Haematological nurses' experiences about palliative care trajectories of patients with life-threatening haematological malignancies: A qualitative study.

AIMS: To explore haematological nurses' experiences about the palliative care trajectories of patients with life-threatening haematological malignancies. DESIGN: A qualitative study with a descriptive and explorative design. METHODS: Data were collected through 12 individual semi-structured interviews of nurses who work with patients with haematological malignancies from four hospitals in Norway. The data were analysed using systematic text condensation. The study was reported according to the Consolidated Criteria for Reporting Qualitative Research checklist. RESULTS: Three categories emerged from the data analysis: focus on a cure delays integration of palliative care, dialogue with patients facilitates palliative care and the need for enhanced interdisciplinary understanding. PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution since nurses' experiences were explored.

Brazilian undergraduate nursing students' critical thinking need to be increased: a cross-sectional study.

OBJECTIVES: to map Brazilian undergraduate nursing students' critical thinking level and investigate the correlation between selected sociodemographic data and critical thinking domains. METHODS: in this descriptive cross-sectional study, participants' (N=89) critical thinking was assessed using the Health Science Reasoning Test. Correlation between critical thinking domains and sociodemographic data was assessed using the Pearson correlation coefficient. RESULTS: the overall results showed a moderate level of participants' critical thinking (mean = 70.7; standard deviation 5.7). A poor performance was identified in 5 of the 8 critical thinking domains. A significant positive correlation was found between education period and critical thinking (p<.001). CONCLUSIONS: poor level in students critical thinking domains may lead to negative consequences for their learning outcomes. Further studies should be carried out to confirm our results, in addition to investigation of teaching methods that encourage and ensure the development of students' critical thinking skills during nursing education.

Simulation-Based Learning Supported by Technology to Enhance Critical Thinking in Nursing Students: Protocol for a Scoping Review.

BACKGROUND: Critical thinking is a crucial skill in the nursing profession, so teaching strategies and methodology must be carefully considered when training and preparing nursing students to think critically. Studies on simulation-based learning supported by technology are increasing in nursing education, but no scoping reviews have mapped the literature on simulation-based learning supported by technology to enhance critical thinking in nursing students. OBJECTIVE: The proposed scoping review aims to systematically map research on the use of simulation-based learning supported by technology to enhance critical thinking in nursing students. METHODS: The proposed scoping review will use the framework established by Arksey and O'Malley and will be reported according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) extension for scoping reviews. A systematic, comprehensive literature search was performed in the LILACS, ERIC, MEDLINE, EMBASE, PsycINFO, and Web of Science databases. Pairs of authors independently selected the articles by screening titles, abstracts, full-text papers, and extract data. The data will be analyzed and thematically categorized. RESULTS: The development of a comprehensive and systematic search strategy was completed in June 2021. The database searches were performed in July 2021, and the screening of titles and abstracts was completed in September 2021. Charting the data began in February 2022. Analysis and synthesis will be performed sequentially, and the scoping review is expected to be complete by May 2023. CONCLUSIONS: The results of this proposed scoping review may identify gaps in the literature and provide an overview of research on the topic of simulation-based learning supported by technology to enhance critical thinking in nursing students. The research may identify nursing students' reported barriers and enablers for learning critical thinking skills through simulation-based learning supported by technology, and the results may help educators enhance their educational approach through knowledge of students' firsthand experiences and further development of successful teaching strategies in nursing education. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/36725.

Technology-Supported Guidance Model to Support the Development of Critical Thinking Among Undergraduate Nursing Students in Clinical Practice: Protocol of an Exploratory, Flexible Mixed Methods Feasibility Study.

BACKGROUND: Critical thinking is an essential set of skills in nursing education, and nursing education therefore needs a sharper focus on effective ways to support the development of these skills, especially through the implementation of technological tools in nursing education. OBJECTIVE: The aim of this study protocol is to assess the feasibility of a technology-supported guidance model grounded in the metacognition theory for nursing students in clinical practice. METHODS: Both quantitative (research questionnaires) and qualitative (focus group interviews) approaches will be used to collect data for a feasibility study with an exploratory, flexible mixed methods design to test a newly developed intervention in clinical practice. RESULTS: The intervention development was completed in December 2020. The intervention will be tested in 3 independent nursing homes in Norway. CONCLUSIONS: By determining the feasibility of a technology-supported guidance model for nursing students in clinical practice, the results will provide information on the acceptability of the intervention and the suitability of the outcome measures and data collection strategy. They will also identify the causes of dropout and obstacles to retention and adherence. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/31646.

Technological literacy in nursing education: A scoping review.

BACKGROUND: Nurses are the key professionals in the introduction, implementation, and use of technology in clinical practice. A lack of technical expertise and technological understanding poses a challenge to the quality of health services and possibly to the safety, dignity, and quality of life of patients. Therefore, possessing technological literacy upon completing nursing baccalaureate studies is essential. However, no previous scoping review has mapped the existing studies of technological literacy in nursing education. OBJECTIVES: To map and assess the published studies on technological literacy in nursing education and to identify how educational institutions operationalize, teach, measure, and maintain students' technological literacy throughout their educational programs. DESIGN: A scoping review was conducted using the methodological framework of Arksey and O'Malley. The reporting was guided by the PRISMA extension for Scoping Reviews. METHODS: A comprehensive systematic search of the MEDLINE, EMBASE, PsycINFO, ERIC, and CINAHL was performed for studies published from January 2008 through March 2020. Two authors independently assessed eligibility and extracted data. The reference lists of the included studies were also examined. RESULTS: The review included 28 papers from 27 studies. Three thematic groupings with their respective subgroups were identified among the included papers: 1) the acquisition (simulated electronic documentation, diversified learning methods, and evaluation learning focus), 2) the measurement (digital/computer literacy/competence, nursing informatics competence, technology acceptance, and students' interests and preferences in technology), and 3) the maintenance (follow-up evaluation) of technological knowledge and skills. CONCLUSIONS: Pedagogical models designed to teach an entire process for the acquisition, measurement, and maintenance of technological literacy are lacking. Studies are needed that bring technological competencies to a higher level, including problem-solving and critical thinking. Educators' competencies should be enhanced. Educational institutions need to ensure the readiness of future nurses for a technology-enriched environment by providing the necessary knowledge in technological literacy. "TWEETABLE ABSTRACT": Due to the importance of technological literacy to the nursing profession, educational institutions must ensure that it is taught to nursing students.

Technology-Supported Guidance Models Stimulating the Development of Critical Thinking in Clinical Practice: Protocol for a Mixed Methods Systematic Review.

BACKGROUND: Critical thinking is an essential skill that nursing students need to develop. Technological tools have opened new avenues for technology-supported guidance models, but the challenges and facilitators of such guidance models, as well as how they stimulate the development of critical thinking, remain unclear. OBJECTIVE: We developed a protocol for a mixed methods systematic review to investigate the use of technology-supported guidance models that stimulate the development of critical thinking in nursing education clinical practice. METHODS: A convergent integrated design following the Joanna Briggs Institute Manual for Evidence Synthesis will be employed. A pair of authors will select the articles by screening titles and abstracts, and the methodological quality of the articles included in the review will be assessed by a pair of authors according to checklists for specific study designs. The data will be extracted using the standardized Joanna Briggs Institute mixed methods data extraction form and following a convergent integrated approach. The thematic synthesis for data transformation will be used. RESULTS: Development of a comprehensive systematic search strategy was completed in October 2020. The database searches were performed on October 21, 2020. As of January 2021, analysis and synthesis is ongoing. Completion of this review is expected by January 2021. CONCLUSIONS: By combining evidence from studies with varied methodological approaches, the results should provide broad insight into the use of technology-supported guidance models for clinical practice in nursing education with a focus on the development of nursing students' critical thinking. The results of this mixed methods systematic review can also be used to develop or improve current technology-supported guidance models for clinical practice in nursing education. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): PRR1-10.2196/25126.

Intensive care nurses' experiences of withdrawal of life-sustaining treatments in intensive care patients: A qualitative study.

OBJECTIVE: To explore the experience of intensive care nurses when participating in the withdrawal of life-sustaining treatments from intensive care unit patients. DESIGN AND METHODS: A qualitative descriptive and explorative design. Data were collected in 2017 and 2018 by interviewing nine intensive care nurses. The data were analysed by using systematic text condensation. SETTING: The nine intensive care nurses interviewed worked in four different intensive care units located in one university hospital and one local hospital. MAIN OUTCOME MEASURES: Experiences when participating in the process of withdrawing life-sustaining treatments. FINDINGS: Three categories emerged from the data analysis: ICU nurses' experiences of stress in the process of treatment withdrawal; a requirement for interdisciplinary support and cooperation; and elements to achieve a dignified treatment withdrawal process. CONCLUSION: The intensive care nurses experienced challenges and emotional reactions when patients were overtreated or when they had to participate in treatments they did not agree with. They considered debriefings to be helpful in dealing with emotions. Thorough planning, good communication, pain relief, and the creation of a peaceful environment were perceived as important elements in achieving a dignified treatment withdrawal process.

Use of simulation-based learning among perioperative nurses and students: A scoping review.

OBJECTIVES: Simulation-based learning has been extensively explored, especially in baccalaureate nursing programmes. Recently, simulation-based learning has been introduced in perioperative nursing. The aim of this scoping review is to investigate work published on the use of simulation-based learning in the field of perioperative nursing. DESIGN AND DATA SOURCES: A scoping review was conducted using the methodological framework of Arksey and O'Malley to identify a broad range of relevant literature, regardless of study design. A comprehensive and systematic search was performed using Medline, CINAHL, Eric, Svemed+, PsychINFO and Embase in May 2016 and then was updated in February 2018. Each database was searched for literature published between 1st January 2005 and 8th February 2018. REVIEW METHOD: Two authors independently assessed literature eligibility and extracted data to answer our research question 'What is known about the use of simulation-based learning in the field of perioperative nursing?' RESULTS: Nine articles and one doctoral thesis were included in the review. There appears to be a paucity of research or results-oriented evidence regarding the use of simulation-based learning in the field of perioperative nursing. Different goals of simulation-based learning were reported. It was difficult to confirm whether these goals had been reached as none of the articles included control groups, and no evaluations had been undertaken against Kirkpatrick's level 3 to see changes in participants' behaviours, and level 4, to determine whether the training had a positive impact on, for example, patient outcomes. CONCLUSION: Owing to the lack of research and the inadequate descriptions of design and method in simulation-based learning in most of the articles included, there is little evidence in the existing literature to guide practitioners of this learning in the field of perioperative nursing. This indicates a need for further research in this area.

Brazilian undergraduate nursing students' critical thinking need to be increased: a cross-sectional study / O pensamento crítico dos estudantes de graduação em enfermagem brasileiros precisa ser ampliado: estudo transversal / Es necesario aumentar el pensamiento crítico de los estudiantes brasileños de graduación en enfermería: estudio transversal

ABSTRACT Objectives: to map Brazilian undergraduate nursing students' critical thinking level and investigate the correlation between selected sociodemographic data and critical thinking domains. Methods: in this descriptive cross-sectional study, participants' (N=89) critical thinking was assessed using the Health Science Reasoning Test. Correlation between critical thinking domains and sociodemographic data was assessed using the Pearson correlation coefficient. Results: the overall results showed a moderate level of participants' critical thinking (mean = 70.7; standard deviation 5.7). A poor performance was identified in 5 of the 8 critical thinking domains. A significant positive correlation was found between education period and critical thinking (p<.001). Conclusions: poor level in students critical thinking domains may lead to negative consequences for their learning outcomes. Further studies should be carried out to confirm our results, in addition to investigation of teaching methods that encourage and ensure the development of students' critical thinking skills during nursing education.

RESUMO Objetivos: mapear o nível de pensamento crítico de estudantes brasileiros de graduação em enfermagem e investigar a correlação entre os dados sociodemográficos selecionados e os domínios do pensamento crítico. Métodos: neste estudo transversal descritivo, o pensamento crítico dos participantes (N=89) foi avaliado por meio do Health Science Reasoning Test. A correlação entre os domínios do pensamento crítico e os dados sociodemográficos foi avaliada pelo coeficiente de correlação de Pearson. Resultados: os resultados gerais mostraram um nível moderado de pensamento crítico dos participantes (média=70,7; desvio padrão 5,7). Foi identificado um desempenho ruim em 5 dos 8 domínios do pensamento crítico. Foi encontrada correlação positiva significativa entre escolaridade e o pensamento crítico (p<0,001). Conclusões: baixos níveis nos domínios de pensamento crítico em estudantes podem levar a consequências negativas para seus resultados de aprendizagem. Novos estudos devem ser realizados para confirmar nossos resultados, além da investigação de métodos de ensino que incentivem e garantam o desenvolvimento das habilidades de pensamento crítico dos estudantes durante a formação em enfermagem.

RESUMEN Objetivos: mapear el nivel de pensamiento crítico de los estudiantes brasileños de pregrado en enfermería e investigar la correlación entre los datos sociodemográficos seleccionados y los dominios del pensamiento crítico. Métodos: en este estudio transversal descriptivo, el pensamiento crítico de los participantes (N=89) fue evaluada mediante el Health Science Reasoning Test. La correlación entre los dominios de pensamiento crítico y los datos sociodemográficos se evaluó mediante el coeficiente de correlación de Pearson. Resultados: los resultados generales mostraron un nivel moderado de pensamiento crítico de los participantes (media=70,7; desviación estándar 5,7). Se identificó un desempeño deficiente en 5 de los 8 dominios del pensamiento crítico. Se encontró una correlación positiva significativa entre educación y pensamiento crítico (p<0,001). Conclusiones: los bajos niveles de los dominios del pensamiento crítico en los estudiantes pueden tener consecuencias negativas para sus resultados de aprendizaje. Se deben realizar más estudios para confirmar nuestros resultados, además de la investigación de métodos de enseñanza que fomenten y aseguren el desarrollo de habilidades de pensamiento crítico de los estudiantes durante su formación en enfermería.

The last three days of life: a comparison of pain management in the young old and the oldest old hospitalised patients using the Resident Assessment Instrument for Palliative Care.

BACKGROUND: Pain is a common symptom in older patients at the end of life. Little research has evaluated pain management among the oldest hospitalised dying patients. AIMS AND OBJECTIVES: To compare the pain characteristics documented by healthcare workers for the young old and the oldest old hospitalised patients and the types of analgesics administered in the last three days of life. DESIGN: A retrospective cross-sectional comparative study. METHODS: The study included 190 patients from a Norwegian general hospital: 101 young old patients (aged 65-84 years) and 89 oldest old patients (aged 85-100 years). Data were extracted from electronic patient records (EPRs) using the Resident Assessment Instrument for Palliative Care. RESULTS: No significant differences were found between the young old and the oldest old patients with regard to pain characteristics. Pain intensity was poorly recorded in the EPRs. Most of the patients received adequate pain control. Morphine was the most frequently administered analgesic for dying patients. Compared to the oldest old patients, a greater proportion of the young old patients received paracetamol combined with codeine (OR = 3.25, 95% CI 1.02-10.40). CONCLUSIONS: There appeared to be no differences in healthcare workers' documentation of pain characteristics in young old and oldest old patients, but young old patients were more likely to receive paracetamol in combination with codeine. IMPLICATIONS FOR PRACTICE: A limitation of the study is the retrospective design and that data were collected from a single hospital. Therefore, caution should be taken for interpretation of the results. The use of systematic patient-reported assessments in combination with feasible validated tools could contribute to more comprehensive documentation of pain intensity and improved pain control.