Journal of Continuing Education in Nursing最新文献

Background: Incivility is detrimental to nurses, patients, and health care organizations. Cognitive rehearsal has shown promise in addressing incivility, yet the most recent review of cognitive rehearsal training contained articles published in 2014 and earlier. This review integrates current knowledge of the effectiveness of cognitive rehearsal training in addressing nursing incivility.

Method: Four databases were searched from January 2018 to April 2023. Thematic analysis was used to analyze 22 studies.

Results: Three main themes emerged: (a) theoretical frameworks, (b) participant responses to cognitive rehearsal training, and (c) work culture influences. Nine theoretical frameworks uncover the mechanism behind nursing incivility and provide guidance on how to remedy it.

Conclusion: Cognitive rehearsal training that includes four core components can foster skills and confidence to address nursing incivility and, in turn, decrease its occurrence, but training alone is not sufficient. Nurse managers and leaders need to model civil behavior, support zero tolerance, create a safe environment for reporting incivility, and intervene effectively. [J Contin Educ Nurs. 2024;55(11):523-529.].

Background: Delirium is acute neurological failure that alters cognition and results in a state of confusion and lack of self-awareness. It commonly affects critically ill patients within intensive care units (ICUs), and the wide array of fluctuating symptoms frequently leads to underdiagnosis. Delirium results in cognitive impairment and increased rates of fatality, and accurate assessments are essential for improving patient outcomes. Barriers to delirium assessment stem from a lack of knowledge and assessment training among ICU nurses.

Method: Using the Cumulative Index to Nursing and Allied Health Literature electronic database, a literature synthesis was conducted, analyzing journal articles addressing delirium education and training among ICU nurses and barriers associated with assessment.

Results: Current literature identifies methods to overcome barriers through training, education, and continuous reinforcement of delirium assessment. The goals of this review are to identify the barriers to delirium assessment and make recommendations for education methods to increase the confidence of ICU nurses in the recognition of delirium to improve patient outcomes.

Conclusion: Early identification of delirium is crucial to improving patient outcomes. A standardized delirium educational program should be developed and implemented throughout the U.S. health care system. [J Contin Educ Nurs. 2024;55(11):530-534.].

Certification exams are often the least understood aspect of certification processes. This article delves into the development of certification exams, highlighting their crucial role in assessing the knowledge and skills required for effective job performance. It explores how exams are meticulously crafted to align with specific job tasks, knowledge areas, and skill sets within various nursing specialties. Through collaborative efforts between practicing nurses and exam developers, these exams are designed to uphold validity, reliability, and fairness standards. Ultimately, certification exams are pivotal in evaluating nurses' competencies in vital aspects of clinical practice, facilitated by ongoing partnerships between nurses and certifying bodies. [J Contin Educ Nurs. 2024;55(11):513-516.].

Health care innovation and entrepreneurship are key drivers of transformation in health care, re-shaping the way care is delivered, managed, and experienced. Innovation in health care spans a range of areas, including digital health, bio-technology, medical devices, tele-health, and health information systems. Entrepreneurs are leveraging technology to create solutions to improve patient outcomes, reduce costs, and address inefficiencies. Nurse inventors and entrepreneurs are blazing new trails that require nursing professional development leaders to consider new opportunities for collaboration. For nursing professional development leaders, fostering relationships with nurse entrepreneurs can unlock numerous benefits, from improving patient safety to enhancing nursing practice and facilitating advisory board appointments. [J Contin Educ Nurs. 2024;55(11):517-519.].

Background: This article is the last of a four-part series to guide educators on the construction and evaluation of multiple-choice test items in the post-licensure environment. Previous articles in this series described the problem and the mechanics of test item construction and evaluation.

Method: A replicable strategy for evaluating the organizational process for constructing multiple-choice test questions is provided. Steps taken to create change are described; work tools are provided.

Results: Guidance and training are needed to create multiple-choice test questions. Many educators have not had training in item construction. Educators welcomed training. Personalized mentorship resulted in improvement. Asynchronous learning alone was helpful and well received and improved self-perceived knowledge, yet fell short of achieving competence.

Conclusion: Voluntary training may not be adequate to assure enculturation of best practices without accountability standards and monitoring. Future research is indicated to assess the situation and provide national standards for adoption within health care organizations. [J Contin Educ Nurs. 2024;55(11):535-542.].

Nursing advocacy is a critical component of nursing practice. An exemplar of how nurses can advocate for an enhanced quality of nursing work environment and safe staffing is provided. Garnering state and national resources can assist in impacting statewide change. [J Contin Educ Nurs. 2024;55(11):520-522.].

Background: With the rising incidence of inflammatory bowel disease (IBD) in pediatric populations, school nurses are increasingly called on to care for and support these students.

Method: The research team surveyed Connecticut school nurses about their experiences, knowledge, and confidence in addressing IBD in the school setting. The team also developed and implemented an online education intervention to improve knowledge and confidence gaps during the 2022-2023 academic year.

Results: Most participants have cared for one to two (46%, n = 66) or several (30%, n = 44) students with IBD. However, 24% (n = 35) have not cared for any students with IBD. School nurses shared their perspectives with three themes identified from the qualitative feedback: (a) limited knowledge and experience with IBD, (b) importance of support at school, and (c) need for interprofessional collaborative practice.

Conclusion: The online education significantly improved school nurses' knowledge (p < .001) and confidence scores (p < .001). Participants found this intervention beneficial to their work. [J Contin Educ Nurs. 202x;5x(x):xx-xx.].

Background: The ability of nurses to deliver culturally mindful health care may be vital to improving the patient-clinician relationship and subsequent health outcomes for marginalized populations. Continuing education in cultural training should be designed to enhance a nurse's cultural humility.

Method: This study explores the concept of nurse cultural humility using the methods outlined by Walker and Avant (2018): define the attributes, offer a model case exemplifying the attributes, discuss the antecedents and consequences, and determine empirical referents.

Results: The defining attributes of cultural humility in nursing are a lifelong process of reflexivity, an understanding and appreciation that the cultural backgrounds of both nurse and patient influence health care encounters, and a commitment to redress and mitigate power imbalances in the patient-clinician relationship.

Conclusion: By clearly defining nurse cultural humility, leaders will be able to develop cultural training interventions to enhance nurse cultural humility and measure the concept accurately. [J Contin Educ Nurs. 202x;5x(x):xx-xx.].

Background: Frontline workers in psychiatric facilities are exposed to considerable risks of verbal and physical assaults, with 40% to 65% of mental health nurses experiencing violence in the workplace. The goal of this pilot study was to assess the readiness and motivation for adopting trauma-informed care (TIC) to address workplace violence in an acute care psychiatric hospital.

Method: A pre-post quality improvement study was conducted in two pilot units of a 274-bed acute care psychiatric hospital, involving a discussion-based seminar and a practical exercise. Surveys assessed participants' readiness and motivation posttraining.

Results: Sixty-eight staff members completed part 1 training, with 63 (92.6%) reporting being prepared to use TIC principles afterward. All 14 staff members (100%) who completed part 1 and part 2 training reported being motivated to apply the TIC model after the intervention.

Conclusion: The results show that TIC training may impact self-reported strategies for reducing workplace violence. Education in trauma-informed care may prove to be beneficial in providing nurses with the necessary skills to effectively implement TIC principles in their daily practices. [J Contin Educ Nurs. 2024;55(10):472-478.].