Critical Care nurses' understanding of the NHS knowledge and skills framework. An interpretative phenomenological analysis

Fluency in Nursing Education and Simulation: A Concept Analysis

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.

Experiences of hand hygiene among acute care nurses: An interpretative phenomenological analysis

Objective:

Occurrences of healthcare-associated infections are associated with substantial direct and indirect costs. Improvement in hand hygiene among acute care nurses has potential to reduce incidence of healthcare-associated infections. Findings from reviews of intervention research have not conclusively identified components that are more or less efficient or effective. Much prior qualitative research has focused on descriptive analysis of policies and practices rather than providing interpretive explorations of how individuals’ perceptions of hygiene might drive practices.

Methods:

We conducted qualitative interview research with eight nurses in the United States who were employed in various patient-care roles. We analyzed the data using an interpretative phenomenological analysis methodology to explore how nurses described their perceptions of, and experiences with, hygiene. We developed themes that explored individual, workplace, and management influences on perception of hygiene.

Results:

Developed themes include practical hygiene, risky business, and hygiene on trial; the latter theme described the conflict between how nurses perceived their own hygiene practices and how they felt hospital management perceived these practices. Other findings included that participants distinguished between policy-mandated use of sanitizer and a personal sense of cleanliness; the latter was more likely to be associated with scrubbing or removal of contaminants than with use of protectants.

Conclusion:

While participants asserted support for facility hand hygiene policies, their behavior in certain instances might be mediated by broadly defined emergent situations and a belief that it is not currently possible to establish a causal link between an healthcare-associated infections and a specific individual or occurrence. Researchers and infection prevention practitioners might consider soliciting greater input from nurses in planning hand hygiene improvement interventions, to encourage ownership, and emphasizing detailed cases as training content to take advantage of individuals’ sensory responses to hygiene.

How to report professional practice in nursing? A scoping review

Background

Nursing professional practice in different contexts of care has been widely described in evidence-based literature. Currently, there is no consensus on a common structure for these descriptions. Understanding and comparing similar practices is made difficult by the varying nature of descriptions provided in scientific literature. Purpose of the study: 1) to report research methods found in the scientific literature that were used to describe the practice of different health professionals; 2) to report on the main concepts used to describe the practice of these health professionals; 3) to propose a structure for the description of the practice in nursing.

Methods

A scoping review following a five-stage approach: 1) identifying the research question; 2) identifying relevant studies; 3) selecting studies; 4) charting data; 5) reporting results. The Medline, CINAHL, psychARTICLES, psyCRITIQUES, psycEXTRA, Psychology and Behavioral Science Collection and psycINFO databases were searched. Each study was analyzed and extracted data were classified by categories and structures used to describe the health professional practices.

Results

Forty-nine studies were included. In these studies, quantitative, qualitative or mixed methods were used to describe professional practice in different health disciplines. Three major concepts were reported most frequently in describing professional practice: roles, domains and activities. The concepts varied greatly among authors. We found that to define roles or to characterize a professional practice, activities must be described and organized on the basis of different domains.

Conclusions

A promising structure for describing nursing professional practice is proposed by the authors of this review. The structure facilitates the accurate description of all domains and activities performed by nurses in different contexts of practice, and will contribute to the development of knowledge about nursing practice in different contexts based on shared concepts.

Electronic supplementary material

The online version of this article (doi:10.1186/s12912-016-0154-6) contains supplementary material, which is available to authorized users.

Basic Competence of Intensive Care Unit Nurses: Cross-Sectional Survey Study

Critical care patients benefit from the attention of nursing personnel with a high competence level. The aim of the study was to describe and evaluate the self-assessed basic competence of intensive care unit nurses and related factors. A cross-sectional survey design was used. A basic competence scale (Intensive and Critical Care Nursing Competence Scale version 1, Likert scale 1-5, 1 = poor and 5 = excellent) was employed among Finnish intensive care unit nurses (n = 431). Intensive care unit nurses' self-assessed basic competence was good (mean 4.19, SD 0.40). The attitude and value base of basic competence was excellent whereas experience base was the poorest compared to the knowledge base and skill base of intensive and critical care nursing. The strongest factor explaining nurses' basic competence was their experience of autonomy in nursing care (F value 60.85, β 0.11, SE 0.01, and P ≤ 0.0001). Clinical competence was self-rated as good. Nurses gave their highest competence self-ratings for ICU patient care according to the principles of nursing care. The ICU nurses also self-rated their professional competence as good. Collaboration was self-rated as the best competence. In basic and continuing education and professional self-development discussions it is meaningful to consider and find solutions for how to improve nurses' experienced autonomy in nursing.