An Innovative Use of the Logic Model for a Qualitative Analysis Framework.

BACKGROUND: Qualitative analysis can be a daunting and time-consuming task for those who are attempting to code qualitative data for the first time. METHOD: This article presents select secondary data analysis from a previously published study to demonstrate the applicability and usefulness of implementing a logic model approach to provide a framework for qualitative analysis. RESULTS: The use of the logic model provided systematic organization during the analysis process, efficiency for analytical tasks, and enhanced trustworthiness by documenting each analysis step. The model allowed for easier visualization of data that facilitated a richer and more focused analysis. CONCLUSION: With qualitative data that are focused on processes or outcomes, implementing a logic model framework to categorize and organize data can be useful and efficient, particularly for a novice analyst whether analyzing qualitative text for quality improvement, evidence-based practice, program evaluation, or formal research. [J Contin Educ Nurs. 202x;5x(x):xx-xx.].

Modifiable factors contributing to belongingness of undergraduate nursing students in the clinical learning environment: An exploratory study.

BACKGROUND: Belongingness has been tied to positive personal and educational outcomes in undergraduate nursing students in the clinical learning environment, but there is limited literature on specific factors that promote these important feelings of acceptance and value alignment. OBJECTIVES: This study aimed to assess demographic characteristics, program/clinical structure factors, and modifiable clinical setting factors that may impact feelings of belongingness in U.S. undergraduate nursing students in the clinical learning environment. DESIGN: A cross-sectional survey design was used to assess the relationship between demographics, program/clinical structure factors, and modifiable clinical setting factors and levels of belongingness using the U.S. version of the Belongingness Scale - Clinical Placement Experience. SETTING: A national study was conducted via the National Student Nurses Association database from December 2022 to January 2023. PARTICIPANTS: 759 volunteer undergraduate nursing students in the U.S. who had completed at least one clinical course. METHODS: An online survey was disseminated to assess demographic factors, program/clinical structure factors, students' perceptions on the frequency of occurrence and perceived value of modifiable clinical setting factors (including clinical format, clinical site, relationship and interpersonal, and miscellaneous factors), and to measure levels of belongingness experienced. RESULTS: Bivariate analyses revealed one statistically significant program/clinical structure factor (p <.001) and 10 statistically significant modifiable clinical setting factors (p <.001) that contribute to belongingness. The findings also support the use of the U.S. version of the BES-CPE as a reliable and valid instrument. CONCLUSIONS: Results demonstrate the importance of fostering belongingness in undergraduate nursing students in the clinical learning environment and, for the first time, extrapolate qualitative findings from the literature into the identification of factors that contribute to these critical feelings of inclusion. There are immediate implications for nursing educators and a rich foundation for future intervention research is proposed.

CE: Current and Emerging Applications of Fecal Microbiota Transplantation.

ABSTRACT: Fecal microbiota transplantation (FMT) is a life-changing treatment for people with recurrent Clostridioides difficile infection (rCDI). Frequently acquired in the hospital, CDI can cause serious gastrointestinal symptoms, including persistent watery diarrhea, abdominal pain, and severe dehydration. Antibiotics, the primary treatment, can unfortunately disrupt the gut microbiome and lead to antimicrobial resistance. FMT involves introducing stool from a healthy donor into the affected recipient to strengthen their compromised microbiome. Individuals receiving this treatment have reported remarkable improvement in clinical outcomes and quality of life. In addition to a discussion of rCDI within the context of the gastrointestinal microbiome, this article provides an overview of the FMT procedure, discusses nursing management of individuals undergoing FMT, and highlights emerging applications beyond rCDI. A case scenario is also provided to illustrate a typical trajectory for a patient undergoing FMT.

Longitudinal Assessment to Evaluate Continued Certification and Lifelong Learning in Healthcare Professionals: A Scoping Review.

The balance of lifelong learning with assessment for continued certification is a challenge faced by healthcare professions. The value of single-point-in-time assessments has been questioned, and a shift to longitudinal assessments (LA) has been undertaken to assess lifelong learning over-time. This scoping review was conducted to inform healthcare certifying organizations who are considering LA as an assessment tool of competence and lifelong learning in healthcare professionals. A search of 6 databases and grey literature yielded 957 articles. After screening and removal of duplicates, 14 articles were included. Most articles were background studies informing the underpinnings of LA in the form of progress testing, pilot studies, and process of implementation. Progress testing is used in educational settings. Pilot studies reported satisfaction with LA's ease of use, online format, and provision of lifelong learning. Implementation processes reveal that key aspects of success include stakeholder participation, phased rollout, and a publicly available content outline. Initial outcomes data affirm that LA addresses knowledge gaps, and results in improved performance on maintenance of certification exams. Future research is needed to substantiate validity evidence of LA and its correlation with high-stakes exam performance when assessing lifelong learning and continued competence of healthcare professionals over time.

Belongingness in undergraduate/pre-licensure nursing students in the clinical learning environment: A scoping review.

AIM: The aim of this scoping review was to map the literature investigating belongingness in undergraduate/pre-licensure nursing students in the clinical learning environment. BACKGROUND: The concept of belongingness, which encompasses feelings of acceptance, connection and value alignment, has been tied to positive outcomes in undergraduate/pre-licensure nursing students including increased learning, participation, confidence and professional socialization. It is critical for educators and clinical staff to foster a sense of belongingness for nursing students to promote positive and effective clinical learning experiences. DESIGN: The scoping review strategy established by the Joanna Briggs Institute was followed. The databases searched were CINAHL Complete (EBSCO), Education Source, Medline Complete (EBSCO), APA PsycINFO (EBSCO) and Epistemonikos. METHODS: Following a search of the five databases, studies were screened by title and abstract by two independent reviewers for inclusion. Data including population, concept, context, methods and key findings relevant to the review question were extracted and synthesized using an instrument developed by the reviewers. RESULTS: A total of 47 articles with varying methodologies were critically appraised. Three overarching focus areas emerged: outcomes resulting from feelings of belongingness versus alienation, factors that contribute to a sense of belongingness in the clinical learning environment and interventions to promote a sense of belongingness while students are immersed in the clinical learning environment. CONCLUSIONS: Belongingness in the clinical learning environment is an important concept that lends itself to positive learning experiences and increased satisfaction of undergraduate/pre-licensure nursing students. Environmental, relational and experiential factors can be maximized and specific interventions employed to promote belongingness. This review identifies a lack of evidence on measured interventional effectiveness at the student, school and clinical unit level. Future research to address these gaps is recommended. TWEETABLE ABSTRACT: Scoping review suggests environmental, relational and experiential factors promote positive outcomes in belongingness of nursing students.

Long-Term Outcomes of a Collaborative Regional Evidence-Based Practice Fellowship.

Academic-practice partnerships provide a model for sharing resources, increasing professional knowledge and skills, improving patient outcomes, and strengthening organizational cultures of quality and safety. This article describes the long-term outcomes of a regional collaborative evidence-based practice fellowship. Results reveal the fellowship had a measurable positive impact on fellows' evidence-based practice knowledge and practice, project outcomes, professional growth, and the culture of excellence within partner organizations.

Capturing the Impact of the Doctor of Nursing Practice Degree on West Texas Health Care.

BACKGROUND: This article describes findings from a Phase 1 investigation exploring the influence of Doctor of Nursing Practice (DNP)-prepared nurses in West Texas. METHOD: Following a focus group session with eight practicing DNPs, the focus group shared how their roles effected safer health care. RESULTS: Final takeaways included their commitment to safer health care and prevention, moving care to the community, and a wish for more variety in projects generated in workplaces. Three themes emerged from the data: DNP leadership practice affects health outcomes through improved quality of care, influence, and innovation; DNP strengths include communication, leadership, and ability to change others' thinking; and the influence of DNP-prepared leaders at all external levels occurs through both increasing awareness of the role and influencing in multiple areas. DNP challenges include lack of understanding by others of the role and the lack of recognition and respect for their educational preparation. CONCLUSION: Leading, innovating, and communicating during constantly changing care models are key skills needed during the current health care crisis. These skills are basic to DNP practice. [J Contin Educ Nurs. 2021;52(4):192-197.].

Original Research: Nurses' Perspectives on Caring for Patients with Do-Not-Resuscitate Orders.

BACKGROUND: Confusion about what a do-not-resuscitate (DNR) order means, including its misinterpretation as "do not treat," has been extensively documented in the literature. Yet there is a paucity of research concerning nurses' perspectives on DNR orders. PURPOSE AND DESIGN: This mixed-methods study was designed to explore nurses' perspectives on the meaning and interpretation of DNR orders in relation to caring for hospitalized adults with such orders. METHODS: Direct care nurses on three units in a large urban hospital were asked to respond online to a case study by indicating how they would prioritize care based on the patient's DNR designation. These nurses were then invited to participate in open-ended interviews with a nurse researcher. Interviews were audiotaped, transcribed, and analyzed. FINDINGS: A total of 35 nurses responded to the case study survey. The majority chose to prioritize palliative care, despite no indication that any plan of care was in place. Thirteen nurses also completed a one-on-one interview. Analysis of interview data revealed this overarching theme: varying interpretations of DNR orders among nurses were common, resulting in unintended consequences. Participants also reported perceived variances among health care team members, patients, and family members. Such misinterpretations resulted in shifts in care, varying responses to deteriorating status, tension, and differences in role expectations for health care team members. CONCLUSIONS: Nurses have opportunities to address misconceptions about care for patients with DNR orders through practice, education, advocacy and policy, and research.

Regulation and accreditation of pre-licensure education of registered nurses: a scoping review protocol.

OBJECTIVE: The objective of the scoping review is to examine and map the literature that reports outcomes of the regulation and accreditation of pre-licensure education of registered nurses (RNs). INTRODUCTION: Pre-licensure nursing education is the basic education that a person must complete before becoming an RN. Regulation and accreditation of nursing education vary by country and may vary within a country. The intended purpose of regulation and accreditation is to protect the public and ensure the quality of education programs; however, there is a gap in published evidence on the outcomes of such regulation and accreditation. INCLUSION CRITERIA: Published and unpublished studies worldwide of any pre-licensure RN students or any pre-licensure graduates of RN programs will be considered. Concepts of interest for the proposed review are reported outcomes related to regulatory activities or accreditation requirements affecting any pre-licensure education programs preparing students to become RNs. The context is pre-licensure regulation or accreditation of RN education in any country or setting. This review will consider quantitative research designs, qualitative research designs, economic evidence evaluations, and textual evidence/gray literature. METHODS: Databases to be searched include CINAHL Complete, Cochrane Central Register of Controlled Trials, Directory of Open Access Journals, Education Source, Health Policy Reference Center, MEDLINE Complete, Epistemonikos, JBI Database of Systematic Reviews and Implementation Reports, and Ovid Nursing. Articles published in English will be included. No date limits will be set. Selected studies will be reviewed and data extracted by two independent reviewers. Extracted data will be placed in a table and synthesized in narrative format.

Learning outcomes of the observer role in nursing simulation: a scoping review protocol.

OBJECTIVE: The purpose of this study is to map the literature investigating learning outcomes that have been measured in the observer role in simulation. A scoping review will be completed to investigate the research question: What learning outcomes have been reported in nurses or nursing students participating in simulation while assigned to the observer role? INTRODUCTION: Simulation-based learning experiences (SBLE) are being utilized more frequently to support learning with increasing numbers of nurses. Despite SBLE becoming more popular, resources and manikin availability are not meeting the demand placed on simulation programs in nursing schools and health care facilities. Programs are placing more learners in observational roles without knowing what learning can be expected. INCLUSION CRITERIA: Studies will be considered if they investigated learning outcomes of any nursing population (e.g. pre-licensure nursing student, graduate nursing student, practicing nurse) placed in an observational role in simulation. Any simulation topic related to nursing care will be considered. The observer role may involve observing one's own or expert behavior. The SBLE may occur in a simulation lab, classroom, community, health care facility, or online setting. Studies that include health care professionals other than nurses will be excluded. Experimental, quasi-experimental, observational, and qualitative studies will be considered. METHODS: The JBI methodology for scoping reviews will be followed. A three-step search strategy will be used to identify potentially relevant articles. Two independent reviewers will screen titles and abstracts, assess full-text studies against the inclusion criteria, and extract data. Results will be presented in a manner that aligns with the objective of the review.