Exploring Faculty Perceptions about Simulation Training: Influence on Career, Confidence, Knowledge and Skill Acquisition and Competence.

Even with insufficient evidence in the literature regarding the impact of faculty development with simulation education, faculty development is critical to building a successful simulation program. Despite simulation being ubiquitous in nursing education across the United States (US), there is little investigation of the impact of the education and training on job satisfaction, skill development and overall confidence when using simulation to teach nursing students. The purpose of this qualitative study was to investigate how has simulation education and training has influenced faculty career fulfillment, acquisition of knowledge, overall self-confidence and competence? Themes that emerged included the following: competency, professional role change, role acquisition, course learner needs, course impact, skill development, and overall ability and confidence. The study results confirmed that a gap exists where faculty without formal education may not be aware of their lack of competence and what training they need to be effective in facilitating clinical simulation.

Development of an RN Champion Model to Improve the Outcomes of Ventilator-Associated Pneumonia Patients in the Intensive Care Unit.

Healthcare-associated infections are costly. Methods to prevent infections must be effective and provide a return on investment to be sustainable. A funded project supported the design and implementation of a unique quality and safety model, using unit-based quality and safety RN champions. The goal was to create and sustain a hospital-wide safety culture focused on preventing ventilator-associated pneumonia (VAP) by adopting the Institute for Healthcare Improvement's VAP bundle. The program began with a pilot in 7 ICUs. Using the RN champion model resulted in the reduction of the incidence of VAP, cost avoidance, and decreased length of stay. Six years later, each adult ICU reached "zero zone."

Virtual simulated patient encounters: Bridging the gap in maternal mental health training for prelicensure nursing students.

Postpartum mood disorders (PPMDs) can result in significant negative impacts for the mother, baby, and family. Nurses can be trained to effectively screen for and educate patients about PPMDs. However, available data suggest that clinical opportunities for practicing these important conversations in real-time can be limited. Focused practice discussing PPMDs with patients may improve a nurse's confidence to conduct screenings and help reduce stigma regarding PPMDs. When in-person clinical learning opportunities are limited, simulated patient encounters can serve as useful and accessible alternatives. Though traditional simulations are often conducted in-person with an actor, they can also be offered to students via a virtual platform. This article describes the creation of two virtual simulated patient encounters (vSPEs) designed to improve prelicensure nursing students' confidence in screening and caring for patients at risk for PPMDs. These vSPEs were implemented during the COVID-19 pandemic to fulfill required labor and birth/postpartum clinical rotation hours. A thorough description of the vSPE design and implementation is provided to encourage nursing and other health professions educators to explore a virtual approach to training students to screen and care for postpartum patients with suspected PPMDs.

Nursing department orientation: are we missing the mark?

Hospitals routinely provide orientation for the new nurses they hire. The evolution of nursing practice is not reflected in the current teaching methods of nursing orientation. The authors examine the past 60 years of nursing department orientation and assert the need to move toward more effective and innovative teaching strategies.

Incidence of uterine tachysystole in women induced with oxytocin.

OBJECTIVE: To determine the incidence of uterine tachysystole (UT) using nomenclature defined by the American College of Obstetricians and Gynecologists (ACOG) and Association of Women's Health, Obstetric and Neonatal Nurses (AWHONN). DESIGN: Cohort study using retrospective chart reviews and concomitant independent analyses of fetal monitor strips. SETTING: A 10-bed labor and delivery unit in a community hospital with an average of 400 deliveries monthly. PARTICIPANTS: Of 346 total deliveries in October 2009, 55 patients qualified for this study. Inclusion criteria were women with a singleton, viable fetus in vertex presentation and who received oxytocin infusion for induction of labor. METHODS: We analyzed 798.5 hours of fetal monitor strips in 30-minute increments according to each of four UT criteria. We collected data on the dose of oxytocin, the National Institute of Child Health and Human Development (NICHD) fetal heart rate categories, maternal age, parity, pregnancy risk factors, indication for induction, mode of delivery, birth weight, and Apgar scores. RESULTS: We identified 661 incidences of UT out of 1,597 increments with an overall UT rate of 41%. Fifty-four of 55 patients (98%) demonstrated one or more occurrences of UT. Interrater reliability achieved an 86.3% correlation (718 vs. 698 occurrences). CONCLUSIONS: Results of this study highlight the need for careful titration of oxytocin and prompt management of UT. This increased awareness can enhance the health, safety, and well-being of pregnant women and their fetuses.

The evolution of a statewide network: the Bay Area Simulation Collaborative.

The Bay Area Simulation Collaborative (BASC), established in 2007, is a group of more than 100 schools of nursing and hospitals, totaling more than 600 faculty and hospital educators, from both service and academia in the ten counties that comprise the San Francisco Bay Area. The California Institute for Nursing & Health Care leads the BASC, which was funded through a grant from the Gordon and Betty Moore Foundation. This 3-year project was designed to train and educate nursing faculty and hospital educators in the concepts of simulation. It was also designed to develop clinical simulation scenarios for use within the BASC. Finally, the project implemented a research and evaluation agenda to demonstrate that simulation makes a positive difference in the critical thinking skills of nursing students. This article will describe the evolution, purpose, and goals of the BASC and how the initial investment has been leveraged to create addition regional collaboratives in the state and ultimately, the California Simulation Alliance.

Cholestasis of pregnancy: a review of the evidence.

Intrahepatic cholestasis of pregnancy is a rare disorder, predominately occurring during the third trimester of pregnancy and characterized by pruritus, jaundice, and biochemical disturbances in liver enzymes. While intrahepatic cholestasis of pregnancy poses little maternal risk, there is significant risk to the fetus such as preterm delivery, non-reassuring fetal status, meconium staining, and perinatal mortality. Current evidence proposes susceptibility to derangements in the sulfation of steroid compounds, affecting the metabolism of progesterone and bile acids in the fetal/placental compartment. Treatment with ursodeoxycholic acid is suggested, coupled with close maternal-fetal surveillance and delivery as close to term as possible.