IN NURSING EDUCATION Research Articles

Challenges and Successes in Introducing Coronary CT Angiography in an Emergency Medicine-Run Observation Unit.

This study was designed to analyze the departmental changes in transitioning the Emergency Department (ED)-run Observation Medicine Unit's routine noninvasive cardiac evaluation from the traditional standard-of-care procedures to coronary computed tomography angiography (CCTA). While the routine use of CCTA for the evaluation of chest pain has been deemed feasible and safe, provider confidence appears apprehensive, and ordering patterns appear reluctant to change. We conducted a retrospective analysis of data from two risk-matched cohorts of EDpatients who presented with symptoms suggestive of acute coronary syndrome (ACS) but without ischemic electrocardiogram (ECG) changes or positive troponin. Endpoints included length of stay, major adverse cardiovascular event (MACE) rates at 28 days, recidivism rate, and downstream findings on coronary catheterization. The adoption of CCTA led to a significant reduction in the length of stay for patients in the ED-run Observation Medicine Unit. Provider and nursing education initiatives were crucial in overcoming initial resistance and improving the implementation of CCTA. Post-education, there was a marked increase in the volume of CCTA performed and a decrease in the length of stay, enhancing overall departmental throughput. The results suggest that CCTA offers a reliable and efficient diagnostic alternative to traditional noninvasive tests, with high diagnostic accuracy contributing to faster decision-making and reduced need for invasive procedures. Continuous education for providers and nursing staff was essential to ensure adherence to the new protocol and improve clinical outcomes. Transitioning to CCTA for routine noninvasive cardiac evaluation in the ED-run Observation Medicine Unit demonstrated significant efficiency and diagnostic accuracy benefits. Successful implementation requires targeted educational efforts to ensure competency and confidence among healthcare providers. The findings support the integration of CCTA into standard clinical practice for the evaluation of chest pain in the emergency setting, with future research needed to validate these results in broader patient populations and assess long-term outcomes.

Nursing education initiatives for elderly with cancer in the Middle East

Nursing education initiatives for elderly with cancer in the Middle East

Nursing education initiatives for elderly with cancer in the Middle East

Nursing education initiatives for elderly with cancer in the Middle East

Retention in nursing education and scholarship programs: Survival analysis of the Veterans Health Administration National Nursing Education Initiative Data.

To investigate factors affecting non-completion by registered nurses (RNs) participating in degree programs supported by the scholarship program of the National Nursing Education Initiative of the United States Veterans Health Administration. Secondarily, to assess overall retention in the scholarship program over time. Retrospective longitudinal design using administrative data. Defining retention time as the time elapsed from enrollment date to non-completion, we performed survival (retention) analysis (i.e.,Kaplan-Meier survival functions, log-rank tests and Cox regressions) to retrospectively analyzea national sample of RNs (N =15,908) enrolled in the scholarship program between the United States federal fiscal years 2000 and 2020. Nurses' mean age was 44 years (range: 19-71), and 86% were females. Six- and 12-month cumulative educational program retention rates were 92% and 84% respectively. The newest group of enrollees (2016-2020), younger nurses (<50 years), and nurses in traditional degree programtype were more likely to complete their academic programs than the earlier groups, older nurses and nurses in non-traditional type, respectively. Male nurses who aspired to advanced occupational levels upon completion were more likely to complete their academic programs compared to those who expected no change from their current level of practice. Multiple factors affected non-completion of academic degree programs by RNs enrolled in the scholarship program. More work is needed to examine these plus additional plausible factors and their correlates extensively. Our findings highlighted areas for quality improvement in employee scholarship programs for RNs. The findings are expected to inform tailoring of proactive helpful intervention towards individual needs and prioritization of limited resources to maximize graduation rate from academic programs for scholarship recipients. The study will have impact on nursing workforce policy makers interested in implementing employee scholarship programs, and on their scholarship recipients.

ESCAPE ROOMS AS AN INNOVATIVE TEACHING STRATEGY IN NURSING EDUCATION

Hemşirelik eğitimi ile öğrencilerin bilgi, beceri ve tutuma yönelik yeterlik kazanmalarının yanı sıra eleştirel düşünme, problem çözme, karar verme, bütüncül ve empatik bakım verme, iletişim ve ekip işbirliği içinde çalışma gibi becerilerle donatılması hedeflemektedir. Büyük çoğunluğunu Z kuşağının oluşturduğu günümüz öğrencileri eğitime aktif katılmayı tercih etmekte, öğrenme sürecine dahil olmak için alternatif, yenilikçi yollara ihtiyaç duymaktadır. Bu nedenle, öğrencilerin eğitim süreçlerinde aktif katılımlarını sağlayacak, geleneksel eğitim yöntemlerini tamamlayan yenilikçi aktif öğrenme yöntemlerinin kullanılması gerekmektedir. Eğitimciler tarafından kullanılan aktif öğretim yöntemlerinden birisi de ‘oyunlaştırma’dır. Hemşirelikte oldukça yeni kullanılan yenilikçi bir öğretim tekniği olarak oyunların, bilgi ve beceriyi geliştirmede olumlu katkılarının olmasının yanı sıra eğlenceli ve motive edici olduğu ve bireylerin rekabet gücünü ortaya çıkardığı, öğrencilerin sosyalleşmesini artırdığı, hata yapmalarına izin verdiği, anında geri bildirim sağladığı ve yaratıcılıklarını geliştirdiği bilinmektedir. Son yıllarda popüler olan oyunlardan birisi de kaçış odası oyunudur. Kaçış odaları, oyuncuların genellikle odadan kaçarak belirli bir hedefi, sınırlı süre içinde gerçekleştirmek için odada bir ya da daha fazla ipuçlarını keşfettiği, bulmacaları çözüp, görevleri yerine getirdiği canlı aksiyon takım tabanlı oyunlardır. Bu makalenin amacı, son yıllarda eğitimde ve hemşirelikte kullanımı yeni olan yenilikçi öğretim stratejisi olarak karşımıza çıkan kaçış odaları, kaçış odalarının hemşirelik eğitiminde kullanımı ve konu ile ilgili yapılmış araştırma sonuçlarını açıklamaktır.

Initiating a Validated Pediatric Post-Anesthesia Emergence Delirium Scale in the Pediatric Post-Anesthesia Care Unit

<h3>Introduction</h3> Emergence Delirium(ED) is a frequent occurrence in the pediatric PACU. The PAED scale is a research validated tool that has been shown to help nurses and anesthesiologists recognize and appropriately treat ED. <h3>Identification of the problem</h3> OurPACU was currently not using a measuring tool. After learning about the scales already in place at a national conference, I discussed with the unit manager and she agreed that a PAED scale would be a valuable tool. The anesthesiologist that agreed to be physician support recommended that we carry this out as a research project. <h3>Purpose of the study</h3> The aim of this study is to assess our PACU nurse's current knowledge of delirium, implement education, as well as encourage documentation of the PAED score. The potential benefits of the study include benefiting future pediatric patients and their nurses by improving how our institution approaches pediatric post-anesthesia delirium. <h3>Methods</h3> IRBapproval was obtained. A survey was constructed to measure 2 things: 1) nurses knowledge of PAED pre and post education and implementation of a PAED scale 2) nurses confidence and satisfaction with several aspects of PAED pre and post education and implementation. An invitation email with a link to the online survey was sent to all nurses who worked in the pediatric PACU. Consent was in the email. The prospective participant can elect to participate in the survey or not participate. The consent described the anonymity of the survey by including the statement "Identifiers will be removed and the de-identified information may be used for future research without additional informed consent from the subject." Pre-interventiondata was collected via survey answers. Training for the PAED scale was implemented in concurrence with pediatric emergence delirium training by anesthesia. One month post intervention, the survey was re-sent. A final six-month post intervention survey was repeated. Each survey knowledge question was scored and results were analyzed using the T-test. <h3>Outcomes/Results</h3> A total of 15 PACU nurses participated. 14 responded to the one month survey and 7 responded to the 6 month survey. The most significant increase was knowledge of the PAED scale (↑ 58.3%, p < 0.0001)) as well as knowledge about patient risk factors (↑ 13.3%, p = 0.01) and dispelling common myths surrounding PAED (↑ 14.6%, p = 0.01). It is unclear at this time if the education initiative was ineffective in regards to the other goals of PAED knowledge, or if our pediatric PACU nurses simply pre-possessed much of this knowledge prior to implementation. Nursing confidence and satisfaction also increased with the largest gains being seen in their satisfaction with the tools they have at their disposal (↑28.8%) and the responsiveness of anesthesiologists (↑26.5%). The anesthesiologists were not included in the education sessions; therefore the increase in satisfaction is likely due to either a change in nursing perception or a change in anesthesiologist behavior due to nurses reporting the PAED score. A six-month follow-up survey was distributed to see how these gains change over time. The complete results are pending analysis. <h3>Discussion</h3> ThePAED scale is a research-validated tool that is easy to use to quickly identify and discern if emergence delirium is present. The nursing education initiative and implementation was successful in increasing knowledge of the PAED scale as well as increasing knowledge about patient risk factors and dispelling common myths surrounding PAED. The documentation piece has taken several months to get built as we have 3^rd party vendors to develop most of our screens. Currently we are waiting for the screen to be included in our assessment options. During the study, a verbal reporting of the score was provided to the anesthesia provider. Further studies to determine documentation compliance would be helpful. <h3>Conclusion</h3> The findings have demonstrated that the pediatric PACU nurses are more confident in identifying true ED. Additionally, it showed that they are more aware of the tool used to score delirium and what intervention(s) are the best to implement. <h3>Implications for perianesthesia nurses and future research</h3> The PAED scale chosen for this study promotes quick and easy scoring. Identifying emergence delirium quickly in pediatric patients is crucial to implementing the appropriate intervention(s). Future research desired is to determine if having the parent at bedside before onset of delirium would decrease the intensity and/or longevity of ED.

Hemşirelik Eğitiminde Teknolojinin Etkisi ve Teknoloji Tabanlı Öğrenme Yöntemlerinin Kullanımı

Teknoloji hayatımızın diğer alanlarını olduğu gibi eğitimi sistemlerini de etkisi altına almıştır. Yeni neslin öğrenme ihtiyaçları, değişen koşullar ve gelişen teknoloji hemşirelik eğitiminde yenilikçi yaklaşımları zorunlu kılmaktadır. Bu süreç hemşire eğitimcileri öğrenci kitlesine uygun ve verimli teknikleri araştırmaya teşvik ederken, öğrencilerin de aktif olarak eğitim faaliyetine katılmasını sağlar. Teknolojideki gelişmeler hız kesmeden sürerken eğitim sistemleri bu gelişmelere istendik ölçüde entegre olamamakta, çoğu eğitim sistemi klasik öğrenme yöntemlerini kullanmaya devam etmektedir. Covid-19 salgını eğitimcileri ve öğrencileri hızla yeni çözümler üretmeye teşvik etmiştir. Bu zor süreçte eğitim büyük oranda mobil cihazlardan ve çevrimiçi platformlardan sürdürülmüştür. Salgın dönemi neden olduğu zorluklarla birlikte eğitimde teknolojinin entegrasyonunu hızlandırmıştır. Bu makalede teknolojinin hemşirelik eğitimindeki etkileri ve teknolojiye dayalı öğrenme yöntemleri üzerinde durulacaktır.

Ready for Anything: A Holistic Approach to Training Sexual Assault Nurse Examiners.

Although numerous training options exist for sexual assault nurse examiner certification, most focus on specific certification-related content rather than on creating a holistic preparation for sexual assault nurse examiner (SANE) practice. Holistic preparation may be preferable for SANE trainees who are early in their nursing careers or who have practiced in limited clinical environments. This article describes a holistic training approach implemented at a SANE training site funded by the Advanced Nursing Education initiative of the Health Resources and Services Administration. Training covers hands-on pelvic and anal examinations, community education, underserved communities, self-care, and other topics that support newly trained SANEs in establishing and maintaining practice. This content has prepared trainees for a wide variety of patient encounters as well as for engaging with the community. With this approach, our trainees have the opportunity to enhance their ability to provide SANE care and to provide additional resources within their primary practice environments.

An evaluation of the Veterans Health Administration National Nursing Education Initiative

BackgroundSince 1999, the Veterans Health Administration's (VHA) National Nursing Education Initiative (NNEI) has provided 16,294 scholarships for registered nurses to attain baccalaureate and advanced nursing degrees. PurposeThe goal of this evaluation was to determine factors that enhanced or hindered a scholarship recipient in the completion of their degree and service obligation. MethodsA regression analysis was performed to identify predictors of degree completion for 10,043 participants in 162 VHA facilities. FindingsSignificant predictor variables for degree completion were intended occupation, entry degree, gender, age, and year entering the program. Eighty-six percent (86.7%) of participants completed the degree requirement. Of those who completed their degree, 97% completed the service obligation. DiscussionAs recruitment and retention initiative, NNEI scholarships are poised to address the VHA nursing staffing shortages as well as build a highly qualified nursing workforce capable of providing the best care to our Nation's Veterans.

Original Research: Nurses' Knowledge and Comfort with Assessing Inpatients' Firearm Access and Providing Education on Safe Gun Storage.

This study sought to evaluate nurses' knowledge and comfort with assessing inpatients' access to firearms and providing education on firearm safety and storage. Facilitators and barriers to such assessment, as well as best methods for educating nurses and patients on firearm safety and storage, were also explored. Nurses from a general medical unit and a psychiatric unit at a large urban hospital were invited to complete a 22-question online survey. Descriptive statistics were computed to analyze survey responses for each unit. Forty-two nurses-21 from each unit-participated. More than 50% of nurses on each unit were unfamiliar with state law on safe gun storage, and none had prior training in educating others on firearm safety and storage. Compared with nurses on the psychiatric unit, those on the general medical unit were less comfortable asking patients about firearm access and safe gun storage. Several facilitators and barriers to assessment emerged. Facilitators identified by similar numbers of nurses on each unit included receiving relevant education and having educational information available for patients. Nurses on both units also endorsed having a safety protocol and a documentation policy in place. Barriers identified by similar numbers of nurses on each unit included lack of adequate knowledge about firearm safety and lack of patient educational materials. More medical unit than psychiatric unit nurses also named lack of time and not knowing what to do with collected information. More than 80% of nurses on each unit reported that they would feel comfortable providing patients with information on safe firearm storage if it were available; a pamphlet was endorsed most often as the best method. A one-hour class involving the security department and other disciplines was the top endorsed nurse learning strategy. Findings from this study highlighted several factors, including nursing specialty, that may influence inpatient assessment of firearm access and safe gun storage. These results can help inform hospital policies and nursing education initiatives aimed at improving safe gun storage practices among patients and the general public.

PARADIGM SHIFT OF LEARNING: PROBLEM -BASED LEARNING IN NURSING EDUCATION- REVIEW ARTICLE

14Apr 2020 PARADIGM SHIFT OF LEARNING: PROBLEM -BASED LEARNING IN NURSING EDUCATION- REVIEW ARTICLE Radha K. , Sharat V. Kondaguli , N. Vijayanarayanan and Sri Devi K Vice- Principal, Bhopal Nursing College , Under ICMR, MOH&FW, Govt of India. BMHRC, Bhopal, MP State. Nursing Tutor, Bhopal Nursing College, Under ICMR , MOH&FW, Govt of India. BMHRC, Bhopal, MP State. Professor, R.D.Memorial College of Nursing, Bhopal, MP State India. Lecturer, Omaskthi college of Nursing, Dharmapauri, Tamil Nadu.

Management of bone health in patients with cancer: a survey of specialist nurses

BackgroundPatients with cancer can experience bone metastases and/or cancer treatment–induced bone loss (CTIBL), and the resulting bone complications place burdens on patients and healthcare provision. Management of bone complications is becoming increasingly important as cancer survival rates improve. Advances in specialist oncology nursing practice benefit patients through better management of their bone health, which may improve quality of life and survival.MethodsAn anonymised online quantitative survey asked specialist oncology nurses about factors affecting their provision of support in the management of bone metastases and CTIBL.ResultsOf 283 participants, most stated that they worked in Europe, and 69.3% had at least 8 years of experience in oncology. The most common areas of specialisation were medical oncology, breast cancer and/or palliative care (20.8–50.9%). Awareness of bone loss prevention measures varied (from 34.3% for alcohol intake to 77.4% for adequate calcium intake), and awareness of hip fracture risk factors varied (from 28.6% for rheumatoid arthritis to 74.6% for age > 65 years). Approximately one-third reported a high level of confidence in managing bone metastases (39.9%) and CTIBL (33.2%). International or institution guidelines were used by approximately 50% of participants. Common barriers to better specialist care and treatment were reported to be lack of training, funding, knowledge or professional development.ConclusionThis work is the first quantitative analysis of reports from specialist oncology nurses about the management of bone metastases and CTIBL. It indicates the need for new nursing education initiatives with a focus on bone health management.

PERCEPTIONS AND ATTITUDE ON USING SOCIAL MEDIA RESPONSIBLY: TOWARD SOCIAL MEDIA LITERACY IN NURSING EDUCATION

Background: As future professionals, nursing students are expected to exhibit online professionalism and to be responsible users of social media. However, the rapid sharing of information on social media exposes nursing students to the risk and danger of spreading unprofessional behaviors like breaches of privacy and confidentiality.&#x0D; Objective: This study looked into the nursing students’ perceptions and attitude toward responsible use of social media.&#x0D; Methods: A descriptive cross-sectional research design was utilized and participated by 298 nursing students in a College of Nursing in Iloilo City, Philippines. The Responsible Use of Social Media Attitude Scale (RUSMAS) created by the researchers was used to collect the data.&#x0D; Results: Findings indicated that nursing students widely use social media and that nursing students had good perceptions and had positive attitude toward responsible use of social media. A significant difference was found in the attitude of nursing students when grouped according to year level.&#x0D; Conclusion: Social media continue to gain interest among nursing students and using it responsibly must be continuously upheld. Academic nursing institutions should develop approaches promoting social media literacy in nursing education.

An Analysis of Pediatric Emergency Nursing Practice and Nursing Competence among Emergency Department Nurses

The purpose of this study was to examine the frequency, perceived importance and competence of pediatric emergency nursing practice (PENP) in nurses who cared for pediatric patients in the emergency department. This cross-sectional descriptive study analyzed 175 emergency department nurses caring for pediatric patients at 7 university hospitals with more than 500 beds, located in Seoul and Gyeonggi Province. The measurement tool was modified from the Classification of Standard Nursing Activities to measure the frequency, importance of PENP, and nursing competence. It comprised 143 items in 16 domains of PENP. The most frequent nursing practice was the domain of 'nursing records and environmental management' and the least frequent practice was the 'research and consulting' domain. The nursing care domain perceived to be most important by nurses was 'specialized intensive nursing care'. The nursing care domain with the highest level of nursing competence was 'hygiene care', and the domain with the least level of nursing competence was the 'research and consulting'. These results will be utilized as basic data for future pediatric emergency nursing education initiatives and for establishing priorities of nursing policy to improve health care for children admitted to the emergency department.

Mission possible: twenty-five years of university and college collaboration in baccalaureate nursing education.

In Canada, nurse educators from five postsecondary institutions in the province of British Columbia established a collaborative nursing education initiative in 1989, with a vision to transform RN college diploma programs to baccalaureate degree programs. The principles, processes, and structures that served to develop and sustain this nursing education initiative are briefly reviewed. Curriculum, scholarship, and education legislation serve as platforms to critically explore a 25-year history (1989-2014) of successes, challenges, and transitions within this unique nursing education collaboration. The importance of curriculum development as faculty development, program evaluation as an adjunct to pedagogical scholarship, diversity of cross-institutional mandates, political interplay in nursing education, collegiality, and courageous leadership are highlighted. Nurse educators seeking to create successful collaborations must draw upon well-defined principles and organizational structures and processes to guide pedagogical practices and inquiry while remaining mindful of and engaged in professional and societal developments.

Using a mentoring approach to implement an inpatient glycemic control program in United States hospitals

Background: establishing an inpatient glycemic control program is challenging, requires years of work, significant education and coordination of medical, nursing, dietary, and pharmacy staff, and support from administration and Performance Improvement departments. We undertook a 2 year quality improvement project assisting 10 medical centers (academic and community) across the US to implement inpatient glycemic control programs. Methods: the project was comprised of 3 interventions. (1) One day site visit with a faculty team (MD and CDE) to meet with key personnel, identify deficiencies and barriers to change, set site specific goals and develop strategies and timelines for performance improvement. (2) Three webinar follow-up sessions. (3) Web site for educational resources. Updates, challenges, and accomplishments for each site were reviewed at the time of each webinar and progress measured at the completion of the project with an evaluation questionnaire. Results: as a result of our intervention, institutions revised and simplified formularies and insulin order sets (with CHO counting options); implemented glucometrics and CDE monitoring of inpatient glucoses (assisting providers with orders); added new protocols for DKA and perinatal treatment; and implemented nursing, physician and patient education initiatives. Changes were institution specific, fitting the local needs and cultures. As to the extent to which Institution׳s goals were satisfied: 2 reported “completely”, 4 “mostly,” 3 “partially,” and 1 “marginally”. Institutions continue to move toward fulfilling their goals. Conclusions: an individualized, structured, performance improvement approach with expert faculty mentors can help facilitate change in an institution dedicated to implementing an inpatient glycemic control program.

Fostering Healthy Work Environments Through Nursing Education Initiatives

In this era of value-based health care, the knowledge, competence, and professionalism of the front-line nurse and other clinical staff are paramount. Everyone involved in patient care must maximize their skill set and drive high performance in the clinical arena. Healthy work environments will be key to achieving and sustaining quality outcomes and developing and retaining high-performing teams.

Double Testing: A Student Perspective

EVALUATION IN NURSING EDUCATION SHOULD BE USED NOT ONLY TO EVALUATE STUDENT ACHIEVEMENT, BUT TO SUPPORT STUDENT LEARNING AS WELL (NATIONAL LEAGUE FOR NURSING, 2012). Double testing allows the instructor to evaluate student learning while reinforcing information, promoting collaboration, and decreasing student anxiety in testing situations. This study used a survey to examine how accelerated nursing students experienced double testing in a medical-surgical course. The study was designed to determine the stress level students experienced with double testing, their satisfaction with the method, and the advantages and disadvantages they perceived. Open-ended questions in the survey instrument provided more information as to the students' thoughts and feelings regarding double testing.With double testing, students take an examination as individuals and then retake the same examination as part of a group. This approach promotes active dialogue, allowing students to address complex care issues and problems regarding the nursing care of patients while in a testing situation. It offers an opportunity to use critical thinking, reinforce learning, and collaborate with peer professionals (Sandahl, 2009), an expectation in health care delivery, education, and research. Students have reported less anxiety when double testing is used as an opportunity for collaboration (Sandahl). This evaluation method provides assessment and evaluation data while fostering group communication skills (Michaelson & Sweet, 2011; Wotring, Alpers, Brown, & Jarrell, 2009).Method A convenience sample of 15 students in a medical-surgical course completed questionnaires after being told that their responses would remain anonymous. Permission was obtained from the university institutional review board prior to surveying the accelerated nursing students.The students (14 were women), completed a medical-surgical exam individually during a specified period of time. The exams and answer sheets were then collected and students were randomly assigned to a four-member group to retake the exam collaboratively. The students were able to discuss the questions and the rationales for their answers in their assigned groups. After the discussion period, the students decided whether to keep their original answers or to change some answers. The students then completed a second answer sheet, and the higher of the two scores was used for the grade calculation. This process was utilized for each unit exam.The survey was conducted on the last day of the course. Students completed five Likert-type scale questions and three open-ended questions regarding their opinions and perceptions of double testing. All students completed the survey.Results using a five-point Likert scale, with scores ranging from 5 (very likely) to 1 (definitely not), 93.3 percent of the students indicated they would recommend double testing for use in a course. They were very likely (66.7 percent) to see advantages when double testing was used. And most (66.7 percent) believed double testing very likely enhanced their learning. Overall, the students rated their acceptance and potential for recommendation of double testing at above average levels. No students were unlikely to recommend double testing.Students also used a Likert scale to estimate their stress level when testing individually and during double testing. With scores ranging from 5 (very high stress) to 1 (no stress), 40 percent rated their stress level as very high and 33.3 percent rated their stress level as high. With double testing, no students reporting having a very high stress level; 53.3 percent reported mild stress.Learning, communication, and collaboration were threads throughout the responses to the open-ended questions. Several students commented on reinforcing learning through discussion, and one student pointed to the opportunity to discuss rationales for selecting answers. Another student wrote, Since nursing is a collaborative profession double testing is more like real-life nursing. …

Cultural CompetenceofPracticing Nurses EnteringanRN-BSN Program

The aim of this exploratory research was to examine the cultural competence of practicing nurses entering an RN to BSN program. As nonwhite populations increase in the United States, the cultural competence of nurses increases in importance. With 38 percent of baccalaureate nursing students in RN-BSN programs, it is important to examine the cultural competence of this population. Fifty-three RN-BSN students completed the Inventory for Assessing the Process of Cultural Competency Among Healthcare Professionals-Revised (IAPCC-R) upon program entry; 50.9 percent were culturally competent as determined by the tool. A strong correlation existed between IAPCC-R scores and student age, with students 20 to 30 years old scoring significantly higher than those in the age range of 41 to 50. The findings suggest and invite more extensive research on the success of the systematic nursing education initiatives of current associate degree programs and adherence to NLNAC standards for cultural competence, particularly in the cultural skill construct.

Integrating QSEN and ACES:An NLN Simulation Leader Project

CARING FOR THE SPECIAL NEEDS OF THE AGING ADULT IS AN INCREASINGLY IMPORTANT FOCUS IN NURSING EDUCATION. Knowledge continues to evolve, creating exciting learning opportunities for nursing students and challenges for nurse educators. one such challenge is to use simulation to operationalize knowledge around safe care of the aging adult. the 2010-2011 national League for nursing (nLn) Simulation Leader Curriculum integration team - nurse educators selected to participate in a yearlong simulation leadership development program - examined key issues in the design, development, use, and integration of simulation in nursing education. the group noted that resources to guide faculty on how to tailor simulation to incorporate competencies around quality and safety in care of the aging are not easily accessible. this article provides an overview of the resources developed by the team for SirC, the nLn Simulation innovation resource Center. it is intended as a guide to incorporate concepts of quality and safety education for nurses into an unfolding simulation focused on care of the aging adult. Background Quality and Safety Education for nurses (QSEn) addresses the nursing competencies needed to assure the quality and safety of patient care. adapted from the institute of Medicine (ioM) competencies for nursing (2003), QSEn outlines essential features of competent nursing practice (nursing competencies) to improve patient safety and quality in health care settings. the six QSEn competencies are: patient-Centered Care, teamwork and Collaboration, Evidence-Based practice, Quality improvement, Safety, and informatics (Cronenwett et al., 2007). Subsets of each QSEn competency include knowledge, skills, and attitudes achievable during the educational process. results of the QSEn national delphi Study (Barton, armstrong, preheim, Gelmon, & andrus, 2009) led to the leveling of QSEn competencies into beginner, intermediate, and advanced learning objectives for integration across a nursing curriculum. The use of an unfolding case study correlates well with a leveled approach in the teaching of quality and safety for care of the older adult. unfolding case studies expose students to multiple aspects of a clinical situation and promote problem solving using an experiential learning method (page, Kowlowitz, & alden, 2010). the curriculum integration team determined that a scenario that unfolded over time would be an ideal simulation exemplar to demonstrate the integration of beginner, intermediate, and advance level QSEn competencies in care of the aging adult client. The NLN, in partnership with the Community College of philadelphia and with funding from the John a. Hartford Foundation, Laerdal Medical, and the independence Foundation, developed the aCES (advancing Care Excellence for Seniors) project to teach nursing students how to care for the older adults. the aCES project features four cases that unfold over time, take place in a variety of health care settings, and require complex decisionmaking. the team determined that blending QSEn with aCES was a natural choice for the focus of the project. Millie Larsen (reese, 2010), one of four aCES cases, includes a web-based text document with links to audio files and other supportive information. aCES provides teaching tools, evidence-based resources, and, importantly, a framework for incorporating the complexities of caring for the aging adult. permission was granted by the nLn to utilize the aCES scenario featuring Millie for inclusion in the curriculum integration project. Millie Larsen's case unfolds in three scenarios, with settings in an outpatient clinic and in an acute care hospital. it concludes with conflict regarding discharge from the inpatient setting. the scenarios reveal a compelling story illustrating the interaction of the multiple factors that affect a geriatric client's health. table 1 illustrates how the simulation leader project integrated the QSEn competencies by level into Millie's unfolding health care encounters. …