Comparison of the traditional and block mode of delivery on undergraduate nursing students' perceived levels of preparedness to use evidence-based practice: a two-group experimental study.

OBJECTIVES: To examine how delivery time impacted on undergraduate nursing students' preparedness for evidence-based practice (EBP) by comparing the traditional semester mode and block mode of delivery models. METHODS: This two-group experimental study compared the traditional semester and block modes of delivery using a self-reported questionnaire. The factor of time was the variable in relation to learning with the block mode delivery being in a compressed timeframe. RESULTS: From a purposive sample, 219 students participated in the self-reported questionnaire. There were only two significant differences were the block mode of delivery students responded less positively to the statements 'the unit of study prepared them for knowledge and skills for EBP' and 'EBP should be discussed and shared in practice'. CONCLUSIONS: The transition from the traditional semester mode to the block mode delivery has had minimal impact on undergraduate nursing students' perceptions of EBP and its application to clinical practice.

Rethinking heart failure care and health technologies from early COVID-19 experiences - A narrative review.

Heart Failure (HF), a common chronic disease, requires multidisciplinary care to optimise outcomes. The COVID-19 pandemic, its impact on people's movement and access to health services, introduced severe challenges to chronic disease management. The era that will evolve after this pandemic is likely to provide uncertainty and service model disruptions. HF treatment is based on guidelines derived from randomised clinical trial evidence. Translational shortfalls from trials into practice have been overcome with post-trial service improvement studies like OPTIMIZE-HF where a team using a process of care can translate evidence to the general population. However, gaps remain for vulnerable populations e.g. those with more severe HF, with multiple comorbid conditions, and certain demographic groups and/or residents in remote locations. Health technology has come with great promise, to fill some of these gaps. The COVID-19 pandemic provides an opportunity to observe, from Australian healthcare lens, HF management outside the traditional model of care. This narrative review describes relatively recent events with health technology as a solution to improve on service gaps.

Development and first validation of a patient-reported experience measure in chronic obstructive pulmonary disease (PREM-C9).

We developed a chronic obstructive pulmonary disease (COPD) patient-reported experience measure (PREM-C9). 174 patients with COPD (86 [49%] with a confirmed diagnosis and 88 [51%] with a self-reported diagnosis of COPD) completed a 38-item list, COPD Assessment Test (CAT) and Hospital Anxiety and Depression Scale (HADS). Hierarchical and Rasch analysis produced a 9-item list (PREM-C9). It demonstrated fit to the Rasch model (χ² p=0.33) and correlated moderately with CAT (r=0.42), HAD-anxiety (r=0.30) and HAD-depression (r=0.41) (p<0.05). A substudy confirmed its ability to detect change prepulmonary and postpulmonary rehabilitation. The PREM-C9 is a simple, valid measure of experience of patients living with COPD, validated in this study population with mild to very severe disease; it may be a useful measure in research and clinical audits.

Insights on leadership from early career nurse academics: findings from a mixed methods study.

AIM: To explore the perceptions of early career nursing academics on leadership in academia. BACKGROUND: There is growing emphasis on leadership capacity building across all domains of nursing. However, there is limited evidence on leadership capacity in early career academics. This study tested an intervention to develop leadership capacity amongst early career nursing academics in two Australian universities. METHODS: A sequential mixed methods design, using online surveys and semi-structured interviews, was used to collect data. RESULTS: Twenty-three early career nursing academics participated. Most had experience of formal leadership roles and were aware of its importance to them as they developed their academic careers. Participants were able to discuss their own views of themselves as leaders; their perceptions of their own needs for leadership development, and ways in which they could seek to develop further as leaders. CONCLUSION: There is a need to provide initial and ongoing opportunities for leadership development amongst nurse academics. These opportunities should be contextualised and recognise factors such as gender, and the effects of structural oppression. IMPLICATIONS FOR NURSING MANAGEMENT: Nurse academics are involved in the preparation of the next generation of clinical leaders and it is imperative that they are able to articulate a clear view of leadership.

Self-efficacy and relevance of bioscience for nursing, midwifery and healthcare students.

AIMS AND OBJECTIVES: To examine nursing, midwifery and allied healthcare students' self-efficacy for science, perceived relevance of bioscience to their studies and expectations for academic success and the changes that occur after completing first-year introductory bioscience subjects. BACKGROUND: Bioscience is a foundation subject that underpins nursing, midwifery and other allied health courses. Bioscience subjects continue to be source of anxiety for students in those courses. Raising students' self-efficacy and perceptions of the importance and utility of bioscience to practice may be a way of ameliorating students' expectations and confidence in this subject area. DESIGN: A prospective correlational survey design. METHODS: Students were surveyed in the first semester of first year and the commencement of the second year. Students were drawn from nursing, midwifery, public health and allied health courses. The surveys contained scales for self-efficacy for science, perceived relevance of bioscience to their course and personal expectations for success in their bioscience subject. RESULTS: Ninety-seven and 82 students completed survey 1 and 2 respectively. Twenty-six surveys could be matched. Self-efficacy increased from survey 1 to survey 2, but expectations for academic success and task value, a measure for relevance, were lower. This was statistically significant for the matched pair sample. Using a mean split, students with high self-efficacy valued science more and had higher expectations for success in their bioscience courses than those with low self-efficacy. CONCLUSION: Academic success in bioscience, confidence undertaking science tasks and perceiving bioscience as relevant to their course are interwoven concepts that are important for nursing, midwifery and applied healthcare students and ultimately for their professional practice. RELEVANCE TO CLINICAL PRACTICE: Literature indicates practitioners may not feel confident in their bioscience knowledge. Assisting undergraduate students to develop confidence in and perceive the relevance of bioscience to their discipline may ultimately impact on clinical practice.

Walking alongside: a qualitative study of the experiences and perceptions of academic nurse mentors supporting early career nurse academics.

PURPOSE: This study explores the experiences and perceptions of academic nurse mentors supporting early career nurse academics (ECNAs). METHODS: Interviews were undertaken with mentors following a mentoring partnership with ECNAs. Data were transcribed verbatim and analysed using a process of thematic analysis. FINDINGS: Four themes emerged from the data, namely; motivation for mentoring; constructing the relationship; establishing safe boundaries and managing expectations. CONCLUSIONS: This study provides a unique insight into the experiences of mentoring within the context of an academic leadership programme for nurses. Such insights highlight the issues facing academics from professional disciplines and can inform strategies to support their career development. CLINICAL RELEVANCE: A sustainable academic nursing workforce is crucial to ensure that effective preparation of future generations of expert clinical nurses. Therefore, it is important to consider strategies that could strengthen the academic nursing workforce.

Safeguarding in medication administration: understanding pre-registration nursing students' survey response to patient safety and peer reporting issues.

AIM: To explore nursing students' experiences of patient safety and peer reporting using hypothetical medication administration scenarios. BACKGROUND: Pre-registration nurse training is tasked with the preparation of students able to provide safe, high quality nursing care. How students' contextualise teaching related to patient safety, risk recognition and management in the clinical setting is less clear. METHOD: A total of 321 third year students enrolled in the final semester of an adult branch pre-registration nursing programme in 2011 in a UK university were surveyed. Using free texts, the questionnaire contained hypothetical medication administration scenarios where patient safety could potentially be at risk. Students' qualitative responses were analysed using thematic analysis. FINDINGS: The response rate was 58% (n = 186). Four themes were identified from the scenarios: (1) Protecting patient safety (2) Willingness to compromise; (3) Avoiding responsibility; (4) Consequences from my actions. CONCLUSION: The findings underscore the importance of contextual teaching about risk management, practical techniques for error management and leadership for optimal patient safety in nursing curricula. IMPLICATIONS FOR NURSING MANAGEMENT: Nurse managers are role models for nursing students in the clinical setting. Nursing management must lead, by example, the patient safety agenda in the clinical setting.

Whistleblowing: An integrative literature review of data-based studies involving nurses.

UNLABELLED: Abstract Aim: To summarise and critique the research literature about whistleblowing and nurses. BACKGROUND: Whistleblowing is identified as a crucial issue in maintenance of healthcare standards and nurses are frequently involved in whistleblowing events. Despite the importance of this issue, to our knowledge an evaluation of this body of the data-based literature has not been undertaken. METHOD: An integrative literature review approach was used to summarise and critique the research literature. A comprehensive search of five databases including Medline, CINAHL, PubMed and Health Science: Nursing/Academic Edition, and Google, were searched using terms including: 'Whistleblow*,' 'nurs*.' In addition, relevant journals were examined, as well as reference lists of retrieved papers. Papers published during the years 2007-2013 were selected for inclusion. FINDINGS: Fifteen papers were identified, capturing data from nurses in seven countries. The findings in this review demonstrate a growing body of research for the nursing profession at large to engage and respond appropriately to issues involving suboptimal patient care or organisational wrongdoing. CONCLUSIONS: Nursing plays a key role in maintaining practice standards and in reporting care that is unacceptable although the repercussions to nurses who raise concerns are insupportable. Overall, whistleblowing and how it influences the individual, their family, work colleagues, nursing practice and policy overall, requires further national and international research attention.

Capturing experiences of patients living with COPD.

The prevalence and incidence of chronic obstructive pulmonary disease in the UK and worldwide is continuing to grow. Surveys are the most common method of collecting information about patients' views, health outcomes and experiences of healthcare. COPD-specific patient-reported outcome measures and quality of life measures exist but there is no COPD-specific patient-reported experience measure; this article describes the stages of developing one.

Final year nursing students' preparedness for medication administration during COVID-19: A multi-site survey study.

AIM: To examine final-year undergraduate nursing students' characteristics and their perceived preparedness for medication administration across three universities during COVID-19. BACKGROUND: Medication administration is a complex process and medication errors can cause harm to the patient. Nurses are at the frontline of medication administration; therefore, nursing students must be well-prepared to administer medicines safely before graduation. Little is known about final-year undergraduate nursing students' perceived medication administration preparedness during COVID-19. DESIGN: A multi-site study using a cross-sectional survey of student demographics, the 'Preparedness for Medication Administration' (Revised) tool and an open-ended question. METHODS: The questionnaire was distributed to nursing students in their final semester of the program in 2022 across two universities in Australia and one in New Zealand. Completed surveys n=214. Descriptive statistics were used to analyse the demographic data. Differences in demographic data and preparedness scores between the three universities were analysed using ranked means, correlation coefficient, Chi-Square, Mann- Whitney U and Kruskal- Wallace H. Directed content analysis was used to analyse the data from the open-ended question. RESULTS: Overall, students reported high preparedness scores for medication. International students reported significantly higher preparedness scores (Md =119, n=29) compared with domestic students (Md=112.00, n=164), U=1759.50, z=-2.231, p=02, r=.16. Mean ranked scores for each item were above average across the three universities. The impact of COVID-19 on curriculum and students' opportunity to practice may be one explanation for the difference in preparedness scores between universities. International participants reported significantly higher scores on the Preparedness for Medication Administration (Revised) tool than domestic participants. Older students were more confident in applying principles of pharmacology to practice. Students' comments generated three major categories and five subcategories indicating preparedness gaps. CONCLUSION: This study provides insights into students' medication management preparedness during restrictions and before transitioning to the role of Registered Nurse. It highlights the need to provide integrated and comprehensive medication education and assessments throughout the curriculum and the need for additional support for newly graduated nurses in medication management due to the restrictions.

Comparison of short and long forms of the Flinders program of chronic disease SELF-management for participants starting SGLT-2 inhibitors for congestive heart failure (SELFMAN-HF): protocol for a prospective, observational study.

Introduction: Congestive heart failure (CHF) causes significant morbidity and mortality. It is an epidemic, and costs are escalating. CHF is a chronic disease whose trajectory includes stable phases, periods of decompensation, and finally palliation. Health services and medical therapies must match the various patient needs. Chronic disease self-management (CDSM) programmes that are patient-focused, identify problems and set actionable goals that appear as a logical, cost-friendly method to navigate patient journeys. There have been challenges in standardising and implementing CHF programmes. Methods and analysis: SELFMAN-HF is a prospective, observational study to evaluate the feasibility and validity of the SCRinHF tool, a one-page self-management and readmission risk prediction tool for CHF, with an established, comprehensive CDSM tool. Eligible patients will have CHF with left ventricular ejection fraction <40% and commenced sodium glucose co-transporter-2 inhibitors (SGLT2-i) within 6 months of recruitment. The primary endpoint is the 80% concordance in readmission risk predicted by the SCRinHF tool. The study will recruit >40 patients and is expected to last 18 months. Ethics and dissemination: This study has been approved by the St Vincent's ethics committee (approval no. LRR 177/21). All participants will complete a written informed consent prior to enrolment in the study. The study results will be disseminated widely via local and international health conferences and peer-reviewed publications.

The Wider Considerations in Closing Chronic Disease Gaps - Focus on Heart Failure and Implementation.

BACKGROUND: Heart failure (HF) is predominately a chronic disease. There are overlaps in HF and chronic disease research and care. Chronic disease and HF research are conducted with multiple goals. The overarching goal is "optimized patient outcomes at maximum costeffectiveness". However, observations on patients can come with many variables; thus, we see differences in clinical translation. This document discusses an argument for three important gaps common to HF and chronic disease, i.e., screening, self-management, and patient-reported outcomes (PRO), and provides a glance of how it could fit into the evidence tree. Pertinent arguments for a framework for health services and models of care are provided as a prelude to future consensus. METHODOLOGY: 1) A preliminary literature review to identify a taxonomy for cardiovascular research, and 2) a review of the published literature describing the translation of research studies into clinical practice for cardiovascular disorders. A spectrum from observational to large randomized controlled trials to post-marketing studies were identified. DISCUSSION: A brief discussion on traditional research and differences focusing on screening, mixed methods research concepts, and chronic diseases models of care. Six steps to facilitate this: 1) Research design; 2) Research application (translation) i. routine ii. challenges; 3. Transforming research to translational level; 4. Funding and infrastructure; 5. Clinical Centres of Research Excellence (CCRE) and collaboration; 6. Governance and cost-effectiveness. CONCLUSION: Implementation research that aims to link research findings to improved patient outcomes in an efficient and effective way is a neglected area. Skills required to perform implementation research are complex. Ways to maximize translational impacts for chronic disease research to clinical practice are described in a HF context.

Defining Vulnerable Patients with Heart Failure: Opportunistic Lessons from Covid-19.

Congestive Heart Failure is a chronic disease that can be associated with poor outcomes. Some patients are more vulnerable, while others who are vulnerable appear absent or silent to health services. COVID-19 pandemic is a good opportunity to explore this important area. This review focuses on chronic disease, heart failure and those who require greater consideration.

The emotional sequelae of whistleblowing: findings from a qualitative study.

AIMS AND OBJECTIVES: To highlight and illuminate the emotional sequelae of whistleblowing from whistleblowers and subjects of whistleblowing complaints. BACKGROUND: Whistleblowing has the potential to have a negative impact on individuals' physical and emotional well-being. However, few empirical studies have been conducted using qualitative methods to provide an in-depth exploration of the emotional consequences for those involved in whistleblowing incidents. DESIGN: Qualitative narrative inquiry design. METHOD: Purposive sampling was used to recruit participants who had been involved in whistleblowing incidents. During interviews participants' accounts were digitally recorded and then transcribed verbatim. Data were then analysed by two researchers until consensus was reached. RESULTS: Findings revealed that participants' emotional health was considerably compromised as a result of the whistleblowing incident. Analysis of the data revealed the following dominant themes: 'I felt sad and depressed': overwhelming and persistent distress; 'I was having panic attacks and hyperventilating': acute anxiety; and, 'I had all this playing on my mind': nightmares, flashbacks and intrusive thoughts. CONCLUSIONS: While it has been previously acknowledged that whistleblowing has the potential to have a negative impact on all aspects of an individual's life, this study notably highlights the intensity of emotional symptoms suffered by participants as well as the extended duration of time these symptoms were apparent. RELEVANCE TO CLINICAL PRACTICE: As professionals, nurses, as well as organisations, have a responsibility to identify those who may be suffering the emotional trauma of whistleblowing and ensure they have access to appropriate resources.

Value of Web-based learning activities for nursing students who speak English as a second language.

There is an increasing need to address the educational needs of students with English as a second language. The authors assessed the value of a Web-based activity to meet the needs of students with English as a second language in a bioscience subject. Using telephone contact, we interviewed 21 Chinese students, 24 non-Chinese students with English as a second language, and 7 native English-speaking students to identify the perception of the value of the intervention. Four themes emerged from the qualitative data: (1) Language is a barrier to achievement and affects self-confidence; (2) Enhancement intervention promoted autonomous learning; (3) Focusing on the spoken word increases interaction capacity and self-confidence; (4) Assessment and examination drive receptivity and sense of importance. Targeted strategies to promote language acculturation and acquisition are valued by students. Linking language acquisition skills to assessment tasks is likely to leverage improvements in competence.

Burden versus benefit: continuing nurse academics' experiences of working with sessional teachers.

Sessional teachers are taking an increasing role in classroom teaching in Schools of Nursing. However, there is a paucity of literature reporting the experiences of, and impact on, career academics working with or alongside the burgeoning numbers of sessional teachers. Therefore, the purpose of this paper is to explore the experiences of continuing academics working with sessional teachers. This qualitative study used purposive sampling to recruit nurse academics and collect narrative data related to their experiences of working with sessional teachers. Four major themes emerged from the data, namely: They have got real credibility - perceptions of clinical currency, We've got people who are very good clinically, but don't know how to teach - lacking skills and confidence, No allegiance to the school or the students - perceived lack of commitment and accountability, and A terrible burden - workload implications for continuing academics. The development and implementation of standards for the recruitment and employment of sessional teachers would benefit both continuing academics and sessional teachers, and assist in the delivery of quality teaching and learning to nursing students.

Linguistic diversity as sociodemographic predictor of nursing program progression and completion.

Attrition from undergraduate nursing programs continues to warrant investigation particularly in the climate of nursing shortages and fiscal reflection on academic institutional programs. This three-year study used a prospective longitudinal survey design to determine entry characteristics of students, attrition, progression and completion in an undergraduate program. Students were surveyed in the first three weeks of commencing their program and gave permission for academic grades to be collected during their six session, three year Bachelor of Nursing program. Of the 740 students enrolled 48% (357 students) were surveyed and 352 students (99%) gave consent for their grades to be collected. One-third of the student cohort graduated in the expected three-year timeframe, one-third had dropped out and one-third was still completing their studies. A higher Grade Point Average and being a native English speaker were most predictive of students completing their course in the minimum expected timeframe.

The influence of socio-demographic factors on stress and coping strategies among undergraduate nursing students.

BACKGROUND: Nursing students may experience high levels of stress during academic study, which may affect their physical and mental health. Continued severe stress may lead to attrition from a program, particularly if utilised coping strategies are not appropriate or effective. In addition, some socio-demographic factors can influence an individual's perceived stress level and choice of coping strategies. AIM: To determine if socio-demographic factors have an impact on perceived stress and preferred coping strategies of students enrolled in undergraduate nursing studies. DESIGN: Descriptive correlational cross-sectional study design. METHODS: Self-report questionnaires including a demographic questionnaire, Perceived Stress Scale, and Coping Strategy Inventory were utilised. A convenience cross-sectional sample of second- and third-year undergraduate nursing students (N = 377) were surveyed. Independent samples t-test, One-way ANOVA and multiple regression analysis were used to analyse data. Voluntary consent was obtained. FINDINGS: A moderate of proportion of participants (60%) were International students. The majority (n = 270, 71.6%) of participants had moderate stress levels. Engagement coping strategies (M = 56.33, SD = 10.27) were preferred over disengagement coping strategies (M = 46.29, SD = 11.36) for managing stress. Independent associations were identified for 'gender', 'age', 'marital status', 'country of birth', 'residential status' and 'language spoken' with stress and utilisation of preferred coping strategies. CONCLUSION: This study has determined that a significant number of students currently enrolled in an undergraduate nursing course may be experiencing a moderate amount of stress. Furthermore, participants' demographic factors may have influenced perceived stress and utilisation of coping strategies. Diversity in background may be contributing to additional stress for some students, who may have migrated alone, without family and support networks. Future research may evaluate strategies to reduce stress for undergraduate nursing students. Students for whom English was second language may require specific support to enhance their educational experience.

The self-regulated learner, entry characteristics and academic performance of undergraduate nursing students transitioning to University.

BACKGROUND: Although the importance of fostering students self-regulated learning is well known, little is known about the relationship between student entry characteristics, particularly students from disadvantaged backgrounds, self-regulatory strategy use and academic performance. The study aim was to examine undergraduate nursing students' entry characteristics, motivational behaviours and learning strategies, and academic performance after transitioning into the first unit of an undergraduate nursing course. DESIGN: A cross-sectional survey. SETTING: A university in Australia. PARTICIPANTS: First-year undergraduate nursing students. METHODS: The Motivational Strategies for Learning Questionnaire, including demographic information, was distributed to students in the fourth week of commencing University, consent was obtained for the use of student unit grades. RESULTS: For the 448 eligible students, n = 282 (62.9%) completed the survey. Students were categorised by age into three groups: 18 years, 19-22 years, and 23+ years. Entry characteristics, motivation and learning strategies scores and academic performance were related to the age category with the greatest difference between 18 and 23+ student groups. 23 years+ had higher scores for 11 MSLQ scales (mean difference 0.78-0.31, p < 0.05) highest grades (F = 4.694, p = 0.010). Students 23+ years had the highest motivational behaviours and learning strategies. The international students' academic grades in this study were lower than the domestic student's grades (t = -2.212, p = 0.028). CONCLUSION: This study highlights the need to address the tensions that exist between attracting quality students, the requirement to assess their quality efficiently and allowing students from disadvantaged groups the opportunity to enter nursing undergraduate degree courses. This study contributes new knowledge to the impact students' entry characteristics have on motivational behaviours, learning strategy use and academic performance. Knowing this would allow faculty to identify students at risk of failure early in the course and offer instructional support.

A comparative study of assessment grading and nursing students' perceptions of quality in sessional and tenured teachers.

PURPOSE: Although the global nursing faculty shortage has led to increasing reliance upon sessional staff, limited research has explored the impact of these sessional staff on the quality of teaching in higher education. We aim to examine differences in (a) student satisfaction with sessional and tenured staff and (b) assessment scores awarded by sessional and tenured staff in students' written assignments. DESIGN: A comparative study method was used. Participants were recruited from students enrolled in the three nursing practice subjects across the 3 years of the baccalaureate program in an Australian university during the second semester of 2008. METHODS: This study collected student data via an online version of the Perceptions of Teaching and Course Satisfaction scale and compared the grades awarded by sessional and tenured academics for a written assessment in a single assignment in each of the nursing practice subjects. Of the 2,045 students enrolled in the nursing practice subjects across the 3 years of the bachelor of nursing (BN) program, 566 (28%) completed the online teaching and course satisfaction survey, and 1,972 assignment grades (96%) were available for analysis. FINDINGS: Compared with tenured academics, sessional teachers received higher rating on students' perception on teaching satisfaction by students in Year 1 (p= .021) and Year 2 (p= .002), but not by students in Year 3 (p= .348). Following the same trend, sessional teachers awarded higher assignment grades to students in Year 1 (p < .001) and Year 2 (p < .001) than tenured academics, with no significant disparity in grades awarded to students in Year 3. CONCLUSIONS: The higher grades awarded by sessional teachers to 1st- and 2nd-year students could be one explanation for why these teachers received higher student ratings than tenured teachers. Not discounting the possibility of grade inflation by sessional staff, it could be that tenured teachers have a higher expectation for the quality of students' work, and hence were more stringent in their assessment grading. Sessional teachers did not receive a higher rating from 3rd-year students, and this could be attributed to a change in student perception as they progress through the course, valuing a broader and more professional aspect of nursing knowledge, which is more likely to be the strength of tenured staff. CLINICAL RELEVANCE: These findings highlight a need for the development and implementation of strategies to facilitate the inclusion of sessional staff teaching in a BN program, in order to prepare graduate nurses that are well-equipped for clinical practice.