Using Collaborative Online International Learning to Support Global Midwifery Education.

BACKGROUND AND LOCAL PROBLEM: The COVID-19 pandemic created a gap in global health learning, requiring creative solutions to bridge the divide. Collaborative online international learning (COIL) is a program between universities located in different geographic areas that aims to build cross-cultural learning and collaboration. INTERVENTION: Faculty members from Uganda and the United States worked collaboratively to plan a 2-session COIL activity for nursing and midwifery students. Twenty-eight students from the United States and Uganda participated in the pilot quality improvement project. MEASURES: Students completed a 13-question REDCap survey measuring satisfaction, time commitment for the activity, and increase in knowledge about differently resourced healthcare systems. Students also were asked to provide qualitative feedback in that survey. RESULTS: Survey results indicate a high level of satisfaction and an increased understanding of a new healthcare system. The majority of students wanted more scheduled activity times, the opportunity to meet face to face, and/or more robust sessions in the future. CONCLUSION: This COIL activity between students in the United States and Uganda was a no-cost activity that provided global health learning opportunities for students during the global pandemic. The COIL model is replicable, adaptable, and customizable for a variety of courses and time spans.

Student experiences of a return to practice programme: a qualitative study.

BACKGROUND: Nurses, midwives and other health professionals who return to practice come from a range of backgrounds and return for a variety of reasons. Much of the research on return to practice concerns programme provision rather than returnee experience. AIM: This qualitative study focused on the experiences of nursing, midwifery and allied health students undertaking a return to practice programme at a higher education institute. It interpreted the perceptions of the student experience of returning to clinical practice following a lapse in professional registration. METHODS: Data collection methods were qualitative and involved focus groups. Findings were analysed using thematic analysis. FINDINGS: Several themes and subthemes emerged from the data, including 'the importance of returnee identity' and 'challenges and barriers'. Findings demonstrated different approaches to and influences on returnees' learning journeys. CONCLUSION: Previous knowledge, skills and experience were often hidden from view and hard to explain although crucial to returnee success.

Being present: Examining the efficacy of an Internet Mantram Program on RN-delivered patient-centered care.

BACKGROUND: The COVID-19 pandemic highlighted nurses' compassionate presence during stressful conditions. Strategies to reduce workplace stress are needed. PURPOSE: The purpose of this study was to evaluate a stress reduction strategy, an Internet-based Mantram Repetition Program (MRP), for nurses caring for hospitalized Veterans. METHODS: A one group pre-/post-test design was used to assess change in nurses' perceived outcomes after participating in the MRP. A post-test-only design was used to assess hospitalized Veterans' perceptions of nursing presence and satisfaction with care. Qualitative interviews were used to supplement quantitative data. FINDINGS: Patients perceived high levels of presence and satisfaction with care. Post MRP, nurses perceived increased mindfulness, compassion satisfaction, spiritual well-being, and nursing presence. Increased mindfulness was associated with greater compassion satisfaction and less burnout. DISCUSSION: For nurses working on the front lines of patient care, the potential for experiencing stress and burnout is a reality. Participating in a MRP could lessen these effects and facilitate nursing presence.

Experience of an 8-Week Online Mindfulness Intervention for Nursing Students: Qualitative Findings.

BACKGROUND: Nurses returning to school often have stressors of work, family, and other obligations. Strategies are needed to mitigate the additional stress and promote academic success. Mindfulness is one proposed strategy. PURPOSE: The purpose was to explore the experience of students participating in an 8-week mindfulness intervention. METHODS: A mixed-methods descriptive study used an emailed survey link with 13 open-ended questions at intervention completion. Interpretive description guided the qualitative analysis. Participant retention, reported practice frequency, and written feedback were analyzed for feasibility and acceptability. RESULTS: Twenty-six participants completed the survey. Time commitment, increased awareness, focus and concentration, and enhanced coping were identified themes. Findings supported the impact of mindfulness on student stress, anxiety and cognition, as well as acceptability and feasibility. CONCLUSIONS: An online mindfulness program appeared effective, feasible, and acceptable. Qualitative findings informed the quantitative outcomes. Nursing faculty can impact student stress and academic success through mindfulness with their teaching.

Quality and extent of implementation of a nurse-led care management intervention: care coordination for health promotion and activities in Parkinson's disease (CHAPS).

BACKGROUND: A recent nurse-led, telephone-administered 18-month intervention, Care Coordination for Health Promotion and Activities in Parkinson's Disease (CHAPS), was tested in a randomized controlled trial and improved care quality. Therefore, intervention details on nurse care manager activity (types and frequencies) and participant actions are needed to support potential dissemination. Activities include nurse care manager use of a holistic organizing framework, identification of Parkinson's disease (PD)-related problems/topics, communication with PD specialists and care coordination, participant coaching, and participant self-care actions including use of a notebook self-care tool. METHODS: This article reports descriptive data on the CHAPS intervention. The study setting was five sites in the Veterans Affairs Healthcare System. Sociodemographic data were gathered from surveys of study participants (community-dwelling veterans with PD). Nurse care manager intervention activities were abstracted from electronic medical records and logbooks. Statistical analysis software was used to provide summary statistics; closed card sorting was used to group some data. RESULTS: Intervention participants (n = 140) were primarily men, mean age 69.4 years (standard deviation 10.3) and community-dwelling. All received the CHAPS Initial Assessment, which had algorithms designed to identify 31 unique CHAPS standard problems/topics. These were frequently documented (n = 4938), and 98.6% were grouped by assigned domain from the Organizing Framework (Siebens Domain Management Model™). Nurse care managers performed 27 unique activity types to address identified problems, collaborating with participants and PD specialists. The two most frequent unique activities were counseling/emotional support (n = 387) and medication management (n = 349). Both were among 2749 total performed activities in the category Implementing Interventions (coaching). Participants reported unique self-care action types (n = 23) including use of a new notebook self-care tool. CONCLUSIONS: CHAPS nurse care managers implemented multiple activities including participant coaching and care coordination per the CHAPS protocol. Participants reported various self-care actions including use of a personalized notebook. These findings indicate good quality and extent of implementation, contribute to ensuring reproducibility, and support CHAPS dissemination as a real-world approach to improve care quality. TRIAL REGISTRATION: ClinicalTrials.gov as NCT01532986 , registered on January 13, 2012.

Podcasting in nursing and midwifery education: An integrative review.

Podcasting is used in higher education so various digital resources can be shared with students. This review aims to synthesise evidence on podcasting in nursing and midwifery education. PubMed, MEDLINE, CINAHL, Scopus and ERIC databases were searched using key terms. 242 articles were found and screened. Data extraction, quality assessment and data analysis, underpinned by a Social Media Learning Model, were conducted on relevant studies. Twenty-six studies were included in the review. Three themes emerged; 1) learning and other outcomes, 2) antecedents to learning, and 3) learning process. Students seemed to acquire new knowledge and skills by using podcasts and it also appeared to improve clinical confidence. The organisation of podcasting, digital literacy and e-Professionalism, the personal motivation of learners, and flexible access to the technology seemed to impact the delivery of this educational intervention. Mechanisms that appeared to affect the learning process were the speed of exchange, the type of social media user, the timeframe, quality of information, the functionality of podcasts and other learning activities. This review synthesised evidence on podcasting in nursing and midwifery education. The technology was seen as a positive learning tool but more robust research examining its efficacy in improving learning outcomes is needed.

Effect of simulation training on students' childbirth skills and satisfaction in Turkey.

This study examined the effects of simulation training on student midwives' management skills for normal childbirth and their satisfaction. This study utilized a quantitative, quasi-experimental, comparison group research design. Students were placed into two groups according to the last digit of their school identity number (odd versus even), given by The Directorate of Student Affairs. Lots were drawn to decide which simulation model the odd and even numbers would represent. One group received simulation training for normal birth skills using a low-fidelity pelvic model (n = 37) while the other group used a high-fidelity computer-based mannequin (n = 38). After the skills training, each student midwife managed the second and third stages of a simulated normal childbirth. The skill checklists were used to evaluate the students' second and third stage labor midwifery skills. After the simulation activity, the Students' Satisfaction and Self-confidence Scale was used to measure their levels of satisfaction with the simulation activity and their self-confidence in learning. There were no significant differences between the groups in terms of childbirth management skills and satisfaction in learning (p > 0.05). Thus, both methods can be recommended for simulation training of student midwives.

Answering the Call: Impact of Tele-ICU Nurses During the COVID-19 Pandemic.

BACKGROUND: The coronavirus disease 2019 pandemic has exacerbated staffing challenges already facing critical care nurses in intensive care units. Many intensive care units have been understaffed and the majority of nurses working in these units have little experience. OBJECTIVE: To describe how the skilled tele-intensive care unit nurses in our health system quickly changed from a patient-focused strategy to a clinician-focused approach during the coronavirus disease 2019 crisis. METHODS: We modified workflows, deployed home workstations, and changed staffing models with the goal of providing additional clinical support to bedside colleagues while reducing exposure time and conserving personal protective equipment for those caring for this highly contagious patient population. The unit changed focus and granted more than 300 clinicians access to technology that enabled them to care for patients remotely, added nearly 200 mobile carts, and allowed more than 20 tele-intensive care unit nurses to work from home. RESULTS: Tele-intensive care unit nursing provided clinical knowledge to the nurses covering current and expanded critical care units. Using technology, virtual rounding, and increased collaboration with nurses, tele-intensive care unit nursing minimized the risk to bedside nurses while maintaining a high level of care for patients. CONCLUSION: Tele-intensive care unit nurses provided a proactive, holistic approach to caring for critically ill patients via camera as part of their routine workflow. In addition, during the coronavirus disease 2019 pandemic, these nurses created a new strategy in virtual health care to be implemented during a crisis.

A Clinical Nurse Specialist-Led Emergency Department Naloxone Distribution Program.

PURPOSE: This article describes the implementation of a clinical nurse specialist-led emergency department overdose education and naloxone distribution program. The program's purpose is to increase naloxone availability to reduce opiate overdose mortality rates within the local community. DESCRIPTION OF PROGRAM: The program distributes naloxone kits to patients in the emergency department after an opioid overdose. The kits are designed to help recipients prevent, recognize, and respond to an opioid overdose. OUTCOME: The program, which includes naloxone take-home kits and clinical guidelines outlining a standard of care for naloxone distribution and coprescribing, was successfully implemented across 11 emergency departments within an integrated health system. More than 250 kits were dispensed within the first year of program implementation along with an online patient education video that received more than 1600 views. In 2017, the county reported an opioid-related overdose death rate of 16.5 (per 100 000 residents). From January 2018 to June 2019, the opioid-related death rate per 100 000 residents was reported at 9.6. CONCLUSION: Although emergency department naloxone distribution programs are feasible in the acute care setting, it was critical for clinical nurse specialists to enlist an interdisciplinary team and engage executive leadership to ensure program success. For others considering such a program, early consideration should be given to determining financial support and evaluating the compliance and regulatory aspects of dispensing medications from emergency settings.

DNP Program Faculty and Graduates' Knowledge and Use of QI and Safety Processes.

BACKGROUND: Across doctor of nursing practice (DNP) programs, wide variation exists for DNP project expectations and curricular integration of Quality and Safety Education for Nurses competencies. PURPOSE: This study examined DNP project characteristics and compared knowledge, skills, and attitudes about quality improvement (QI) processes between DNP program faculty and graduates. METHODS: This descriptive study used a national convenience sample of DNP program faculty and graduates from multiple settings (N = 147) who completed an electronic survey of a modified version of the Quality Improvement Knowledge, Skills, and Attitudes Survey. RESULTS: Most DNP projects were QI/practice improvement (85.5%) and required interprofessional collaboration (65%) and implementation of a practice change (55.8%) with evaluation (65.5%). DNP program faculty (n = 73) and graduates (n = 30) had no significant differences in QI knowledge or skills; faculty reported less confidence in their knowledge (P = .002) and skills (P = .007) than graduates. CONCLUSIONS: Faculty development efforts to improve QI knowledge and skills for DNP program faculty are needed.

Perinatal/neonatal palliative care: Effecting improved knowledge and multi-professional practice of midwifery and children's nursing students through an inter-professional education initiative.

This paper presents a study that examines the potential value of a new and innovative inter-professional education (IPE) experience for final year midwifery and children's nursing students focused on improving awareness of end-of-life care for infants in conjunction with the support of their families. The study uses an action research approach to examine midwifery and children's nursing student experiences of an IPE initiative in developing knowledge regarding perinatal/neonatal palliative care. The setting is a Higher Education Institute in the South of England that included final year midwifery students (n = 39) and children's nursing students (n = 34) taking part in the study. Qualitative and quantitative data indicated that the IPE intervention had proven worth in developing knowledge and confidence in the students as both student groupings felt they lacked knowledge and confidence about perinatal/neonatal palliative care before attending the study day. Students felt that learning with, from and about the other profession represented was important in generating their knowledge. Educators should explore innovative ways to enable the further development of the fledgling speciality of perinatal/neonatal palliative care through education on an interprofessional platform.

Empowered Holistic Nursing Education as the Philosophical Framework for an RN-BS Program: A Six-Year Impact Evaluation Study.

The educational structure of many nursing programs is largely monocultural, with a traditional pedagogy. Empowered holistic nursing education (EHNE) creates a learning environment with more cultural responsiveness and support for diverse classrooms. The aim of this study was to determine what impact the theory had on diversification. With EHNE the philosophical framework of a new RN-to-BSN program, student demographic data were collected, along with exit survey questions. A statistically significant increase was found in the diversification of the six cohorts. The EHNE shows potential as a programmatic framework for increasing diversification of the nursing profession.

Developing a spiritual care competency framework for pre-registration nurses and midwives.

This paper identifies competencies in spiritual care from an in-depth literature review and develops a theoretical framework for competencies in spiritual care. It forms part of a larger modified Delphi study which recruited international nursing/midwifery experts. Using Braun and Clark (2006) adapted six-phase content thematic analysis, 7 domains and 116 competency items were generated from an in-depth literature review in three areas; spirituality and spiritual care, spiritual care education, and spiritual care curricular contents.

Effects of Relaxation Techniques on Nursing Students' Academic Stress and Test Anxiety.

BACKGROUND: This mixed-methods study examined the effects of relaxation techniques on first-year baccalaureate nursing (BSN) students' academic stress, test anxiety, and intention to stay in the nursing profession. METHOD: To evaluate the effects of using relaxation techniques, 45 students participated in a 6-week relaxation technique intervention and a focus group. A pretest was disseminated the first week of class and a posttest was disseminated at the end of the semester, followed by a focus group interview. RESULTS: The paired-sample t test indicated that students who used relaxation techniques significantly decreased in academic stress and test anxiety. A thematic analysis of the focus group interview indicated relaxation techniques prior to examinations helped to reduce mental and physical stress and fear of failure and increased the likelihood of their intention to stay in the nursing profession. CONCLUSION: Institutional learning experiences that reduce students' academic stress and test anxiety can include relaxation techniques. [J Nurs Educ. 2019;58(9):534-537.].

Nurses+QI=better hospital performance? A critical review of the literature.

NHS regulators, such as NHS Improvement and the Care Quality Commission, promote staff involvement in quality improvement (QI), while national nursing leaders and the Nursing and Midwifery Council advocate nurses' involvement in improving services. This article critically explores the evidence base for a national nursing strategy to involve nurses in QI using a literature review. A thematic analysis shows that nurse involvement in QI has several positive outcomes, which are also included in the NHS Improvement's Single Oversight Framework for NHS Providers. The article concludes that nurse involvement in QI helps improve hospital performance.

Nursing Global Health Competencies Framework.

AIM: This article describes the process of developing the Nursing Global Health Competencies Framework. BACKGROUND: Despite progress in the identification of global health competencies in nursing education, a theoretical underpinning to guide curriculum development and research in global health nursing was needed. METHOD: Scoping review of the literature; deduction. DISCUSSION: The framework contains one dimension, nursing core value and principles, delineated with seven subcategories: social justice and equity, holistic care, advocacy, health as human right, sustainability, advocacy, and collaboration. The framework also contains four assumptions: environmental focus, care focus, education focus, and competency leveling. CONCLUSION: A framework for global health in nursing education is critical to guide the development of competencies and relevant curricula to reflect the core values and principles of nursing. The literature germane to global health nursing was synthesized to define the relationships of core values in a graphic framework that depicts the essential concepts.

An exploration of providing mental health skills in a generic advanced clinical practice programme.

BACKGROUND: advanced clinical practitioners (ACPs) are expected to be competent in their holistic assessment and management of individuals, which includes those with both physical and mental health problems. A mental health component was introduced within a generic advanced practitioner programme to support the development of mental health skills required by advanced clinical practitioners in training (ACPiTs). AIMS: this research investigated the efficacy of content specific to mental health within an MSc ACP generic programme. METHODS: a single case study approach was adopted, which used a purposive sample of 10 ACPiTs to explore personal beliefs and experiences using semistructured interviews. Verbatim transcription was undertaken followed by content and thematic analysis. FINDINGS: Themes emerged included communication skills, and increased competence and self-awareness. CONCLUSION: insights provided by the ACPiTs showed they recognised the value of mental health teaching and exposure within their training programme in advancing their knowledge and skillset and, ultimately, increasing confidence in their clinical practice.

Evaluating mindfulness training for medical and PhD nursing students.

BACKGROUND: it is recognised that mindfulness training can positively impact holistic wellbeing and can improve mood, focus and resilience. Health service students often experience high levels of psychological morbidity. Engaging in mindfulness techniques may positively impact the psychological wellbeing of healthcare students. This is of vital importance to ensure optimum learning for healthcare practice with its associated challenges. METHOD: an evaluation was conducted with medical students (n=4) and PhD nursing students (n=6), who took part in a mindfulness-based workshop, followed by five weekly 30-minute sessions of mindfulness training, including a 15-minute meditation exercise. Data collection was carried out at baseline and post intervention, followed by a focus group discussion to elucidate qualitative experiences. RESULTS: significant findings were identified with respect to cognitive mindfulness scores (P=0.02) and resilience (P=0.04). DISCUSSION: data reflected three themes: the impact of mindfulness and maintaining practice, improvements in wellbeing, and improvements in academic endeavour. CONCLUSIONS: this evaluation found significant improvements in the ability to cope with stress and increased attention and resilience in all students. Although results are not generalisable in this small evaluation, students reported increased concentration levels and improved focus, both of which are likely to impact positively on any psychological symptoms, particularly those related to workload pressures.