Construction of a nursing assessment framework for patients in anaesthesia recovery period: A modified Delphi study.

AIM: To construct a nursing assessment framework for patients in anaesthesia recovery period. DESIGN: A three-round modified Delphi method was employed to capture the consensus of 22 panellists. METHODS: The initial items in the nursing assessment framework for patients in anaesthesia recovery period were developed based on the mini-clinical evaluation exercise (mini-CEX). A panel of 22 experts participated in this study. The panellists have more than 10 years of experience in either clinical anaesthesia, or post-anesthesia nursing, or operating room nursing, or surgical intensive nursing. Between March and April 2023, the panellists evaluated and recommended revisions to the initial framework. RESULTS: This study resulted in the development of a nursing assessment framework for patients in anaesthesia recovery period. The initial version of the framework consisted of six dimensions with 27 items. Six items were modified after the first round of consultation. After the second round, five modifications and four deletions were made based on expert opinion. The third round resulted in a convergence of expert opinion. The framework, which consists of 24 items across five dimensions, was refined. The five dimensions are as follows: History-taking, Physical assessment, Clinical judgement, Organizational efficiency and Humanistic concern. CONCLUSION: The nursing assessment framework for patients in anaesthesia recovery period was reached consensus between the 22 experts' opinions. IMPLICATIONS FOR THE PROFESSION AND PATIENT CARE: The assessment framework constructed in this study could be used for the process evaluation of post-anesthesia nursing. The framework may guide perianesthesia nurses in the timely and effective assessment of patients during this critical phase of care. It may be used for perianesthesia nursing education or to evaluate nurses' assessment skills. REPORTING METHOD: The study is reported in accordance with the Guidance on Conducting and Reporting DElphi Studies (CREDES) recommendations. PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution.

In-situ simulation for nursing students' professional competence development in postanesthesia care: A quasi-experimental study.

AIM: To evaluate the differences in professional competence development between nursing students in routine clinical practice and those who experienced four additional in-situ simulations. BACKGROUND: The amount of clinical practice time available to nursing students is limited. Occasionally, clinical settings do not provide all of the content that nursing students are expected to acquire. In high-risk clinical scenarios, such as the postanesthesia care unit, clinical practice may not provide sufficient context for students to develop the professional competence. DESIGN: This was a non-blinded, non-randomized, quasi-experimental study. The study was conducted in the postanesthesia care unit of a tertiary hospital in China between April 2021 and December 2022. Nursing students' self-assessed professional competence development and faculty-assessed clinical judgment were used as indicators. METHODS: A total of 30 final year undergraduate nursing students were divided into two groups according to the time they arrived at the unit for their clinical practice. Nursing students in the control group followed the routine teaching protocol of the unit. Students in the simulation group received four additional in-situ simulations during the second and third weeks of their practice in addition to the routine program. Nursing students self-assessed their postanesthesia care unit professional competence at the end of the first and fourth weeks. At the end of the fourth week, the nursing students were evaluated on their clinical judgment. RESULTS: Nursing students in both groups scored higher on the professional competence at the end of the fourth week than at the end of the first week and there was a trend of higher competence improvement in the simulation group than in the control group. For clinical judgment, nursing students in the simulation group scored higher than the control group. CONCLUSIONS: In-situ simulation contributes to the development of professional competence and clinical judgment of nursing students during their clinical practice in the postanesthesia care unit.

Bedside handover with structured and relayed forms in a postanesthesia care unit: A pre- and post-implementation study.

BACKGROUND: Early postoperative patients are vulnerable. Poor communication between health care professionals may seriously damage patients' wellbeing. There is a risk of information loss when bedside handover is performed. OBJECTIVES: To investigate whether the implementation of structured and relayed forms to shift-to-shift bedside handovers improve the frequency of appropriate handover elements and reduces the incidence of adverse events and postoperative length of stay for patients in a postanesthesia care unit. METHODS: This quality improvement project was conducted in a postanesthesia care unit of a tertiary stomatological hospital in China. The study population was patients under surveillance in the postanesthesia care unit for >12 h. A pre- and post-implementation approach was employed. The pre-implementation of unstructured bedside handovers and the post-implementation of bedside handovers with structured and relayed forms were compared. The indicators measured were appropriate handover elements, adverse patient events, and postoperative hospital stay. RESULTS: There were 387 and 395 morning handovers observed pre- and post-implementation of bedside handovers with structured and relayed forms, respectively. Of the 21 elements that should be delivered, 17 elements were noted to be improved. No improvement was found in the incidence of adverse events and postoperative hospital stay. CONCLUSIONS: Bedside handovers with structured and relayed forms increased the incidence of appropriate handover elements. The use of structured and relayed forms did not affect on the incidence of adverse events and postoperative hospital stay. Individualized relayed handover forms may be developed and implemented according to the characteristics in which they are administered.

Development of the professional competence and professional self-concept of undergraduate nursing students during the clinical practice period: A cross-lagged panel analysis.

AIM: To explore the relationship of the development of professional competence and professional self-concept of undergraduate nursing students during the clinical practice period. BACKGROUND: Clinical practice is one of the most important aspects of nursing education. Nursing students combine theoretical knowledge, psychomotor skills and emotions in a professional socialization process through clinical practice sessions. DESIGN: A two-time point longitudinal design was performed. A cross-lagged model was employed to analyze the relationship between the development of professional competence and professional self-concept of undergraduate nursing students during their clinical practice period. METHODS: A total of 210 undergraduate nursing students were included in this study. The questionnaire was distributed two months and six months after their clinical practice started. Professional Self Concept of Nurses Instrument and Professional Competence Scale for Undergraduate Nursing Students were the two main instruments. RESULTS: Both the professional competence and professional self-concept of Undergraduate nursing students increase at the end of the sixth month compared with the end of the second month after their clinical practice started. The results of the cross-lagged analysis showed that the professional self-concept was partially responsible for the development of professional competence. The effect of professional competence on the development of professional self-concept, in contrast, was not found in this study. CONCLUSIONS: Clinical nursing educators should pay greater attention to the development of the professional self-concept of undergraduate nursing students. More attention should be paid to creating a supportive clinical learning environment to facilitate the improvement of undergraduate nursing students' professional self-concept and professional competence.

Translation, Cross-Cultural Adaptation, and Psychometric Properties of the Chinese Version of the Surgical Fear Questionnaire.

PURPOSE: To translate the Surgical Fear Questionnaire into Chinese, to culturally adapt, and test the validity and reliability of the Chinese version of the Surgical Fear Questionnaire. DESIGN: The translation and cultural adaptation process followed Sousa's guidelines, including the evaluation of this scale by the selected participants and content validity measurement by experts. A cross-sectional design was employed to the psychometric properties evaluation phase. METHODS: A convenience sample of 336 participants from three hospitals was recruited between July 2019 and December 2019. Internal consistency reliability, construct validity, and convergent validity with the Hospital Anxiety and Depression Scale were analyzed. FINDINGS: Confirmatory and exploratory factor analyses of the Chinese version of the Surgical Fear Questionnaire yielded a two-factor solution, with each factor comprised of four items, which were the same as the original English scale. The Chinese version showed a moderate correlation with the two domains of the Hospital Anxiety and Depression Scale. Cronbach's alpha and McDonald's Omega in the present sample showed excellent internal consistency. CONCLUSIONS: The Chinese version of the Surgical Fear Questionnaire is a reliable and valid instrument to assess the fear before surgical procedures under general anesthesia.