Levels Of Nursing Education Research Articles

Occupational health nurses’ achievement of competence and comfort in respiratory protection and preferred learning methods results of a nationwide survey.

Additional findings are presented from a 2012 nationwide survey of 2,072 occupational health nurses regarding how they achieved competence in respiratory protection, their preferred methods of learning, and how they motivated employees to use respiratory protection. On-the-job training, taking a National Institute for Occupational Safety and Health spirometry course, or attending professional conferences were the primary ways occupational health nurses gained respiratory protection knowledge. Attending professional conferences was the preferred method of learning, varying by type of industry and years of occupational health nurse experience. Employee motivational strategies were not widely used; the most common strategy was to tailor respiratory protection training to workplace culture. Designing training methods that match learning preferences, within the context of the organization's safety and quality improvement culture, is a key recommendation supported by the literature and these findings. Including respiratory protection content and competencies in all levels of academic nursing education is an additional recommendation. Additional research is needed to link training strategies with consistent and correct use of respiratory protection by employees.

The impact of the work environment of nurses on patient safety outcomes: A multi-level modelling approach

BackgroundPatient safety is a priority for health services in all countries. The importance of the nurse's role in patient safety has been established. Effective nurse staffing levels, nurse education levels, and a positive work environment for nurses are factors which are known to impact on patient safety outcomes. ObjectivesThis study sought to explore the relationship between the ward environment in which nurses practice and specific patient safety outcomes, using ward level variables as well as nurse level variables. The outcomes were nurse-reported patient safety levels in the wards in which they work, and numbers of formal adverse events reports submitted by nurses in the last year. DesignThis cross-sectional quantitative study was carried out within a European FP7 project: Nurse Forecasting: Human Resources Planning in Nursing (RN4CAST) project. Settings108 general medical and surgical wards in 30 hospitals throughout Ireland. ParticipantsAll nurses in direct patient care in the study wards were invited to participate. Data from 1397 of these nurses were used in this analysis. MethodsA nurse survey was carried out using a questionnaire incorporating the Practice Environment Scale of the Nursing Work Index (PES-NWI). Ethical approval was obtained from the authors’ institution and all ethics committees representing the 30 study hospitals. Multilevel modelling was carried out to examine the impact of ward level factors on patient safety. These included proportions of nurses on the ward educated to degree level, and aggregated ward-level mean for PES-NWI scores. ResultsThe study results support other research findings indicating that a positive practice environment enhances patient safety outcomes. Specifically at ward level, factors such as the ward practice environment and the proportion of nurses with degrees were found to significantly impact safety outcomes. The models developed for this study predicted 76% and 51% of the between-ward variance of these outcomes. The results can be used to enhance patient safety within hospitals by demonstrating factors at ward-level which enable nurses to effectively carry out this aspect of their role. ConclusionsThe importance of ward-level nurse factors such as nurse education level and the work environment should be recognised and manipulated as important influences on patient safety.

Jordanian Nurses Knowledge and Attitude Regarding Pain Management

Optimal pain management requires knowledgeable and trained nurses. The aim of this study is to investigate nurses' knowledge and attitudes regarding pain treatment in Jordan. The sample included 211 nurses from 4 hospitals in Jordan. The Nurses' Knowledge and Attitudes Survey Regarding Pain was used to measure the nurses' pain management knowledge and attitudes. Data were analyzed using descriptive statistics, unpaired t test, and Spearman correlation test. The results indicate that 51.7% of participants were male and the average age was 27.2 (SD 4.7) years. In addition, most nurses had a bachelor's degree (90.5%) and worked in medical and surgical wards. Furthermore, 52% of nurses reported no previous pain education in the last five years. The average of correct answers was 19.3 out of 40 (SD 4.7) and the rate of correct answers ranged from 10% (item 38) to 72% (item 22). It was found that there were no significant differences between nurses' gender and educational level and the total knowledge and attitude score, except for exposure to previous pain education (t = −3.64; df = 195; p < .001). Nurses with previous pain education got higher mean scores on the questionnaire. Jordanian nurses expressed a lower level of pain knowledge than that reported worldwide. Continuous education and reforming undergraduate curricula to address pain management are recommended.

Quality of work life among primary health care nurses in the Jazan region, Saudi Arabia: a cross-sectional study.

BackgroundQuality of work life (QWL) is defined as the extent to which an employee is satisfied with personal and working needs through participating in the workplace while achieving the goals of the organization. QWL has been found to influence the commitment and productivity of employees in health care organizations, as well as in other industries. However, reliable information on the QWL of primary health care (PHC) nurses is limited. The purpose of this study was to assess the QWL among PHC nurses in the Jazan region, Saudi Arabia.MethodsA descriptive research design, namely a cross-sectional survey, was used in this study. Data were collected using Brooks’ survey of quality of nursing work life and demographic questions. A convenience sample was recruited from 134 PHC centres in Jazan, Saudi Arabia. The Jazan region is located in the southern part of Saudi Arabia. A response rate of 91% (n = 532/585) was achieved (effective response rate = 87%, n = 508). Data analysis consisted of descriptive statistics, t-test and one way-analysis of variance. Total scores and subscores for QWL items and item summary statistics were computed and reported using SPSS version 17 for Windows.ResultsFindings suggested that the respondents were dissatisfied with their work life. The major influencing factors were unsuitable working hours, lack of facilities for nurses, inability to balance work with family needs, inadequacy of vacations time for nurses and their families, poor staffing, management and supervision practices, lack of professional development opportunities, and an inappropriate working environment in terms of the level of security, patient care supplies and equipment, and recreation facilities (break-area). Other essential factors include the community’s view of nursing and an inadequate salary. More positively, the majority of nurses were satisfied with their co-workers, satisfied to be nurses and had a sense of belonging in their workplaces. Significant differences were found according to gender, age, marital status, dependent children, dependent adults, nationality, nursing tenure, organizational tenure, positional tenure, and payment per month. No significant differences were found according to education level of PHC nurses and location of PHC.ConclusionsThese findings can be used by PHC managers and policy makers for developing and appropriately implementing successful plans to improve the QWL. This will help to enhance the home and work environments, improve individual and organization performance and increase the commitment of nurses.

The Clinical Nurse Leader: Improving Outcomes and Efficacy in the Emergency Department

Emergency departments across the country are in a state of crisis. The impending shortage of nurses and nurse educators, increasing complexity of illness, and uncertainty regarding the future of health care are just some of the issues being faced today. In addition, as outcomes become an increasingly critical measure of success, the education level of nurses has come under examination. Studies have shown that higher levels of education result in improved outcomes, leading several professional organizations to recommend a baccalaureate degree as the minimum degree for entry-level practice. 1 Benner P Sutphen M Leonard V Day L Book highlights from Educating Nurses: A Call for Radical Transformation. The Carnegie Foundation for the Advancement of Teaching. http://www.carnegiefoundation.org/elibrary/educating-nurses-highlights Google Scholar These recommendations include requiring nurses licensed after 2012 to earn a master's degree within 10 years and transitioning advanced practice degrees from master's to doctoral degrees. 1 Benner P Sutphen M Leonard V Day L Book highlights from Educating Nurses: A Call for Radical Transformation. The Carnegie Foundation for the Advancement of Teaching. http://www.carnegiefoundation.org/elibrary/educating-nurses-highlights Google Scholar , 2 American Academy of Colleges of Nursing AACN position statement on the practice doctorate in nursing. http://www.aacn.nche.edu/dnp/dnppositionstatement.htm Google Scholar As health care becomes increasingly complex, the bedside nurse not only needs to be skilled in practice but needs to be knowledgeable about policy, outcome evaluation, and evidence-based practice. In response to these concerns and others raised by professional and credentialing organizations, the role of the Clinical Nurse Leader (CNL) was developed. Andrea Perry, Member, Sacramento Chapter, is Staff Nurse II, Sutter Roseville Medical Center, Roseville, CA.

The Impact of Hospital Nursing Characteristics on 30-Day Mortality

Evidence indicates that hospital nursing characteristics such as staffing contribute to patient outcomes. Less attention has been given to other hospital nursing characteristics central to optimal professional practice, namely nurse education and skill mix, continuity of care, and quality of the work environment. To assess the relative effects and importance of nurse education and skill mix, continuity of care, and quality of work environment in predicting 30-day mortality after adjusting for institutional factors and individual patients characteristics. A cross-sectional analysis of outcome data for 18,142 patients discharged from 49 acute care hospitals in Alberta, Canada, for diagnoses of acute myocardial infarction, congestive heart failure, chronic obstructive pulmonary disease, pneumonia, or stroke between April 1, 1998, and March 31, 1999, was done. Mortality data were linked to patient demographic and comorbidity factors, institutional characteristics, and hospital nursing characteristics derived from a survey of all registered nurses working in acute care hospitals. Using multilevel analysis, it was determined that the log-odds for 30-day mortality varied significantly across hospitals (variance .044, p < .001). Patient comorbidities and age explained 44.2% of the variance in 30-day mortality. After adjustment for patient comorbidities and demographic factors, and the size, teaching, and urban status of the study hospitals in a fixed-effects model, the odds ratios (95% confidence interval) of the significant hospital nursing characteristics that predict 30-day mortality were as follows: 0.81 (0.68-0.96) for higher nurse education level, 0.83 (0.73-0.96) for richer nurse skill mix, 1.26 (1.09-1.47) for higher proportion of casual or temporary positions, and 0.74 (0.6-00.91) for greater nurse-physician relationships. The institutional and hospital nursing characteristics explained an additional 36.9%. Hospital nursing characteristics are an important consideration in efforts to reduce the risk of 30-day mortality of patients.

Association between nurse staffing and hospitalised children's health outcomes: A systematic review.

Review question/objective: The objective is to identify the association of nurse staffing with hospitalised children's health outcomes. More specifically, the objective is to identify the association of nursing hours per patient day, nurse-to-patient ratio, skill mix, nurse education level and nurse experience on children's health outcomes in paediatric, acute care hospitals. Inclusion criteria: Types of participants: The review will consider studies that include hospitalised children aged 0-18 years of age. Types of intervention(s)/phenomena of interest: The review will consider studies that evaluate aspects of nurse staffing: nursing hours per patient day, nurse-to-patient ratio, skill mix, staff turnover, nursing staff overtime, overtime hours of care, float/agency/traveller total hours of care, absenteeism and nurse characteristics such as level of education, years of experience. Types of outcomes: This review will consider studies that include the following outcome measures: mortality, failure to rescue, adverse events, nosocomial infections, postoperative complications, patient safety, patient/family satisfaction, length of stay, measures of processes of care e.g. peripheral intravenous infiltration and pain management.

Investigation and analysis of humanistic quality status among clinical nurses in advanced nursing professional education

Objective To understand humanistic quality and comprehensive among 1999-2004 graduates of higher vocational education level of nurses in jiangsu province, so as to provide the reference for health care and education. Methods Humanity quality and comprehensive were investigated among thirty hospital nurses in jiangsu province. Results Among 20 items, the lowest satisfaction one literature retrieval the highest one was civilized terminology. In the top 10 no satisfaction items included 6 rigid humane quality ability items, 4 flexible humanistic quality ability items. Among hospitals, the lowest satisfaction was in Grade three class B. Conclusions The colleges, according to the needs of hospitals, should pay more attention to the students' abilities in terms of literature retrieval ability, humanities knowledge, computer application and English application abilities, etc. Key words: Advanced vocational education; Secondary Vocational Education; Nurse; humanistic quality; Questionnaire

The Relationship Between Nurse Education Level and Patient Safety: An Integrative Review

The relationship between patient safety and nurse education level has implications for current and prospective nurses, hospital administrators, policy makers, and nurse educators. This integrative literature review assesses the current state of science on the topic during a 20-year period, using the Agency for Healthcare Research & Quality's Patient Safety Indicators to measure outcomes. Twenty-four studies of variable quality were included. Although studies suggest that increasing RN dose (i.e., number of care hours) and skill mix (versus LPN) are associated with improved patient safety, evidence linking RN education level (i.e., BSN, ADN, diploma) is sorely lacking.

Development and Application of Evaluation Indices for Hospital Infection Surveillance and Control Programs in the Republic of Korea

To develop new evaluation indices of infection control and to use them to evaluate Korean infection surveillance and control programs (ISCPs). We performed a questionnaire-based survey to 164 acute care general hospitals throughout the Republic of Korea that had more than 300 beds. Study methods were based completely on those of the Study on the Efficacy of Nosocomial Infection Control (SENIC). Four SENIC indices (hospital epidemiologist index, infection control nurse index, surveillance index, and control index) and 4 newly developed indices (healthcare worker index, quality improvement index, resource index, and hand hygiene facilities index) were used to evaluate Korean ISCPs. Data were collected by questionnaire from June 17 to October 11, 2003. One hundred sixty-four general hospitals with more than 300 beds in the Republic of Korea. Personnel from 85 general hospitals responded to the study questionnaire. The reliability and validity of the evaluation indices were statistically significant (P<.05). The 8 evaluation indices were categorized into 2 factor groups: personnel factors (hospital epidemiologist index and infection control nurse index) and activity factors (the remaining 6 indices). Korean ISCPs showed a major weakness in surveillance. The scores for the newly developed evaluation indices were better than those for the SENIC evaluation indices. However, most Korean hospitals were estimated to have had only slight reductions in nosocomial infection rates. The evaluation indices were influenced significantly by the number of beds in the hospital, whether the hospital was located in the Seoul-Gyonggi region, the presence of full-time infection control nurses at the hospital, the education level of the infection control nurses, and the nurses' experience in infection control (P<.05). The reliability and validity of the SENIC evaluation indices and the newly developed evaluation indices were satisfactory in evaluating Korean ISCPs. However, surveillance should be improved to increase the efficacy of Korean ISCPs.

The Impact of Hospital Nursing Characteristics on 30-Day Mortality

Evidence indicates that hospital nursing characteristics such as staffing contribute to patient outcomes. Less attention has been given to other hospital nursing characteristics central to optimal professional practice, namely nurse education and skill mix, continuity of care, and quality of the work environment. To assess the relative effects and importance of nurse education and skill mix, continuity of care, and quality of work environment in predicting 30-day mortality after adjusting for institutional factors and individual patients characteristics. A cross-sectional analysis of outcome data for 18,142 patients discharged from 49 acute care hospitals in Alberta, Canada, for diagnoses of acute myocardial infarction, congestive heart failure, chronic obstructive pulmonary disease, pneumonia, or stroke between April 1, 1998, and March 31, 1999, was done. Mortality data were linked to patient demographic and comorbidity factors, institutional characteristics, and hospital nursing characteristics derived from a survey of all registered nurses working in acute care hospitals. Using multilevel analysis, it was determined that the log-odds for 30-day mortality varied significantly across hospitals (variance = .044, p < .001). Patient comorbidities and age explained 44.2% of the variance in 30-day mortality. After adjustment for patient comorbidities and demographic factors, and the size, teaching, and urban status of the study hospitals in a fixed-effects model, the odds ratios (95% confidence interval) of the significant hospital nursing characteristics that predict 30-day mortality were as follows: 0.81 (0.68-0.96) for higher nurse education level, 0.83 (0.73-0.96) for richer nurse skill mix, 1.26 (1.09-1.47) for higher proportion of casual or temporary positions, and 0.74 (0.60-0.91) for greater nurse-physician relationships. The institutional and hospital nursing characteristics explained an additional 36.9%. Hospital nursing characteristics are an important consideration in efforts to reduce the risk of 30-day mortality of patients.

Surgical patients are at lower risk of death in hospitals with more degree-educated nurses

Question What is the relationship between the education level of hospital nurses and risk-adjusted 30-day mortality in surgical patients? Study design Outcomes analysis using questionnaire and hospital discharge data. Main results Risk of 30-day mortality reduced by 5% when the proportion of degree-educated nurses increased by 10% ( p⩽0.02). A mean workload increase of one patient per nurse increased risk of 30-day mortality by 5% ( p⩽0.03). Hospitals with more degree-educated nurses were: larger, more likely to undertake advanced surgical techniques ( p<0.001), more commonly teaching hospitals and had lower mean work loads ( p<0.001). Length of nursing experience was not found to be a predictor of mortality ( p>0.52). Authors’ conclusions People were less likely to die after surgery in hospitals with a higher proportion of degree-educated nurses.

A proposed framework for differentiating the 21 Pew competencies by level of nursing education.

Now nearly a decade old, the original Pew Health Professions Commission Competencies have stood up well to the test of time. The competencies were designed to provide all health professionals, from physicians to physical therapists, with a general guide to the values, skills, and knowledge they would need to be successful in the health care system that was beginning to emerge in the late 1980s. They have been used across the range of health professions and in many practice settings to create a framework for curricular change, work redesign, and assessment of professional competence. The interpretation of the competencies offered here should prove to be a useful tool to nurses and health system leaders as they carry on the hard work of adapting the current model of nursing practice to the demands and realties of the contemporary and continually evolving health care environment. This work is important for two reasons. First, many of the skills and attributes of the professional nurse are not adequately used or valued by the health care system because the profession is both fragmented and poorly differentiated and articulated. Without markers that define and promote collaborative practice within nursing, the full potential of nurses at all levels of preparation will continue to be inadequately and inappropriately deployed. This model exacerbates the current nursing shortage because it fails to use nurses in appropriate, well-delineated, and challenging roles. Without this kind of differentiation, one that can be owned and supported by all nurses, there will continue to be suboptimal use of the nursing workforce in the United States. The framework of differentiated Pew competencies and the companion teaching-learning strategies proposed here offer one approach to rationalizing both nursing education and practice, with the potential for improving the quality of care, and reducing fragmentation, cost, and public confusion.