Teaching Circle to Improve Nursing Clinical Judgment in an Undergraduate Nursing Program.

BACKGROUND: Clinical judgment combines both decision making capacity and the ability to think critically. In an effort to foster clinical judgment in students, a quality improvement plan was initiated. METHOD: A teaching circle was created by key nursing faculty. After a review of the literature, goals, objectives, and aims were articulated. Faculty development, through the use of "lunch and learn," was delivered using webinars, discussion, and application of item writing. RESULTS: Faculty benefited from the teaching circle's professional development activities by gleaning tools to develop, measure, and assess clinical judgment with undergraduate nursing students in nursing courses. CONCLUSION: Professional faculty development is necessary to effectively prepare students for the rigors of contemporary practice. The use of a teaching circle is one effective strategy to foster success for programmatic improvement. Further research is warranted to explore best teaching learning strategies in the construct of clinical judgment. [J Nurs Educ. 2020;59(4):218-221.].

Planning and managing a complex multisite study in the age of technology.

A 2-year long, multisite research study that evaluated cardiopulmonary resuscitation skill decay among nursing students was conducted at 10 schools of nursing across the United States. The study was conducted in two phases and required carefully timed sessions for skill performance. Multisite studies in nursing education need to be carefully planned. Time delays should be anticipated with processes and Institutional Review Board protocols across sites. All team members were trained and consistently supported during the entire study. While challenges and obstacles were identified, innovative solutions were implemented that assisted the research team to successfully complete the study. The use of new and existing technology allowed the team to surmount many of the challenges encountered in this study. The purpose of this article is to describe the logistics, processes, challenges, and lessons learned related to conducting a complex multisite study.

Using an Interactive Framework to Assess a Cultural Simulation for Learning: Tag Team Patient Safety Simulation.

BACKGROUND: The purpose of this pilot study, a replication of a study that originated in Australia for large classroom sizes, was to assess the effect of a culturally sensitive simulation-based pedagogical strategy on student learning. METHOD: This quasi-experimental approach, using a pretest-posttest design with a nonequivalent simulation (n = 43) and nonsimulation (n = 73) group, mimics an approach called Tag Team Patient Safety Simulation. A scenario was enacted focusing on the cultural needs of Nasifah, a 67-year-old woman requiring home-based palliative care. Challenging conversations were navigated by participants and observers through the engagement of antagonist and cue cards. RESULTS: The simulation-based strategy improved student understanding of working with culturally sensitive populations. CONCLUSION: This improvement had no greater learning effect than with the traditional based pedagogical strategy. However, student engagement may have been greater. The need to measure retention, the implications of the findings, the limitations of the study, and directions for future research are discussed. [J Nurs Educ. 2019;58(10):591-594.].

Autologous Blood Transfusion for Postpartum Hemorrhage.

Postpartum hemorrhage (PPH) is a leading contributor to maternal morbidity and mortality in the United States and globally. Although the rate of PPH is generally decreasing nationally, severity of PPH appears to be increasing, potentially related to the various comorbidities associated with women of childbearing age. There is increasing evidence of risks associated with allogeneic blood transfusion, which has historically been the classic therapeutic approach for treatment to PPH. Pregnant women are particularly susceptible to the implications of sensitization to red cell antigens, a common sequela to allogenic blood transfusion. Autologous blood transfusion eliminates the potential of communicable disease transmission as well as the conceivable threat of a blood transfusion reaction. Recent technological advances allow cell salvage coupled with the use of a leukocyte filter to be used as an alternative approach for improving the outcome for women experiencing a PPH. Modest changes in standard operating procedure and continued training in use and application of cell salvaged blood may assist in minimizing negative outcomes from PPH. Salvaged blood has been demonstrated to be at least equal and often superior to banked blood. We discuss nursing implications for application of this technology for women with PPH. Continued research is warranted to evaluate the impact that application of cell salvage with filtration has on the patient experiencing a PPH.

Pandemic flu: a major concern for pregnant women.

Nurses caring for pregnant women and infants are on the front lines to mitigate serious consequences that may occur with an influenza pandemic. To assist nurses in becoming prepared for a pandemic, this article will address various types of influenza viruses, effects of influenza on pregnant women, diagnosis, treatment and ways to protect pregnant women and newborns.