Essential global health competencies for baccalaureate nursing students in the United States: A mixed methods Delphi study

Strategies for academic nursing to advance global and planetary health: A call to action

Nurses play a crucial role in addressing human health influenced by global forces such as pandemics, and political conflicts that displace millions; in leading efforts to promote planetary health; and in achieving the United Nations (UN) Sustainable Development Agenda. Academic nursing programs have a significant role in actualizing nursing's impact on global health (GH) and planetary health (PH). This paper describes how nursing programs can actualize their GH and PH nursing perspectives to benefit students and society, thereby increasing nursing's effectiveness and improving health outcomes in local and global settings. Numerous strategies to actualize GH and PH perspectives were derived from current literature and an assessment of eleven nursing program websites. Nursing programs may adopt program-wide strategies such as reflecting GH and PH in their mission statement; through education, in courses; and through faculty or student scholarship, policy endeavors, and/or partnerships. Now is the time to take such action, recommitting to GH and PH nursing and deepening nursing's impact. Academic nursing programs' leadership role in society, and their role in preparing nurses to lead, educate, discover, and advocate is essential for the health of populations and the planet long into the future.

Competency scale of quality and safety for greenhand nurses: instrument development and psychometric test

BACKGROUND

Guaranteeing nursing service safety and quality is a prioritized issue in the healthcare setting worldwide. However, there still lacks a valid scale to measure the quality and safety competencies of newly graduated nurses globally.

METHODS

This scale was developed in two phases. In Phase One, a literature review and three-round e-Delphi were conducted to generate the initial item pool; while in Phase Two, five experts tested the content validity of the scale. The construct validity was evaluated using confirmatory factor analysis (CFA), and the data were collected among 1,221 newly graduated nursing students between May, 2017 and August, 2017. Finally, the internal consistency reliability and test-retest reliability were tested.

RESULTS

The final version's Competency Scale of Quality and Safety (CSQS) was confirmed by the CFA involving 64 items in six dimensions, including patient-center care, safety, evidence-based practice, collaboration and teamwork, continuous quality improvement, and informatics. The results of data showed that the data supported the modified model of CSQS (Standardized Root Mean Square Residual = 0.03, p = 0.053, Adjusted Goodness of Normed Fit Index = 1.00, Root Mean Square Error of Approximation = 0.007, Fit Index = 0.95, Goodness of Fit Index = 0.97, χ2/df = 1.06), and the standardized factor loadings of items were from 0.59 to 0.74 (p < 0.05). The internal consistency reliability of the total scale was 0.98, and the test-retest reliability was 0.89.

CONCLUSIONS

CSQS was a valid and reliable instrument to measure the safety and quality abilities of greenhand nurses, and could be fully utilized by nursing students, greenhand nurses, nursing educators, as well as hospital nursing managers.

Competencies expected of undergraduate nursing students: A scoping review

AIM

Nursing competencies are crucial indicators for providing quality and safe care. The lack of international agreement in this field has caused problems in the generalization and application of findings. The purpose of this review is to identify the core competencies necessary for undergraduate nursing students to enter nursing work.

DATA SOURCES

We conducted a structured search using Scopus, MEDLINE (PubMed), Science Direct, CINAHL, Web of Science, and Google Scholar.

REVIEW METHODS

We conducted a scoping review using the methodology recommended by the Joanna Briggs Institute, supported by the PAGER framework, and guided by the PRISMA-ScR Checklist. Inclusion criteria included full-text articles in English, quantitative and qualitative research related to competencies for undergraduate students or newly graduated nurses, competency assessment, and tool development from 1970 to 2022. We excluded articles related to specific nursing roles, specific contexts, Master's and Ph.D. curricula, hospital work environment competencies, and editorial.

RESULTS

Out of 15,875 articles, we selected 43 studies, and data analysis with summative content analysis identified five themes named individualized care, professional nursing process, nursing administration, readiness, and professional development.

CONCLUSION

Considering the dynamics of competencies and their change with time, experience, and setting, it is necessary to update, localize, and levelling of the proposed competencies based on the culture of each country.

IMPACT

These competencies provide a guide for undergraduate nursing curriculum development and offer a framework for both clinical instruction and the evaluation of nursing students.

Global Health Competencies and Educational Needs for Nursing Students in South Korea

BACKGROUND

Despite the increasing demand for global health education, relatively few global health courses currently are offered in Korea.

METHOD

This mixed-methods study examined the need for global health competency and global health education experience for nursing students. A survey of 208 nursing students was conducted from May 2020 to August 2020, and three focus groups were conducted with 12 nursing students.

RESULTS

The average score of global health nursing competencies was 2.8 ± 0.7 on a scale ranging from 1 to 4. Female, higher academic achievement, fluent English, and higher global health education experience had a significant effect on global health competency. The most influential factor was more experience with global health education. Nursing students' perceptions and educational needs related to global health education were classified into four subthemes.

CONCLUSION

The development of global health education programs for nursing students is needed. [J Nurs Educ. 2023;62(2):75-82.].

High-Risk Medication in Home Care Nursing: A Delphi Study

AIMS

The aims of the study were to reach consensus on which medications in home care nursing should be considered high-risk medication (HRM) and to obtain recommendations about which interventions home care nurses can perform to improve quality of care and safety in managing these HRM.

DESIGN

This is an international Delphi study with 13 purposively selected experts from 4 different countries.

METHODS

A 3-round iterative Delphi survey was conducted from May 2018 to October 2018, based on a list of 32 medications previously reported as HRM in community care. A proposal for HRM was based on this literature search, and experts were asked to reflect on which (groups of) medications should be considered HRM by home care nurses (completeness of the list, risk assessment per [group of] medication, the need for home care nurse interventions, and the need for an HRM care procedure). The cutoff point for consensus was set at 80% of expert agreement.

RESULTS

The panel assessed the initial list and added 30 (groups of) medications. In the last round, consensus of 80% or more was reached for 27 (groups of) medications to be considered HRM by home care nurses. For 28 medications, additional interventions by a home care nurse were considered warranted. A procedure or protocol for home care nurses was deemed necessary for 12 medications.

CONCLUSIONS

We identified a set of (groups of) medications that should primarily be considered HRM by home care nurses.Impact:• What problem did the study address? This study clarified which medications should be considered HRM by home care nurses.• What were the main findings? Experts identified a set of 27 (groups of) medications that should primarily be considered HRM by home care nurses.• Where and on whom will the research have an impact? The results provide essential information for home care agencies when setting up an HRM policy.

Reaching Consensus on Global Health Competencies for Undergraduate Nurses in Indonesia: A Delphi Study

BACKGROUND: Trends in the era of globalization show an increasing need for nurses to have the Global Health Competencies (GHC) so as to enable them to address global health problems particularly in the pandemic Covid-19. However, evidence-based information about relevance and feasibility of these competencies for undergraduate nursing students in Indonesia is very limited. AIM: This study aims to achieve consensus among experts on global health competencies for Indonesian undergraduate nursing students. METHODS: Using the 2-rounds Delphi method in a sequential mixed-method design, a total of 35 nursing experts voluntarily participated in the study. Six experts participated in the first round, and 29 others were in the second round, hence the collection of Quantitative and qualitative data. The Item Content Validation Index (I-CVI) = 0.78 and Scale Content Validation Index (S-CVI) = 0.9 were used to determine the level of agreement among the experts. RESULTS: At the end of round 2, an agreement was reached on the 9 GHC domains. However, from the original 44 competencies there were 5 competencies that was excluded in the first round and 3 competencies in the second round. These results were supported by the most frequent comments from the experts that these competencies were lacking in clarity, suitability and irrelevant to undergraduate nurses’ competencies. CONCLUSION: In conclusion, this study has resulted in an agreement among experts regarding global health competencies for undergraduate nursing students in Indonesia. It is predicted that the findings of this study can contribute to the development of global health competencies in the nursing profession. Having these competencies will enable nurses to participate in overcoming global health problems. Validation of the new GHC by larger groups of nursing educators and graduate users is required. Keywords: Delphi, global health competencies, Indonesia, nurses.

Embracing diversity: measuring the impact of an international immersion learning experience on nursing students’ cultural beliefs and values

Objectives

An international Nursing Leadership Collaborative covened in Japan to hold a patient safety and quality workshop for nursing students from six countries. The purpose was to measure students’ self reported beliefs reflecting sensitivity and openness to cultural diversity before and after the international experience.

Methods

A pre-post-test design was used and the Beliefs, Events, and Values Inventory was administered to international undergraduate and graduate nursing students.

Results

The group aggregate data analysis indicate that prior to the start of the workshop, the group presented itself as quite introspective and after the workshop the group reported being more sophisticated in making causal explanations about why the world works in the way it does.

Conclusions

Nursing students experienced an expanded awareness of their beliefs and values that reflect a greater degree of intercultural sensitivity for acceptance of inclusivity and diversity after the experience.

Global Health in Swedish Nursing Curricula: Navigating the Desirable and the Necessary

Global health challenges are likely to be aggravated in the coming years by rapid climate change and environmental degradation. To address the resulting health inequities, nurses need an integrated understanding of environmental and social determinants of health. This study adopts an explorative inductive approach to examine how global health and sustainability are expressed the course syllabi of undergraduate nursing programmes (n = 24) in Sweden. After excluding biomedical and other unrelated content, 67 syllabi were selected for a thematic analysis. Results indicate that global health, the social determinants of health and sustainability tend to appear in a fragmented manner in the syllabi. Global health content is often limited, relegated to elective courses, or altogether missing. A theoretical framework is lacking, and focus lies on an individual rather than structural perspective. Based on international policy, earlier studies on undergraduate nursing education and theoretical work, suggestions are made for how global health and sustainability content could be integrated into nursing education, notably by using a structural competency approach.

Construction of evaluation indexes of nursing students' quality and safety competencies: A Delphi study in China

BACKGROUND

Providing quality and safe nursing care is considered the cornerstone of the healthcare system globally. However, there are no comprehensive evaluation indicators of nursing students' quality and safety competencies in China.

AIM

To develop the evaluation indicators and achieve experts' consensus on bachelor nursing students' quality and safety competencies at their graduation.

METHODS

Based on the framework of the American Association of Colleges of Nursing's Quality and Safety Education for Nurses, literature review, semi-structured interview, and e-Delphi technique, the evaluation indicators were developed and obtained consensus through the participation of 22 nursing educational experts from August 2016 to May 2017.

RESULTS

The evaluation indicators consisted of six domains, including safety care, patient-center care, collaboration and teamwork, continuous quality improvement, informatics, and evidence-based practice competencies, and 88 indicators. These indicators obtained ≥76% consensus on the experts' judgments.

CONCLUSIONS

The evaluation indicators achieved the consensus on a panel of nursing experts, which were scientific and practicable. It could provide guidance for establishing a nursing curriculum to prepare bachelor nursing students' quality and safety competencies.

Text network analysis of research topics and trends on global health nursing literature from 1974 -2017

AIMS

The purpose of this study is to examine the relationship between keywords in existing global health nursing studies during 44 years (1974-2017) and to develop schematic diagrams of the relationship between these keywords from a macro perspective. It is to identify the trend of the literature in global health nursing field.

DESIGN

A descriptive bibliometric analysis of publications in global health nursing.

METHODS

The keywords from 7,115 articles and literatures were examined using the Text Rank Analyzer via the applied text network analysis with NetMiner 4.0.

RESULTS

As for global health nursing, keywords with the most frequent appearance and the highest networking degree in centrality were 'study', 'patient', 'nurse', and 'women'. Six central keywords were also found highly related to other keywords: 'global health nursing', 'study', 'patient', 'care', 'nurse', and 'education'. By measuring the degree of keywords connected to other keywords in centrality, six clusters were established. Then, emerging topics assessed by time periods were identified as follows: the beginning phase ('breastfeeding', 'women', and 'children'), the development phase ('quality', 'life', and 'human immunodeficiency virus'), the maturation phase ('mental health', 'depression', and 'global health'), and the expansion phase ('pregnancy', 'palliative care', and 'infectious disease').

CONCLUSION

The identified trends on this study will help nurse leaders to grasp the trends and insights for global health and to train future nurses to serve clients better in the practice fields.

IMPACT

Keywords with the highest appearance and centrality in the network were found in the global health articles. The bibliometric analysis showed various subjects according to the following phases: beginning development maturation and expansion. The awareness of the trend change in the global health helps nursing researchers and educators modify the curriculum of global health nursing and train future nurses to be equipped with the global health competencies.

Ethical Considerations for Short-Term Global Health Projects

Various types of health professional volunteers from high-income nations are increasingly engaged in short-term global health projects in low- and middle-income countries. The goal of global health projects is to improve health for all people and address health inequities. Short-term projects lasting days to months can create challenges for volunteers and hosts. Despite attempting to do good, volunteer efforts may unwittingly cause harm to host organizations by planning projects without consideration for the local infrastructure, the community, and the health care staff. Although well-intentioned and often beneficial, volunteer efforts can fail to provide adequate follow-up or may disrupt or override local health efforts. In some low-resource settings, dire health needs and lack of supervision may result in volunteers practicing beyond their professional scope. Recently published guidelines, competencies, and position statements have addressed ethical behaviors for short-term global health experiences. Partnerships that are founded on principles of justice and autonomy provide an avenue for mutual collaboration. Short-term global health projects that focus on host needs are likely to strengthen local capacity to improve health outcomes. This article reviews guidelines for short-term global health experiences and addresses the ethical principles for planning effective projects.

Global Health Education Programs in the Americas: A Scoping Review

Background:

The interest in Global Health (GH) as an academic discipline has increased in the last decade. This article reports the findings of a scoping review of studies about Global Health education in the Americas.

Objective:

To analyse educational programs on global health in the Americas.

Method:

Five electronic databases were used in a scoping review: PubMed, Scopus, Web of Knowledge, CINAHL, and Lilacs. Data collection happened in November 2017–March 2018. The following stages were rigorously observed: identification, selection, charting, and summarizing the studies that were included. To process the data, we used IRaMuTeQ software.

Findings:

Forty-six studies were identified and organized in categories: 1) diversity of the topics addressed in GH; 2) models of teaching; 3) emotional, cultural, and collaborative aspects in teaching GH; 4) student preparation for GH experiences; and 5) structures required for a GH course.

Conclusions:

The existing global health curriculum in the Americas is diffuse and limited, with a greater focus on clinical aspects. Thus, a minimum curriculum for students from different areas is needed. Results evidenced that the teaching of global health in the Americas is still incipient, although it is promising. The lack of a common curriculum for the courses in the region makes it difficult to train sensitive and capable professionals to achieve the 2030 Sustainable Development Goals.