Journal of Professional Nursing最新文献

Nursing program administrators, faculty, academic success coaches, and remediation specialists have implemented many interventions in support of baccalaureate nursing students' retention and graduates' NCLEX-RN® first-time pass rates. A private university's undergraduate nursing program's team incorporated additional evidence-based interventions aimed improving students' achievement of benchmarks following a 3-year decline in NCLEX-RN pass rates. Interventions expanded the prelicensure academic program's activities using a continuous quality improvement approach. A simulation center was constructed and a director was hired. A consultant also facilitated faculty engagement in curricular revisions. A new position, coordinator tutor/remediation specialist, was filled and the academic success coach launched interventions that complemented an initial and subsequent strategies for success initiative. New interventions were trialed and evaluated and became integral to students' and graduates' success. The academic success coach's commitment to students' achievements promoted their engagement in interventions. Pass rates increased and were sustained. Examples of interventions, supported by evidence, are presented in tables for review. A logic model depicts components of the program plan and its interventions as augmented by prospective strategies and remediation interventions. Continuous quality improvement processes will continue. Students and graduates have commented positively on the benefits of the assorted, success-promoting interventions.

Background

The curriculum for our generalist masters in nursing program required a heavy credit load of science courses shared with the nurse practitioner programs. The bundle of required courses far exceeded the masters in nursing program completion outcomes, increasing tuition costs and prolonging the program of study for students who were not seeking advanced practice credentials.

Purpose

The purpose of this project was to streamline the curriculum and better align course content with MS program expected learning outcomes, student learning needs, and recent accreditation requirements.

Process

Course expected learning outcomes were drafted and mapped to program expected learning outcomes and AACN The Essentials: Core Competencies for Professional Nursing Education (2021) concepts and sub-competencies. A two-course series totaling 5 credits was developed to integrate the 4Ps (pathophysiology, pharmacology, physical/health assessment, and health promotion) into an online master's level nursing curriculum while decreasing the total number of credits.

Outcomes

A total of 67 students successfully completed the online courses during the first semester. Minor revisions based on student feedback were made after the first implementation.

Conclusions

Integrating the 4Ps into a series of two courses is a feasible option for streamlining a generalist masters in nursing curriculum.

Background

Simulation-based learning experiences allow undergraduate nursing students to develop competence and confidence through deliberate practice with immediate feedback on the learner's performance through debriefing. With the transition to competency-based nursing education, nursing faculty need more guidance in implementing competency-based evaluations in the simulation setting.

Purpose

This Delphi study aims to inform the future development of a competency-based tool – SimComp – based on the American Association of Colleges of Nursing (AACN) Essentials.

Methods

A Delphi framework was used to recruit expert nursing faculty to complete the surveys via an online platform. Data analysis occurred through open-ended questions and quantitative methods to ensure that the responses from expert panelists were used to form the results.

Results

After four rounds of this Delphi study, a consensus was achieved on 111 appropriate items for assessing competence in the simulation-based learning environment.

Conclusion

While further research is warranted, this study provides insight for nursing institutions considering implementing or increasing the use of simulation within their program for competency-based evaluations.

Background

Learning medication administration is essential for nursing students, but the first time can be stressful and shape their clinical development. Previous research primarily focused on student knowledge and technical aspects.

Purpose

This phenomenological study helped explore the lived experiences of nursing students and faculty during student's first medication administration in the clinical setting to gain a deeper understanding of their thoughts, feelings, and perspectives.

Method

Semi-structured interviews were conducted with female student and faculty informants (N = 12). Using a phenomenological study, data were analyzed using van Manen's hermeneutic six-step research activity method.

Results

Five overarching themes were found: administrating medication, (un)preparedness for complexities in the clinical environment, transformative experience, overcoming fears, and reaping the rewards.

Conclusion

First-time medication experiences are greater than an exercise in skill proficiency and may be improved if faculty provides more structured learning experiences and take sufficient time for student preparation in relating medication knowledge to the skill, technology usage, and supporting students' attitudes toward nurse-patient interactions. These are essential aspects of the medication administration learning process as nursing programs shift toward competency-based education. Clinical faculty also need support in their role as educators and to be facilitated to find this time, considering their multiple responsibilities.

Background

Psychiatric nurses are responsible for maintaining professional boundaries. However, professional boundaries are as described as unclear and psychiatric nursing students are at risk of crossing these boundaries. Educational instruction regarding professional boundaries within psychiatric nursing often lacks foundational structure placing students at risk of transgressions.

Purpose

The purpose of the study was to describe boundaries in psychiatric nursing practice, identify strategies effective in teaching professional boundaries, and inform curriculum development in psychiatric nursing education.

Method

Interpretive description was utilized to answer: How do psychiatric nurse educators interpret and explain professional boundaries in psychiatric nursing undergraduate education? Psychiatric nurse educators and psychiatric nurses were recruited from an academic institution in western Canada. Twenty participants engaged in semi-structured interviews. Eight of those participants also attended a focus group.

Result

Participants reported that ‘textbook’ definitions of boundaries were insufficient in illustrating the complexities of the construct. Rather, relational forms of learning such as educators sharing clinical stories, role play activities, clinical supervision, and clinical debriefing were described as helpful strategies.

Conclusion

Foundational knowledge regarding professional boundaries in psychiatric nursing practice appears to be incorporated in the formal curriculum. However, learning is enhanced through the informal and hidden curriculum.

Background

Background checks are used in nursing education to assess public risk. To date, no study has described the most common and most serious findings in nursing students.

Purpose

Our study describes the most common and most serious characteristics of BGC findings in nursing students attending large universities.

Method

Our retrospective study describes characteristics of aggregated, de-identified background check data from a convenience sample of 16 US nursing programs set in large universities 2014–2019.

Findings

Sampled programs collected 45,613 background checks, with 1548 findings (3.4 %). Severity of findings included criminal (62.5 %), non-criminal (4.6 %), felony (0.8 %), and other (11.6 %). Severity data were missing from 20.4 % of records. Finding types included substance use (23.7 %), disorderly conduct (8.7 %), property crimes (2.4 %) and crimes against persons (1 %). Type data was missing from 64.3 % of records.

Discussion

Future research should examine whether background check type or severity indicates a nursing student poses a public risk.

The American Association of Colleges of Nursing (AACN) released updated nursing curriculum Essentials in 2021. The new Essentials document reflects an innovative and unique approach to nursing education and provides a framework for competency-based education and assessment to prepare students to work in a profession that is ever-changing.

The first in the state of Oregon, a Masters Entry into Professional Nursing program was launched with a curriculum based on the new Essentials with the goal to remain true to the program's current concept-based approach while incorporating elements of a competency-based curriculum. As with all new programs, curricular design is paramount and requires careful planning to ensure the curriculum aligns with education trends, meets the needs of diverse learners, adheres to regulatory requirements and standards, and has strong faculty buy-in.

Curriculum development done in a systematic fashion with faculty input is imperative. All current faculty were invited by the school of nursing (SON) leadership to participate in the curriculum development process. Regularly scheduled meetings were held, and all interested faculty participants were able to provide input. This process also included the SON Curriculum Committee and SON Faculty Council, to ensure all faculty were included in the process and appraised of the curriculum development. The faculty members who participated in the systematic development process then served as advocates for the new curriculum and helped create a smooth transition when the new MEPN program was introduced.

Background

Student nurses often do not receive adequate preparation, support, and debriefing related to witnessing or experiencing critical events in the clinical setting.

Purpose

The purpose of this analysis was to describe the experiences of student nurses who have witnessed critical events in the clinical setting, the support and preparation they received, and staff and faculty actions they perceived as facilitating or hindering their processing of the event.

Methods

This is a sub-analysis of a Straussian Grounded Theory qualitative study.

Results

Staff and faculty actions that helped and hindered the processing of the critical event were identified at four time points: pre-event, during the critical event, immediately post-event, and in the days and weeks following.

Conclusions

Students exposed to critical events during their clinical rotations can experience psychological trauma. If unresolved, this can result in new nurses entering the profession already in distress. Preparation and support for witnessing critical patient events should start at the beginning of nursing school. During critical patient events, students need faculty or staff to be actively present to explain the event and support the student throughout the event. Immediate debrief and follow-up is recommended and should continue weeks or months after the event.

Nursing education is shifting toward competency-based education (CBE) in line with the American Association of Colleges of Nursing's (AACN) 2021 Essentials. This pedagogical shift from knowledge-based leaner outcomes to competency-based learner and program outcomes affects how faculty teach, how students learn, and how programs allocate resources to support this change. The initial move toward CBE necessitates scrutiny of current curricula and alignment of curriculum, teaching strategies, and assessment tactics framed within the ten domains of the Essentials.

Drawing on the Donabedian quality improvement framework, one school of nursing's curricular revisions project team discusses their strategies and challenges in implementing the AACN Essentials, illustrating the structural, procedural, and initial outcomes of adopting the Essentials across programs and specialties.

Key to this approach is engaging all relevant stakeholders and mapping current curricula to the Essentials' many competencies and subcompetencies. This work informs curricular revisions and fosters faculty engagement and creativity. Lessons learned highlight a critical need for ongoing faculty development and use of learner-centric pedagogies to achieve students' competency development and practice readiness.

This article offers insights and guidance for nursing programs embracing CBE and aligning with AACN Essentials.

With the widespread adoption of online education, nursing educators have observed significant challenges related to learner engagement and participation. Over the past decade, the implementation of Caring has consistently displayed a beneficial influence on creating and maintaining a sustainable online learning environment. However, existing online nursing curricula often lack a Caring and learner-centered approach. The aim of this integrative review is to analyze existing research and gain a comprehensive understanding of the factors that promote a sense of Caring in online nursing education programs. A systematic search for published peer reviewed, English language literature identifying the factors that contribute to Caring in online nursing education was conducted utilizing five databases. Findings from 18 included articles suggest that a combination of Caring strategies implemented by faculty and students, and the utilization of institutional resources contribute to enhanced student outcomes. Faculty driven strategies that promote an online Caring environment are Caring communication, role modeling, building personal connections, demonstrating teaching passion, and embodying emotional intelligence. Student behaviors that promote a Caring online environment include deliberate commitment to learning, genuine presence, active listening, and meaningful interactions with peers. Furthermore, incorporating instructional design to develop a Caring learning platform provides synergy to the student and faculty strategies to produce a Caring environment