Nursing students' satisfaction with the quality of clinical placement and their perceptions of preceptors competence: A prospective longitudinal study

BACKGROUND

Previous studies have demonstrated that preceptor training programs enhance preceptor competence and effectiveness. However, there is little research that has investigated the link between preceptor training and the quality of clinical placement.

AIM

This study sought to determine if preceptor training influences nursing students' satisfaction with the quality of their clinical placement and their perceptions of preceptor competence.

DESIGN

Prospective longitudinal survey.

METHODS

A total of 189 nursing students from two Nursing Training Colleges in the north of Ghana were surveyed before and after a preceptor training program using two validated questionnaires. Data were analyzed using descriptive statistics and paired samples t-test.

RESULTS

There was a statistically significant increase in student satisfaction with the quality of their clinical placement following preceptors' participation in a preceptor training workshop (t(149) = 4.567, p < 0.001). Student perception of preceptor competence also had a statistically significant improvement following preceptor training, increasing from an average of 136.96 ± 21.45 at baseline to 156.49 ± 25.403 in the follow-up survey (t(142) = 6.731, p < 0.001). Furthermore, the percentage of students who perceived preceptors to be highly competent increased from 23.3 % at baseline to 53.8 % following the preceptor training.

CONCLUSION

The findings from this study indicate that when supported by preceptors who themselves have had training in effective preceptorship, students are more likely to report higher quality clinical placement and perceive preceptors to be more competent.

Depression, anxiety and stress among Australian nursing and midwifery undergraduate students during the COVID-19 pandemic: a cross-sectional study

OBJECTIVES

To assess depression, anxiety and stress among undergraduate nursing and midwifery students during the COVID-19 pandemic, and identify socio-demographic and educational characteristics associated with higher depression, anxiety and stress scores.

METHODS

Cross-sectional study during August-September 2020, using an anonymous, online, self-administered survey. E-mail invitations with a survey link were sent to 2,907 students enrolled in the Bachelor of Nursing suite of courses, offered across four campuses of a single university in Victoria, Australia. Depression, anxiety and stress were assessed using the DASS-21. Data on socio-demographic and educational characteristics, self-rated physical health and exposure to COVID-19 were also collected. DASS-21 subscale scores were compared with existing data for various pre-pandemic and COVID-19 samples. Multiple regression was used to investigate factors associated with higher scores on depression, anxiety and stress subscales.

RESULTS

The response rate was 22% (n=638). Mean scores on all DASS-21 subscales were significantly higher (p<0.001) than means from all comparative sample data. The proportions of students reporting moderate to severe symptoms of depression, anxiety and stress were 48.5%, 37.2% and 40.2% respectively. Being a woman, being younger, having completed more years of study and having poorer self-rated general health were all significantly associated (p<0.05) with higher scores on at least one DASS-21 subscale.

CONCLUSIONS

Almost half of participants reported at least moderate symptoms of depression; more than a third reported at least moderate symptoms of anxiety or stress. Poor psychological wellbeing can impact students' successful completion of their studies and therefore, has implications for nursing and midwifery workforce recruitment and retention. During and after pandemics, universities should consider screening undergraduate students not only for anxiety and stress, but also for depression. Clear, low-cost referral pathways should be available, should screening indicate that further diagnosis or treatment is required.

Factors associated with the decision to prescribe and administer antipsychotics for older people with delirium: a qualitative descriptive study

OBJECTIVES

To explore factors associated with decision-making of nurses and doctors in prescribing and administering as required antipsychotic medications to older people with delirium.

DESIGN

Qualitative descriptive.

SETTING

Two acute care hospital organisations in Melbourne, Australia.

PARTICIPANTS

Nurses and doctors were invited to participate. Semi-structured focus groups and individual interviews were conducted between May 2019 and March 2020. Interviews were audio-recorded and transcribed verbatim. Data were analysed using thematic analysis.

RESULTS

Participants were 42 health professionals; n=25 nurses and n=17 doctors. Themes relating to decisions to use antipsychotic medication were: safety; a last resort; nursing workload; a dilemma to medicate; and anticipating worsening behaviours. Nurses and doctors described experiencing pressures when trying to manage hyperactive behaviours. Safety was a major concern leading to the decision to use antipsychotics. Antipsychotics were often used as chemical restraints to 'sedate' a patient with delirium because nurses 'can't do their job'. Results also indicated that nurses had influence over doctors' decisions despite nurses being unaware of this influence. Health professionals' descriptions are illustrated in a decision-making flowchart that identifies how nurses and doctors navigated decisions regarding prescription and administration of antipsychotic medications.

CONCLUSIONS

The decision to prescribe and administer antipsychotic medications for people with delirium is complex as nurses and doctors must navigate multiple factors before making the decision. Collaborative support and multidisciplinary teamwork are required by both nurses and doctors to optimally care for people with delirium. Decision-making support for nurses and doctors may also help to navigate the multiple factors that influence the decision to prescribe antipsychotics.