An Interruption Management Education Bundle: Feasibility Testing With Nursing Students.

BACKGROUND: Interruptions and distractions are pervasive in health care settings, increase risks for errors, and decrease task efficiency. Researchers recommend the use of strategies to mitigate their negative effects. PURPOSE: The purpose was to assess the feasibility and acceptability of (1) an education bundle that included an interruption management strategy and (2) simulated scenarios with embedded interruptions and distractions. METHODS: Nineteen undergraduate nursing students participated in this repeated-measures, multimethods feasibility study. Data on interruption management behaviors were collected across 3 timepoints via direct observation of individual-simulated medication administration. Participants' perceptions of the education bundle were explored via semistructured interviews. RESULTS: Participants described the simulated scenarios as realistic and interruption management strategy as easy to use and remember. Participants voiced increased confidence in handling interruptions after learning the strategy. The strategy averaged 4 seconds to apply. CONCLUSIONS: Findings support the feasibility and acceptability of the bundle and need for studies to investigate the impact of the strategy on errors and task durations.

Nursing Students' Medication Administration: A Focus on Hand Hygiene and Patient Identification.

BACKGROUND: Procedural failures during medication administration include a lack of appropriate hand hygiene and failure to verify patient identification prior to administration of medication. Procedural failures are common among nurses and nursing students and can lead to serious patient harm. METHOD: A descriptive cross-sectional research design was used to collect observational data from a simulation-based experience of a medication administration scenario. RESULTS: Thirty-five senior baccalaureate nursing students from two geographically distant universities in the United States participated in the study. All of the participants made at least one procedural failure during the simulated experience. Hand hygiene compliance was 40.3%, and patient identification compliance was 43.8%. CONCLUSION: Students often failed to comply with medication administration safety guidelines. Nursing programs must make changes to the methods used to teach safe medication administration to prepare students for this critical skill. [J Nurs Educ. 2023;62(7):403-407.].

Innovative Projects: A Unique Approach to Telehealth Education.

ABSTRACT: During the COVID-19 pandemic, telehealth utilization grew astronomically, encouraging more institutions of higher education to become innovative and proactive in preparing health care providers to deliver high-quality telehealth care. Telehealth can be creatively implemented throughout health care curricula given the appropriate guidance and tools. This article speaks to the development of student telehealth projects as part of the work of a national taskforce funded by the Health Resources and Services Administration and charged with the development of a telehealth toolkit. Proposed telehealth projects allow students to take the lead in their innovative learning and allow faculty to facilitate project-based evidence-based pedagogy.

Association of external interruptions with increased medication administration duration and self-interruptions: A direct observational study: Empirical research quantitative.

AIMS: To examine task duration and frequency of self-interruptions among study participants during externally interrupted compared with externally uninterrupted simulated medication administration. BACKGROUND: Interruptions are prevalent during nursing medication administration and can lead to inefficient, delayed, omitted and unsafe patient care. Interrupted nursing tasks are shown to take longer to complete compared to uninterrupted tasks; however, studies seldom indicate if the time spent in the interruption was included or excluded in the reported task duration. It is unknown if the time spent in the interruption leads to longer task completion times or if other factors, such as the time needed to re-engage in the primary task and/or self-interruptions, are involved. Little is known about associations between external interruptions and self-interruptions during nursing tasks. Self-interruptions are caused by an individual's own decision to stop an activity to attend to something else. DESIGN: Cross-sectional within-subjects design. METHODS: This two-site study investigated task duration and frequencies of self-interruptions during externally interrupted and externally uninterrupted simulated medication administration. Data on medication administration duration, external interruption duration and self-interruptions were collected via direct observation from November 2019-February 2020. The time spent in the external interruption was deducted from the medication administration duration. RESULTS: Thirty-five participants were included in the study. The externally interrupted task had a significantly longer duration and significantly more frequent self-interruptions within-subjects compared to the externally uninterrupted task. Self-interruptions were most often due to forgotten supplies. CONCLUSIONS: The findings suggest that the time needed to re-engage with an externally interrupted task and/or self-interruptions may lead to longer task completion times. IMPACT: Researchers are encouraged to investigate mediators of interruptions that lead to longer task completion times and errors. Findings can be used to develop and implement interruption management strategies that aim to improve the safety and quality of patient care. REPORTING METHOD: Equator guidelines were followed using the STROBE reporting method. PATIENT/PUBLIC CONTRIBUTION: No patient or public involvement in this study. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE: Educators and researchers can use the study findings to guide teaching methods and direct future studies. By gaining a better understanding of the mediators of interruptions that create longer task completion times and increase the risk for errors, tailored interruption management strategies that aim to improve the safety and quality of healthcare can be developed and implemented.

Telehealth Competencies: Leveled for Continuous Advanced Practice Nurse Development.

BACKGROUND: The COVID-19 pandemic spurred a rapid uptake of telehealth utilization, with advanced practice registered nurses (APRNs) at the forefront of telehealth care delivery. To advance training of nurse practitioners and support curricular development, essential APRN student competencies in telehealth were developed. PROBLEM: Although telehealth competencies have been developed, little is understood about their evaluation across the curricula. Moving to competency-based nursing education involves leveling broad competencies into subcompetencies, including those for telehealth. Subcompetencies support frequent, multimodal evaluation of student progress across APRN curricula. APPROACH: Adapting Benner's Novice to Expert Theory, faculty experts in telehealth and graduate nursing education used an iterative process to develop and level subcompetencies aligned with the Four Ps of Telehealth framework. OUTCOMES: Telehealth subcompetencies were leveled for preclinical and clinical rotations and for readiness for practice. CONCLUSIONS: The leveled subcompetencies, aligned with the Four Ps of Telehealth framework, will support APRN faculty in diverse programs as they implement competency-based education in telehealth.

A Scoping Literature Review of Simulation Training Program Curriculum Standards.

SUMMARY STATEMENT: Simulation educator training is well supported in the literature and endorsed by the Society of Simulation in Healthcare as well as the International Nursing Association for Clinical Simulation and Learning. Despite growth of domestic and international training programs, there is a lack of consensus regarding curriculum standards. Our aim was to identify core curricular components of comprehensive simulation training programs. A scoping literature review of all relevant publications from 2000 to 2020 was conducted using a 6-step design. A team of 10 multidisciplinary, international simulation educators independently reviewed all citations with discrepancies resolved by third-person review. Of the initial 320 identified unique publications, a total of 15 articles were included, all published within the last 6 years. Four themes were identified: domains (n = 6), competencies (n = 3), objectives (n = 8), and other characteristics (n = 3). The findings support a greater understanding of the core curricular content across simulation training programs to support standardization.

Establishing psychological safety in simulation: Faculty perceptions.

BACKGROUND: A psychologically safe learning environment is defined as one where individuals feel comfortable to take interpersonal risks without fear of negative consequences. Despite knowledge of best practice for simulation, there is a lack of knowledge regarding how nursing faculty perceive and establish psychological safety in a simulated learning environment. OBJECTIVES: The purpose of this study was to explore nursing faculty's perceptions of psychological safety as it exists within a simulation learning environment for pre-licensure nursing students. DESIGN: Mixed methods with online survey data collection. SETTINGS/PARTICIPANTS: Purposive sampling was used to recruit simulation nursing faculty who had previously participated in the National League for Nursing Leadership Development Program. Faculty were recruited from the United States and Canada. METHODS: Data were collected using a series of open-ended questions through the online survey tool, SurveyGizmo. Content analysis was utilized to discover how faculty established psychological safety during the pre-brief, scenario, and debriefing phases of simulation. Three researchers independently, then collaboratively, reviewed the data, identifying themes and patterns across each phase. RESULTS: Thirty-seven nursing faculty participated in the study. Across the phases of pre-brief, scenario, and debriefing, five themes emerged: (1) Setting the Stage; (2) It's ok, It's Simulation; (3) Everyone is Here to Learn; (4) Planned Strategies; and (5) Facilitator as Observer. CONCLUSIONS: Faculty perceive that they play a role in establishing a psychologically safe learning environment during all three phases of a simulation experience. Scenarios are purposefully designed to emotionally protect students while they participate in unfamiliar encounters. Strategies are implemented throughout all three phases to facilitate student risk-taking as part of the learning process. Faculty watch for verbal and non-verbal cues by students signaling a potentially psychologically unsafe learning environment, and intervene to protect them if necessary.

Faculty Attitudes and Adoption of Simulation: Pilot Testing of a New Instrument.

BACKGROUND: This study evaluated the reliability and validity of a new instrument, the Faculty Attitudes and Adoption of Simulation (FAAS). The FAAS was designed to identify faculty attitudes toward and levels of perceived knowledge and adoption of simulation. The instrument was developed based on a comprehensive literature review. METHOD: A convenience sample of 47 faculty members was used. Content validity, internal consistency reliability, and convergent construct validity were evaluated. RESULTS: Content validity, measured through a content validity index, was found to be .91. Pilot testing of the FAAS demonstrated a Cronbach's alpha of .83. Construct validity was evaluated by comparing the FAAS with a related tool called the Faculty Attitudes and Intent to Use Related to the Human Patient Simulator instrument (r = .64, p < .001). CONCLUSION: Pilot testing of the FAAS demonstrated initial reliability and validity for measuring faculty attitudes toward and perceived knowledge and adoption of simulation. [J Nurs Educ. 2017;56(6):356-359.].