Online Learning to Improve Nurses' Knowledge, Attitudes, and Self-Efficacy About Managing Postoperative Pain in Older Adults.

BACKGROUND: Older adults undergoing total knee arthroplasty may develop chronic pain without effective postoperative pain management. Increasing nurses' knowledge, changing their attitudes, and developing their pain management self-efficacy could improve the effectiveness of pain management. AIM: To determine the effectiveness of an online learning program to help registered nurses to manage postoperative pain in older adults undergoing total knee arthroplasty. DESIGN: A quasi-experimental pre-test-post-test design with intervention and control groups. METHOD: Six inpatient units were randomly selected at a large tertiary care medical center. Sixty nurses were evenly divided between intervention and control groups to participate in online learning about postoperative pain management in patients undergoing total knee arthroplasty. The content was based on Kolb's experiential learning theory. Data were collected on nurses' knowledge and attitudes toward pain management and pain management self-efficacy at baseline and after completion. Data were analyzed using descriptive statistics, chi-square tests, paired t-tests, and independent t-tests. RESULTS: The knowledge and attitudes about pain management and pain management self-efficacy toward older adults undergoing total knee arthroplasty of nurses in the intervention group significantly improved compared to the baseline and were also significantly higher than in the control group. CONCLUSIONS: An online learning program improves nurses' understanding and ability to manage pain in older adults undergoing total knee arthroplasty. This was therefore an effective learning method.

Development and evaluation of an intravascular link nurse network to sustain improvements in practice.

Link nurses have been used to support many areas of specialist nursing practice since the 1980s. They add value as they provide a practical and timely way of sharing information and knowledge and raising awareness with the wider multidisciplinary team. One strategy to improve standards and sustain improvements in the care of vascular access devices was to develop an intravascular link nurse network: 'Finding the missing link'. The link nurses are supported to attend quarterly masterclasses underpinned by the current evidence base. The masterclasses provide forums and workshops for learning, sharing initiatives, processes, progress and feedback. Results from the 2018/2019 sessions evaluation showed that 80% of the link nurses scored the workshops as excellent, 14% good, less than 1% fair and poor, and 4% did not provide an answer. Overall, 87% of link nurses were extremely likely to recommend the programme, 13% were likely to recommend it, and 93% found it helpful in their personal and professional growth. The network with supporting masterclasses has proven to be an effective strategy within the Trust.

Reflections on a methodology for analyzing professional practice and its possible use in nursing.

In order for nursing work not to become mechanistic, the team needs to develop a critical eye to its knowledge, its know-how and its know-to-be. The training of nursing professionals from a critical and reflective perspective motivated this study, which was based on the theoretical reference and the experience of the authors with use of the analytical methodology of the Groupe Entraînement de Analyze de Situations Éducatives (Training Group to Analyze Educational Situations) professional practice. This methodology aims to analyze professional situations in a group with the presence of a facilitator. The objective is to analyze the contributions of the Groupe Entraînement de Analyze de Situations Éducatives to train reflective professionals in nursing. The steps, rules of operation and the role of the participants are explained in order to promote a safe environment for all, enabling group members to develop hypotheses to understand the situation and develop analysis and reflection skills. It is concluded that this methodology offers the opportunity to open a space for reflective thinking, respecting the different roles and times intended for the speech of each participant, building their professional identity.

Examination of the teaching styles of nursing professional development specialists, part I: best practices in adult learning theory, curriculum development, and knowledge transfer.

The American Nurses Association advocates for nursing professional development (NPD) specialists to have an earned graduate degree, as well as educational and clinical expertise. However, many NPD specialists have limited exposure to adult learning theory. Limited exposure to adult learning theory may affect NPD educational practices, learning outcomes, organizational knowledge transfer, and subsequently, the professional development of the nurses they serve and quality of nursing care. An examination of current teaching practices may reveal opportunities for NPD specialists to enhance educational methods to promote learning, learning transfer, and organizational knowledge and excellence. This article, the first in a two-part series, examines best practices of adult learning theories, nursing professional development, curriculum design, and knowledge transfer. Part II details the results of a correlational study that examined the effects of four variables on the use of adult learning theory to guide curriculum development for NPD specialists in hospitals.

Using principles of quality and safety education for nurses in school nurse continuing education.

School nurses require ongoing continuing education in a number of areas. The Quality and Safety Education for Nurses (QSEN) framework can be utilized in considering school nurses' roles and developing continuing education. Focusing on neurology continuing education, the QSEN framework is illustrated with the example of concussion management in athletes. QSEN strategies can stimulate change to the status quo and outline the knowledge, skills, and attitudes that need to be adapted. With their competencies and knowledge, professional school nurses can incorporate evidence-based practices in conjunction with input from health care providers and families to create high-quality care and positive outcomes for students.

Simulation, Storytelling, and Pediatric End-of-Life Care: A Continuing Professional Development Approach for Nurse Residents.

Background: Providing end-of-life (EOL) care to pediatric patients and their families is challenging. Newly licensed nurses, especially those working with the hematology/oncology population, have little to no experience providing the specialized care needed for the dying child. An evidence-based continuing professional development activity provided a novel approach to improve the knowledge, attitudes, and comfort levels of nurse residents related to pediatric EOL care. Method: A high-fidelity simulation module of a pediatric oncology patient at the EOL was embedded into a 12-month nurse residency program. The module employed several teaching strategies including a storytelling approach. Results: Thirteen pediatric nurse residents participated in the program. While the evidence-based intervention increased participants' EOL care knowledge, their overall attitudes, and comfort levels remained unchanged. Discussion: EOL simulation with a storytelling approach is a highly valuable method of teaching new nurses how to care for a dying patient. Additional studies are needed to explore how to increase the comfort levels of new nurses in the delicate population of pediatric hematology/oncology.

Fostering healthy work environments through nursing education initiatives.

In this era of value-based health care, the knowledge, competence, and professionalism of the front-line nurse and other clinical staff are paramount. Everyone involved in patient care must maximize their skill set and drive high performance in the clinical arena. Healthy work environments will be key to achieving and sustaining quality outcomes and developing and retaining high-performing teams.

Teaching the business of health care.

This column identifies teaching modalities for assessing economic value, creating strategic plans, supporting implementation of cost-saving initiatives, and constantly evaluating.

Overcoming barriers in online workshop development: an ELITE experience.

The Emerging Learning and Integrated Technologies Education (ELITE) Faculty Development Program created eight online workshops to assist nurse educators in using technology within their organization's nurse education program. Continuing education units were provided for completion of the individual online workshops. The ELITE program worked through several barriers to transform content that was previously presented during face-to-face workshops into standalone online offerings. Barriers and implementation strategies for the on-site to online transition included restructuring workshop objectives, keeping current with rapid technology changes, altering a course management system to meet the needs of the program and the learner, and crafting independent practice opportunities for the online learner. The online workshop development experience of the ELITE program may assist other continuing education and staff development professionals who are updating their program offerings or pursuing online education for the first time.

Simulation in nursing practice: the impact on patient care.

Simulation has a well-known history in the military, nuclear power, and aviation. It is also a recommended teaching and learning strategy supported by several landmark studies. Although in the past 20 years simulation has become more integrated into the education of nurses and physicians, it has not been as well integrated into the development of skills for practicing nurses. This article will provide an overview of simulation techniques and uses and review of selected simulation research. Despite recommendations for using simulation and growing integration of simulation into education, we still lack empirical evidence of its impact on patient outcomes. Our discussion provides a review of the current uses of simulation in the nursing practice environment with several exemplars and offers recommendations to develop a simulation program.

Developing and using multiple-choice tests in clinical settings.

Tests can be used to assess attitudes, knowledge, and comprehension of principles in clinical scenarios across a range of content areas. Multiple-choice tests, when well prepared, can be an efficient means of achieving these aims. They can also be used to introduce a topic or to assess prior knowledge for an in-service education session or workshop.

Rocking the boat: challenges ahead for continuing education providers.

Recent evidence has provided a clear mandate for change in the way that registered nurses are educated-in both academic and continuing nursing education environments. This article explores strategies for changing the usual and customary approaches to better meet the needs of learners and prepare them to function effectively in a complex and challenging health care environment.

Evidence-based practice for staff nurses.

BACKGROUND: Barriers to the involvement of staff nurses in evidence-based practice include time commitments, staffing challenges, and limited experience in identifying evidence. METHODS: A 1-day, hands-on course focused on small, achievable, evidence-based practice projects; follow-up after the course by a project director; and commitment to implementation of participants' projects by management. Faculty included a librarian who helped with computer searches and a quality assurance representative to facilitate availability of institutional data for project evaluation. RESULTS: Nine courses held over a 3-year period involved 79 home institution nurses and 76 community nurses. Course evaluations were overwhelmingly positive. Completed projects were displayed on participants' units and circulated throughout the institution. The courses are continuing as part of the regular annual nursing education calendar. CONCLUSION: Streamlined approaches to teaching evidence-based practice can be used to involve staff nurses and raise awareness of evidence-based practice across nursing. Key positive findings include achievable projects, provisions for follow-up, and management support.

Developing a skills-based competency course.

Skills-based competency programs evaluate whether participants can demonstrate knowledge, skills, and professional behaviors associated with a skill in a simulated or actual clinical setting. Critical elements for program development include accurate and precise outcome statements that delineate the skill to be performed and valid and reliable evaluation criteria that identify the critical behaviors necessary for safe and competent performance.

A spotlight on strategies for increasing safety reporting in nursing education.

Health care policy changes have ripple effects that touch many different areas of the health care arena. Quality and safety are at the forefront of this discussion. In health care institutions, error reporting is expected to monitor and improve patient safety. Procedures are in place for reporting errors. However, multiple barriers lead to low use of reporting methods. Creating a reporting system that leads to transparency could positively affect the health care system. Introducing nurses to error reporting at the beginning of their educational experience could lead to a reduction in barriers to error reporting and promote error reporting. This article discusses strategies to increase error and near-miss reporting in a school of nursing.

Development of a model home health nurse internship program for new graduates: key lessons learned.

A nursing shortage, the aging baby boomer population, an escalating need for home health care, and limited availability of health care dollars are threatening to undermine the quality of health care in the United States. The National Center for Health Workforce Analysis projects a deficit of 275,000 full-time equivalents by 2010 (-12%) and a deficit of 800,000 by 2020 (-29%). This article focuses on one home health agency's strategy to support nurse graduates transitioning from student to professional nurse. Based on Benner's (1984) hallmark theory from novice to expert, the goals of this program are to enhance job satisfaction and social integration, facilitate autonomy, increase critical thinking and psychomotor skills, and develop additional competencies. Eleven key lessons learned are outlined.

Professional development for an advanced practice nursing team.

Since its development in 1998, the Cardiology Advanced Practice Nurse team has been plagued by retention issues. The coordinator for the team developed this leadership project while participating in the 2008 to 2009 Maternal-Child Health Leadership Academy sponsored by Sigma Theta Tau International and Johnson & Johnson. The focus of this project was to develop, implement, and evaluate initiatives to empower the advanced practice nurse team, promote their professional development, and ultimately improve retention of team members. Although evaluation data show progress toward addressing work environment issues, retention remains an ongoing problem.

Disaster preparedness for nurses: a teaching guide.

As one of the largest groups of health care providers in the United States, nurses are trained to attend to the physical, psychological, and spiritual needs of their patients, making them highly qualified to influence the outcomes of victims of an emergency situation. Unfortunately, nursing programs offer limited content on delivering care under extreme conditions, and few continuing education programs are available to practicing nurses. This article provides a brief educational presentation that can be used without an extensive time commitment or in-depth instructor knowledge of the subject. The course content has been presented to nurses at the American Red Cross, at local chapter meetings of professional nursing organizations, and to both graduate and undergraduate nursing students. This presentation is not designed to be a comprehensive study of disaster nursing, but serves as a starting point that might lead to further study and encourage active participation in preparedness education and planning.

Clinical Scholar Preparation: An Approach That Works.

The Colorado Center for Nursing Excellence established a formal didactic course in 2005 to deliberately prepare clinical faculty using expert clinical nurses. Independently, the National League for Nursing, in 2018, established criteria for certification for clinical nurse educators. The content of this course content closely mirrors those competencies and provides preparation for the exam. As a result, Clinical Scholars have established themselves as important players in nursing education in Colorado.