Measuring the Success of a Transition to Practice Program With Strategic Quality Outcome Measures.

Transition to practice programs, like many other educational programs, are scrutinized by organizations to demonstrate value to the organization in exchange for precious human and financial resources. By developing quality outcome measures aligned to the organizational strategy, transition to practice leaders can optimize support and ensure sustainability. [J Contin Educ Nurs. 2024;55(10):464-466.].

Evaluating the Quality of Multiple-Choice Test Questions in the Postlicensure Environment.

BACKGROUND: Multiple-choice test questions are among the main measures of knowledge used by educators in the postlicensure environment; however, these tests are often constructed in the absence of guidelines or the means to evaluate examination quality after administration. METHOD: Previously, guidance was provided on constructing quality test items. Here we present instruction for professional development specialists to use postadministration test data for an item analysis, providing insight on test flaws and opportunities for iterative examination improvement. RESULTS: The topics of item difficulty, index of discrimination, and distractor analysis are covered for independent analysis, and topics such as reliability are addressed for those who have access to a formal program. CONCLUSION: Three levels of strategies are described: using a learning management system for item analysis, using free open-source software, and using a minimal standards method of evaluating test items. [J Contin Educ Nurs. 2024;55(10):487-492.].

Impact of Evidence-Based Charge Nurse Education on Charge Nurse Skills and Nurse-Specific Metrics.

OBJECTIVE: This research study was designed to analyze the impact of an evidence-based charge nurse (CN) education program on novice and experienced CNs' self-confidence and satisfaction with the role, skill competencies, and nursing metrics. BACKGROUND: Charge nurses are critical to effective daily unit operations. However, executive nursing leadership found that unit performance varied by CN despite experience. METHODS: University faculty partnering with nurse leaders developed an evidence-based CN education program including a series of classes, coaching in skills and role responsibilities by nurse leaders, and evaluation of skills competencies before and after the CN education program. RESULTS: The CN program was associated with significant positive changes in CN performance, nurse-specific metrics, hospital-acquired events, and patient satisfaction. CONCLUSIONS: Interventions targeting frontline leaders positively impact CN performance.

Clinical Scholar Preparation: An Approach That Works.

The Colorado Center for Nursing Excellence established a formal didactic course in 2005 to deliberately prepare clinical faculty using expert clinical nurses. Independently, the National League for Nursing, in 2018, established criteria for certification for clinical nurse educators. The content of this course content closely mirrors those competencies and provides preparation for the exam. As a result, Clinical Scholars have established themselves as important players in nursing education in Colorado.

Effectiveness of Evidence-Based Practice (EBP) Education on Emergency Nurses' EBP Attitudes, Knowledge, Self-Efficacy, Skills, and Behavior: A Randomized Controlled Trial.

BACKGROUND: Emergency care clinicians are expected to use the latest research evidence in practice. However, emergency nurses do not always consistently implement evidence-based practice (EBP). An educational intervention on EBP was implemented to promote emergency nurses' use of EBP, and the effectiveness of it was evaluated. AIMS: This study aimed to evaluate the effectiveness of an EBP educational intervention on emergency nurses' EBP attitudes, knowledge, self-efficacy, skills, and behavior. The study also examined learners' satisfaction with the EBP educational intervention. METHODS: A randomized controlled trial with parallel groups with evaluations before the education, immediately after it, and 6 and 12 months after the education was conducted at four emergency departments in two university hospitals. The experimental group (N = 40) received EBP education while the control group (N = 40) completed self-directed EBP education. The primary outcomes were emergency nurses' EBP attitudes, knowledge, self-efficacy, skills, and behavior, while the secondary outcome was satisfaction with the EBP education. RESULTS: Thirty-five participants of an experimental and 29 participants of a control group completed the study. There were no statistically significant (p < .05) improvements and differences between groups in EBP attitude, self-efficacy, or behavior immediately after the EBP education. At the 6-month measurement point, the experimental group showed significantly better EBP attitudes, behavior, knowledge, and self-efficacy than the control group. At the 12-month measurement point, the improvements began to decrease. The groups also differed significantly in terms of participant satisfaction with how the teacher encouraged learners to ask clinical questions. LINKING EVIDENCE TO ACTION: The EBP educational intervention implemented in this study had a positive effect on emergency nurses' EBP attitudes, knowledge, self-efficacy, skills, and behavior. The effects of the education appeared the best 6 months after the education. After this point, the results began to decrease and approached baseline levels. EBP educational interventions designed for emergency nurses should apply various teaching strategies to improve their EBP attitude, knowledge, self-efficacy, skills, behavior, and satisfaction with the education.

Closing the gap: The effect of an evidence-based intervention in increasing COPD nurses' knowledge.

BACKGROUND: Chronic obstructive pulmonary diseases (COPD) is the leading cause of respiratory failure and is associated with high morbidity and mortality rates. Nurses play a vital role in ensuring effective, safe, and person-centered care in COPD. AIM: To assess the effect of an evidence-based intervention in increasing the COPD knowledge in a sample of care nurses, staffing public primary, and secondary healthcare services infrastructures and hospitals. METHODS: An intervention that entailed a combination of an educational program and the use of an educational algorithm based on the Global Strategy for the Diagnosis, Management, and Prevention of COPD was performed. RESULTS: At the baseline, the mean total percentage of correct answers was very low (52.74%) as opposed to the other time intervals in which there was a huge increase after the session that was maintained 3 and 6 months later. The highest effect in the total knowledge score was attributed to the educational session followed by the use of the educational algorithm. CONCLUSION: The effect of the intervention on the mean score of correct answers was very strong, which is confirmed by the consistency of the high performance of nurses after 3 and 6 months, respectively.

Nurse Leaders' Assumptions and Attitudes Toward Residency Programs for New Graduate Nurses.

The Future of Nursing Report from 2010 offered key recommendations for the practice of nursing, including the need for nurse residency programs for all new graduate nurses. Although numerous articles can be found about the programs themselves, finding information about the support of nurse leaders for such programs is more challenging. In the spring of 2019, a small group of invited nurse leaders from across the United States met during a "Think Tank." The purpose of this gathering was to discuss a policy brief offered by the American Academy of Nursing requiring all new graduate registered nurses to participate in a nurse residency program as part of their transition into practice. To determine nurse leaders' assumptions and attitudes toward nurse residency programs, the think tank planners conducted a national survey. Over 500 members of the American Organization for Nursing Leadership participated in this survey. In this article, the authors offer that nurse leaders are supportive of residency programs for new graduate nurses although some are still struggling with demonstrating the value proposition. In addition, nurse leaders are not in support of a national mandate.

Impact of a Formal Educational Skill-Building Program Based on the ARCC Model to Enhance Evidence-Based Practice Competency in Nurse Teams.

BACKGROUND: Implementation of evidence-based practice (EBP) is necessary for healthcare systems to improve quality, safety, patient outcomes, and costs. Yet, EBP competency is lacking in many nurses and clinicians across the country. AIM: The purpose of this initiative was to determine whether nursing teams (Executive Leader, Clinical/Mid-level Leader, and Direct Care Nurse) attending a 5-day EBP continuing education skill-building program (immersion) was an effective strategy to build EBP competence, practice, and culture sustainability over time. The Advancing Research and Clinical Practice Through Close Collaboration Model was used to guide this initiative. METHODS: A project team was assembled, including leaders with EBP expertise from the Air Force Medical Service and The Helene Fuld Health Trust National Institute for EBP in Nursing and Healthcare at The Ohio State University. Five survey instruments were used to evaluate outcomes, including Organizational Culture and Readiness for System-Wide Implementation of Evidence-Based Practice, Evidence-Based Practice Beliefs, Evidence-Based Practice Implementation, and Evidence-Based Practice Competencies, as well as the Knowledge Assessment Questionnaire test. Nursing teams were invited to participate and complete the program with the implementation of EBP projects over the following year. RESULTS: Participants' EBP knowledge, skills, competencies, and beliefs were significantly improved and sustained over 12 months. LINKING EVIDENCE TO ACTION: A team-based EBP skill-building program was an effective strategy for building EBP competence, practice, and culture. This initiative demonstrated that the direct involvement of leadership and infrastructure to support EBP were crucial factors for building and sustaining an EBP culture.

Reflections on an educational intervention to encourage midwives to work in a continuity of care model - exploration and potential solutions.

OBJECTIVE: To explore barriers and facilitators for midwives working in a midwifery continuity of carer model, and to assess if an educational intervention could help address some of these barriers, designed to help achieve NHS England's target of majority of women receiving midwifery continuity of carer by March 2021. DESIGN: Two-day workshops were co-designed by experienced continuity midwives, service managers and midwifery educators using implementation theory delivered to maternity staff, with barriers assessed prior to training and re-assessed at the end. SETTING AND PARTICIPANTS: 1407 maternity healthcare professionals from 62 different National Health Service trusts across England attended 56 different workshops. FINDINGS: Perceived barriers to working in this model were reported more frequently than facilitators. Reported facilitators prior to training included perceived benefits to the midwife and to women. Reported barriers included personal and professional concerns, fear, issues with the national agenda and institutional and/or organisational issues. The educational intervention was able to address the majority of barriers raised. The training was well evaluated, with an average rating of 4.2 on a five-point Likert scale. KEY CONCLUSIONS: While this specific educational intervention appears to have been useful in addressing concerns with working in a continuity model, further work is needed to identify barriers to change. This will aid more local designed interventions. IMPLICATIONS FOR PRACTICE: If policy targets related to continuity of carer are to be achieved then working in this way needs to be sustainable and appeal to the current midwifery workforce.

Effect of palliative care training on perceived self-efficacy of the nurses.

BACKGROUND: Nurses are involved in providing end-of-life care for end stage individuals and their self-efficacy is one of the key factors bearing on such care. The purpose of this study was to determine the effect of palliative care on perceived self-efficacy of the nurses. METHODS: This is a quasi-experimental study with pretest-posttest design. Sampling was randomized and included 40 individuals. The intervention consisted of palliative care training for four sessions, each lasting 45 min. Data were collected using demographic and perceived self-efficacy questionnaires completed before and after the intervention. Data were then analyzed by SPSS 16 software using descriptive and inferential statistics. RESULTS: The mean age of the participants was 38.6 and their work experience was 14.25 years. The majority of the participants were female (85%) and had a bachelor level of education (92.5%). The findings showed that "perceived self-efficacy", "psychosocial support" and "symptom management" improved significantly after intervention (p < 0.05). CONCLUSION: Based on the results, palliative care education has the potential to increase nurses' perceived self-efficacy. Since all members of the health care team Including nurses play an important role in providing palliative care, nursing managers can take an effective step to maximize the capacity of nurses by planning and supporting training in this regard.

Effects of de-implementation strategies aimed at reducing low-value nursing procedures: a systematic review and meta-analysis.

BACKGROUND: In the last decade, there is an increasing focus on detecting and compiling lists of low-value nursing procedures. However, less is known about effective de-implementation strategies for these procedures. Therefore, the aim of this systematic review was to summarize the evidence of effective strategies to de-implement low-value nursing procedures. METHODS: PubMed, Embase, Emcare, CINAHL, PsycINFO, Cochrane Central Register of Controlled Trials, Web of Science, and Google Scholar were searched till January 2020. Additionally, reference lists and citations of the included studies were searched. Studies were included that described de-implementation of low-value nursing procedures, i.e., procedures, test, or drug orders by nurses or nurse practitioners. PRISMA guideline was followed, and the 'Cochrane Effective Practice and Organisation of Care' (EPOC) taxonomy was used to categorize de-implementation strategies. A meta-analysis was performed for the volume of low-value nursing procedures in controlled studies, and Mantel-Haenszel risk ratios (95% CI) were calculated using a random effects model. RESULTS: Twenty-seven studies were included in this review. Studies used a (cluster) randomized design (n = 10), controlled before-after design (n = 5), and an uncontrolled before-after design (n = 12). Low-value nursing procedures performed by nurses and/or nurse specialists that were found in this study were restraint use (n = 20), inappropriate antibiotic prescribing (n = 3), indwelling or unnecessary urinary catheters use (n = 2), ordering unnecessary liver function tests (n = 1), and unnecessary antipsychotic prescribing (n = 1). Fourteen studies showed a significant reduction in low-value nursing procedures. Thirteen of these 14 studies included an educational component within their de-implementation strategy. Twelve controlled studies were included in the meta-analysis. Subgroup analyses for study design showed no statistically significant subgroup effect for the volume of low-value nursing procedures (p = 0.20). CONCLUSIONS: The majority of the studies with a positive significant effect used a de-implementation strategy with an educational component. Unfortunately, no conclusions can be drawn about which strategy is most effective for reducing low-value nursing care due to a high level of heterogeneity and a lack of studies. We recommend that future studies better report the effects of de-implementation strategies and perform a process evaluation to determine to which extent the strategy has been used. TRIAL REGISTRATION: The review is registered in Prospero (CRD42018105100).

Implication of the training ad continuing education process for the interprofessional performance.

OBJETIVES: to analyze the implication of the training/continuing education process of professionals of the Expanded Nucleus of Family Health and Basic Care (Portuguese acronym: Nasf-AB) for their interprofessional performance. METHODS: a qualitative case study performed with Nasf-AB teams representative of four macro-regions of health of the state of Santa Catarina. Participation of 43 professionals, who answered collective interviews. The results were later submitted to thematic analysis. RESULTS: the training is strongly influenced by the Biomedical Model, which acts as an obstacle to interprofessional performance, given the challenges in the daily routine of Nasf-AB professionals. Continuing education emerges as a potential for the successful collaborative work among teams, and between the teams and Family Health professionals. FINAL CONSIDERATIONS: there are important limits in the training of professionals. However, the constant interprofessional development promoted by strategies of continuing education contributes to broaden the support and collaborative practices that qualify services and strengthen Basic Care.

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.

What is the evidence that can inform the implementation of a preceptorship scheme for general practice nurses, and what is the evidence for the benefits of such a scheme?: A literature review and synthesis.

OBJECTIVES: This is a literature review of the published evidence of the benefits and suggested structure of preceptorship programmes for General Practice Nursing, with the aim of informing General Practices and networks who are instituting preceptorship programmes. DESIGN & DATA SOURCES: A literature search was carried out in the CINAHL Plus database of English language papers from the year 2000-2019 using the search terms; (Precept* OR mentor*) AND ("community practice" OR "primary care" OR "general practice" OR "new GPN" OR "new general practice nurse" OR "nurse new to general practice" OR "induction GPN" or "GPN"). REVIEW METHOD: A literature review and narrative synthesis of the evidence. RESULTS: Our searches produced twelve papers. Seven papers reported on single preceptorship programmes in General Practice or primary care, with qualitative or quantitative evaluation of their effects. Three qualitative papers reported participant experience of preceptorship, or discussed the learning needs that preceptorship must address. Two literature reviews reported the evidence for preceptorship in General Practice or nurse practitioner programmes. CONCLUSION: The quality of the evidence on General Practice Nurse preceptorship is low. There is a lack of robust evidence on the effects, and the benefits. These should be evaluated as preceptorship programmes are implemented. The limited available evidence suggests that a structured preceptorship programme, of more than 4 months duration, which allows the development of peer-to-peer support, is a good model for General Practice Nurse preceptorship. The involvement of doctors and the wider practice team is essential for the success of such a programme. Preceptors require training and support in the role. General Practice Nurse preceptorship should support the development of existing professional competencies, including the ability to make real-time autonomous clinical decisions. The financial costs, and cost of time away from clinical care, should be ameliorated as far as possible, when instituting a national General Practice Nurse preceptorship programme.

Impact of continuing medical education for primary healthcare providers in Malaysia on diabetes knowledge, attitudes, skills and clinical practices.

Background: Continuing Medical Education (CME) is a cornerstone of improving competencies and ensuring high-quality patient care by nurses and physicians. The Ministry of Health (MOH) Malaysia collaborated with Steno Diabetes Centre to improve diabetes-related competencies of general physicians and nurses working in primary care through a six-month training programme called the Steno REACH Certificate Course in Clinical Diabetes Care (SRCC).Objective: This impact evaluation aimed to assess the effect of participation of general physicians and nurses in the SRCC in selected public primary healthcare clinics in Kuala Lumpur and Selangor, Malaysia.Design: The quasi-experimental, embedded, mixed-methods study used concurrent data collection and the Solomon four-group design. Participants in an intervention group (Arm 1) and control group (Arm 3) were assessed by pre-and post-test, and participants in separate intervention (Arm 2) and control (Arm 4) groups were assessed by post-test only. Quantitative and qualitative methods were used to assess the effect of the programme.Results: Thirty-four of the 39 participants in the intervention groups (Arms 1 and 2) completed the SRCC and were included in the analysis. All 35 participants in the control groups (Arms 3 and 4) remained at the end of the study period. Significant improvements in diabetes-related knowledge, skills and clinical practise were found among general physicians and nurses in the intervention group after the six-month SRCC, after controlling the pretest effects. No clear changes could be traced regarding attitudes.Conclusion: SRCC participants had significant improvements in knowledge, skills and clinical practice that meet the current needs of general physicians and nurses working in primary care in Malaysia. Thus, SRCC is an effective CME approach to improving clinical diabetes care that can be scaled up to the rest of the country and, with some modification, beyond Malaysia.

From Competence to Continuing Competency.

In 2011, a task force sponsored by an organization that has Accreditation Board for Specialty Nurse Certification-accredited programs published a definition of continuing competence. Eight years later, the organization sponsored the work of another task force to revisit that definition, with the 2018-2019 task force broadening its focus beyond the U.S. borders and beyond nursing. After an extensive literature review, task force members collated their findings into four categories: Identifying Competencies, Validating Competencies, The International Perspective on Competency Assessment, and Competency in Disciplines Other Than Nursing. The task force identified perspectives on continuing competency and found that although licensing and credentialing organizations addressed the topic thoroughly, little attention was devoted to the perspectives of the public, individual clinicians, and recipients of clinicians' services. This article identifies that little consensus exists on definitions of competence and competency, international perspectives have much to offer, and theoretical frameworks for research on competence and competency are lacking. [J Contin Educ Nurs. 2020;51(1):15-24.].

Evaluation of the Impact of the Wound Treatment Associate (WTA) Education Program on Practice and Quality Patient Outcomes.

PURPOSE: The Wound Treatment Associate (WTA) program is an education offering of the WOCN Society. This evidence-based continuing education program prepares nurses to serve as a unit-based resource for nursing staff. The WTA program is approved by the American Nurses Credentialing Association (ANCC) for 32.25 contact hours and aimed at licensed health care personnel. This article focuses on the impact of this education program, in particular a reduction in hospital-acquired pressure injury (HAPI) in acute care and decrease in visits per episode (VPE) and supply costs in home health. METHODS: Surveys were sent to all course participants to date to fulfill the summative evaluation requirement for ANCC approval to determine the perception of improvement in knowledge, skills, and practice. An additional survey was developed and reviewed by members to send to WTA program course coordinators. RESULTS: Participants (n = 153) reported an increase in confidence in knowledge and skills about wound care and use in nursing practice. The number of respondents to the course coordinator survey was lower (n = 48). Coordinators did report a reduction in pressure injuries in acute care. Home health respondents noted a decrease in VPE and reduction in the cost of supplies. Data reported on abstracts and posters suggested positive impacts of pressure injury prevention programs in acute and home health care. CONCLUSIONS: Although there are limitations to the aforementioned reporting, incorporating the WTA program into pressure injury prevention programs and wound treatment programs showed a reduction in HAPIs in acute care and decreased VPE and supply costs in home health.

Multiprofessional team perception of a music therapeutic workshop developed by nurses.

OBJECTIVE: To understand the perception of a multiprofessional team regarding the use of music in a therapeutic workshop developed by nurses. METHOD: Qualitative study, of the exploratory type. Data were collected through semi-structured interviews, with the participation of 13 professionals from a Psychosocial Care Center in a municipality of Minas Gerais' Zona da Mata, and analyzed according to Michel Maffesoli's comprehensive sociology approach. RESULTS: The testimonies revealed that the use of music in the nurse's activities in mental health represents a re-signification of nursing care and favors the user's subjectivity. FINAL CONSIDERATIONS: This study allowed us to show that nurses need to listen to the music that comes from the heart, from the soul, and to the truths that are not always stated in the scenarios of therapeutic practices with individuals going through psychic suffering. Therefore, the care offered should be centered on the human history, which wants to be unveiled and understood.

Emergency nurses' experience of adult basic and advanced life support workstations as a support strategy for clinical practice in the emergency department.

BACKGROUND: Standards endorsed by the Australian Resuscitation Council in 2014 recommend that healthcare providers trained in cardiopulmonary resuscitation should have their skills refreshed at least annually and for those who infrequently perform resuscitation, more frequent refresher training is advised. Emergency nurses were given the opportunity to attend workstations to refresh their knowledge and skills essential to resuscitation practice. The aim of this manuscript was to report the perception of the nurses' experience following attendance at the workstations. METHODS: Lesson plans were developed for six workstations. Consented participants were invited to complete an on-line evaluation survey of their experience following programme participation and at 6-months following programme attendance. Thematic analysis and descriptive statistics were used to report outcomes RESULTS: A total of 143 nurses working in the Emergency Department consented to participate. Following attendance at the workstations, most reported increased knowledge and skills (93.7 %), increased confidence (91.9 %) and that they practiced skills (91.9 %) during workstation participation. At 6-months follow-up the majority of nurses (97.1 %) found the programme to be beneficial and 82 (80.4 %) reported using the knowledge and skills gained from the programme in their clinical practice. CONCLUSIONS: Emergency nurses felt more confident in delivering patient care following attendance at the resuscitation workstations. Ongoing education was highly regarded by emergency nurses.