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Promoting Best Practices in Item Writing and Exam Construction: Faculty and Institutional Approaches
No full textCourse exams are used for summative evaluation in nursing programs. Graduates of prelicensure nursing programs are required to pass the National Council Licensure Examination (NCLEX) before becoming licensed as a nurse. The NCLEX is comprised of multiple choice, multiple response, fill in the blank, and technology-enhanced items. Nursing faculty have a responsibility to evaluate students using well-developed assessments tools and to prepare graduates for the NCLEX, therefore, item writing and test construction skills are vital. However, item writing and exam construction skills and formal item writing training are lacking among many faculty.1,2 Best-practices for item writing and test construction exist.3 If faculty are not using best practices, exams may not be accurately discerning students’ true achievement of learning outcomes.A recent integrative review4 highlighted the need for formalized faculty development programs specific to item writing and exam construction. Current faculty development approaches focus on continuous improvement, ongoing professional development, peer and expert collaboration, and the using current item writing and exam construction resources.4 Despite this, gaps exist in faculty abilities and confidence in item writing1, as well as institutional initiatives to promote exam best practices.4,5This presentation will provide educators with a checklist to assist in developing comprehensive programs to promote item writing and exam best practices with institutional and individual components. The checklist and associated exemplars will be presented to illustrate how schools can address the recommended components. Areas that will be explored include using educational theories to prepare faculty in item writing, test construction, and item analysis through individual and group approaches, evaluating faculty item and exam development skills, incorporating linguistic modification, scaffolding faculty development from multiple-choice to technology-enhanced item writing, developing mentoring structures using faculty champions, creating comprehensive organizational policies, and incorporating sound program evaluation plans. Outcome evaluation plans will be discussed and will include student, faculty, and program level outcomes. The creation and implementation of programs to improve item writing and exam construction promotes valid and reliable evaluation of student learning, supporting competency attainment and readiness for practice
Validation of a Nursing Workload Tool to Improve Staffing in a Pediatric Hospital
No full textNursing workload encompasses the full range of tasks nurses must complete, including direct and indirect patient care and workplace responsibilities.1 High workload has been associated with increased stress, reduced job satisfaction, and a greater risk of patient harm.2-3 Excessive workloads limit time for assessments, critical thinking, and effective communication, all essential to preventing harm.4-5 Shifting from patient acuity to workload metrics is a strategy for managing nurse workloads and supporting better outcomes. In a pediatric hospital, nurse leaders transitioned from a patient acuity system to one incorporating nurse workload for nurse assignments. The project aimed to validate a nursing workload tool and create more balanced assignments.
A group of veteran bedside nurses were recruited to collaborate with electronic medical record (EMR) specialists. Bedside nurses and EMR specialists evaluated each medication, order, and flowsheet to quantify the time required for each task. This resulted in an automated nurse workload score calculated by the EMR and updated hourly. Nurses piloted the tool on 3 units, assessing its practicality and validating the acceptable range for workload scores. Nurses provided feedback on score accuracy through surveys. The project team addressed documented discrepancies in scores. Nurse leaders rounded weekly, gathering bedside nurses’ perceptions of their workload using 3 categories (low, medium/appropriate, and high). Team leaders and a biostatistician analyzed nurses\u27 perceptions and calculated workload scores to identify the ideal workload range.
After a 60-day pilot, 342 nurse assignments were evaluated. Assignments categorized as low, medium, and high were compared to their corresponding workload scores. Cross tabulation showed that 24.6% of assignments were perceived as low, 52.6% as medium, and 22.8% as high. Among low assignments, 66% had scores of 7.9 or below, while 62.72% of medium assignments fell within the range of 8-12. High assignments were reported in 62.75% of cases with scores of 12.1 or above.
After the pilot, the workload tool was implemented across all inpatient units. Nurses received education on using the tool to support safe staffing, with a target workload range of 8-12 per nurse. Ongoing surveys further validated the score ranges for low, medium, and high assignments. A key takeaway was that involving bedside nurses in decision-making ensures staffing solutions align with real clinical needs
Re-Fracture Within One Year After Hip Fracture Surgery in the Elderly and its Related Factor
No full textBackground and Purpose Hip fracture is the most common cause of trauma admissions in the elderly. The incidence of contralateral hip fracture after hip fracture in the elderly is 10.8%, resulting in more disability, mortality, and increased medical cost. The study is to investigate the incidence of re-fracture in the elderly and possible related factors, including demographics, fracture types and treatments, osteoporosis parameters, lifestyle, body mass index, comorbidities, and clinical visits.
Methods This is a retrospective study. Data were collected from chart reviews of older adults who received hip fracture surgery at a hospital in Taiwan between 2018 and 2021. Data analysis was made by descriptive statistics, chi-square test, Mann-Whitney U test and logistic regression.
Results 407 patients were included. Among them, 277 were female. Their mean age was 81 years. Fractures occurred in the femoral neck and intertrochanteric region. Fracture types are displaced, comminuted and nondisplaced fractures. Surgical treaments included internal fixation and hemiarthroplasty. The median Frax score of hip fractures was 8.3%. The median Frax score of major osteoporotic fracture was 17%. The median T score was -3.2 . Median BMI was 22.3 kg/m2. Among them, 273 had hypertension, 140 had hyperlipidemia, 162 had diabetes and 19 had vision problems. The median number of clinical visits in one year was 6. Within a year, 135 patients suffered new fracture. The incidence of re-fracture was 33.2%. Median time to refracture was 5 months. Refractures occurred in the spine, contralateral femur and ipsilateral femur. Refracture types included nondisplaced, displaced, and comminuted. Treatments included medical therapy, internal fixation, spine surgery, and hemiarthroplasty. Logistic regression results showed that hypertension and the number of clinical visits were important predictors of re-fractures. The risk of further fractures was significantly higher in patients with hypertension (OR:1.81) and those with more clinical visits (OR:1.16).
Conclusion Our study showed high incidence of re-fracture after hip fracture surgery in the elderly. Spine is the most common site for new fractures. This suggests that it is key to care such patients to prevent them from further fractures. Among them, patients with hypertension and patients with high frequency of orthopedic clinical visits are at high-risk. Nurses should pay attention to this high-risk group to prevent further fractures
[Excerpt from] Harmony by Design: Navigating Work and Life in Healthcare
Get PDFHarmony by Design: Navigating Work and Life in Healthcare reimagines how we approach well-being in a fast-paced, high-pressure world. Rather than striving for a rigid sense of balance, this book introduces a more flexible and fulfilling concept: harmony. It\u27s about aligning your values, goals, and daily actions to create a life that feels whole and sustainable.
Authors Sharon M. Weinstein, Marla J. Vannucci, and Katie Boston-Leary blend practical tools with thoughtful reflection, drawing from the latest nursing competencies and real-world challenges to help readers manage stress, lead with empathy, and build meaningful careers without sacrificing personal well-being.
What sets this book apart is its dual focus: personal transformation and organizational change. It encourages readers to take ownership of their well-being while also fostering environments where others can thrive.
Harmony by Design is more than a guide—it\u27s a blueprint for living and leading with clarity, compassion, and purpose. Whether you\u27re a healthcare professional, leader, or student, this book offers the tools and mindset for you to thrive in both your work and your life.https://www.sigmarepository.org/book_excerpts/1080/thumbnail.jp
The Lived Experience of Filipino Nurses Caring for Patients with COVID-19
Get PDFReports of individuals exhibiting respiratory symptoms causing sudden deaths emerged as a pandemic in the start of a new decade. The onset of the novel Coronavirus Disease 2019 (COVID-19) as a worldwide health crisis brought out the significance of the nurses’ role in healthcare. This descriptive phenomenological research focused on the caring experiences of Filipino nurses among patients who were infected with COVID-19 in Negros Oriental, Philippines. Seven participants were identified through purposive and snowball sampling and were asked the question: What is it like to be caring for patients diagnosed with COVID-19 in Negros Oriental, Philippines during this pandemic?After comprehensive interviews via an online videoconferencing platform, Collaizi’s data analysis revealed thirty themes after an analysis of 244 significant statements and 275 formulated meanings. These were organized into seven sub-themes leading to the formation of three (3) major themes namely: (1) Understanding the unknown, (2) Fulfilling the nursing role despite challenges and (3) Influencing the nurses’ psychosocial well-being.The study findings were also related to the nursing theory of Boykin & Schoenhofer’s Nursing as Caring. Participants encountered constraints and dilemmas from being left with no choice and expressing refusal to work to accepting the role and assuming professional responsibility. While living in the caring process and fulfilling their role, the participants tackle through several healthcare organizational challenges. Participants reported overwhelming nurse-to-patient ratios (1:7 to 1:20), leadership gaps and work inequalities. Their patient interactions influence the nurses’ psychosocial well-being holistically allowing them to look into a wide range of emotional responses, build nursing resilience and cultivate supportive communities.Understanding the experiences of Filipino nurses in this study benefits the nursing workforce considering Philippines as the world’s largest supplier of nurses. The participant responses are calls to nursing leadership across nations to incorporate resilience in nursing education, increase public awareness, prevent stigma, and improve policy development in relation to disaster risk reduction management and pandemic preparedness. Filipino nurses with shared experiences shed light on the profound challenges and unwavering dedication during the pandemic, as reflected in a participant’s statement, “If nobody will go, then who will?
Peer Champions for Team Well-Being
Get PDFCo-worker peer support is a critical component of unit cohesion and social support in high stress exposure teams and can mitigate stress-related symptoms.1 A primary advantage of co-worker peer support is that it is available when needed and provided by those who “get” the context of the stress experience. The effectiveness of peer support programs has begun to take hold, helping institutions address issues of shame and isolation among their healthcare workers.2 Following the COVID pandemic, we see even more calls for health systems, state boards, licensing bodies, and professional organizations to step up and prioritize clinician well-being.3
There are many peer support approaches used in health care and high-stress occupations.2,4 Peer support can range from consumers of mental health services to certified and trained crisis counselors. Peer support that uses Wisdom5and Stress First Aid6 approach is designed to leverage the core values of health workers, empowering them to help each other and including peers and co-workers within the sphere of those who may need help. In this context, a peer is any one with whom we have a longitudinal working relationship. Peers have the advantage of knowing each other’s baseline coping skills, and they often understand the constellation of work and life stressors that may be pressing on a peer. A peer truly understands the effort and challenges of doing the work and often has a wisdom gained over years of experience. A peer is in the best position to advocate for resilience strategies in the workplace, can see a stress injury and provide stress first aid, and knows what the trusted resources are within an organization. A peer support champion role is more than a good friend at work.
Trained peer support champions are a critical component of creating healthy work environments.7 The recruitment, development, training, and ongoing support of Peer Support Champions requires evidenced-based strategies, that integrate knowledge and skills to:
- To foster peer support strategies within their work teams that include wisdom practices and Stress First Aid- Recognize when a system issue is causing unnecessary stress- Assist their team members build resiliency and engage with organizational and other well-being resources- Assist team members with signs of stress injury and who are in distres
Psychometric Properties of the Chinese Version of the Clinical Nurses Grit Scale in Employed Nurses
No full textBackground: Grit, recognized as a positive psychological trait, significantly influences the intention of employed nurses to remain in their workplace. The Clinical Nurses Grit Scale (CN-GRIT), initially developed by Korean scholars, has been employed to assess grit in clinical nursing environments. However, a Chinese version of the Grit Scale specifically designed for evaluating the grit of nurses does not currently exist.
Purposes: This study aimed to: (1) translate the original English version of the CN-GRIT into a traditional Chinese version (TC-CN-GRIT), (2) confirm its factor structure, and (3) analyze its psychometric properties among newly employed nurses.
Methods: A psychometric study utilizing a cross-sectional web-based design was conducted in Taiwan. A total of 264 nurses completed a self-administered online questionnaire that included a demographic datasheet, the Short Form Grit Scale, the Connor-Davidson Resilience Scale-10 (CD-RISC), the Thoughts of Quitting Scale (TQS), and the 14-item Clinical Nurses Grit Scale. Data analysis was performed using IBM SPSS 24.0, employing Cronbach\u27s alpha, intra-class correlation, and Pearson’s correlation to assess reliability and concurrent validity. Exploratory factor analysis (EFA) was also conducted.
Results: The internal consistency and stability of the TC-CN-GRIT total scale were found to be .93 and .91, respectively. The EFA yielded a satisfactory Kaiser-Meyer-Olkin value of .915 and a Bartlett\u27s test value of 2345.687 (p \u3c .001), indicating that 70.07% of the total variance was explained by the three-factor structure of the TC-CN-GRIT. In terms of convergent validity, the scale exhibited moderate correlations with the Short Form Grit Scale (r = .479), CD-RISC (r = .510), and TQS (r = -.415). The standard error of measurement and the minimal detectable change were 33.15 and 8.73 respectively.
Conclusions / Implications for Practice: The 14-item TC-CN-GRIT instrument demonstrated robust reliability and validity among nurse participants. The TC-CN-GRIT can effectively measure grit in nurses, offering valuable insights that may enhance nursing management, research, and education
Factors Affecting Korean Nursing Students’ Perception of Family-Centered Care
No full textPurpose: Family-centered care is a core philosophy in pediatric nursing that emphasizes recognizing family individuality, facilitating family involvement, building partnerships and sharing information. There is evidence of several benefits of family-centered care, such as improved parent-child bonding, enhanced infant brain development, and reduced length of hospital stays. Despite the emphasis on the importance of family-centered care in undergraduate pediatric nursing education in Korea, there is a lack of research on nursing students\u27 perceptions of it. The aim of this study was to assess nursing students\u27 perceptions of family-centered care and to examine the factors affecting these perceptions in Korea.
Methods: A cross-sectional study design was used. Participants were 217 undergraduate nursing students in South Korea. Data were collected from July to August 2024. A structured questionnaire was used to assess nursing students’ emotional intelligence, communication competence, interpersonal competence, and perceptions of family-centered care. The SPSS version 27.0 was used to analyze the data.
Results: The overall mean of the students\u27 perceptions of family-centered care was 4.17±0.52 (range=1-5). Perceptions of family-centered care varied significantly according to demographic variables: Juniors scored higher than Seniors (t=3.53, p=.001), students with childhood hospitalization experience scored higher than those without (t=2.00, p=.046), those with family-centered care education experience scored higher than those without (t=2.25, p=.025), and those without pediatric nursing practice experience scored higher than those with it (F=7.39, p\u3c.001). There was a positive correlation between students’ perceptions of family-centered care and emotional intelligence (r=31, p\u3c.001), communication competence (r=45, p\u3c.001), and interpersonal competence (r=31, p\u3c.001), while there was a negative correlation with age (r=-.14, p=.039). The factors significantly affecting students’ perceptions of family-centered care included childhood hospitalization experience (β=.12) and communication competence (β=.38), explaining 26.1% of the variance.
Conclusion: To improve nursing students\u27 perceptions of family-centered care, it is essential to develop and implement programs that strengthen communication competence. This will enable future pediatric nurses to practice family-centered care effectively
Substance Use in Nursing: Barriers and Facilitators in Returning to Work Under Monitoring
No full textBackground: The US is currently experiencing a substance use epidemic, with overdose deaths rising significantly. Substance use disorders (SUD) affect 17.3% of individuals aged 12 or older, including nurses (RNs) who face unique occupational stressors. RNs with SUD pose risks to both personal & patient safety. Regulatory bodies often impose monitoring & disciplinary actions on RNs with SUD, creating challenges for their return-to-work (RTW). Little is known about what supports & hinders successful return-to-work for RNs after substance use discipline
Methods: This study used Group Concept Mapping (GCM) to identify & prioritize facilitators and barriers in the RTW process for RNs under monitoring agreements due to substance use-related licensure discipline. RNs were recruited via purposive sampling and professional networks. Participants generated, sorted, & rated statements about RTW facilitators and barriers based on their perceived impact. Data were analyzed using multidimensional scaling and cluster analysis to identify key themes and priorities.
Results: Fourteen participants sorted 51 facilitator statements into six clusters: Monitoring Recommendations, Autonomy and Self-Efficacy, Caring for the Caregivers/Prevention, Nurses Helping Nurses, Reintroduction to Practice, & Positive Employer Factors. Key facilitators included phased reductions in monitoring requirements, supportive employer practices, peer support, & clear guidance from occupational health services. Participants also identified 48 barriers, categorized into five clusters: Work-Related Challenges, Financial Burden, Administrative Challenges, Impact on Mental Health, and Peer and Co-Worker Support. Mental health impacts and visibility of disciplinary actions were the most stressful barriers.
Discussion: Structured monitoring programs, supportive work environments, & peer support are critical in facilitating RTW for RNs recovering from SUD. This study highlights the importance of consistent RTW policies to address specific challenges faced by these RNs. The mental and socioemotional challenges underscore the need for better support systems, including RN-specific support groups and mental health resources. Additionally, policy changes, such as reducing the visibility of disciplinary records and providing financial support during recovery, could ease the RTW process. Further research should explore long-term recovery strategies and the perspectives of RNs navigating these challenges
Interprofessional Collaboration Through Leadership Initiatives: Eco-Friendly Cost Effective Strategy
No full textBackground/Introduction: The world is increasingly adopting environmentally friendly practices to combat ecological degradation caused by single-use products. While these items offer convenience, their widespread use contributes significantly to waste generation. To address this issue, we identified the introduction of recycled tissues as a sustainable and cost-effective solution.
Methodology: A multidisciplinary team was formed, including representatives from the Department of Infection Prevention and Hospital Epidemiology (DIPHE), the Office of Environment and Sustainability, and the Purchase and Supply Chain Management Division (PSCMD). We conducted a pre-and post-analysis to identify necessary changes, supported by a literature review to ensure patient and staff safety with the introduction of recycled paper tissues. Experts in microbiology, infectious disease, and infection control reviewed the proposed solution against international best practice guidelines, focusing on the recycling process and its effectiveness in eliminating microorganisms. Microbiological and laboratory tests were performed, and updates from manufacturers were requested. After thorough expert reviews, procurement was approved by the Environment and Sustainability office. The PSCMD team presented multiple tissue products to DIPHE, ultimately selecting a pro-recycled tissue known for its quick-drying and non-sticky properties.
Results: The initiative yielded significant cost savings alongside environmental benefits. A comparison of pre-and post-consumption data from October 2023 to March 2024 with the following six months showed that introducing pro-recycled tissue products saved Rs. PKR 7,233,368, representing a 15% reduction in costs compared to previous products. Importantly, the quality and quantity of tissue usage remained consistent, with no pilferage observed, further reducing costs. These tissues, made from recycled paper and cardboard, maintain the same user experience and are projected to save around 6,000 trees annually.
Conclusion: Our transition to eco-friendly products reflects a strong commitment to sustainability in healthcare. We plan to explore additional innovative options while continuously evaluating these changes to ensure environmental safety and patient well-being. The successful replacement of traditional tissue and toilet paper with recycled alternatives, approved by Infection Control, demonstrates this commitment