Engaging Nursing Students: Integrating Evidence-Based Inquiry, Informatics, and Clinical Practice.

The nursing research class requires faculty to create a spirit of inquiry while integrating technology, flexibility, and responsiveness to student needs. This article discusses new pedagogies to actively engage students in the evidence-based nursing process and the achievement of course learning outcomes. Through course exemplar, the author demonstrates a creative method to engage traditional baccalaureate nursing students in a nursing project that links evidence to improved patient outcomes.

Improving Patient Access to the My HealtheVet Electronic Patient Portal for Veterans.

Background: The US Department of Veterans Affairs My HealtheVet (MHV) patient portal is a secure online tool that provides patients access to personal health information. Although facilitators exist to encourage veteran registration, barriers to both adoption and use among veterans persist. This quality improvement project sought to improve veteran access to MHV. Observations: Using Plan-Do-Study-Act (PDSA) methodology, we identified barriers to registration, evaluated processes for enrollment, and integrated a process improvement champion into a rural primary care clinic workflow. After 3 PDSA cycles, the integration of new processes resulted in increased enrollment and engagement with MHV. Fourteen veterans registered for MHV at the point-of-care in a 3-month time frame. Conclusions: Use of a connected electronic health record platform and implementation of an MHV champion in the outpatient primary care setting improved rural veteran access to personal health information. Audit and feedback on processes that provide access to health information is an important strategy to narrow the gap between veterans who access patient portals and those who do not.

Standardizing nurse practitioner student evaluation during high-stakes clinical examinations.

ABSTRACT: Nurse practitioners (NPs) require clinical competence in advanced health assessment skills to differentiate between normal, variations of normal, and abnormal patient findings. High-stakes clinical examinations, using live hands-on simulation scenarios and standardized patients (SPs) or other human role players, are accepted teaching and evaluation tools for NP students. Providing objective, valid, and reliable feedback to students during high-stakes clinical examinations is of considerable value for ongoing skill development. The study examined opportunities to improve the quality of student evaluation in simulation testing modes. A purposive sample of 17 video recordings of health students' comprehensive examination of an SP or physical examination teaching associate (PETA) from a nursing graduate level health assessment course was evaluated. Using a standardized rubric, students were scored live and after a comprehensive examination of a SP/PETA and via a secure web-based video platform by the faculty and an independent reviewer. Evaluator group examination score comparisons revealed that distributions of examination scores within evaluator groups were not similar. Median examination scores were significantly different between groups; faculty median examination scores significantly higher than SPs/PETAs. Efficiency of student evaluation may be increased by improving reviewer training, reducing checklist length, and adopting electronic scoring. Development of an exemplary teaching video providing explanation and detail for expected student skill performance will allow reviewers to practice and improve competence in reliable scoring, reduce time and effort of scorers, and increase accuracy of scoring.

Utilization of clinical practice guidelines: barriers and facilitators.

Clinical practice guidelines augment clinician decision making. Researchers cite a lack of knowledge of guideline existence, complexity of guidelines, staff attitude, lack of training, time and resource constraints as reasons for nonadherence. This project sought to understand factors that promote or prevent guideline implementation at the point of care. Respondents' viewed clinical practice guidelines as valid tools necessary to standardize patient care and exhibited proficiency in synthesis and integration of guidelines into clinical decisions and treatment plans. Efficient and effective guidelines impact patient safety and quality by increasing the consistency of behavior and replacing idiosyncratic behaviors with best practices.