Clinical Nurse Educators Research Articles

Multisource feedback to graduate nurses: a multimethod study.

(1) To explore graduate nurses' perceptions of the influence of multisource feedback on their performance and (2) to explore perceptions of Clinical Nurse Educators involved in providing feedback regarding feasibility and benefit of the approach. Graduate registered nurses are expected to provide high-quality care for patients in demanding and unpredictable clinical environments. Receiving feedback is essential to their development. Performance appraisals are a common method used to provide feedback and typically involve a single source of feedback. Alternatively, multisource feedback allows the learner to gain insight into performance from a variety of perspectives. This study explores multisource feedback in an Australian setting within the graduate nurse context. Multimethod study. Eleven graduates were given structured performance feedback from four raters: Nurse Unit Manager, Clinical Nurse Educator, preceptor and a self-appraisal. Thirteen graduates received standard single-rater appraisals. Data regarding perceptions of feedback for both groups were obtained using a questionnaire. Semistructured interviews were conducted with nurses who received multisource feedback and the educators. In total, 94% (n=15) of survey respondents perceived feedback was important during the graduate year. Four themes emerged from interviews: informal feedback, appropriateness of raters, elements of delivery and creating an appraisal process that is 'more real'. Multisource feedback was perceived as more beneficial compared to single-rater feedback. Educators saw value in multisource feedback; however, perceived barriers were engaging raters and collating feedback. Some evidence exists to indicate that feedback from multiple sources is valued by graduates. Further research in a larger sample and with more experienced nurses is required. Evidence resulting from this study indicates that multisource feedback is valued by both graduates and educators and informs graduates' development and transition into the role. Thus, a multisource approach to feedback for graduate nurses should be considered.

종합병원 임상간호사 실무교육에서의 기초간호학 교육현황

Purpose: The purpose of this study was to investigate the extent and the nature of biological nursing science education for clinical nurses in general hospital. Methods: Five advanced general hospitals located in Seoul and Gyeonggi province were conveniently sampled. Contents of education for nurses conducted by the hospital nursing department from January 1 to December 31 of 2015 were collected. Contents of education included biological nursing science and the scope of inclusion and time of assignment were analyzed. Results: A total of 271 cases of nursing education data were collected and 223 cases were analyzed after excluding 48 cases whose contents were not confirmed. Biological nursing science was included in the contents of education for 117 cases (52.5%), but not for 106 cases (47.5%). Regarding the frequency of the biological nursing science education contents, ‘pathophysiology’ was the most frequently included (n=286), followed by ‘structure and function of the human body’ (n=191), ‘mechanisms and effects of drugs’ (n=114) and ‘clinical microbiology’ (n=43). Conclusion: Results of this study confirmed that the education for clinical nurses included a lot of biological nursing science related contents. These results can be used as basis for the development of curriculum and training course for nurses. Key Words: General hospital; Clinical nurses; Biological nursing science; Education; Training Key Words: ì¢ í•©ë³‘ì›; 임상간호사; 기초간호학; 교육; 연수

A Leadership Education and Development Program for Clinical Nurses.

The Leadership Education and Development (LEAD) Program was designed to transform care at the bedside by empowering clinical nurses as leaders. The heart of LEAD was enhancing communication skills of clinical nurses with clinical colleagues and, most importantly, patients and families. Key concepts of leadership/management were included: personal awareness, personal leadership skills/abilities, leading change, leading others individually and in teams, enhancing the patient/provider experience, and the leadership role in outcomes management. A quantitative, longitudinal, survey design was used with 2 cohorts. The program consisted of six 4-hour sessions for 3 to 6 months. Leadership practices were measured before program implementation, at the end of the program, and 3 months after program completion. There were significant increases in leadership practices sustained 3 months after program completion. A range of other outcome measures was included. There is a need for additional leadership development programs for clinical nurses.

Around the world.

1. 16th Clinical Nursing and Nurse Education Conference 21-22 November, Melbourne, Victoria, Australia tinyurl.com/clinical-nurse.

Analysis of Nurse's Clinical Education Performance based on Work Theory and The Indicator of Competence

Introduction: Clinical Learning is a process of transformation of the student to become a professional nurse. Clinical Nurse Educator contributes to improve the quality of clinical learning because of variety of roles ranging from planning, implementing and evaluating learning clinical practice. Improving the quality of clinical practice learning, can be reached by improving the performance of Clinical Nurse Educator. The aim of this study was to know the effect of psychological variables and organizational variables to the competence and performance of Clinical Nurse Educators. Sample was Clinical Nurse Educators who work inpatient wards at Kediri Baptist Hospital inpatient wards. Method: This study was conducted in two stages. Phase I measure the competence and performance of Clinical Nurse Educator by Supervisor and students, as well as psychological variables and organizational variables by using questionnaires. Phase II was done by Focused Group Discussion to discuss about the variables that affect Clinical Nurse Educator performance. Data processed using Partial Least Square with α = 0.05, path coefficient = 0.5 and t table = 1.96. Result: The results of this research is showed that Performance Nurse Educator can be improved by increasing Individual Competence with path coefficient= 0.600 and t = 6.741. The individual competence will be increase by improving pscychological aspect nurse educator such as perception, personal aspect, motivation, learning skill and attitude with path coefficient = 0.518 and t = 2.715. Psycological Aspect can be increasing by improving Organization Variable such as Organization Resource, Salary, Organization Structure and Job Description with path coefficient = 0.825 and t = 19.658. Discussion: The conclusion of this result that increase of nurse educator competence and performance can be effort by improving psycological aspect and organizational variableKeywords: competence, performance, clinical nurse educator

Status survey and influencing factors analysis of core competence of diabetes specialist nurses in Chongqing

Objective To investigate the status and influencing factors of core competence of diabetes specialist nurses in Chongqing. Methods 118 diabetes specialist nurses from Chongqing were selected by convenience sampling and were surveyed by questionnaires. Results The ability of clinical nursing and health education were in an advanced level; the ability of nursing management, guidance, consultation and clinical research were in a medium level; the ability of ethical decision-making was in an inferior level. Hospital types, departments they belong and professional titles may to some degree influence core competence of diabetes specialist nurses. Conclusions The core competence training for diabetes specialist nurses in Chongqing meets requirements of specialist nurses′ training; according to factors influencing core competence, training units should take targeted intervention measures to effectively promote core competence of the nurses. Key words: Diabetes; Specialist nurse; Core competence; Status survey; Influencing factor

CPR guidelines update

Ruby Chu is a Medical Critical Care Line Clinical Nurse Educator at the Michael E. DeBakey VA Medical Center in Houston, Tex. The author has disclosed no financial relationships related to this article.

Translation and validation of the clinical learning environment, supervision and nurse teacher scale (CLES + T) in Croatian language

Clinical practice is essential to nursing education as it provides experience with patients and work environments that prepare students for future work as nurses. The aim of this study was to translate the “Clinical Learning Environment, Supervision and Nurse Teacher” questionnaire in Croatian language and test its validity and reliability in practice. The study was performed at the Faculty of medicine, Josip Juraj Strossmayer University of Osijek, Croatia in April 2014. The translated questionnaire was submitted to 136 nursing students: 20 males and 116 females. Our results reflected a slightly different factor structure, consisting of four factors. All translated items of the original constructs “Supervisory relationship”, “Role of nurse teacher” and “Leadership style of the ward manager” loaded on factor 1. Items of “Pedagogical atmosphere on the ward” are distributed on two factors (3 and 4). The items of “Premises of nursing on the ward” loaded on factor 2. Three items were identified as problematic and iteratively removed from the analysis. The translated version of the aforementioned questionnaire has properties suitable for the evaluation of clinical practice for nursing students within a Croatian context and reflects the specifics of the nursing clinical education in this country.

Role of clinical nurse educators (CNEs) in levodopa-carbidopa intestinal gel (LCIG) clinical studies in Parkinson’s disease (PD) (P6.379)

Role of clinical nurse educators (CNEs) in levodopa-carbidopa intestinal gel (LCIG) clinical studies in Parkinson’s disease (PD) (P6.379)

Performance of Clinical Nurse Educators in Teaching Pharmacology and Medication Management: Nursing Students' Perceptions.

BackgroundPharmacological knowledge and medication management skills of student nurses greatly depend on the clinical nurse educators’ performance in this critical issue. However, the Iranian nurse educators’ performance in teaching pharmacology and medication management are not adequately studied.ObjectivesThe current study aimed to investigate the nursing students’ perceptions on the status of clinical pharmaceutical and medication management education.Materials and MethodsA cross-sectional study was conducted on all 152 nursing students registered in the seventh and eighth semesters at the Qom and Naragh branches of Islamic Azad University, and Kashan University of Medical Sciences in 2013 - 2014 academic year. The students’ perceptions on the performance of clinical nurse educators in teaching pharmacology and medication management were assessed using a researcher made questionnaire. The questionnaire consisted of 31 items regarding clinical educators’ performance in teaching pharmacology and medication management and two questions about students’ satisfaction with their level of knowledge and skills in pharmacology and medication management. Descriptive statistics was employed and analysis of variance was performed to compare the mean of scores of teaching pharmacology and medication management in the three universities.ResultsAmong a total of 152 subjects, 82.9% were female and their mean age was 22.57 ± 1.55 years. According to the students, instructors had the weakest performance in the three items of teaching pharmacology and medication management based on the students’ learning needs, teaching medication management through a patient-centered method and teaching pharmacology and medication management based on the course plan. The students’ satisfaction regarding their own knowledge and skill of pharmacology and medication management was at medium level.ConclusionsNursing students gave a relatively low score in several aspects of their instructors’ performance regarding teaching pharmacology and medication management. It seems that many clinical nurse educators in the studied settings were incompetent especially in teaching pharmacology and medication management, while these are critical areas and need special attention.

Profiling nursing resources in Australian emergency departments

Emergency nurses have a key role in managing the large numbers of patients that attend Australian emergency departments (EDs) annually, and require adequate educational preparation to deliver safe and quality patient care. This paper provides a detailed profile of nursing resources in Australian EDs, including ED locations, annual patient attendances, nurse staffing including level of education, and educational resources. Data were collected via online surveys of emergency Nurse Unit Managers and Nurse Educators and the MyHospitals website. Data were analysed by hospital peer group and state or territory. Comparisons were made using the Kruskal-Wallis Test and Spearman Rank Order Correlation. In 2011-2012, there were a median of 36,274 patient attendances to each of the 118 EDs sampled (IQR 28,279-46,288). Most of the nurses working in EDs were Registered Nurses (95.2%). Organisations provided educational resources including Clinical Nurse Educators (80.6%), learning packages (86%) and facilitation of postgraduate study (98%), but resources, both human and educational varied substantially between states and territories. One-third of emergency nurses held a relevant postgraduate qualification (30%). There are important variations in the emergency nursing resources available between Australian states and territories. The high percentage of RNs in Australian EDs is a positive finding, however strategies to increase the percentage of nurses with relevant postgraduate qualifications are required.

Battling Supply Waste in the ICU: A Bedside Cart Standardization Project

DO YOU KNOW how much waste is generated from one hospital? How about from one patient? Do you know how much money your hospital could save if you streamlined processes surrounding supply management at the bedside? Most likely, your answer to these questions would be that you have no idea. Well, neither did we. What we did know was that we were wasting a lot of supplies with each patient admission and discharge, and it led us to wonder what would happen if we changed our practice around what supplies we kept at the patient's bedside. Marie Cockerham, BSN, RN, CCRN, Critical Care Clinical Nurse Educator, University of Washington Medical Center. Amy Haverland, BSN, RN, CCRN, Nurse Manager, Surgical Intensive Care Unit, University of Washington Medical Center. Nicole Solvang, BSN, RN, CCRN, Staff Nurse, Medical Surgical Intensive Care Unit, University of Washington Medical Center, Seattle WA 98195.

In defense of clinical conferences in clinical nursing education

Clinical conferencing has been a consistent feature of clinical education, but the current clinical education environment poses many challenges to its continuance. The paper raises concern regarding the current state of clinical conferencing as part of clinical practice education in nursing. This topic is of great concern, but has there is little direction for clinical educators. The paper reviews the literature on conferencing and recommends avenues for future research.

Pilot study of a dedicated education unit: Lessons learned

Background and objective : Nursing programs in Australia, New Zealand, and the United States are implementing Dedicated Education Units (DEU) as an innovative approach to provide clinical experiences for undergraduate nursing students. In August 2014 a university in Texas received a state grant to institute a pilot implementation of a DEU as a means of increasing the number of pre-licensure nursing students in the BSN program. The following objectives were designed to provide structure to implement and evaluate the DEU project: (1) Develop and implement a DEU model for pre-licensure nursing clinical education in four medical-surgical courses, using two nursing units at a local regional hospital; (2) Test the effectiveness of the DEU model of clinical education for pre-licensure nursing students; and (3) Increase the number of BSN-prepared nurses serving as DEU Clinical Instructors who enroll in a MSN-Nurse Educator program by six in the first semester of the grant. Methods : A variety of methods were used to evaluate effectiveness of this project, including focus groups of participants; qualitative assessment of the project orientation process for students, faculty and staff; quantitative analysis of examination scores, course scores, competency evaluations, and enrollment data. Results : Project evaluation revealed some positive results; however, problems related to orientation and ongoing support were seen as a barrier to successful implementation. Work overload for the Clinical Instructors also negatively impacted the effectiveness of the project. The number of students involved in this project was dictated by the space available in the designated DEUs. Even though the small sample size was insufficient for a research study, the results of this project may be of interest to others implementing a DEU. Conclusions : This paper focuses on lessons learned from the implementation a DEU pilot project and provides a number of suggestions for addressing challenges. The analysis of the results of this pilot project and related recommendations to avoid or ameliorate the challenges may be instructive for other schools planning to initiate a DEU.

Commencing a nurse education role development journey in a regional Australian health district: Results from a mixed method baseline inquiry

Background : Health service-based nurse education roles (NERs) are well positioned to support the integration of theory and practice in Australian nursing. Despite this they are widely viewed as both poorly described and undervalued. Objective: To establish role parameters, typical activity profiles and views and attitudes about their roles, professional practices & linkages, among a sample of regional Australian nurses in NERs. Methods : Design: Participatory action research baseline inquiry. Participants: Nurse educators (NEs) and clinical nurse educators (CNEs) of the Northern New South Wales Local Health District. Mixed method baseline survey (n = 38, 84% response rate) and focus group study (3 groups, n = 33 participants in total). Results : Most survey participants were active in writing education programme material for Registered Nurses (RNs). Two thirds of survey respondents reported responsibility for medical staff training. CNEs were called upon to provide clinical relief (prompted by high patient acuity, sick leave and meal breaks) to the wards and units significantly more frequently than NEs. Activity logging indicated wide-ranging role domain diversity. Providing education and supporting clinical staff were the most prominent role domains for both NEs and CNEs. Dissatisfaction with aspects of NER was high – no role domain attracted higher than 60% overall satisfaction from this representative sample. Most participants were not research-active and many indicated the need for improvements in their linkages to the nursing academy. Focus group discussion suggested a group who were spread thinly, answerable to multiple governance tiers and intellectually under-supported. No consistent guiding educational philosophy was discernible in relation to participants’ own teaching activity. Conclusions : Principle issues related to the diversity of operational and professional responsibility tied to multiple impacting governance structures. Stable and purposeful linkages to nursing faculties/academia were also lacking.

Key components of financial-analysis education for clinical nurses.

In this study, we identified key components of financial-analysis education for clinical nurses. We used a literature review, focus group discussions, and a content validity index survey to develop key components of financial-analysis education. First, a wide range of references were reviewed, and 55 financial-analysis education components were gathered. Second, two focus group discussions were performed; the participants were 11 nurses who had worked for more than 3 years in a hospital, and nine components were agreed upon. Third, 12 professionals, including professors, nurse executive, nurse managers, and an accountant, participated in the content validity index. Finally, six key components of financial-analysis education were selected. These key components were as follows: understanding the need for financial analysis, introduction to financial analysis, reading and implementing balance sheets, reading and implementing income statements, understanding the concepts of financial ratios, and interpretation and practice of financial ratio analysis. The results of this study will be used to develop an education program to increase financial-management competency among clinical nurses.

G240(P) Competent ward co-ordinators-meeting training needs through simulation

Aims Taking charge of a ward is daunting for newly qualified nurses. This abstract describes the development of a ward co-ordinators competency pathway, written to support and develop band 5 paediatric nurses in a leadership role, following Trust workforce review re-defining the band 5 role, requiring them to co-ordinate on a shift basis, post-preceptorship. The development of this pathway responded to the skill mix review comparing our nursing bands with other specialist children’s Trusts. 1 Methods Review of national paediatric job descriptions and band 5 role. Trust band 5 job description rewritten against AFC national profile and matching other paediatric Trust band 5’s. Consultation with other Trusts reviewing post-preceptorship training programmes for band 5 nurses. Trust steering group consisting of educators and nurse managers to design a training programme enabling band 5 nurses to become competent practitioners. Band 5 nurses consulted to determine their development needs for this challenging role. Support gained from Trust Nursing Executive and Learning and Development Department. Results This learning consists of a Trust designed bespoke training day utilising simulation to introduce band 5 nurses to both clinical and management scenarios, complementing an accompanying pathway/clinical competencies booklet to be completed with a “buddy” in their clinical workplace within a specific timeframe. A local evaluation of the project shows that of 17 band 5 nurses who have completed the pathway, 9 are satisfied and 8 extremely satisfied with the efficacy of simulation day as a teaching method. Conclusion The study day uses a blended learning approach utilising simulation, group work and role play and is facilitated by Clinical Nurse Educators, Matrons and Senior nurses. Both the day and pathway document promote a reflective and interactive approach, highly valued by band 5 nurses going through the programme and has resulted in supported and competent ward co-ordinators. We have developed a unique and cost effective pathway which can be adapted to meet varying clinical staff groups. It encompasses modern technologies/teaching methods, resulting in essential staff development/retention and better patient safety. 2 References Civil Eyes Research. Civil Eyes Research Project with Specialist Children’s Hospitals. www.civil-eyes.com, 2010 DoH 2011 – A Framework for Technology Enhanced Learning http://www.dh.gov.uk/publications

Abstract NS2: Post Stroke Assessment Tool for Nurses Validated

Introduction: Nurses who provide inpatient care to acute ischemic stroke (AIS) patients routinely perform neurologic assessments that are intended to monitor the stability of neurological deficit. A variety of assessment tools are used, however none of these tools have been validated as a stroke specific assessment tool for nurses. The purpose of this study was to evaluate the validity of a novel nurse performed stroke assessment tool, the Post Stroke Assessment Tool (PSAT). Methods: An interdisciplinary team, from a single certified primary stroke center devised the PSAT. The PSAT encompasses evaluation of 4 components of neurologic function (level of consciousness, cranial nerves, limb strength, and limb coordination). PSAT scores range from 0 (no deficits) to 63. A Clinical Nurse Educator trained neurology nurses on PSAT performance prior to study initiation. A nurse performed the PSAT on patients with AIS. A physician performed the National Institutes of Health Stroke Scale (NIHSS) within 30 minutes of PSAT completion. General linear regression and Pearson correlation was used to evaluate the relationship between scores. All analysis was done in SAS® Version 9.3 for Windows. Results: A total of 26 nurses conducted a PSAT on 46 patients. Mean NIHSS was 6.1 (S.D. +/- 6.9) and mean PSAT score was 10.2 (S.D. +/- 11.8). The r 2 was 0.8349. Overall, the model was significant (p-value < 0.0001). Both the regression model and Pearson correlation showed a significant relationship between PSAT and NIHSS (p <0.0001 for both). Spearman correlations showed a significant relationship between PSAT and NIHSS within each category (p < 0.003 for each category). Conclusions: In this exploratory study, the PSAT appears to be a reliable nursing assessment tool to monitor post stroke neurologic deficit. Total and categorical PSAT scores highly correlated with total and categorical NIHSS scores. No attempt to compare inter-rater reliability from one nurse to another was included in this study. Future research concerning the reliability of the PSAT will be necessary before this tool can become a standard nursing assessment for patients following AIS.

Strengthening the foundation for the future of nursing through a Summer Study Hall program at an academic medical center.

The purpose of this article was to describe the development and implementation of an innovative Summer Study Hall program developed by clinical nurse specialists (CNSs)/clinical nurse educators (CNEs) in an urban academic medical center. The program was implemented as a strategy to give nursing students the opportunity to enhance their clinical skills. The chosen skills are considered high risk for hospitals and have major impact on the American Nurses Association National Database for Nursing Quality Indicators, such as ventilator-associated pneumonia and catheter-acquired urinary tract infections. The secondary purpose of the program is to provide a venue to be able to work with potential employees and determine if they have the potential to be promising employees. A group of 20 students voluntarily met with a CNS/CNE weekly for 4 weeks in a simulation laboratory to review and demonstrate skills such as Foley catheter insertion and suctioning. The program was very well received by participants as well as by the CNS/CNE faculty. The program will continue annually, and some modifications have been made to include nonclinical topics such as professional development skills (eg, interviewing skills and résumé preparation).

Meaningful Graphs

Karen J. George, DNP, RN, CEN, VHA-CM Nurse III Clinician James H. Quillen VAMC Mountain Home, Tennessee Neil Coogan, MSN, MBA, RN-BC, CEN, is Clinical Nurse Educator, Nursing Education Department, Bay Pines VA Healthcare System, Bay Pines, Florida.