Epistemic discourses concerning the competence developed in a norwegian master's degree program in health science.

It has been claimed that various discourses related to competence influence higher education, but there is limited understanding of the discourses underlying competence development. The specific aim of this study was to explore epistemic discourses concerning the development of competence of health professionals with a master's degree in health science. Accordingly, the study was qualitative and adopted discourse analysis. Twelve participants, all of whom were Norwegian health professionals aged between 29 and 49 years, participated in this study. Four participants were in the final stage of study for their master's degree with three months left before completion, four had completed their degree two weeks before their participation, and four had been working for one year after the completion of their degree. Data were collected in three group interviews. Three epistemic discourses were revealed: (1) a critical thinking competencies discourse, (2) a scientific thinking competencies discourse, and (3) a competence-in-use discourse. The former two discourses were considered the dominant discourses and indicated that a knowing "that" discourse connected the specialized competence of different health professionals with a wider field of competence. This wider field transcended the boundaries of various health disciplines and represented a novel competence developed through a synergizing process between critical and scientific thinking competencies, which seems to drive continued competence development. A competence-in-use discourse was formed in the process. This discourse can be viewed as a unique outcome that contributes to health professionals' specialized competence and suggests that a knowing "how" discourse was also an underlying background discourse.

An Effective Academic Medical Center-Based Strategy to Enhance Diversity Among Nurse Researchers.

The Connell-Jones Endowed Chair Diversity Nursing Research Scholars Program was created to promote engagement in nursing research and scholarship among nurses of color. Preliminary evaluation suggests that the program was widely beneficial, resulting in enrollment in doctoral education for some. Establishing opportunities that promote exposure and participation in nursing research and scholarship among nurses of color helps cultivate cohorts of diverse nurses armed to address health disparities through the advancement of nursing knowledge.

Why Pursue a Doctorate? Findings From a Study of Doctorally Prepared RNs in an Integrated Healthcare System.

OBJECTIVE: The aim of this study was to examine the motivations and perceptions of RNs with completed doctorates in an integrated healthcare system. BACKGROUND: Historically, PhD preparation was the primary doctorate available for nurses, preparing them to conduct research and hold leadership positions. The recent growth of Doctor of Nursing Practice (DNP) programs that focus on either advanced clinical practice or executive competencies has significant implications for the future of nursing in practice settings. METHODS: A 30-item survey was sent to all 93 RNs at a healthcare system who have completed doctorates. RESULTS: A response rate of 71% found DNPs outnumber PhDs 3 to 1. PhDs are significantly more likely to perceive concrete benefits associated with their degrees, and DNPs are more likely to report that their degrees have not made a difference in their jobs. CONCLUSIONS: Leaders in practice and education must collaborate to ensure that both DNPs and PhDs are engaged in positions that use their highest level of competence in any setting.

Being a nurse between research and clinic: What challenges and opportunities for a PhD-prepared nurse? Overview from an Italian paediatric hospital.

AIM: To report a reflection on the role, challenges and opportunities for nurses with advanced education in research outside the academic field. DESIGN: A discursive paper. DATA SOURCES: We reported the case of an Italian paediatric research hospital where PhD-prepared nurses started to apply their knowledge and competencies in different fields, both in clinical and organizational settings. From this experience, an overview of the possible barriers and challenges that PhD-prepared nurses may face up within the hospital setting. DISCUSSION: The application of PhD-prepared nurses in hospital settings could be an opportunity to advance high standards of quality of care in managerial and clinical areas and to create networks between highly specialized professional figures and different clinical-care realities. CONCLUSION: More research is needed to explore how to apply the advanced competencies of PhD-prepared nurses within healthcare organizations to provide high-quality and safe care and services. This paper can provide insights for a reflection on applying and developing PhD-prepared nurses' skills and competencies within the hospital setting in clinical, research and managerial areas. This can enhance the effective application of highly competent nursing professional figures. PATIENT OR PUBLIC CONTRIBUTION: No Patient or Public Contribution, due to study design.

Analysis of education and previous nursing experience of certified PNPs in the United States.

BACKGROUND: Educational programs to prepare nurse practitioners (NPs) were historically built upon foundational nursing experience. Originally prepared as certificate programs in 1965, the educational requirements for nurse practitioners (NPs) rapidly shifted from certificate programs to the Master's degree (DellaBella, 2015; Fairman, 2008). As Doctor of Nursing Practice (DNP) degree programs increase in number, it is unknown whether this foundational nursing experience has changed, or if it differs by certification type for pediatric nurse practitioners (PNPs). This study aimed to evaluate the educational preparation and prior nursing experience of primary care and acute care certified PNPs. METHODS: A national survey of members of the Pediatric Nurse Practitioner Certification Board (N = 17,530) was completed (Mudd et al., 2022). A sub-analysis of this data was conducted (n = 1974). RESULTS: There was no statistical evidence among either primary or acute care PNPs of an association between previous nursing experience and type of degree preparation (Master's or DNP). There was only a weak association between educational preparation and experience among acute care nurse practitioners. Most respondents were prepared at the Master's level, and 85% of all respondents had >1 year of nursing experience prior to returning for additional PNP education. DISCUSSION: This study adds to the literature as it describes the educational preparation and foundational nursing experience of primary and acute care PNPs. It can serve as a benchmark as the move to the DNP continues for Advanced Practice Registered Nurse preparation.

Factors Influencing Medication Administration Outcomes Among New Graduate Nurses Using Bar Code-Assisted Medication Administration.

Paramount to patient safety is the ability for nurses to make clinical decisions free from human error. Yet, the dynamic clinical environment in which nurses work is characterized by uncertainty, urgency, and high consequence, necessitating that nurses make quick and critical decisions. The aim of this study was to examine the influence of human and environmental factors on the decision to administer among new graduate nurses in response to alert generation during bar code-assisted medication administration. The design for this study was a descriptive, longitudinal, observational cohort design using EHR audit log and administrative data. The study was set at a large, urban medical center in the United States and included 132 new graduate nurses who worked on adult, inpatient units. Research variables included human and environmental factors. Data analysis included descriptive and inferential analyses. This study found that participants continued with administration of a medication in 90.75% of alert encounters. When considering the response to an alert, residency cohort, alert category, and previous exposure variables were associated with the decision to proceed with administration. It is important to continue to study factors that influence nurses' decision-making, particularly during the process of medication administration, to improve patient safety and outcomes.

Describing Medication Administration and Alert Patterns Experienced by New Graduate Nurses During the First Year of Practice.

The aim of this study was to describe medication administration and alert patterns among a cohort of new graduate nurses over the first year of practice. Medical errors related to clinical decision-making, including medication administration errors, may occur more frequently among new graduate nurses. To better understand nursing workflow and documentation workload in today's clinical environment, it is important to understand patterns of medication administration and alert generation during barcode-assisted medication administration. Study objectives were addressed through a descriptive, longitudinal, observational cohort design using secondary data analysis. Set in a large, urban medical center in the United States, the study sample included 132 new graduate nurses who worked on adult, inpatient units and administered medication using barcode-assisted medication administration. Data were collected through electronic health record and administration sources. New graduate nurses in the sample experienced a total of 587 879 alert and medication administration encounters, administering 772 unique medications to 17 388 unique patients. Nurses experienced an average medication workload of 28.09 medications per shift, 3.98% of which were associated with alerts, over their first year of practice. In addition to high volume of medication administration, new graduate nurses administer many different types of medications and are exposed to numerous alerts while using barcode-assisted medication administration.

The NLN/Jonas Ten-Year Story: Perceptions of Nurse Educator Scholars.

ABSTRACT: The aim of the NLN/Jonas Scholars Program is to support doctoral nursing students whose program of research focuses on research in nursing education. As a 10-year review, 23 nursing students pursuing a doctorate participated in focus groups with the goal of describing the influence of a year-long mentoring program on their career trajectory. Analysis of the data revealed two themes: having someone believe in me and my research topic and being mentored and learning to mentor others. The findings support that being skilled in conducting pedagogical research with mentorship advances nursing education practice, scholarship, and leadership.

DNP-Authored Articles in Peer-Reviewed Journals 2011-2021.

BACKGROUND: With an increasing number of doctor of nursing practice (DNP) graduates, the volume of peer-reviewed journal publications among DNP-prepared nurses is rising. PURPOSE: The primary aim of this study was to quantify, analyze, and categorize DNP-authored peer-reviewed journal publications. METHODS: A descriptive research design was used to analyze DNP-authored peer-reviewed journal publications in the WorldCat, EBSCO Discovery Service, and PubMed databases from 2011 through 2021. RESULTS: The 3839 journal publications included at least one DNP-prepared nurse author. There were 2495 (65%) publications with a DNP first author, 921 (24%) with a DNP solo author, and 2918 (76%) included publication collaboration. The majority of publications were practice- (40%), nursing- (17%), and education-focused (15%). Science translation in evidence-based practice and quality improvement publications accounted for 24%. CONCLUSIONS: This study demonstrates the proliferation of DNP-authored peer-reviewed journal publications, which may indicate an increase in the number of nursing care quality initiatives occurring in the clinical setting.

Assessment of nursing faculty retirement projections.

BACKGROUND: Nursing faculty retirement is a critical factor contributing to the nursing faculty shortage. PURPOSE: To assess the accuracy of projections on 2016 to 2025 nursing faculty retirements made in a previous study by Fang and Kesten (2017). METHODS: The 2016 to 2022 full-time nursing faculty data collected by American Association of Colleges of Nursing were used to examine the accuracy of the retirement projections for the same years. DISCUSSION: The study found that the mean age of full-time nursing faculty decreased for the first time; the number of faculty retirees and their age distributions projected by Fang and Kesten (2017) were accurate; there was a larger loss of nursing faculty at senior ranks to retirements than was anticipated; nursing faculty aged 50 to 59 in 2015 have made significant progress in doctoral attainment, senior rank, and graduate-level teaching by 2022, but they were still underrepresented in senior ranks compared to the 2016 to 2022 retirees; and for nursing faculty with a PhD degree, their growth was slower than their loss to retirements. CONCLUSION: The findings demonstrate the usefulness of the specific methods for faculty retirement projections. The decline in the mean age of nursing faculty is a positive sign that there is an increased recruitment of younger nurses into academia. The increase in the number of younger nurses entering academia with Doctor of Nursing Practice (DNP)-degree preparation can be leveraged through PhD-DNP collaboration to prepare practice-ready nursing graduates who contribute to health care improvements. Nursing schools need to implement innovative strategies to mentor younger faculty for their successful succession.

Improved professional competencies and leadership in PhD-prepared nurses and doctoral students after participating in the cross-national and web-based Nurse-Lead program.

BACKGROUND: Doctor of Philosophy (PhD)-prepared nurses are expected to exercise leadership in their various roles. Therefore, European nurse scholars developed a cross-national web-based Nursing Leadership and Mentoring Educational (Nurse-Lead) program. PURPOSE: To evaluate changes in leadership practices, professional and research competencies as well as career development of PhD-prepared nurses and doctoral nursing students after participation in the Nurse-Lead program. METHODS: A pre-post-test evaluation was conducted. Surveys addressed leadership, professional and research competencies, and career development. Quantitative data were analyzed with descriptive statistics and paired sample t-tests. Content analysis was used for qualitative data. DISCUSSION: The 30 participants showed significant improvements in all leadership practices, professional competencies, and most research competencies. Participants reported increased confidence in decision-making, taking on new responsibilities, and becoming more visible within research teams. CONCLUSION: Web-based, international leadership and mentoring programs are promising tools for the leadership and professional development of PhD-prepared nurses and doctoral nursing students.

Incorporating a Psychiatric Telehealth Simulation in a Family Nurse Practitioner Curriculum.

The prevalence of mental health disorders in primary care is high and challenges related to the COVID pandemic warrant further training of the family nurse practitioner. A telehealth simulation learning experience that included common primary care diagnoses in mental health-general anxiety, depression, and substance use disorder-was incorporated into a non-clinical behavioral health course. Formative evaluation provided by licensed nurse practitioners confirmed the need for improving interviewing techniques, engaging clients, and promoting safety among this population. Students' confidence during the encounter was measured using the Simulation Effectiveness Tool. Findings suggest a simulation learning experience is an effective resource for training nurse practitioner students to treat mental health disorders.

Consumers' Experiences of Comprehensive-Prepared Graduate Nurses and Their Nursing Care in Acute Mental Health Settings.

Pre-registration nursing education has long moved away from preparing nurses with mental health specialisation to nurses with comprehensive knowledge and skills. However, the consumers' experiences of comprehensive-prepared nurses and their nursing care has not been widely explored. This paper reports on a study with consumers to explore their experiences with comprehensive-prepared graduate nurses and the nursing care that they provide in acute mental health settings. An exploratory qualitative study using semi-structured interviews was chosen as the research method. Purposeful sampling recruited 12 consumers and data saturation was achieved. Braun and Clarke's method of thematic analysis was used to analyse the collected data and three themes emerged. The themes are: (i) You got what it takes to be a mental health nurse, (ii) Slow down and spend quality time with us, and (iii) Read in between the lines when we share our negative lived experiences. The findings are useful for identifying strategies to develop evidence-based nursing education for comprehensive-prepared graduate nurses to improve the consumers' experiences of their nursing care.

Improving New Graduate Nurse Retention With a Transition to Emergency Nursing Practice Program.

INTRODUCTION: Emergency department turnover rates increased at Sentara Northern Virginia Medical Center. Most applicants were new graduate registered nurses. A strength, weakness, opportunity, threat analysis revealed 3 weaknesses regarding new graduate registered nurses in emergency departments. Transition to practice program was necessary, new graduate registered nurse competency needed to progress rapidly, and retention rates needed improvement. METHODS: The emergency department registered nurse transition to practice pathway was created to address these challenges. Retention statistics were garnered through new graduate registered nurses length of employment. Improving retention rates at Sentara Northern Virginia Medical Center led to expansion of the program to the other 11 hospitals in the system. Self-report surveys were created later to evaluate the new graduate registered nursess' satisfaction with the program and perception of clinical confidence. RESULTS: Using the emergency department registered nurse transition to practice pathway, turnover rates at Sentara Northern Virginia Medical Center dropped from 46% to 5.1%. Post expansion, the overall program retention rates were 96% at 6 months, and 86% at 1 year. The 2-year retention rate prior to COVID-19 was 82%, afterward, it dropped to 65%. Most surveyed new graduate registered nurses had a confidence level of 25% or less on the first day. After their 17-week orientation, 54% reported confidence levels had risen to 75%. Within 6 months, 81% reported 75% confidence, at 1 year, 87% reported levels between 75% and 100%, and at 2 years, 100% reported a confidence level between 75% and 100%. DISCUSSION: This development of the emergency department registered nurse transition to practice pathway resulted in improved emergency department registered nurse retention and confidence. Savings from reduced turnover and reduced temporary labor staffing were achieved with this program. Implementation takes careful resource management, ongoing analysis, and research to validate return on investment.

Postgraduate Developments Among Perianesthesia-Trained Nursing Graduates in Japan: A Cross-Sectional Survey.

PURPOSE: To elucidate the postgraduation situation of those who have completed a perianesthesia nurse (PAN) educational course offered in master's degree programs in Japan. DESIGN: This cross-sectional study used an anonymous self-administered questionnaire. METHODS: Of the 42 individuals who completed a PAN educational course offered in master's degree programs in Japan by March 2021, 41 were targeted, excluding the author of this study. The questionnaire was distributed by mail between November 20, 2021, and January 14, 2022, and the participants were asked to return the completed questionnaire by mail. Those working as PANs were asked about their work content, work satisfaction, and thoughts on their prospects in the perianesthesia nursing field. Those not working as a PAN were asked about their future intentions to do so. FINDINGS: The response rate was 95.1% (39/41). PANs are involved in various perianesthesia tasks, and there were no respondents who answered "No" to the question of whether they were glad to have become a PAN. However, of those working as PANs, only 16 (53.3%) indicated that they would like to continue working in that role. Few respondents (n = 3; 10.0%) considered future PAN prospects to be "good," while eight (26.7%) respondents answered "poor," and many (n = 19; 63.3%) stated "neither." CONCLUSIONS: Under the current situation, PANs in Japan do not necessarily have a positive outlook for the future, the causes for which must be analyzed to make the necessary improvements.

National evaluation of DNP students' use of the PICOT method for formulating clinical questions.

BACKGROUND: The intent of the PICOT (i.e., Population, Intervention, Comparison, Outcome, Time) method is to formulate focused clinical questions to facilitate the discovery of relevant evidence through systematic searching, with the components of the question serving as the foundation for the search. Doctor of Nursing Practice (DNP) graduates use evidence-based practices to institute changes in their organizations' systems and policies, thereby yielding positive effects on both patient and system outcomes. Given that the clinical question is the foundation of the evidence-based practice process, DNP graduates' competence in the PICOT method needs to be better understood. AIMS: This analysis aimed to describe how DNP students used the PICOT method to ask clinical questions in their DNP projects. METHODS: Project questions were retrieved from a subset (n = 129, 60.56%) of an existing national random sample of publicly available DNP projects spanning the years 2010 to 2021 from Commission on Collegiate Nursing Education-accredited schools (n = 213). Project questions using the PICOT method were further evaluated with a scoring system of 0 = no and 1 = yes for missing elements, formatting, directional outcome, and project purpose. Possible scores ranged from 0 to 8, with higher scores indicating more errors. Discussion among five researchers, until agreement was achieved, yielded consensus. RESULTS: Although the PICOT method was project author-identified in 66 (31.0%) projects, only four (6%) followed the PICOT method. All 66 (100%) were intervention questions. There were 2.74 (SD 1.55) mean errors, ranging from 0 to 6. No questions were missing P or O. Specific errors included missing I 3 (4.5%) or missing C 37 (56%), poor formatting 34 (51.5%), directional outcome 44 (66.7%), and project purpose 38 (57.6%). Thirty-three (50%) of the questions were missing T; however, T is not used for searching, so researchers recalculated the mean error without T (M = 2.24, SD = 1.28, range 0-5). LINKING EVIDENCE TO ACTION: Gaps in the accurate use of the PICOT method to construct clinical questions can lead to biased searches, inaccurate clinical problem identification, and, when used as the project purpose, jumping to non-evidence-based solutions. Academic faculty and clinical educators can mitigate these skewed outcomes and enhance their impact on quality outcomes by helping DNP-prepared nurses shore up this foundational skill.

The effects of using a flipped classroom pedagogy in nursing anesthesia education: a program evaluation.

BACKGROUND: The flipped classroom (FC) pedagogy improves undergraduate student proficiency and satisfaction. However, its effectiveness has not been demonstrated in nursing anesthesia education. OBJECTIVES: Pre- and post-FC tests and course evaluations were retrospectively compared to determine if FC was an effective pedagogy for a nursing anesthesia program (NAP). METHODS: The design of the study was a retrospective program evaluation. Two groups were compared with 59 students in the pre-FC group taught via traditional lecture and 61 students in the post-FC group taught with FC. Answers to the same 167 test questions were compared using an independent t-test and five course evaluation questions were statistically compared using NPAR1WAY procedure with the Wilcoxon option to determine if significant differences existed between the two nursing anesthesia student cohorts. RESULTS: The post-FC students exhibited a significant 4 % increase in test scores and expressed increased satisfaction compared to their pre-FC counterparts. CONCLUSIONS: This retrospective program evaluation showed that student proficiency and satisfaction improved between the groups after changing to the FC pedagogy. However, research is needed to determine the true value of using FC in nursing anesthesia education. IMPLICATIONS FOR AN INTERNATIONAL AUDIENCE: The flipped classroom model can be beneficial in graduate nursing education with our ever-changing student population.

[Nursing skill levels and implementation of Advanced Nursing Practice in Austria: A cross-sectional study]. / Pflegerische Qualifikationsniveaus und Umsetzung von Aufgaben für eine Advanced Nursing Practice in Österreich.

Nursing skill levels and implementation of Advanced Nursing Practice in Austria: A cross-sectional study Abstract: Background: New fields of practice are emerging under the concept of "Advanced Nursing Practice" (ANP) that offer specialised care provided by nurses who hold master's degrees. In Austria, nurses are currently being trained as Advanced Practice Nurses (APN). Aim: The project aimed to investigate which advanced nursing practice tasks according to the Hamric model are undertaken by nurses at different levels of qualification in Austria. Methods: Certified nurses did participate in a cross-sectional survey through an online questionnaire based on the Role Delineation Model and tailored to the Austrian context. The tasks were assigned based on the Hamric model and were tested and evaluated descriptively according to the qualification level through factor analysis. Results: Completed data was available from 105 participants, among them 80% with undergraduate education, 20% with a master's degree. A tendency in the results showed that the level of qualification was related to the activities carried out. The higher the academic degree, the more activities were performed in the field of leadership. The central ANP-competencies, research and education, are rather weak among all respondents. Conclusion: The results show that activities corresponding to the competencies of an ANP are performed by a heterogeneous group of nurses. Conditions and a standardized understanding of ANP need to be established in order to offer a professional practice that matches the competency profile.

Simulation-based learning in palliative care in postgraduate nursing education: a scoping review.

BACKGROUND: Nurses require advanced competence in palliative care, but they face wide variations in education and a shortage in opportunities for clinical placement. Simulation-based learning (SBL) can enable students to develop clinical skills, critical thinking and confidence. No scoping reviews to date have mapped the use of SBL in palliative care within postgraduate nursing education. METHODS: The aim of this scoping review was to systematically map published studies on the use of SBL in palliative care in postgraduate nursing education. A scoping review was conducted using Arksey and O'Malley's (Int J Soc Res Meth 8(1):19-32, 2005) methodological framework. A systematic and comprehensive search of the Cumulative Index to Nursing and Allied Health Literature (CINAHL), the Education Resources Information Center (ERIC), Ovid MEDLINE, Ovid EMBASE, Allied and Complementary Medicine and PsycINFO was performed for studies published between January 2000 and April 2022. Two authors independently assessed papers for inclusion and extracted data. Reporting followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) checklist. The protocol was registered on the Open Science Framework. RESULTS: This review includes 10 studies. Three thematic groupings were identified: enhanced understanding of the importance of teamwork, interdisciplinarity and interpersonal skills; preparedness and confidence in one's ability to communicate during emotionally challenging situations; and impact and relevance to one's own clinical practice. CONCLUSIONS: The use of SBL in palliative care in postgraduate nursing education seems to enhance students' understanding of the importance of teamwork and interdisciplinarity. The review shows contradictory results regarding whether SBL in palliative care increases students' confidence in their communication skills. Postgraduate nursing students experienced personal growth after participating in SBL. Because our findings indicate that limited research has been conducted within this field, future research should (1) explore postgraduate nursing students' experiences with SBL in palliative care with a focus on more practical content such as symptom management, (2) examine the relevance and application of SBL in clinical practice, and (3) be reported in line with recommendations on the reporting of simulation research.

The Impact of DNP Scholarly Projects on Healthcare Organizations: A Road Map for Success.

Many DNP scholarly projects occur in healthcare organizations, often taking various forms based on specific academic requirements. Projects require site mentorship, project facilitation, and institutional review board resources. This article highlights the impact of DNP scholarly projects on healthcare organizations and provides a road map for success for healthcare leaders and site mentors.