Harnessing Innovative Technologies to Train Nurses in Suicide Safety Planning With Hospital Patients: Formative Acceptability Evaluation of an eLearning Continuing Education Training.

BACKGROUND: Suicide is the 12th leading cause of death in the United States. Health care provider training is a top research priority identified by the National Action Alliance for Suicide Prevention; however, evidence-based approaches that target skill building are resource intensive and difficult to implement. Novel computer technologies harnessing artificial intelligence are now available, which hold promise for increasing the feasibility of providing trainees opportunities across a range of continuing education contexts to engage in skills practice with constructive feedback on performance. OBJECTIVE: This pilot study aims to evaluate the feasibility and acceptability of an eLearning training in suicide safety planning among nurses serving patients admitted to a US level 1 trauma center for acute or intensive care. The training included a didactic portion with demonstration, practice of microcounseling skills with a web-based virtual patient (Client Bot Emily), role-play with a patient actor, and automated coding and feedback on general counseling skills based on the role-play via a web-based platform (Lyssn Advisor). Secondarily, we examined learning outcomes of knowledge, confidence, and skills in suicide safety planning descriptively. METHODS: Acute and intensive care nurses were recruited between November 1, 2021, and May 31, 2022, to participate in a formative evaluation using pretraining, posttraining, and 6-month follow-up surveys, as well as observation of the nurses' performance in delivering suicide safety planning via standardized patient role-plays over 6 months and rated using the Safety Plan Intervention Rating Scale. Nurses completed the System Usability Scale after interacting with Client Bot Emily and reviewing general counseling scores based on their role-play via Lyssn Advisor. RESULTS: A total of 18 nurses participated in the study; the majority identified as female (n=17, 94%) and White (n=13, 72%). Of the 17 nurses who started the training, 82% (n=14) completed it. On average, the System Usability Scale score for Client Bot Emily was 70.3 (SD 19.7) and for Lyssn Advisor was 65.4 (SD 16.3). On average, nurses endorsed a good bit of knowledge (mean 3.1, SD 0.5) and confidence (mean 2.9, SD 0.5) after the training. After completing the training, none of the nurses scored above the expert-derived cutoff for proficiency on the Safety Plan Intervention Rating Scale (≥14); however, on average, nurses were above the cutoffs for general counseling skills per Lyssn Advisor (empathy: mean 4.1, SD 0.6; collaboration: mean 3.6, SD 0.7). CONCLUSIONS: Findings suggest the completion of the training activities and use of novel technologies within this context are feasible. Technologic modifications may enhance the training acceptability and utility, such as increasing the virtual patient conversational abilities and adding automated coding capability for specific suicide safety planning skills. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): RR2-10.2196/33695.

The effect of an educational intervention on perioperative registered nurse's knowledge, attitudes, and behaviors towards pressure injury prevention in surgical patients.

BACKGROUND: Pressure injuries continue to be a significant problem in perioperative patients. Surgical patients are particularly at risk due to lack of mobility and sensation during surgery and the early recovery period. The AORN (2024) recommends that healthcare organizations develop a comprehensive prevention program that includes risk assessment, prevention, and education. OBJECTIVES: To measure the effect of an educational intervention on perioperative nurses' knowledge, attitudes, and behaviors towards pressure injury prevention after one week and again after six months. METHODS: Nurse's knowledge, attitudes, and behaviors were measured at three different time periods using quantitative nonexperimental pretest posttest longitudinal design. Three hundred fifty-four perioperative registered nurses from 11 acute care hospitals participated. RESULTS: Nurses' knowledge scores were in the moderate range. Statistically significant differences were found between pre-test and posttest 1 scores, indicating that knowledge improved after nurses completed the education intervention and information was retained six months after. Nurses' attitudes were neither positive nor negative towards pressure injury prevention. Regarding behavior, the majority of nurses reported carrying out pressure injury prevention strategies, however only half reported carrying out daily risk assessment strategies. CONCLUSIONS: To prevent pressure injury in perioperative patients, it is imperative that guidelines for the prevention of perioperative pressure injury (AORN, 2024) are integrated into nursing practice.

Partnering With Clinicians Supporting Nursing Students' Clinical Placement at a Regional Hospital.

BACKGROUND: Innovative models are required to maximize nursing student placements in environments of shrinking budgets, increasing hospital demands, and casualization and aging of the workforce. This article reports the success of a service-academic partnership in a dedicated education unit. METHOD: This cross-sectional observational study in a regional hospital analyzed survey data using validated tools completed by buddy nurses (n = 80) and postplacement evaluation completed by students (n = 102) and the nurse leadership team (n = 17). RESULTS: Postimplementation, nursing student placement days increased, and participants were positive about the partnership. Although most of the nursing students (n = 96) reported they were very or extremely satisfied with their placement, they rated student facilitators higher than their buddy nurses. CONCLUSION: Increasing enrollments will not solve the nursing workforce shortage unless student placements of quality and quantity are provided. Partnership in support of clinical staff remains critical to create time to provide quality supervision. [J Nurs Educ. 2024;63(9):619-625.].

Non-Pharmacological Pain and Stress Management (N-PPSM) in Pediatric Wards: A Nurses' Perspective.

PURPOSE: To describe the nurses' use of non-pharmacological pain and stress management (N-PPSM) in pediatric wards and their perceptions of the benefits and perceived barriers that encourage and limited their use of these methods. METHODS: This was a descriptive cross-sectional study involving 125 nurses working in the pediatric ward of an Indonesian hospital. Data collection utilized modified non-pharmacological method questionnaires, and data analysis involved t-tests and ANOVA. RESULTS: The most widely used N-PPSM by nurses are cognitive methods such as providing education (48%), physical methods by positioning (40%), emotional support (36%), environmental support (45%), and family support (60%). Nurses stated that N-PPSM had few side effects (50.4%), were inexpensive (49.6%), could be performed independently (51.2%), and were easy to use (52.8%). However, during its implementation, there were several obstacles including lack of experience (42.4%), lack of training (48%), lack of equipment (45.6%), nurse belief (36.8%), lack of time (44%), patient unwilling (47.2%), and patient belief (41.6%). Work experience influences the overall utilization of N-PPSM (p-value = .043). CONCLUSION: The findings from this research emphasize the significance of enhanced training for nurses working in the utilization of N-PPSM in pediatric wards. CLINICAL IMPLICATIONS: Findings from this study can enhance nurses' knowledge and competence in using N-PPSM in pediatric wards, thus improving patient care. Hospitals may consider implementing new policies, education, training, and infrastructure to support N-PPSM. Educational institutions can also incorporate these methods into nursing curricula, increasing nurses' awareness and skills in using N-PPSM in pediatric patients.

A Novel Approach to Supporting Ambulatory Nursing Professional Development.

BACKGROUND: Because of the growth of nursing care in ambulatory clinics, nursing education and professional development needs have increased. METHOD: At one academic medical center, development of a combined centralized-decentralized nursing professional development model addressed the needs of this expansion. RESULTS: Hiring dedicated nursing professional development staff for prioritized education programs improves throughputs and outputs associated with nursing professional development. CONCLUSION: Implementation of unit-based clinic rounding has improved staff engagement with education, professional development, and quality outcomes. [J Contin Educ Nurs. 2024;55(9):449-455.].

Development of a Critical Reflection Mentorship Program to Enhance Critical Thinking Among Novice Nurses.

BACKGROUND: The increasing complexity of care and the decrease in overall nursing experience pose a threat to patient safety and clinical outcomes in health care. Within the local environment, a critical need was identified to connect expert bedside nurses with novice nurses to support the development of critical thinking. METHOD: This article describes the development and pilot evaluation of a critical reflection mentorship program, Beyond the Bedside. The program was developed and deployed in three inpatient units within an adult academic health center. Critical thinking was evaluated using the Nursing Critical Thinking in Clinical Practice Questionnaire (N-CT-4 Practice) pre- and postprogram implementation. RESULTS: Five nurses participated in the pre- and postevaluation, and the N-CT-4 Practice mean scores were significantly higher after program implementation. CONCLUSION: Education leaders should prioritize programs that support critical thinking among novice nurses, and the Beyond the Bedside program can be adapted for use in other health care settings. [J Contin Educ Nurs. 2024;55(9):456-460.].

Effects of a Standardized Patient-Based Delirium Care Education Program.

Background and Purpose: An education program to improve the delirium care competency of nurses is important as they play an integral role in caring for patients with delirium. This study aimed to examine the effects of a standardized patient (SP)-based delirium care education program on new graduate nurses' performance and self-confidence. Methods: A waitlist control group with a crossover design was adopted. The SP-based delirium care education program was designed, implemented, and evaluated. Generalized estimating equations were used to analyze differences in performance and self-confidence scores between the intervention and waitlist control groups. Results: The education program was found to significantly affect rater-assessed performance, SP-assessed performance, and self-confidence when controlled for gender and age. Implications for Practice: An SP-based delirium care education program improved new graduate nurses' performance and self-confidence in caring for patients with delirium. Nurse educators should provide experiential learning opportunities to ensure that recent nurse graduates have achieved optimal delirium care competency.

Think-aloud approach combined with case-based learning in nursing teaching round for new nurses in cancer hospital.

BACKGROUND: The transition from nursing students to working as new nurses can be a challenging process. This study aimed to assess the efficacy of a pedagogical approach amalgamating the think-aloud approach and case-based learning in the instructional rounds for new nurses. METHODS: Utilizing convenience sampling, new nurses were selected between 2020 and 2021 in China cancer hospital. A total of 98 participants agreed to participate, with 50 enrolled in 2020 as the control group and 48 in 2021 as the observation group. Across a span of weeks 1, 3, 5, 7, 9, and 11, each clinical department conducted six teaching rounds. The observation group engaged in teaching rounds combining the think-aloud approach with case-based learning, whereas the control group solely utilized case-based learning. Disparities in case analysis scores and critical thinking ability between the two groups were scrutinized, alongside an analysis of learning strategies and the observation group feedback. RESULTS: The observation group exhibited superior case analysis scores (91.92 ± 6.33) and overall critical thinking ability scores (308.39 ± 35.88) in comparison to the control group, which scored (85.27 ± 5.39) and (275.11 ± 31.32) respectively, reflecting statistically significant variances (t = 1.868 ~ 6.361, P < 0.05). Predominant learning strategies employed in the observation group ranged from cognitive to meta-cognitive, followed by psychosocial strategies. During interviews focused on nurses' feedback on the learning process, themes emerged surrounding the enhancement of learning proficiency, invigoration of learning enthusiasm, and bolstering psychological well-being. CONCLUSION: The combination of think-aloud approach and case-based learning in nursing teaching rounds greatly improves the efficiency of training and the critical thinking acuity of new nurses. Concurrently, it facilitated an evaluation of learning strategies, thereby offering valuable insights for the nursing teaching rounds of new nurse.

How clinical resource nurses can support new nurses and address safety concerns.

ABSTRACT: Inexperienced nursing staff can jeopardize patient safety and contribute to burnout. This quality improvement project evaluated a clinical resource nurse (CRN) role designed to address disparities in nurses' skills and experience. Survey results suggested that the CRN role effectively supported novice nurses.

Impact of aromatherapy on anxiety among ICU nurses: A randomized, blinded, placebo-controlled trial.

PURPOSE: The purpose of this study was to examine the effect of aromatherapy with an essential oil blend containing lavender, bergamot, ylang-ylang, and sweet orange, compared with placebo, on perceptions of anxiety in ICU RNs. METHODS: Nurses recruited from six adult ICUs and a neonatal ICU participated in this blinded, randomized, placebo-controlled study, which took place over a 30-day intervention period. RESULTS: Although there were no statistically significant changes in anxiety pre- to postintervention or between the intervention and placebo groups, there were also no adverse events or untoward effects. CONCLUSION: The results of this study may support aromatherapy as an evidence-based strategy to reduce anxiety in ICU nurses. Additional research is needed.

Online Educational Module Improves Knowledge of Nurses on Bowel Preparation for Colonoscopy.

The effectiveness of colonoscopy is limited by the adequacy of bowel preparation. Nurses are essential in providing bowel cleansing agents and instructions for hospitalized patients before colonoscopy. This study aims to assess and improve the knowledge of nurses on bowel preparation for inpatient colonoscopy. Participants were asked to complete the survey before and after completing an educational module. The module and survey questions were placed in the NetLearning environment of the hospital intranet. A minimum post-test score of 80% was required to pass the course. A total of 1,107 nurses participated in the survey. Overall, the average score improved from 87% to 93% after the module (p < .0495). Knowledge of the different ways of consuming bowel cleansing agents improved from 54.3% to 83.6% (p = .0001). Only 56.2% of nurses knew how to carry out a split-dose bowel preparation regimen, which increased to 80.1% after the educational module (p = .0001). Nurses' knowledge about the different ways of consuming bowel cleansing agents before colonoscopy and the split-dose regimen is inadequate. A simple online educational module significantly improved the knowledge of nurses on bowel preparation for colonoscopy.

Early Identification, Intervention, and Prevention of Hospital-Acquired Pressure Injuries Using a Nurse-Driven Pressure Injury Prevention Program.

PURPOSE/OBJECTIVES: The purpose of this quality improvement project was to reduce the hospital-acquired pressure injury (HAPI) rate to less than 1.177 per 1000 patient-days, increase staff competency and care in pressure injury prevention best practices through implementation of a nurse-driven pressure injury prevention program, to engage patients in pressure injury prevention through implementation of skin rounds, and improve staff adherence to documentation requirements for pressure injury interventions on an amputee/stroke unit. DESCRIPTION OF THE PROJECT/PROGRAM: HAPIs can lead to negative patient outcomes including pain, infection, extended hospitalization, and morbidity. Using an evidence-based education strategy, the Agency for Healthcare Research and Quality pressure ulcer prevention clinical pathway and skin rounds were implemented. Focused education for nursing, staff competency, daily audits, HAPI rates, and documentation compliance were evaluated pre and post intervention. OUTCOMES: The HAPI rate reduced from 1.177 to 0.272 per 1000 patient-days. After completion, the unit maintained zero pressure injuries, daily patient care for pressure injuries improved, documentation compliance increased, and staffs' knowledge and skill set in early identification, intervention, and prevention of pressure injuries heightened. CONCLUSION: A nurse-driven pressure injury prevention program was successful in the reduction of the HAPI rate.

Summarizing a Debriefing Session in Professional Development.

The summary of the debriefing session is critical to acknowledge the work of each participant and to identify the learnings. Key approaches include the importance of including everyone and maintaining a positive, upbeat attitude. [J Contin Educ Nurs. 2024;55(9):423-424.].

Leveraging the Impact of Nurses on the Educational Experience and Professional Development of the Physician Trainee.

Nurses play an essential role in the receptivity and support of the learning environment for physician trainees as they develop their clinical skills and professional identity. Although effective interprofessional teams are increasingly identified as critical to patient safety, their impact on the educational experience of learners in the clinical environment is under-recognized. We argue that highlighting nurses' contributions to physician trainee development at the start of their employment in an academic setting can encourage all providers to actively build a supportive clinical learning environment. [J Contin Educ Nurs. 2024;55(9):421-422.].

Evaluating Intensive Care Nurses' Knowledge of Incontinence-Associated Dermatitis: A Multicenter Cross-sectional Study.

OBJECTIVE: To determine the knowledge levels of nurses working in the ICU about incontinence-associated dermatitis (IAD). METHODS: A descriptive cross-sectional study was conducted in adult ICUs at two private and three public hospitals in a province in Turkey. The study included 296 nurses who agreed to participate in the research. Researchers used the "Nurse Identification Form" and the "IAD Knowledge Test" to collect data on nurses' IAD knowledge. Data analysis included the use of percentage distribution and the Mann-Whitney U, Kruskal-Wallis, and Spearman correlation tests. RESULTS: The mean age of the nurses was 26.55 ± 3.89 years (range, 20-47 years), and the duration of working in the ICU was 2.71 ± 2.55 years (range, 1-22 years). Of the nurses, 183 (61.8%) worked in general ICUs. Of those, 69 (23.3%) received IAD training. Nurses achieved a 49.8% correct response rate on the IAD knowledge test. Nurses working in tertiary and general ICUs demonstrated higher IAD knowledge levels (Ps = .003 and .047, respectively). There were no relationships between age, career length, institution, ICU type, and IAD knowledge level. CONCLUSIONS: Nurses' knowledge level of IAD was low in intensive care. To remedy this, IAD should be added to intensive care nursing certificate programs as content, and the use of IAD risk assessment and diagnosis scales in ICUs should be expanded.

Using Debriefing in Professional Development Courses.

Debriefing is a valuable tool to use when developing teamwork skills. The skill set can be either a specific outcome talent, such as a class on building teams, or a team skill set needed to successfully complete a team project. Professional development faculty can work to acquire and expand the skills described in this column. [J Contin Educ Nurs. 2024;55(8):375-377.].

Distinctive Transition to Practice Program Design Leads to Reliable Positive Outcomes.

Designing a transition to practice program to increase foundational skill competency and interprofessional collaboration before unit orientation can produce outcomes that consistently outperform benchmarks. Established structures and processes drive the program to be easily amenable to incremental improvement, further maturing and sustaining the program's positive impacts. [J Contin Educ Nurs. 2024;55(8):369-371.].

Current trends and obstacles in off-the-job nursing ethics training in Japanese hospitals: a cross-sectional study.

Objectives: This study aims to fill the existing gap by examining the current status of off-the-job nursing ethics training in large hospitals in Japan and its integration with on-the-job training to provide targeted insights for enhancing future ethics training. Method: A cross-sectional study was conducted among the nursing education staff of large Japanese hospitals [N=309] by self-administered questionnaire. The questionnaire was the following main points 1) current trends in nursing ethics training 2) planners' concerns, and 3) the link between training and clinical practice. Descriptive statistics were used, closed-ended questions were analyzed through simple tabulations while open-ended questions underwent textual analysis. Results: The hospitals of 76.6% (309) conducted off-the-job nursing ethics training. Their training consists of a combination of lectures and exercises. The focus was to raise nurses' awareness of ethical problems or improve their analytical ability. The objectives were to be able to participate in discussions from an ethical perspective. The main problems were the lack of connection with on-the-job, and a shortage of training personnel. Conclusions: The key to providing off-the-job and on-the-job is to create a mechanism for circulation. The implications of the results are the necessity of constructing ethics education in medicine to develop medical professionals who can discuss and act from ethical perspectives. Future research is expected to include the creation of a multidisciplinary ethics training program for the hospital.