Pre-registration Nurse Education Programmes Research Articles

The application of antimicrobial stewardship knowledge to nursing practice: A national survey of United Kingdom pre-registration nursing students.

To assess student nurses understanding and skills in the application of antimicrobial stewardship knowledge to practice. Quantitative. Cross-sectional survey. Five hundred and twenty three student nurses responded across 23 UK universities. Although students felt prepared in competencies in infection prevention and control, patient-centred care and interprofessional collaborative practice, they felt less prepared in competencies in which microbiological knowledge, prescribing and its effect on antimicrobial stewardship is required. Problem-based learning, activities in the clinical setting and face-to-face teaching were identified as the preferred modes of education delivery. Those who had shared antimicrobial stewardship teaching with students from other professions reported the benefits to include a broader understanding of antimicrobial stewardship, an understanding of the roles of others in antimicrobial stewardship and improved interprofessional working. There are gaps in student nurses' knowledge of the basic sciences associated with the antimicrobial stewardship activities in which nurses are involved, and a need to strengthen knowledge in pre-registration nurse education programmes pertaining to antimicrobial management, specifically microbiology and antimicrobial regimes and effects on antimicrobial stewardship. Infection prevention and control, patient-centred care and interprofessional collaborative practice are areas of antimicrobial stewardship in which student nurses feel prepared. Interprofessional education would help nurses and other members of the antimicrobial stewardship team clarify the role nurses can play in antimicrobial stewardship and therefore maximize their contribution to antimicrobial stewardship and antimicrobial management. There is a need to strengthen knowledge from the basic sciences, specifically pertaining to antimicrobial management, in pre-registration nurse education programmes. No patient or public contribution. What Problem Did the Study Address? Nurses must protect health through understanding and applying antimicrobial stewardship knowledge and skills (Nursing and Midwifery Council 2018); however, there is no research available that has investigated nurses understanding and skills of the basic sciences associated with the antimicrobial stewardship activities in which they are involved. What Were the Main Findings? There are gaps in student nurses' knowledge of the basic sciences (specifically microbiology and prescribing) associated with the antimicrobial stewardship activities in which nurses are involved. Problem-based learning, and activities in the clinical setting, were reported as useful teaching methods, whereas online learning, was seen as less useful. Where and on Whom Will the Research Have an Impact? Pre-registration nurse education programmes. The relevant reporting method has been adhered to, that is, STROBE.

Supporting nursing degree apprentices: advice for higher education institutions and employers.

A nursing degree apprenticeship offers an alternative route into nursing from the traditional preregistration nurse education programme by enabling apprentice employees to work and study at the same time. This route could address some of the issues associated with attrition from preregistration nurse education programmes, such as financial challenges. However, nursing degree apprentices may experience other challenges, for example suboptimal work-life-study balance and inadequate support from employers and higher education institutions (HEIs), resulting in dissatisfaction with or non-completion of their apprenticeship programme. This article examines some of the literature on apprenticeships and suggests ways in which employers, HEIs and nursing degree apprentices can work together to improve the apprenticeship experience.

Considering changes to education.

Sam Foster, Chief Nurse, Oxford University Hospitals, looks at research commissioned by the Nursing and Midwifery Council into views on changing the standards for pre-registration nursing education programmes.

Delivery of antimicrobial stewardship competencies in UK pre-registration nurse education programmes: a national cross-sectional survey

Registered nurses perform numerous functions critical to the success of antimicrobial stewardship, but only 63% of pre-registration nursing programmes include any teaching about stewardship. Updated nursing standards indicate that nurses require antimicrobial stewardship knowledge and skills. To explore the delivery of key antimicrobial stewardship competencies within updated pre-registration nursing programmes. This study had a cross-sectional survey design. Data were collected between March and June 2021. Lecturers from 35 UK universities responsible for teaching antimicrobial stewardship participated in this study. The provision of antimicrobial stewardship teaching and learning was inconsistent across programmes, with competencies in infection prevention and control, patient-centred care and interprofessional collaborative practice taking precedent over competencies pertaining to the use, management and monitoring of antimicrobials. Online learning and teaching surrounding hand hygiene, personal protective equipment and immunization theory was reported to have increased during the pandemic. Only a small number of respondents reported that students shared taught learning with other healthcare professional groups. There is a need to ensure consistency in antimicrobial stewardship across programmes, and greater knowledge pertaining to the use, management and monitoring of antimicrobials should be included. Programmes need to adopt teaching strategies and methods that allow nurses to develop interprofessional skills in order to practice collaboratively.

What might COVID-19 have taught us about the delivery of Nurse Education, in a post-COVID-19 world?

For Nurse Education in the UK, pre-existing challenges already included the need to develop curricula to align with new Nursing and Midwifery Council (NMC) educational standards; and increased numbers entering pre-registration Nurse Education programmes in order to address workforce deficits. Further disruption due to COVID-19, forced Nurse Educators overnight to rapidly adopt and to innovatively use current and emerging technologies to maintain engagement with, and to continue delivering education to, students during the pandemic. Although the full extent of these enforced changes is unknown at this time, this paper argues that online delivery is a necessary and inevitable transition, addressing some of these pre-existing challenges, and that the pandemic has hastened this. It is therefore crucial that Nurse Educators lead the way in navigating this period of uncertainty, viewing the pandemic as an opportunity to plan for the future, to establish how online teaching and learning can continue to benefit Nurse Education in a post-COVID-19 world, not just in the UK, but across the globe.

Designing an adolescent safeguarding curriculum framework for preregistration nurse education programmes.

Adolescence is a crucial period of transition during which young people are exposed to a range of safeguarding risks in the wider social context. However, it has been identified that the need to safeguard adolescents is less well recognised than the need to safeguard children. Furthermore, there is evidence that child development education provided as part of preregistration nurse education programmes tends to neglect adolescent development. Therefore, there is a need to adopt a life-course approach - which focuses on all stages of child development, including adolescence - and to review child development education to support future nurses in their role in safeguarding young people in practice. This article proposes a curriculum framework for adolescent safeguarding education, outlining a structure to support nurse educators when designing or reviewing preregistration nurse education programmes.

Use of a mnemonic to support suicide intervention training for nursing students

Recently, there has been an increased awareness of the extent of suicide as a global issue. In the UK, the reduction of deaths caused by suicide is a governmental goal in England, Northern Ireland, Scotland and Wales, which has led to the development of training initiatives to improve the recognition and management of suicide risk. Since many of the groups of people who are at increased risk of suicide are in contact with healthcare services, nurses will frequently encounter people who experience suicidal ideation. This is recognised in the updated Nursing and Midwifery Council standards of proficiency for registered nurses, which state that nurses in all fields of practice are required to be able to recognise and assess people who show signs of self-harm and/or suicidal ideation.This article explores the use of the mnemonic ‘TIPTOES’ (trauma, intent, plan, time frame, other experience of suicide, encouragement, support recovery) to support nursing students to develop their confidence and competence in suicide intervention.The Scottish Government’s Suicide Prevention Action Plan (Scottish Government 2018) identified the need for ongoing improvement in strategies to prepare and support people working with individuals at risk of suicide. Suicide intervention training is an integral element of pre-registration nurse education programmes, although evidence suggests that nurses often find this issue challenging in practice (Thomas 2017). This article explores how the mnemonic ‘TIPTOES’ (trauma, intent, plan, time frame, other experience of suicide, encouragement, support recovery) may assist nursing students in remembering and understanding the main steps of the suicide intervention process. The article also discusses the wider applicability of the mnemonic, which was developed by the School of Health and Nursing at the University of the West of Scotland, for nurses and other healthcare professionals.

Service user involvement in preregistration child nursing programmes.

Service user involvement is a fundamental part of preregistration nursing education programmes, however achieving this for child nursing students is challenging. Service user involvement can be achieved through online forums but this method can lack the emotional interaction and opportunity for deep reflection. This article reviews the background and challenges of service user involvement in preregistration child nursing programmes, further exploring the evaluation of a group of final year child nursing students' experience of appreciating the journey of two service users. The input from service users provided the opportunity for reflection, empathy and improved student self-awareness in nursing practice. Students gained perspective of the holistic needs of the service user, which empowered them to have confidence in their communication skills to ensure the voice of the child is heard and their rights are upheld. This article concludes that service user involvement is crucial in preregistration nursing programmes for the development of child nursing students, not only affecting their training but also the future workforce.

An analysis of delegation styles among newly qualified nurses.

Aim The aim of this research was to explore how newly qualified nurses learn to organise, delegate and supervise care in hospital wards when working with and supervising healthcare assistants. It was part of a wider UK research project to explore how newly qualified nurses recontextualise the knowledge they have gained during their pre-registration nurse education programmes for use in clinical practice. Method Ethnographic case studies were conducted in three hospital sites in England. Data collection methods included participant observations and semi-structured interviews with newly qualified nurses, healthcare assistants and ward managers. A thematic analysis was used to examine the data collected. Findings Five styles of how newly qualified nurses delegated care to healthcare assistants were identified: the do-it-all nurse, who completes most of the work themselves; the justifier, who over-explains the reasons for decisions and is sometimes defensive; the buddy, who wants to be everybody's friend and avoids assuming authority; the role model, who hopes that others will copy their best practice but has no way of ensuring how; and the inspector, who is acutely aware of their accountability and constantly checks the work of others. Conclusion Newly qualified nurses require educational and organisational support to develop safe and effective delegation skills, because suboptimal or no delegation can have negative effects on patient safety and care.

Informing Pre-Registration Nurse Education: A Proposal Outline On The Value, Methods And Ethical Considerations Of Involving Children In Doctoral Research

As pre-registration nurse education programmes evolve within the United Kingdom, it is imperative to involve patient/client groups within the research process, as the outcome may invoke a change in the care delivery of the registered nurse (RN). This paper focuses upon children and how children might hypothetically contribute to informing a generic nursing programme in their capacity as a rights holder and expert in their own lives. Even though their contribution and value has been debated around their capacity as research advisor, research participant and co researcher, this paper explores how the child’s view of their experience of hospital and of the good nurse could be best captured. Research is a powerful vehicle that can enable their voice to equally inform UK nurse educators and policy makers so that the child’s health care needs are effectively met in hospital by RN’s who complete a generic programme.

Matter of life or death.

Should suicide prevention be included in all fields of pre-registration nurse education? The question is up for debate at RCN congress later this month. If the resolution in favour of the move is passed, then the RCN council will be asked to influence higher education institutions to make it a reality. Suicide is ‘everyone’s business’, says Annessa Rebair, who put forward the resolution with colleagues at the North of Tyne branch. ‘My background is mental health nursing and in mental health, suicide is something we talk about,’ she explains. ‘But what about the 70 per cent of people who die by suicide who did not come into contact with mental health services? That is something that bothers me as a human being. ‘I decided to look at what we were doing in education and found that suicide prevention is not on the agenda; it isn’t in the undergraduate curriculum.’ As a senior lecturer in mental health at the University of Northumbria, she has given students the option to attend sessions on suicide. Students, she says, have been keen. ‘When I ask students how many of them have been affected by suicide, around two thirds will raise their hands.’ Ms Rebair recommends the approach taken by the SuicideTALK programme (www.livingworks.net/ programs/suicidetalk): Tell – the person needs to tell someone about their thoughts and feelings. Ask – the nurse should explore the above and ask, directly and clearly, if they feel suicidal. Listen – this may be the first time the person has expressed their thoughts and feelings to anyone. Keep safe – help the person to explore what needs to be done to keep them safe; help them commit to a plan, whether it is seeking immediate help from services or exploring the inclusion of trusted others. The curriculum for pre-registration nurse education programmes is already packed. What should be left out to make room for suicide prevention? ‘That is not for me to say,’ says Ms Rebair. ‘What I am saying is that it should be included. The detail can be worked out later.’ Ms Rebair is a trustee at Papyrus, the charity for prevention of young suicide. She hopes to raise the profile of suicide prevention among all nurses and benefit nursing students in particular. ‘Students are a vulnerable group of younger people,’ she says. Clare Wylie, head of policy and research at Samaritans, says there is considerable evidence Signs that someone is at risk of suicide

Deciding to fail

Within pre-registration nursing education programmes, clinical competence is verified via continuous assessment in practice. Registered nurses who have undertaken mentor preparation assess competence in practice and have a responsibility to confirm that nursing students are capable of safe and effective practice prior to registration. This requires mentors to identify underperforming students and manage the situation appropriately. Drawing on interview data from 10 mentors who had failed a student in practice this paper will highlight the processes, alongside, the difficulties and dilemmas associated with managing a failed assessment successfully. Three key concepts emerging from the data will provide the framework for this paper, namely: identifying the weak student; creating possibilities for success; deciding to fail.Within the concept of ‘Identifying the weak student’ participants discuss how they recognised the early indicators of possible failure. While, ‘Creating possibilities for success’ reveals the strategies mentors used to attempt to facilitate students’ progress. The final concept ‘Deciding to fail’ exposes the emotional consequences for both the mentor and the student of a failed assessment and the importance of debriefing following the event. The paper concludes by discussing the support needs of mentors as this emerged as crucial in the process of managing a failed assessment.

Preparing nurses to work in primary care: educators’ perspectives

To report nurse educators' perspectives of the appropriateness of pre-registration nursing education programmes in preparing nurses to practise in primary care. Data were collected through semi-structured telephone and face-to-face interviews with eight nurse educators, and were subject to thematic analysis. Nurse educators believed that nursing education programmes did not adequately prepare newly qualified nurses to work in primary care because they provided limited experience in this setting. Factors such as shortage of practice placements in primary care and lack of mentors to supervise and support students were identified as major barriers to student learning and subsequent preparedness to work in primary care.

Deciding to fail

Within pre-registration nursing education programmes, clinical competence is verified via continuous assessment in practice. Registered nurses who have undertaken mentor preparation assess competence in practice and have a responsibility to confirm that nursing students are capable of safe and effective practice prior to registration. This requires mentors to identify underperforming students and manage the situation appropriately. Drawing on interview data from 10 mentors who had failed a student in practice this paper will highlight the processes, alongside, the difficulties and dilemmas associated with managing a failed assessment successfully. Three key concepts emerging from the data will provide the framework for this paper, namely: identifying the weak student; creating possibilities for success; deciding to fail. Within the concept of ‘Identifying the weak student’ participants discuss how they recognised the early indicators of possible failure. While, ‘Creating possibilities for success’ reveals the strategies mentors used to attempt to facilitate students’ progress. The final concept ‘Deciding to fail’ exposes the emotional consequences for both the mentor and the student of a failed assessment and the importance of debriefing following the event. The paper concludes by discussing the support needs of mentors as this emerged as crucial in the process of managing a failed assessment.

Pre-registration nurse education: building the foundations of a nursing career and profession?

All nursing careers are built on the foundation of one’s pre registration nurse education: it is from these foundations that student nurses (and later Registered Nurses) develop their understanding of what it is to be a nurse and to be part of the nursing profession. These foundations lead to aspirations about where careers in nursing may lead (e.g. Barton and le May, 2012) and these, in turn, influence the development of the profession of nursing. As a result of the introduction of the latest Standards for Pre-registration Nurse Education by the Nursing and Midwifery Council (NMC) (2010), all pre-registration nurse education programmes in the United Kingdom, like many others across the world, will have to be at degree level from 2013. There have been many differing views expressed in reaction to this requirement, at one end of the continuum is the view that this is nothing new as degree level courses in nursing have existed in the United Kingdom and internationally for over 30 years, indeed some post-graduate courses exist within pre registration nurse education – a point of view explored by Kathryn Jones in her editorial on this topic. At the other end of the continuum, is the somewhat spurious notion that a move to degree level preparation for nurses will distract them, during their studies and once qualified, from their core role of competently nursing people. Much media attention, public debate and professional re-focussing activities – e.g. the Willis commission on nurse education (Education Commission, 2012) and no doubt the Nursing and Care Quality Forum (Department of Health, 2012) – has become entwined with this change, so much so that one could be forgiven for thinking that obtaining graduate status for nurses is the only important change introduced within the new standards. This, of course, is not the case – the NMC standards show all of us involved in educating nurses, be that in the lecture room, the simulation suite or at the patient’s side, the key components of this endeavour required to build a 21st century workforce. The standards show prospective nurses what contemporary nursing involves, they show practising nurses areas for updating

Untangling a complex issue: An overview of initiatives to support nursing and midwifery student recruitment, selection and retention in Scottish Universities

The reasons behind attrition rates in nursing and midwifery are many and complex. However, of the four UK countries, Scotland has been consistently cited as having the highest attrition rate from its pre-registration nursing and midwifery education programmes. This paper provides an overview of a nationally coordinated programme of work to support evidence-based intervention and identifies both opportunities for further national and international initiatives and presents early indicators of improvement in retention and completion.

Evaluating clinical competence assessment

To evaluate clinical competence assessment in pre-registration BSc nursing programmes in one geographical area in the Republic of Ireland. A mixed method approach comprising focus group interviews and survey questionnaires was used. The sample comprised preceptors and nursing students across three disciplines of nursing--general, mental health and intellectual (learning) disability. Methods of analysis were thematic analysis and the Statistical Package for Social Sciences (SPSS) (Version 15). Students' and preceptors' views of competence assessment and the process of competence assessment are reported. The study focused on language complexity, the assessment framework, the amount of time allocated for interviews and achievement of purpose. The main conclusions were that language needs to be user-friendly, the process needs to be easy to follow and all aspects of clinical competence must be assessed. The response rate from students was 87% but the preceptor response rate was lower (30%). Competence based assessment in the clinical environment is a core component of pre-registration nurse education programmes. Competing demands in the clinical environment challenge both the student and preceptor during the competence assessment process.

Tighter controls of student mentors may be problematic

The mentorship of students on approved preregistration nursing education programmes has long been a source of concern for everyone involved with the quality of student supervision and completion of learning outcomes. There are severe critics of the system, which is believed to have led to shoddy practice where students pass practice placement objectives without any proper control or checks to see if they have achieved them. In some instances, students have hardly worked with their mentors and have been faced with the prospect of failing their placements because no-one can verify what they have accomplished.

Embedding cancer care within pre-registration nurse education programmes: Policy, practice and opportunities for change

This paper discusses policy and professional drivers which outline the need for, and inclusion of cancer education within pre-registration nursing curricula within the UK. It also evaluates arguments in favour of the development of separate and distinctive cancer modules within nurse training programmes against those advocating a more integrated or thematic approach. The authors suggest that there are advantages and disadvantages to each strategy, and argue that the most important factor irrespective of the approach taken, is that cancer learning outcomes are clearly enunciated within all pre-registration nursing curricula and constructively aligned against teaching, learning and assessment strategies which may encompass a single module or entire programme. The authors then discuss their personal experience of teaching cancer care using both approaches and posit one suggestion for an embedded pre-registration cancer-care curriculum developed as the catalyst for a broader debate on the scope and content of cancer-care education within pre-registration nursing curricula.

Nursing knowledge and the expansion of day surgery in the United Kingdom

Background The amount of surgery undertaken within United Kingdom Day Surgery Units has risen considerably over the past 15–20 years. Throughout this pioneering era, nursing roles and responsibilities within the modern surgical environment have developed although have largely shadowed medical advances. Evidence based nursing knowledge appears to have contributed very little to the recent success of day surgery. This may be due, in part, to the lack of attention given to modern surgical practices within current pre-registration nurse education programmes of study. Aim The aim of this educational audit was to evaluate the consideration given to modern surgical practices in the programmes of study of recently qualified staff nurses employed within Day Surgery Units in the United Kingdom in order to gauge the extent of the challenge. Method A postal audit was designed and sent to n = 247 Day Surgery Units. The audit was intended to elicit information from the staff nurses regarding their experiences of modern, elective day surgery during their nurse education programmes of study. Results Two hundred and seventy seven staff nurses responded revealing that the level of attention to day surgery practices within pre-registration programmes was extremely low. The professions’ actual and potential theoretical contribution to modern surgical practices was virtually nil. Their experience of pre-operative nursing intervention appeared mainly to involve the teaching of traditional surgical in-patients nursing skills. The inclusion of modern surgical practices into the theoretical assignments within the programmes of study was very limited. Once qualified, the vast majority of staff nurses experienced no additional formal education for their new role. Conclusions The results are discussed in relation to the re-focusing of pre-registration nurse education, changing clinical roles and the future of nursing within the modern surgical arena.