The effect of serious game and problem-based learning on nursing students' knowledge and clinical decision-making skill regarding the application of transfusion medicine in pediatric nursing.

PURPOSE: Comparing the effect of serious game and problem-based learning on nursing students' knowledge and clinical decision-making skill regarding the application of transfusion medicine in pediatric nursing. DESIGN AND METHODS: In this quasi-experimental study, 76 undergraduate nursing students were enrolled through a convenience sampling method, and were allocated to one of the three groups of serious game, problem-based learning, and control through the block randomization method. Data were collected using a valid and reliable 3-part researcher-made tool, completed before and two weeks after the intervention. Statistical analysis was performed using paired t-test, analysis of covariance, and Bonferroni post hoc test. A significance level of <0.05 was considered. RESULTS: After the intervention, mean scores of both knowledge and clinical decision-making skill increased significantly in both intervention groups (p < 0.05). Mean post-test scores of both knowledge and clinical decision-making skill in the serious game group, and only clinical decision-making skill in the problem-based learning group were significantly higher than the control group (p < 0.05). However, no significant difference was observed regarding mean post-test scores of both knowledge and clinical decision-making skill between the intervention groups (p > 0.05). CONCLUSIONS: Both serious game and problem-based learning are proven to be effective in improving nursing students' knowledge and clinical decision-making skill regarding the application of transfusion medicine in pediatric nursing. PRACTICE IMPLICATIONS: Since learning now occurs beyond classrooms and the new generation of students spend most of their time in virtual places, utilizing technology-based teaching methods like serious games can benefit both educators and students by providing continuous education, saving their time and expenses, etc.

The initial experiences of junior nursing college students when communicating with children during pediatric clinical practicum: A phenomenological study.

PURPOSE: Nursing students feel stressed during pediatric clinical practicum due to limited communication encounters with hospitalized children. The purpose of this study was to describe junior nursing college students' experiences of communicating with children during pediatric clinical practicums. DESIGN AND METHODS: A qualitative phenomenological research design was used. Purposive sampling was used to recruit 18 junior nursing college students who completed their pediatric clinical practicum. Data were collected using semi-structured interviews and were analyzed using Colaizzi's seven-step method for data analysis. RESULTS: Three themes emerged from the data. (1) Difficulties in communicating during initial practicum: fear, rejection, self-doubt of communication abilities, and unfamiliarity with the application of communication techniques posed frustrations among nursing students. (2) Efforts to learn during practicum: self-empowerment, seeking a diverse support system, adjusting communication methods, and striving to establish good relationships allowed nursing students to adapt to the pediatric curriculum. (3) Effective communication at the later stages of practicum: mastering fundamental communication techniques and exercising pediatric therapeutic communication techniques allowed nursing students to feel accomplished. CONCLUSIONS: Junior nursing college students initially encountered difficulties and frustration when communicating with children during their pediatric clinical practicum. This study serves as a guide for educators of pediatric nursing to design courses on communication with hospitalized children. PRACTICE IMPLICATIONS: These findings could be used to develop foundation courses on communicating with children for first-time pediatric nursing practicum students; for example, formulating a course on therapeutic play for children that encompasses communication techniques, pediatric ward simulation, and introduction to therapeutic play.

Development and effectiveness of a metaverse reality-based family-centered handoff education program in nursing students.

PURPOSE: Effective patient handoffs are vital in pediatric populations. This study aimed to develop and identify the impact of a metaverse-based handoff program using ZEPETO on nursing students' handoff competence, handoff self-efficacy, learning realism, and satisfaction. DESIGN AND METHODS: This study used a non-randomized, pre-post nonequivalent group design to develop, implement, and verify a metaverse-based handoff simulation program in a nursing school in South Korea. We assigned 69 senior nursing students from a university to an experimental group or a control group. We developed a metaverse-based, handoff simulation program of family-centered care by building a pediatric intensive care unit (PICU) using ZEPETO. The program included an online lecture, a metaverse rounding discussion, and a metaverse-based handoff simulation of postoperative care for infants with congenital heart disease. We measured handoff competence, handoff self-efficacy, learning realism, and learning satisfaction pre- and post-program. RESULT(S): The experimental group showed significantly higher handoff self-efficacy than the control group (t = 3.17, p = 0.002). No significant differences were found in handoff competency, learning realism, or learning satisfaction between the groups. CONCLUSION(S): This study confirmed that a family-centered care-based handoff metaverse simulation program based on the experiential learning theory enhanced nursing students' handoff self-efficacy. The program equipped students to conduct safe and effective handoffs in real-world clinical settings by providing an immersive learning experience and emphasizing patient-centered communication. PRACTICAL IMPLICATIONS: Based on these results, family-centered, handoff education programs are recommended to be developed that focus on learning realism and learning satisfaction to enhance nursing students' handoff competence.

The SPN Pediatric Nursing Excellence Model: Differentiating pediatrics.

The question of what makes an "excellent" pediatric nurse has been asked frequently by both pediatric and non-pediatric nurses for many years. Longevity in the practice setting, increased formal education in the care of children and families, positive satisfaction surveys post encounter, quantity of professional presentations and publications, and specialty certification are often listed when discussing pediatric nursing excellence. However, pediatric nursing excellence (PNE) is not well defined. Current recognition mechanisms such as clinical ladders, Magnet© and Pathways© programs, and Benner's stages of clinical competence are not specific for pediatric nursing practice. Once the characteristics of pediatric nursing excellence are determined, they can be used as the basis for identifying pediatric-specific quality indicators. In 2020, SPN initiated a project to define the construct of "pediatric nursing excellence". Two years later, SPN published its Pediatric Nursing Excellence Model, consisting of a visual depiction accompanied by definitions of 16 concepts that comprise the PNE Model. This article presents the five stages of the development process, the components of a model of pediatric nursing excellence, and the potential uses of such a model.

Investigation of the relationship between nursing students' knowledge level of paediatric emergency practices and paediatric comfort and worry.

AIM: This study aimed to examine the relationship between nursing students' knowledge level of paediatric emergency practices and their clinical comfort and worry status. METHODS: A cross-sectional correlational design was used. Data was collected using the "Personal Information Form," "Paediatric Nursing Student Clinical Comfort and Worry Assessment Tool," and "Paediatric Emergency Practices Information Questionnaire. RESULTS: The nursing students' knowledge level of paediatric emergency practices was good (14.76 ± 2.67/2-20). Their level of worry in paediatric services was above average (14.14 ± 4.8/5-25), while their paediatric clinical comfort level was at an average level (17.61 ± 3.72/10-30). It was found that as the nursing students' knowledge level of paediatric emergency practices increased, their comfort in paediatric clinics improved (r = 0.11, p = 0.003), and their worry levels decreased (r = -0.382, p < 0.001). Variables such as knowing the emergency number to call in case of poisoning and taking the child to a health facility after an electric shock contributed to the students' clinical comfort and worry (p < 0.005). CONCLUSION: The students' worry levels in paediatric clinics were above average, while their paediatric clinical comfort levels were average. As students' knowledge of paediatric emergency practices increased, they felt more comfortable in the clinical setting and had lower worry levels. IMPLICATION OF PRACTICE: Providing nursing students with theoretical and practical training centred on paediatric emergency situations before their clinical rotations are believed to enhance their comfort in paediatric clinics.

Nursing students' views on trauma-informed pediatric nursing care and family-centered care.

PURPOSE: We studied the views of nursing students on family-centered care (FCC) and their knowledge, opinions, self-rated competence, current practice, and perceived implementation barriers with regard to trauma-informed pediatric nursing care. METHODS: This survey was a descriptive correlational study. The sample consisted of 261 nursing students, 3rd and 4th years, who had completed the Child Health and Diseases Nursing Course. The data were obtained using the "Student Information Form," "Family-Centered Care Attitude Scale," and "trauma-informed care (TIC) Provider Survey." RESULTS: Nursing students were knowledgeable and held favorable opinions about TIC. The survey showed that students with higher levels and those with a hospitalization experience during childhood had higher scores regarding TIC. A positive relationship was found between the students' TIC to mean score and FCC attitude mean score. CONCLUSIONS: Nursing students are not competent to practice TIC, especially with pediatric patients. Therefore, they need to develop relevant skills for helping pediatric patients. PRACTICE IMPLICATIONS: Efforts to improve nursing students' trauma-informed pediatric care should highlight specific skills related to helping pediatric patients manage emotional responses to difficult medical experiences. By integrating TIC into the baccalaureate curricula, nursing educators can provide the students with appropriate skills and facilities so that they can provide holistic and highly effective care to highly vulnerable patients.

Nurses' and nurse educators' experiences of a Pediatric Nursing Continuing Professional Development program in Rwanda.

OBJECTIVES: In 2016, a Pediatric Nursing Continuing Professional Development (PNCPD) program was created and implemented in Kigali, Rwanda, through the Training, Support, and Access Model (TSAM) for Maternal, Newborn, and Child Health (MNCH). This partnership project between Canada and Rwanda provided pediatric nursing education to forty-one Rwandan nurses and nurse educators in 2018 and 2019. The objective of this research study was to explore the experiences of nurses and nurse educators applying pediatric knowledge and skills to academic and clinical settings after participating in the PNCPD program. METHODS: This study was situated within an interpretive descriptive perspective to explore the ways in which knowledge gained during the PNCPD program in Rwanda was applied by nurses and nurse educators in their nursing practice, both academically and clinically. Data was collected through individual interviews. Inductive content analysis was used for data analysis. RESULTS: The analysis of the interviews resulted in the emergence of five themes: Transformations in Pediatric Nursing Practice, Knowledge Sharing, Relationship-Based Nursing, Barriers and Facilitators to Knowledge Implementation, and Scaling-up PNCPD within the Health System. CONCLUSIONS: The results of this study have the potential to inform positive changes to child health care in Rwanda, including scaling up pediatric nursing education to other areas of the healthcare system.

A sustainable model for pediatric oncology nursing education and capacity building in Latin American hospitals: Evolution and impact of a nurse educator network.

Through an "educate-the-educator" twinning model, pediatric oncology nurse educator roles and programs have been established at hospitals in Latin America since 2008. However, with increasing demand for nurse educator programs in the region, a twinning approach was no longer sustainable. Thus, a "nurse educator network" approach was established to scale adaptable, standardized multisite education and quality initiatives. The development, expansion, and impact of a sustainable network approach for pediatric oncology nursing capacity building in Latin America is described. The educator network approach serves as a potential model for other geographical regions. Coronavirus disease 2019 (COVID-19) impact and adaptations are addressed.

Hospice nurses request paediatric-specific educational resources and training programs to improve care for children and families in the community: Qualitative data analysis from a population-level survey.

BACKGROUND: Children with serious illness who receive hospice care often interface with nurses who lack training, experience and comfort in the provision of paediatric palliative and hospice care. Hospice nurse preferences for paediatric-specific training are not well known. AIM: To describe the types of paediatric-specific training received and educational content preferred by hospice nurses. DESIGN: Population-level dissemination of a cross-sectional survey with qualitative analysis of open-ended survey items. SETTING/PARTICIPANTS: Nurses from 71 community-based hospice organizations across 3 states completed the survey. RESULTS: An open-ended response was provided by 278/551 (50.5%) survey respondents. A total of 55 respondents provided 58 descriptions of prior paediatric-specific training, including a formal 2-day course (n = 36; 65.5%), on-the-job education (n = 13, 23.6%), online training (n = 5, 9.1%), nursing school (n = 2, 3.6%) and paediatric advanced life support courses (n = 2, 3.6%). A total of 67 respondents described 74 hospice-led educational efforts, largely comprised of a 2-day course (n = 39; 54.2%) or provision of written materials (n = 11; 15.3%). A total of 189 respondents described 258 preferences for paediatric-specific training, with nearly half (n = 93; 49.2%) requesting 'any' or 'all' types of education and the remainder requesting education around medication use (n = 48; 25.4%), symptom assessment/management (n = 32; 16.9%), pain assessment/management (n = 28; 14.8), communication (n = 29; 15.3%) and psychosocial assessment/management (n = 28; 14.8). CONCLUSIONS: Hospice nurses self-report inadequate exposure to educational resources and programs, in conjunction with a strong desire for increased paediatric-specific training. Identification of targetable gaps should inform the development of educational resources, policies and other supportive interventions to improve delivery of care to children and families in the community.

Pediatric Pain Management Knowledge Levels of Intern Nursing Students.

BACKGROUND: One of the most common problems in children that pain can not be managed adequately by the health workers. Knowledge level of nurses is an important factor in effective pain management. AIMS: This study was designed to determine intern nursing students' level of pediatric pain management knowledge (PPMK) and the affecting factors. DESIGN: The study used a descriptive, comparative, correlational, and cross-sectional design. SETTINGS: Research was conducted at a Nursing School of a State University. PARTICIPANTS/SUBJECTS: The study was carried out on 72 pediatric nursing internship students. METHODS: Data were collected using a demographic data form for affecting factors such as grade point averages, age, gender, previous pain education, and self-sufficiency, and a pain management knowledge questionnaire consisting of six subdimensions: awareness of pain, pain physiopathology, barriers to pain management, pain diagnosis, pain assessment, and pain control. Data were analyzed using quartiles, correlation, regression analysis, and the Structural Equation Model. RESULTS: The mean age of the participants was 22.64 ± 1.02, and 63.9% of them self-evaluated their current knowledge as inadequate. The PPMK score was 67.58 ± 7.37 and the students got medium level scores from the overall subdimensions. On the other hand, they got the lowest scores from the pain control (29.35 ± 4.29) and the highest scores from the pain assessment (5.49 ± 1.55). A moderate level of significant relationship was found in the Structural Equation Model (p < .05). CONCLUSIONS: The students were determined to have a moderate PPMK level and get the lowest scores, particularly from the pain control.

Design and Implementation of an Innovative Undergraduate Pediatric Clinical Experience With Teenagers of Mexican Heritage.

This article describes an innovative community-based pediatric clinical rotation for undergraduate nursing students. Students were charged with conducting interactive educational sessions on health-related topics of interest to participants in a six-week summer day camp for adolescents of Mexican heritage. At the completion of the experience, students identified social determinants of health that impacted the health of the community and the impact of the experience on their nursing practice. Overall, both the adolescents and the nursing students benefited from the experience. Community-academic partnerships can be used to promote student learning while contributing to the overall health of the community.

Implementation of the m-ISHAPED Tool for Nursing Interdepartmental Handoffs.

BACKGROUND: Handoffs can pose risks to patients. LOCAL PROBLEM: Nurses throughout a children's hospital understood patient handoffs differently, resulting in handoff errors (failures) across departments. METHODS: Lean principles were used to modify and implement the ISHAPED (Introduction, Story, History, Assessment, Plan, Error Prevention, and Dialogue) tool. INTERVENTIONS: The team implemented a modified ISHAPED (m-ISHAPED) tool to align the content shared and the expectations for interdepartmental handoff. RESULTS: Improvements were seen in reported patient safety events from 6.84 to 1.57 per 100 patient days (P < .001) and nurse satisfaction from 81.1% to 90.6% (P < .001). CONCLUSIONS: A standardized process for interdepartmental nursing handoff was successfully implemented.

Developing competencies in genetics nursing: Education intervention for perinatal and pediatric nurses.

Nurses need to be appropriately trained in genetics to provide clinical care based on best practice for patients and families. This exploratory study describes an educational intervention using authentic stimulus material centered on a clinical case study of a family with a baby with Down syndrome. Quantitative and qualitative data were collected from a sample of 15 nurses and 27 students from three universities in Japan before and after completing an entry-level workshop on competency-based genetics nursing. Participants reported increased perceived genetics knowledge and clinical confidence. Despite more than 90% of the participants reporting that they understood the underlying genetics knowledge, their confidence and the ethical aspects of genetics nursing had not been promoted after the seminar. In contrast, the reflections, coded into three categories, showed they recognized families' needs for psychological support, family decision making, and protection and privacy and suggested that nurses had undergone a profound shift in understanding about these issues. Although indicating that a single seminar was insufficient, the study findings will be useful to develop educational materials on genetics for both students and nurses.

Nonsynostotic plagiocephaly: a child health care intervention in Skaraborg, Sweden.

BACKGROUND: The aim was to evaluate the intervention's effect on prevention and reversal of nonsynostotic plagiocephaly. METHODS: Thirty-eight intervention group nurses were educated about nonsynostotic plagiocephaly and asked to follow guidelines; 18 control group nurses were not. In a longitudinal single-blinded clinical intervention, parents brought infants to well-child visits according to the national schedule. Cranial shape was assessed in 176 intervention and 92 control group infants at 2-, 4-, and 12-month visits. RESULTS: Asymmetry at two months reversed by four months four times more often in intervention than control subgroup infants (OR = 4.07, p = 0.02) when adjusted for parent awareness of written information from their nurse. Asymmetry at two months reversed by 12 months fivefold when parents were aware of written information (OR = 0.19, p = 0.04). The risk for persistent asymmetry at 12 months was lower for intervention than control group infants (RR = 0.35, p = 0.03). Of infants with no asymmetry at two months, 25% in intervention and 22% in control group developed brachycephaly. CONCLUSIONS: The intervention contributed to early reversal and reducing infants' risk for persistent asymmetry. Parents' awareness of written information contributed to reversal. Preventing brachycephaly was difficult. Further research is needed.

"There was Only One Nurse for Everyone": Student Reflections of a School Nursing Clinical Experience.

PURPOSE: Undergraduate nursing faculty face challenges when teaching pediatric clinicals. Changes to pediatric care and hospital admissions have contributed to a shortage of clinical sites where students can learn to care for children with varied nursing needs. The purpose of this study was to describe benefits and barriers of pediatric clinical placements with a school health component. DESIGN AND METHODS: A qualitative analysis of 38 student reflective journals was conducted to identify experiences following student participation in school nursing clinicals. RESULTS: Three themes and three sub-themes were identified. Major themes included: benefits of the clinical experience, suggestions for improvement, and an appreciation for the school nurse role with subthemes of greater responsibility than anticipated, resource constraints, and lack of support. CONCLUSIONS: School nursing clinical experiences allow nursing students to interact with children with broad range of ages, abilities, and health statuses, and preview a professional pathway they may otherwise never be exposed to. School nursing experiences also help nurse educators address the shortage of inpatient pediatric clinical site placements while facilitating student exposure to the impact of social justice and social determinants on child health. PRACTICE IMPLICATIONS: Nurse educators are encouraged to incorporate school nursing clinical experiences in pediatric curricula. Partnering with school districts in which student enrollment reflects diversity in culture, socio-economic status, and access to healthcare should be a priority so students may see first-hand the impact of social determinants on the health of clients and populations.

Delirium Knowledge, Self-Confidence, and Attitude in Pediatric Intensive Care Nurses.

PURPOSE: A diagnosis of delirium places a critically ill child at risk of increased morbidity/mortality. Although delirium is common in critically ill children, only 2% of pediatric intensive care units (PICU) screen for delirium. The impediments to screening include knowledge deficits regarding delirium and delirium screening tools. The purpose of this improvement science project was two-fold. The first was to implement delirium screening in a PICU. The second was to evaluate the impact of multifaceted education on PICU nurses' delirium knowledge, self-confidence and attitude towards delirium. DESIGN & METHOD: A series of three plan-do-study-act cycles (PDSA) were used to implement this practice change. Multifaceted education was provided during the PDSA cycles. Two questionnaires were used to assess for changes in delirium knowledge, self-confidence and attitude towards delirium among PICU nurses. Analysis of variance (ANOVA) was used for data analysis. RESULTS: Forty-two PICU nurses completed a questionnaire measuring delirium knowledge, self-confidence, and attitude during each PDSA cycle. A significant increase in delirium knowledge, self-confidence, and attitude towards delirium was found after education (p = .003; p < .001; p = .036) and 3 months post implementation of delirium screening (p = .023; p < .001; p = .027) as compared to pre-education. CONCLUSION & PRACTICE IMPLICATIONS: Multifaceted education is a successful tool in improving nurses' knowledge, self-confidence and attitude regarding delirium. The use of PDSA cycles is a practical systematic method to improve quality of care. Improving knowledge, self-confidence and attitude have the potential to mitigate adverse effects of delirium in the critically ill child.

Using Standardized Actors to Promote Family-centered Care.

PURPOSE: The purpose of this study was to examine nursing students' performance in providing family-centered care and empathic communication in a pediatric simulation. This study was considered an innovative approach within our undergraduate program because the use of standardized actors (SAs) was new to the program and had only previously been used in our graduate program. METHOD: This study used a mixed method design of descriptive comparative data and content analysis to examine nursing students' performance in providing family-centered care and empathic communication in a pediatric simulation. RESULTS: There were 146 students who participated in this study. Thematic analysis indicated that empathy needs to extend beyond the patient to the family. A comparison of the standardize actors' and peer assessment of student empathy was significant. CONCLUSIONS: Nurse educators can use standardized actors as caregivers in simulation as an effective teaching strategy to connect theory and the philosophy of family-centered care to its application in pediatric nursing practice. PRACTICE IMPLICATIONS: Family-centered care is a key philosophy in pediatric nursing. Students report that there is a significant gap between family-centered care theory and its application to practice. Few baccalaureate nursing students receive experience in family interactions during their clinical time. Therefore, this research supports the need for incorporating family-centered care simulation practices in nursing education to increase student nurses' readiness to practice in specialty settings such as pediatrics.

Pediatric End-of-life Simulation: Preparing the Future Nurse to Care for the Needs of the Child and Family.

PURPOSE: Preparing a future nurse to respond to the complex and sensitive needs of a child and family during the end-of-life requires more than didactic content in a classroom. During clinical experiences, students may care for children diagnosed with a terminal illness however; it is less likely that a student will have a clinical opportunity to care for a child and their family at the end-of-life. Without having an experience, it is challenging to teach students how to care for the dying child and family including how to appreciate the emotions, thoughts, and expectations when faced with a pediatric death (Lindsay, 2010). DESIGN AND METHODS: The instructional model integrates an end-of-life simulation into an undergraduate pediatric nursing course allowing students to practice caring for a child and their family while developing an understanding of the unique needs of a dying pediatric patient. RESULTS: Post simulation, students participating in guided reflection, identified several themes impacting their experience with end-of-life care, including symptom management, emotional care and "what to say". CONCLUSIONS: The structured simulated experience provided knowledge, skill and awareness to the role of the nurse when providing care at the end-of-life. PRACTICE IMPLICATIONS: Nurses' behaviors and responses when caring for a child can have a significant impact on the family's experience and memory of their child's death. Unintended actions may result in the family experiencing negative impressions, causing further distress to the grieving family (Butler, Hall, Willetts, & Copnell, 2015).