Journal of nursing staff development : JNSD最新文献

Externships are meant to bridge the gap between the educational and practice setting for nursing. This project began with discussions of outcomes for nurse extern programs. The Schutzenhofer Nurse Activity Scale and the Meleis Nurse Self-Description Form were used to measure identified outcomes of professional activities and autonomy. Forty-one participants began the study, but 33 completed the pretest and posttest both. Analysis of data showed a positive correlation in Posttest 1 between age and the Meleis Nurse Self-Description Form (NSDF). Dimensions of professional activity changed most in older students. At the end of Phase 2, analysis of data showed significantly greater professional autonomy. However, no significant change in NSDF was seen throughout time. Participants reported increased self confidence.

In this article, the authors discussed the successful evaluation of an orientation system for newly employed registered nurses in a large teaching hospital using the IOP model. This methodology can be successfully applied to any educational program that is consolidated into an organization's goals. Although not well examined, orientation has been reported to be costly (Bethel, 1992; del Bueno, Weeks, Brown-Stewart, 1987). The system presently used at this hospital uses at least 1 week of a nurse educator's time, 3-10 weeks for a newly employed registered nurse, and 3-10 weeks for a preceptor RN. Such an investment of personnel resources mandates examination of the processes and outcomes of the program to ensure newly employed RNs become competent practitioners as efficiently as possible. The use of the IOP model particularly was useful in examining a complex orientation system in a multicentered hospital. Use of this systematic program evaluation separated the overall orientation process into workable components. Tools, such as the algorithm, allowed for easy visualization and comprehension of the process steps. This was indispensable because of the number and scope of people involved in the orientation program. The evaluation process was impartial and focused on the program steps, not on the individuals. Because of this impartiality, people were able to gather and work cohesively to improve the overall program. Use of the IOP model assisted the nurse educators in determining that PBDS was not achieving the goal of identifying individual learning needs. Rather, PBDS was a useful tool in establishing baseline competency of newly employed RNs. The system clearly identified those individuals who had above average knowledge bases and those individuals who had more learning needs. For those with more learning needs, PBDS provides a starting point for planning a structured orientation. Thus, a Phase II PBDS assessment could be used as a more unit-specific assessment to validate whether the RN has achieved the orientation objectives. Although the IOP model is not a strict research methodology, it is appropriate for examination of a program as fluid and ongoing as this. Finally, ongoing run charts or statistical trends will assist the nurse educators in monitoring the quality and effectiveness of the orientation program.

A new healthcare reforms are implemented and as the Joint Commission on Accreditation of Healthcare Organization standards are revised, the demand for continuous quality improvement/total quality management in acute care settings continues to rise. In this article, the authors describe the process used to introduce nursing staff to continuous quality improvement/total quality management. A curriculum committee of staff nurses, nurse educators, and clinical specialists used the continuous quality improvement process to develop a 1-day program that included didactic and experiential activities geared toward assisting the staff nurse to participate actively in total quality management initiatives.

The Mayo Medical Center, Rochester, Minnesota, has developed a unique collaborative method to educate both the experienced and the recent graduate nurse about critical care. These programs are 12 to 16 weeks and include a classroom, a skills lab, computer-assisted learning, and preceptor instruction. The curriculum model design incorporates Benner's novice-to-expert professional advancement model. Professional growth of the critical care nurse occurs through a combination of educational strategies that build on general theory to the application of critical thinking skills. The result of this program is a competent, practicing, critical care nurse.

Staff nurses were surveyed on their perceived and actual level of knowledge of diabetes mellitus. Staff nurses (n = 32) employed at a rural 62-bed acute care hospital in the southeastern United States constituted a convenience sample. The Diabetes Self-Report Tool was used to assess staff nurses' perceptions of knowledge of diabetes mellitus. Using a Likert-type scale a mean score of 88% was obtained concerning perceived knowledge. The Diabetes Basic Knowledge Test was used to measure the actual level of knowledge of diabetes mellitus. A mean score of 75% was obtained on the Diabetes Basic Knowledge Test. Nurses' perception of knowledge was not related to actual knowledge scores. Study findings raise questions for the nurse involved in staff development concerning the adequacy of nursing competency validation in the area of diabetes management.

The nurse case manager role is continually evolving. Case managers are being challenged to perform new functions. There are few articles concerning orientation programs for case managers. This article provides a successful orientation program and clinical orientation schedule for a unique unit-based nurse case manager/educator role. The orientation program is outlined based on the four competency domains of the nurse case manager/educator clinical expertise, resource management, staff education, and patient/family education. Program topics and an orientation schedule are provided.

Using shared decision making, staff nurses designed a new system to support student nurses in their learning needs. This new system improved continuity of care and patient care follow through and assisted in strengthening relationships between the student, unit staff, and clinical instructors.

Focus groups facilitate change in healthcare institutions by providing comparative perceptions of all levels of healthcare staff in the environment, obtaining impressions of new options for healthcare delivery for which no information is available, and stimulating new ideas to improve cost-effective quality care. The authors discuss their experience using this data gathering and evaluation approach during the planning and implementation of a new nursing practice model. Factors to consider when using focus groups are offered, and lessons learned from the experience are presented.