The latest medical research on Nurse
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Request AccessPeer support in intensive care unit follow-up: A qualitative evaluation.
Nur Crit CarePatients formerly admitted to an intensive care unit and their relatives seek information about life after critical illness to understand their symptoms and what to expect as survivors, and they express a desire to talk to others with similar experiences. Various operational models of post-intensive care peer support exist, and studies have reported potential beneficial mechanisms in patients involved in peer support programs. However, most models have not been formally evaluated.
To evaluate the content and setting of structured group meetings and explore participants' experiences of meeting peers.
A qualitative evaluation combining focused ethnographic observations and semi-structured interviews with 22 participants attending three intensive care unit café meetings in a university hospital. A thematic analysis was conducted using all data collected.
Three main themes emerged; 'Accommodating the diversity of patients and relatives', 'A range of possibilities for identification' and 'A newfound community'. Findings indicate that the content, setting and timing of the café meetings were of minor concern for the participants. Patients and relatives should attend together because the consequences of surviving a critical illness affect both. Larger groups of participants appeared to increase the likelihood of encountering broad variances in participants' experiences from the critical illness trajectory. The findings indicate that before attending a meeting, the participants did not find previous experiences sufficient in managing their new life situations and they felt alone in their experiences.
When setting up peer support for former intensive care patients, the most important aspect is to create a secure space for patients and their relatives to meet.
Nurse independent prescribing: exploring the opportunities and challenges.
Nursing StandardThe Nursing and Midwifery Council states that nurses should be able to demonstrate competence in prescribing practice at the point of registration ...
Post-ICU psychology support during the COVID-19 pandemic.
Nur Crit CareCritical illness survival rates have improved, but patients frequently face prolonged new or worsened physical, cognitive and psychosocial impairments (Josepha op't Hoog et al., 2022, Aust Crit Care). These difficulties associated with critical care admission are known as post-intensive care syndrome (PICS).
The multidisciplinary InS:PIRE programme was developed to support patients in the recovery period from critical illness. During the COVID-19 pandemic, the psychology support offered by this service was adapted from an in-person group to individual remote review. This audit evaluated both the extent to which this input aligned with the recommended guidelines and the acceptability of this adapted delivery to this patient group, which could help guide post-pandemic psychology input to the service.
The records of 207 patients were analysed retrospectively. The nature of support offered to a sub-sample of 50 patients detailed in clinical summary letters was compared with the Faculty of Intensive Care Medicine (2019) guidelines. Telephone calls were made to gather feedback on the virtual psychology support from 10 patients.
Psychological difficulties were identified by 111 of the 207 patients who attended the virtual clinic. A total of 88 of these patients accepted referral for virtual psychology support and 67 (76%) of those patients attended. The virtual psychology support offered was found to be largely in accordance with ICU aftercare guidance and acceptable to patients. Patients found the summary letters of consultations accurate and helpful. Most patients expressed a preference for in-person support and the opportunity to meet other patients.
This audit highlights issues important to patients in the post-ICU period based on individual consultations not previously possible. Patient opinion was sought on the impact of changing the delivery of post-ICU psychological support, which will help guide future improvements in the service.
Shared Governance Through Bylaws: Transformation Within a College of Nursing.
Journal Nursing EduEnhancing faculty voice and promoting shared governance within academia has long been called for but has not been well-reported. A college of nursing in the midwestern United States identified shortcomings in its organizational structure including lack of faculty voice, communication barriers, lack of faculty participation in decision making, and academic programs operating independently.
A workgroup was formed to transform the bylaws to promote shared governance, including faculty voice, equality, and engagement.
The bylaws were revised and presented to faculty for discussion, further revisions, and vote. The revised bylaws were approved and implemented in August 2021.
Through transformation of the bylaws, the college's 12-committee structure was reconceptualized to five standing committees and 13 subcommittees. Clear communication lines and cross-committee collaboration was established to break down the former academic program silos. Faculty with primary teaching assignments are equally represented throughout the structure with voice, vote, and responsibility. [J Nurs Educ. 2024;63(5):277-281.].
Design and Implementation of a Nursing Capstone Across a Multisite Health System.
Journal Nursing EduThe coronavirus disease 2019 (COVID-19) pandemic created profound effects in nursing education. Using a robust academic-practice partnership, a college of nursing and a health care organization collaborated to launch Jefferson Capstone Experience (JCE), an education delivery model that included a one-to-one, 108-hour clinical preceptorship between an experienced RN and an undergraduate nursing student.
The expedited design, implementation, and evaluation of JCE is described. The mixed-method program evaluation included surveys, interviews, and focus groups with students, faculty, and preceptors.
Students and preceptors reported high levels of satisfaction with JCE. All parties emphasized the importance of clear and timely communication, academic practice collaboration, and organization. A significant number of capstone graduates accepted a position with a capstone clinical partner.
Although the logistics of planning and implementation were challenging, an immersive and largely positive experience was created for undergraduate students, which created a robust hiring pipeline of new-to-practice nurses. [J Nurs Educ. 2024;63(5):292-297.].
Community, Public, and Population Health Content in Nursing Curricula: National Survey Results.
Journal Nursing EduPolicy, societal, and system changes are prompting nursing programs to expand population health content in curricula. This study examined the current state of community, public, and population health (CPPH) education in nursing curricula throughout the United States.
This descriptive study examined CPPH education in nursing programs nationally. A survey was developed and distributed to nursing programs from January to May 2021.
CPPH content integration occurred across all program levels, and the majority of the participants were involved in the development of CPPH-specific curriculum. Programs experienced reductions in CPPH curriculum due to coronavirus disease 2019 (COVID-19), lack of experienced faculty, budget constraints, and an emphasis on acute care.
The continuation of CPPH education in current nursing curricula is critical. National and academic nursing organizations must continue to monitor CPPH content in nursing curricula to assure a competent CPPH nursing workforce. [J Nurs Educ. 2024;63(5):282-291.].
The Effect of Interprofessional Education on Student Readiness for Collaborative Practice.
Journal Nursing EduHealth care reform promotes interprofessional patient-centric health care models associated with improved population health outcomes. Interprofessional education (IPE) programs are necessary to cultivate collaborative care, yet little evidence exists to support IPE pedagogy within nursing and other health science academia.
This quasiexperimental study examined differences in pre- and posttest Readiness for Interprofessional Learning Scale (RIPLS) scores following an IPE intervention. The IPE intervention consisted of a video presentation and a debriefing session after a simulated interprofessional collaborative patient care conference that introduced baccalaureate nursing and health science students to the roles and responsibilities of clinicians in team-based primary care. Pre- and postintervention RIPLS scores were analyzed.
Pre- and postintervention RIPLS scores increased across all subscales, with distinct variation between nursing and health science student subscales.
This IPE intervention had positive effects on students' readiness for interprofessional learning. Additional research is warranted to support health science pedagogy. [J Nurs Educ. 2024;63(5):304-311.].
The Effect of Distance Reiki on State Test Anxiety and Test Performance: A Randomized Controlled Trial of Nursing Students.
Journal Nursing EduThis randomized controlled, pretest-post-test intervention study examined the effect of distance reiki on state test anxiety and test performance.
First-year nursing students (n = 71) were randomized into two groups. One week before the examination, intervention group participants performed reiki remotely for 20 minutes for 4 consecutive days, and control group participants received no intervention.
The intervention group had lower posttest cognitive and psychosocial subscale scores than pretest scores (p > .05). The control group had a significantly higher mean posttest physiological subscale score than pretest score (p < .05). Final grade point averages were not significantly different between the intervention and control groups (p > .05). One quarter of the intervention group participants noted reiki reduced their stress and helped them perform better on the examination.
Reiki is a safe and easy-to-practice method to help students cope with test anxiety. [J Nurs Educ. 2024;63(5):298-303.].
Competency-Based Medication Administration and Error Reporting.
Journal Nursing EduAccuracy is needed with medication administration, a skill that involves rule-based habits and clinical reasoning. This pilot study investigated the use of an evidence-based checklist for accuracy with oral medication administration and error reporting among prelicensure nursing students. Checklist items were anchored in the mnemonic C-MATCH-REASON© (Client, Medication, ADRs, Time, Client History, Route, Expiration date, Amount, Site, Outcomes, Notation).
Nineteen participants randomly assigned to crossover sequence AB or BA (A: checklist; B: no checklist) practiced simulation scenarios with embedded errors. Nursing faculty used an observation form to track error data.
Using the C-MATCH-REASON© checklist compared with not using the checklist supported rule adherence (p = .005), knowledge-based error reduction (p = .011), and total error reduction (p = .010). The null hypothesis was not rejected for errors found (p = .061) nor reported (p = .144), possibly due to sample size.
C-MATCH-REASON© was effective for error reduction. Study replication with a larger sample is warranted. [J Nurs Educ. 2024;63(5):320-327.].
The Effects of the COVID-19 Pandemic on Nursing Education Programs.
Journal Nursing EduThe U.S. Boards of Nursing (BONs) collect annual report data from their nursing programs as part of their approval process. This paper highlights the 2020 and 2021 annual report data on the effect of coronavirus disease 2019 (COVID-19) on all nursing programs in 17 BONs in 2020 and 19 in 2021.
Nursing programs answered 16 questions on the effect of COVID-19 on their programs. Because BONs require annual report data, all programs in the participating states answered the questions, which included 798 programs in 2020 and 929 in 2021.
Major disruptions in nursing education occurred during the pandemic. Clinical experiences and didactic classes were greatly affected, though alternative strategies were used. Student and faculty attrition rates were particularly high in 2021.
The authors call for a national forum where nurse leaders analyze what happened and make recommendations for future crisis events. [J Nurs Educ. 2024;63(5):312-319.].
Pursuing Success in a Hybrid PhD Nursing Program.
Journal Nursing EduLittle is known about hybrid PhD nursing students' experiences.
The purpose of this study was to describe and analyze the experiences of PhD nursing students in a hybrid program using a convergent mixed methods design. Recent nursing PhD alumni (n = 18), and current PhD students (n = 4) were recruited at a research-intensive university in the southwestern United States.
Four metainferences were identified: (1) the facilitator of faculty as both advisors and mentors; (2) the facilitator of peers as support, motivation, and a source of advice that preceded advisors; (3) the barrier of receiving conflicting feedback from advisory and dissertation committees; and (4) the barrier of not understanding the PhD student process.
Peer support is fundamental for hybrid PhD nursing student success; conflicting feedback and not understanding the process are significant barriers. Strategies are recommended to mitigate barriers to facilitate hybrid PhD nursing students' success. [J Nurs Educ. 2024;63(5):328-331.].
Addressing Nurse Burnout: The Relationship Between Burnout and Physical Activity.
American J NursingDuring the COVID-19 pandemic, nurses have faced innumerable challenges, which have contributed to staggering increases in burnout rates. In the health care arena, burnout has been associated with the onset or exacerbation of physical illness, neglect of self-care, fatigue, decreased patient satisfaction, higher medication error rates, lack of nurse engagement, and increased nurse turnover.
This cross-sectional study sought to determine whether a correlation exists between self-reported physical activity and nurses' perception of burnout in a sample of hospital RNs. The secondary aim was to determine whether a correlation exists between the level of perceived burnout and the number of medication errors or near misses.
Participants were asked to provide demographic information, complete the Copenhagen Burnout Inventory (CBI) and the Godin Leisure-Time Exercise Questionnaire (GLTEQ), and self-report the number of medication errors or near misses they were involved in during the previous 12 months. Data were analyzed using Stata version 17 software.
A total of 216 participants returned usable surveys. Regarding the relationship between burnout and physical activity levels, data analysis was performed for the 210 participants who completed both the CBI and the GLTEQ. Compared with the least physically active nurses, the most active nurses had significantly lower CBI scores, with 68.5% of those reporting low or no burnout also scoring 24 or more on the GLTEQ. The least physically active nurses had significantly higher CBI scores, with 47.6% of those reporting high burnout also scoring 13 or less on the GLTEQ. Moreover, 90% of the nurses with high burnout levels had directly cared for COVID-19 patients at some point between 2020 and 2022. Medical-surgical nurses experienced significantly higher levels of burnout compared with nurses working in other service areas. No significant relationship was found between the number of medication errors or near misses and burnout levels.
This study found that the most physically active nurses reported lower levels of burnout, while the highest levels of burnout were found in the least active nurses. Although COVID-19 infection rates have eased, many nurses, particularly those who have cared for COVID-19 patients and those who work in medical-surgical environments, continue to experience burnout. Targeted programs to reduce work-related burnout, as well as organizational sponsorship of and unit-level support for such programs, are urgently needed. This study's findings suggest that promotion of physical activity may be an essential component to alleviating burnout.
