Strengthening new graduate nurse residency programs in critical care: recommendations from nurse residents and organizational stakeholders.

BACKGROUND: Thirty-four new graduate nurses participated in a critical care nurse residency program in preparation for opening a new intensive care unit. At the end of the program, multi-constituent focus groups were held to assess program effectiveness. METHOD: Participants included 34 new graduate nurses, 18 preceptors and staff nurse partners, five clinical nurse specialists, and five nurse directors. Twelve focus groups were held; groups included four to eight nurses from the same role group. Two independent reviewers analyzed recordings and transcripts of focus group content to identify themes. RESULTS: Five themes were identified: program design, developing nursing expertise, program impact on the unit, future expectations, and communication. Comments were used to guide program improvements and offer new insights for residency programs in acute and critical care. CONCLUSION: Obtaining structured input from multiple program stakeholders is beneficial in evaluating a program's impact and identifying areas for improvement.

Incorporating scenario-based simulation into a hospital nursing education program.

Nurse educators are challenged to provide meaningful and effective learning opportunities for both new and experienced nurses. Simulation as a teaching and learning methodology is being embraced by nursing in academic and practice settings to provide innovative educational experiences to assess and develop clinical competency, promote teamwork, and improve care processes. This article provides an overview of the historical basis for using simulation in education, simulation methodologies, and perceived advantages and disadvantages. It also provides a description of the integration of scenario-based programs using a full-scale patient simulator into nursing education programming at a large academic medical center.

Health care providers' attitudes regarding family presence during resuscitation of adults: an integrated review of the literature.

PURPOSE: Family presence (FP) during resuscitation is a controversial practice that leads to disagreement among health care professionals. A systematic review of the literature was performed to answer the question: What are the attitudes of health care providers regarding family presence during resuscitation of adults? METHODS: MEDLINE, PubMed, and CINAHL databases were searched using the following terms: family, family presence, family witnessed, cardiopulmonary resuscitation, nurses, personnel, patient, attitudes, attitude of health personnel, and ethics. Criteria for inclusion consisted of research studies addressing health care providers' attitudes toward family presence during adult resuscitation conducted in the United States that were published between 1998 and 2008. RESULTS: The literature search produced 480 titles. Thirteen full-text articles met criteria for inclusion in the evidence tables. Findings of this integrated literature indicate that: between and within discipline differences in attitudes, perceived burden on staff, perceived effects on family, lack of medical knowledge of family, and existence of a hospital policy influence provider attitudes toward FP. CONCLUSIONS AND IMPLICATIONS: More research is needed to determine if FP is evidence based; however, there is sufficient evidence to consider implementing FP. There is wide variation in support for FP among health care professionals, although nurses generally are more favorable. If an institution elects to implement an FP policy or evidence-based practice guideline, it must carefully consider the many provider, patient, family, and system-level factors that can hinder or promote the success of this initiative.