Reducing Lung Injury from Blind Insertion of Small-Bore Feeding Tubes.

ABSTRACT: Using a blind insertion technique to insert small-bore feeding tubes can result in inadvertent placement in the lungs, leading to lung perforation and even mortality. In a Magnet-designated, 500-bed, level 2 trauma center, two serious patient safety events occurred in a four-week period due to nurses blindly inserting a small-bore feeding tube. A patient safety event review team convened and conducted an assessment of reported small-bore feeding tube insertion events that occurred between March 2019 and July 2021. The review revealed six lung perforations over this two-year period. These events prompted the creation of a multidisciplinary team to evaluate alternative small-bore feeding tube insertion practices. The team reviewed the literature and evaluated several evidence-based small-bore feeding tube placement methods, including placement with fluoroscopy, a two-step X-ray, electromagnetic visualization, and capnography. After the evaluation, capnography was selected as the most effective method to mitigate the complications of blind insertion. In this article, the authors describe a quality improvement project involving the implementation of capnography-guided small-bore feeding tube placement to reduce complications and the incidence of lung perforation. Since the completion of the project, which took place from December 13, 2021, through April 18, 2022, no lung injuries or perforations have been reported. Capnography is a relatively simple, noninvasive, and cost-effective technology that provides nurses with a means to safely and effectively insert small-bore feeding tubes, decrease the incidence of adverse events, and improve patient care.

Interdisciplinary and Innovative: A Nursing and Computer Science Collaboration to Create a Barcode Medication Administration System.

ABSTRACT: Preventing medication errors remains a priority in nursing education. The implementation of Barcode Medication Administration (BCMA) systems is one strategy that has been used to reduce medication errors. Practice using BCMA in simulated settings may enhance the transfer of these skills to the clinical practice setting. However, the purchase of BCMA educational products available for nursing students can be cost prohibitive for many nursing programs. To overcome the barrier of cost, an interdisciplinary and innovative collaborative approach was used to create a fully functional low-cost BCMA system.

Using the "Do-Si-Do Simulation Model" to Engage Learners.

ABSTRACT: The "Do-Si-Do Simulation Model" was developed to provide simulation experiences for students when resources are limited and provide nursing students insight into health care simulation as a potential nursing career. The aim of this study was to gain insight on student perceptions of the use of the model as an active learning strategy and determine if it should be used in future courses. Twenty-four students who participated in two scenarios as nurses in the simulation room and as patients/operators in the control room agreed that use of the strategy enhanced their learning. They recommended its use in future courses.

Using "Breakout Boxes" for Pharmacology Review.

The "Breakout Boxes" activity is an interactive teaching strategy in which students work in teams to solve puzzles. By unlocking boxes that hold additional clues for opening more boxes, students eventually solve the puzzle. The aim of this study was to gain insight on student perceptions of the use of Breakout Boxes as an active learning strategy in nursing education and determine if it should be used in future courses. Thirty-nine students who participated in the Breakout Boxes activity agreed that the use of the strategy was fun and suggested that it be used in future courses.

Applying the Flipped Classroom Model to Psychomotor Skill Acquisition in Nursing.

This descriptive study aimed to examine baccalaureate student psychomotor skill performance when given different methods of pre-skill lab preparation materials in a flipped classroom environment. Students utilized either a narrated video demonstration of the skill or a skill instruction sheet with photographic images as lab preparation materials. Psychomotor skill performance of insulin pen administration was evaluated. Results suggest the type of preparation methods used with the flipped classroom pedagogy does not significantly affect student performance on psychomotor skill acquisition.

Flipped Classroom: Do Students Perceive Readiness for Advanced Discussion?

BACKGROUND: Use of the flipped classroom model is recognized as a popular method of instruction. Effective preclass preparation methods can create more time for instructors to reinforce application, evaluation, and analysis of information using active learning strategies. METHOD: This quasi-experimental study used a convenience sample of 42 third-year baccalaureate nursing students. Students were randomized into two groups and received either a narrated video (vodcast) or guided readings for the preclass preparation. A quiz was administered to assess preparation prior to class, and students completed a survey following the classroom activities. RESULTS: Students preferred media preparation to guided readings. This preference translated to higher quiz scores. Positive correlations were noted between quiz scores and students' understanding and increased confidence. CONCLUSION: Students' preference for the vodcast translated to the perception of an increase in confidence and understanding of the material. [J Nurs Educ. 2018;57(3):163-165.].

Collaborative Classroom Simulation (CCS): An Innovative Pedagogy Using Simulation in Nursing Education.

Collaborative Classroom Simulation (CCS) is a pedagogy designed to provide a simulation learning experience for a classroom of students simultaneously through the use of unfolding case scenarios. The purpose of this descriptive study was to explore the effectiveness of CCS based on student perceptions. Baccalaureate nursing students (n = 98) participated in the study by completing a survey after participation in the CCS experience. Opportunities for collaboration, clinical judgment, and participation as both observer and active participant were seen as strengths of the experience. Developed as a method to overcome barriers to simulation, CCS was shown to be an effective active learning technique that may prove to be sustainable.