Mentors' cultural competence at mentoring culturally and linguistically diverse nursing students in clinical practice: An international cross-sectional study.

AIMS: This study aimed to identify mentors' cultural competence profiles at mentoring culturally and linguistically diverse nursing students in clinical practice and explore associating factors. BACKGROUND: Globalization has had a significant impact on healthcare, increasing the diversity of healthcare workforces and the number of culturally and linguistically diverse nursing students in clinical practice. The cultural competence of mentors is important to secure students' safe and successful learning. The mentor role in clinical practice contributes toward enabling and ensuring students' high-quality and goal-oriented development of competence. DESIGN: This study implemented a cross-sectional design with a final sample of 270 clinical practice mentors from Finland, Lithuania, Spain and Slovenia. METHODS: The data were collected using an online survey including the Mentors' Cultural Competence Instrument, Mentors' Competence Instrument and background questions during 2020-2021. The data were analyzed using a K-mean cluster algorithm to identify mentors' competency profiles. RESULTS: Three significantly differing mentor competency profiles (Profile A 42%, Profile B 41%, Profile C 17%) were identified in this study. The cultural competence of the mentors in clinical practice varied between intermediate and high levels. Mentors rated their cultural competence as best in the area of cultural sensitivity and awareness, whereas the lowest scored area was cultural interaction and safety. CONCLUSIONS: This study showed that the cultural competence of mentors in clinical practice varied and was influenced by mentors' work experience, age, job title and frequency of mentoring. This study provides new knowledge that could help to develop cultural competence operating models and education to enhance the cultural competence of healthcare professionals.

Autopercepción en competencias docentes en tutores/as de formación sanitaria especializada: estudio transversal / Self-perception in teaching competences in specialized health training mentors: a cross-sectional study

Introducción: La figura del tutor/a en la formación de residentes es relevante y tiene un importante impacto en la formación del profesional. Es objetivo de este estudio conocer las competencias docentes percibidas por los/las tutores/as de formación sanitaria especializada. Material y métodos: Estudio con diseño cuantitativo, descriptivo, transversal y exploratorio, realizado en la Unidad Docente Multiprofesional de Atención Familiar y Comunitaria Costa Ponent. Se emplearon las escalas de competencia de las/los tutores/as (Mentors Competence Instrument) y de competencia cultural de los/las tutores/las (Mentors Cultural Competence Instrument) y 12 preguntas sobre antecedentes. La fiabilidad de las escalas se estimó mediante el coeficiente Alfa de Cronbach, considerándose como puntuación mínima aceptable 0.70. Resultados: Participó el 100% de la población diana (34 personas). El 50% (n=17) no había participado en formaciones de tutorización previamente. El 44,1% (n=15) hacía menos de una semana que había tutorizado estudiantes. El 35.3% (n=12) planificaba 30 minutos/día para la acción tutorial. El 76.5% (n=26) no tenía experiencia en tutorizar estudiantes con diversidad lingüística y cultural. La mayoría (91.2%; n=31) de las/los tutoras/es se perciben como competentes en: la “reflexión durante la tutorización”, las “características de la tutora o el tutor” y la “motivación del tutor/a”. Conclusión: Las/los participantes perciben poseer un elevado nivel competencial en la tutorización del estudiantado. Sin embargo, autoevalúan como medio-bajo su nivel en competencia cultural como tutor/a. Se requiere una formación en tutorización acreditada y continuada en la competencia docente y que potencie la competencia cultural de la tutorización. (AU)

Introduction: The role of the mentor in the training of speciality nursing students is relevant and has a relevant impact on the training of the professional. The objective of this study is to know the teaching competencies perceived by the mentors of specialized health training. Material and methods: A quantitative, descriptive, cross-sectional, and exploratory design study, carried out in the Multiprofessional Teaching Unit for Family and Community Care Costa Ponent. The Mentors Competence Instrument and the Mentors Cultural Competence Instrument were used to assess the participants’ self-perceived level of competency. Additionally, different sociodemographic characteristics of the population were also gathered through a 12-item questionnaire. The reliability of the scales was estimated using Cronbach’s alpha coefficient, considering 0.70 as a minimum acceptable score. Results: 100% of the target population (34) participated in the study: 50% of the sample (n = 17) had not previously participated in mentoring training; 44.1% (n = 15) had mentored students for less than a week; 35.3% (n = 12) planned 30 minutes / day for the mentoring action; 76.5% (n = 26) had no experience in mentoring students with linguistic and cultural diversity. The majority (91.2%; n = 31) perceived themselves as competent in: “reflection during the mentoring process”, the “characteristics of the mentor” and the “motivation of the mentor”. Conclusions: The participants perceive that they have a high level of competence in the students mentoring. However, they self-assess their level of cultural competence as a mentor as medium-low. Accredited and continuous training in mentoring is required in teaching competence and enhancing the mentors’ cultural competence. (AU)

Working Environment, Personal Protective Equipment, Personal Life Changes, and Well-Being Perceived in Spanish Nurses during COVID-19 Pandemic: A Cross-Sectional Study.

During the COVID-19 pandemic, nurses have had to face logistical problems related to critical changes in their work environment, the supply of personal protective equipment (PPE), and hard personal life decisions. This study aimed to investigate the changes in the working environment, PPE use, personal lives, and well-being as perceived by nurses in hospitals and primary care centers in Spain, during the COVID-19 pandemic. A descriptive cross-sectional survey study was conducted in April 2020, including 61 public and private hospitals, and 852 primary care centers. A total of 1296 nurses participated. The redeployment practice for organizational or vulnerability reasons was used by 26.4% of the participants. A total of 61.9% of the nurses doubled the time they used masks, and 8.3% of them could only replace the mask once a week. A total of 11.2% (n = 145) of the nurses left home to avoid infecting their family. Finally, 60.97% of the participants stated that their well-being was reduced compared to the state before the pandemic. Changes in the work environment, the use of PPE, and personal life may be related to the decrease in personal well-being perceived by the nurses.

Mentors' competence in mentoring nursing students in clinical practice: Detecting profiles to enhance mentoring practices.

AIMS: To describe the mentoring competence of clinical practice nurse mentors and identify different mentor profiles. DESIGN: Cross-sectional research design, secondary analysis. METHODS: An international, cross-sectional study design was performed in five European countries. A total of 1 604 mentors from 33 healthcare organizations participated in the study between 2016-2019. The Mentors' Competence Instrument (MCI), which includes seven sub-dimensions and 44 items, was used to collect data. K-means cluster and binary regression analyses were performed to detect mentor profiles and determine how various factors affect competence, respectively. RESULTS: The K-means cluster analysis identified three distinct profiles: A (n = 926); B (n = 566); and C (n = 85). The profiles showed significantly different values (p < .001) across all seven areas of mentoring competence. In comparison with the other profiles, nurses in profile A were older, had more work experience and were more probably to have completed mentoring-specific training.

Mentoring of nursing students-A comparative study of Japan and five European countries.

AIMS: This study aimed to explore mentoring competence in nursing student mentors during clinical practice by identifying different mentor profiles and connections between different competence areas among five European countries and Japan. METHODS: The study implemented a cross-sectional design in Finland, Italy, Lithuania, Slovenia, Spain, and Japan during 2016 and 2019. In total, 6208 mentors were invited, and 1862 participated from 58 healthcare organizations. The data were collected with a survey questionnaire by including background question items with the Mentor Competence Instrument. K-clustering and structural equation modeling were used for data analysis. RESULTS: Four mentor profiles, A (43%), B (30%), C (18%), and D (9%), were identified according to the seven mentoring competence areas with high statistical significance (p < 0.001). Higher mentoring competence (mean >3.50) was observed among Finnish, Lithuanian, and Slovenian mentors with university education in nursing, older ages, more work experience, and previous education in mentoring. Lower competence (mean <2.49) was observed among Japanese and Italian mentors with diplomas in nursing, younger ages, less work experience, and no previous education in mentoring. CONCLUSION: Mentoring requires motivated, highly competent mentors since mentoring is a critical aspect of nursing education. Mentoring roles should be given to nurses with higher education and mentoring training. Younger, less experienced nurses without formal mentoring training may need support from senior nurses when performing mentoring roles and could also facilitate a more balanced workload between patient care and mentoring for senior nurses.

Ethical Tenets of PRN Medicines Management in Healthcare Settings: A Clinical Perspective.

Prescription and administration of pro re nata (PRN) medications has remained a poorly discussed area of the international literature regarding ethical tenets influencing this type of medication practice. In this commentary, ethical tenets of PRN medicines management from the clinical perspective based on available international literature and published research have been discussed. Three categories were developed by the authors for summarising review findings as follows: 'benefiting the patient', 'making well-informed decision', and 'follow up assessment' as pre-intervention, through-intervention, and post-intervention aspects, respectively. PRN medicines management is mainly intertwined with the ethical tenets of beneficence, nonmaleficence, dignity, autonomy, justice, informed consent, and error disclosure. It is a dynamic process and needs close collaboration between healthcare professionals especially nurses and patients to prevent unethical practice.

PRN Medicines Optimization and Nurse Education.

Medicines management is a high-risk and error prone process in healthcare settings, where nurses play an important role to preserve patient safety. In order to create a safe healthcare environment, nurses should recognize challenges that they face in this process, understand factors leading to medication errors, identify errors and systematically address them to prevent their future occurrence. ''Pro re nata'' (PRN, as needed) medicine administration is a relatively neglected area of medicines management in nursing practice, yet has a high potential for medication errors. Currently, the international literature indicates a lack of knowledge of both the competencies required for PRN medicines management and the optimum educational strategies to prepare students for PRN medicines management. To address this deficiency in the literature, the authors have presented a discussion on nurses' roles in medication safety and the significance and purpose of PRN medications, and suggest a model for preparing nursing students in safe PRN medicines management. The discussion takes into account patient participation and nurse competencies required to safeguard PRN medication practice, providing a background for further research on how to improve the safety of PRN medicines management in clinical practice.

Nurses' Adherence to Patient Safety Principles: A Systematic Review.

Background: Quality-of-care improvement and prevention of practice errors is dependent on nurses' adherence to the principles of patient safety. Aims: This paper aims to provide a systematic review of the international literature, to synthesise knowledge and explore factors that influence nurses' adherence to patient-safety principles. Methods: Electronic databases in English, Norwegian, and Finnish languages were searched, using appropriate keywords to retrieve empirical articles published from 2010-2019. Using the theoretical domains of the Vincent's framework for analysing risk and safety in clinical practice, we synthesized our findings according to 'patient', 'healthcare provider', 'task', 'work environment', and 'organisation and management'. Findings: Six articles were found that focused on adherence to patient-safety principles during clinical nursing interventions. They focused on the management of peripheral venous catheters, surgical hand rubbing instructions, double-checking policies of medicines management, nursing handover between wards, cardiac monitoring and surveillance, and care-associated infection precautions. Patients' participation, healthcare providers' knowledge and attitudes, collaboration by nurses, appropriate equipment and electronic systems, education and regular feedback, and standardization of the care process influenced nurses' adherence to patient-safety principles. Conclusions: The revelation of individual and systemic factors has implications for nursing care practice, as both influence adherence to patient-safety principles. More studies using qualitative and quantitative methods are required to enhance our knowledge of measures needed to improve nurse' adherence to patient-safety principles and their effects on patient-safety outcomes.

Development and testing of an evidence-based model of mentoring nursing students in clinical practice.

BACKGROUND: Mentoring in clinical settings is an important factor in the development of nursing students' professional knowledge and competences, but more knowledge of mentors' current and required competences is needed to improve nursing students' clinical learning. OBJECTIVES: This study aimed to develop and test an evidence-based model of mentoring nursing students in clinical practice. DESIGN: An international cross-sectional survey coordinated in five European countries: Finland, Italy, Lithuania, Slovenia and Spain. METHODS: Mentors, 4980 registered nurses working in both primary and specialist healthcare organizations, were invited to participate in the study during 2016-2019. The final sample consisted of 1360 mentors (mean age 41.9 ± 11). Data were collected with background questions and the Mentor Competence Instrument. The instrument was psychometrically validated then the data were used to construct a Structural Equation Model (SEM) with Full Imputation Maximum Likelihood (FIML) estimation. RESULTS: All of six hypotheses were verified. In summary: mentors' characteristics related to their motivation and reflection are positively related to mentoring practices in the workplace, which (together with constructive feedback) are positively related to and foster goal-orientation in students' clinical learning and student-centered evaluation. All parameters in the SEM model were significant and the model's fit indexes were verified (RMSEA = 0.055; SRMR = 0.083; CFI = 0.914, TLI = 0.909). CONCLUSION: Our evidence-based modeling confirms the research hypotheses about mentorship, and identifies focal competences for designing mentors' education to improve students' clinical learning and establish a common European mentoring model. Mentorship is important for both healthcare organizations and educational systems to enhance students' clinical competences, professional growth and commitment to the nursing profession and organizational environments.

PRN Medicines Management for Psychotropic Medicines in Long-Term Care Settings: A Systematic Review.

Many medications are prescribed and administered PRN (pro re nata, as needed). However, there are few integrative reviews to inform PRN psychotropic medication use in long-term care facilities and nursing or care homes. Accordingly, this integrative systematic review aimed to improve our understanding of PRN medicines management with a focus on psychotropic medications (antipsychotics, sedatives, anxiolytics, and hypnotics) in long-term care settings. Keywords relating to PRN in English, Norwegian, and Spanish were used, and articles published between 2009 and 2019 were retrieved. Based on the inclusion criteria, eight articles were used for data analysis and synthesis. This review offers a description of PRN prescription and administration of psychotropic medications in long-term care. Variations were observed in the management of PRN psychotropic medications based on residents' underlying health conditions and needs, duration of use, and changes between medications and doses. Neither the reasons for PRN prescription and administration nor the steps taken to identify and manage any associated adverse reactions or adverse drug events were reported. Further initiatives are needed to improve PRN medicines management to explore factors that affect PRN prescription and administration and to develop appropriate PRN guidelines to prevent harm and improve the safety of people living in long-term care facilities.

Investigación cualitativa en enfermería y competencia cultural / Qualitative nursing research and cultural competence

La Competencia cultural como conocimiento aplicado a la Enfermería será uno de los temas de investigación mas significativos para las próximas décadas y el desarrollo de sus teorías y modelos representa el camino de progreso hacia la consecución de unos cuidados de calidad. El objetivo principal de este trabajo es mostrar las características del equipo de investigación en Enfermería a la hora de profundizar en el terreno de los cuidados, siempre desde la perspectiva de la Competencia cultural y obviamente mediante una metodología de investigación cualitativa. En el desarrollo del trabajo se define el área estudiada así como los componentes de la Competencia cultural aplicada a la investigación que son tres: el conocimiento cultural, la sensibilidad cultural y la colaboración cultural. Es a partir del desarrollo de estos tres puntos cuando podemos llegar a entender el papel del equipo investigador dentro de la metodología cualitativa aplicada a los cuidados de Enfermería, siempre teniendo como referencia la calidad en cuanto a la relación que se establezca entre el investigador y el individuo. Resulta necesario concluir afirmando que siempre que se de un relación de calidad habrá una posibilidad de llevar a cabo un investigación cualitativa de calidad que genere conocimiento enfermero (AU)

La situación social de la juventud en el area del cuidado a traves de la prensa escrita. La década de 1868-1878 en Alicante (España) / Social situation of youth in the care area, case studied though the written mass media during the 1868-1878 decade in Alicante (Spain)

El estudio de la prensa escrita como fuente bibliográfica primaria para la historia de nuestra profesión ofrece datos significativos sobre el área del cuidado y su repercusión social, en el marco espacio temporal al que corresponde la prensa estudiada. Así, la prensa escrita aporta una visión de la situación social de la juventud en el área del cuidado durante la década de 1868- 1878 con todas las peculiaridades y los rasgos característicos de esta época (AU)