Evaluating Nurse Data Navigation Training Program: A Quality Improvement Project.

Nursing ability to navigate data by sourcing, visualizing, and managing data provides for skill and insights development. Effectiveness of clinical, operational and strategic decision making is underpinned by sound understanding of the data. The object of this quality improvement project is to design, deliver and evaluate a nursing specific training program using spreadsheet software Excel to improve nurse competence and confidence in data navigation.

An Examination of Factors That Predict the Perioperative Culture of Safety.

The perioperative setting is an intricate, complicated work environment in which patients are vulnerable to adverse events. Using a convenience sample, we examined relationships between the length of perioperative nurse experience, perioperative nurse engagement, and an OR culture of safety. We explored differences in safety culture scores based on CNOR certification status. There was no significant relationship between the length of perioperative nurse experience and the level of OR culture of safety. However, perioperative nurse engagement had a significant relationship with an OR culture of safety (P < .001), and this factor was a significant predictor of an OR culture of safety (P < .001). Perioperative nurses who held CNOR certification had significantly higher culture of safety scores compared with those who did not (P = .004). Additional research on perioperative nurse engagement and factors relating to patient safety may help perioperative leaders develop and implement engagement strategies.

Contemporary nursing graduates' transition to practice: A critical review of transition models.

AIM AND OBJECTIVE: To critically review contemporary transition theories to determine how they apply to the newly qualified graduate registered nurse programmes. BACKGROUND: Graduate nurse transition to employment is the time of significant change which has resulted in high attrition rates. Graduates are often challenged by their expectation of nursing practice and the reality of the role. The transition from hospital-based training to university-based training has resulted in the need for primary employment to commence with graduate/orientation/internship programmes to help support new graduates transition into clinical practice. One transition model, Duchscher's stages of transition theory, utilised three former theories to develop a final model. DESIGN: A narrative critical literature review. METHOD: The theories selected for the review were Kramer's reality shock theory, Benner's novice to expert theory, Bridges transition theory and Duchscher's stages of transition theory. CONCLUSION: Duchscher's stages of transition theory reflects the experiences of registered nursing transition into the workforce directly from university. The application of the theory is effective to guide understanding of the current challenges that new graduate nurse's experience today. There is a need for new graduates to complete their university degree as advanced beginners in order to decrease the experience of transition shock and keep pace with rapidly changing demands of the clinical environment. This may be achieved by increasing ward-based simulation in university education. A theoretical framework can provide a deep understanding of the various stages and processes of transition and enable development of successful programmes. RELEVANCE TO CLINICAL PRACTICE: Both universities and hospitals need to adapt their current practice to align with the needs of new graduates due to large student numbers and ongoing systematic advancements to decrease the attrition rate.

Competências para o cuidado de mulheres no parto e nascimento mobilizadas em egressos de um curso nacional de especialização em enfermagem obstétrica / Skills for the care of women in childbirth mobilized in graduates of a national specialization course in obstetric nursing

A atenção obstétrica no Brasil e no mundo vivenciou consideráveis progressos, a exemplo da redução da razão de mortalidade e taxas de morbidade materna e neonatal. A enfermagem obstétrica é apontada como uma das profissões potenciais para mudança do modelo obstétrico vigente no Brasil. No entanto, desafios ainda persistem para a efetivação do modelo humanizado e para a atuação da enfermagem, e um deles está no quantitativo de profissionais formados, preparados e qualificados para tal. Compreendendo este desafio, a Escola de Enfermagem da Universidade Federal de Minas Gerais, com financiamento do Ministério da Saúde e vinculado à Rede Cegonha, desenvolve o Curso de Especialização em Enfermagem Obstétrica (CEEO), em parceria com Instituições Federais de Ensino Superior (IFES) de todas as regiões do país. O Curso objetivou a formação de especialistas com atuação em serviços públicos de atenção obstétrica, que além de seguir marcos legais e políticos nacionais para a certificação, adotou as Competências Essenciais (CE) para o exercício básico da obstetrícia como referência. Neste contexto, esta dissertação teve por objetivo identificar as competências mobilizadas por enfermeiros trabalhadores egressos de um curso nacional de especialização em Enfermagem Obstétrica. Esta pesquisa é um recorte de um estudo maior intitulado "Especialização em Enfermagem Obstétrica: avaliação do processo de desenvolvimento e efeitos do curso na perspectiva da formação-intervenção", não experimental, descritiva e de abordagem quantitativa, com uso de banco de dados. Os locais da pesquisa foram as IFES que sediaram o CEEO II ­ Rede Cegonha que ocorreu durante o período de Outubro de 2016 a Janeiro de 2019. Os participantes foram trabalhadores especializandos que concluíram o curso em janeiro de 2019. A coleta de dados foi realizada por meio de dois questionários autoaplicáveis: um referente aos dados sócio demográficos e informações profissionais e o segundo sobre as CE. Os dados foram analisados por meio de estatística descritiva e analítica. Os resultados apontaram para um alto escore de competência e confiança nos domínios relacionados ao trabalho de parto, parto, nascimento e cuidados com o recém-nascido. As competências com maiores escores estavam relacionadas à amamentação, cuidados com o RN em sala de parto e fisiologia do trabalho de parto e as competências com menores escores relacionadas às emergências e urgências obstétricas. Os maiores escores eram dos profissionais com menor tempo de atuação na área, que assistiram entre 20 e 39 partos, que participaram de cursos e eventos nos últimos anos e que prestava assistência em partos na instituição em que atuava. Os resultados evidenciaram que o CEEO II ­ Rede Cegonha contribuiu para a formação de um quantitativo de profissionais qualificados e competentes para atenção obstétrica no e para o SUS e para o fortalecimento das capacidades institucionais, uma vez que investiu na força de trabalho com foco nas necessidades dos serviços e competências de campo, aumentando seus poderes de agir e rumo às mudanças efetivas no modo de ofertarem o cuidado.(AU)

In the whole world midwifery had considerable progress, for example the decrease of mortality and rates of maternal and neonatal morbidity. The midwives are pointed out as one of the potential professional to change the Brazilian obstetric model. However there are challenges that still persist for the implementation of the humanized model and for the performance of nursing, and one of them is the number of prepared and contemplated professionals to offer assistance. In this context, the Nursing School of the Federal University of Minas Gerais, with funding from the Ministry of Health and linked to the Rede Cegonha strategy, develops the Specialization Course in Obstetric Nursing (CEEO), in partnership with Federal Institutions of Higher Education (IFES) at all regions of the country. The course aimed to educate nurses from public health services in nursing obstetrics, adopting the essential competences (CE) for the basic exercise of obstetrics as a reference. In this context, this dissertation aimed to identify the competencies mobilized by the graduated nurses of a national course of specialization in Obstetric Nursing. This research is a part of larger study "Specialization in Obstetric Nursing: evaluation of the process of development and effects in the perspective of training-intervention", a non-experimental, descriptive study with quantitative approach, using database. The research places were the IFES that hosted CEEO II ­ Rede Cegonha from October 2016 to January 2019. Data were collected through two self-applied questionnaires: one given to socio-demographic data and professional information and the second on CE. Data were analyzed using descriptive and analytical statistics. The results pointed to a high score of competence and confidence in data on labor, delivery care and care of the newborn. The competencies with higher scores were related to breastfeeding, care of newborns in the delivery room and physiology of labor, and those with lower scores related to emergencies and obstetric emergencies. The highest scores were from professionals with less time in the area, who attended between 20 and 39 births, who participated in courses and events in the last years and those who assist deliveries at the institution they work. The results showed that CEEO contributed to the formation of a number of qualified and competent professionals for obstetric care in and for the National Health System and for the strengthening of institutional capacities, since it invested in the workforce of health professional focusing on the needs of the services and field competencies, increasing their powers of action and towards the effective changes in offering care.(AU)

Evaluating the Impact of EBP Education: Development of a Modified Fresno Test for Acute Care Nursing.

BACKGROUND: Proficiency in evidence-based practice (EBP) is essential for relevant research findings to be integrated into clinical care when congruent with patient preferences. Few valid and reliable tools are available to evaluate the effectiveness of educational programs in advancing EBP attitudes, knowledge, skills, or behaviors, and ongoing competency. The Fresno test is one objective method to evaluate EBP knowledge and skills; however, the original and modified versions were validated with family physicians, physical therapists, and speech and language therapists. AIMS: To adapt the Modified Fresno-Acute Care Nursing test and develop a psychometrically sound tool for use in academic and practice settings. METHODS: In Phase 1, modified Fresno (Tilson, 2010) items were adapted for acute care nursing. In Phase 2, content validity was established with an expert panel. Content validity indices (I-CVI) ranged from .75 to 1.0. Scale CVI was .95%. A cross-sectional convenience sample of acute care nurses (n = 90) in novice, master, and expert cohorts completed the Modified Fresno-Acute Care Nursing test administered electronically via SurveyMonkey. FINDINGS: Total scores were significantly different between training levels (p < .0001). Novice nurses scored significantly lower than master or expert nurses, but differences were not found between the latter cohorts. Total score reliability was acceptable: (interrater [ICC (2, 1)]) = .88. Cronbach's alpha was 0.70. Psychometric properties of most modified items were satisfactory; however, six require further revision and testing to meet acceptable standards. LINKING EVIDENCE TO ACTION: The Modified Fresno-Acute Care Nursing test is a 14-item test for objectively assessing EBP knowledge and skills of acute care nurses. While preliminary psychometric properties for this new EBP knowledge measure for acute care nursing are promising, further validation of some of the items and scoring rubric is needed.

Development and implementation of a competency-based clinical evaluation tool for midwifery education.

BACKGROUND: The learning goals and evaluation strategies of competency-based midwifery programs must be explicit and well-defined. In the US, didactic learning is evaluated through a standardized certification examination, but standardized clinical competence evaluation is lacking. DESCRIPTION OF THE TOOL: The Midwifery Competency Assessment Tool (MCAT) has been adapted from the International Confederation of Midwives' (ICM) "Essential Competencies" and from the American College of Nurse-Midwives' (ACNM) "Core Competencies", with student self-evaluation based on Benner's Novice-to-Expert theory. The MCAT allows for the measurement and monitoring of competence development in all domains of full-scope practice over the course of the midwifery program. APPLICATION AND EVALUATION OF THE TOOL: Strengths of the MCAT are that it provides clear learning goals and performance evaluations for students, ensures and communicates content mapping across a curriculum, and highlights strengths and gaps in clinical opportunities at individual clinical sites and for entire programs. Challenges of the MCAT lie in balancing the number of competency items to be measured with the tedium of form completion, in ensuring the accuracy of student self-evaluation, and in determining "adequate" competence achievement when particular clinical opportunities are limited. CONCLUSIONS: Use of the MCAT with competency-based clinical education may facilitate a more standardized approach to clinical evaluation, as well as a more strategic approach to clinical site development and use.

From novice to expert: a surgical care practitioner's reflection on their role development.

As co-lead for the AfPP Advancing Surgical Roles Specialist Interest Group, I was recently asked about which procedures a surgical care practitioner (SCP) can be trained to undertake and how the SCP role can be developed fully within the remit of the surgical team. This question enabled me to reflect upon and explore the development of my own role of a vascular and general SCP using Benner's adaptation of the Dreyfus' expertise acquisition model that describes the transition that nurses and, one could argue, all healthcare professionals make from novice to expert practitioners (Benner 1984) (Figure 1).

A conceptual framework for interdisciplinary curriculum design: a case study in neuroscience.

Teaching of interdisciplinary fields of study poses a challenge to course organizers. Often interdisciplinary courses are taught by different departments, and hence, at best provide a multidisciplinary overview. Scientific progress in neuroscience, for instance, is thought to depend heavily on interdisciplinary investigations. If students are only taught to think in particular disciplines without integrating these into a coherent framework to study the nervous system, it is unlikely that they will truly develop interdisciplinary thinking. Yet, it is this interdisciplinary thinking that is at the heart of a holistic understanding of the brain. It is, therefore, important to develop a conceptual framework in which students can be taught interdisciplinary, rather than multidisciplinary, thinking. It is also important to recognize that not all teaching needs to be interdisciplinary, but that the type of curriculum design is dependent on the aims of the course, as well as on the background of the students. A rational curriculum design that aligns learning and teaching objectives is, therefore, advocated.

The Dreyfus model of clinical problem-solving skills acquisition: a critical perspective.

CONTEXT: The Dreyfus model describes how individuals progress through various levels in their acquisition of skills and subsumes ideas with regard to how individuals learn. Such a model is being accepted almost without debate from physicians to explain the 'acquisition' of clinical skills. OBJECTIVES: This paper reviews such a model, discusses several controversial points, clarifies what kind of knowledge the model is about, and examines its coherence in terms of problem-solving skills. Dreyfus' main idea that intuition is a major aspect of expertise is also discussed in some detail. Relevant scientific evidence from cognitive science, psychology, and neuroscience is reviewed to accomplish these aims. CONCLUSIONS: Although the Dreyfus model may partially explain the 'acquisition' of some skills, it is debatable if it can explain the acquisition of clinical skills. The complex nature of clinical problem-solving skills and the rich interplay between the implicit and explicit forms of knowledge must be taken into consideration when we want to explain 'acquisition' of clinical skills. The idea that experts work from intuition, not from reason, should be evaluated carefully.