American Association of Colleges of Nursing: New Essentials, Quality and Safety Domain.

Since 1986, the American Association of Colleges of Nursing (AACN) has published its Essentials, a framework to guide all levels of nursing education and practice. This brief overview will describe the latest AACN Essentials.

Representation of dark skin tones in foundational nursing textbooks: An image analysis.

PURPOSE: This study aimed to analyze and quantify the representation of dark skin tones (DST) images/graphics across fifteen foundational and clinical nursing textbooks to understand the degree of portrayed diversity in current nursing texts. BACKGROUND: The United States (U.S.) population is becoming more ethnically and racially diverse. There is a scarcity of nursing literature, studies, and educational materials on the assessment and early recognition of common skin assessment in patients with dark skin tones (DST). The underrepresentation of people with DST images in didactic material suggests that omissions of these images in educational resources may introduce bias in health care provider education and practice. METHODS: Fifteen popular foundational and clinical nursing textbooks were selected and analyzed. All the photo images and drawn graphics in these textbooks were coded according to Fitzpatrick's skin phototype (FSP) scale, which categorizes skin tone as (a) "Light" or Fitzpatrick scale I or II, (b) "Medium" or Fitzpatrick scale III or IV, and (c) "Dark" or Fitzpatrick scale V or VI. The training was provided for data collectors before analysis to ascertain good inter-rater reliability (Cohen's kappa = 0.960 for light skin tone, Cohen's kappa = 0.899 for medium skin tone, and Cohen's kappa = 0.913 for dark skin tone). RESULTS: Analysis of 14,192 photo images and drawn graphics depicting skin tone was completed across 15 foundational and clinical nursing textbooks. 12.3 % of photo images and 2.4 % of drawn graphics depicted dark skin tones, compared to 60.9 % of photo images and 82.8 % of drawn graphics that displayed light skin tones in these textbooks. CONCLUSIONS: Nursing textbooks overrepresent light skin tones and underrepresent dark skin tones. While the approximate racial distribution of the U.S. population is 59.3 % non-Hispanic-White, 13.6 % Black/African American, and 26.6 % Person of Color, the images and graphics of skin tones represented 68 % light, 15 % medium, and 9.4 % dark. RELEVANCE TO CLINICAL PRACTICE: All healthcare providers are expected and required to deliver competent clinical care to an increasingly diverse population. For teaching-learning, more visual representations of DST and comparative images between what to expect in dark, medium, and light skin tones can help improve knowledge deficits and increase health equity.

Challenges and Facilitators of Using Smartphones in Educational Activities: Medical and Nursing Students' Perspective.

BACKGROUND: Todays, smartphone technologies and applications are used in the medical and nursing fields. Medical and nursing students are among the groups in which the use of these tools is observed. OBJECTIVES: To investigate their views on the barriers and facilitators of the use of these technologies. METHODS: Four hundred people (200 people from each group) were invited randomly. A questionnaire was used to collect data. To collect data, hospitals were referred and the questionnaires were provided to students and after completion, they were collected. Data analysis was performed using SPSS software and descriptive and inferential statistics. RESULTS: The most important barriers from the students' view included internet problems in the university or hospital, lack of technical support for this technology in the hospital or university, the quality of existing applications, lack of appropriate Apps in the local language, non-introduction of appropriate Apps and not knowing the right Apps. The most important facilitators were the appropriate support services in the university or hospital, placing the appropriate Apps on the department or university website, designing native Apps with the participation of experts, and introducing the appropriate Apps by professors or universities. CONCLUSION: The use of Apps is increasing among medical and nursing students. In this regard, attention to the existing barriers and their elimination and strengthening the facilitators, and providing the necessary technical and educational infrastructure to facilitate the useful applications should be considered by decision-makers.

Assessing acceptance of augmented reality in nursing education.

The Covid-19 pandemic has negatively affected every aspect of human life. In these challenging times nursing students, facing academic and psychological issues, are advised to use augmented reality applications in the field of health sciences for increasing their motivations and academic performances. The main motive of the study was to examine the acceptance status of nursing students in implementing augmented reality technology in their education and training. The study is a quantitative research study, and it uses the causal-comparative screening method. The data used in the study was collected online from 419 nursing students. The hybrid method was preferred. First, the hypotheses based on the linear relationships were defined between the variables which were then tested by the method of structural equation modeling. Second, the method of artificial neural networks was used to determine the non-linear relationships between the variables. The results show that the nursing students have a high intention of using augmented reality technology as a way of self-learning. It was also found that the most emphasized motive behind this intention is the expectation that using augmented reality technology will increase their academic performance. They also think that AR technology has many potential benefits to offer in the future. It was observed that a considerable number of students already use augmented reality technology for its usefulness and with a hedonic motivation. In conclusion, nursing students have a high acceptance of using augmented reality technology during their education and training process. Since we live in a world where e-learning and self-learning education/training have become widespread, it is estimated that students will demand augmented reality applications as a part of holistic education, and as an alternative to traditional textbooks.

Exploring factors affecting the facilitation of nursing students to learn paediatric pain management in Rwanda: A descriptive qualitative study.

Nurse educators and nurse preceptors play a fundamental role in facilitating nursing students' acquisition and utilization of professional competencies. Previous studies about key elements for teaching and learning about pain in nursing education programs include students' personal characteristics and previous experiences; educators' knowledge, skills, and beliefs; learners' exposure to leaders in pain education; and curricular pain content and delivery approaches. These studies were mainly carried out in developed countries, with a context of educational and health care systems different from those of developing countries. The current study explores academics', clinical nurse preceptors', and nursing students' perceptions about factors influencing the facilitation of nursing students' competency for paediatric pain management in Rwanda. A qualitative descriptive exploratory design was used in this study that utilized in-depth interviews with six nurse educators and eight nurse preceptors, and focus group discussions with nineteen senior year nursing students. The study setting included five sites: two academic institutions and three clinical settings. Narratives from participants were transcribed verbatim and analysed using thematic analysis. The analysis yielded six themes describing factors that affected the facilitation of students' learning about paediatric pain management. The themes included student motivation, facilitators' attributes, collaboration between academics and clinicians, nurses' limited autonomy for decision-making regarding PPM practices, shortage of human and material resources, and educational qualification. Knowing these factors is essential as it provides an opportunity to design targeted interventions aimed to enhance the capacity of nurse educators and clinical nurse preceptors involved in teaching nursing students about paediatric pain management.

A Commitment to Quality: The History of Nurse Anesthesia Accreditation Part Two: 1983-2019.

In 1934, Gertrude Fife, President of the National Association of Nurse Anesthetists (NANA) sought to elevate the standards of anesthesia practice and standardize the education of nurse anesthetists. NANA members located schools, developed education standards and a school approval process, that eventually led to creation of the Council on Accreditation of Nurse Anesthesia Educational Programs (COA) in 1975. Examination of historical documents demonstrated that COA developed into a well-known accreditation agency recognized by both governmental and non-governmental organizations, enhancing the standards of anesthesia education and promoting high-quality educational programs. Note: See the April 2020 issue of AANA Journal for Part One of this article.

Robotics in Teaching-Learning: But in Nursing?

In this teaching-learning column, the use of robotic technology is explored as a possible adjunctive assistant to faculty. Given the advances in technology and the imposed restrictions of the recent COVID-19 pandemic, a discussion of using robotic technology in the teaching-learning of nursing seems timely and relevant. Questions to consider are explored. Then a concern and a possibility are presented for incorporating this advancing technology into teaching-learning from a humanbecoming perspective. Faculty are encouraged to enter into a deeper dialogue with colleagues in exploring options for incorporating robots with the caveat that the core of teaching-learning must remain the presence of teacher with student on the co-created never ending journey of the unfolding mystery in coming-to-know.

Challenges of Preparing Nursing Students for Practice: The Faculty Perspective.

BACKGROUND: A significant challenge facing nursing is new graduate RNs' unreadiness for practice. To better understand the issue, this study presents the challenges nursing faculty encounter in preparing nursing students for clinical practice through semi-structured interviews. METHOD: Eight faculty from a private midwestern university's prelicensure Bachelor of Science in Nursing (BSN) program participated in the study. A modified version of Colaizzi's data analysis method was used to interpret the data. RESULTS: Three main interrelated themes were identified: Facilitating Learning Among Today's Nursing Students, Teaching in an Era of Information Explosion and Health Care Reform, and Providing High-Quality Clinical Education. CONCLUSION: Findings from this study contribute to a deeper understanding of the challenges in preparing competent future nurses and offer insight into factors influencing the underpreparation of some new graduate BSN RNs. [J Nurs Educ. 2021;60(4):225-228.].

Improving Nurse Preceptor Competence With Clinical Teaching on a Dedicated Education Unit.

BACKGROUND: Nurse preceptors have varying backgrounds of teaching experience and often cite insufficient preparation as a common reason for difficulties transitioning from the role of clinician to educator. This project evaluated an online education program for nurse preceptors of prelicensure students. METHOD: Nurse preceptors received online instruction and howto examples in the form of clinical teaching vignettes to improve the teaching component of their role. Pre- and postsurveys were used to help determine program effectiveness. RESULTS: After the training, nurse preceptors indicated they felt more competent when teaching students, and likewise, students reported increased satisfaction with the quality of teaching. CONCLUSION: There are numerous roles assumed by nurse preceptors. Although many nurse preceptors are expert clinicians, they may lack expertise in the teaching role. Preceptor preparation programs that provide practical examples through the use of vignettes can contribute to the development of teaching competencies. [J Contin Educ Nurs. 2021;52(5):226-231.].

Implications of Clinical Shift Length on Nursing Student Learning Outcomes.

BACKGROUND: One area of clinical education that requires further understanding is the role clinical shift lengths play in nursing student learning outcomes. METHOD: This study used a mixed-methods design. Collaborative nursing students were randomly placed into clinical groups. Students either completed two 6-hour clinical shifts per week or one 12-hour shift. Groups completed a survey questionnaire and an NCLEX-based pre- and posttest. RESULTS: Mean scores for the 12-hour group (1.4 grade points) were higher compared with the 6-hour group (0.8 grade points) (p = .043). The survey also measured students' attitudes, and a correlation was demonstrated in several other categories of questions. Qualitatively, students in the 12-hour group valued their time to a greater degree. CONCLUSION: Although there are merits to both 6-hour and 12-hour shift lengths, findings demonstrated students preferred 12-hour shifts, had statistically higher scores in NCLEX preparation, and developed more therapeutic relationships with clients, families, and instructors. [J Nurs Educ. 2021;60(5):253-258.].

A Multicenter Study of Student Engagement and Satisfaction in Online Programs.

BACKGROUND: Students who are more satisfied and engaged in online courses have better learning experiences and outcomes. METHOD: Survey data were collected during a 4-month period in 2019. The research team created a survey to collect demographic information and assess student satisfaction. Student engagement was measured using the 19-item Online Student Engagement Scale. RESULTS: Overall student engagement and satisfaction scores in online programs were moderately high. Generation Z participants and students from PhD programs were the most satisfied and engaged in their programs. CONCLUSION: Students who are more engaged in online coursework are more satisfied and thus are more likely to remain and successfully complete their respective programs. [J Nurs Educ. 2021;60(5):259-264.].

Kirkpatrick Model Evaluation of Accelerated Second-Degree Nursing Programs: A Scoping Review.

BACKGROUND: This scoping review examined the outcomes of accelerated second-degree baccalaureate and master of nursing programs using the Kirkpatrick four-level model. METHOD: A systematic search of four major scientific databases identified 15 articles meeting study inclusion criteria. The articles were assessed for educational outcomes, and extracted data were organized according to the four-level Kirkpatrick model consisting of reaction, learning, behavior, and results. RESULTS: Both second-degree baccalaureate and master of nursing program students showed strong academic achievement, high employment rates, and high program satisfaction but reported lack of perceived preparedness for a clinical position. No studies evaluated the long-term impacts of the programs on graduates' clinical practice or patient outcomes. CONCLUSION: Accelerated second-degree nursing programs quickly and efficiently produce licensed nurses. The care provided by the graduates of these accelerated programs needs to be investigated in both short- and long-term to better determine overall program effectiveness. [J Nurs Educ. 2021;60(5):265-271.].

An Examination and Comparison of Stethoscope Hygiene in Nursing Education Programs.

BACKGROUND: Improper stethoscope hygiene has been found to contribute to the development of health care associated infections, which affects approximately one in every 30 hospitalized patients. Various pathogens have been found on the stethoscopes of health care workers. METHOD: A correlational descriptive design was used to compare stethoscopes from 117 nursing students. Sterile swab samples were obtained from four separate areas of each stethoscope. Samples were plated and incubated for 24 to 48 hours. RESULTS: Bacteria were found on all parts of the stethoscopes from both undergraduate and graduate nursing students, with the earpiece having the highest percentage of contamination. Staphylococcus was the most prevalent microbe found on all four swab sites. CONCLUSION: Educating students about stethoscope hygiene and consistently reinforcing it in practice are essential to reduce the transmission of pathogens in the health care environment. Nurses can model best practice with students and other disciplines to increase the likelihood of adherence. [J Nurs Educ. 2021;60(5):277-280.].

Strategies and criteria targeting the reform and development for the teaching resource of nursing undergraduate: A multi-center cross-sectional study.

ABSTRACT: Teaching resource of nursing students play an important role in improving clinical performance, while there is a little know and dearth of the access and development criteria or guidance of teaching resources for nursing undergraduates.To develop the admission and development criteria of education resources for nursing undergraduates, and to explore and determine its composition and connotation.A cross-sectional survey has been used.A total of 22 Chinese nursing schools and affiliated teaching bases (hospitals and community health centers).A total of 20 nursing experts were consulted to develop the questionnaire of admission and development criteria of teaching resource for nursing undergraduates in China, and then 285 valid experts from 22 Chinese nursing schools and affiliated teaching bases (hospitals and community health centers) conducted the questionnaire survey to evaluate experts' consensus rate and view on the composition and connotation of the developed criteria.There were 6 domains and 43 items included in the admission and development criteria of teaching resource for nursing undergraduates, which domains included educational budget and allocation of resources, infrastructure, clinical teaching bases, books and information services, educational experts, and educational exchanges. The experts' consensus rate was more than 90.2%.The standard is helpful to guide the future admission and development of teaching resource for nursing undergraduates, and favor the education quality improvement of nursing undergraduates.

Advancing Evidence-Based Practice Through Implementation Science: Critical Contributions of Doctor of Nursing Practice- and Doctor of Philosophy-Prepared Nurses.

PURPOSE: Describe the evolution of implementation science and the roles and potential collaborations of doctorally prepared nurses to advance implementation science in practice settings. METHODS: Review of academic preparation and areas of expertise for doctorally prepared nurses as it relates to implementation science and evidence-based practice (EBP). FINDINGS: There have been substantial gains in the number of academic programs in healthcare that include content on EBP, resulting in healthcare teams that are motivated to align practices with best evidence. Unfortunately, many EBP initiatives stall during early stages of implementation, resulting in fragmented practices and persistent gaps between evidence and practice. Implementation science aims to bridge this gap and provides a structured, science-based approach to implementation. Few healthcare teams are familiar with implementation science, and many do not incorporate knowledge from the field when implementing EBPs. Doctorally prepared nurses are in a unique position to serve as leaders in EBP implementation due to the breadth and depth of academic preparation and their pivotal roles across practice settings. CONCLUSIONS: Collaboratively aligning existing strengths of PhD and DNP prepared nurses with knowledge of implementation science can advance implementation of EBP across practice settings to effectively incorporate and sustain meaningful change to improve outcomes. LINKING EVIDENCE TO ACTION SECTION: Doctorally prepared nurses are in a unique position to advance and apply the science of implementation in practice settings. Nurse scientists can generate evidence on effective strategies and outcomes among healthcare teams to successfully integrate evidence based practices into routine care. Nurse leaders and educators can apply these findings and use an implementation science approach when leading clinical teams in evidence-based practice changes.

Perceptions of student accoucheurs regarding gender inequality in midwifery training at Free State maternal healthcare institutions.

BACKGROUND: Worldwide, gender inequality has been a dominating factor in the training of student accoucheurs in most maternal healthcare institutions. This poses challenges for the maternal healthcare institutions where student accoucheurs are placed for clinical practice as most women become reluctant or refuse to accept their services. Gender inequality has a negative impact on the training of student accoucheurs as most of them become demotivated which could lead to a high attrition rate. OBJECTIVES: This study explored and described the perceptions of student accoucheurs regarding gender inequality in midwifery training at the Free State maternal healthcare institutions. METHOD: An explorative and descriptive qualitative research design was undertaken. There were 40 student accoucheurs that formed 10 focus group discussions. Each focus group discussion had four participants. Tesch's eight-steps of data analysis was used to analyse data. RESULTS: Three major themes emerged during data analysis: meeting the training requirements in midwifery, women's autonomy in a choice of healthcare provider versus student accoucheurs' autonomy to be trained in midwifery and staff establishment to render maternal healthcare. CONCLUSION: The participants perceived prejudice, rejection and resistance by women in maternity units as a contributing factor to gender inequality, which has a negative impact on their training in midwifery. The study recommends that health directorates, nurse managers and training institutions should consider revising maternal healthcare policies regarding the recruitment and placement of willing accoucheurs in maternity units in order to address gender inequality.

Changing Student Outcomes Without Sacrificing Student Satisfaction.

BACKGROUND: Faculty teaching a large class size implemented evidence-based teaching strategies (EBTS) to improve mastery of core concepts in an accelerated undergraduate pediatric nursing course. METHOD: Pre- and poststudent outcomes were analyzed using data from course assessments and American Technologies Institute (ATI) concept mastery testing to evaluate the effectiveness of course revisions. ATI designates three proficiency levels to determine mastery. A proficiency of level two exceeds the minimum expectations for mastery, whereas a proficiency level of three suggests students exceed NCLEX-RN standards of content. RESULTS: Data indicated implementation of new EBTS facilitated improvement in student content mastery. Students exceeded the minimum expectations for NCLEX-RN standards of pediatric content. Course revisions resulted in all students achieving benchmark on ATI concept mastery testing with a three-fold increase in students achieving the highest level of proficiency. CONCLUSION: EBTS can be adapted for a large class size learning environment with improved learning outcomes. [J Nurs Educ. 2021;60(3):169-171.].

QSEN in an Amazon World.

ABSTRACT: Quality and Safety Education for Nurses (QSEN) was launched in 2005 as a national nursing initiative aimed at preparing nurses with the competencies needed to continuously improve the quality and safety of the health care they provide. The six QSEN competencies-and the knowledge, skills, and attitudes that each entails-have served as a basis for significant curricular revision, more enlightened professional practice, relevant research, and health care system improvements. Since the launch of QSEN, new technologies have emerged, the range of care sites has broadened, new practice roles have emerged, and patients and families have become more active health care consumers. This article highlights these changes, considers Amazon as a powerful contemporary social force, examines the company's core values, and considers their relevancy to the six QSEN competencies. Essential new literacies and cognitive capacities are also identified. Lastly, the authors outline steps nurses can take to incorporate the QSEN competencies, along with the literacies and capacities, into their practice and organizations. Doing so is vital to delivering safe, high-quality care in this rapidly changing health care climate, and will enable nurses to claim their leadership and thrive professionally in an Amazon world.

Effect of the Specific Training Course for Competency in Doing Arterial Blood Gas Sampling in the Intensive Care Unit: Developing a Standardized Learning Curve according to the Procedure's Time and Socioprofessional Predictors.

BACKGROUND: Standardization of clinical practices is an essential part of continuing education of newly registered nurses in the intensive care unit (ICU). The development of educational standards based on evidence can help improve the quality of educational programs and ultimately clinical skills and practices. OBJECTIVES: The objectives of the study were to develop a standardized learning curve of arterial blood gas (ABG) sampling competency, to design a checklist for the assessment of competency, to assess the relative importance of predictors and learning patterns of competency, and to determine how many times it is essential to reach a specific level of ABG sampling competency according to the learning curve. DESIGN: A quasi-experimental, nonrandomized, single-group trial with time series design. Participants. All newly registered nurses in the ICU of a teaching hospital of Tehran University of Medical Sciences were selected from July 2016 to April 2018. Altogether, 65 nurses participated in the study; however, at the end, only nine nurses had dropped out due to shift displacement. METHODS: At first, the primary checklist was prepared to assess the nurses' ABG sampling practices and it was finalized after three sessions of the expert panel. The checklist had three domains, including presampling, during sampling, and postsampling of ABG competency. Then, 56 nurses practiced ABG sampling step by step under the supervision of three observers who controlled the processes and they filled the checklists. The endpoint was considered reaching a 95 score on the learning curve. The Poisson regression model was used in order to verify the effective factors of ABG sampling competency. The importance of variables in the prediction of practice scores had been calculated in a linear regression of R software by using the relaimpo package. RESULTS: According to the results, in order to reach a skill level of 55, 65, 75, 85, and 95, nurses, respectively, would need average ABG practice times of 6, 6, 7, 7, and 7. In the linear regression model, demographic variables predict 47.65 percent of changes related to scores in practices but the extent of prediction of these variables totally decreased till 7 practice times, and in each practice, nurses who had the higher primary skill levels gained 1 to 2 skill scores more than those with low primary skills. CONCLUSIONS: Utilization of the learning curve could be helpful in the standardization of clinical practices in nursing training and optimization of the frequency of skills training, thus improving the training quality in this field. This trial is registered with NCT02830971.