Nursing Administration Quarterly最新文献

Nurse leaders are obligated to ensure that nurses are prepared to engage in the provision of safe high-quality nursing care by creating a learning environment where their clinical knowledge and critical reasoning can be safely developed and refined. Simulated educational experiences can accelerate learning and provide nurse's the ability to confidently and competently deliver clinical care in a highly efficient manner.

Tabletop simulation can be used to support and test system processes for clinical workflows. This paper will describe an innovative approach to testing change in clinical workflows for direct admissions to the operating room and interventional radiology departments in a 700-bed urban hospital in the Pacific Northwest and will highlight the specific benefits to nurse leaders. The simulation exercise involved key stakeholders and subject matter experts from various departments and aimed to evaluate the process workflow, provoke discussion on gaps, uncover improvement opportunities, and formulate recommendations. The simulation experience was broadly acknowledged by those involved as novel, engaging, suitable for complex process changes in health care settings and promoting valuable collaboration.

This systematic review aims to evaluate the effectiveness of simulation in enhancing the knowledge and skills required for preventing, managing, and treating pressure injuries (PIs) among nursing students. A systematic review of English articles published between January 1, 2014, and March 31, 2024, was conducted to determine the effectiveness of simulation in PI education. PubMed, Cochrane Library, Medline (OVID), Scopus, Web of Science, CINAHL, and Science Direct databases were searched using the keywords "simulation", "pressure ulcer", "pressure injury", "nursing", and "nursing education". The study data were analyzed using the content analysis method. Of the 101 articles retrieved from the databases, 5 met the eligibility criteria. The study found that simulation in PI prevention and management education increased students' knowledge and skill levels, enhanced their satisfaction and communication skills, and was more effective than traditional didactic education. This systematic review supports the use of simulation as an educational tool for nursing students in preventing, implementing protective interventions, and managing PI. Furthermore, it encourages further research to explore the role and effectiveness of different formats of simulation, particularly high-fidelity simulation, in PI management education and their impact on student achievement and clinical practice.

In the face of ever-evolving shifts in health care, the demand for advanced practice providers (APPs), including nurse practitioners and physician assistants, continues to grow as the nation faces provider shortages and increased patient complexity. Because of different educational backgrounds and previous professional experience, there is a gap in readiness for practice following completion of academic programs, leading to high rates of turnover and financial implications for health care institutions. The creation of APP fellowship programs is a strategy many health institutions implement to provide enhanced support for new graduate APPs. These programs offer fully licensed and credentialed nurse practitioners and physician assistants additional experience within medical specialty areas. The establishment and operational cost associated with an APP fellowship program is a significant barrier health systems face. This article discusses how Saint Luke's Health System developed an APP fellowship program to address these barriers. The model addresses specific fellow needs and has contributed to improved employee retention rates, increased clinical competency, and overall provider satisfaction within Saint Luke's Health System. The evolution of the model, successes, barriers, and opportunities for future program growth are discussed within this article.

Delivering simulation across a health system can engage the entire workforce by moving beyond traditional educational delivery and focusing on broader organizational needs specific to a particular organization. The commonly known use of simulation as a form of life support education has progressed to include fully immersive simulation experiences focusing on team-based communication, leadership, fellowship, and clinical care. It continues beyond this point with the inclusion of patient safety strategies, root cause analysis investigation, leadership, and management training, and recently, it has included environments that catalyze innovation in complex healthcare systems. The focus on pure fiscal elements of simulation-based approaches does not give a health system the accurate nontangible benefits simulation can provide, and importantly, acknowledging that each location has differing needs is essential when considering what investment should be made and where. A small community hospital will have vastly different needs from specialty hospitals that deliver specialist care. It must also be understood that every simulation center, to some extent, will always be unique, as it should. The commonly quoted statement "when you have seen one simulation center, you have seen one simulation center" really does reflect the reality of this established and rapidly growing specialty. In this article, we reflect on the traditional use of simulation and discuss some wider uses that may engage a wider audience and, importantly, provide a greater return on investment for your facility, making the case for investment more reasonable and impactful to each part of a busy health system.

Ensuring a smooth transition from education to practice for new nurses is essential in helping stem the flow of nurses out of the profession. However, traditional nurse residency education has only included didactic education sessions. In a novel new graduate emergency Nurse Residency Program, simulation-based education was ranked as the best part of the new graduate Nurse Residency Program. The result of incorporating simulation experiences was increased satisfaction by program participants and a decrease in turnover.

The System-transforming, Patient centered Longitudinal Interprofessional Community-based Education (SPLICE) Initiative was a Health Resources and Services Administration (HRSA) funded project designed to educate and train health professions learners in team-based primary care within a clinical environment. The SPLICE project team developed multiple learning activities including case studies and simulations that integrated the IPEC Core Competencies within clinical scenarios. The interprofessional aspects were also modeled by faculty facilitators from different professions. Each activity was thoroughly evaluated by the learners using mixed methods processes including data from retrospective pretest-posttest self-assessments, open-ended surveys, and focus groups. Faculty, staff, and learners invested countless hours of volunteer time due to the enthusiasm and passion for the work supported with HRSA funding to implement and evaluate the SPLICE initiative. Outcomes include the development of an enhanced primary care simulation template; the creation of 21 unique primary care simulations that integrated the IPEC competencies; improved confidence and competence in over 700 learners; over 110 faculty trained in simulation and debriefing skills; clinical skills training for Federally Qualified Health Center (FQHC) staff; improved quality improvement processes at a local FQHC; and a high rate of retention of the graduates in primary care. This project demonstrated a significant return on the investment beyond the initial HRSA funding.