Nurses' perceptions of nursing education transformation and its impact on care delivery in Singapore.

AIMS: To explore nurses' perceptions of the transformation in Singapore's nursing education and its impact on the delivery of nursing care. BACKGROUND: Nursing education in Singapore has sailed through a sea of changes, from the apprenticeship model of training in hospitals to institutions of higher learning. Limited primary studies have explored the evolution of nursing education, and none have explored its impact on the delivery of nursing care, based on nurses' perceptions. METHODS: A descriptive qualitative design with purposive and snowball sampling was used to recruit 18 experienced nurses from local teaching institutions and healthcare clusters. Semistructured individual face-to-face interviews were conducted using an interview guide. Data were analysed using thematic analysis. The Consolidated Criteria for Reporting Qualitative Research reporting guideline was used to report the study. FINDINGS: Five themes emerged: 'evolution of the nursing education approach', 'clinical learning environments', 'evaluation of changes in the nursing education approach', 'attitudes toward the provision of various levels of education' and 'influences of various competencies on the delivery of nursing care'. CONCLUSION: Changes in teaching pedagogies, learning, assessment, curriculum structure, content and clinical learning environment were commonly reported, which provided insights into understanding nursing education transformation and its impact on nursing practice. IMPLICATIONS FOR NURSING EDUCATION: The findings could better prepare nurses for the demanding needs of the contemporary healthcare landscape. Nurse educators and leaders should evaluate gaps in nursing education and implement strategies to improve students' learning experiences and outcomes. IMPLICATIONS FOR NURSING POLICY: Policy-makers can draw on our findings to revise the core competencies guidelines and improve future training by supporting the healthcare needs of society.

Patient education interventions for haemodialysis and peritoneal dialysis catheter care: An integrative review.

Background: Inadequate training on how to care for haemodialysis and peritoneal dialysis catheters can lead to mechanical issues with the catheters and infectious complications (such as peritonitis) that could endanger patient safety, reduce the effectiveness of the dialysis treatment, and have a negative impact on patient morbidity and mortality. Such incidents can be prevented as they are mostly dependant on controllable factors - proper dialysis catheter care, which can be addressed through effective patient education. Effective patient education is crucial in ensuring that patients are equipped with the knowledge and skills necessary for both peritoneal and haemodialysis catheter care. Aims: To synthesise evidence on the: (1) patient educational interventions on haemodialysis and peritoneal dialysis catheter care; and (2) reported learning and clinical outcomes of the educational interventions provided for patients with haemodialysis and peritoneal dialysis catheter. Design: Integrative review. Methods: This review followed the framework by Whittemore and Knafl. The literature search was performed using four electronic databases: PubMed, CINAHL, Cochrane Library and ProQuest Nursing and Allied Health. The Joanna Briggs Institute Critical Appraisal Tool was used to appraise the articles that fit the inclusion and exclusion criteria. Studies published in the English language were retrieved. Results: A total of 14 studies were included. All the studies focused on educating patients who were on either tunnelled (permanent) haemodialysis catheters or peritoneal dialysis catheters. The findings identified: (1) teaching strategies used for educating patients on haemodialysis catheter care (2) teaching strategies for educating peritoneal dialysis patients on peritoneal dialysis catheter care and (3) outcomes of patient education on both haemodialysis and peritoneal dialysis catheters. Written materials and educational videos were used to instruct patients on haemodialysis catheters care. Different educational strategies for educating patients on peritoneal dialysis catheter care were also reported. They varied in terms of the composition and experience of the implementation care team members, educational approach, training duration, training location, timing relative to catheter placement, assessment method and follow-up support. The various teaching strategies were assessed and compared based on the patients' knowledge levels, catheter-related mechanical issues, and catheter-related infectious consequences (such as peritonitis). Conclusion: This review highlighted various education materials and compared different educational practices on tunnelled (permanent) haemodialysis catheter and peritoneal dialysis catheter care that healthcare providers used to increase knowledge and reduce catheter-related blood stream infections and peritonitis rates.