2022 in PubMed, CINAHL, SCOPUS, PsycInfo and EMBASE databases, using a combination of predetermined keywords. Four authors made the selection independently and the methodological quality was assessed using the RoBANS, Analytical cross-sectional studies Critical Appraisal Tool and MMAT tools. Information was extracted using a matrix and analyzed through the thematic synthesis approach.

RESULT

Studies (14,000) were identified from the search and 11 met the predetermined inclusion criteria. The main identified themes were personal characteristics, education-related factors, cognitive factors, psychological characteristics and social factors influencing readiness to practice. Some barriers also affect readiness for practice among undergraduate nursing students.

CONCLUSION

Multiple personal, educational and community factors interact in diverse ways to influences nursing students readiness to practice.

REGISTRATION

The protocol for the conduct of this study was registered on the International Prospective Register of Systematic Reviews (PROSPERO) with the registration number CRD42020222337.

A cross-sectional study of the knowledge, skills, and 6 rights on medication administration by nurses at emergency department

Introduction: Medication errors occur when a patient is given the wrong drug or receives incorrect pharmacological therapy. Incorrect drug administration can cause fatal errors resulting in the patient’s death. Approximately 44,000-98,000 patients die each year due to medication errors and this condition is found often in the Emergency Room (ER) due to the complexity. Therefore, this study aims to analyze the relationship between nurses’ knowledge, skills, and 6 rights on medication at Emergency Department. Design and Methods: This is an analytical observational study involving 70 nurses randomly selected using consecutive sampling and working at the ER department of Saiful Anwar Hospital Malang. Data were collected through a questionnaire and analyzed descriptively to determine the knowledge and skills of nurses and the implementation of the correct principles of medication administration. Results: The results showed that most of the emergency room nurses had good knowledge and skills in applying the correct principles of medicine. However, the majority could not calculate the drug dose accurately. The spearman rank results showed that there was a relationship between knowledge and the 6 correct drug principles (p<0.001, α= 0,05; r = 0.491) with a percentage of 44%. This indicates that a higher knowledge results in the correct implementation of the drug. Similarly, there was a significant positive correlation between skills and proper medicine (p<0.001, α= 0,05; r = 0.378). Conclusions: It can be inferred that a higher nurse’s knowledge and skill results in a better administration of medicine.

Final-Year Nursing Students' Experiences During the COVID-19 Pandemic: A Scoping Review

BACKGROUND

The transitional experience from final-year nursing students (FYNS) to newly graduated RNs (NGRN) challenges individuals' professional and personal identities. Multiple studies have documented the experiences of FYNS graduating in the pandemic, but no studies have synthesized the findings.

METHOD

This scoping review examined the barriers and facilitators FYNS experience as they transitioned to become NGRN during the coronavirus disease 2019 (COVID-19) pandemic. Databases were searched for relevant articles, and articles published in peer-reviewed journals between 2019 and 2021 that focused on the support of FYNS in clinical settings in North America, Europe, and Australia were included.

RESULTS

Three themes were identified: emotional turmoil and coping, clinical competence and readiness for practice, and teaching strategies.

CONCLUSION

This review revealed important insight on how the pandemic affected FYNS' transition to practice and identified gaps in the literature for future research. [J Nurs Educ. 2023;62(1):6-11.].

Nursing Students' Knowledge, Personality Traits, and Self-Efficacy Related to Medication Administration Error

BACKGROUND

Nursing education influences medication administration practices, which involve clinical decision making and risk perceptions.

METHOD

This mixed-methods concurrent nested study explored the relationship among knowledge, personality traits, and self-efficacy related to medication administration error in fourth-year, prelicen-sure nursing students (n = 60) who were recruited from three campuses of a large university.

RESULTS

Results indicated low mean knowledge (70.75) and neuroticism (2.44) scores, and high mean self-efficacy and confidence (5.78) and conscientiousness (4.51) scores. Conscientiousness was correlated with both knowledge (r = .271, p = .036) and neuroticism (r = -.313, p = .015). Thematic analysis yielded four themes: nature of risk perceptions, more opportunities to learn, experiences with medication administration error, and intrinsic characteristics influence errors. Convergence was evident in both knowledge and personality data; self-efficacy/confidence and risk perceptions data diverged.

CONCLUSION

Knowledge, personality traits, and self-efficacy appear to influence nursing students' risk perceptions of medication administration error, indicating an area for future research. [J Nurs Educ. 2022;61(7):367-374.].

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

BACKGROUND

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

METHOD

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

RESULTS

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

CONCLUSION

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

Effect of progressive muscle relaxation exercise on clinical stress and burnout in student nurse interns

PURPOSE

To determine the effects of progressive muscle relaxation exercise (PMRE) on clinical stress and burnout in student nurse interns.

DESIGN AND METHODS

This is a randomized controlled trial. Interns were divided into control group (CG; n = 78) or experimental group (EG; n = 67) randomly. PMRE was performed by students in the EG. Personal information form, Burnout Measure Short Version (BMS) and Physio-Psycho-Social Response Scale (PPSRS) for nursing students were administered to both groups in the first and last meeting.

FINDINGS

There was a significant difference in posttest scores between groups; EG posttest scores on the BMS, on the PPSRS, and subscales were lower than those of the CG.

PRACTICE IMPLICATIONS

PMRE training ameliorates burnout and PPSRs to stress during clinical practice in nursing students.