Effect of robot for medication management on home care professionals' use of working time in older people's home care: a non-randomized controlled clinical trial.

BACKGROUND: Medication management has a key role in the daily tasks of home care professionals delivered to older clients in home care. The aim of this study was to examine the effect of using a robot for medication management on home care professionals´ use of working time. METHODS: A pragmatic non-randomized controlled clinical trial was conducted. The participants were home care professionals who carried out home care clients' medication management. Home care clients were allocated into intervention groups (IG) and control groups (CG) (n = 64 and 46, respectively) based on whether or not they received the robot. Data were collected using the Working Time Tracking Form prior to and 1 and 2 months after introducing the intervention. The t-test was used to compare the groups at each three timepoints. Analysis of Covariance was used to examine the groups' differences for the total time for medications as the number of visits per day as the covariate. RESULTS: With robot use, the total amount of home visits decreased by 89.4% and 92.4% after 1 and 2 months of intervention use, respectively, compared to pre-intervention (p < 0.001). The total working time used for medication management considering the number of visits per day decreased from 54.2 min (95% CI 37.4-44.3) to 34.9 min (31.4-38.3), i.e., by slightly over 19 min (p < 0.001) in the IG group. During the follow-up, the total working time used for medication management considering the number of visits per day remained the same in the CG group. CONCLUSION: Using a robot for medication management had a notable effect on decreasing the use of working time of home care professionals. For health services, decreased use of working time for medication management means that the time saved can be assigned to services that cannot be replaced otherwise. More digital solutions should be developed based on home care clients' and professionals' needs to meet the challenge of the growing number of older people in need of home care and ensure their safety. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT05908604 retrospectively registered (18/06/2023).

Nurse educator competence in four European countries-A comparative cross-sectional study.

AIM: The aim of this article is to describe and compare the nurse educator competences in four European countries using three different evaluators: nurse educators (n = 329), heads of a nursing subject (n = 60) and student nurses (n = 1058). DESIGN: The study was conducted as a comparative cross-sectional survey in Finland, Malta, Slovakia and Spain between May 2021 and February 2022. METHODS: The data were collected with an online survey. The instrument used was a 20-item Tool for Evaluation of Requirements of Nurse Teachers, utilizing a 5-point Likert-type scale. The data were analysed statistically and reported according to STROBE guidelines. RESULTS: Nurse educators' competence evaluated positively in all the groups of evaluators, with a mean of >3.5. The self-evaluation of nurse educators' competence was higher than the other evaluators' evaluations. Having a degree in nursing, having completed some pedagogical studies and longer work experience as a nurse educator had a positive association with higher self-evaluated competence among nurse educators. CONCLUSIONS: Nurse educator competence is at a good level in the selected European countries, but further studies are required to find the reasons behind the differences in evaluations. PUBLIC CONTRIBUTION: Each participating educational institution named a contact person who distributed the surveys to the participants and returned the study's metadata to the researchers.

A successful nursing education promotes newly graduated nurses' job satisfaction one year after graduation: a cross-sectional multi-country study.

BACKGROUND: Job satisfaction is a key factor for the successful transition of newly graduated nurses (NGNs) and for retaining NGNs in their workplaces. However, there is limited evidence of the relationship between satisfaction regarding the nursing education program and NGNs' job satisfaction in the first year after graduation. Therefore, this study aims to examine the association of the nursing education related factors and NGNs' job satisfaction. METHODS: A cross-sectional study design with the utilization of data collected from the same respondents one year earlier as educational factors was applied. The data were collected from NGNs (n = 557) in 10 European countries using an electronic survey between February 2019 and September 2020, and analyzed in detail for four countries (n = 417). Job satisfaction was measured with three questions: satisfaction with current job, quality of care in the workplace, and nursing profession. Nursing education related factors were satisfaction with nursing education program, level of study achievements, nursing as the 1st study choice, intention to stay in nursing, and generic nursing competence. The data were analyzed statistically using logistic regression. RESULTS: Most of the NGNs in the 10 countries were satisfied with their current job (88.3%), the quality of care (86.4%) and nursing profession (83.8%). Finnish, German, Lithuanian and Spanish NGNs' satisfaction with the nursing education program at graduation was statistically significantly associated with their job satisfaction, i.e., satisfaction with their current job, the quality of care, and the nursing profession. Moreover, NGNs who had fairly often or very often intention to stay in nursing at graduation were more satisfied with their current job, with the quality of care, and with the nursing profession compared with NGNs who had never or fairly seldom intention to stay in nursing at graduation. CONCLUSIONS: Nursing education plays a significant role in NGNs' job satisfaction one year after graduation, indicating the importance to start career planning already during nursing education. Both nursing education providers and healthcare organizations could plan in close collaboration a transition program for NGNs to ease the transition phase and thus increase the NGNs' job satisfaction and ultimately the high-quality care of the patients.

Self-assessed competence of final-year nursing students.

AIM: To examine the overall level of self-assessed competence of final-year nursing 'bachelors' degree students in the Czech Republic. In addition, the study aimed at the factors associated with the students' level of competence. DESIGN: A cross-sectional observational study. METHODS: Data were collected with the Czech version of the Nurse Competence Scale from 274 final-year nursing students of the bachelor's nursing program. Data were analysed using descriptive statistics and multiple regression analyses. RESULTS: Majority of the students (80.3%) assessed their level of competence as good or very good. The highest level of competence was assessed in the category of 'managing situations' (VAS mean 67.8) and 'work role' (VAS mean 67.2). Previous work experience in healthcare and successful supervisory experience had a positive association with self-assessed competence. Students who completed clinical placement during the COVID-19 pandemic assessed their level of competence as lower than students before the pandemic. No Patient or Public Contribution.

Home care professionals' experiences of successful implementation, use and competence needs of robot for medication management in Finland.

AIM: To describe home care professionals' individual experiences of the implementation, use and competence needs of a robot for medication management in older people's home care. DESIGN: A qualitative focus group interview study. METHODS: Data were collected during spring and autumn 2021 by semi-structured focus group interviews and analysed using inductive content analysis. The participants were 62 home care professionals working in older people's home care. RESULTS: The successful implementation and use of the robot for medication management consisted of a timely and adequate introduction before the implementation of the robot, the fluent usability of the robot in daily work, and confidence in work competence. There is a need for the reorganization of home care professionals' use of digital solutions to make workflow fluent, prevent burnout and turnover among home care professionals. Professionals' competence should also be developed to ensure that it corresponds to digitalized healthcare. PATIENT AND PUBLIC CONTRIBUTIONS: No patient or public contribution.

Graduating Nursing Students' Empowerment and Related Factors: Comparative Study in Six European Countries.

New nurses are needed in healthcare. To meet the role expectations of a registered nurse, nursing students must feel empowered at graduation. However, there are only a few studies focusing on nursing students' empowerment. This study aims to describe and analyze graduating nursing students' level of empowerment in six European countries and potential related factors. A comparative and cross-sectional study was performed in the Czech Republic, Finland, Italy, Portugal, Slovakia, and Spain with graduating nursing students (n = 1746) using the Essential Elements of Nurse Empowerment scale. Potentially related factors included age, gender, a previous degree in health care, work experience in health care, graduation to first-choice profession, intention to leave the nursing profession, level of study achievements, satisfaction with the current nursing programme, clinical practicums, theoretical education, and generic competence measured with the Nurse Competence Scale. The data were analysed statistically. Graduating nursing students' self-assessed level of empowerment was moderate, with statistical differences between countries. Those with high empowerment had no intention to leave the nursing profession, had a higher level of study achievements, and a higher self-assessed generic competence level. The results suggest that empowerment needs to be enhanced during nursing education. Further research is needed to understand the development of empowerment during the early years of a nursing career.

The first COVID-19 new graduate nurses generation: findings from an Italian cross-sectional study.

BACKGROUND: Nursing education has been disrupted by the onset of the COronaVIrus Disease 19 (COVID-19) pandemic, potentially impacting learning experiences and perceived competencies at the time of graduation. However, the learning experiences of students since the onset of COVID-19, their perceived competences achieved and the employment status one month after graduation, have not been traced to date. METHODS: A cross sectional online survey measured the individual profile, the learning experience in the last academic year and the perceived competences of the first COVID-19 new nursing graduates in two Italian universities. Details relating to employment status and place of employment (Covid-19 versus non-COVID-19 units) one month after graduation were also collected and the data compared with those reported by a similar cohort of new graduates pre-pandemic in 2018-2019. All those who graduated in November 2020 and attended their third year after the onset of the COVID-19 pandemic were eligible. The online survey included individual, nursing programme and first working experience variables alongside the Nurse Competence Scale (NCS). Descriptive and inferential statistical analyses were performed. RESULTS: A total of 323 new graduates participated. In their last academic year, they experienced a single, long clinical placement in non-COVID-19 units. One month after graduation, 54.5% (n = 176) were working in COVID-19 units, 22.9% (n = 74) in non-COVID-19 units and 22.6 (n = 73) were unemployed. There was no statistical difference among groups regarding individual variables and the competences perceived. Fewer new graduates working in COVID-19 units experienced a transition programme compared to those working in non-COVID-19 units (p = 0.053). At the NCS, the first COVID-19 new graduate generation perceived significantly lower competences than the pre-COVID-19 generation in the 'Helping role' factor and a significant higher in 'Ensuring quality' and 'Therapeutic interventions' factors. CONCLUSIONS: The majority of the first COVID-19 new graduate generation had been employed in COVID-19 units without clinical experience and transition programmes, imposing an ethical debate regarding (a) the role of education in graduating nurses in challenging times with limited clinical placements; and (b) that of nurse managers and directors in ensuring safe transitions for new graduates. Despite the profound clinical placement revision, the first COVID-19 new graduate generation reported competences similar to those of the pre-COVID-19 generation, suggesting that the pandemic may have helped them to optimise the clinical learning process.

Nursing students' self-directed learning abilities and related factors at graduation: A multi-country cross-sectional study.

AIM: To describe nursing students' level of self-directed learning abilities and identify possible factors related to it at graduation in six European countries. DESIGN: A cross-sectional comparative design across the countries. METHODS: The study was conducted from February 2018 to September 2019. Nursing students (N = 4,135) from the Czech Republic, Finland, Italy, Portugal, Slovakia and Spain were invited to respond to the research instruments (the Self-Rating Scale of Self-Directed Learning and the Nurse Competence Scale) at graduation. The data were analysed using the chi-square test, Pearson correlation coefficient and the linear model. RESULTS: The nursing students' (N = 1,746) overall self-directed learning abilities were at high level in all countries. Statistically significant differences occurred between countries. Spanish nursing students reported the highest level of self-directed learning abilities while students from the Czech Republic reported the lowest. Higher level of self-directed learning abilities was related to several factors, particularly with the self-assessed level of competence and country.

Effectiveness of a combined web-based and simulation-based continuing education on home-care professionals' competence to evaluate older people's acute care needs in Finland.

Home-care professionals need competences to ensure that they evaluate their older peoples' health conditions, especially in acute care situations. This study aims to investigate the effectiveness of combined web-based and simulation-based continuing education on home-care professionals' competence regarding evaluating older people's needs for acute care. A quasi-experimental pre-test-post-test study was conducted with home-care professionals who were working in older people's care in Finland. Home-care professionals (N = 254) had participated in combined web-based and simulation-based continuing education in 2017-2019. Data were collected using a questionnaire developed for this study before (n = 171) and after (n = 83) the education. The data were analysed statistically. The mean competence score was 3.22 ± 0.51 before the education and 3.92 ± 0.57 after the education. Improvements were detected in overall competence and in all eight subscales. Improvements were highest in health assessment and consultation and the lowest in type 2 diabetes, but this was already the highest level of self-assessed competence in the pre-test assessment. The combined web-based and simulation-based continuing education was effective in increasing the home-care professionals' competence in evaluating older people's needs for acute care. Evaluating older people's needs for acute care should be embedded in curricula and continuing education programmes.

The level of competence of graduating nursing students in 10 European countries-Comparison between countries.

AIM: To analyse graduating nursing students' self-assessed competence level in Europe at graduation, at the beginning of nursing career. DESIGN: An international cross-sectional evaluative design. METHODS: Data were collected in February 2018-July 2019 from graduating nursing students in 10 European countries. Competence was assessed with a validated instrument, the Nurse Competence Scale (NCS). The sample comprised 3,490 students (response rate 45%), and data were analysed statistically. RESULTS: In all countries, graduating nursing students assessed their competence as good (range 50.0-69.1; VAS 0-100), albeit with statistically significant differences between countries. The assessments were highest in Iceland and lowest in Lithuania. Older students, those with working experience in health care, satisfied with their current degree programme, with excellent or good study achievements, graduating to 1st study choice and having a nursing career plan for future assessed their competence higher.

Nurse educators' perceptions of factors related to the competence of graduating nursing students.

BACKGROUND: Clinical practice, clinical nursing teaching, curricula, working experience and previous healthcare degrees are factors related to the competence of graduating nursing students from the points of view of nursing students and clinical mentors. However, nurse educators' perceptions of these factors are lacking in previous studies, despite assessing student performance and competence is a core competence and one of the main duties of nurse educators. OBJECTIVES: The aim of this study was to describe nurse educators' perceptions of factors related to graduating nursing students' competence. DESIGN: The study was conducted using a descriptive qualitative approach utilising focus group interviews in data collection. PARTICIPANTS: A purposive sample consisting of 23 volunteer nurse educators from five Finnish universities of applied sciences took part in seven group interviews. METHODS: Data was collected in guided, semi-structured interviews, based on a literature review of previous studies. The data was analysed using a deductive-inductive content analysis. RESULTS: According to nurse educators, six main categories describing factors related to graduating nursing students' competence were found: (1) commitment to the nursing profession, (2) experiences in healthcare, (3) learning abilities, (4) learning environments, (5) student characteristics and (6) the nurse educator's role. CONCLUSIONS: To ensure the adequate competence of the graduating nursing students, students' commitment to the nursing profession and their learning abilities and should be supported, and the quality of the learning environments, especially those of study groups and successful clinical practices, should be ensured during the education.

Clinical learning environment and graduating nursing students' competence: A multi-country cross-sectional study.

The purpose of this study was to explore nursing students' perceptions of their final clinical learning environment and its association with their self-assessed competence, satisfaction with nursing education, and turnover intentions at graduation in six European countries. A multi-country comparative cross-sectional study was conducted with nursing students (n = 1746) from the Czech Republic, Finland, Italy, Portugal, Slovakia, and Spain using the Nurse Competence Scale and the Clinical Learning Environment and Supervision scale. Nursing students' overall perceptions of their final clinical learning environment and supervision were positive in all the countries studied. The correlation between the students' perceptions of their final clinical learning environment and competence was statistically significant and positive. Satisfaction with the nursing program and clinical practicum and no consideration of career change were related to positive perceptions of the final clinical learning environment. Highlighting the importance of the supervisory relationship and pedagogical atmosphere, nursing students' positive perceptions of the final clinical learning environment and supervision contribute to a better level of self-assessed competence and satisfaction with the nursing program and clinical practicum, leading to lower turnover intentions.

Students' Self-assessed Competence Levels during Nursing Education Continuum - A Cross-sectional Survey.

During nursing education, nursing students are required to develop their competence to be able to fulfill their duties safely as Registered Nurses. The aims of this study were to explore 1) nursing students' self-assessed competence levels during education 2) the relationship with competence and frequency at which competencies are utilized in clinical practice, and 3) factors related to competence levels. 841 (response rate 67.6 %) nursing students responded to the Nurse Competence Scale in a cross-sectional study. The self-assessed overall competence levels were improving during the education continuum (VAS-means 1st 56.6; 2nd 58.3; 3rd 59.8 and 3.5th -year students 68.4). Every group revealed a significant positive correlation with competence and frequency at which competencies are utilized in clinical practice in clinical placement. Risk factors for low competence were also identified. Systematic multimethod competence evaluations with longitudinal designs are needed to monitor outcomes of nursing education.

Self-assessed level of competence of graduating nursing students and factors related to it.

BACKGROUND: The transition from a nursing student to a professional nurse is both challenging and stressful. Competence of graduating nursing students is related to patient safety and there is a need for assessment of competence. However, there is a lack of research on the level of competence at the moment of graduation. OBJECTIVES: To describe the level of competence of graduating nursing students based on students' self-assessments and to identify possible related factors. DESIGN: Cross-sectional survey design. METHODS: The data were collected using an on-line survey (the Nurse Competence Scale) in 2011 and administered to 302 graduating nursing students in Finland practicing in their final clinical placement in university hospitals. The sample contained 154 students (response rate 51%). The data were analyzed statistically. RESULTS: The self-assessed overall competence was on good level (66.7, VAS 0-100). The competence was highest in helping role and in diagnostic functions, being slightly lower in therapeutic interventions and work role. Pedagogical atmosphere during the final clinical placement had a statistically significantly positive correlation with the overall level of competence. CONCLUSIONS: Graduating nursing students have good competence at the moment of graduation based on their self-assessments. Self-assessment is a basis for competence development, and systematic self-assessments should be used during the education. Teacher and supervisor assessments and knowledge-tests could be used alongside with self-assessments of competence to give a wider picture of the competence.