Self-Efficacy in the Cannulation Technique for Intraosseous Access in Pediatric Cardiac Arrest: Egg Versus Bone.

OBJECTIVES: The use of intraosseous (IO) access is recommended in cardiac arrest when peripheral venous access is not accessible. Various methodologies exist that are used for teaching and learning about cannulation of the IO route both in education and in research. The purpose of the present study was to compare self-efficacy in the cannulation technique for IO access through different techniques. METHODS: A randomized comparative study was conducted. A total of 118 nursing students participated. The participants were randomly distributed into 2 intervention groups: chicken bone and egg. A checklist was used for data collection to evaluate the IO cannulation technique in nursing students and another to analyze self-efficacy. RESULTS: The average total score of self-efficacy for all participants was 8.84 (standard deviation (SD) = 0.98). No statistically significant differences were found when comparing the total self-efficacy score and the intervention group ( U = 1604.500; z = -0.733; P = 0.463). No statistically significant differences were found between both groups for the average total score of the procedure ( U = 6916.500; z = -0.939; P = 0.348). The egg group carried out the IO cannulation procedure in a significantly less amount of time (M = 126.88, SD = 82.18) than the chicken bone group (M = 183.77, SD = 108.28), finding statistically significant differences ( U = 4983.500; z = -5.326; P < 0.001). CONCLUSIONS: Using an egg to teach and learn about IO access could be considered a methodology that is equally effective as using a chicken bone, with the advantage of achieving IO access in a lesser amount of time.

Time out! Pauses during advanced life support in high-fidelity simulation: A cross-sectional study.

BACKGROUND: Prolonged preshock pauses are associated with negative effects on patient outcomes and survival. A greater understanding of these pauses may help to improve the quality of advanced life support (ALS) and clinical outcomes. OBJECTIVE: The objective of this study was to identify the pauses that occur during ALS situations in high-fidelity simulation scenarios and the frequency and duration of these pauses. METHODS: One hundred forty-two nursing students participated in this cross-sectional study, involving high-fidelity simulation scenario of cardiorespiratory arrest in a simulated hospital room. Pauses were assessed using an observation checklist. RESULTS: Students performed the scenario in an average time of 8.32 (standard deviation = 1.13) minutes. Pauses between chest compressions were longer than recommended (mean = 0.36, standard deviation = 1.14). A strong positive correlation was found between the identification of the arrhythmia and the initiation of countershock (rs = 0.613, p < 0.001). CONCLUSIONS: Nursing students generally performed ALS within the time limits recommended by resuscitation guidelines. Early identification of shockable rhythms may lead to early nurse-initiated defibrillation. Strategies to speed up the identification of arrhythmias should be put in place to minimise preshock pauses and improve ALS outcomes.

Original Research: How Magnet Hospital Status Affects Nurses, Patients, and Organizations: A Systematic Review.

OBJECTIVE: As the number of Magnet hospitals continues to rise in the United States and abroad, the body of literature regarding various outcomes at Magnet hospitals is increasing also. A systematic review examining and compiling the most recent evidence would be invaluable to those seeking to pursue Magnet recognition for their facility. We conducted this systematic review to investigate how Magnet hospital status affects outcomes for nursing professionals, patients, and health care organizations. METHODS: In January 2018, the databases CINAHL, ProQuest, PubMed, and La Biblioteca Cochrane Plus were searched for relevant studies. The reference lists of selected articles were also examined to identify additional studies. The PRISMA statement was followed, and established methods for systematic review were used to produce a narrative summary. The quality of the reviewed studies was assessed according to the 22-item Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) checklist for observational studies. RESULTS: Of the 163 studies identified, 21 met the eligibility criteria and are included in this review. On the whole, lower rates of nursing shortages, burnout, job dissatisfaction, and turnover were observed at Magnet hospitals compared with non-Magnet hospitals. The rates of patient mortality, falls, hospital-acquired infections, and pressure ulcers were also lower. Nursing work environments were found to be safer and were associated with a higher quality of care in Magnet hospitals than in non-Magnet hospitals, and Magnet hospitals were found to provide more cost-effective care. CONCLUSION: This review provides nursing managers and administrators with the most recent evidence demonstrating that Magnet hospitals have better nursing work environments and are associated with better outcomes for nurses, patients, and organizations than non-Magnet hospitals. This evidence should inform future decision-making with regard to pursuing Magnet designation.

Nursing Degree students' perception about their clinical practice environment: a phenomenological study. / Percepción de los estudiantes del Grado en Enfermería sobre su entorno de prácticas clínicas: un estudio fenomenológico.

AIM: To explore the perception of fourth-year nursing students of the healthcare environment where their training process in clinical practices takes place. METHODS: Phenomenological qualitative study based on the hermeneutical philosophy of Gádamer that included the development of focus groups and semi-structured interviews in a sample of fourth-year nursing students from the University of Almería. The collection period was in February 2016. The information obtained was transcribed and analyzed by inductive strategies in search of emerging categories. RESULTS: The analysis revealed two main categories: (1) influence of the clinical environment on the healthcare and teaching performance of nurses and on student learning and (2) training and job prospects for the future professionals. Each of them showed two subcategories with their corresponding codes. The information collected showed the experiences and perceptions of Nursing students regarding the healthcare environment where their training process in clinical practices takes place. CONCLUSIONS: This study enabled us to discover the perception of fourth-year nursing students of the environment where their training process in clinical practices takes place. Knowledge of this phenomenon helps to identify deficits in students' clinical learning and to adapt university curricula to their training needs in order to guarantee their success as professionals facing future clinical-labour demands.

Development of a web-based tool to evaluate competences of nursing students through the assessment of their clinical skills.

BACKGROUND: Assessing the clinical ability of nursing students continues to be a fundamental challenge within the nursing degree. Designing innovative teaching strategies while ensuring an educational experience that results in safe nursing practices is an additional challenge for all educators. OBJECTIVES: To design, develop and implement a tool to evaluate the clinical skills of nursing students. DESIGN: A two-phase study. In the second phase, a pre-experimental study was conducted. SETTINGS: Health Sciences Department of the University of Almería, Spain. PARTICIPANTS: 250 Nursing students in the second year of their degree. METHODS: The study was divided into 2 phases: 1st) Web-based tool design and development and 2nd) Usability testing. In the second phase, a pre-experimental study was conducted both with an experimental group and a control group. RESULTS: In the first phase, a panel of 15 experts confirmed that the content and technical aspects of the tool were adequate (scores of 4-5/5). In the second phase, the participants of the experimental group showed higher final scores in the evaluated skills section, as well as shorter evaluation time and a greater number of observations and registered incidents than the participants in the control group. Finally, the students of the experimental group indicated a greater degree of satisfaction with the evaluation system used. CONCLUSIONS: The web-based tool designed is an effective strategy to evaluate clinical skills. It is important to have strategies and instruments that allow us to demonstrate the development and acquisition of the skills required for future nursing professionals.