Assessing the Impact of the COVID-19 Pandemic on Nursing Education: A National Study of Prelicensure RN Programs.

Background: The COVID-19 pandemic has had a profound impact on prelicensure nursing education, leading to widespread disruptions that may have implications for nursing students' learning and engagement outcomes. Understanding how the rapid shift to online and simulation-based teaching methods has affected new graduates' clinical preparedness is critical to ensure patient safety moving forward. Purpose: To assess the impact of institutional, academic, and demographic characteristics on prelicensure nursing students' academic, initial postgraduation, and early career outcomes during the COVID-19 pandemic. Methods: We conducted a mixed-methods longitudinal study focused on prelicensure registered nurse (RN) students entering the core of their didactic and clinical nursing coursework during the pandemic. This study uses a combination of real-time student and faculty self-report data, including externally validated instruments, within and end-of-program standardized test scores, and focus group findings. Various statistical methods, ranging from simpler descriptive and non-parametric methods to Generalized Estimating Equation (GEE) models and detailed textual analysis, are applied to assess student, faculty, and institution-level data. Results: The final sample includes more than 1,100 student and faculty participants affiliated with 51 prelicensure RN programs located across 27 states. Leveraging more than 4,000 course observations collected from fall 2020 to spring 2022 and supplemented by the rich personal narratives of over 60 focus group participants, this study illuminates the breadth, scale, and ever-evolving nature of prelicensure RN programs' efforts to maintain the continuity of nursing students' education during the public health crisis. In doing so, it captures the many ways in which nursing administrators, faculty, and students sought to address the unparalleled challenges they confronted on a day-to-day basis. In particular, the findings provide critical insights into the efficacy of the changes nursing programs made to their course delivery formats to adjust to the confluence of rapidly evolving federal, state, and private restrictions to stem the spread of COVID-19. Conclusion: This study stands as the most comprehensive assessment of prelicensure nursing education in the United States since the onset of COVID-19. It extends knowledge by linking potential deficiencies in students' didactic and clinical education during the pandemic and their early career preparedness, clinical competence, and the patient safety implications therein.

Academic-clinical nursing partnership use an evidence-based practice model.

AIMS AND OBJECTIVES: The purpose of this study was to compare the experience of a new clinical model with traditional clinical teaching and examine the effects of evidence-based practice strategies among staff and student nurses. BACKGROUND: This provides an innovative approach to nursing student clinical learning that emphasised the academic-clinical partnership with the use of a new model called the Evidence-based Clinical Academic Partnership (ECAP) model. The model incorporates three main components (a) unit transformation into an innovative hybrid version of a dedicated education unit (hDEU); (b) Evidence-in-Action (EIA) rounding; and (c) the cognitive apprenticeship theoretical framework. DESIGN: This pilot study used a mixed-method, quasi-experimental design. METHODS: The quantitative portion included a pre-test, post-test non-randomised quasi-experimental design using self-reported survey data. The qualitative methodology used was a hermeneutic phenomenological approach to data interpretation of three focus groups with staff nurses and unit leaders. SQUIRE 2.0 guidelines were followed (Ogrinc et al., 2016). CONCLUSIONS: The themes that emerged emphasised relationships and the partnership with this innovative approach to clinical teaching. The staff nurses emphasised the need for a collaborative approach and having the presence of the academic faculty member as a way to support the teaching and learning aspects with students. RELEVANCE TO CLINICAL PRACTICE: This study did provide significant contributions to the development of an innovative clinical model and highlighted the importance of the academic-clinical partnership with the education of undergraduate nursing students. The study results provided insight to the ways the hDEU framework may be strengthened, such as increased communication and partnership in the implementation of the ECAP model. Implementing curricular change to include innovative clinical models within a nursing programme is vital in this time of healthcare transformation.

Virtual Study-Abroad Through Web Conferencing: Sharing Knowledge and Building Cultural Appreciation in Nursing Education and Practice.

BACKGROUND: With a focus on building global citizens, a U.S. and Norwegian academic collaborative partnership fostered clinical learning experiences addressing cultural and health care comparisons. High-impact educational practices integrated into international clinical experiences, combined with virtual global learning classrooms, highlighted the Sustainable Development Goals. PROBLEM: Given nursing education's requirements, devising innovative strategies expanded global learning in brief but transformative experiences while integrating nontraveling students, especially relevant considering current pandemic-related travel restrictions. APPROACH: We developed an educational experience pairing U.S. students (17 in person; 64 through web conference) and Norwegian students (50 in person; 3 for web conference) in population health experiences, providing required clinical hours and a shared cultural exchange. Integration of nontraveling students in joint virtual global experiences broadened the global learning opportunity for all. CONCLUSION: This work offers insight into how faculty used a virtual global learning experience as a synergistic tool with traditional study abroad.

Provider-directed education to reduce unnecessary neuroimaging in uncomplicated headache disorders.

BACKGROUND: More than 1.9 million annual outpatient visits to neurologists in the United States are associated with headache diagnoses. For uncomplicated headache disorders, the evidence-based practice (EBP) guidelines recommend against neuroimaging unless specific neurological signs and symptoms are present; however, neuroimaging rates have only modestly decreased since the guidelines were developed. LOCAL PROBLEM: We evaluated unnecessary neuroimaging rates in patients with uncomplicated headache at the Emory Department of General Neurology. The rate of unnecessary neuroimaging suggested a provider knowledge gap in the use of neuroimaging in patients with uncomplicated headaches. METHODS: A provider-directed educational session was delivered, and outcomes were evaluated 8 weeks after implementation. The postintervention rates of unnecessary neuroimaging were compared with preintervention rates. INTERVENTIONS: A 15-minute educational session on the EBP guidelines for neuroimaging use in uncomplicated headache was presented to all general neurology providers (n = 9). The providers were given an electronic version of the presentation and a pocket-sized EBP algorithm for neuroimaging in this population. RESULTS: Data collected from the project site's neuroimaging dashboard showed a significantly lower proportion of unnecessary neuroimaging orders in the 8-week posteducational interval (4.2%) compared with the 8-week preeducation interval (7.2%) (t = 2.78, p = .014), a 41.6% reduction. CONCLUSIONS: We found that a provider-directed educational session reviewing the EBP guidelines for neuroimaging in patients with uncomplicated headache disorders was successful in lowering rates of neuroimaging. Implementing similar projects in other departments could further reduce unnecessary neuroimaging use across the organization.

Beyond Articulation Agreements: Expanding the Pipeline for Baccalaureate Nursing in Ohio.

AIM: This article discusses a regionally located approach to seamless nursing education progression in Ohio. The Ohio Action Coalition supported nursing programs in creating educational pathways involving cooperative efforts of academia and clinical practice to provide access for students to achieve a baccalaureate degree. BACKGROUND: The Ohio Action Coalition was formed in 2011 and received its first State Implementation Program grant in 2013, with a major focus on promoting seamless academic progression models. METHOD: The seamless academic progression models have been fully implemented, demonstrating positive results for the progression of baccalaureate-prepared nurses in Ohio. RESULTS: The efforts in Ohio have demonstrated over a 10 percent increase in baccalaureate-prepared nurses. CONCLUSION: Ohio is moving the needle for higher education of nurses at a faster rate than average across the nation.

Use of an Electronic Reporting Tool and Clinical Surveillance Process in the Neonatal Intensive Care Unit to Decrease Risk for Central Venous Catheter Complications Associated With Tip Migration.

This quality improvement project formalized central venous catheter tip surveillance augmented by the use of electronic patient reporting tool. The project setting was a large level IV academic neonatal intensive care unit with a representative convenience sample of patients with central venous catheters and quality improvement reports of complications from tip migration. Providers received education before implementation of a central venous catheter tip surveillance program using a revised electronic reporting tool was initiated. Provider evaluations of the electronic reporting tool included compliance with the guidelines and use of the tool in multidisciplinary patient rounds, and were entered into a database for analysis. Nine evaluations of the electronic reporting tool were completed, with an average of 97% compliance with guidelines. Seven evaluations during multidisciplinary patient rounds using the reporting tool data demonstrated use by both resident physicians and advanced practice nurses. Central venous catheter patient data were reviewed after process implementation. Overall, infant central venous catheter complications related to tip migration decreased following implementation. Therefore, the use of an electronic reporting tool improved compliance with evidence-based clinical practice guidelines and resulted in a decrease in the risk for central venous line complications related to tip migration in this setting.

Doctoral Degree Preferences for Nurse Educators: Findings From a National Study.

BACKGROUND: Current doctoral degree options may not meet needs of nurses desiring educator roles in academic or health care settings. PURPOSE: The purpose of the study was to assess preferences for existing terminal degree options for nurse educators and determine the need for a new doctoral degree in nursing education. METHOD: Nurses in practice, academia, and leadership nationwide (n = 826) answered a 19-item needs assessment survey regarding adequacy of and interest in terminal degree options. RESULTS: More than 60% reported current doctoral degrees available to nurse educators lack content in curriculum development and teaching-learning best practices in nursing. Most data supported a new terminal degree. CONCLUSION: A primary factor in nurses choosing not to enroll in a terminal degree program may be limited availability of education aligned with career goals. The doctor of nursing education, a practice degree parallel to the DNP, could prepare nurses for academic and practice educator roles.

Pride and Competency in Accelerated Nursing Programs.

AIM: The aim of this study was to examine student-level and school-level variation in pride and competency in accelerated nursing programs and the relationship between student satisfaction with instructional methods and perceptions of pride and competency. BACKGROUND: Nursing students in accelerated, second-degree programs have a greater need to feel competent when compared to traditionally educated nurses; however, evidence to illuminate a relationship between faculty instructional methods and student pride and competency is lacking. METHOD: The method was a secondary analysis of data collected from 3,506 students in 130 programs over seven years. RESULTS: Higher levels of satisfaction with instructional methods were associated with higher levels of pride and competency in nursing skills. There was no significant variation in pride and competency in nursing skills across institutions. CONCLUSION: Student satisfaction with instructional methods in accelerated nursing education has an impact on student pride and competency.

Pathways to BSN Education: Teamwork in Ohio.

AIM: The Ohio Action Coalition was formed to address the key recommendations of the Institute of Medicine's Future of Nursing report. BACKGROUND: The Future of Nursing Campaign for Action is a national initiative to guide implementation of the recommendations in the Future of Nursing report. METHOD: Through statewide meetings, leaders from nursing education and practice adopted a statewide competency model. Regional teams provided detailed regional gap analyses using the Ohio Nurse Competency Model and address the Institute of Medicine's foundational pillar that nurses should achieve higher levels of education. RESULTS: Communication among baccalaureate and community colleges and nursing practice has increased statewide as a result of this collaborative project. The teams are committed to exploring ways to standardize and develop adaptable seamless academic progression models for implementation across communities. CONCLUSION: Ultimately, the goal is to positively impact the academic preparation of the Ohio nursing workforce.