Implementing a Novel Interprofessional Clinical Informatics Curriculum.

A novel interprofessional clinical informatics curriculum was developed, piloted, and implemented, using an academic medical record. Targeted learners included undergraduate, graduate, and professional students across five health science colleges. A team of educators and practitioners representing those five health science colleges was formed in 2016, to design, develop, and refine educational modules covering the essentials of clinical informatics. This innovative curriculum consists of 10 online learning modules and 18 unique imbedded exercises that use standardized patient charts and tailored user views. The exercises allow learners to adopt the role of various providers who document in EMRs. Students are exposed to the unique perspectives of an attending physician, nurse, radiological technician, and health information manager, with the goal of developing knowledge and skills necessary for efficient and effective interprofessional communication within the EMR. The campus-wide clinical informatics curriculum is online, flexible, asynchronous, and well-established within each college, allowing faculty to select and schedule content based on discipline-specific learner and course needs. Program modifications over the past 4 years have correlated with a positive impact on the students' experience.

Use of an Academic Electronic Health Record With an Interprofessional Simulation for Advanced Practice Nursing Students.

ABSTRACT: Simulation with interprofessional teams provides case management opportunities for advanced practice RN students they may not encounter in preceptorships. We designed standardized patient simulations to improve health care safety and outcomes; an academic electronic health record was used in some simulations. We report quality improvement findings from 74 APRN students who completed a survey with open-ended questions. We found that simulation in interprofessional teams positively impacted role immersion, confidence, problem-solving skills, and teamwork. Use of the academic electronic health record added realism. The findings are being incorporated as part of continuous quality improvement in the teaching-learning process.

Evidence-Based Practice Competence in Nursing Students Preparing to Transition to Practice.

BACKGROUND: Opportunities to embed and evaluate evidence-based practice (EBP) competency in the clinical setting across nursing curricula are not well described in the literature. AIMS: This research aims to describe how clinical learning environments influence senior nursing students' integration of EBP competencies in their practice and perceptions of EBP competence development in a traditional baccalaureate nursing program. METHODS: A sequential, mixed-methods design was used with senior students upon completion of their last two clinical experiences in the nursing program. Students completed the EBP Work Environment Scale (Pryse, McDaniel, & Schafer, 2014) and semi-structured interviews. FINDINGS: Students appraised EBP Work Environments positively during preceptor-led experiences as opposed to instructor-led, group clinical experiences. Students described the evolution of emerging EBP competence throughout their nursing education and emphasized the importance of coursework in intentionally developing EBP competence. LINKING EVIDENCE TO ACTION: Assessment of clinical experiences and models that contribute to EBP competence is needed. Participants in this study emphasized the importance of coursework that builds on EBP competencies, and the tremendous value of nurse preceptors that encouraged growth in their ability to engage with EBP in clinical practice.

An Electronic Medical Record Training Conversion for Onboarding Inpatient Nurses.

In recent times, policies stemming from the American Recovery and Reinvestment Act of 2009 have served as a stimulus for healthcare organizations to adopt an electronic medical record. As a result, nurses are now more knowledgeable of and experienced with an electronic medical record. In August 2016, our facility converted from instructor-led training to electronic learning for inpatient nurse electronic medical record training, hoping to capitalize on previous experience with the clinical information system. However, a complete program evaluation of this transition had yet to be conducted. The purpose of this study was to evaluate electronic learning usability and the return on investment of an electronic medical record training conversion. Evaluations of electronic medical record electronic learning training were collected from 75 newly hired, inpatient nurses from November and December 2017, and compared to our instructor-led program. Results showed that users found it effective and were satisfied with this training method. The electronic learning had superior efficiency, reducing training time by ~50% compared to instructor-led training, while proving to yield effectiveness and satisfaction. The return on investment was $18 540, with a gain of 593.25 hours in nursing time during the study period of two months. These results support the organizational decision to convert to electronic learning, further supporting the conversion for other clinical roles.

Critical Care Helicopter Overtriage: A Failure Mode and Effects Analysis.

OBJECTIVE: Overtriage (OT) of helicopter emergency medical services (HEMS) poses significant burden to multiple stakeholders. The project aims were to identify the following: 1) associated factors, 2) downstream effects, and 3) focus areas for change. METHODS: We undertook a failure mode and effects analysis (FMEA) to evaluate our HEMS interfacility transport process. Data were collected from organizational finances and 3 key stakeholder groups: 1) interfacility patients transferred by HEMS in 2017 who were discharged from the receiving facility within 24 hours (n = 149), 2) flight registered nurses (n = 19), and 3) referring emergency medicine providers (EMPs) (n = 30) from the top HEMS users of 2017. The completed FMEA identified failure modes, the frequency and severity of effects, and unique risk profile numbers (RPNs). RESULTS: Twelve failure modes were identified with 30 potential causes. Leading failure modes included inappropriate HEMS requests by EMPs (RPN = 343), inappropriate activation by EMS for interfacility transport (RPN = 343), and minimizing patient/family involvement in decision making (RPN = 315). Significant burdens to organizational finances and flight registered nurse satisfaction were identified. CONCLUSION: Associated factors for interfacility HEMS OT, downstream effects, and areas for change were identified. EMP and emergency medical services practices, HEMS processes, and shared decision making may affect regional OT rates.

Evidence-Based Practice Competence in Nursing Students: An Exploratory Study With Important Implications for Educators.

BACKGROUND: Evidence-based practice (EBP) is a core pillar of nursing education and an expectation in clinical practice. Students struggle to conceptualize the use of EBP into actual clinical practice despite the development of EBP competencies. AIMS: This study explored perceptions of EBP education and competence in baccalaureate students using Melnyk's (Worldviews on Evidence-Based Nursing, 11, 2014 and 5) EBP competencies for practicing registered nurses as a basis for comparison. METHODS: The researchers used a sequential, mixed-methods design. A survey was developed to assess information sources and patterns of use, and semistructured interviews explored factors affecting students' understanding of EBP and information-seeking behaviors in the clinical setting. FINDINGS: There were 118 participants in the survey and 12 in follow-up interviews. A major theme was that participants had difficulties distinguishing between EBP and research. Students were able to identify experiences that fostered attainment of basic EBP competencies, such as searching for evidence, but were less able to describe higher-order activities such as integrating evidence to plan EBP changes or disseminating best practices. LINKING EVIDENCE TO ACTION: Clinical learning environments are an ideal place to apply and see EBP in action, but nurse educators cannot assume students arrive ready to apply EBP knowledge and skills to clinical practice. Nurse educators need evidence-based tools to assess student EBP competence across a variety of settings. Research examining the generalizability of the EBP competencies in varying curricular models as well as didactic and clinical settings is needed.

Effect of simulation on nursing knowledge and critical thinking in failure to rescue events.

Failure to rescue events are hospital deaths that result from human error and unsafe patient conditions. A failure to rescue event implies that the last and best chance to avoid tragedy is not acted on in time to avoid a disaster. Patient safety is often compromised by nurses who do not perform accurate assessments (vigilance), do not detect clinical changes (surveillance), or do not display critical thinking (recognition that something is wrong). This project used simulation as a teaching strategy to enhance nursing performance. Medical-surgical nurses took part in a simulated failure to rescue event in which the patient's clinical condition deteriorated rapidly. Nursing knowledge and critical thinking improved after the simulation and showed the effectiveness of simulation as a teaching strategy to address nursing knowledge and critical thinking skills.

Peer Review: Factors That Motivate Students to Provide Supportive Peer Feedback.

BACKGROUND: Students who value peer feedback processes are more likely to provide supportive feedback to peers. PURPOSE: The purpose of this study was to explore the factors that motivate and demotivate students to provide supportive feedback to peers. METHOD: A secondary analysis of qualitative data collected from 148 graduate nursing students in 7 master's-level courses was conducted to identify the themes related to motivating and demotivating factors in peer review and how they related to students' sense of value for providing supportive peer feedback. RESULTS: Common themes included perceived potential for supportive peer feedback to improve self, peer, and team performance, and quality of patient care. Themes related to demotivation included lack of time and fear of negative impact on peers. CONCLUSION: Faculty should emphasize to students the positive impact of supportive peer feedback on nursing care. Assignments can be structured to promote a fair exchange of supportive feedback between peers.

Effects of Clinical Nurse Educator Professional Role Development: An Evidence-Based Quality Improvement Project.

Centralization of clinical nurse educators (CNEs) from medical-surgical and critical care in a rural Midwestern hospital created role confusion and poor role outcomes. An evidence-based quality improvement project was developed to integrate the Association of Nursing Professional Development's transition to practice fellowship and practice model. Outcomes were focused on CNE self-assessed competency and three nurse-sensitive quality outcomes. Results were mixed but support that CNEs influenced patient quality outcomes and improved their self-assessed competency.

Using an Escape Box in Continuing Nursing Education for Multidisciplinary Emergency Preparedness.

An escape room is a strategy that engages learners and allows them to participate actively in a lesson. This article describes the implementation of an escape box as an escape room lesson and teaching method during an inpatient nursing skills day with a multidisciplinary team. Participants totaled 75 and included nurses, respiratory therapists, and advanced practice nurses. Learning goals included the promotion of knowledge, teamwork, and collaboration to develop a teamwork approach in an emergency situation. The outcomes demonstrated that an escape box as an escape room format is an effective teaching methodology to increase learner engagement and enhance learning in continuing education with a multidisciplinary team. [J Contin Educ Nurs. 2021;52(2):85-89.].

Using learning outcomes to inform teaching practices in human patient simulation.

This evaluation research focused on methods for improving simulation instruction by determining if students' knowledge about simulation subject matter improved and was retained following a simulation experience. Using a pretest/posttest approach, NCLEX-style questions pertaining to the simulation subject matter content were administered to nursing students from two prelicensure nursing courses immediately preceding the simulation, immediately following the simulation, and then again at their final examinations. These findings have helped faculty determine when their simulation instruction is effective and have provided a guide for revising their simulation teaching. While this pretest/posttest method offers insight into student learning outcomes, it perhaps more importantly creates a systematic approach for evaluating simulation instruction.

Doctoral Degree Preferences for Nurse Educators: Findings From a National Study.

BACKGROUND: Current doctoral degree options may not meet needs of nurses desiring educator roles in academic or health care settings. PURPOSE: The purpose of the study was to assess preferences for existing terminal degree options for nurse educators and determine the need for a new doctoral degree in nursing education. METHOD: Nurses in practice, academia, and leadership nationwide (n = 826) answered a 19-item needs assessment survey regarding adequacy of and interest in terminal degree options. RESULTS: More than 60% reported current doctoral degrees available to nurse educators lack content in curriculum development and teaching-learning best practices in nursing. Most data supported a new terminal degree. CONCLUSION: A primary factor in nurses choosing not to enroll in a terminal degree program may be limited availability of education aligned with career goals. The doctor of nursing education, a practice degree parallel to the DNP, could prepare nurses for academic and practice educator roles.

Student and Faculty Perceptions of iPad Integration in a Prelicensure Program.

This article provides an overview of strategies for integration of iPads into a prelicensure nursing program. The study evaluated the actual use of iPads in the classroom, skills and simulation laboratories, and clinical settings and examined the satisfaction of students and faculty with the iPad platform. The study findings provide guidance for a phased-in iPad implementation for prelicensure nursing programs.

Blogging for Evaluating Objectives in an International Nursing Course.

Nursing educators need to adapt to meet students in new technological spaces and in the increasingly global environment. This article provides background on blogging as an educational tool and the use of a blogging assignment for evaluation of course objectives in an international graduate nursing course. The blog is a part of a study-abroad experience in Kenya, where graduate nursing students learn about Kenyan culture and work in the health care system.