Do Experienced Nurses Benefit From Training on Bleeding Control in the Community Setting?

INTRODUCTION: Nurses' preparedness to provide hemorrhage control aid outside of the patient care setting has not been thoroughly evaluated. We evaluated nurses' preparedness to provide hemorrhage control in the prehospital setting after a proof-of-concept training event. METHODS: We performed a secondary analysis of evaluations from a voluntary hemorrhage control training offered to a group of experienced nurses. Education was provided by a nurse certified in Stop the Bleed training and using the Basic Bleeding Control 2.0 materials. The training lasted approximately 1 hour and included a didactic portion followed by hands-on practice with task trainer legs. Participants were surveyed after training to assess their preparedness to provide hemorrhage control aid using a 5-point Likert scale (1 = strongly disagree to 5 = strongly agree); comments and feedback were also requested. Mean (SD) was used to analyze Likert scale data. Content analysis was performed to identify common themes in qualitative data. RESULTS: Forty-five experienced nurses participated in the voluntary training. Nursing experience included obstetrics, pediatrics, critical care, acute care, community health, and psychiatric/mental health. Only 39% of participants reported having previously completed a similar course. After training completion, participants reported an increase in their preparedness to provide hemorrhage control aid (mean 3.47 [SD = 1.40] vs mean 4.8 SD [.04], P < .01). Major themes identified included wanting to feel prepared to help others, refreshing skills, and knowing how to respond in an emergency. DISCUSSION: Regardless of background and experience, nurses may benefit from more advanced hemorrhage control education to prepare them to provide aid in prehospital emergency settings.

Incubating Collaboration for a Neonatal Scholars Writing Group.

One method to improve writing and scholarship is through the formation of writing teams. While not new, we will present our innovative strategy for creating an effective neonatal writing team for faculty and students. Tuckman's Model of Team Development was used to guide our group through the five stages of effective teams including forming, storming, norming, performing, and adjourning to develop an effective writing group. The application of this model facilitated a strong foundation for our writing group, the Neonatal Scholars Interest Group, through the intentional movements through developmental stages and the ability to sustain our writing group. Furthermore, the impact of our writing group, as a model, resulted in several other specialized writing groups within our school. Our writing group improved the knowledge and skills of nurse faculty and students in sustained writing efforts through successful scholarship dissemination, mentoring students, and advancing nursing education and practice.

Development and implementation of a virtual "collaboratory" to foster interprofessional team-based learning using a novel faculty-student partnership.

BACKGROUND: Safe and efficient healthcare demands interprofessional collaboration. To prepare a practice-ready workforce, students of health professions require opportunities to develop interprofessional competencies. Designing and delivering effective interprofessional learning experiences across multiple professions is often hampered by demanding course loads, scheduling conflicts, and geographical distance. To overcome traditional barriers, a case-based online interprofessional collaboratory course was designed for professions of dentistry, nursing, occupational therapy, social work and public health using a faculty-student partnership model. AIM: To build a flexible, web-based, collaborative learning environment for students to actively engage in interprofessional teamwork. METHODS: Learning objectives addressed Interprofessional Education Collaborative (IPEC) core competency domains of Teamwork, Communications, Roles/Responsibilities, and Values/Ethics. Four learning modules were aligned with developmental stages across the case patient's lifespan. Learners were tasked with producing a comprehensive care plan for each developmental life stage using interprofessional teamwork. Learning resources included patient and clinician interviews, discussion board forums, elevator pitch videos, and interprofessional role modelling. A mixed methods quality improvement approach integrated the pre and post IPEC Competency Self-Assessment Tool with qualitative student feedback. RESULTS: In total, 37 learners participated in the pilot. IPEC Competency Assessment Interaction domain mean scores increased from 4.17/5 to 4.33 (p = 0.19). The Values domain remained high (4.57/5 versus 4.56). Thematic analysis highlighted five core themes for success: active team engagement, case reality, clear expectations, shared team commitment, and enjoyment. CONCLUSIONS: A faculty-student partnership model was feasible and acceptable for designing and implementing a virtual, interprofessional team-based course. Using a quality improvement cycle fast-tracked improvements to course workflow, and highlighted strategies for engaging students in online team-learning.

Innovations in Academic/Clinical Partnerships During COVID-19 to Prepare a Ready Nursing Workforce.

Management of the COVID-19 pandemic required healthcare leaders and frontline workers to rapidly innovate and adjust to a new reality that has forever transformed nursing education and practice. Throughout the pandemic, key stakeholders in Alabama lobbied for transformations in clinical training practice that ultimately improved students' exposure to clinical environments and alleviated the pressure on practicing nurses and other healthcare workers during pandemic hospitalization surges. The present article highlights the key partners and regulatory innovations that led to these successes in Alabama.

What Would You Do?: Engaging Remote Learners Through Stop-Action Videos.

BACKGROUND: Engaging remote learners can be challenging for nurse educators. With an increase in virtual learning, nurse educators are seeking activities that support engagement and improve critical thinking. PROBLEM: Students in virtual classes need learning experiences that support critical thinking and involve appropriate case studies for knowledge application. APPROACH: Stop-action video vignettes as unfolding case studies employ technology that can facilitate critical thinking and active learning in a virtual setting. Stop-action video vignettes can be useful in enhancing student learning through 3 methods: video-based discussion, text-based discussion, and branching matrices. CONCLUSION: Stop-action video vignettes with unfolding case studies may provide effective and versatile activities to engage students and enhance learning.

Interprofessional team-based education: A comparison of in-person and online learner experiences by method of delivery and health profession.

BACKGROUND: Building capacity for teamwork, communication, role clarification and recognition of shared values is essential for interprofessional healthcare workforce development. Requirements to demonstrate interprofessional practice competencies have coincided with pivots to online delivery. Comparison of in-person and online delivery models for interprofessional education is important for future curriculum design. PURPOSE: This article presents an evaluation of in-person and online delivery modes for interprofessional team-based education and compares learner experiences across different health professions. METHODS: Students from 13 health professions (n = 2236) participated between Spring 2020 and Fall 2021. In-person and online delivery models were compared, assessing learner perceptions of efficacy for interprofessional practice, using reflective pre-post responses to the Interprofessional Collaborative Competency Attainment Scale (ICCAS). RESULTS: Mean ICCAS scores improved for in-person and online delivery (0.79 vs 0.66), with strong effect (Cohen's D 2.03 and 1.31 respectively; p < 0.001). Statistically significant differences were observed across professions, although all experienced ICCAS score improvements. Logistical benefits were evident for online delivery. CONCLUSION: In-person and online interprofessional team-based education can provide valuable learner experiences for large student cohorts from multiple professions. ICCAS score differences should be weighed against potential logistical benefits of online delivery. Timing of delivery and determinants of differences in student response across professions warrant evaluation for future curriculum design.

Improving Quality in Neonatal Care Through Competency-Based Simulation.

Approximately 440,000 patients die each year due to preventable errors. Although human error is inevitable, we can mitigate this risk by enhancing skills and clinical competencies by improving the quality of neonatal care through competency-based simulation. Clinical skills are learned activities necessary to function within an environment. Skills gained during pre-licensure nursing education, on-site clinical training, and experience as a clinical care provider, collectively demonstrate a clinician's overall competence to function within a clinical setting. Simulation is a method of supporting nurses to establish, maintain, and remediate competency-based skills for safe and effective healthcare. Evidence suggests that simulation improve clinical skills and maintain patient safety. With this knowledge, many professional organizations have adopted and set standards for the use of simulation, as an educational methodology, to improve clinician skills and competence providing only the highest quality care to neonates within the Neonatal Intensive Care Unit.

Integrating a simulated electronic medical record system and barcode medication administration into a pre-licensure nursing program.

BACKGROUND: Many healthcare facilities implement technology to reduce medication errors. Nursing schools are exploring implementing similar technology to promote best practice. PURPOSE: Our institution developed a quality improvement project to evaluate the integration of similar technology into pre-licensure curriculum. METHOD: Our quality improvement project examined using a simulated electronic medical record (EMR) and a barcode medication administration (BCMA) system in pre-licensure nursing curriculum. In our initial project, 96 second-semester BSN students participated in a skill check off using the system. RESULTS: Student perception was positive, 96% of respondents stated the system increased realism, and 94% indicated improved clinical preparedness. CONCLUSION: Implementing this system was a positive experience which enriched our pre-licensure curriculum.

Academic-Practice Partnership Pivot During COVID-19 Pandemic Surge.

Health care systems continue to experience the sequential aftermath of the COVID-19 pandemic, with major care access, quality, safety, financial sustainability, and workforce considerations. Yet, academic-clinical partnership opportunities exist for transformational change, even when efforts to respond to a pandemic seem insurmountable. A nursing partnership between an academic health center nursing school and university health system provided short- and long-term support for the nursing workforce shortage during a COVID-19 surge. An academic-clinical integration framework guided planning, clinical support activities, outcomes achieved, technology innovations, and shared lessons associated with these efforts. The COVID-19 surge response steps included a call to action, preparation for surge support by the academic and clinical partners, and a team approach for clinical service delivery by faculty, students, and staff. Through the 6-week COVID-19 surge response, more than 10 000 hours of hospital nurse staffing were provided by nursing school faculty and students; over 770 worked shifts that provided approximately 30% of the full surge hospital supplemental staffing and approximately 46 000 vaccine encounters. Well-established academic-clinical nursing partnerships allow for quick pivots in the rapidly changing COVID-19 environment that can enhance nursing clinical proficiency and competency, augment clinically immersive learning, and reinforce analytics to measure health outcomes, lower costs, improve access, quality, safety, and workforce conditions.

COVID-19 Telehealth Fair Partnership for Capacity Building in Primary Care Nursing.

Telehealth in health care delivery grew exponentially throughout the COVID-19 pandemic. This growth occurred because of necessity, yet requires capacity building to maximize the technology's use. In this article, we discuss the development, implementation, and evaluation of a telehealth fair to build capacity in the use of telehealth technology within primary care nursing. The telehealth fair consisted of didactic and simulation components. Undergraduate and graduate nursing students completed the telehealth fair supported by a team of 12 nursing faculty and 6 clinical partner sites. Findings suggest statistically significant increases in student self-assessment of knowledge in telehealth, self-confidence in the use of telehealth, and readiness in the use of telehealth technology. Participant satisfaction following completion of the telehealth fair was high, with average scores of 4.2 to 4.58 (out of 5) for the didactic and 4.57 to 4.86 for the simulation components. The telehealth fair provided an invaluable opportunity for participants to enhance their learning relative to telehealth within primary care nursing. The experience also provided an opportunity for students to gain clinical hours during a pandemic when clinical placements in the community were limited. The experience also enhanced telehealth practice readiness of nursing students entering the workforce.

Simulating Telehealth Experiences in the Neonatal Care Environment: Improving Access to Care.

Telehealth in the neonatal environment can improve remote medical care and access to specialized care and training eliminating barriers for effective health care delivery. Clinicians are utilizing telehealth in their practice to provide specialized care and training in areas that have little access. Educating health care clinicians on the basics of telehealth is an essential component of clinical training programs. Use of simulation-based telehealth experiences as part of that training can provide hands-on learning in a safe, realistic environment. Simulation can prepare health care teams in using telehealth technology in managing patient care, postdischarge care, and specialized care programs.

A Tribute to Chad Epps: A Mentor, Educator, Leader, Collaborator, and Friend.

SUMMARY STATEMENT: Dr Chad Epps' journey in healthcare simulation touched countless lives in his role as a mentor, educator, leader, collaborator, and friend. Here, we highlight Chad's lasting impact upon which we all stand today.

A Distance Accessible Education Model: Teaching Skills to Nurse Practitioners.

INTRODUCTION: Health care providers in rural areas are often unable to attend continuing education trainings due to limited staffing coverage. The coronavirus pandemic has created a unique situation, requiring many health care providers to obtain continuing education through virtual offerings. METHODS: This study used a descriptive design with a team-developed presurvey for demographics, 2 posttraining instruments, and a team-developed competency validation checklist. RESULTS: The study sample included nurse practitioner (NP) students and practicing NPs. All participants met competency in the skills validation. DISCUSSION: The results indicate that continuing education and competency validation of procedures is feasible in a virtual format.

Simulation to Enhance Communication Skills in Neonatal Nursing Practice.

Effective communication is essential to the delivery of safe, quality health care. Handoff reporting, situational reporting, interprofessional collaboration, caregiver communication, and team huddles are forms of status reporting and communication common in a neonatal nursing practice. Adequate training for health care professionals on effective communication techniques is often lacking. Simulation provides a method to develop and refine necessary communication skills for neonatal health care professionals and affords the opportunity for the learner to immerse into realistic clinical scenarios. The purpose of this article is to review communication techniques in the neonatal setting and describe methods of utilizing simulation to enhance communication skills for neonatal nursing practice.

Medical Surgical Nurse Self-perceived Competency in Posttraumatic Stress Disorder/Substance Use Disorder Veteran Care in a Non-Veterans Health Administration Setting.

OBJECTIVE: This study evaluated the self-perceived readiness of medical-surgical nurses in a non-Veterans Health Administration (VHA) facility to care for veterans with posttraumatic stress disorder (PTSD) and substance use disorder (SUD). BACKGROUND: Nurses caring for veterans with PTSD and SUD at facilities other than the VHA should be equipped with the knowledge, skills, and attitudes to provide care for this population. METHODS: Nurses evaluated their self-perceived knowledge, skills, attitudes, experiences, and perspectives related to caring for veterans. RESULTS: Nurses overwhelmingly indicated that they had no knowledge of the "Have you served?" campaign, and fewer than half inquired about military status when assessing patients CONCLUSION: Nurses caring for veterans in non-VHA facilities do not consistently identify veterans or assess for service-related conditions, including PTSD and SUD. Nurses report low skill levels related to identifying, addressing, and referring patients with service-related conditions.

Building Capacity for Nursing and Midwifery Education Through an Asynchronous Online Course.

BACKGROUND: Global organizations urge toward transformative, lifelong learning for nurses and midwives. Throughout Latin America and the Caribbean, strengthening the quality of nursing and midwifery education is top priority. A regional partnership of World Health Organization Collaborating Centers aimed to develop a user-friendly, culturally relevant, and adaptable educational quality improvement intervention. METHOD: Following the five-step ADDIE process, experts analyzed objectives and needs, designed activities and assessments, and determined optimum delivery of course content. A self-directed, asynchronous online course was developed, in line with regional needs and mandates. Three sequential online educational modules for English-speaking and Spanish-speaking nurse and midwife educators focused on (a) principles of teaching and learning, (b) instructional strategies, and (c) methods to evaluate students and courses. Content and design were externally reviewed and culturally adapted. CONCLUSION: Upon completion of pilot testing and evaluation, final course versions in both languages are expected to become freely accessible. [J Nurs Educ. 2020;59(1):38-41.].

Professional Development for Simulation Education.

Professional development in simulation methodologies is essential for implementation of quality, consistent, simulation-based experiences. Evidence demonstrates that participation in comprehensive training positively impacts learner outcomes. There are many benefits to professional development, however, challenges exist requiring thoughtful planning, administrative buy-in, and fiscal support. While there are no established guidelines, the literature provides an ongoing consensus related to overall concepts and strategies for training in simulation. We describe a continuum of growth for simulationists, ranging from novice/advanced beginner, competent/proficient, to expert. As a novice, one must conduct a self-assessment of current strengths and create a development plan to advance simulation skills and knowledge. A simulationist should use evidenced-base guidelines, mentorship, and feedback to inform simulation practices. They should be knowledgeable of the standards of best practice, modalities, simulation design, learning theories, and professional integrity. Simulationists must seek ongoing advancement through certification, scholarship, and lifelong learning. This chapter describes the continuum of education and methodologies for the development of simulationists.

Low-cost thoracentesis simulation for nurse practitioner students.

The fast-paced hospital setting is not routinely a conducive environment for practicing procedural skills. Simulation learning can provide an opportunity for learners to achieve accuracy, confidence, and competence when performing the thoracentesis procedure. The cost associated with many commercial-brand manikins and the additional supplies needed to teach thoracentesis is expensive. However, thoracentesis is a skill many nurse practitioners (NPs) need to learn. The use of a whole, unstuffed turkey purchased at a supermarket to simulate a thoracentesis is a way in which NP students can safely practice this skill. Nurse practitioner students perform assessment skills on another student, whereas students perform the thoracentesis procedure on this turkey carcass. Nurse educators can teach NP students to safely, accurately, and efficiently perform a thoracentesis procedure using a low-cost simulator. Nurse educators can teach NP students how to perform a thoracentesis using a turkey carcass at a relatively low cost with a high yield.

Identifying Geriatric Patients at Risk for Malnutrition: A Quality Improvement Project.

Malnourishment leads to poor outcomes in the geriatric surgical population and national guidelines recommend preoperative nutrition screening. However, care practices do not reflect current recommendations. As a quality-improvement project, a validated nutritional screening tool, the Mini Nutritional Assessment-Short Form (MNA-SF), was implemented in the preoperative clinic of a large academic health center to identify patients at-risk for malnutrition prior to elective surgery. Patients were screened during the nursing intake process and categorized as no nutritional risk; at-risk for malnourishment; or severely malnourished. During the four-week screening period, 413 patients met inclusion criteria with 67.8% (n = 280) screened. No nutritional risk was identified in 77.5% (n = 215) of patients, 18.2% (n = 51) were at-risk, and 4.3% (n = 12) were malnourished. This project will inform and guide a prehabilitation plan for nutrition optimization to improve healthcare quality, outcomes, and costs in the geriatric surgical population.

Improving Transition to Practice: Integration of Advanced Cardiac Life Support Into a Baccalaureate Nursing Program.

BACKGROUND: Nursing students often lack the skills and confidence to intervene in the care of a deteriorating patient as they transition into clinical practice. Exposure to these situations is limited during their academic career. Our team sought to address this by embedding American Heart Association (AHA) advanced cardiac life support (ACLS) content into the curriculum and offering certification to senior-level students. METHOD: The senior skills course was redesigned to include education on current AHA ACLS guidelines and skills. ACLS algorithms were introduced and reinforced by mock code labs utilizing rapid cycle deliberate practice and interprofessional simulation. After completion of the semester, students were given the option to be ACLS certified. RESULTS: Students and stakeholders reported positively on the ability to certify in ACLS at our institution prior to graduation and reported increased confidence in their ability to manage patients with cardiopulmonary arrest. CONCLUSION: Providing simulated experiences for these clinical situations can reportedly increase confidence and improve preparedness in senior-level BSN students. [J Nurs Educ. 2019;58(3):182-184.].