The Effect of Interprofessional Education on Student Readiness for Collaborative Practice.

BACKGROUND: Health care reform promotes interprofessional patient-centric health care models associated with improved population health outcomes. Interprofessional education (IPE) programs are necessary to cultivate collaborative care, yet little evidence exists to support IPE pedagogy within nursing and other health science academia. METHOD: This quasiexperimental study examined differences in pre- and posttest Readiness for Interprofessional Learning Scale (RIPLS) scores following an IPE intervention. The IPE intervention consisted of a video presentation and a debriefing session after a simulated interprofessional collaborative patient care conference that introduced baccalaureate nursing and health science students to the roles and responsibilities of clinicians in team-based primary care. Pre- and postintervention RIPLS scores were analyzed. RESULTS: Pre- and postintervention RIPLS scores increased across all subscales, with distinct variation between nursing and health science student subscales. CONCLUSION: This IPE intervention had positive effects on students' readiness for interprofessional learning. Additional research is warranted to support health science pedagogy. [J Nurs Educ. 2024;63(5):304-311.].

Preparing Primary Care Registered Nurse Preceptors for Emerging Care Coordination and Chronic Disease Self-Management Roles.

Nurse educators must prepare the future RN work-force to practice in emerging primary care roles. This program evaluation report describes the approach taken to develop and evaluate a novel preceptor education program designed to prepare RNs to precept nursing students in primary care coordination and disease self-management roles. The program was designed as a three-stage hybrid learning intervention with the goals of preparing RNs to (a) provide primary care coordination and disease self-management support and (b) precept nursing students. Evaluation tools were designed to reflect specific learning objectives of these goals pre- and postintervention. Preliminary evaluation data indicate the preceptor program provided a useful set of educational activities to prepare primary care RN preceptors for their new roles. Participants reported increased confidence levels in primary care coordination and disease self-management and student precepting responsibilities. Nursing students' evaluations showed positive primary care clinical experiences. [J Contin Educ Nurs. 2023;54(10):454-461.].

Simulation-Enhanced Interprofessional Education for Ambulatory Care Registered Nurses and Health Professions Students.

Ambulatory care RNs and health professions students have limited education on interprofessional care before entering clinical settings. This article describes a program evaluation of a simulation-enhanced interprofessional education (Sim-IPE) experience designed for ambulatory care RNs and health professions students. An 11-item electronic post-Sim-IPE survey was administered to collect perceptions of the Sim-IPE experience. Most responses indicated the Sim-IPE promoted learning about each other's roles, was designed for their level of knowledge and skills, and provided sufficient information. The participants indicated that they felt supported and would use their learning in a clinical setting. Open-ended survey responses identified positive aspects of the Sim-IPE, areas for improvement, and suggestions for future Sim-IPE. The National League for Nursing Jeffries Simulation Theory was used to guide a program evaluation of the Sim-IPE. The program evaluation identified positive aspects and areas for improvement for future interprofessional education experiences. [J Contin Educ Nurs. 2023;54(5):226-232.].

Nursing Student Medication Administration Practice in the Clinical Setting: A Descriptive Study.

BACKGROUND: Nurses are instrumental in preventing medication errors that cause patient harm. Increased practice and educational interventions are suggested to prepare nursing students to safely administer medications. However, a quantified account of the reality of nursing student medication administration practice in the clinical setting is unknown. METHOD: This cross-sectional descriptive study assessed the frequency and quality of nursing student medication administration practice in the clinical setting. A convenience sample of prelicensure nursing students (n = 222) completed an electronic Nursing Student Medication Administration Survey after each clinical day for one semester. RESULTS: Overall, participants on average had one medication administration experience, administered two drugs, and administered medications to one patient. Most medication administration experiences were supervised by bedside RNs. CONCLUSION: Medication administration opportunities in the clinical setting are unpredictable and vary by facility and nursing program policy. Further investigation is necessary. [J Nurs Educ. 2022;61(3):137-142.].

Primary-care registered nurse telehealth policy implications.

Coronavirus disease 2019 (COVID-19) has drastically changed health-care delivery models within primary-care settings. Primary-care providers are limiting routine care face-to-face office visits while triaging COVID-19 symptomatic patients to hospital emergency rooms. Primary-care providers are rapidly adopting telehealth modalities for care provisions during this unprecedented pandemic to allow practices to continue delivering primary care while preventing community spread of COVID-19. Federal legislation has responded to emergent public-health needs by removing barriers that have impeded widespread adoption of telehealth modalities. This legislation has omitted professional registered nurses (RNs) from delivering reimbursable telehealth services, which is problematic for primary-care practice. RNs historically have led telehealth service delivery and should therefore be included in new legislation as eligible health professionals permitted to provide reimbursable telehealth services. RNs improve quality outcomes in primary care within innovative team-based care models and are essential clinicians capable of providing ongoing care coordination and disease management for patients needing to stay on track with their usual care needs.

Registered nurse education in primary care: Barriers and resolutions.

BACKGROUND: American health care is facing unprecedented challenges due to population aging, chronic disease prevalence, and financial restructuring. The Affordable Care Act (ACA) is transforming the primary care landscape from a reactive, episodic, fee-for-service system to a proactive, preventive, value-based system. A proactive, preventive, and value-based primary care model requires Registered Nurses (RNs) prepared to lead integrated, team-based, coordinated, and proactively managed care. The Health Resources and Service Administration (HRSA) forecasted an inadequate supply of RNs prepared to meet future primary care demands and highlighted the lack of education as a key problem. The primary care RN workforce shortage requires immediate attention by academic, political, and research stakeholders. HRSA has responded with academic funding to increase primary care RN education. PROCEDURES: This article describes key barriers and resolutions one HRSA-funded academic institution experienced while implementing a primary care RN education program, along with research implications for the future of primary care nursing. RESULTS: This article describes the project's stakeholder, faculty, and student engagement methods. This article also describes the clinic RN preceptor development program, and depicts the Primary Care RN Education Program Student Clinical Experience Preceptorship Model. CONCLUSIONS: Nursing education must align with transforming healthcare models while anticipating potential barriers and resolutions to enhancing curriculum with primary care nursing education and clinical experiences. This article provides insight for other academic institutions interested in developing primary care curriculum and academic-clinic partnership models to foster community-based primary care clinical experiences.

INPUT: An academic-practice partnership to an underserved rural community.

The INPUT project is a model partnership that changed the way health care was offered to the underserved in rural Western North Carolina. Grant funding provided a full-time Family Nurse Practitioner (FNP) to a free clinic and created clinical placements for FNP students. Students had opportunities to learn about unique aspects of care for vulnerable, underserved populations to encourage them to consider working in rural communities. The clinic saw an increase in patient visits and offered more continuity in follow-up care. This academic-practice partnership represents a successful example of how working together can benefit the collaborators and community.

Social Determinants and Educational Barriers to Successful Admission to Nursing Programs for Minority and Rural Students.

In 2010, the Institute of Medicine made a recommendation in The Future of Nursing Report to diversify the student population of the health care professions in order to provide increasing minority providers to meet the culturally competent needs of the growing multicultural populations of the United States (Institute of Medicine, 2010). The Nursing Network and Careers and Technology Nurse Mentoring Program provides a nursing mentor to underrepresented ethnic minority and educationally disadvantaged students and a significant scholarship and stipend for tuition and monthly living expenses. Ethnically diverse and rural students have lifelong familial and geographical educational barriers that prevent them from succeeding. There are a plethora of major environmental and familial factors that need to be addressed by society for these students to be successful. These factors include improvement of county schools by financial support, improving the home environment through social supportive services, and implementing improved parent-child bonding with nurse family partnerships. Nursing faculty must embrace new approaches for increasing the number of ethnically diverse nursing providers through novel admission criteria and collaborative cohort peer-mentoring programs.

INCREASING DIVERSITY IN OUR SCHOOLS OF NURSING.

This article will review one school's quest to address the multi-level social, historical, environmental and structural determinants faced by under-represented ethnic minorities (UREM) and disadvantaged background (DB) students as they seek entrance into a nursing program. Nursing Network Careers and Technology (NN-CAT) provides a nursing career network for underrepresented and disadvantaged students in western North Carolina and has increased the number of underrepresented and disadvantaged students who are admitted, retained and graduate with a bachelor's degree in nursing from Western Carolina University. Initial data from this NN-CAT program have demonstrated that addressing social determinants and eliminating barriers can increase the number of UREM and educationally disadvantaged students who successfully matriculate in our schools of Nursing and subsequently graduate. These nurses then enter the workforce and provide culturally meaningful care in their local communities.

Lipid Emulsion in Treatment of Local Anesthetic Toxicity.

Epidural, spinal, regional, local, and intravenous administration of local anesthetics (LAs) is a cornerstone of anesthetic practice. LA toxicity is a grave consequence that is of great significance to anesthesia providers. Outcomes of LA toxicity range from inconvenient symptoms such as tinnitus, twitching, and hypotension to seizures; cardiovascular or respiratory collapse; and death. Lipid emulsion has emerged as a potential "magic bullet" in treating LA toxicity. This literature review provides background information and proposed mechanisms of action for LAs and lipid emulsion as well as animal experiments and a case report that speak to the effectiveness of lipid emulsion in the face of LA toxicity.

Analysis and recommendations for reducing risks of patient crosscontaminations via noncritical medical devices.

Based on the serious problem of health care-associated infections and the understanding that patient crosscontamination is essentially preventable, opinions were sought from health care providers for insight into likely sources of crosscontamination in US hospitals, probable causes, and areas for additional investigation. Respondents indicated that inadequate disinfection of noncritical, patient care devices pose an underrecognized threat to patient crosscontamination. This led the researchers to question reliance upon the current Centers for Disease Control and Prevention (CDC) Guideline for Disinfection and Sterilization in Healthcare Facilities for such items. The CDC Guideline follows the Spaulding approach, which categorizes items and their disinfection treatment based on the risk of infection from the intended use of the item. A failure modes, effects, and criticality analysis approach is recommended as an additional refinement to the CDC Guideline whereby likely sources of cross-contamination are identified irrespective of intended use. Enhancing infection control practices with this approach promotes the development of preventive plans for cleaning and disinfection that can mitigate such risk.

Can script concordance testing be used in nursing education to accurately assess clinical reasoning skills?

The Script Concordance Test (SCT) has been used successfully in medical schools to assess clinical reasoning in medical students, but it has not been widely used in nursing education. The purpose of this study was to provide additional evidence of the validity and reliability of the SCT in evaluating clinical reasoning in nursing students by replicating a previous study. The test was administered to 48 first-year Bachelor of Science in Nursing students. A scoring grid was developed using the aggregate scores method based on the modal responses of 13 panel members. The reliability of the scores was measured by Cronbach's alpha coefficient, and the scores of the students and the panel were compared using a t test. The difference between the panel's and the students' scores was statistically significant, and the reliability of the scores is high. The SCT provides a reliable, standardized, and easy-to-administer method of evaluating clinical reasoning in nursing students.

Exploring the value of an international service-learning experience in Honduras.

The purpose of this study was to determine the effect of an international service-learning experience in Honduras on the cultural competence of the participants. The study included a quantitative portion in which participants utilized the Cultural Competence Assessment instrument as a pretest-posttest evaluation of change in cultural competence, and a qualitative portion in which students discussed their feelings about the experience. The quantitative portion showed an increase in cultural competence behaviors following the experience. The qualitative portion resulted in four themes that emerged from the interviews: a) stepping outside my world, b) connecting with culturally different people, c) awe of community, and d) learning innovation. These results indicate that the international service-learning experience was successful in increasing the participants' ability to provide culturally congruent care.