Knowledge, attitudes, practices, and related factors of low anterior resection syndrome management among colorectal surgery nurses: a multicenter cross-sectional study.

PURPOSE: With the widespread development of low and ultra-low rectal sphincter-preservation surgery, low anterior resection syndrome, a new clinical challenge, has received increased attention. As the principal practitioners of this syndrome management, colorectal surgery nurses require sufficient relevant knowledge and skills, but few studies have been conducted of their actual ability and practice of managing the syndrome. The study adopted a knowledge, attitude, and practice model to evaluate low anterior resection syndrome management among colorectal surgery nurses. METHOD: A multicenter cross-sectional study was conducted, in which 361 registered nurses in colorectal surgery from 6 hospitals in 4 cities were enrolled. A structured paper questionnaire was used to collect demographics, scale scores for knowledge, attitudes and management practice, and training needs. RESULTS: Participants scored poorly in knowledge, attitude, and practice. Whether training had been received or not was an important factor affecting the knowledge, attitude, and practice of nurses, and the majority of participants had not received training. Nurses with lower levels of education had worse knowledge and practice, and contract nurses scored lower than staff nurses in terms of knowledge and attitude. CONCLUSIONS: The critical role of nurses in patient management places high demands on their knowledge, attitude, and practice. However, the present study demonstrated that the current knowledge, attitude, and practice of colorectal surgery nurses regarding the syndrome gave cause for concern, and whether training had been received was a key factor affecting these three aspects. Therefore, training is a key strategy to eliminate the gaps identified.

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.

Factors influencing nurses' engagement with CPD activities: a systematic review.

BACKGROUND: Continuing professional development (CPD) is necessary for nurse registration and development. Understanding the factors influencing engagement may enhance CPD uptake. REVIEW QUESTION: What factors influence hospital-based nurses' engagement with CPD activities in the UK? DESIGN: This was a systematic review incorporating narrative synthesis. Database searches for published and grey literature from January 1995 to November 2018 were conducted via EBSCO Discovery Service, the British Nursing Index and the British Library. REVIEW METHODS: An approved systematic review protocol was followed with studies then assessed against strict inclusion and exclusion criteria. Included studies were critically appraised, data extracted and a narrative synthesis conducted. FINDINGS: Five studies were reviewed. Four themes emerged: nurses' individual resources, their professional motivation, organisational commitment to learning and development, and managerial support. CONCLUSION: Factors influencing nurses' engagement with activities are multifaceted and inter-woven. A question-based checklist to facilitate discussions between nurses and educators, managers or appraisers is presented.

Mobile Application as a Learning Aid for Nurses and Nursing Students to Identify and Care for Stroke Patients: Pretest and Posttest Results.

Cerebrovascular accident is a serious public health problem and requires the attention of professionals who can detect, diagnose, and provide care in a timely fashion. A quantitative quasi-experimental study was conducted using a mobile app called mSmartAVC for clinical evaluation of nursing care at the bedside. The study aimed at measuring the knowledge of nurses and nursing students in the detection and care of cerebrovascular accident. In this study, a total of 115 nurses from health services in the South of Brazil and 35 nursing students of a community university participated. The stages focused on development, modeling of clinical cases, problem-based learning, pretest (before) app use, and posttest (after) use of the app. The results of the pretest and posttest corrections showed a substantial statistical difference (P < .001), indicating a significant knowledge gain after the use of the app, particularly in terms of the detection scales and interpretation of the imaging tests. The mSmartAVC app used at the bedside supported decision-making for detection and nursing care. It was possible to confirm that the use of mobile apps plays an essential role as a learning tool for nurses and nursing students.

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.

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.

Neonatal cardiopulmonary resuscitation project in Japan.

In July 2007, the Neonatal Cardiopulmonary Resuscitation (NCPR) program in Japan was launched to ensure that all staff involved in perinatal and neonatal medicine can learn and practice NCPR based on the Consensus on Science with Treatment Recommendations developed by the International Liaison Committee on Resuscitation. In 1978 in North America, a working group on pediatric resuscitation was formed by the American Heart Association Emergency Cardiac Care Committee and concluded that the resuscitation of newborns required a different strategy than the resuscitation of adults. The original first edition of the Neonatal Resuscitation Program textbook was published in 1987. The NCPR program consists of three courses for health-care providers and two courses for instructors. A course and B course are for newly certified health-care providers and course S is for health-care providers who are renewing their certification. As of 31 March 2019, 3,227 advanced instructors (I instructor) and 1,877 basic instructors (J instructor) were trained to teach A, B, and S courses to health-care providers on the basis of their license. In total 7,075 A courses and 4,012 B courses were held; 131 651 people attended A course or B course of the NCPR program, and 77 367 were certified. A total of 1,865 S courses, which were developed in 2015, were held and 12 875 people attended this course. Here, we introduce the background, purpose, history, and content of the development of the NCPR program in Japan.

Development and Validation of the Achieving Effective & Safe Opioid Prescribing-Advanced Practice Registered Nurse (AESOP-APRN) Survey: A Pilot Study.

BACKGROUND: Advanced practice registered nurses (APRNs) are essential partners in the management of pain, both in primary care and in pain specialty practices. One of the more controversial treatment practices surrounds the use of opioid analgesic medication for the relief of pain in persons with chronic pain. Although several guidelines have been developed, the extent and impact of APRN knowledge, attitudes, and values about pain management and opioid prescribing practices are not known. In addition, regulatory mandates may encumber APRN scope of pain management practice. AIMS: This manuscript describes the development and pilot testing of the Achieving Effective & Safe Opioid Prescribing-APRN (AESOP-APRN) Survey conceptualized to address these topics. DESIGN: Instrument development. PARTICIPANTS/SUBJECTS: Advanced practice registered nurses. METHODS: Phase I addressed development, content validity determination, and survey refinement. APRN-focused discussion groups, expert review, and analysis of content were conducted. In phase II, pilot testing was conducted to determine reliability. RESULTS: APRNs are aware of regulatory restrictions to practice and potential implications on patient outcomes. The Initial Content Validity Index suggested refinement of survey questions. After content revision, final ratings were acceptable. A sample of APRNs (N = 23) completed the survey. Cronbach's α range (.65-.91) suggests acceptable internal consistency for a new survey. CONCLUSIONS: Even at this initial phase, the newly developed AESOP-APRN Survey accurately represents the underlying thematic concepts of interest; however further psychometric analyses are required, and instrument refinement is possible. Additional study should include analysis of members from a variety of health care disciplines, as was the intention of the development of the Core Competencies for Pain Management from which many items were derived.

Exploring health economics course competencies' value for nurse administrators.

BACKGROUND: A survey of nursing administrators in the United States was conducted to solicit opinions about health economics (HE) course competencies for baccalaureate nursing programs. PURPOSE: To provide rationale for intensifying educational efforts to increase nurses' awareness about the value of HE skills in their everyday work. METHODS: Participants were asked to rate six HE competencies using a Likert scale. Paired-samples t tests, bivariate correlations, and standard multiple linear regressions were used to analyze survey results. DISCUSSION: A strong direct relationship exists between the amount of prior knowledge nursing administrators have about HE and the perceived level of usefulness of HE skills. CONCLUSION: Nurses' contributions to creating value in healthcare must be encouraged. Increasing the share and accessibility of the HE content in continuing education offerings could be one way to expand HE knowledge among practicing nurses and promote cost-effective delivery of healthcare in the United States.

An Educational Intervention to Improve Nurses' Understanding of Pain in Children in Western India.

Accurate assessment of pain and its management is a challenging aspect of pediatric care. Nurses, usually the primary caregivers, showed inadequate knowledge and restrictive attitudes toward pain assessment. We evaluated an educational intervention to improve nurses' assessment of pain in a teaching hospital in India. A convenient sample of nurses working in the neonatal intensive care unit, pediatric ward, pediatric intensive care unit, and pediatric cardiac intensive care unit were included in the study. Workshops to improve understanding of pain, its assessment, and management strategies were conducted. A modified and consensually validated Knowledge and Attitudes Survey Regarding Pain questionnaire-2008 consisting of 25 true/false questions, eight multiple choice questions, and two case scenarios was administered before, immediately after, and 3 months after the workshops to evaluate impact of the intervention. Eighty-seven nurses participated. Mean (standard deviation) experience was 4.04 (5.9) years. Thirty-seven percent felt that they could assess pain without pain scales. About half (49.4%) of the nurses had not previously heard of pain scales, while 47.1% reported using a pain scale in their routine practice. Significant improvement was observed between pretest and post-test total scores (15.69 [2.94] vs. 17.51 [3.47], p < .001) as well as the pretest and retention score (15.69 [2.94] vs. 19.40 [4.6], p < .001). Albeit the study site and sampling frame may limit the reliability of the findings, the educational intervention was successful, and better retention test scores suggest a cascading effect. Pain assessment and management education of children should be incorporated in the nursing curriculum and should be reinforced in all pediatric units.

Implementation of an Evidence-Based and Content Validated Standardized Ostomy Algorithm Tool in Home Care: A Quality Improvement Project.

Many nurses have limited experience with ostomy management. We sought to provide a standardized approach to ostomy education and management to support nurses in early identification of stomal and peristomal complications, pouching problems, and provide standardized solutions for managing ostomy care in general while improving utilization of formulary products. This article describes development and testing of an ostomy algorithm tool.

Effect of patients' rights training sessions for nurses on perceptions of nurses and patients.

BACKGROUND: Patients' rights are universal values that must be respected; however, it is not easy to put such values and principles into effect as approaches and attitudes differ from individual to individual, from society to society, and from country to country. If we want to reach a general conclusion about the status of patient rights in the world as whole, we should examine the situation in individual countries. OBJECTIVE: To study the effect of training sessions for nurses about patients' rights on the perceptions of nurses and patients in two Egyptian hospitals. METHODS: Quasi-experimental with pre- and posttest design was used in this study. Two groups of participants were included in the study: the first with 97 nurses and the second with 135 patients. A questionnaire sheet was used for nurses and patients to assess their perceptions about patients' rights before starting sessions. The training sessions were developed based on the baseline information gathered in the assessment phase and related literature. After the implementation of the sessions, a posttest was immediately conducted for nurses, while for patients the posttest was conducted 1 month after implementation to evaluate the effect of the nurses' training sessions on the patients' perceptions. The same tools were used in pretest and posttest. Ethical considerations: Written approval was sought and obtained from the administrators of the studied hospitals prior to conducting the study. Oral consent was obtained from nurses and patients willing to participate. Confidentiality and anonymity of the participants were strictly maintained through code numbers on the questionnaires. RESULTS: The improvement in nurses' knowledge and perceptions about patients' rights after implementation of the training sessions was remarkable. Moreover, an improvement in patients' perceptions regarding their rights was reported. CONCLUSION: Repetition of the training sessions is suggested to achieve continuous improvement. Provision of posters and booklets about a bill of patient rights within the hospitals and conduction of further study to examine nurses' performance and patients' satisfaction based on code of ethics are recommended.

Effectiveness of an Online Educational Module in Improving Evidence-Based Practice Skills of Practicing Registered Nurses.

BACKGROUND: Implementation of evidence-based practice (EBP) at the bedside has been difficult to achieve. Significant gaps between current research and actual practice have been identified and must be addressed in effort to increase utilization of EBP. AIMS: The purpose of this study was to evaluate the efficacy of an online EBP educational intervention and to examine the relationship between educational preparation and years of nursing experience on nurses' practice, attitudes, and knowledge and skills of EBP. METHODS: An experimental pretest-posttest design study with three randomized groups utilizing the EBPQ instrument was conducted. RESULTS: No significant differences were noted in EBPQ subscale scores of practice, attitude, or knowledge and skills from pre- to posttest. In addition, no statistical difference in EBPQ subscale scores regarding educational preparation or years of experience were noted. LINKING EVIDENCE TO PRACTICE: While nurses report positive attitudes toward EBP, their perceptions of practice and knowledge and skills score much lower. Educational interventions are needed for practicing nurses to overcome this knowledge deficit to successfully implement EBP. However, the use of online, independent, computer-based learning modules, while cost-efficient and offer several benefits when educating nurses, may not necessarily be the most effective method for teaching EBP knowledge and skills to practicing nurses.

School nurse intention to pursue higher education.

In 2011, the Institute of Medicine recommended that 80% of the nurses possess a minimum of a bachelor of science in nursing by 2020 and double the number of doctorally prepared nurses. This has prompted a significant number of registered nurses to advance their educational level. School nurses in Louisiana are not required to have a bachelor's degree. In many states, the bachelor's degree is required for all school nurses, and many school nurses are prepared at the masters' and doctoral levels. The purpose of this study was to examine the intention of Louisiana school nurses to pursue higher education in nursing. A survey was distributed to all members of the Louisiana School Nurses Organization, and results indicated that 65% of the participants were motivated to return to school. Incentives and barriers to pursuing higher education were identified, and strategies for overcoming these barriers were proposed.

Nursing department orientation: are we missing the mark?

Hospitals routinely provide orientation for the new nurses they hire. The evolution of nursing practice is not reflected in the current teaching methods of nursing orientation. The authors examine the past 60 years of nursing department orientation and assert the need to move toward more effective and innovative teaching strategies.

A student evaluation workshop with rural nursing preceptors.

Increasingly, clinicians and faculty members are motivated to provide students quality preceptorship placements in rural areas, particularly in light of the potential for recruitment of new graduates to underserved areas. Invariably, student performance evaluation is an onerous task for many preceptors and one in which they often feel ill-prepared. Rural preceptors may face additional challenges given the lesser availability of educational resources and professional development. In this article, the authors detail the development, pilot testing, and evaluation of a workshop on student evaluation that was created in collaboration with rural nurse preceptors.

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.

Application of telemedicine in the COVID-19 epidemic: An analysis of Gansu Province in China.

This paper analyzes the application of various telemedicine services in Gansu Province, China during the COVID-19 epidemic, and summarizes the experiences with these services. In addition, the satisfaction levels of patients and doctors with the application of telemedicine in COVID-19 were investigated, the deficiencies of telemedicine in Gansu were determined, and recommendations for modification were proposed. Coronavirus Disease 2019 (COVID-19) has broken out in China, and Gansu Province in Northwest of China has not been spared. To date, there are 91 local COVID-19 cases and 42 imported cases. 109 hospitals were selected as designated hospitals during the COVID-19 outbreak, and most of them were secondary hospitals. However, it was unsatisfactory that the ability of medical services is relatively low in most of secondary hospitals and primary hospitals. Therefore, we helped the secondary hospitals cope with COVID-19 by means of remote consultation, long-distance education, telemedicine question and answer (Q&A). Our practical experience shows that telemedicine can be widely used during the COVID-19 epidemic, especially in developing countries and areas with lagging medical standards.