Integrating the fundamentals of care framework in baccalaureate nursing education: An example from a nursing school in Denmark.

AIMS AND OBJECTIVES: To describe and discuss the process of integrating the Fundamentals of Care framework in a baccalaureate nursing education at a School of Nursing in Denmark. BACKGROUND: Nursing education plays an essential role in educating nurses to work within healthcare systems in which a demanding workload on nurses results in fundamental nursing care being left undone. Newly graduated nurses often lack knowledge and skills to meet the challenges of delivering fundamental care in clinical practice. To develop nursing students' understanding of fundamental nursing, the conceptual Fundamentals of Care framework has been integrated in nursing education at a School of Nursing in Denmark. DESIGN AND METHODS: Discursive paper using an adjusted descriptive case study design for describing and discussing the process of integrating the conceptual Fundamentals of Care Framework in nursing education. RESULTS: The process of integrating the Fundamentals of Care framework is illuminated through a description of the context, in which the process occurs including the faculty members, lectures, case-based work and simulation laboratory in nursing education. Based on this description, opportunities such as supporting a holistic approach to an evidence-based integrative patient care and challenges such as scepticism among the faculty are discussed. CONCLUSION: It is suggested how integration of Fundamentals of Care Framework in lectures, case-based work and simulation laboratory can make fundamental nursing care more explicit in nursing education, support critical thinking and underline the relevance of evidence-based practice. The process relies on a supportive context, a well-informed and engaged faculty, and continuous reflections on how the conceptual framework can be integrated. RELEVANCE TO CLINICAL PRACTICE: Integrating the Fundamentals of Care framework can support nursing students' critical thinking and reflection on what fundamental nursing care is and requires and eventually educate nurses in providing evidence-based fundamental nursing care.

La prueba tuberculínica y el trabajo invisible de enfermería / The tuberculin test and the invisible nursing work

Introducción: La Tuberculosis es la segunda causa mundial de mortalidad, después del SIDA, causada por un agente infeccioso. Objetivos: teorizar la administración y lectura de la reacción Tuberculiníca como práctica enfermera, liberándola de concepciones positivistas y patriarcales que obturan el desarrollo del conocimiento enfermero. Métodos: revisión bibliográfica en las bases de datos especializadas (CUIDEN, REDALYC y LILACS) y análisis Meta teórico. Conclusiones: analizando críticamente la prueba Tuberculiníca se puede recuperar la práctica enfermera como fuente de teoría para incrementar el conocimiento enfermero, redundando en beneficio de los pacientes y el sistema de salud(AU)

Introduction: tuberculosis is worldwide the second cause of mortality caused by an infectious agent, after AIDS. Objectives: to theorize about the administration and reading of the tuberculin reactions as a nursing practice, freeing it from positivist and patriarchal conceptions that obdurate the development of the nursing knowledge. Methods: bibliographic review in the specialized databases (CUIDEN, REDALYC y LILACS) and meta-theoretical analysis. Conclusions: critically analyzing the tuberculin test, the nursing practice can be recovered as a source of theory to increase nursing knowledge, resulting in the benefit of patients and the health system(AU)

Mindful Communication for Caring Online.

Six studies containing information related to conveying and sustaining caring in online nursing classrooms were analyzed for communication patterns among faculty and students. Six consistent communicative elements emerged from this analysis: offering full presence, acknowledging shared humanity, attending to the individual, asking for and providing frequent clarification, demonstrating flexibility, and pointing out favorable opportunities while acknowledging challenges. These elements reflected key aspects of Jean Watson's Caring Science and Thich Nhat Hanh's Mindfulness trainings, prompting guidelines and suggestions for engaging in mindful caring communication online.

Workplace learning in midwifery education in Flanders (Belgium).

Workplace learning plays a crucial role in midwifery education. Twelve midwifery schools in Flanders (Belgium) implemented a new competency framework and aimed at implementing a more standardized and evidence-based method to learn and assess competencies, as well as to guide continuous competency development in practice. This paper describes the introduction of 'Embo's continuous workplace learning model', a holistic and competency-based method that integrates all workplace learning components. Available research evidence helps concluding the learning model is a feasible approach to organize workplace learning in such a way that continuous professional competency development is achieved.

Atrial electrogram interpretation improves after an innovative education program.

BACKGROUND: To avoid adverse patient outcomes from inappropriate treatment, it is recommended that an atrial electrogram (AEG) be recorded whenever atrial arrhythmias develop in patients after cardiac surgery. However, AEGs are not commonly performed because nurses lack knowledge about differentiating atrial rhythms on AEGs. OBJECTIVE: To investigate whether completing a novel online evidence-based education program on interpreting AEGs would improve critical care nurses' AEG interpretation. METHODS: Specialized critical care nurses were taught about obtaining and interpreting atrial rhythms on AEGs using a 42-minute online mini-movie. AEG interpretation was assessed pre and two and eight weeks post-intervention. RESULTS: AEG interpretation increased two weeks post intervention and was retained at eight weeks. Some participants used this newly acquired knowledge to interpret arrhythmias that were not taught during the education program. CONCLUSION: Accurate interpretation of AEGs is an easy skill for specialized critical care nurses to learn via an online education program.

Teaching evidence based practice and research through blended learning to undergraduate midwifery students from a practice based perspective.

The international world of higher education is changing with universities now offering students flexible delivery options that allow them to study away from campus and at a time convenient to them. Some students prefer on line learning while others prefer face to face contact offered through a traditional lecture and tutorial delivery modes. The response by many universities is to offer a blend of both. While online and blended mode of delivery may be suitable for some subjects there is little knowledge of the efficacy of blended learning models to teach evidence based practice and research (EBPR) to undergraduate midwifery students. EBPR is a challenging, threshold level subject upon which deeper knowledge and skills are built. This paper describes the design, delivery, and evaluation of an undergraduate EBPR course delivered in blended mode to first year midwifery students. Components of the blended learning innovation included: novel teaching strategies, engaging practical activities, role play, and e-learning strategies to maintain engagement. University-based course evaluation outcomes revealed very positive scores and the course was rated within the top ten percent of all courses offered within the Health Group at the host University.

Nurse Executives' Perceptions of the Executive Training for Research Application (EXTRA) Program.

BACKGROUND: To improve the overall quality and effectiveness of the Canadian health care system through better decisions supported by research-based evidence (RBE), the Canadian Health Services Research Foundation (CHSRF) and partners have created the Executive Training for Research Application (EXTRA) program. OBJECTIVES: To evaluate how nurse executive fellows perceive changes in their levels of knowledge of RBE and in their level of use of RBE following participation in the EXTRA program. METHODS: Nurse executives in the first four cohorts of the program (2004-2007) completed a survey during their 2-year fellowship period. RESULTS: Statistically significant improvements were observed regarding nurse executives' perceived knowledge and use of RBE. According to the participants, the EXTRA fellowship contributes to their role and function in their organization by providing tools, learning, and access to resources and networking, which contributes to their credibility, leadership, and knowledge transfer skills. CONCLUSIONS: The EXTRA program has been structured to reduce barriers and to enhance the facilitators found in the literature on the implementation of evidence-based practices (EBP) in health care settings. Overall, nurse executives perceived that the benefits of participating in the EXTRA program were both individual and organizational.

FIRST2ACT: educating nurses to identify patient deterioration - a theory-based model for best practice simulation education.

Delayed assessment and mismanagement of patient deterioration is a substantial problem for which educational preparation can have an impact. This paper describes the development of the FIRST(2)ACT simulation model based on well-established theory and contemporary empirical evidence. The model combines evidence-based elements of assessment, simulation, self-review and expert feedback, and has been tested in undergraduate nurses, student midwives and post-registration nurses. Participant evaluations indicated a high degree of satisfaction and substantial self-rated increases in knowledge, confidence and competence. This evidence-based model should be considered for both undergraduate and post-registration education programs.

The master student presenter: Peer teaching in the simulation laboratory.

The professional nurse needs to be able demonstrate the roles of teacher, manager, lifelong learner, research consumer, and provider of care. A teaching strategy that fosters the integration of these roles by the student is the Master Student Presenter (MSP) assignment, whereby students teach peers a fundamental skill in the simulation laboratory setting. The objectives of this assignment are for students to: (a) synthesize current literature to establish an evidence-based practice, (b) deliver an oral presentation, (c) demonstrate a skill to fellow students, and (d) evaluate peers on skill performance. Using the MSP assignment in the simulation laboratory contributes to the process of integrating these roles, which students build upon throughout their nursing education.

Utilizing a mock trial to demonstrate evidence-based nursing practice: a staff development process.

In a healthcare environment, programs for staff development are essential. Continuing education promotes nursing competence and enhances a commitment to the profession. In this article, the authors illustrate the experience with a recent staff development initiative, describe lessons learned, and provide recommendations for future staff development programming.

Redressing the balance in mental health nursing education: arguments for a values-based approach.

Evidence-based practice (EBP) has become a dominant epistemology in nursing education, and has devalued the complex interpersonal components of mental health nursing. A curriculum for mental health nursing, which values the personhood of service users, should focus on those processes that promote recovery within a therapeutic relationship committed to collaboration and respect for diversity. These relationships become possible where the preparation of mental health nurses for practice includes an examination of self in terms of beliefs and values and their consequences on others. The combination of action and reflection in praxis provides a means by which self-examination and professional obligation can be examined in order to construct a moral identity, which is responsive to the needs of people with mental health problems. Praxis is more than a means of reflecting on practice: it draws together skill, practice knowledge, attitudinal style, and moral reasoning. For this reason, ethical values have a vital role to play in the development of contemporary nursing praxis.

Views on evidence from nursing and midwifery opinion leaders.

National registration standards in Australia require nurses and midwives to be educationally prepared to use an evidence-based framework for their practice. These standards assume a shared professional understanding of evidence and, an agreed approach towards educational preparation for evidence implementation. In this study, a qualitative phenomenographic approach is used to explore the ways in which nursing opinion leaders understand 'evidence' within the context of evidence-based practice (EBP). Semi-structured in-depth interviews were conducted with 23 nursing and midwifery opinion leaders across the state of New South Wales, Australia. The findings suggest that views of evidence are deeply imbedded within individual clinical, contextual and professional experiences, and are highly variable. Establishing basic consensus on the meaning of evidence for the nursing and midwifery context is fundamental to the successful educational preparation of nurses and midwives for EBP. It is proposed that future evaluations of EBP education in nursing and midwifery examine the assumptions on which such programs are based as individual variation may be a significant factor in both defining and measuring the success of educational interventions for evidence implementation.

Application of evidence-based teaching in maternal and child health in remote Vietnam.

OBJECTIVE: To develop, implement, and evaluate an evidence-based multidisciplinary teaching program to improve maternal and infant health in remote Vietnam. METHODS: Needs assessments identified prevention of infection, neonatal resuscitation, and prevention of postpartum hemorrhage as primary targets. A 3-day workshop based on the small group, interactive, skills-based SCORPIO method was developed. Participants underwent formative written and performance-based assessments. Qualitative and quantitative evaluation of course content and teaching method was conducted. RESULTS: Two annual workshops were conducted for 58 health professionals, all of whom demonstrated skills acquisition to an adequate standard on completion. The workshops were rated as good or excellent overall by 100% of the participants, who reported that the content would help with their clinical work and that the teaching method was acceptable and easy to understand. CONCLUSION: We demonstrated the SCORPIO method can be adapted to teach knowledge and clinical skills in remote Vietnam. Further work is needed to demonstrate an effect on health outcomes.