Leveraging Academic-Clinical Partnerships to Create an Operating Room Nurse Pipeline.

This article describes an academic-clinical partnership program between a school of nursing and an American Nurse Credentialing Center Magnet®- and National Cancer Institute-designated Comprehensive Cancer Center based on a shared vision and multifaceted for optimal new graduate operating room (OR) recruitment and use of clinical partner resources. The program, now in its 3rd year, has a 100% retention rate among the cohorts. Implementing a multifaceted OR partnership program based on nursing theory is a strategy for workforce development to increase retention of new graduate OR nurses.

The art of balance: Preceptors' experiences of caring for deteriorating patients.

AIM: To explore nurse preceptors' experiences of caring for deteriorating patients while providing guidance and supervision to a new graduate nurse. BACKGROUND: Fostering novice nurse development during high-stakes encounters may be challenging for preceptors. Despite myriad preceptor literature, there is limited published research on experience of caring for deteriorating patients while serving as preceptor to a novice nurse. DESIGN: Qualitative interpretive phenomenological analysis. METHOD: Data were collected through one-on-one, semistructured interviews between August 2016-September 2017 until data saturation occurred. Diekelmann's method was used to analyse the narratives of the purposive sample of 11 nurse preceptors. RESULTS: The findings reveal the experience of preceptors as they balanced their role as nurse with preceptor role to ensure patient safety and novice nurse development. Supporting the novice to care portrays the ways preceptors facilitated novice nurse development in caring for deteriorating patients. Impacting the preceptor role was remembering their own novice experience. Knowing when to step in was influenced by the preceptor's clinical expertise as they came to know (or not) when it was necessary for them to assume care of the patient. Debriefing: an essential preceptor tool emerged as a critical aspect of the experience to review technical aspects of care, vent emotions and provide evaluative feedback and reassurance to the novice. CONCLUSION: Preceptors' experiences of caring for deteriorating patients while precepting novice nurses require a balancing of roles to ensure patient safety and novice nurse development. Preceptors' clinical expertise was critical in knowing when to step in and assume care of the patient. RELEVANCE TO CLINICAL PRACTICE: Caring for deteriorating patients while serving as preceptor to novice nurses requires clinical expertise to ensure patient safety and novice nurse development. Clinical leaders may use the findings from this study to improve preceptor development and support.

Enhancing Interprofessional Education With Team-Based Learning.

Interprofessional education (IPE) has gained momentum across health profession schools in simulation and clinical settings. Exploring interprofessional experiences in the classroom setting may further enhance collaborative skills while advancing clinical knowledge. The authors describe an innovative approach to IPE to teach chronic care concepts to graduate nursing, physician assistant, and public health students. Enhancing IPE with a team-based learning approach resulted in improved knowledge of chronic care management, student perceptions of mutual respect, and perceived development of communication and teamwork skills.

Challenging graduate nurses' transition: Care of the deteriorating patient.

AIM AND OBJECTIVE: To explore graduate nurses' experiences of caring for deteriorating patients during the first year of practice. BACKGROUND: Hospital-based transition programmes have been established to ease graduate nurse transition. Despite this, novice nurses persistently cite caring for deteriorating patients as a clinical challenge. Few studies have explored the unique needs of novice nurses during such encounters, even less research has been undertaken from their perspective. DESIGN: Qualitative interpretive phenomenological analysis. METHOD: One-on-one, semi-structured, in-depth, audio-recorded interviews were conducted between July-November 2014. A purposive sample of eight novice nurses working in acute care, ICU and the ED was recruited through the use of flyers. RESULTS: Three major patterns with related themes illuminate the experience of caring for deteriorating patients as it is lived by graduate nurses. Dwelling with uncertainty occurred during initial encounters with deteriorating patients with its deeply felt impact upon these novices causing them to question their capability of becoming a nurse. 'Success' or 'failure' of their performance during these encounters extended to their view of themselves as nurses and impacted transition. Building me up was influenced by participants' expressed need for and importance of trusted relationships with preceptors, nurse colleagues and/or educators as they learned to care for deteriorating patients. A new lifeline: Salient being emerged as change in participants' identity and increased self-understanding as professional nurses. CONCLUSION: Caring for deteriorating patients impacted graduate nurses because they viewed such encounters to be 'high stakes' not only for their patient but also for themselves. Crucial to their development were trusted relationships with preceptors, nurse colleagues and/or educators. RELEVANCE TO CLINICAL PRACTICE: The findings identify needs of graduate nurses' during a high-stakes patient encounter and shed light upon one aspect of transition. Clinical leaders may use the findings from this study to improve preceptor development and transition programme curricula.

Caregivers of older persons with multiple sclerosis: determinants of health-related quality of life.

OBJECTIVE: This study was conducted to determine which factors (clinical and demographic) are associated with mental and physical health-related quality of life (HRQOL) for caregivers of older persons with multiple sclerosis (MS). The Andersen's Healthcare Utilization Model guided this study. Knowledge of identified predictors of HRQOL may prompt nurses who care for persons with MS to address these issues and provide supportive care. METHODS: A cross-sectional descriptive design was used to examine the relationship between patient with MS and caregiver clinical and demographic factors with caregiver physical and mental HRQOL. Patients with MS aged 60 years or older and their caregivers from four MS centers on Long Island, New York, self-selected into this study (n = 102). A caregiver survey was administered that collected demographic information and included validated questionnaires measuring HRQOL, caregiver burden, and caregiver perception of risk for neuropsychological impairment of patients with MS. Patient surveys collected demographic information and validated questionnaires measuring cognition, depression, and disability. Multivariate linear regression was used to examine patient and caregiver variables to explain caregiver physical and mental HRQOL. RESULTS: The caregivers in this study were older (mean age = 61 years) with existing comorbidities. We found that caregiver mental HRQOL was negatively associated with patient depression and, surprisingly, positively associated with caregiver burden and caregiver comorbidity of heart disease. Caregiver physical HRQOL was negatively associated with caregiver comorbidities of arthritis and diabetes and lower household income. CONCLUSION: The challenges older caregivers face when caring for older persons with MS have been shown to affect their mental and physical QOL. Nurses who care for older patients with MS will increasingly rely on older caregivers to provide patient-centered interventions. This descriptive study, based on the Anderson theoretical model, provides insight on factors impacting older caregivers' HRQOL. Further research is necessary to elucidate the types of interventions that support them as they care for older patients with MS.

Flipping the classroom with team-based learning in undergraduate nursing education.

This article describes the use of team-based learning (TBL) within a flipped classroom setting in an undergraduate nursing course. TBL facilitates active learning through the use of small group, classroom activities. Students used classroom time to solve problems while developing important professional competencies. A preclass PowerPoint lecture with narration, a component of the flipped classroom, was added to address student feedback. Despite mediocre course evaluations, improved student performance on the final course examination was noted.