Nurses' perspectives, attitudes and experiences related to e-learning: A systematic review.

OBJECTIVE: To summarize the current evidence on registered nurses (RNs) perspectives, attitudes and experiences related to e-learning. DESIGN: A systematic review of the literature. DATA SOURCES: The CINAHL, PubMed, Embase, the Cochrane Library, Scopus and Web of Science databases were searched for studies published in English from 2000 to 2021. REVIEW METHODS: The study followed the 2020 Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. Inclusion criteria comprised studies with cross-sectional, quasi-experimental, qualitative, and randomised control designs on the attitudes toward, perspectives and experiences of registered nursing about e-learning. Quality appraisal for each study, based on their designs, was assessed using the Joanna Briggs Institute (JBI) critical appraisal checklist. Data were synthesized using a narrative approach. RESULTS: In the 15 included studies, 4 were high quality while 11 were moderate quality. Four themes were revealed in this review including e-learning approaches, facilitators of e-learning and barriers to e-learning barriers to e-learning among RNs and learning in practice barriers. CONCLUSIONS: The systematic review uncovered that E-learning is an effective method for integrating knowledge with practice and promoting professional development among RNs in healthcare settings. However, RNs may lack motivation to engage with E-learning and face challenges associated with user-friendly platforms.

The mental health impact of COVID-19 on pre-registration nursing students in Australia: Findings from a national cross-sectional study.

AIM: The study aimed to measure and describe the mental health impact of COVID-19 on Australian pre-registration nursing students. BACKGROUND: The COVID -19 pandemic has had a swift and significant impact on nursing students across the globe. The pandemic was the catalyst for the closure of schools and universities across many countries. This necessary measure caused additional stressors for many students, including nursing students, leading to uncertainty and anxiety. There is limited evidence available to identify the mental health impact of COVID-19 on Australian pre-registration nursing students currently. DESIGN: A cross-sectional study was conducted across 12 Australian universities. METHODS: Using an anonymous, online survey students provided demographic data and self-reported their stress, anxiety, resilience, coping strategies, mental health and exposure to COVID-19. Students' stress, anxiety, resilience, coping strategies and mental health were assessed using the Impact of Event Scale-Revised, the Coronavirus Anxiety Scale, the Brief Resilience Scale, the Brief Cope and the DASS-21. Descriptive and regression analyses were conducted to investigate whether stress, anxiety, resilience and coping strategies explained variance in mental health impact. Ethical Approval was obtained from the University of New England Human Research Ethics Committee (No: HE20-188). All participating universities obtained reciprocal approval. RESULTS: Of the 516 students who completed the survey over half (n = 300, 58.1%) reported mental health concerns and most students (n = 469, 90.9%) reported being impacted by COVID-19. Close to half of students (n = 255, 49.4%) reported signs of post-traumatic stress disorder. Mental health impact was influenced by students' year level and history of mental health issues, where a history of mental health and a higher year level were both associated with greater mental health impacts. Students experienced considerable disruption to their learning due to COVID-19 restrictions which exacerbated students' distress and anxiety. Students coped with COVID-19 through focusing on their problems and using strategies to regulate their emotions and adapt to stressors. CONCLUSION: The COVID-19 pandemic has considerably impacted pre-registration nursing students' mental health. Strategies to support nursing students manage their mental health are vital to assist them through the ongoing pandemic and safeguard the recruitment and retention of the future nursing workforce. IMPACT STATEMENT: This study adds an Australian understanding to the international evidence that indicates student nurses experienced a range of negative psychosocial outcomes during COVID-19. In this study, we found that students with a pre-existing mental health issue and final-year students were most affected. The changes to education in Australian universities related to COVID-19 has caused distress for many nursing students. Australian nursing academics/educators and health service staff need to take heed of these results as these students prepare for entry into the nursing workforce. PATIENT OR PUBLIC INVOLVEMENT: The study was designed to explore the impact of COVID-19 on the mental health of undergraduate nursing students in Australia. Educators from several universities were involved in the design and conduct of the study. However, the study did not include input from the public or the intended participants.

Perioperative nurses' experiences of caring for donation after cardiac death organ donors and their family within the operating room.

Background: Worldwide, operating rooms have seen the re-emergence of donation after cardiac death organ donors to increase the number of available organs. There is limited information on the issues perioperative nurses encounter when caring for donor patients after cardiac death who proceed to organ procurement surgery. Objectives: The purpose of this paper is to report a subset of findings derived from a larger study highlighting the difficulties experienced by perioperative nurses when encountering donation after cardiac death organ donors and their family within the operating room during organ procurement surgery from an Australian perspective. Methods: A qualitative grounded theory method was used to explore perioperative nurses' (n = 35) experiences of participating in multi-organ procurement surgery. Results: This paper reports a subset of findings of the perioperative nurses' experiences directly related to donation after cardiac death procedures drawn from a larger grounded theory study. Participants revealed four aspects conceptualised as: 'witnessing the death of the donation after cardiac death donor'; 'exposure to family'; 'witnessing family grief' and 'stepping into the family's role by default'. Conclusion: Perioperative nurses' experiences with donation after cardiac death procedures are complex, challenging and demanding. Targeted support, education and training will enhance the perioperative nurses' capabilities and experiences of caring for the donation after cardiac death donor and their family with the operating room context.

Coping and caring: support resources integral to perioperative nurses during the process of organ procurement surgery.

AIMS AND OBJECTIVES: To discuss and explore the levels of support provided to perioperative nurses when participating in multi-organ procurement surgery and the impact to their overall well-being. BACKGROUND: Assisting within multi-organ procurement surgical procedures has been recognised to impact on the well-being of perioperative nurses leaving little opportunity for them to recover from their participation or to seek available support resources. To date, this area has remained largely unexplored with limited evidence of how nurses manage and cope with these procedures, in addition to the support received in the workplace. DESIGN: A qualitative grounded theory method. METHODS: The study was informed by perioperative nurses (n = 35) who had previous participatory experience in these surgical procedures from two Australian states. Theoretical sampling directed the collection of data via semistructured in-depth interviews. Data were analysed using the constant comparative method. RESULTS: Three components of levels of support were identified from the data: lacking support within the operating room organisation; surgical team support and access to external professional support. CONCLUSION: These findings offer new insights into how nurses manage and cope with their participation in organ procurement surgical procedures and what types of support resources can be seen as barriers or enablers to their overall experiences. The need for timely and adequate support is vital to their overall well-being and future participation in organ procurement surgery. These findings have the potential to guide further research with implications for clinical initiatives and practices, looking at new ways of supporting perioperative nurses within the clinical environment both locally and internationally. RELEVANCE TO CLINICAL PRACTICE: Healthcare organisations need to acknowledge the emotional, psychosocial and psychological health and well-being of nurses impacted by these surgical procedures and provide appropriate and timely clinical support within the work environment.

Duty and dilemma: Perioperative nurses hiding an objection to participate in organ procurement surgery.

Perioperative nurses assist in organ procurement surgery; however, there is a dearth of information of how they encounter making conscientious objection requests or refusals to participate in organ procurement surgery. Organ procurement surgical procedures can present to the operating room ad hoc and can catch a nurse who may not desire to participate by surprise with little opportunity to refuse as a result of staffing, skill mix or organizational work demands. This paper that stems from a larger doctoral research study exploring the experiences of perioperative nurses participating in multi-organ procurement surgery used a grounded theory method to develop a substantive theory of the nurses' experiences. This current paper aimed to highlight the experiences of perioperative nurses when confronted with expressing a conscientious objection towards their participation in these procedures. A number of organizational and cultural barriers within the healthcare organization were seen to hamper their ability in expressing a conscience-based refusal, which lead to their reluctant participation. Perioperative nurses must feel safe to express a conscientious objection towards these types of surgical procedures and feel supported in doing so by their respective hospital organizations and not be forced to participate unwillingly.

Experiential learning not enough for organ procurement surgery: implications for perioperative nursing education.

CONTEXT: Perioperative nurses play a vital role in assisting in surgical procedures for multiorgan procurement, receiving little education apart from on-the-job experiential learning when they are asked to participate in these procedures. OBJECTIVES: Within an Australian context and as part of a larger study, this article describes issues that hindered perioperative nurses' participatory experiences as a result of lacking education, previous exposure, and preparation for assisting in surgical procedures for organ procurement. DESIGN: The grounded theory method was used to develop a substantive theory of perioperative nurses' experiences of participating in surgical procedures for multiorgan procurement. PARTICIPANTS: Thirty-five perioperative nurses who had experience in surgical procedures for organ procurement from regional, rural, and metropolitan hospitals of 2 Australian states, New South Wales and Western Australia, participated in the research. RESULTS: Levels of knowledge and experience emerged from the data as an influencing condition and was reported to affect the perioperative nurses' participatory experiences when assisting in procurement surgical procedures. Six components of levels of knowledge and experience were identified and are described. CONCLUSION: The findings from this study provide a unique contribution to the existing literature by providing an in-depth understanding of the educational needs of perioperative nurses in order to assist successfully in multiorgan procurement procedures. These findings could guide further research with implications for clinical initiatives or education programs specifically targeting the perioperative nursing profession both locally and internationally.

Australian perioperative nurses' experiences of assisting in multi-organ procurement surgery: a grounded theory study.

INTRODUCTION/BACKGROUND: Multi-organ procurement surgical procedures through the generosity of deceased organ donors, have made an enormous impact on extending the lives of recipients. There is a dearth of in-depth knowledge relating to the experiences of perioperative nurses working closely with organ donors undergoing multi-organ procurement surgical procedures. AIM: The aim of this study was to address this gap by describing the perioperative nurses experiences of participating in multi-organ procurement surgical procedures and interpreting these findings as a substantive theory. DESIGN: This qualitative study used grounded theory methodology to generate a substantive theory of the experiences of perioperative nurses participating in multi-organ procurement surgery. SETTING: Recruitment of participants took place after the study was advertised via a professional newsletter and journal. The study was conducted with participants from metropolitan, rural and regional areas of two Australian states; New South Wales and Western Australia. PARTICIPANTS: Thirty five perioperative nurse participants with three to 39 years of professional nursing experience informed the study. METHODS: Semi structured in-depth interviews were undertaken from July 2009 to April 2010 with a mean interview time of 60 min. Interview data was transcribed verbatim and analysed using the constant comparative method. RESULTS: The study results draw attention to the complexities that exist for perioperative nurses when participating in multi-organ procurement surgical procedures reporting a basic social psychological problem articulated as hiding behind a mask and how they resolved this problem by the basic social psychological process of finding meaning. CONCLUSION: This study provides a greater understanding of how these surgical procedures impact on perioperative nurses by providing a substantive theory of this experience. The findings have the potential to guide further research into this challenging area of nursing practice with implications for clinical initiatives, management practices and education.