An International Scoping Exercise Examining Practice Experience Hours Completed by Nursing Students.

BACKGROUND: There is global acceptance of the need for prelicensure nursing students to complete practice experience hours during their program of education. Yet questions remain about these practice experiences, including those related to duration. METHOD: This article reports findings of a scoping exercise that compared the number of practice experience hours mandated for students undertaking courses that lead to RN licensure in Australia, New Zealand, the United Kingdom, and the United States. RESULTS: Substantial differences were evident between the four countries regarding the number of mandated practice experience hours. There is no clearly linked research evidence to justify the decision made in relation to the mandated number of hours. CONCLUSION: Internationally, there is a need to reexamine the rationale for mandating a minimum number of practice experience hours for students in programs of education that lead to licensing as an RN. [J Nurs Educ. 2019;58(1):33-41.].

Anesthesia interventions that alter perioperative mortality: a scoping review.

BACKGROUND: With over 230 million surgical procedures performed annually worldwide, better application of evidence in anesthesia and perioperative medicine may reduce widespread variation in clinical practice and improve patient care. However, a comprehensive summary of the complete available evidence has yet to be conducted. This scoping review aims to map the existing literature investigating perioperative anesthesia interventions and their potential impact on patient mortality, to inform future knowledge translation and ultimately improve perioperative clinical practice. METHODS: Searches were conducted in MEDLINE, EMBASE, CINAHL, and the Cochrane Library databases from inception to March 2015. Study inclusion criteria were adult patients, surgical procedures requiring anesthesia, perioperative intervention conducted/organized by a professional with training in anesthesia, randomized controlled trials (RCTs), and patient mortality as an outcome. Studies were screened for inclusion, and data was extracted in duplicate by pairs of independent reviewers. Data were extracted, tabulated, and reported thematically. RESULTS: Among the 10,505 publications identified, 369 RCTs (n = 147,326 patients) met the eligibility criteria. While 15 intervention themes were identified, only 7 themes (39 studies) had a significant impact on mortality: pharmacotherapy (n = 23), nutritional (n = 3), transfusion (n = 4), ventilation (n = 5), glucose control (n = 1), medical device (n = 2), and dialysis (n = 1). CONCLUSIONS: By mapping intervention themes, this scoping review has identified areas requiring further systematic investigation given their potential value for reducing patient mortality as well as areas where continued investment may not be cost-effective given limited evidence for improving survival. This is a key starting point for future knowledge translation to optimize anesthesia practice.

Losing the rural nursing workforce: Lessons learnt from resigning nurses.

BACKGROUND: Australian workforce planning predicts a shortfall of nurses by 2025 with rural areas being most at risk. Rural areas have lower retention rates of nurses than metropolitan areas, with remote communities experiencing an even higher turnover of nursing staff. There have been few studies that examine the impact of nurse resignations on rural nursing workforces. OBJECTIVE: This paper is abstracted from a larger study into the reasons why nurses resign from rural hospitals and explores the resignation period. DESIGN: A qualitative study using grounded theory methods. Following in-depth interviewing and transcription, data analysis occurred with the assistance of NVivo software. SETTING: Rural NSW. PARTICIPANTS: Twelve registered nurses who had resigned from rural NSW hospitals and not for reasons of retirement, maternity leave or relocation; two participants were re-interviewed. RESULTS: While the overall study identified a grounded theory which explained rural nurses resign from hospitals due to a conflict of values, three additional themes emerged about the resignation practices at rural hospitals. The first theme identified a 'window period' which was an opportunity for the nurse to be retained. The second theme identified that nurses who had resigned were not involved in formal exit processes such as exit interviews. The third theme captured the flow-on effect from rural nurse resignations resulting in nurses leaving the profession of nursing. CONCLUSION: To facilitate nurse retention, it is important that rural hospitals manage nurse resignations more effectively. This includes re-examining resignation procedures, how nurses are treated and collecting meaningful data to inform retention strategies.