Bridging the experience-complexity gap with longitudinal clinical placements.

BACKGROUND: Clinical learning is a critical element to prepare nursing students for the profession. There is limited evidence on the experience-complexity gap among novice nursing students entering the workforce. PURPOSE: This study aimed to implement a novel longitudinal clinical experience program and examined readiness for practice for undergraduate nursing students. METHODS: We used a prospective cohort design using the Casey-Fink Readiness for Practice survey. FINDINGS: There have been 2,004 clinical placements filled since the start of the program. Repeated exposure at one organization provided consistency and continuity while allowing students to develop relationships with patients and staff in a variety of settings. The medical-surgical two clinical experience was a pivotal course that influenced students' perception to enter the nursing workforce. DISCUSSION: Clinical and academic partners must collaborate to provide the necessary competencies required to enter the workforce. Longitudinal clinical programs may improve nursing students readiness for practice. CONCLUSION: The continous and immersive nature of the longitudinal clinical experience program facilitated the development of critical thinking skills and clinical competence, suggesting that longitudinal clinical placements can bridge the experience-complexity gap in nursing education.

Impact of the Pandemic on Newly Licensed Nurses' Role Transition Experiences.

This study examined differences in newly licensed nurses' role transition experiences while enrolled in a nurse residency program before and during the pandemic. The Casey-Fink Graduate Nurse Experience Survey measured baseline, 6-month, and 12-month program outcomes. The prepandemic cohort had higher subscale scores at baseline. Both cohort groups showed significant increases in role confidence, patient safety, communication/leadership, and job satisfaction. Despite the pandemic, nurse residency program completion rates remained stable. Implications for nursing professional development practitioners are presented.

Competency Assessment of Pediatric Intensive Care Nurses.

One of the biggest challenges that clinical nurse educators at the unit level face today is measuring the ongoing competency of nursing staff members to ensure provision of high-quality, evidence-based care. Pediatric nursing leaders at an urban, level I trauma teaching institution in the southwestern United States used a shared governance approach to create a standardized competency assessment tool for pediatric intensive care unit nurses. Donna Wright's competency assessment model was used as a framework to guide the tool's development. The adoption of the standardized competency assessment tool was aligned with the organization's institutional goals and enabled clinical nurse educators to comprehensively evaluate staff members on a regular basis. This standardized competency assessment system for pediatric intensive care nurses is more effective than use of a practice-based, task-oriented assessment method and has improved nursing leaders' ability to staff the pediatric intensive care unit safely.

Content Validity and Interrater Reliability of a Newborn Fall Risk Assessment Tool: KAnt Fall.

BACKGROUND: Newborn falls are a safety concern in the acute care setting. To our knowledge, a valid and reliable tool for assessing newborn fall risk has not been developed. PURPOSE: To evaluate the content validity and interrater reliability of a tool for nurses to assess the fall risk of newborns in the acute care setting. METHODS: Content validity was established using a modified Delphi technique with neonatal intensive care unit (NICU) nurses (n = 27). Item-level content validity indices and an average scale content validity index were calculated. For interrater reliability, pairs (n = 130) of NICU nurses simultaneously assessed multiple newborns using the tool, and an intraclass correlation coefficient was calculated. RESULTS: The initial tool had 28 items classified in 2 sections (newborn and caregiver variables). Fourteen items met predefined cut-off values for content validity. This resulted in the tool (KAnt Fall) having 7 items for assessing newborns and 7 items for caregivers. The intraclass correlation coefficient was 0.99 indicating excellent interrater reliability. IMPLICATIONS FOR PRACTICE: The tool will help assist nurses in systematically identifying newborns at high risk for falls. This assessment will allow nurses to identify and implement timely preventive actions for hospitalized newborns at high risk for falls. IMPLICATIONS FOR RESEARCH: Since this was a single-center study in 1 NICU, future research is needed in other hospitals and types of newborn settings (eg, labor and delivery and postpartum units). Further testing of KAnt Fall is also needed to establish additional psychometric properties.

Mask-Ed™: Let's Get Real With Simulation.

BACKGROUND: With the increasing shortage of clinical placement sites, nurse educators must be creative in providing alternative learning modalities that prepare students for nursing practice. Mask-Ed™ simulation may help address this challenge. PURPOSE: The purpose of this study was to describe junior-year undergraduate nursing students' experiences with Mask-Ed™ simulation in the context of caring for older adults. METHODS: Using a qualitative descriptive design, focus groups were conducted with 18 students who experienced Mask-Ed™ during 1 semester. RESULTS: Six themes emerged: (1) seeing the older adult as a person, not just a patient; (2) seeing the older adult in a new light; (3) authenticity of the experience and realistic scenarios; (4) ability to give myself to it; (5) safe space to practice; and (6) dress rehearsal for the RN role. CONCLUSIONS: Mask-Ed™ changed participants' perceptions of older adults and their consideration of pursuing a nursing career with this patient population. Participants also expressed Mask-Ed™ was a safe and authentic simulation to help prepare for nursing practice.

The lived experiences of graduate nurses transitioning to professional practice during a pandemic.

BACKGROUND: Graduate nurses face challenges during their transition to professional practice. Understanding these experiences during a pandemic has not been explored. PURPOSE: The purpose of this study is to describe the lived experiences of graduate nurses transitioning to practice during a pandemic. METHODS: Using a hermeneutic phenomenological approach, focus groups were conducted with fifteen nurses who were at three different stages of transition and participating in a 12-month Graduate Nurse Residency Program. FINDINGS: Seven themes emerged: 1) being new is overwhelming, even more so during COVID-19, 2) need to be flexible, 3) pandemic knowledge and practice disconnect, 4) communication barriers worsened with masks, 5) being a "COVID nurse," 6) no self-care, and 7) gratitude: still glad to be a nurse. DISCUSSION: Findings emphasize the important focus on graduate nurse support and educational foundation for role transition into professional practice, especially during a pandemic. Participants expressed lack of preparedness for practice but remain excited about being a nurse.

The nurse COVID and historical epidemics literature repository: Development, description, and summary.

BACKGROUND: During COVID-19, a Kaggle challenge was issued to data scientists to leverage text mining to provide high-level summaries of full-text articles in the COVID-19 Open Research Dataset (CORD-19) data set, a data set containing articles around COVID-19 and other epidemics. A question was asked: "What if nursing had something similar?" PURPOSE: Describe the development and function of the Nursing COVID and Historical Epidemic Literature and describe high-level summaries of abstracts within the repository. METHOD: Nurse-specific literature was abstracted from two data sets: CORD-19 and LitCOVID. LitCOVID is a data set containing the most up-to-date literature around COVID-19. Multiple text mining algorithms were utilized to provide summaries of the articles. DISCUSSION: As of July 2020, the repository contains 760 articles. Summaries indicate the importance of psychological support for nurses and of high-impact rapid education. CONCLUSION: To our knowledge, this repository is the only repository specific for nursing that utilizes text mining to provide summaries.

Reducing Discomfort After Cesarean Birth Using Abdominal Binders.

PURPOSE: The purpose of this study was to evaluate potential benefits of use of an abdominal binder after cesarean birth. STUDY DESIGN AND METHODS: A randomized controlled trial was conducted at a Magnet-designated, academic medical center in the southwest United States. English- and Spanish-speaking adult women scheduled for an elective cesarean birth were randomized to the intervention or control group. Outcomes were measured for the first 48 hours postoperatively, including pain, medication use, and self-reported symptom distress. RESULTS: Randomization resulted in balanced groups. Women who used the abdominal binder after cesarean birth reported a decrease in pain after ambulation, whereas women in the control group reported an increase in pain after ambulation (p < .001). Women in the binder group reported less distress on the Breathe and Cough items of the Symptom Distress Scale than those in the control group. On postoperative day 2, women in the binder group used more ibuprofen (p = .002) and acetaminophen (p = .027) than the control group. CLINICAL IMPLICATIONS: Use of an abdominal binder by women after cesarean birth can decrease pain, potentially enhancing speed of postoperative recovery. As a nursing intervention, abdominal binders may offer women a safe nonpharmacologic option to provide postoperative comfort.

Incivility and Professional Comportment in Critical Care Nurses.

BACKGROUND: Civility among critical care nurses is important for achieving positive patient outcomes. Professional comportment refers to nurse behaviors that are respectful, knowledgeable, deliberate, and compassionate. OBJECTIVE: To examine the relationship between perceptions of nurse-to-nurse incivility and professional comportment among critical care nurses, and the extent to which nurse characteristics influence their perceptions. METHODS: Data were collected from nurses in 14 critical care units. Correlational analysis examined the relationship between nurses' perceptions of nurse-to-nurse incivility and professional comportment. Regression analysis was used to identify predictors of nurse-to-nurse incivility. RESULTS: Decreased perceptions of nurse-to-nurse incivility were associated with increased perceptions of professional comportment. Nurses' reports of receiving education about professional comportment was a significant predictor of increased nurse perceptions of professional comportment. CONCLUSION: Professional comportment education for critical care nurses is important and may provide an option to decrease incivility and promote healthy work environments for nurses.

To Lecture or Not to Lecture? That is the Question.

A quasi-experimental mixed-methods study compared the effects of an unfolding case study with lecture in a nursing orientation class on new graduate registered nurses' knowledge, perceived learning, and satisfaction with the instructional method. Although results showed that the unfolding case study was engaging, learners who received content in a lecture format achieved significantly higher posttest scores. Nursing professional development specialists will find this article helpful when considering instructional methods for new graduate registered nurses.

Financial, performance, and organizational outcomes of a nurse extern program.

Nurse externships help prepare nursing students for practice, but the organizational costs are high. To decrease costs, nurse educators collaborated to revise their existing nurse extern program. Nursing professional development educators who want to implement a nurse extern program within an organization will benefit by learning about the planning, implementation, and evaluation of a nurse extern program designed to decrease costs while producing well-prepared new graduate nurses.

Using problem-based learning in the clinical setting to improve nursing students' critical thinking: an evidence review.

In preparation for the progressive nature of today's acute care hospital environments and the requirements for safe and effective patient care, it is essential that nursing students learn how to think critically. Problem-based learning is a method of education designed to encourage critical thinking. This article examines the evidence regarding the use of problem-based learning to improve critical thinking. A review of published literature was conducted using the CINAHL, ERIC, PsychInfo, and PubMed databases with the keywords nursing, problem-based learning, and critical thinking. Although the evidence is still accumulating, the studies reviewed indicate a positive relationship between problem-based learning and improved critical thinking in nursing students. There is a need for more rigorous research on the use of problem-based learning to examine the effects on critical thinking. Until this occurs, nursing instructors must rely on the extant evidence to guide their practice or continue to use the traditional model of clinical nursing education.