School nurse online emergency preparedness training: an analysis of knowledge, skills, and confidence

Impact of an Online Course to Improve School Nurses' Mental Health Competencies

School nurses play a key role in supporting student mental health, and many school nurses report the need for additional mental health education. The Mental Health Training Intervention for Health Providers in Schools (MH-TIPS) is a training and implementation support system for school nurses to enhance their skills in promoting student mental health. The current study evaluated the feasibility of the MH-TIPS online curriculum for school nurses, and its impact on their preparedness and ability to support student mental health. Participants included 1,282 registered nurses and nurse practitioners. Descriptive statistics indicated that MH-TIPS online was feasible, relevant, and accessible for school nurses and helped them support student mental health. School nurses reported significant improvements in their preparedness to conduct brief mental health interventions with students and motivate students to seek help. MH-TIPS online is a promising tool to increase the ability of school nurses to support student mental health.

Effectiveness of e-Learning on Neonatal Nurses' Pain Knowledge and Pain Measurement Skills: A Pilot Study

BACKGROUND

Reported benefits of virtual programs include user satisfaction and feasibility to train nurses to utilize pain scales. However, the effectiveness of the virtual neonatal pain management program on nurses' knowledge and scoring skill acquisition has not been examined.

PURPOSE

This study developed a comprehensive virtual program on neonatal pain management and examined its effectiveness on nurses' knowledge and skill acquisition of selected pain scales.

METHODS

Evidence-based content was designed as a virtual program and pre-and posttests to examine skill and knowledge acquisition were developed and validated. Analysis of covariance was used to assess the differences from pre- to posttest based on the intensity of participants' involvement while examining the overall effectiveness of the program.

RESULTS

A total of 115 nurses representing 7 hospitals completed the virtual neonatal pain management program, and 52 nurses completed the posttest. The Student paired t test showed an increase in posttest scores from pretest scores among participants. Participants' final degrees and years of experience were not related to posttest scores. The analysis of covariance showed that the high study group had a significantly higher amount of change in total scores and pain measurement skill scores than the low study group on the posttest.

IMPLICATIONS FOR PRACTICE

The virtually delivered neonatal pain management program can be useful for nurses' attainment of knowledge and skills for managing neonatal pain, including an appropriate use of selected scoring tools.

IMPLICATIONS FOR RESEARCH

It is necessary to examine how organizational unit attendance rate for e-learning and posttest results are related to patient outcomes.

VIDEO ABSTRACT AVAILABLE AT

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Development of emergency nursing care competency scale for school nurses

BACKGROUND

School nurses perform vital student emergency services at school, and assessing their emergency nursing care competency is critical to the safety and quality of care students receive. The purpose of the study was to develop a scale for measuring school nurses' competency.

METHODS

This was an instrument development and validation study. It was conducted according to the revised DeVellis scale development process coupled with the application of the International Council of Nurses' Nursing Care Continuum Competencies Framework. Eight experts specializing in school health and emergency care evaluated the content validity, while 386 school nurses evaluated the scale. The validity evaluation comprised factor analysis, discriminative validity analysis according to differences in school nurse experience, and criterion validity analysis. Scale internal consistency was analyzed using Cronbach's α value.

RESULTS

The final scale comprises a self-reported 5-point Likert scale with 30 items based on three factors and three sub-factors. Both the convergent validity of the items by factor and the discriminative validity were both confirmed. The criterion validity was also found to be positively correlated with the Triage Competency Scale.

CONCLUSION

The scale may be used to identify factors influencing school nurses' competency in emergency nursing care and contribute to research in competency-based education programs.

Effectiveness of m-learning HiSense APP-ID in enhancing knowledge, empathy, and self-efficacy in caregivers of persons with intellectual disabilities: a randomized controlled trial

M-learning is a flexible form of digital education that can benefit professional caregivers. The m-learning intervention ‘HiSense APP-ID’ was developed to support caregivers of persons with intellectual disability (ID). The intervention focuses on improving knowledge about sensitive and responsive caregiving for persons with ID. This randomized controlled trial of 101 professional caregivers of persons with moderate or mild ID evaluated whether m-learning improves practical and theoretical knowledge about secure attachment in persons with ID, and increases empathy and self-efficacy. The ‘HiSense APP-ID’ consists of 120 multiple-choice questions relating to attachment theory and the experience of persons with ID. Participants answer four questions each day for 30 days. In pre-, post-, and follow-up assessments, all participants completed a series of questionnaires concerning social validity, knowledge, self-efficacy, and empathy. Linear mixed effects modeling was then used to assess the effectiveness of the intervention. Users rated the app positively on usefulness, ease of use, design, and development of their own skills. Knowledge improved in the group of participants who followed m-learning. An interaction effect was found for empathic concern, but no significant effect was found for social empathy or self-efficacy. Thus, m-learning is a useful and flexible educational tool for professional caregivers of persons with ID, and the ‘HiSense APP-ID’ was able to improve theoretical knowledge in very short sessions spaced over a longer period of time.

Impact of Education on School Nurses' Knowledge of Inflammatory Bowel Disease

Background/Aims

School nurses’ knowledge of inflammatory bowel disease (IBD) has not been evaluated. We aimed to investigate school nurses’ knowledge of IBD and determine whether education could improve this knowledge.

Methods

School nurses were invited to complete self-reported questionnaires on IBD. Then, IBD specialists from tertiary referral hospitals provided a 60-minute lecture with educational brochures on two occasions, with a 3-month interval. Within 6 months after the educational interventions, school nurses were asked to complete the same IBD questionnaire via e-mail.

Results

Among 101 school nurses who were invited to participate, 54 nurses (53.5%) who completed two consecutive questionnaires were included in this study (median age, 45 years; range, 25 to 59 years; 100% female); 11.1% and 7.4% of the study participants had no knowledge regarding ulcerative colitis and Crohn’s disease, respectively. They had heard of IBD most frequently from doctors (33.3%), followed by internet sources (25.9%). After 6 months, the number of nurses who could explain IBD to students with over 30% confidence increased from 24 (44.5%) to 42 (77.8%) (p<0.001). Most nurses (81.5%) reported that the educational intervention was helpful for managing students with abdominal pain or diarrhea. The number of students who received IBD-related welfare services from the Daegu Metropolitan Office of Education doubled when compared with the corresponding number during the prior educational year.

Conclusions

There is room for improvement in school nurses’ knowledge of IBD. A systematic educational program on IBD should be implemented for these nurses.

A Survey of School Nurse Emergency Preparedness 2014-2015

Well-prepared school nurses are more likely to handle emergencies properly. Thus, assessing crisis management preparedness is important. In August 2014, a questionnaire was sent to 275 nurses in a large Texas school system to collect data about nurse and school characteristics, emergency frequency and management, and equipment availability. Completed surveys (201, 73%) were analyzed. Fisher's exact test was used to evaluate comparisons among nurses' confidence levels, school characteristics, emergencies, and medical emergency response plans (MERP). Logistic regression was used to estimate associations between characteristics and nurses reporting less confidence. Most respondents were experienced nurses. Shortness of breath was the most common event faced. Odds of less confidence were significantly higher among nurses with <5 years' experience, working at elementary schools, schools without a MERP or where it was not practiced, or caring for <10 schoolchildren weekly. Overall, recommended emergency management guidelines were met.

Reliability and Validity of a Tool to Measure School Nurse Perceptions and Practices Associated With Childhood Obesity Prevention

BACKGROUND AND PURPOSE

Childhood obesity prevention (COP) should include increasing school nurse involvement. Measurements of school nurse perceptions influencing COP practices are limited. The purpose of this study is to evaluate the reliability and validity of 5 measures of school nurse COP practices and perceptions.

METHODS

A 70-item anonymous survey was completed by 171 Florida registered nurse (RN) school nurses and tested for reliability and validity.

RESULTS

Internal reliability was acceptable with Cronbach's alphas ranging from .81 to .94. Uncertain to adequate test-retest reliability was determined by correlation coefficients (r = .55-.78). Significant correlations (p < .05) based on hypothesized relationships provided moderate support for construct validity.

CONCLUSIONS

Results support use of these scales in research with targeted school nurse populations to promote COP practices.

Using School Staff Members to Implement a Childhood Obesity Prevention Intervention in Low-Income School Districts: the Massachusetts Childhood Obesity Research Demonstration (MA-CORD Project), 2012-2014

Introduction

Although evidence-based interventions to prevent childhood obesity in school settings exist, few studies have identified factors that enhance school districts’ capacity to undertake such efforts. We describe the implementation of a school-based intervention using classroom lessons based on existing “Eat Well and Keep Moving” and “Planet Health” behavior change interventions and schoolwide activities to target 5,144 children in 4th through 7th grade in 2 low-income school districts.

Methods

The intervention was part of the Massachusetts Childhood Obesity Research Demonstration (MA-CORD) project, a multisector community-based intervention implemented from 2012 through 2014. Using mixed methods, we operationalized key implementation outcomes, including acceptability, adoption, appropriateness, feasibility, implementation fidelity, perceived implementation cost, reach, and sustainability.

Results

MA-CORD was adopted in 2 school districts that were facing resource limitations and competing priorities. Although strong leadership support existed in both communities at baseline, one district’s staff reported less schoolwide readiness and commitment. Consequently, fewer teachers reported engaging in training, teaching lessons, or planning to sustain the lessons after MA-CORD. Interviews showed that principal and superintendent turnover, statewide testing, and teacher burnout limited implementation; passionate wellness champions in schools appeared to offset implementation barriers.

Conclusion

Future interventions should assess adoption readiness at both leadership and staff levels, offer curriculum training sessions during school hours, use school nurses or health teachers as wellness champions to support teachers, and offer incentives such as staff stipends or play equipment to encourage school participation and sustained intervention activities.

The Effect of Smartphone-Delivered Emergency Preparedness Education on Coping Knowledge Among Fifth- and Sixth-Grade Elementary Schoolchildren in South Korea

This study examined the effect of an intervention on coping knowledge among fifth- and sixth-grade elementary schoolchildren who received smartphone-delivered emergency preparedness education. This was a quasi-experimental study using a pre-/posttest design. Eighty-six children were recruited to participate. The children in the experimental group ( n = 44) received smartphone-delivered emergency preparedness education while those in the control group ( n = 42) received traditional lecture-centered education. Data were analyzed using a repeated-measured analysis of variance. Subsequently, the experimental group scored significantly higher than the control group on coping knowledge ( F = 7.96, f = .31, p = .010). The use of technology such as smartphone-delivered emergency preparedness education may be effective to improve their coping knowledge of fifth- and sixth-grade elementary schoolchildren.

Impact of an Education Intervention on Missouri K-12 School Disaster and Biological Event Preparedness

BACKGROUND

A 2011 nationwide school pandemic preparedness study found schools to be deficient. We examined the impact of a school nurse educational intervention aimed at improving K-12 school biological event preparedness.

METHODS

Missouri Association of School Nurses (MASN) members were e-mailed a survey link in fall 2013 (ie, preintervention), links to online education modules (ie, intervention) in late fall, and a postintervention survey link in spring, 2014. School biological event readiness was measured using 35 indicators, for a possible score range of 0-35. A paired t-test compared pre- to postintervention preparedness scores.

RESULTS

A total of 133 school nurses (33.6% response rate) completed a survey; 35.3% of those (N = 47) completed both pre- and postintervention survey that could be matched. Pre- and postintervention preparedness scores ranged from 5 to 28.5 (x‾ = 13.3) and 6.5 to 25 (x‾ = 14.8), respectively. Postintervention scores were significantly higher than preintervention scores for those who watched at least 1 module (t = -2.3, p < .05).

CONCLUSION

The education intervention was effective at improving school preparedness, though the impact was small. The education intervention needs to be reassessed, especially in regard to providing a longer intervention period.

Polish school nurses' knowledge of the first-aid in tooth avulsion of permanent teeth

Background

The frequency of dental trauma in schools is secondary only to accidents at home. The aim of this study was to evaluate the knowledge of first aid in the avulsion of permanent teeth presented by Polish school nurses from different areas.

Methods

A cross-sectional study with the use of a structured self-administrative questionnaire was conducted in 2014 on school nurses working in randomly selected Polish provinces. The instrument consisted of demographic questions, questions referring to nurses’ experience and training in dental trauma and questions checking knowledge of first-aid in the avulsion of permanent teeth. The maximum number of points to be scored was eight. Data were analyzed with the Kruskal-Wallis, the Mann–Whitney U and Chi² tests with the level of statistical significance at p < 0.05.

Results

The final sample consisted of 164 nurses of which 70.1 % had experience with dental injuries and 45.7 % witnessed a tooth avulsion in pupils. 10.4 % nurses participated in training courses concerning tooth avulsion and 67.1 % of them independently broadened their knowledge. The knowledge of the first-aid management of an avulsed tooth was moderate (4.72 ± 1.95 points). 78.1 % of nurses chose a correct definition of the term of ‘tooth avulsion’. Only 7.3 % of them were aware that the replantation could be conducted by any witness of an accident. Saline was most often chosen as a proper transport medium for an avulsed tooth (57.9 %), whereas 16.1 % of nurses indicated milk. 13.4 % of evaluated nurses showed readiness to conduct an immediate replantation. Most respondents preferred calling child’s parents and advising them to bring the child to a dentist (63.4 %). The main factor influencing nurses’ level of knowledge was self-education (p < 0.001). Being a witness to dental trauma (p = 0.0032) and working in schools with sports classes (p = 0.0423) were positive determinants of improved knowledge. Nurses from large agglomerations had significantly lower knowledge (p = 0.005). The main source of information for self-education was the Internet.

Conclusions

The evaluated nurses were in need of education with regard to the management of dental trauma cases. The Internet should be used to deliver evidence-based knowledge to medical staff working at schools.

The effectiveness of Internet-based e-learning on clinician behaviour and patient outcomes: A systematic review

BACKGROUND

The contemporary health workforce has a professional responsibility to maintain competency in practice. However, some difficulties exist with access to ongoing professional development opportunities, particularly for staff in rural and remote areas and those not enrolled in a formal programme of study. E-learning is at the nexus of overcoming these challenges. The benefits of e-learning have been reported in terms of increased accessibility to education, improved self-efficacy, knowledge generation, cost effectiveness, learner flexibility and interactivity. What is less clear, is whether improved self-efficacy or knowledge gained through e-learning influences healthcare professional behaviour or skill development, whether these changes are sustained, and whether these changes improve patient outcomes.

OBJECTIVE

To identify, appraise and synthesise the best available evidence for the effectiveness of e-learning programmes on health care professional behaviour and patient outcomes.

DESIGN

A systematic review of randomised controlled trials was conducted to assess the effectiveness of e-learning programmes on clinician behaviour and patient outcomes. Electronic databases including CINAHL, Embase, ERIC, MEDLINE, Mosby's Index, Scopus and Cochrane - CENTRAL were searched in July 2014 and again in July 2015.

QUALITY ASSESSMENT AND DATA EXTRACTION

Studies were reviewed and data extracted by two independent reviewers using the Joanna Briggs Institute standardised critical appraisal and data extraction instruments.

DATA SYNTHESIS

Seven trials met the inclusion criteria for the analysis. Due to substantial instructional design, subject matter, study population, and methodological variation between the identified studies, statistical pooling was not possible and a meta-analysis could not be performed. Consequently, the findings of this systematic review are presented as a narrative review.

RESULTS

The results suggest that e-learning was at least as effective as traditional learning approaches, and superior to no instruction at all in improving health care professional behaviour. There was variation in behavioural outcomes depending on the skill being taught, and the learning approach utilised. No papers were identified that reported the effectiveness of an e-learning programme on patient outcomes.

CONCLUSION

This review found insufficient evidence regarding the effectiveness of e-learning on healthcare professional behaviour or patient outcomes, consequently further research in this area is warranted. Future randomised controlled trials should adhere to the CONSORT reporting guidelines in order to improve the quality of reporting, to allow evaluation of the effectiveness of e-learning programmes on healthcare professional behaviour and patient outcomes.

Academic-Community Partnership to Develop a Novel Disaster Training Tool for School Nurses: Emergency Triage Drill Kit

As children spend approximately 28% of their day in school and disasters may strike at any time, it is important for school officials to conduct emergency preparedness activities. School nurses, teachers, and staff should be prepared to respond and provide support and first aid treatment. This article describes a collaborative effort within the Los Angeles Unified School District to enhance disaster preparedness. Specifically, the article outlines the program steps and tools developed to prepare staff in mass triage through an earthquake disaster training exercise.

Behavioral health emergencies managed by school nurses working with adolescents

BACKGROUND

As members of interdisciplinary teams, school nurses provide behavioral health services. Studies indicate that school nurses may lack sufficient continuing education in adolescent behavioral health and in the management of behavioral health emergencies, specifically. We conducted this study to describe the adolescent behavioral health emergencies managed by school nurses.

METHODS

We used data from a New Mexico public school nurse workforce survey to describe the involvement of school nurses in managing adolescent behavioral health emergencies. We included all respondents who self-identified as working in a secondary school (N = 186). We conducted descriptive analyses.

RESULTS

Two thirds of survey respondents had provided emergency management in the prior school year for child abuse or neglect, depression, and violence at school. Over 40% had provided emergency management for a suicidal student in the prior school year. Although almost 80% of respondents identified "violence at school" as a very important continuing education topic, 40% reported having received continuing education on this topic in the prior 5 years.

CONCLUSIONS

In New Mexico, public school nurses provide substantial amounts of emergency management for adolescent behavioral health problems. Continuing education received by school nurses on behavioral health emergencies may not be commensurate with their clinical responsibilities.

Emergency preparedness: school nurses leading the way

Nurses are trained to think in terms of the nursing process, which encompasses the five steps of assessment, diagnosis, outcomes/planning, implementation, and evaluation. Cities and towns have developed emergency plans based on the "all-hazards" approach. School district plans are also formulated based on the all-hazards approach of hazard mitigation, preparedness, response, and recovery, which mirrors the nursing process. Individual school efforts focus on thesefourprinciples to facilitate development of a comprehensive plan for each school. Utilizing the principles of education, collaboration, resource utilization, leadership, and advocacy throughout the evolution of an updated and functional plan allows for an inclusive and adaptable plan. Like the nursing process, these steps are not separate and distinct, but a continuous process.

Systematic review of effectiveness of situated e-learning on medical and nursing education

OBJECTIVES

Because of the complexity of clinical situations, traditional didactic education is limited in providing opportunity for student-patient interaction. Situated e-learning can enhance learners' knowledge and associated abilities through a variety of activities. Healthcare providers who interact with virtual patients in designed situations may avoid unnecessary risks and encounters with real patients. However, the effectiveness of situated e-learning is inconsistent. The purpose of this study is to determine the effectiveness of situated e-learning in prelicensure and postlicensure medical and nursing education.

METHODS

Literature databases of PubMed, Medline, CINAHL, ERIC, and Cochrane Library were searched. The study eligibility criteria included articles published in English, which examined the effectiveness of situated e-learning on the outcomes of knowledge and performance for clinicians or students in medicine and nursing. Effect sizes were calculated with 95% confidence intervals.

RESULTS

Fourteen articles were included for meta-analysis. Situated e-learning could effectively enhance learners' knowledge and performance when the control group received no training. Compared to traditional learning, the effectiveness of situated e-learning on performance diminished but still remained significant whereas the effect become insignificant on knowledge. The subgroup analyses indicate the situated e-learning program significantly improved students' clinical performance but not for clinicians.

CONCLUSIONS

Situated e-learning is an effective method to improve novice learners' performance. The effect of situated e-learning on the improvement of cognitive ability is limited when compared to traditional learning. Situated e-learning is a useful adjunct to traditional learning for medical and nursing students.

The Physiotherapy eSkills Training Online resource improves performance of practical skills: a controlled trial

BACKGROUND

E-learning is a common and popular mode of educational delivery, but little is known about its effectiveness in teaching practical skills. The aim of this study was to determine whether the Physiotherapy eSkills Training Online resource in addition to usual teaching improved the performance of practical skills in physiotherapy students.

METHOD

This study was a non-randomised controlled trial. The participants were graduate entry physiotherapy students enrolled in consecutive semesters of a neurological physiotherapy unit of study. The experimental group received the Physiotherapy eSkills Training Online resource as well as usual teaching. The Physiotherapy eSkills Training Online resource is an online resource incorporating (i) video-clips of patient-therapist simulations; (ii) supportive text describing the aim, rationale, equipment, key points, common errors and methods of progression; and (iii) a downloadable PDF document incorporating the online text information and a still image of the video-clip for each practical skill. The control group received usual teaching only. The primary outcomes were the overall performance of practical skills as well as their individual components, measured using a practical examination.

RESULTS

The implementation of the Physiotherapy eSkills Training Online resource resulted in an increase of 1.6 out of 25 (95% CI -0.1 to 3.3) in the experimental group compared with the control group. In addition, the experimental group scored 0.5 points out of 4 (95% CI 0 to 1.1) higher than the control group for 'effectiveness of the practical skill' and 0.6 points out of 4 (95% CI 0.1 to 1.1) higher for 'rationale for the practical skill'.

CONCLUSION

There was improvement in performance of practical skills in students who had access to the Physiotherapy eSkills Training Online resource in addition to usual teaching. Students considered the resource to be very useful for learning.