Past, Present and Future: Perspectives on an Oral History of Intellectual Disability Nursing.

Thirty-one participants engaged in this oral history research study aimed at exploring the lived experience of intellectual disability nurses and healthcare assistants' knowledge of the trajectory of intellectual disability nursing over the last 30 years in the Republic of Ireland and England. This paper documents some of these experiences offering perspectives on intellectual disability nursing and what is important for the future. Findings from Ireland consider the nature of intellectual disability services and the registered nurse in intellectual disability. Findings from England focus on opportunities and restrictions in intellectual disability nursing, shared visions, the changing context within which work took place and also the internal and external supports that impacted their roles. It is evident that intellectual disability nurses must be responsive to the changing landscape of service provision and also the requirements for contemporary new roles to meet the changing needs of people with intellectual disabilities.

Patient-reported experiences of consultation with an advanced nurse practitioner: Factor structure and reliability analysis of the patient enablement and satisfaction survey.

AIM: The aim was to analyse the psychometric properties of a patient-reported-experience measure, the Patient Enablement and Satisfaction Survey (PESS), when used to evaluate the care provided by Advanced Nurse Practitioners (ANPs) in terms of factor structure and internal consistency. The PESS is a 20-item, patient-completed data collection tool that was originally developed to measure patient experience and enablement following consultation with nurses in general practice. DESIGN: Cross-sectional survey; validity and reliability analysis. METHODS: The sample in this study consisted of 178 patients who consulted with 26 ANPs working in four different specialities. Data were collected between June and December 2019. An exploratory factor analysis of the PESS was conducted to determine convergent validity which was supported by parallel analysis and the traditional Kaiser criterion. The internal consistency of individual PESS items was determined via Cronbach's alpha, McDonald's omega, the Average Variance Extracted tests and item-subscale/total score correlations. RESULTS: A three-factor structure (PESS-ANP) was found through exploratory factor analysis and this was supported by parallel analysis, the traditional Kaiser criterion and the percentage of variance explained criterion. A high degree of internal consistency was reported across all factors. One question was omitted from the analysis ('Overall Satisfaction') following the identification of problematic cross-loadings. The three factor solution was identified as: patient satisfaction, quality of care provision and patient enablement. CONCLUSION: The findings of this study propose a three-factor model that is sufficiently reliable for analysing the experience and enablement of patients following consultation with an ANP. IMPACT: Increasingly, patient-reported experience measures are being used to evaluate patients' experience of receiving care from a healthcare professional. The PESS was identified to be reliable in evaluating the experience of patients who receive care from an ANP while a three-factor structure was proposed that can capture specific attributes of this care.

An evaluation of the drug calculation skills of registered nurses.

Mathematical skill and proficiency underpin a number of nursing activities, with the most common application being in relation to drug dosage calculation and administration. Medication errors have been identified as the most common type of error affecting patient safety and the most common single preventable cause of adverse events and they can occur as a result of mathematical calculation error and or conceptual error. The purpose of this study was to evaluate the drug calculation skills of registered nurses (n = 124) on commencement of employment. The findings of this study indicate that there are inconsistencies in the amount of pharmacology content and drug calculation skills delivered within nursing curricula. The most frequent type of drug calculation errors are attributed to conceptual errors and participants identified ward based education on drug calculation as a pathway for improving the drug calculation skills of registered nurses. The study recommends that medication education, encompassing mathematical and conceptual drug calculation skills should be identified as a distinct competency in nursing curricula and continuing education programme.

Developing skills for teaching: reflections on the lecture as a learning tool for the novice midwife educator.

This paper explored how I, as a novice midwife educator in a Higher Education Institution, utilised my reflections on the preparation, delivery and evaluation of a lecture to develop my teaching skills. My personal teaching and learning philosophy was informed by humanism. Reflecting on my teaching and learning philosophy, and the teaching and learning theories that guided the session, enabled me to identify aspects of my teaching that required further development. Similarly, the process permitted me to recognise positive aspects that I could take forward and build upon in my professional development as an educator. The key learning for me as a novice educator is outlined, with an emphasis placed on preparation and strategic question formulation.

Undergraduate nursing students' learning styles: a longitudinal study.

This paper reports on the main findings of a longitudinal study of the learning styles of one cohort of undergraduate pre-registration nursing students at an Irish university. The Honey and Mumford (2000a) Learning Styles Questionnaire was administered to a sample of students in their first (n=202) and final year of study (n=166), the final sample number (58) was based on matched pairs. The most common dominant learning style in first year was the dual learning category (35%) while a large proportion of the students (53%) in their final year had no dominant learning style. The preferred learning style of students in their first (69%) and final (57%) year was reflector. Learning styles were significantly different at the two time points and there was a significant relationship between some learning styles and students' age but not with academic achievement. Total scores of all learning styles showed significant improvements across the two time points of the study. An important implication for nurse education practice is the need for nurse educators to be aware of students' learning styles and in an attempt to maximise students' learning potential, utilise a range of teaching and learning methodologies and assessments that develop all learning styles.

A literature review of the individual and systems factors that contribute to medication errors in nursing practice.

AIM: This paper reports a review of the empirical literature on factors that contribute to medication errors. BACKGROUND: Medication errors are a significant cause of morbidity and mortality in hospitalized patients. This creates an imperative to reduce medication errors to deliver safe and ethical care to patients. METHOD: The databases CINAHL, PubMed, Science Direct and Synergy were searched from 1988 to 2007 using the keywords medication errors, medication management, medication reconciliation, medication knowledge and mathematical skills, and reporting medication errors. RESULTS Contributory factors to nursing medication errors are manifold, and include both individual and systems issues. These include medication reconciliation, the types of drug distribution system, the quality of prescriptions, and deviation from procedures including distractions during administration, excessive workloads, and nurse's knowledge of medications. IMPLICATIONS FOR NURSING MANAGEMENT: It is imperative that managers implement strategies to reduce medication errors including the establishment of reporting mechanisms at international and national levels to include the evaluation and audit of practice at a local level. Systematic approaches to medication reconciliation can also reduce medication error significantly. Promoting consistency between health care professionals as to what constitutes medication error will contribute to increased accuracy and compliance in reporting of medication errors, thereby informing health care policies aimed at reducing the occurrence of medication errors. Acquisition and maintenance of mathematical competency for nurses in practice is an important issue in the prevention of medication error. The health care industry can benefit from learning from other high-risk industries such as aviation in the prevention and management of systems errors.

Adverse events in health care: a literature review.

AIM: This paper aims to develop understanding of the nature, costs and strategies to reduce or prevent a range of adverse events experienced by people within the health care system. BACKGROUND: Care interventions are not always based on safe practice and adverse events can and do occur that cause or place at risk patients lives and well-being. The nature of adverse events is diverse and can be attributed to a multitude of individual and system contributory factors and causes. EVALUATION: A review of the literature was undertaken in 2006 and 2007 using the following databases: Pubmed, CINAHL, Biomed Ovid, Synergy and the British Nursing Index. This paper evaluates the literature that pertains to adverse events and seeks understanding of this complex issue. KEY ISSUES: Published statistics confirm that globally, professional errors in clinical practice and care delivery occur at an unacceptably high level and result in considerable human and financial consequences. CONCLUSION: Reaching understanding of the multiple factors that contribute to unsafe clinical practice situations requires a cultural shift in organizations. IMPLICATION FOR NURSING MANAGEMENT: Reasons for adverse events are complex and require healthcare managers to evaluate the system issues which impact on the delivery and organization of care.

The mature student question.

Demographic changes resulting in an increase of mature students on to pre-registration nursing programmes within our university has lead to the development of a welcoming programme for pre-registration mature nursing students. Three questionnaires were utilised in the development and evaluation of the welcoming programme. Each questionnaire had open ended questions which were thematically collated and summarised. The closed questions were computer analysed to derive simple descriptive statistics. The main components of the welcoming programme were socialisation of the individual to university life and study skills. The study found that there was a small significant difference between the needs of mature students and of standard entry students in relation to information about the nursing course, study skills and time management. The students who participated in the welcoming programme progressed a little better on the nursing course. Students' recommendations for further development of the programme included, additional study and IT skills and an introduction to subject areas on the nursing course. If we are to continue to recruit mature students on to our nursing courses we need to ensure that supports are in place to facilitate the mature student prior to and during their nursing course.