Nurses' perceptions of education on invasive mechanical ventilation

Nursing Activity Score for estimating nursing care need in intensive care units: findings from a face and content validity study

AIM

To re-evaluate the face and content validity of the Nursing Activity Score currently adopted in evaluating activities that best describe workloads in intensive care units and their weight in describing average nursing time consumption.

BACKGROUND

The Nursing Activity Score calculates the amount of nursing time that each patient will require over the next 24 hours. It has been widely used around the world since its first validation in 2003. However, no re-evaluation of its validity with regard to the advancements achieved in intensive care units nursing care has been documented to date.

METHOD

A research project was undertaken from 2012 to 2015, aimed at critically evaluating and validating this tool in the current context of Italian intensive care units nursing care. The 23 items were translated forward and backward into the Italian language, then a panel of 10 experts in critical care evaluated the face validity. Content validity was evaluated through focus groups involving seven critical care expert registered nurses.

FINDINGS

The Nursing Activity Score instrument has been considered as not fully adequate to measure current intensive care units nursing activities and their weightings have been considered not fully adequate to score average nursing time consumption. From the content validity process, lack of adequacy has emerged with respect to the concept of nursing care underpinning the tool, the interventions included, its capability to predict the nursing resources needed, advancements achieved in intensive care units nurses' roles and competences, and the contextual factors that may influence consumption of nursing time.

CONCLUSIONS

Development of the Nursing Activity Score tool both conceptually and in its structure, in view of the innovations that have occurred in the context of intensive care units, is necessary to continue to have a common tool to help clinicians and managers to capture accurately and compare nursing care required by patients in critical care settings.

IMPLICATIONS FOR NURSING MANAGEMENT

There is a need to revise the Nursing Activity Score tool, enabling its use in estimating nursing workloads in current Italian intensive care units practice. A taskforce of clinical nurses and nursing managers, capable of protecting the valuable original Nursing Activity Score project and to advance its further development is recommended.

Nurses' perceptions of education on invasive mechanical ventilation

BACKGROUND

Intensive care units (ICUs) encompass advanced clinical management and technology, mandating continuing education for nurses to maintain competency. This study examined nurses' perceptions of current education on invasive mechanical ventilation in an Australian ICU.

METHODS

Qualitative data were obtained from five optional open-ended questions as part of a larger 30-item cross-sectional survey of 160 ICU nurses. Content analysis was used to code the data, developing concepts and themes.

RESULTS

Fifty nurses (31%) completed at least one open-ended question. Content analysis identified five major themes: advanced knowledge, in-service education, practical structured education, interactive bedside teaching, and practicing safe care. Respondents' perceived continuing education on invasive mechanical ventilation to be more focused on novice than experienced ICU nurses and recommended practical, structured bedside teaching as the preferred method of education.

CONCLUSION

Respondents recognized the need for interactive, practical, bedside education sessions to transfer learning into the everyday work environment.