Empowering clinical supervisors to flourish though critical companionship.

Education for professional nursing practice has undergone a significant shift over the last few decades impacting nursing practice and the relationship between nurses. Enhancing professional practice and acting as a conduit for empowering nurses to be active participants in their learning and development is Practice Development. This action research project with philosophical premises of critical companionship and human flourishing aimed to develop the knowledge and skills of registered nurses in their ability to provide clinical supervision of nursing students in practice. The overall project consisted of two action research cycles in two different health facilities. Participants in both projects identified similar issues and common learning needs including; how to better understand and develop skills in reflective practice; how to provide a positive learning and enabling environment; and how to provide effective solution focused feedback. Workshop facilitators witnessed the flourishing of participants as they were enabled to negotiate their learning requirements; grow and develop in their roles over the workshop series. Participants themselves identified personal growth in skills, knowledge and confidence in being a preceptor as a result of the workshops in the study. Overall, this study has resulted in the development and capacity building of the nursing workforce clinical placement capacity through the development of clinical supervisors.

Securement and Dressing Devices for Central Venous Catheters.

Editor's note: This is a summary of a nursing care-related systematic review from the Cochrane Library.

Review of transnational nursing education programme curricula: process, findings, and recommendations.

BACKGROUND: The University of Wollongong (UOW) delivers two Transnational International Programmes (TNEP) in Hong Kong (HK): a 1-year undergraduate Bachelor of Nursing (Conversion) degree and a 2-year postgraduate Master of Nursing degree. A curriculum review of these programmes has been undertaken to ensure the quality of the programme remains consistently high and competitive in an international environment. AIM: The aim of the Curriculum Review Project was to utilise the experience of expert academic staff to review the TNEP curricula delivered by an Australian University in Hong Kong (HK) to ensure it met contemporary needs of students, the university, and the Hong Kong Authority. METHODS: The curriculum review projects followed a qualitative research methodology. Thematic analysis was undertaken utilising Braun and Clarke's six-phase method (2006), as this method facilitated an inductive semantic approach where themes are strongly linked to the data and sourced from the explicit meaning of the discourse within the interview (Braun and Clarke, 2006). RESULTS: In total, there were 6 participants who were all permanent academic staff members within the School of Nursing at the UOW. The results of this project have been reported within a strengths, weaknesses, opportunity, and threats (SWOT) framework. Participants recognised the value and challenges to both individual students and the broader nursing profession in HK. Overall, there was a perception that being involved as an academic staff member in a TNEP developed both their subject knowledge and teaching skills. CONCLUSIONS: This project has demonstrated that the TNEP makes an important contribution to the nursing profession in HK, while also facilitating the growth and development of academic staff at UOW.

Nurse practitioner work: A case study.

Abstract Within any professional practice, knowledge developments to support service delivery and to understand roles inherent within that practice context are critical. The purpose of this article is to present findings from case study research that used the AUSPRAC Research Toolkit Interview Schedule and to propose an additional theme to the Interview Schedule. Case Study method was used to explore the role of a nurse practitioner (NP) within a specific context of practice in an Australian Healthcare institution. Three semi-structured interviews with a NP using the AUSPRAC Research Toolkit Interview Schedule and one additional interview were employed. Data was analysed where initial free coding, then theme generation contributed to knowledge development. The AUSPRAC Research Toolkit Interview Schedule generated knowledge about the NP role. Themes identified for interviews in the Schedule were: the organisation of care, team functioning and patient service. Analysis of data from these themes identified that information related to ongoing development of professional practice was not forthcoming from the participant. The authors recommend adding a fourth theme to the Interview Schedule to enable exploration of the professional elements of the NP role.

The Nurse Practitioner Role: A pilot study based on the Interview Schedule from the AUSPRAC Research Toolkit.

Abstract Within any professional practice, knowledge developments to support service delivery and to understand roles inherent within that practice context are critical. The purpose of this article is to present findings from case study research that used the AUSPRAC Research Toolkit Interview Schedule and to propose an additional theme to the Interview Schedule. Case Study method was used to explore the role of a nurse practitioner within a specific context of practice in an Australian Healthcare institution. Three semi-structured interviews with a Nurse Practitioner using the AUSPRAC Research Toolkit Interview Schedule and one additional interview were employed. Data was analysed where initial free coding, then theme generation contributed to knowledge development. The AUSPRAC Research Toolkit Interview Schedule generated knowledge about the nurse practitioner role. Themes identified for interviews in the Schedule were; the organisation of care, team functioning and patient service. Analysis of data from these themes identified that information related to ongoing development of professional practice was not forthcoming from the participant. The authors recommend adding a fourth theme to the Interview Schedule to enable exploration of the professional elements of the Nurse Practitioner role.

Psychometric testing of the abbreviated Clinical Learning Environment Inventory (CLEI-19).

AIM: This paper is a report of a test of the psychometric properties of a 19-item version of the Clinical Learning Environment Inventory. BACKGROUND: Although the clinical learning environment provides the 'real-life' context essential for preparing nursing students for their professional role, the quality of student learning is influenced by the quality of the clinical placement. METHODS: Nursing students completed an abbreviated (19-item) form of the Clinical Learning Environment Inventory to rate their perception of the clinical learning environment. Descriptive statistics, principal component analysis, discriminant validity and Cronbach's alpha reliabilities were computed. RESULTS: Between March and December 2009, 231 online surveys were submitted. The mean age of participants was 30.3 years (sd: 10.4) and 87% were female. All 19 items loaded on two factors, 'Clinical Facilitator Support of Learning' and 'Satisfaction with Clinical Placement', with factor loadings above the 0.4 threshold. Cronbach's alpha coefficient was 0.93 for the total Clinical Learning Environment Inventory-19, with subscales ranging from 0.92 to 0.94. Multiple regression uncovered that participants who engaged in health-related paid work were independently and significantly more positive on the 'Clinical Facilitator Support of Learning' subscale, whereas those who worked >16 hours a week, or allocated the afternoon shift were independently and significantly more negative on the 'Satisfaction with Clinical Placement' subscale. CONCLUSION: Providing an effective and productive clinical experience is vital in preparing nursing students to become competent clinicians. The Clinical Learning Environment Inventory-19 offers a useful measure to explore nursing students' satisfaction with two aspects of this clinical experience--clinical facilitator support of learning and the clinical learning environment.

The effect of Personal Digital Assistants in supporting the development of clinical reasoning in undergraduate nursing students: a systematic review.

BACKGROUND: The objective of this review was to determine whether the use of Personal Digital Assistants (PDAs) would provide greater support in developing undergraduate nursing students' clinical reasoning, in comparison to more traditional resources such as textbooks. SEARCH STRATEGY: The search strategy sought to identify published data from five electronic databases: CINAHL, Medline, Cochrane Library, Meditext and Scopus. Unpublished literature was also sought in digital dissertations, conference proceedings, relevant scholarly websites and reference lists. SELECTION CRITERIA: All undergraduate nursing students were considered eligible for inclusion. Types of interventions considered for this review were inclusive of all forms of PDAs and traditional resources. The research setting of this systematic review reflects the diversity of nursing practice, and includes the classroom, clinical or simulated environment. The process of clinical reasoning was defined by four outcome measures; alterations in theoretical nursing knowledge, clinical skills, problem solving and reflection. ASSESSMENT AND EXTRACTION OF DATA: Studies of potential significance to the review were assessed for methodological quality independently by two reviewers using the Joanna Briggs Institute Meta Analysis of Statistics Assessment and Review Instrument. Authorship of the studies was not concealed from the two reviewers. From the nine studies assessed for quality, only data from four studies were included in the review. RESULTS: Four published studies were included in the systematic review of literature. The designs of the studies included a nonrandomised quasi-experimental design, case control study, comparative descriptive design and a pre test post test mixed method study. Four outcomes were identified by the four included studies. These outcomes addressed possible effects of PDA usage on undergraduate nursing students' practice of medication administration, self-efficacy, anticipation to exercise professional nursing judgment and clinical reasoning.This systematic review provides evidence that the use of PDAs is able to improve nursing students' self-efficacy and accuracy in clinical situations that require direct and context-free answers, such as medication administration, but is not as supportive as textbooks in assisting students to apply this knowledge critically in decision making and problem solving. IMPLICATIONS FOR PRACTICE: The use of PDAs by undergraduate nursing students can improve students' confidence in the often stressful clinical environment. This bears significance in contemporary nursing education where undergraduates are failing to maximise the clinical experience because of insufficient support or guidance from busy clinicians or supervisory staff. From these findings, PDAs are also beneficial in improving the accuracy and efficiency of medication administration in nursing students. However, the application of the knowledge provided by PDAs is not supported to be used critically in its application to decision making and problem solving. Nursing students need to be educated in methods to develop critical analysis in order to use these resources effectively. IMPLICATIONS FOR RESEARCH: This systematic review highlights the poor quantity of literature currently available in nursing and the subsequent need for primary quantitative studies examining the effect of PDAs in developing undergraduate nursing students' clinical reasoning skills.

An innovative model of supportive clinical teaching and learning for undergraduate nursing students: the cluster model.

Students look forward to their clinical practicum to learn within the context of reality nursing. As educators we need to actively develop models of clinical practicum whereby students are supported to engage and learn in the clinical learning environment. The aim of this paper is to describe an innovative model of supportive clinical teaching and learning for undergraduate nursing students as implemented in a large teaching hospital in New South Wales, Australia. The model of supportive clinical teaching and learning situates eight students at a time, across a shift, on one ward, with an experienced registered nurse from the ward specialty, who is employed as the clinical teacher to support nursing students during their one to two week block practicum. Results from written evaluation statements inform the discussion component of the paper for a model that has proved to be successful in this large healthcare facility.

Exploring the information and communication technology competence and confidence of nursing students and their perception of its relevance to clinical practice.

AIM: This paper profiles a study that explored nursing students' information and communication technology competence and confidence. It presents selected findings that focus on students' attitudes towards information and communication technology as an educational methodology and their perceptions of its relevance to clinical practice. BACKGROUND: Information and communication technology is integral to contemporary nursing practice. Development of these skills is important to ensure that graduates are 'work ready' and adequately prepared to practice in increasingly technological healthcare environments. METHODS: This was a mixed methods study. Students (n=971) from three Australian universities were surveyed using an instrument designed specifically for the study, and 24 students participated in focus groups. FINDINGS: The focus group data revealed that a number of students were resistant to the use of information and communication technology as an educational methodology and lacked the requisite skills and confidence to engage successfully with this educational approach. Survey results indicated that 26 per cent of students were unsure about the relevance of information and communication technology to clinical practice and only 50 per cent felt 'very confident' using a computer. CONCLUSION: While the importance of information and communication technology to student's learning and to their preparedness for practice has been established, it is evident that students' motivation is influenced by their level of confidence and competence, and their understanding of the relevance of information and communication technology to their future careers.

Facilitating undergraduate nurses clinical practicum: the lived experience of clinical facilitators.

Clinical practicum experience for undergraduate nurses remains undisputed as an essential component of any program. Exposure to the reality of professional practice and its integration of explicit, with tacit knowledge, is invaluable in producing skilled clinicians. Currently there are many issues that have arisen regarding clinical practice education for undergraduate nurses in Australia including; ongoing financial support and resourcing of clinical placements. Developing an understanding of these issues is central to the provision of quality clinical education. The aim of this study is to reveal dimensions of the lived experience of being a clinical facilitator, a popular model of nursing clinical education, to come to an understanding of how facilitation actually takes place in the clinical environment. The Hermeneutic phenomenological approach used in this study has brought to light five essential themes that elucidate the phenomena of facilitation. Those themes have been identified as; knowing your own limitations, employing the notion of stepping in or stepping back, developing alliances, acknowledging the reciprocity of the learning experience, and identifying appropriate clinical buddies. The recommendations from this study will have an impact on current issues and will inturn, influence the quality of clinical education for all stakeholders.

Essence of caring for a person dying.

The present paper aims to illustrate the essence of caring through the philosophical lens of palliative care gained from one family's experience within a home environment. The narrative used provided a vehicle through which a family member recalled the experience of caring for her mother, who was dying. The essence of caring is portrayed by the use of exemplars gained from the narrative situated within a palliative context depicting both the person dying and the carer's perspective. The narrative offers the opportunity to better understand cultural knowledge, history and social practices from the perspective of the family unit, and to understand how families might be best supported by health professionals engaged in care delivery. The commitment demonstrated by family members in caring for a family member dying is significant and needs to be more valued as a contribution to our understanding of this life event. From the analysis of this family's experience, health professionals are afforded an insight into the diversity of needs that encompass the essence of care being provided in the home. This opportunity allows health professionals to gain further insight into this significant life event, leading to an enhancement of their practice and enabling them to be better equipped to meet the individual needs of family units.