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Using Gamified Teaching Platforms in the Medical Education of Medical Officers and Soldiers
No full textBackground: Health service nursing officers and soldiers are responsible for maintaining the health of both military personnel and civilians. Their training mainly focuses on classroom lectures and technical operations. With an increase in volunteers specializing in medicine and nursing, the demand for enhanced medical education has grown. Adjusting the environment and teaching models to boost learners\u27 intrinsic and extrinsic motivation—while balancing academics and practice and incorporating military medical experts\u27 experience—is crucial. We aim to introduce innovative teaching into traditional models to study its correlation with learning effectiveness among military medical personnel.Methods: We replaced traditional homework assignments with a gamified teaching platform. This goal-oriented approach combined clinical scenarios with feedback to enrich the training experience. Through competitive gaming, intrinsically motivated learners acquired new knowledge within existing frameworks, building long-term memory via challenges and feedback. We compared cognitive differences and learning performance before and after implementing innovative teaching across different classes. Additionally, we assessed learners\u27 satisfaction to inform future innovative teaching in military academies.
Results: Comparing classes of the same level on the acceptance of innovative teaching and among different ranks, 96.8% were eager to replace paper-based homework with digital methods, and 82.5% wished to access course content via mobile phones before class. Learning outcomes showed significant improvements after innovative teaching; pass rates in theoretical subjects increased from 82.6% to 93.2% (p \u3c 0.005), serving as a reference for medical education of grassroots health service personnel.
The training of medical and nursing officers and soldiers is a cornerstone for advancing military health services. Their cognition and attitudes significantly affect the effectiveness and quality of health service execution across the military
Implementation of Evidence-Based Symptom Management Algorithms to Reduce Emergency Room Encounters
No full textBackground & Significance: Oncology patients often seek emergency room (ER) care for symptom management. Accessing care through the ER can result in increased risks for: nosocomial infections, treatment delays, hospitalization/rehospitalization, and healthcare costs.1,2 Early identification/intervention for symptom management is crucial for improving patient outcomes. Implementing evidence-based symptom management (EBSM) algorithms may reduce ER encounters.
Purpose: To determine: 1) the most common symptoms reported 2) the EBSM algorithm and category of recommendations used, and 3) if EBSM algorithms decreased ER encounters.Methods: EBSM algorithms were implemented to address the nine most common symptoms (pain, nausea/vomiting, diarrhea, fatigue, hair/skin/nails, constipation, fever, peripheral neuropathy, and mucositis). The EBSM algorithms used a “stop light method” red (severe), yellow (moderate) green (mild) to categorize symptom severity and guide recommendations.Data Collection/Analysis: Pre-implementation data included the most common symptoms reported and the number of ER encounters (per month). Post implementation data collection included the previous metrics, plus specific EBSM algorithm and category of recommendation. Descriptive statistics and a one-tailed Independent Samples t test (alpha 0.5) were conducted to examine the difference in ER encounters before/after implementation.
Results: Pre-implementation the most common symptoms reported were nausea, vomiting, and diarrhea, with 286 ER encounters. Post-implementation EBSM algorithms were used 193 times for 214 oncology patients, addressing symptoms such as pain (n= 42), nausea/vomiting (n= 38), diarrhea (n= 28), fatigue (n= 27), hair/skin/nails (n= 23), constipation (n=13), fever (n=9), peripheral neuropathy (n=7), and mucositis (n=6). Recommendations fell into red (n=18), yellow (n=39), and green (n=98) categories. Post-implementation ER encounters decreased by 27% from 286 to 208, indicating a significant difference between pre- and post-implementation groups t (2.24), p=.033), with the pre-group having more ER encounters (M =72, SD =10) than the post-group (M =52, SD 14). The effect size between the pre- and post-implementation groups was calculated using Cohen’s d, resulting in a value of 1.64, indicating a large effect
Differences in Nurses’ Perceptions of the Work Environment
No full textNurses play a critical role in delivering safe, high quality patient care. However, nurses continue to face staffing shortages, turnover, workplace violence, and challenging work environments. Research shows that work environments have a direct impact on nurses and the quality of care provided. Nursing leaders are in a prime position to advocate for healthy work environments that will sustain the nursing workforce and provide nurses with a workplace that is safe, empowering, and satisfying. This research study was part of a larger non-experimental descriptive study on healthy work environments. The study assessed how nurses in different professional roles within a quaternary care academic hospital system perceived their overall work environment across six standards.This research study was a non-experimental descriptive study using a cross-sectional survey design. The American Association of Critical Care Nurses’ Healthy Work Environment Tool (HWEAT) was used to assess how nurses perceived their overall work environment at a quaternary care academic medical center. Respondents completed the HWEAT anonymously and self-identified their role as nurse leader, direct care staff, non-direct care staff, or advanced practice registered nurse. A total of 565 responses were collected over two months. Multiple linear regression was used to assess the relationship between the HWEAT outcomes and the professional role of nurse respondents.The Healthy Work Environment Assessment Tool evaluated organizational performance across the six standards of a healthy work environment: skilled communication, true collaboration, effective decision making, appropriate staffing, meaningful recognition, and authentic leadership. A statistically significant difference was observed in the perceptions of the work environment between nurse leaders and the other nursing groups. Nurse leaders scored all six subscales much higher than other respondents, demonstrating a significant gap in perception of the health of the work environment. Nurse leaders perceived the work environment to be much healthier in comparison to other nursing groups.
The results demonstrate that nurse leaders must have a better understanding of nurses’ perceptions of a healthy work environment. By doing so, nurse leaders can identify specific strategies that can help create healthier work environments and improve the overall performance of the organization
Successful Strategies for Disseminating Research and Evidence-Based Quality Improvement Projects
Get PDFThe 15-year gap between the discovery of new knowledge and the implementation of that knowledge in practice is too long and causes unnecessary patient harm. In this presentation, strategies to disseminate research through presentations, publications, social and public media, and health policy will be discussed. Strategies to develop in-depth dissemination plans will be highlighted, including ways to scale evidence to make a positive impact in real-world clinical practice settings
Assessing Nurses’ Competency and Readiness: The First Step in a Journey to EBP
No full textAims: To examine relationships between nurse characteristics and evidence-based practice (EBP) competency, beliefs, organizational culture and readiness, implementation self-efficacy, and mentors access to inform implementation of EBP.Background. An abundance of literature demonstrates the beneficial effects of using EBP in clinical care and return on investment. Many hospitals continue to struggle with EBP adoption, and literature demonstrates that many nurses express lack EBP competence. In a healthcare system, with different organizational culture, resources, and nurses, an assessment of the current state of nurses’ EBP competency and their perceptions of support for EBP is needed to identify potential interventions to implement and sustain EBP.
Methods: A cross-sectional descriptive correlational study of nurses spanning 6 states and 36 hospitals from a large healthcare system in Western United States participated in a survey that included demographic questions and instruments that measured EBP competencies, beliefs, organizational culture and readiness, implementation self-efficacy, and access to mentors.
Assessment of Findings: 1468 nurses participated in the study. Of these, 881 were frontline nurses, followed by nurse leaders (n = 201) and had an average of 15.2 years of experience. Nurses rated themselves competent in only one basic competency (Asks Clinical Questions). Years of experience and higher education were statistically significant factors in EBP competency. Organizational Culture and Readiness was the lowest scoring scale, with participants rating having access to mentors only a little bit of the time. Job satisfaction positively correlated with EBP Beliefs, Organizational Readiness, and Access to Mentors (p \u3c.001) and intent to leave was negatively correlated with Access to Mentors (p \u3c.001). In addition, Magnet status didn’t have a statistically significant effect on individual competencies; however, it did have a statistically significant effect on Beliefs, Implementation, Organizational Culture and Readiness, and Access to Mentors.
Conclusions and Implications: Nurses lack confidence in their EBP competency. Although EBP is embedded in baccalaureate and DNP programs, there continues to be a need to improve EBP competency. Improving culture by encouraging leadership support for EBP and embedding formal structures such as providing EBP mentors could make a significant difference in EBP competency, and EBP implementation self-efficacy
The Journey to EBP Excellence in Healthcare: Overview
No full textBackground. In the contemporary landscape of healthcare, evidence-based practice (EBP) has emerged as a cornerstone for ensuring optimal outcomes and enhancing the quality of care. EBP combines the best available evidence with clinical expertise and patient preferences.1 It is well-documented that when nurses engage in EBP, it leads to better patient outcomes. Nevertheless, its implementation faces several obstacles. Nurses lack confidence in fundamental EBP skills and encounter barriers such as inadequate resources, insufficient leadership support, and a lack of EBP mentors. Successfully overcoming EBP barriers at the organizational level requires the adoption of a structured conceptual framework for guiding and sustaining practice. The Advancing Research and Clinical Practice Through Close Collaboration (ARCC) model, originally designed for hospital systems to integrate and sustain EBP, was used to provide a framework to facilitate the journey to EBP adoption.
Purpose. This symposium will describe the journey one healthcare system has taken to foster the implementation and sustainability of EBP.
Results. The first presentation will describe the results of a system wide study on EBP competencies, beliefs, self-efficacy, organizational culture, and access to mentors. The second presentation describes the verification of psychometric properties of three recently developed shortened instruments: EBP Beliefs, EBP Implementation, and Organizational Culture and Readiness Scales. The final presentation will describe the development of two new educational programs, EBP for Leaders and the EBP Fellowship.
Discussion/Implications. Fostering a culture of EBP within a large healthcare system containing multiple hospitals with varying strengths and opportunities necessitates a multi-faceted approach. By applying the ARCC framework, the organization devised a comprehensive strategic plan for sustaining EBP. The introduction of an EBP fellowship and an EBP course for leaders addressed the identified barriers by creating EBP-competent nurses, educating leaders, and developing mentors, all of which contribute to fostering a successful EBP culture. By facilitating dialogue, sharing best practices, and promoting the adoption of EBP through the symposium, we aspire to contribute to the ongoing advancement of EBP practice to drive better outcomes
Verification of Psychometrics for Three Shortened Nursing EBP Scales and an EBP Mentoring Scale
No full textAims. Report on the on the psychometric properties for three shortened EBP (EBP Beliefs, EBP Implementation Scale, and the Organizational Culture and Readiness for System-Wide Integration of EBP) and the EBP Mentoring Scale.
Background. Melnyk and colleagues developed several scales to measure nurses’ beliefs, knowledge, and competencies, as well as scales to measure organizational readiness and support of EBP. However, the initial instruments were extensive and ranged from 18 to 29 items, making the combination of the tools lengthy. These instruments were all adapted to shortened scales and preliminary reliability has been reported. On all 3 shortened scales (EBP Beliefs, Implementation, and Culture and Readiness), participants respond on a 5-point Likert type scale (1=Strongly Disagree; 5=Strongly Agree). Preliminary psychometrics for the scales were strong, however, they have not been extensively used. The EBP Mentoring scale is an 8-question 5-point Likert type scale (1=Not at All; 5=Very much so).
Methods. This study was a one-time, cross-sectional, descriptive, correlational study consisting of nurses spanning 6 states and 36 hospitals from a large healthcare system in the western United States completing a survey with EBP-based scales. Psychometric testing was performed using SPSS (IBM SPSS Statistics v.21)
Results. Prior to launch of the study, the project team reviewed all items included in the scales to assess validity. Nurses (N=1468) from a single, large healthcare system participated in this study. Data were analyzed to confirm reliability of the three shortened scales and the mentoring scale. All three shortened scales showed good to excellent internal consistency with the Implementation Scale having the highest Cronbach\u27s alpha (0.906) followed by Culture and Readiness (0.893) and Beliefs (0.84). All items on all three short scales were highly correlated (Beliefs: 0.51 to 0.779; Implementation: 0.74 to 0.802; Culture and Readiness: 0.681 to 0.775; p\u3c 0.001 for all).
Conclusions/Implications. The recently developed scales appear to be both valid and reliable. All items show a strong positive relationship indicating assessment of related EBP measures. The scales can be applied to assess the application of EBP in healthcare organizations. Having shortened instruments to assess EBP application will decrease the time burden for respondents as well as enable leaders to quickly and efficiently access different EBP constructs
Developing and Validating an Emerging Infectious Disease Prevention Competencies Scale
No full textAim: To develop an instrument and evaluate its psychometric properties for emerging infectious disease assessing prevention competencies among health and care workers in long-term care institutions.
Design: A cross-sectional, descriptive design utilizing both qualitative and quantitative methods was employed.
Methods: The scale was developed according to scale development guidelines in two phases, namely the scale development phase and scale testing phase, with the staff of long-term care institutions as the study population and their workplaces as the sampling unit.
Results: The scale comprises 27 items across three dimensions: 14 items pertaining to professional role performance, 7 items addressing workplace resources, and 6 items focusing on soft skills in communication and collaboration. Content analysis was conducted via a focus group discussion; content validity analysis was carried out via expert reviews; item analysis was performed via a pilot study; and construct validity and reliability were ensured via factor analysis and internal consistency testing, respectively. The total variance explained by the three factors of the 27-item scale was 64.785%, demonstrating acceptable validity and reliability with a Cronbach’s α value of .968.
Conclusion: The Emerging Infectious Disease Prevention Competencies Scale demonstrates excellent reliability and validity, making it suitable for clinical practice and research. In practice, this instrument could also assist managers in adjusting policies to adapt to dynamic situations and enhance the quality of care in long-term care institutions. Nonetheless, further research is warranted to refine the scale and enhance its generalizability
Exploring the Experience of Nursing Students During their Community Health Nursing Clinical Placement at Schools
No full textCommunity health nursing is an exciting, challenging, and evolving field that creatively integrates various areas of nursing practice with public health knowledge (Stanhope & Lancaster, 2016). Learning in practical settings is invaluable for student nurses; that is why clinical placements account for 50% of nursing curriculum requirements (Henderson, 2011). At Makassed University of Beirut, the community nursing practicum takes place in schools, with school nurses serving as mentors during these placements.
This research study aims to: Explore the experiences of student nurses during community clinical practice. Develop guidelines to enhance learning during community clinical practice.
The study sample consisted of 157 nursing students enrolled in a community nursing course from 2015 to 2020. The evaluation of students’ performance was conducted by mentors at the end of each clinical experience, alongside students\u27 reflections on their daily experiences using the DEAL Model.
Results: The analysis of mentors’ evaluations indicated that students demonstrated a strong cooperative attitude in the school environment. While student nurses consistently implemented screenings for students in schools, they required more practice in independently evaluating student complaints. The reflections were analyzed thematically, leading to the identification of four primary themes: direct nursing care, communication skills, leadership abilities, and client education. Data showed that students were generally satisfied with their community experiences.
Recommendations: There is a need to clarify and emphasize the responsibilities of school nurses by applying the school practicum guidelines. Furthermore, it is important to define the role and responsibilities of instructors in the community practicum to enable mentors to provide effective feedback and support for students. Lastly, incorporating community health concepts into all nursing courses throughout the Bachelor of Nursing program is essential
An Empirical Exploration of Attitudes, Practices, and Needs Regarding Trauma-Informed Education Among Nursing Faculty
No full textPandemic-related stressors have increased traumatic stress among students and faculty. Trauma-informed education (TIE) can help prevent re-traumatization and promote a healthy academic environment. The initial findings and ongoing work at one institution to assess nursing faculty knowledge, attitudes, practices, and needs regarding TIE implementation will be reported.
Detailed abstract attached