Teaching and Learning Practice Development for Change

An evaluation of professional development for staff working with nursing students in distress

Clinical learning experiences are known to exacerbate nursing student anxiety, causing them to present to clinical placement in distressed, meaning anxious, states. Students already living with anxiety are also more likely to suffer setbacks at this time. Supervising Registered Nurses (RNs), in the clinical settings, struggle to support this student cohort. A professional development activity was designed to introduce RNs to higher education and nursing students' known mental health concerns (such as anxiety) and to arm them with strategies for working with distressed students. A research approach that enabled researchers to collaborate with participants was employed to design the intervention. A study evaluated the impact of the educational intervention with 45 Australian RN supervisors. Two tailed T-tests were chosen to explore the statistical difference between pre- and post-test mean results across the survey items. A 95% confidence interval was used. Statistical significance was set at <0.05. The evaluation indicated the activity could be useful for improving supervising RNs' mental health literacy, thus enhancing their understanding of how to work with distressed students. Participants recommended the activity be offered to any staff supporting student clinical learning. Collaboration between nursing researchers and nursing clinical staff produced a meaningful professional development activity and motivated the participants to increase their mental health literacy and understanding of strategies to support distressed students. Future projects should adopt similar approaches that would support both RNs' ability to support students' during clinical learning and students in distress would also benefit.

Reported use of evidence in clinical practice: a survey of rehabilitation practices in Norway

Background

The South Eastern Health Region in Norway serves approximately 2.8 million people, which is more than half of Norway’s population. Physical medicine and rehabilitation services are provided by 9 public hospital trusts and 30 private rehabilitation facilities. The purposes of this study were to conduct a psychometric analysis of the EBP Implementation Scale (EBPIS) and describe rehabilitation clinicians’ self-reported 1) use of evidence-based practices (EBPs), 2) use of EBPs across hospitals, and 3) determine factors associated with use of EBPs in the South Eastern Health Region in Norway.

Methods

A cross-sectional study using an online survey was conducted with public hospitals and private rehabilitation centers. The survey, which was distributed throughout the region, included the EBPIS, 8 questions related to EBP in the health region, and demographics. Response frequencies were calculated and described. Internal consistency and factor structure of the EBPIS and its subscales were determined. Associations and differences in groups with similar demographics, EBPIS scores, and use of EBPs were identified.

Results

A total of 316 individuals completed the survey, including allied health clinicians, nurses, psychologists, social workers, and physicians. The EBPIS mean score was 30/72. A factor analysis identified that the EBPIS can be divided into 3 subscales: literature search and critical appraisal (α = .80), knowledge sharing (α = .83), and practice evaluation (α = .74). EBP activities reported were primarily related to literature searches, critical appraisal, and discussing evidence. Approximately 65 and 75% of respondents agreed that the same OMs and evidence based interventions were used within the local clinic respectively. Fewer agreed that the same OMs (13%) and evidence-based interventions (39%) are used regionally.

Conclusion

The EBPIS and its subscales demonstrated excellent internal consistency. Practice variability exists in rehabilitation throughout Southeastern Norway. An increased emphasis on use of EBP throughout the region is needed.

Nurses' perceptions of a mental health education programme for Australian nurses

In the present study, we present qualitative findings of study of nurses' perceptions of a mental health education programme for Australian nurses. Many nurses avoid disclosing their mental health problem/illness because of the stigmatization by health workers. Mental health education is a successful means to address workplace stigma; thus, it can be anticipated that such education can address workplace difficulties experienced by nurses with mental health problems. During 2008, a qualitative study was conducted to obtain nurses' perceptions of a short mental health education programme for nurses. The workshop purpose was to improve mental health literacy in order to improve support to colleagues with mental health problems. Semistructured, audio-taped interviews were conducted with 13 nurses and then transcribed. A framework analysis approach guided interpretation of the data. The education programme had limited effect on the participants' attitudes towards colleagues with mental health problems. This was likely due to their high level of mental health literacy and experiences prior to the workshop. Participants felt that a more focused nurse-specific programme might have been more efficacious. Implementing a nurse-specific education session is potentially an effective means to improve support to nurses who experience mental health problems.

Clinical nurse educators' perceptions of research utilization: barriers and facilitators to change

Translation of research to practice remains a challenge. The educator, as a role model and change agent, is strategically placed to facilitate staff development and organizational change, thereby helping to close the gap from research to practice. Understanding barriers to research utilization may facilitate the application of evidence-based practice. [corrected] In this study, the BARRIERS scale was used to assess perceptions of research utilization in a convenience sample of 122 clinical nurse educators in California. Greatest barriers were organizational and nurse characteristics, including lack of authority to change, insufficient time, and limited research knowledge and awareness. Educators from Magnet hospitals and educators with advanced degrees perceived the organization as less of a barrier. Strategies to facilitate and implement change are discussed.

Meeting the challenges: delivering interactive stoma care education

This article illustrates how the authors used the following frameworks: audit cycle, clinical governance, essence of care and evaluations to create a fun, interactive and transferable method of delivering an education programme in the workplace environment. The article demonstrates the benefits of using action planning, benchmarking and overcoming difficulties in delivering education across two organizational boundaries (primary and secondary care). 'Today's 6 x 30 minute Stoma Challenges are...' a full and fun afternoon of interactive stoma education for primary and secondary care staff delivered in an innovative and creative way. The main objective is to enhance qualified and unqualified nurses existing knowledge and skills in relation to stoma care. Also encouraging staff development therefore enhancing the patients' experiences regardless of whether they are in a primary or secondary care setting.

Integrating an evidenced-based research intervention in the discharge of mental health clients

The purpose of this Canadian qualitative study was to explore the experiences of clinical staff who implemented a research intervention: the Transitional Discharge Model (TDM). The TDM provided mental health clients who were hospitalized with peer support and an inpatient staff member to bridge the therapeutic transitioning from hospital staff to the community care provider. Staff from three tertiary care mental health facilities in Canada identified their learning needs in regard to providing the intervention. An educational program was developed and delivered to the clinical staff to support and facilitate the implementation of the new TDM. The extent of the utilization of knowledge and implementation of the TDM varied across the three tertiary care mental health facilities. Focus groups (N=49) with clinical staff were conducted to explore various factors related to the training process as well as the challenges and benefits of implementing the TDM. Data were analyzed using Leininger's Phases of Ethnonursing Qualitative Data Analysis [Leininger, M. (2002). The theory of culture care and the ethnonursing research method. In M. Leininger & M. McFarland (eds.), Transcultural nursing: Concepts, theories, research, and practice (3rd ed.). New York: McGraw-Hill]. Findings revealed that clinical staff experienced challenges in roles and responsibilities, relationships with others, values and beliefs of clients, staff and community, resources, and the processes of care. From the findings, strategies were identified to support the integration of knowledge about the TDM into practice and to increase clinical staff's skills in implementing research interventions. These included support from others, as well as support of practice, policy, and education.