Work With ChatGPT, Not Against: 3 Teaching Strategies That Harness the Power of Artificial Intelligence.

BACKGROUND: Technological advances have expanded nursing education to include generative artificial intelligence (AI) tools such as ChatGPT. PROBLEM: Generative AI tools challenge academic integrity, pose a challenge to validating information accuracy, and require strategies to ensure the credibility of AI-generated information. APPROACH: This article presents a dual-purpose approach integrating AI tools into prelicensure nursing education to enhance learning while promoting critical evaluation skills. Constructivist theories and Vygotsky's Zone of Proximal Development framework support this integration, with AI as a scaffold for developing critical thinking. OUTCOMES: The approach involves practical activities for students to engage with AI-generated content critically, thereby reinforcing clinical judgment and preparing them for AI-prevalent health care environments. CONCLUSIONS: Incorporating AI tools such as ChatGPT into nursing curricula represents a strategic educational advancement, equipping students with essential skills to navigate modern health care.

Learning Environments in Undergraduate Nursing Education During COVID-19: A Scoping Review.

BACKGROUND: The COVID-19 pandemic radically changed nursing education. PURPOSE: To map the existing literature on learning environments (LEs) in undergraduate nursing education during COVID-19 and identify the LE elements based on the 4 domains of Gruppen's conceptual framework: personal, social, organizational, and physical and virtual spaces. METHOD: Eligible articles were reviewed using the Joanna Briggs framework. RESULTS: The search retrieved 5003 articles, of which 80 met the inclusion criteria. Most studies were cross-sectional and conducted in the United States. Of the studies included, 68 studies focused on the personal component of students, 67 investigated physical and virtual space components, 19 examined the social domain, and 15 examined organizational aspects. CONCLUSIONS: The COVID-19 pandemic significantly influenced the LE of nursing students. Based on the current review of LE in nursing education, nurse educators and researchers can develop interventions to maintain the quality and accessibility of nursing education in future crises.

Evaluating a Shared Reflective Practice to Develop Nursing Student Clinical Judgment.

BACKGROUND: Self-reflection is a valuable method that nurse educators can use to develop clinical judgment skills among prelicensure nursing students. Little research exists on improving clinical judgment in second-degree nursing students in the clinical setting. PURPOSE: To determine the implications of increasing clinical judgment skills in prelicensure nursing students using a shared structured reflection teaching innovation within a required baccalaureate clinical course. METHODS: This educational innovation used qualitative descriptive methods to evaluate its effectiveness in the clinical setting among students in the final semester of an accelerated prelicensure nursing program. RESULTS: Students reported increased accountability for their learning, a sense of intentionality with their nursing practice, and a deeper sense of community with their peers. CONCLUSIONS: Shared reflective practices in the clinical setting show promise for increasing clinical judgment and supporting a competency-based curriculum.

Analysis of a Needs Assessment Survey to Develop an Online Resource Repository Supporting Nurse Anesthesia Educators.

BACKGROUND: Without highly qualified nurse anesthesia educators and administrators, the health care system will be threatened by the inadequate supply of certified registered nurse anesthetists (CRNAs). PURPOSE: American Association of Nurse Anesthesiologists' Faculty Stabilization Task Force (FSTF) analyzed reasons for high faculty turnover and developed recommendations to support nurse anesthesia faculty and administrators. METHODS: A survey evaluated participants' current role, leadership development opportunities, mentorship experiences, and resource needs. RESULTS: Of 109 respondents, 87 (80%) were program administrators or assistant administrators with less than 5 years of experience in their role. Despite academic experience, 51% felt adequately prepared for their role. CONCLUSIONS: The FSTF provided 2 recommendations: to create a robust faculty development program for all faculty at all levels of CRNA education and a repository of information needed for program administrators and faculty to oversee and educate students in a high-quality CRNA program.

Using Collaborative Online International Learning to Support Global Midwifery Education.

BACKGROUND AND LOCAL PROBLEM: The COVID-19 pandemic created a gap in global health learning, requiring creative solutions to bridge the divide. Collaborative online international learning (COIL) is a program between universities located in different geographic areas that aims to build cross-cultural learning and collaboration. INTERVENTION: Faculty members from Uganda and the United States worked collaboratively to plan a 2-session COIL activity for nursing and midwifery students. Twenty-eight students from the United States and Uganda participated in the pilot quality improvement project. MEASURES: Students completed a 13-question REDCap survey measuring satisfaction, time commitment for the activity, and increase in knowledge about differently resourced healthcare systems. Students also were asked to provide qualitative feedback in that survey. RESULTS: Survey results indicate a high level of satisfaction and an increased understanding of a new healthcare system. The majority of students wanted more scheduled activity times, the opportunity to meet face to face, and/or more robust sessions in the future. CONCLUSION: This COIL activity between students in the United States and Uganda was a no-cost activity that provided global health learning opportunities for students during the global pandemic. The COIL model is replicable, adaptable, and customizable for a variety of courses and time spans.

Nurses' Perceptions of the Impact of a National Educational Program in Pediatric Oncology Nursing: A Cross-Sectional Evaluation.

Background: Specific knowledge is required in pediatric oncology, and specialization of nurses has been identified as a priority. In Sweden, a national program in pediatric oncology nursing has been offered since 2003. The aim of this study was to gain knowledge of nurses' perceptions of the impact of this educational program. Methods: Eighty nurses who had completed the educational program in three cohorts (2012-2019) were invited to participate in this cross-sectional survey. An electronic study-specific questionnaire containing multiple-choice questions was used. Data were analyzed using descriptive statistics and correlation tests. Results: Fifty-nine (74%) nurses completed the survey, of whom 98% responded that they would recommend the program to a large/fairly large extent. At the time of the survey, 15 (25%) participants had left pediatric oncology care. Among the remaining 44, 31 (71%) of the nurses were working bedside, and 13 (42%) of these combined this with a special position (e.g., consultant nurse). The education resulted in career advancement, as the number of nurses with special positions increased following completion of the program, from 20% to 59%. The vast majority stated that the knowledge gained from the education contributed to increased confidence in interactions with the children/families. Discussion: Continuing education of nurses in pediatric oncology has an impact on career opportunities in clinical practice and contributes to nurses' confidence and professional work. However, education is not enough to retain competent nurses. Employers need to be aware of the role of the work environment, aspects of work-life balance and career paths.

Implementing the Role of Neonatal Assessment Nurse to Improve Skin-to-Skin Care and Breastfeeding Exclusivity.

OBJECTIVE: To improve rates of exclusive breastfeeding during the postpartum hospital stay by implementing a new role of dedicated neonatal assessment nurse (NAN), whose primary function was neonatal care beginning immediately after birth. DESIGN: Quality improvement project with plan-do-study-act using evidence-based guidelines for implementing the NAN role. SETTING/LOCAL PROBLEM: Labor and delivery department of a tertiary care teaching hospital in the southeastern United States; breastfeeding exclusivity rates at this hospital were in the range of 50%. PARTICIPANTS: Registered nurses employed in the labor-delivery-recovery unit, mother-baby unit, and NICU. INTERVENTION/MEASUREMENTS: The NAN role was implemented to promote immediate skin-to-skin care (SSC) for stable newborns after vaginal and cesarean birth. Each NAN's competency was evaluated at the beginning and end of the education session through a pretest/posttest, and a skills validation was used to affirm their readiness for the new role. The outcome measure was breastfeeding exclusivity at the time of discharge from the hospital. SSC initiation and duration immediately after birth were the process measures. RESULTS: Twenty-five bedside registered nurses participated in this quality improvement project. There was a statistically significant difference between the pretest and posttest scores (p < .001), indicating a knowledge increase. All nurses met the skills validation criteria. The rate of SSC immediately after vaginal birth increased from 49% to 82% and after cesarean birth from 33% to 63%. Breastfeeding exclusivity rate at the time of discharge from the hospital increased from 50% to 86%. CONCLUSION: The NAN role provided transitional care at the bedside without the separation of mothers and newborns. This was an innovative role, without the need to hire new staff, that provided evidence-based care, resulting in improved SSC and exclusivity of breastfeeding before discharge.

An Innovative Academic/Practice Partnership to Support Nursing Workforce Needs and Student Clinical Education.

ABSTRACT: Innovation is needed to solve nursing workforce issues during times of crisis. A collaborative effort between a hospital system and several universities resulted in the Bridge to Professional Practice Program that was implemented during a period of high patient volume and nursing student downtime. The program provided support for staffing needs and clinical hours to promote readiness for practice for students. The program evaluation outcomes and recommendations for improvement are addressed.

The Robert Wood Johnson Foundation Future of Nursing Scholars program: The scholar experience.

BACKGROUND: Robert Wood Johnson Foundation Future of Nursing Scholars program used multi-pronged approach to support nurses completing accelerated PhD programs. PURPOSE: The purpose of this manuscript was to describe scholars' experiences completing PhDs, their dissertation characteristics, program leadership development sessions, scholar perceptions of program components. METHODS: Of 201 scholars, 157 (78%) completed quantitative exit surveys, providing: satisfaction with doctoral programs and FNS curricula, types of dissertation data used, dissertation formats. Interviews held with five scholars to capture representative themes. FINDINGS: Scholars utilized primary and secondary data for dissertations; 53% primarily used secondary data. The majority (68%) used manuscript dissertation formats. Approximately 64% completely agreed program curricula helped prepare them for professional transitions, to work collaboratively, lead confidently. Proportion of FNS graduates (42%) pursuing postdoctoral positions exceeded national trends. DISCUSSION: Despite stresses posed by accelerated PhD programs, scholars are well-situated to advance nursing science. Findings suggest secondary data analyses work well for accelerated programs. Scholar program experiences were positive.

Nursing outcomes for patients with multiple traumas and impaired physical mobility: An integrative review.

PURPOSE: This research identifies nursing outcomes for patients with multiple traumas who present changes in physical mobility. METHODS: This was a thorough literature review, following Whittemore and Knafl's method and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses´ guidelines (2005) and adopting the Oxford Center for Evidence-Based Classification Medicine-Levels of Evidence (2011). The literature search included databases from Virtual Health Library, Cochrane Library, Excerpta Medica Database, Medical Literature Analysis and Retrieval System Online, PubMed, SciVerse Scopus, The Cumulative Index to Nursing and Allied Health Literature, and Web of Science. It was conducted between October and December 2019 and updated in April 2022. FINDINGS: Upon our first analysis of the 254 articles that could correlate to the present study, we concluded that 15 of them are of foremost relevance. The nursing outcomes found are correlated with skin care, position in hospital bed, pressure injury prevention, self-care assistance to bath, intimate, and oral hygiene, pain control, circulatory precaution, and impaired physical mobility assistance. All of these outcomes are directly or indirectly involved with the consequences of mobility impairment. CONCLUSIONS: The main nursing outcomes of our research identified for patients with multiple traumas were related to mobility, the consequences of immobility, self-care, and skin maintenance. In conclusion, this review highlights the importance of measuring outcomes related to the provision of nursing care. IMPLICATIONS FOR NURSING PRACTICE: The nursing outcomes classification provides results that can be used across the continuum of care to assess the patient's status after nursing interventions. It also allows for improved care for multiple trauma patients who have altered mobility, identifying the real needs of these patients.

OBJETIVO: Esta pesquisa propõe a identificação dos resultados de enfermagem para pacientes politraumatizados que apresentam alterações na mobilidade física. MÉTODOS: Trata-se de uma revisão minuciosa da literatura, seguindo o método de Whittemore e Knafl e as diretrizes Preferred Reporting Items for Systematic Reviews and Meta-Analyses (2005) e adotando o Oxford Centre for Evidence-Based Classification Medicine - Levels of Evidence (2011). A busca na literatura incluiu bases de dados da Biblioteca Virtual em Saúde; Biblioteca Cochrane; Base de dados Excerpta Medica; Sistema de Análise e Recuperação de Literatura Médica Online; PubMed®; SciVerse Scopus; O Índice Cumulativo para Enfermagem e Literatura de Saúde Aliada; e Web of Science. As buscas foram realizadas entre outubro e dezembro de 2019 e atualizadas em abril de 2022. RESULTADOS: Em nossa primeira análise dos 254 artigos que poderiam se correlacionar com o presente estudo, concluímos que 15 deles são de maior relevância. Os resultados de enfermagem encontrados estão correlacionados aos cuidados com a pele, posição no leito hospitalar, prevenção de lesão por pressão, assistência ao autocuidado ao banho, higiene íntima e oral, controle da dor, precaução circulatória e assistência à mobilidade física prejudicada. Todos os resultados acima mencionados estão direta ou indiretamente envolvidos com as consequências do comprometimento da mobilidade. CONCLUSÕES: Os principais resultados de enfermagem de nossa pesquisa identificados para pacientes politraumatizados foram relacionados à mobilidade, consequências da imobilidade, autocuidado e manutenção da pele. Em conclusão, esta revisão destaca a importância de medir os resultados relacionados à prestação de cuidados de enfermagem. IMPLICAÇÕES PARA A PRÁTICA DE ENFERMAGEM: A Classificação de Resultados de Enfermagem fornece resultados que podem ser usados ​​em todo o continuum de cuidados para avaliar o estado do paciente após intervenções de enfermagem. Também permite melhorar o atendimento aos politraumatizados que apresentam mobilidade alterada, identificando as reais necessidades desses pacientes.

Qualitative study of the perspectives of women with lived experience of domestic and family violence on accessing healthcare.

AIMS: To explore the perceptions of women with lived experience of domestic and family violence on accessing healthcare and to identify how nurses can facilitate and support women experiencing domestic and family violence to receive the care they need. DESIGN: A qualitative single site study. METHODS: As part of an evaluation of a nurse-led domestic and family violence service, a 2-h focus group was conducted with four women with lived experience of domestic and family violence on 14 December 2021. The Levesque Framework provided a novel approach to identify barriers and facilitators to healthcare access. The focus group guide included eight open-ended questions. The audio recording was transcribed and analysed using Braun and Clark's thematic analysis process. RESULTS: The Levesque Framework helped highlight individual and structural challenges in accessing healthcare faced by women experiencing domestic and family violence. Dominant themes were first contact, comprehensiveness of services and domestic violence awareness. CONCLUSION: The growing incidences of domestic and family violence are confounding communities worldwide. Despite the high profile of domestic and family violence in Australia, access to healthcare remains problematic. These preliminary findings suggest that nurses have opportunities to facilitate access in relation to the approachability, acceptability and appropriateness of services. Realizing these opportunities requires education that enables nurses' capacity to provide an effective first contact and facilitate comprehensive care by embodying a no wrong door culture. We intend to explore these concepts in future focus groups. IMPACT: This study explored the factors impacting access to healthcare for women experiencing domestic and family violence. Accessing healthcare when experiencing domestic and family violence in Australia is problematic. Findings suggest that nursing has opportunities to facilitate the approachability, acceptability and appropriateness of services. These findings will be valuable to nurses across all healthcare settings, nursing education providers and health workforce planners.

Men in the service of humanity: Sociocultural perceptions of the nursing profession in South Africa

Background. The classification of nursing as a female-gendered profession, along with patriarchally determined cultural gender roles, makes it difficult for men to select nursing as a career and to excel in their caring capacity as nurses.Objective. To gain in-depth insights into and an understanding of male nursing students' perceptions of the nursing profession. Methods. A generic qualitative approach, which was explorative, descriptive and contextual, was used to conduct the study. Sixteen male nursing students at two nursing education institutions in KwaZulu-Natal Province, South Africa, were purposively sampled to participate in the study. Data were collected using semi-structured interviews and unstructured observation. Thereafter, thematic analysis was used to analyse the data. Results. Three main themes were developed from the interview data. The participants perceived nursing as the extension of women's work, with low social status ‒ nursing is not considered to be a profession for men. During the provision of nursing care, feelings of discomfort and embarrassment were experienced. They feared misinterpretation of their care, especially when caring for the naked body when alone with a patient. They resorted to the use of cautious caring, where they do not provide physical care alone, but seek support, especially from female nurses.Conclusion. Male nursing students require role models to support them in their academic journey towards becoming competent practitioners. A male-friendly environment should be created to enable them to provide quality nursing care to all patients. The society needs to be empowered in understanding that men choose the nursing profession to provide care, and that they are capable of caring for the sick.

Influence of social determinants of health in family-effectiveness / Influencia de los determinantes sociales de la salud en la eficacia familiar / Influência dos determinantes sociais da saúde na eficácia familiar / Influence of social determinants of health in family-effectiveness

Introduction: The Social Determinants of Health are defined by the living conditions of the population, how they are born, grow, live, work and age, and are considered as the main responsible for the health of populations. Objective: To evaluate the influence of social determinants of health on effectiveness of family functioning. Materials and Methods: A quantitative study was carried out with 200 participants between 2017 and 2018. To assess the correlation between proximal, intermediate and distal social determinants of health and the level of effectiveness of family functioning, home visits were made to 100 families who responded the Assessment of strategies in Family Effectiveness instrument and a sociodemographic questionnaire. Data were analyzed by simple frequency, Spearman's correlation coefficient (ρ) (p <0.05), and subjected to descriptive analysis from the perspective of systemic organization. Results: The social determinants that showed a positive correlation coefficient with the level of effectiveness of family functioning were the years of study and the fixed family income. There was a negative correlation with the main source of income (number of occupations) or source of income and the presence of other members or relatives in the family. Discussion: Investments in education can improve the family's ability to organize, solve or prevent adverse events, increase income and provide more time for family relationships and the achievement of congruence, as evidenced by other authors. Conclusions: The proximal and intermediate social determinants of health influenced the level of effectiveness of family functioning.

Introducción: Los Determinantes Sociales de la Salud están definidos por las condiciones de vida de la población, cómo nacen, crecen, viven, trabajan y envejecen, y son considerados como los principales responsables de la salud de las poblaciones. Objetivo: Evaluar la influencia de los determinantes sociales de la salud en la efectividad del funcionamiento familiar. Materiales y Métodos: Se realizó un estudio cuantitativo con 200 participantes entre 2017 y 2018. Para evaluar la correlación entre los determinantes sociales de salud proximales, intermedios y distales y el nivel de efectividad del funcionamiento familiar, se realizaron visitas domiciliarias a 100 familias que respondieron el instrumento Evaluación de estrategias en Efectividad Familiar y un cuestionario sociodemográfico. Los datos fueron analizados por frecuencia simple, coeficiente de correlación de Spearman ( ρ ) (p <0,05 ), y sometidos a análisis descriptivo desde la perspectiva de la organización sistémica. Resultados: Los determinantes sociales que mostraron un coeficiente de correlación positivo con el nivel de efectividad del funcionamiento familiar fueron los años de estudio y el ingreso familiar fijo. Hubo una correlación negativa con la principal fuente de ingresos (número de ocupaciones) o fuente de ingresos y la presencia de otros miembros o familiares en la familia. Discusión: Las inversiones en educación pueden mejorar la capacidad de la familia para organizarse, solucionar o prevenir eventos adversos, aumentar los ingresos y brindar más tiempo para las relaciones familiares y el logro de la congruencia, como lo evidencian otros autores. Conclusiones: Los determinantes sociales proximales e intermedios de la salud influyeron en el nivel de efectividad del funcionamiento familiar.

Introdução: Os Determinantes Sociais da Saúde são definidos pelas condições de vida da população, como nascem, crescem, vivem, trabalham e envelhecem, sendo considerados como os principais responsáveis pela saúde das populações. Objetivo: Avaliar a influência dos determinantes sociais da saúde na eficácia do funcionamento familiar. Materiais e Métodos: Foi realizado um estudo quantitativo com 200 participantes entre 2017 e 2018. Para avaliar a correlação entre os determinantes sociais proximais, intermediários e distais da saúde e o nível de eficácia do funcionamento familiar, foram realizadas visitas domiciliares a 100 famílias que responderam o instrumento Avaliação de estratégias em eficácia familiar e um questionário sociodemográfico. Os dados foram analisados por frequência simples, coeficiente de correlação de Spearman ( ρ ) (p < 0,05 ), e submetidos à análise descritiva sob a ótica da organização sistêmica. Resultados: Os determinantes sociais que apresentaram um coeficiente de correlação positiva com o nível de efetividade do funcionamento familiar foram os anos de estudo e a renda familiar fixa. Houve correlação negativa com a principal fonte de renda (número de ocupações) ou fonte de renda e a presença de outros membros ou parentes na família. Discussão: Investimentos em educação podem melhorar a capacidade da família de se organizar, resolver ou prevenir eventos adversos, aumentar a renda e proporcionar mais tempo para as relações familiares e para o alcance da congruência, conforme evidenciado por outros autores. Conclusões: Os determinantes sociais proximais e intermediários da saúde influenciaram o nível de efetividade do funcionamento familiar.

Qualidade da formação em enfermagem: análise a partir de dados do sistema nacional de avaliação / Quality of nursing graduation: analysis from data from a national assessment system / Calidad de la educación en enfermería: análisis basado en datos de un sistema nacional de evaluación

Objetivo: Analisar a qualidade da formação em Enfermagem no Ceará, Brasil. Métodos: Estudo descritivo, retrospectivo, de abordagem quantitativa, a partir dos resultados do Exame Nacional de Desempenho dos Estudantes e do Conceito Preliminar de Cursos. Foram incluídas todas as Instituições de Ensino Superior que dispunham de cursos de Enfermagem e que obtiveram nota no Exame Nacional de Desempenho até 2017. Resultados: No Ceará, existem 65 cursos de Enfermagem, sendo seis públicos (9,2%) e 59 privados (90,8%). As instituições públicas apresentam melhores resultados no Exame Nacional de Desempenho, no entanto, as privadas apresentam melhores notas nos quesitos estrutura e oportunidades de ampliação da formação. Entre os 21 cursos, apenas 10 possuem conceito 4 e 5 no Exame Nacional de Desempenho e, também, no Conceito Preliminar de Cursos. Apenas 3 obtiveram conceito menor que 3 no Exame Nacional de Desempenho e todos obtiveram conceito igual ou maior que 3 no Conceito Preliminar de Cursos. Conclusão: A partir dos critérios estabelecidos pelo Ministério da Educação, os cursos de Enfermagem do Ceará podem ser considerados de qualidade, no entanto há que se refletir até que ponto os profissionais oriundos de instituições com notas 3 estão preparados para atender as demandas de saúde da população. (AU)

Objective: To analyze the quality of nursing education in Ceara, Brazil. Methods: Descriptive, retrospective study with a quantitative approach, based on the results of the National Student Performance Examination and the Preliminary Concept of Courses. All Higher Education Institutions that had Nursing courses and that obtained a grade in the National Performance Examination until 2017 were included. Results: In Ceará, there are 65 Nursing courses, six of which are public (9.2%) and 59 private (90.8%). Public institutions present better results in the National Performance Examination, however, private ones' present better marks in terms of structure and opportunities for training expansion. Among the 21 courses, only 10 have grade 4 and 5 in the National Performance Exam and also in the Preliminary Concept of Courses. Only 3 obtained a grade lower than 3 in the National Performance Examination and all obtained grade equal to or higher than 3 in the Preliminary Concept of Courses. Conclusion: Based on the criteria established by the Ministry of Education, nursing courses in the State of Ceará can be considered of quality, however, it is necessary to reflect to what extent professionals from institutions with grades 3 are prepared to meet the health demands of population. (AU)

Objetivo: Analizar la calidad de la educación en enfermería en Ceará, Brasil. Métodos: Estudio descriptivo, retrospectivo con enfoque cuantitativo, basado en los resultados del Examen Nacional de Desempeño del Estudiante y el Concepto Preliminar de Cursos. Se incluyeron todas las Instituciones de Educación Superior que contaban con cursos de Enfermería y que obtuvieron calificación en el Examen Nacional de Desempeño hasta 2017. Resultados: En Ceará, hay 65 cursos de Enfermería, seis de los cuales son públicos (9,2%) y 59 privados (90,8%). Las instituciones públicas presentan mejores resultados en el Examen Nacional de Desempeño, sin embargo, las instituciones privadas presentan mejores calificaciones en términos de estructura y oportunidades para ampliar la formación. De los 21 cursos, solo 10 tienen 4º y 5º grado en el Examen Nacional de Desempeño y también en el Concepto Preliminar de Cursos. Solo 3 obtuvieron una calificación inferior a 3 en el Examen Nacional de Desempeño y todos obtuvieron una calificación igual o superior a 3 en el Concepto Preliminar de Cursos. Conclusión: Con base en los criterios establecidos por el Ministerio de Educación, los cursos de enfermería en el Estado de Ceará pueden ser considerados de calidad, sin embargo es necesario reflexionar en qué medida los profesionales de instituciones con grado 3 están preparados para atender las demandas de salud de la población. (AU)

Reimagining a children's palliative care educational programme for registered nurses in response to the COVID-19 pandemic.

BACKGROUND: Children with life-limiting conditions are a unique population with multiple health and social care needs. Key literature indicates the need for education to support registered nurses providing care, including palliative care, to these children. In response to the COVID-19 pandemic, a palliative care programme was converted to an online programme, adopting a blended approach between national and regional facilitators. OBJECTIVES: To assess nurses' satisfaction with a re-designed palliative care programme centred around the care of children with life-limiting conditions, including their perceptions of the online format. DESIGN AND METHODS: A descriptive correlational design and online survey was used to explore the participants' perception of the content and online delivery of the Care of the Child with a Life-Limiting Condition programme. Nine sessions, comprised of five national and four regional webinars, were delivered. RESULTS: Attendees registered (n = 169) from throughout the Republic of Ireland, with 130 attending all webinars. Attendees stated online delivery of education increased their accessibility to highly qualified experts. The short, concise nature of sessions was well received. Online delivery and recorded sessions contributed to convenience with the ability to access and process information in attendees' own time being welcomed. However, the negative impact of losing face-to-face interactions was noted, including the opportunity to build relationships with colleagues caring for children with life-limiting conditions. CONCLUSIONS: Results suggest that the redesigned online programme contributed to participants' knowledge, encouraged participation and increased accessibility. An e-Learning model enables specialised education to be more equitable and accessible, ensuring regional areas are not disadvantaged due to geographical remoteness from tertiary educational centres. However, the lack of face-to-face contact was acknowledged as a hindrance to socialisation and networking. When developing future programmes, focus should be put on creating opportunities for networking and social development to compensate for the lack of face-to-face contact.

Educação permanente em saúde como prática possível: uma experiência na atenção primária / Educación permanente en salud como práctica posible: experiencia en atención primaria / Permanent health education as a possible practice: an experience in primary care

RESUMO Objetivo: descrever o processo de análise de necessidades, execução e avaliação de um programa educativo na Atenção Primária à Saúde, na lógica da Educação Permanente em Saúde (EPS). Método: pesquisa-ação com abordagem mista, desenvolvida entre 2014 e 2016, com trabalhadores da saúde. A coleta de dados ocorreu nos encontros de grupo focal, oficinas do programa educativo e aplicação de questionários. Os dados qualitativos foram submetidos à análise de discurso do sujeito coletivo, e os dados quantitativos, à análise estatística descritiva. Resultados: a necessidade priorizada foi a comunicação prejudicada no ambiente de trabalho; e, durante a execução do programa educativo, os participantes pactuaram acordos para superação dos problemas identificados, a exemplo da criação de espaços de diálogo e fluxos definidos de comunicação. Sentiram-se satisfeitos em participar, e percebeu-se que o programa educativo causou impacto positivo no trabalho. Considerações finais: o objetivo de descrever todo processo da EPS foi alcançado. Houve maior estímulo para um movimento de transformação no processo de trabalho, em referência ao aprimoramento da comunicação na dimensão profissional da gestão do cuidado, a partir de um paradigma dialógico e crítico, capaz de ressignificar o processo de ensino-aprendizagem no trabalho. Como produto, tem-se um modo mais efetivo de operar a EPS.

RESUMEN Objetivo: describir el proceso de análisis de necesidades, ejecución y evaluación de un programa educativo en la Atención Primaria de Salud, en la lógica de la Educación Permanente en Salud (EPS). Método: investigación-acción con enfoque mixto, desarrollada entre 2014 y 2016, con trabajadores de la salud. La recolección de datos tuvo lugar en los encuentros de grupo focal, talleres del programa educativo y aplicación de cuestionarios. Los datos cualitativos fueron sometidos al análisis de discurso del sujeto colectivo, y los datos cuantitativos, al análisis estadístico descriptivo. Resultados: la necesidad priorizada fue la comunicación perjudicada en el ambiente de trabajo; y, durante la ejecución del programa educativo, los participantes pactaron acuerdos para superar los problemas identificados, a ejemplo de la creación de espacios de diálogo y flujos definidos de comunicación. Se sintieron satisfechos de participar, y se percibió que el programa educativo causó impacto positivo en el trabajo. Consideraciones finales: el objetivo de describir todo el proceso de EPS fue alcanzado. Hubo mayor estímulo para un movimiento de transformación en el proceso de trabajo, en referencia al perfeccionamiento de la comunicación en la dimensión profesional de la gestión del cuidado, a partir de un paradigma dialógico y crítico, capaz de resignificar el proceso de enseñanza-aprendizaje en el trabajo. Como producto, se tiene un modo más efectivo de operar la EPS.

ABSTRACT Objective: to describe the process of needs analysis, execution and evaluation of an educational program in Primary Health Care, in the logic of Permanent Health Education (PHE). Method: action research with mixed approach, developed between 2014 and 2016, with health workers. Data collection occurred in focus group meetings, educational program workshops and questionnaire application. The qualitative data were submitted to discourse analysis of the collective subject, and quantitative data were submitted to descriptive statistical analysis. Results: the prioritized need was impaired communication in the work environment; and, during the implementation of the educational programme, participants agreed agreements to overcome the identified problems, such as the creation of dialogue spaces and defined communication flows. They were satisfied to participate, and it was noticed that the educational program had a positive impact on the work. Final considerations: the objective of describing the entire Process of PHE was achieved. There was a greater stimulus for a movement of transformation in the work process, in reference to the improvement of communication in the professional dimension of care management, from a dialogical and critical paradigm, capable of resignifying the teaching-learning process at work. As a product, there is a more effective way to operate PHE.

Validade de construto e confiabilidade do Families' Importance In Nursing Care-Nurses' Attitudes / Validez del constructo y fiabilidad del Families' Importance In Nursing Care-Nurses' Attitudes / Construct validity and reliability of the scale Families' Importance In Nursing Care-Nurses' Attitudes

Resumo Objetivo Avaliar a validade de construto e a confiabilidade interna da versão brasileira da escala Families' Importance in Nursing Care-Nurses' Attitudes (FINC-NA). Métodos Estudo metodológico, cujos dados foram coletados em novembro de 2019, com 283 enfermeiros, atuantes em três hospitais universitários do estado do Paraná. Utilizou-se o coeficiente α-Conbrach para determinar a consistência interna, análise fatorial exploratória (AFE) em componentes principais, com rotação Varimax para a validade de construto. A relação entre variáveis observadas e variáveis latentes foi avaliada por meio da Análise Fatorial Confirmatória (AFC). Resultados Os participantes tinham idade média de 40 anos, a maioria era casada, do sexo feminino, e mais de 30% tinham título de mestre ou doutor. Na AFE foram eliminados cincos itens (correlação abaixo de 0,30). O modelo final conservou três fatores, explicando 52,2% da variância dos dados, sendo os mesmos reinterpretados teoricamente. Na AFC os três fatores apresentaram forte correlação (acima de 0,7), porém mais três itens foram excluídos. Não se confirmou relação de causa e efeito entre os três construtos, mas foi ratificado que os itens são confiáveis para se medir as três novas dimensões após a reinterpretação, pois todas as cargas fatoriais são maiores que 0,5. O instrumento final validado conta com 18 itens distribuídos em três fatores e um α-Conbrach de 0,91. Conclusão A escala possui propriedades psicométricas satisfatórias, demonstrando adequadas evidências de validade e confiabilidade.

Resumen Objetivo Evaluar la validez del constructo y la fiabilidad interna de la versión brasileña de la escala Families' Importance in Nursing Care-Nurses' Attitudes (FINC-NA). Métodos Estudio metodológico, cuyos datos fueron recopilados en noviembre de 2019, con 283 enfermeros que trabajan en tres hospitales universitarios del estado de Paraná. Se utilizó el coeficiente α-Conbrach para determinar la consistencia interna, el análisis factorial exploratorio (AFE) en componentes principales, con rotación Varimax para la validez del constructo. La relación entre variables observadas y variables latentes fue evaluada mediante el análisis factorial confirmatorio (AFC). Resultados Los participantes tenían una edad promedio de 40 años, la mayoría casada, de sexo femenino y más del 30 % tenía título de maestría o doctorado. En el AFE, se eliminaron cinco ítems (correlación inferior a 0,30). El modelo final conservó tres factores, lo que explica el 52,2 % de la varianza de los datos, que fueron reinterpretados teóricamente. En el AFC, los tres factores presentaron una fuerte correlación (superior a 0,7), pero otros tres ítems fueron excluidos. No se confirmó relación de causa y efecto entre los tres constructos, pero se ratificó que los ítems son confiables para medir las tres nuevas dimensiones después de la reinterpretación, ya que todas las cargas factoriales son mayores a 0,5. El instrumento final validado cuenta con 18 ítems distribuidos en tres factores y un α-Conbrach de 0,91. Conclusión La escala tiene propiedades psicométricas satisfactorias y demuestra evidencias de validez y fiabilidad adecuadas.

Abstract Objective To assess the construct validity and internal reliability of the Brazilian version of the scale Families' Importance in Nursing Care-Nurses' Attitudes (FINC-NA). Methods This is a methodological study, whose data were collected in November 2019, with 283 nurses, working in three university hospitals in the state of Paraná. Cronbach's α coefficient was used to determine internal consistency, exploratory factor analysis (EFA) in principal components, with Varimax rotation for construct validity. The relationship between observed variables and latent variables was assessed using confirmatory factor analysis (CFA). Results Participants had an average age of 40 years, most were married, female, and more than 30% had a master's or doctoral degree. In EFA, five items were eliminated (correlation below 0.30). The final model retained three factors, explaining 52.2% of the data variance, which were theoretically reinterpreted. In CFA, the three factors showed a strong correlation (above 0.7); however, three more items were excluded. A cause-and-effect relationship was not confirmed between the three constructs, but it was confirmed that the items are reliable for measuring the three new dimensions after reinterpretation, as all factor loadings are greater than 0.5. The final validated instrument has 18 items distributed into three factors and a Cronbach's α coefficient of 0.91. Conclusion The scale has satisfactory psychometric properties, demonstrating adequate evidence of validity and reliability.

A Comfort Measures Only Checklist for Critical Care Providers: Impact on Satisfaction and Symptom Management.

PURPOSE: This quality improvement project created a guide for critical care providers transitioning patients to comfort measures only encouraging communication, collaboration, and shared decision making; ensuring management of patients' end-of-life symptoms and needs; and enhancing provider satisfaction by improving structure and consistency when transitioning patients. DESCRIPTION OF THE PROJECT: Interviews conducted with staff in intensive care units revealed opportunities to improve structure and processes of transitioning patients at the end of life. A subcommittee of experts designed a checklist to facilitate interdisciplinary conversations. Impact on provider satisfaction and symptom management was assessed. Presurveys circulated used a Research Electronic Data Capture tool. A checklist was implemented for 3 months, and then postsurveys were sent. Charts were audited to identify improvement in symptom management and compared with retrospective samples. OUTCOMES: Clinical improvements were seen in communication (12%), collaboration (25%), shared decision making (22%), and order entry time (17%). In addition, 72% agreed the checklist improved structure and consistency; 69% reported improved communication, collaboration, and shared decision making; 61% felt it improved knowledge/understanding of patient needs; and 69% agreed it improved management of patient symptoms. CONCLUSION: After checklist implementation, staff felt more involved and more comfortable, and reported more clarity in transitioning patients; no improvement in patient outcomes was realized.