Nurse spiritual self-care: A scoping review.

BACKGROUND: The health care research on spirituality has focused on patients. Less is known about the spiritual self-care of nurses who work with these patients in all types of challenging environments. Nurse spiritual self-care may be helpful in reducing workplace stress and burnout. PURPOSE: The purpose of this review was to provide a comprehensive understanding of the conceptual definitions, theory and measurement of nurse spiritual self-care as reflected in the current literature. METHODS: The review framework was aligned with the recommendations consistent with the Joanna Briggs Institute guidance for scoping reviews. FINDINGS: Ten studies were included. Three included explicit definitions and five explicitly stated theories. Five quantitative, four qualitative, and one mixed measurement of concept were found. DISCUSSION: This scoping review identified conceptualizations, theoretical frameworks, and measurements that can be foundational to future research in this area. Our paper highlights the need for further research on nurse spiritual self-care.

Effectiveness of using a simulation combined with online learning approach to develop discharge teaching skills.

BACKGROUND: Despite evidence of the impact of discharge teaching on patient outcomes, nursing students are poorly prepared in the pedagogical skills necessary for their role as patient and family educators in clinical practice. This study evaluated the effectiveness of simulation combined with online learning to improve nursing students' discharge teaching skills. METHODS: The module included simulations before and after an online module on patient/family teaching for hospital discharge. Evaluation measures were student and independent rater evaluations using the Quality of Discharge Teaching Scale- Evaluation form (QDTS-E). RESULTS: Students (n = 153) improved their performance on both content and delivery subscales of the QDTS-E by 20% (student self-evaluations) and 18% (independent raters). However, correlations between student and rater scores were low (r = 0.08-0.22). CONCLUSION: Use of simulation with online learning in a discharge teaching module can help students build patient education skills to improve post-discharge patient outcomes, contributing to national health priorities to reduce hospital readmissions. With further refinement and testing, the learning module and QDTS-E evaluation form may also be useful for evaluation and continuing education of clinical nursing staff.

A Delphi Study to Understand Clinical Nursing Faculty Preparation and Support Needs.

BACKGROUND: Nursing programs are challenged with staffing qualified clinical faculty. Many hires, part time and full time, lack formal preparation or experience in leading student clinical groups. To have prepared clinical faculty, it is important to understand their learning preparation and support needs. METHOD: A two-round Delphi study was conducted to explore the preparation and support needs of undergraduate clinical faculty across nursing programs in a midwestern state. RESULTS: Clinical faculty indicated several areas for development, including clear expectations of the role, better communication, training and orientation, and support. A better understanding of roles and expectations was demonstrated by clinical nursing faculty who were full time and those with nursing degrees that included nurse education coursework. CONCLUSION: Strategies for clinical faculty preparation and support include clarifying expectations, providing orientation, and communicating consistently and frequently. [J Nurs Educ. 2019;58(10):583-590.].

Intentional learning: A concept analysis.

AIM: To use a concept analysis to determine a clear definition of the term "intentional learning" for use in nursing. BACKGROUND: The term intentional learning has been used for years in educational, business, and even nursing literature. It has been used to denote processes leading to higher order thinking and the ability to use knowledge in new situations; both of which are important skills to develop in nursing students. But the lack of a common, accepted definition of the term makes it difficult for nurse educators to base instruction and learning experiences on or to evaluate its overall effectiveness in educating students for diverse, fast-paced clinical practices. DESIGN AND REVIEW METHODS: A concept analysis following the eight-step method developed by Walker and Avant (2011). DATA SOURCES: Empirical and descriptive literature. RESULTS:  Five defining attributes were identified: (1) self-efficacy for learning, (2) active, effortful, and engaged learning, (3) mastery of goals where learning is the goal, (4) self-directed learning, and (5) self-regulation of learning. CONCLUSION: Through this concept analysis, nursing will have a clear definition of intentional learning. This will enable nurse educators to generate, evaluate, and test learning experiences that promote further development of intentional learning in nursing students. Nurses in practice will also be able to evaluate if the stated benefits are demonstrated and how this impacts patient care and outcomes.

Student motivation, stressors, and intent to leave nursing doctoral study: A national study using path analysis.

BACKGROUND: The demand for doctorally prepared nurses worldwide is higher than ever. Universities have responded with increased numbers of DNP and Ph.D. in Nursing programs. There are more doctoral nursing students than ever before yet they remain one of the least studied student populations. This is concerning given the high attrition rates reported in doctoral programs. The few studies that do exist are typically qualitative and exploratory in nature. OBJECTIVES: The aim of this national study of Ph.D. and DNP students was to examine how the effects of environmental stressors predict the students' intent to leave their current program of doctoral study. DESIGN: A descriptive survey design was utilized for the study. SETTINGS: Participation requests were sent by email to deans/directors of all Ph.D. and DNP programs across the United States, with the request to forward to all currently enrolled students. PARTICIPANTS: Eight hundred and thirty-five (n=835) Ph.D. and DNP participants responded to this survey. METHODS: The survey was analyzed utilizing path analysis. RESULTS: Findings of the path analysis indicate that two types of stress significantly predicted students' intention to leave. First, stressors related to program issues, primarily relationships between student and faculty/advisor, significantly predict intent to leave. As program stressors rise, so does intent to leave. The other significant factor was related to support issues, specifically support from family/friends. This inverse relationship indicated as family support declines, intent to leave rises. CONCLUSIONS: It is impossible to remove all stressors from students' lives during their doctoral studies. A better understanding of the environmental stressors that affect them offers the potential for nursing programs looking to incorporate adequate resources and support which will help minimize attrition and promote persistence of their doctoral students. Specific recommendations are provided that may assist programs looking to decrease doctoral nursing student attrition.

Nursing Practices and Policies Related to Family Presence During Resuscitation.

BACKGROUND: Despite its shown benefits, family presence during resuscitation (FPDR) is a controversial topic among critical care nurses and is not routinely implemented. OBJECTIVES: The objective of this study was to describe FPDR practices among critical care nurses, as well as the prevalence of FPDR policies and education. METHODS: The study used a descriptive survey design. Data were collected from a convenience sample of critical care nurses obtained at a national level. A 25-item demographic and professional attribute survey was administered to all participants. RESULTS: There were 124 critical care nurses who participated. Results indicated critical care nurses have vast resuscitative care experience; however, FPDR is not a routine component. In the past year, 23% (n = 29) had never experienced FPDR, and only 17% (n = 21) had experienced it more than 5 times. Furthermore, 48% (n = 59) had never invited FPDR, and 45% (n = 56) had invited it only 1 to 5 times. A lack of FPDR policy was noted, with 73% (n = 91) indicating their facility or unit did not have a policy or they were unsure if one existed. Only 38% (n = 47) had ever received education on FPDR. DISCUSSION: Despite the shown benefits of FPDR, it is not a routine component of resuscitation in critical care settings. Nurse managers and educators should focus on policy creation and education to help guide nurses at the bedside. The impact of policy and education on critical care nurses' support for and implementation of FPDR requires further study.

Family Presence During Resuscitation: Impact of Online Learning on Nurses' Perception and Self-confidence.

BACKGROUND: Family presence during resuscitation (FPDR) is supported by patients and their family members. Nurses, however, including critical care nurses who frequently implement resuscitative care, have mixed views. OBJECTIVES: To determine the impact of online learning on critical care nurses' perception of and self-confidence with FPDR. METHODS: A 2-group, random assignment, pretest and posttest quasi-experimental study was conducted with critical care nurses recruited nationally. An online learning module on FPDR was developed and administered to the intervention group. Perceptions and self-confidence for FPDR were measured by using the Family Presence Risk- Benefit Scale (FPR-BS) and the Family Presence Self-confidence Scale (FPS-CS). Two-factor, mixed-model factorial analysis of variance was used to compare mean scores. RESULTS: A total of 74 critical care nurses participated in the study. Mean FPR-BS and FPS-CS scores were significantly greater in the intervention group than in the control group. For the intervention group, mean scores on the FPR-BS increased from 3.63 to 4.07 (P < .001) and on the FPS-CS increased from 4.24 to 4.57 (P < .001), signifying improved perception and self-confidence. Scores did not change significantly in the control group: mean FPR-BS score increased from 3.82 to 3.88 (P = .23) and the mean FPS-CS score of 4.40 did not change (P > .99). CONCLUSIONS: Online learning is a feasible and effective method for educating large numbers of critical care nurses about FPDR. Online learning can improve perceptions and self-confidence related to FPDR, which may promote more widespread adoption of FPDR into practice.

Implementation and Evaluation of an APRN-Led Opioid Monitoring Clinic.

Evidence-based strategies helped reduce opioid doses and identify abuse and misuse in patients referred to an opioid monitoring clinic.

What predicts nurse faculty members' intent to stay in the academic organization? A structural equation model of a national survey of nursing faculty.

OBJECTIVE: To investigate the relations among several factors regarding the academic context within a nationally representative sample of U.S. nursing faculty. DESIGN: Correlational design using structural equation modeling to explore the predictive nature of several factors related to the academic organization and the work life of nursing faculty. SETTING: A survey was used to evaluate several aspects of the work life of U.S. nursing faculty members. PARTICIPANTS: Nursing faculty members in academic organizations across the U.S. serving at either CCNE- or NLNAC-accredited institutions of higher education. METHODS: Standard confirmatory factor analysis was used to assess the validity of a proposed measurement model, and structural equation modeling was used to evaluate the validity of a structural/latent variable model. RESULTS: Several direct and indirect effects were observed among the factors under investigation. Of special importance, perceptions of nurse administration's support and perceived teaching expertise positively predicted U.S. nursing faculty members' intent to stay in the academic organization. CONCLUSIONS: Understanding the way that nursing faculty members' perceptions of the various factors common to the academic context interact with intent to stay in the academic organization is essential for faculty and nursing administrators. This information can assist administrators in obtaining more resources for faculty development to lobby for additional faculty in order to meet the teaching, research, and service missions of the organization; and to personalize relationships with individual faculty members to understand their needs and acknowledge their efforts.

Outcomes of newly practicing nurses who applied principles of holistic comfort theory during the transition from school to practice: a qualitative study.

The aim of this qualitative study was to explore if newly practicing nurses benefited from learning holistic comfort theory during their baccalaureate education, and to provide a conceptual framework to support the transition from school to practice. The study was conducted among graduates of an accelerated baccalaureate nursing program where holistic comfort theory was embedded as a learner-centered philosophy across the curriculum. A phenomenological process using van Manen's qualitative methodology in education involving semi-structured interviews and thematic analysis was used. The nurses recalled what holistic comfort meant to them in school, and described the lived experience of assimilating holistic comfort into their attitudes and behaviors in practice. Themes were established and a conceptual framework was developed to better understand the nurses' lived experiences. Results showed that holistic comfort was experienced as a constructive approach to transcend unavoidable difficulties during the transition from school to practice. Participants described meaningful learning and acquisition of self-strengthening behaviors using holistic comfort theory. Holistic comfort principles were credited for easing nurses into the realities of work and advocating for best patient outcomes. Patient safety and pride in patient care were incidental positive outcomes. The study offers new insights about applying holistic comfort to prepare nurses for the realities of practice.

A national survey examining the professional work life of today's nursing faculty.

OBJECTIVE: To examine factors that influence faculty member's work life in order to provide a supportive environment for recruiting and retaining nursing faculty. DESIGN: A cross-sectional non-experimental design incorporating correlation-based analyses gathered from a 45-item online survey. SETTING: The survey gauged several aspects of the nurse faculty work life, including teaching competence, productivity, and organizational support. PARTICIPANTS: US nurse faculty employed at either a CCNE or NLNAC accredited nursing program. METHODS: A stepwise linear regression analysis was conducted to ascertain which aspects of work life significantly predicted nurse faculty members' intent to stay or leave the faculty role. A one-way ANOVA examined whether faculty members' intent to stay or leave the faculty role varied as a function of generation. RESULTS: Data from 808 useable surveys demonstrated that perceptions of administration's support for faculty improvement, perceptions of productivity, choice of pursuing a professional career in nursing, and the application of perceived teaching expertise significantly predicted faculty members' intent to stay or leave the faculty role. Moreover, generational membership influenced faculty members' intent to stay or leave the faculty role. CONCLUSIONS: Academic nurse administrators can positively affect the work life of their faculty and their intent to stay in the organization through support for the development of teaching and research roles with time and resources, recognition of faculty efforts, consideration of faculty needs from individual and generational perspectives, and targeted mentoring for career development.

The structural relationships between organizational commitment, global job satisfaction, developmental experiences, work values, organizational support, and person-organization fit among nursing faculty.

UNLABELLED: GUTIERAIM: The aim of this correlational study was to examine the relations between organizational commitment, perceived organizational support, work values, person-organization fit, developmental experiences, and global job satisfaction among nursing faculty. BACKGROUND: The global nursing shortage is well documented. At least 57 countries have reported critical shortages. The lack of faculty is finally being recognized as a major issue directly influencing the ability to admit and graduate adequate numbers of nurses. As efforts increase to both recruit and retain faculty, the concept of organizational commitment and what it means to them is important to consider. DESIGN: A cross-sectional correlational design was used. METHODS: The present study investigated the underlying structure of various organizational factors using structural equation modelling. Data were collected from a stratified random sample of nurse faculty during the academic year 2006-2007. RESULTS: The final model demonstrated that perceived organizational support, developmental experiences, person-organization fit, and global job satisfaction positively predicted nurse faculty's organizational commitment to the academic organization. Cross-validation results indicated that the final full SEM is valid and reliable. CONCLUSIONS: Nursing faculty administrators able to use mentoring skills are well equipped to build positive relationships with nursing faculty, which in turn, can lead to increased organizational commitment, productivity, job satisfaction, and perceived organizational support, among others.

Effects of overweight and obesity on walking characteristics in adolescents.

Child and adolescent obesity is growing at a staggering rate. Associated potential health risks have been acknowledged in the adult population, and similar concerns have been raised for children and adolescents. However, distinguishing locomotor characteristics related to obesity have yet to be clearly identified for adolescents. The aims of the study were to examine the effects of walking velocity and gender on spatio-temporal characteristics of gait between normal weight (NW) and overweight and obese (OWO) adolescents. In addition, we sought to identify characteristics of gait that are related to body mass index percentile (BMI%). Adolescent students in grades 7-10 (N=111) from a charter school participated in the study. All participants walked at two speeds (preferred, fast) over an instrumented walkway (120 Hz). Spatio-temporal characteristics of gait were extracted from four walkway passes and evaluated. Results identified significant (p<.05) differences in velocity, percent double support, percent swing phase, and stance width between groups. Only stance width was different (p<.05) between genders. Models to predict BMI% from kinematic walking parameters were of moderate strength (averaging 43.5% explained variance) and were generally stronger for females versus males. Percent double support was the primary predictor variable of BMI% across speed and gender. It is suggested that OWO adolescents may be challenged with control of movement of the center of mass during the support phase of walking.

Survey of generational aspects of nurse faculty organizational commitment.

PURPOSE: To describe organizational commitment and generational differences in nursing faculty. The study provides new knowledge on generational differences in organizational commitment among nursing faculty with regard to work values, perceived organizational support, perceived person-organization fit, developmental experiences, and global job satisfaction. METHODS: A cross-sectional, descriptive design was used with random stratified sampling procedures. Surveys measuring organizational commitment and related constructs were sent electronically to 4886 faculty, yielding a 30% response rate. RESULTS: Significant differences were noted between generations of faculty regarding organizational commitment and related measures. RECOMMENDATIONS: Include specific strategies for fostering commitment from each generation.

Nursing's leadership in positioning human health at the core of urban sustainability.

The United Nations predicts that by 2050 nearly three fourths of the world's population will live in urban areas, including cities. People are attracted to cities because these urban areas offer diverse opportunities, including the availability of goods and services and a higher quality of life. Cities, however, may not be sustainable with this population boom. To address sustainability, urban developers and engineers are building green structures, and businesses are creating products that are safe for the environment. Additionally, efforts are needed to place human health at the core of urban sustainability. Without human health, cities will not survive for future generations. Nursing is the discipline that can place human health in this position. Nursing's initiatives throughout history are efforts of sustainability-improving human health within the physical, economic, and social environments. Therefore, nursing must take a leadership role to ensure that human health is at the core of urban sustainability.

An online doctoral education course using problem-based learning.

The number of doctoral nursing programs has greatly increased over the past several years. There has also been a shift toward delivering programs either partially or fully online. The literature lacks discussions about doctoral-level teaching methods in the online environment. This article describes the use of a semester-long problem-based learning activity in an online doctoral course focusing on nurse educator leadership. The Students-As-Faculty Experience created for this course features the use of a virtual nursing program in which students are cast as faculty members confronting issues via faculty meetings and sharing rotating roles as chairperson. Students were vested in the process by co-designing the course in terms of developing agenda items for the meetings and evaluation rubrics. Through playing the roles of faculty and chairperson, the students reported a distinct improvement in their leadership abilities and confidence at the end of the course.

Attaining organizational commitment across different generations of nurses.

AIM: To inform nurse managers about the generational differences that exist among nurses, how it affects the work environment and how this information can be used to encourage organizational commitment. BACKGROUND: Every person is born into a generational cohort of peers who experience similar life experiences that go on to shape distinct generational characteristics. Thanks to delayed retirements, mid-life career changes, job re-entry and a small but significant group of younger graduates, the nursing profession is now experiencing four generations in the workforce: Veterans, Baby Boomers, Generation X and the Millennial Generation. At the same time, the literature on organizational commitment is expanding and can provide a compelling context through which to view generational differences among nurses. IMPLICATIONS FOR NURSING MANAGEMENT: As part of an overall strategy to increase organizational commitment, consideration of generational differences in nurses can be helpful in leading to increased job satisfaction, increased productivity and decreased turnover among staff. In the face of the global nursing shortage, managers should increase their knowledge of generational diversity just as they have with ethnic and cultural diversity in the past. Understanding how to relate to the different generations and tap into their individual strengths can lead to improved nursing work environments.

Recent RN graduate perceptions of educational preparation.

Nursing education programs strive to deliver curricula that prepare and transition graduates not just to survive but to truly thrive in any workplace environment. It is therefore important to reach out to those who have recently entered the nursing workforce to understand their views on educational preparation for practice. The purpose of this descriptive survey was to examine the perceptions of recent nurse graduates with regard to how well their educational programs prepared them for practice in their first jobs as registered nurses. Three hundred fifty-two nurses registered in the state of Nevada who graduated from a basic nursing program within the past five years completed the Survey of Nurses' Perceptions of Educational Preparation. Respondents perceived they were inadequately prepared in pharmacology, clinical practice, leadership/management, and the use of patient electronic medical records. In addition, respondents felt their programs prepared them more for success on the NCLEX-RN than for practice. Recommendations for addressing these issues are offered.

Learning to let go: the challenge of de-crowding the curriculum.

Nurse educators often lament there is not enough time to teach all the content students need to learn. Every year, information regarding healthcare increases exponentially. Typically, educators respond by increasing content without removing outdated information resulting in overcrowded courses. Little time is left for meaningful learning of concepts and life-long learning skills to sustain graduates throughout their careers. Reliance on conventional teacher-centered approaches to curriculum development have generated calls from professional organizations for innovative education programs. Innovation begins by shifting focus from massive amounts of content to teaching essential concepts and abilities necessary for today's health care environment. Decreasing the overload of content is imperative when moving from a teaching centered to a learning-centered curricula. Instead of concentrating on rote memorization, students engage in meaningful learning. De-crowding the curriculum can be frustrating because there is no quick fix. The challenge is to consider both faculty philosophical beliefs and assumptions about how students learn. Assumptions and beliefs regarding teaching, learning, essential content, and the learning environment should be clear from the outset. Without considering assumptions and beliefs efforts to de-crowd the curriculum rapidly devolve into a test of wills between faculty members. The authors present an overview of learning-centered education, a systematic method for de-crowding the curriculum, and a discussion of challenges encountered.

A case for learning-centered curricula.

Nurses must be able to anticipate and manage the care of patients with complex conditions in a rapidly changing, highly technological health care environment. Yet many of today's nursing programs are failing to provide curricula to meet the changing needs of students who will work in that environment. Typical teacher-centered programs are content heavy and focus on what faculty want to teach, not what students need to learn. Learning-centered education shifts the focus from teaching to student learning. Learning-centered programs identify student learning outcomes that are reflective of current nursing practice, use authentic assessment, and provide learning experiences that move students toward the achievement of outcomes. This article describes the major benefits of a learning-centered curriculum, and a model depicts the dynamic relationship among learning experiences, assessment, and student learning outcomes. We also offer suggestions for nursing faculty who are considering the move from teacher-centered to learning-centered curricula.