Effectiveness and experiences of team-based learning in nurse education programs: a mixed methods systematic review protocol

Enhancing the use of pain assessment at emergency department: a best practice implementation project

OBJECTIVES

The main aim of the best practice implementation project was to enhance the use of pain assessment and the compliance with evidence-based criteria regarding pain assessment among incoming patients to emergency department.

INTRODUCTION

Adequate approaches to pain assessment and documentation have been demonstrated beneficial for emergency department patients. Evidence-based recommendations establish a focus on education about the implications for evaluating and recording pain in order to improve outcome strategies and quality of care.

METHODS

The implementation project was undertaken in the emergency department following JBI Implementation framework in order to seek whether pain assessment was taken and registered as per protocols. Random selection for 100 anonymized emergency department admission episodes, which had to meet the specified inclusion criteria, was carried out.

RESULTS

The baseline audit showed low compliance in criterion 3 (C3) 'Pain was documented in each assessment' (6%), C4 'Pain was assessed after treatment' (9%) and C5 'Pain was assessed prior to discharge' (10%). In the follow-up audit, noticeable improvement was shown for four of the criteria; C3 (14%), C4 (22%) and for C5 (41%). C1 'Pain was assessed in a timely manner' improved from 81% up to 95%. C2 'Use of a validated scoring tool' had a compliance of 100% as the hospital's assessing system default has NRS-11 scale set up.

CONCLUSION

We performed an audit of pain assessment documentation. Enhancing the use of pain assessment among emergency department nurses by means of specific training emphasizing the importance of documentation showed a positive impact on practice. Follow-up audit results justify the continuity of the implemented strategies.

Noise reduction in the ICU: a best practice implementation project

INTRODUCTION

Sleep deprivation is a relevant problem among patients hospitalized in ICUs. Further, noise is the most critical disruptive factor according to patients.

OBJECTIVE

To implement scientific evidence-based best practices for noise control in an adult ICU.

METHODS

This was an evidence-based implementation project of best practices in noise control, conducted in a high-complexity hospital's adult ICU. The intervention consisted of three steps: baseline audit and identification of barriers, implementation of best practices, and a follow-up audit.

RESULTS

No compliance with best practices was detected in the baseline audit. After the implementation phase, the unit reached compliance levels of 78-88% for most of these criteria only one criterion related to noise level did not match the expected compliance.

CONCLUSION

Adherence to best practices regarding noise control was satisfactory, achieving more than 70% compliance in the six audit criteria. Only the noise level did not reach the threshold recommended by the WHO - a difficulty reported in other studies.

RELEVANCE TO CLINICAL PRACTICE

Best practices related to noise control are essential for managing sleep deprivation in ICUs and include changes in the behaviour of involved professionals.

Nursing students' perception of class immersion facilitators in psychiatric nursing: Team-based learning combined with flipped learning

BACKGROUND

Psychiatric nursing is a complex subject for nursing students due to abstract concepts and required pre-licensure competencies including collaboration and communication. A student-centred educational approach is needed to encourage engagement and immersion in class.

OBJECTIVES

This study aimed to use students' perspectives to explore factors facilitating class immersion in a psychiatric nursing subject using team-based learning combined with flipped learning.

DESIGN

This study used a qualitative approach.

SETTINGS

Team-based learning combined with flipped learning was applied in a 3-credit psychiatric nursing subject over a 15-week semester at a university in Daejeon, South Korea.

PARTICIPANTS

Participants included 12 senior nursing students who had completed a psychiatric nursing subject.

METHODS

Data were collected using individual interviews, and analysed by reflexive thematic analysis. Data analysis was based on constructivist learning theory.

RESULTS

The following four main themes emerged, teacher as a facilitator, inquiry-based learning, collaboration, and reflection. The teacher's role as a facilitator was to guide student's self-directed learning and immersion in enjoyable classes with a non-hierarchical environment. Realistic complex problems allowed students to prepare for future clinical practice and helped students with immersion. Students actively integrated different opinions through collaboration with team members and became immersed in class. Students were able to immerse more in class through critical thinking process and immediate feedback.

CONCLUSIONS

The findings suggest that team-based learning combined with flipped learning based on constructivist learning theory may be an effective instructional approach for increasing class immersion in a psychiatric nursing subject, thereby improving instructor's design for the subject.

Systematic review of the characteristics of brief team interventions to clarify roles and improve functioning in healthcare teams

AIM

Describe brief (less than half a day) interventions aimed at improving healthcare team functioning.

METHODS

A systematic review on brief team interventions aimed at role clarification and team functioning (PROSPERO Registration Number: CRD42018088922). Experimental or quasi-experimental studies were included. Database searches included CINAHL, Medline, EMBASE, PUBMED, Cochrane, RCT Registry-1990 to April 2020 and grey literature. Articles were screened independently by teams of two reviewers. Risk of bias was assessed. Data from the retained articles were extracted by one reviewer and checked by a second reviewer independently. A narrative synthesis was undertaken.

RESULTS

Searches yielded 1928 unique records. Final sample contained twenty papers describing 19 studies, published between 2009 and 2020. Studies described brief training interventions conducted in acute care in-patient settings and included a total of 6338 participants. Participants' socio-demographic information was not routinely reported. Studies met between two to six of the eight risk of bias criteria. Interventions included simulations for technical skills, structured communications and speaking up for non-technical skills and debriefing. Debriefing sessions generally lasted between five to 10 minutes. Debriefing sessions reflected key content areas but it was not always possible to determine the influence of the debriefing session on participants' learning because of the limited information reported.

DISCUSSION

Interest in short team interventions is recent. Single two-hour sessions appear to improve technical skills. Three to four 30- to 60-minute training sessions spread out over several weeks with structured facilitation and debriefing appear to improve non-technical skills. Monthly meetings appear to sustain change over time.

CONCLUSION

Short team interventions show promise to improve team functioning. Effectiveness of interventions in primary care and the inclusion of patients and families needs to be examined. Primary care teams are structured differently than teams in acute care and they may have different priorities.