Beliefs and Decision-Making of First-Time Mothers Planning to Use a Breast Pump.

Beliefs and decision-making processes associated with breast pump use in first-time mothers providing human milk to healthy, term newborns soon after birth are explored in this qualitative, descriptive study. Eight women participated in an individual semistructured interview in a community hospital in the southeastern United States. Guided by the theory of planned behavior, conventional content analysis about prenatal and early postpartum beliefs of planning and utilizing breast pumps yielded themes of Resource Gathering, Intention Refining, and Behavior Navigating. An understanding of these beliefs gives insight into ways health professionals can increase collaboration with expectant and new mothers about the selection and safe use of breast pumps, resource availability at various stages, and infant-feeding goals.

Strategies for progression in a PhD nursing program within a transition model.

BACKGROUND: There is a need for interventions to improve the PhD pipeline for nursing program enrollment. PhD nursing students who have navigated the program successfully are in a strategic position to help by sharing their stories. Several strategies for successful completion of a PhD program and some common expected barriers have been documented in the literature. METHOD: The authors used personal reflections from their first and second years of study in a PhD nursing program to identify strategies to progress through a program. The personal reflections were analyzed by their student cohort and a faculty advisor using the Bridges' Transition Model as a theoretical framework. The cohort members included five females and one male, ages 29-48, attending a PhD nursing program in the Southeastern, US. RESULTS: The following strategies were identified from the personal reflections: seeking and offering support within your cohort; establishing a relationship with mentors; identifying and using a reference manager; mastering time management; soaking up statistics; and focusing on your focus. The strategies listed above occurred within the ending and/or neutral zone phases of the Bridges' Transition Model. CONCLUSION: It is important to note the early phases of transition and need for success strategies in these specific phases of transition. PhD nursing students are in a strategic position to positively influence the PhD pipeline by providing personal reflections that inform future PhD nursing students as well as PhD nursing programs.

Improving Perinatal Care Through Theory Application.

Theories from various perspectives can increase nurses' understanding of maternal behaviors throughout the developmental process of pregnancy and postpartum. The purpose of this article is to present relevant theories that maternity nurses will likely find useful, and to demonstrate their applicability through an unfolding exemplar case. Nurses can provide improved and more sensitive care when guided by psychosocial theories such as Rubin's tasks of pregnancy, prenatal attachment, pregnancy as a liminal phase, and the grief work in postpartum as proposed by Mercer. Use of relevant theories can promote holistic nursing care, increase critical thinking, and improve nursing responsiveness to unique family situations such as pregnancy after loss and premature birth.

Expectations and experiences of nursing students in clinical courses: A descriptive study.

BACKGROUND: Students entering nursing programs have expectations for what they will encounter in the clinical setting. OBJECTIVES: Nursing student excitement about beginning clinical, expectations for learning, anticipated time to prepare for each clinical day, and learning styles were examined. DESIGN: Descriptive study. SETTING: Baccalaureate nursing program in a public university in the Southeastern United States. PARTICIPANTS: Students enrolled in their first clinical nursing courses. METHODS: Students responded to a survey at the beginning of their junior year (n = 96) and to a follow-up survey at the end of that academic year (n = 72). The initial survey asked what they were most excited about for junior year clinical experiences, what they expected to learn, the best way to learn skills and new content, and how long they expected to spend preparing for the clinical experience. The follow-up survey asked students what they were most excited about related to the upcoming senior year clinical experiences, what they thought were the important things they learned during their junior year that would help them practice as a registered nurse, and how long, on average, they spent preparing for clinical experiences. RESULTS: Initially, students were excited about experience/practice/observation and they expected to learn nursing skills and procedures. They expected to learn how to communicate effectively with patients and families. These same categories were dominant at follow-up. Learning styles for a new skill or new content varied among the students. Expectations for time in clinical preparation and time actually spent in this activity differed. CONCLUSIONS: Students were excited and expected to learn predominantly nursing skills through hands-on experiences and active communication with patients. They have a variety of learning styles. Faculty must embrace expectations and learning styles of students and provide a variety of learning opportunities. Also, faculty should dispel unrealistic ideas about clinical experiences.

Promoting Best Practice for Perinatal Care of Deaf Women.

To evaluate perinatal nursing care for Deaf women, we conducted a pilot, descriptive study exploring women's prenatal, labor, and postpartum experiences. We used the Quality and Safety Education for Nurses (QSEN) framework to analyze women's responses and to explore implications for practice. Themes and women's stories are presented within the QSEN structure to promote informed and individualized perinatal nursing care for Deaf families. It is essential for nurses to stay abreast of resources and technological advances and to use culturally competent principles of communication. Nurses' knowledge of Deaf culture helps guide care, and their understanding of legal provisions and the Americans with Disabilities Act can lead to greater advocacy for Deaf women. Additional research is necessary to fill the current void in the literature about perinatal care for Deaf women.

Concerns of nursing students beginning clinical courses: A descriptive study.

BACKGROUND: Students harbor fears related to the clinical environment that influence their participation and learning. Some studies have addressed general anxieties in undergraduate nursing students, but few have asked students to report their fears and concerns prior to entering the clinical environment. Therefore, this study examined the fears and concerns of undergraduate nursing students beginning clinical courses as well as their continued concerns upon completion of the first year of instruction. The study also assessed their confidence in physical assessment skills. METHODS: Ninety-six junior nursing students enrolled in a generic baccalaureate nursing program completed a survey, two items of which asked about their fears and concerns related to beginning clinical experiences and their confidence in physical assessment. A follow up survey was completed at the end of the junior year by 72 students. RESULTS: Making a mistake, lack of course success, and not knowing how to do something were students' major concerns prior to the start of clinical experiences. Bad experiences with a nurse or instructor, freezing up, and uncomfortable patient/family experiences were also concerns. Not knowing how to do something persisted as a concern at the completion of the first year. Fears about being/feeling left alone in a clinical setting as well as concern about the senior year also emerged on the post survey. Confidence in physical assessment was a mean of 60.46 on a scale of 0-100 at the beginning of clinical instruction and 71.28 at the end of the junior year. CONCLUSIONS: Faculty should structure learning activities that decrease anxiety and enhance students' confidence prior to initial clinical experiences. Opportunities might include in-depth orientation to clinical settings and various simulations that allow practice of skills and communication. Awareness of predominant student fears and concerns can also guide staff nurses to provide a welcoming environment and enhance learning.

Prospective Validation of Central Line-Days Derived From an Electronic Medical Record System.

Validation of the number of central line-days by hospitals is required by the National Healthcare Safety Network. A prospective study that compared a daily report of such days generated by an electronic medical record with observational audits by nurses revealed that the report was 100% sensitive and 99.9% specific.