An Integrative Review of Response Rates in Nursing Research Utilizing Online Surveys.

BACKGROUND: Online surveys in nursing research have both advantages and disadvantages. Reaching a sample and attaining an appropriate response rate is an ongoing challenge and necessitates careful consideration when designing a nursing research study using an online survey approach. OBJECTIVE: In this study, we aimed to explore response rates and survey characteristics of studies by nurse researchers that used online methodologies to survey nurses, nursing students, and nursing faculty. METHODS: We conducted an integrative review of research studies that used online surveys for data collection published from 2011 to 2021. We examined response rates and survey characteristics such as recruitment method, use of incentives, question type, length of survey, time to complete the survey, and use of reminders. RESULTS: Our review included 51 studies published by nurses with target samples of nurses, nursing students, or nursing faculty. Study sample sizes ranged from 48 to 29,283, the number of respondents ranged from 29 to 3,607, and the response rates ranged from 3.4% to 98%, with an average of 42.46%. Few patterns emerged regarding recruitment or other factors to enhance response rates; only five studies used incentives. CONCLUSION: Response rates to online surveys are unlikely to reach the rates seen in older mailed surveys. Researchers need to design online survey studies to be easily accessible, concise, and appealing to participants.

Introducing Nursing Students to Pastoral Care Providers Via Simulation.

ABSTRACT: During a mock code simulation scenario in a medical-surgical undergraduate nursing course, two priests as pastoral care providers were included as interprofessional team members. Perceptions of the inclusion of pastoral care in an end-of-life simulation were assessed as part of a mixed-method study that included a qualitative analysis of debriefing sessions. Students reported an increase in awareness of the role of pastoral care in healthcare and learned to consider the spiritual aspects of end-of-life care. Participation of priests in an end-of-life simulation enhanced students' learning of spirituality as an aspect of nursing care.

Psychometric Testing of the Preceptor Self-Assessment Tool (PSAT)-40 for Nursing Preceptors.

Background The aim of this study was to complete the third phase of development of the Preceptor Self-Assessment Tool (PSAT). Method Psychometric testing was conducted via an online Qualtrics survey with a statewide sample of 320 nurse preceptors from July to September 2020. Exploratory factor analysis and internal consistency and scale reliability testing were conducted on the 64-item PSAT. Results Exploratory factor analysis identified three factors: (1) inter/intrapersonal skills and attitudes, (2) knowledge and understanding, and (3) administrative resources and support. Cronbach's alpha values for the PSAT-40 ranged from 0.978 to 0.998. Final scale reliability was excellent at 0.983. Conclusion The Preceptor Self-Assessment Tool, now in its final form as the PSAT-40, has established construct validity and reliability and can be used to assess competency as a preceptor. Nurse educators can use this instrument to assess the needs of nurse preceptors and develop strategic nursing preceptor education programs. [J Contin Educ Nurs. 2022;53(11):491-499.].

A Longitudinal View of Perceptions of Entering Nursing Practice During the COVID-19 Pandemic.

Background The COVID-19 pandemic significantly changed the landscape of health care and transition to practice for new graduates. The purpose of this pilot study was to explore the effects of the pandemic on the first-year experience of new nurses. Method A longitudinal, observational, descriptive study design was used. One hundred eighteen survey links were sent to new bachelor of science in nursing graduates from June 2020 to May 2021, with 56 responses to the first survey. Results Participants indicated the COVID-19 pandemic negatively affected the new graduate experience, resulted in concern for personal health and safety, and negatively altered preparation for the first year in practice. However, desire to be a nurse and view of nursing remained positive. Conclusion The first year in practice is stressful and challenging. The pandemic posed additional challenges to employers and new graduates. Future research should explore the long-term impact of the pandemic on an already strained nursing workforce. [J Contin Educ Nurs. 2022;53(6):256-263.].

The quest for workload equity in nurse faculty teaching.

BACKGROUND: While nurse faculty may believe that they teach more than faculty in other academic departments, their perceptions are difficult to corroborate when workload policies are not transparent at institutions. PURPOSE: This descriptive study was designed to examine inequities in teaching workloads between nurse faculty and their academic colleagues from the perspectives of Deans and Directors of Nursing Programs. METHODS: A web-based, investigator-developed survey was emailed to Nurse Unit Leaders in spring, 2019. The final sample included 224 respondents. Data were analyzed with descriptive statistics. FINDINGS: Nurse Unit Leaders perceived that nurse faculty teach larger classes and more courses than their academic peers. Survey respondents attributed these and other variations at their institutions to the complexity of teaching responsibilities in nursing units and the limited understanding of these responsibilities by university administrators. DISCUSSION: Ensuring equitable teaching workloads requires transparent policies and an organizational culture committed to faculty governance.

Development of the Preceptor Self-Assessment Tool and Use of the Content Validity Index.

BACKGROUND: Competency of staff nurse preceptors is an essential factor that determines the success of preceptorship experiences. Competency assessment is complex, and no self-assessment tool exists. METHOD: This article describes phase two of the development of the Preceptor Self-Assessment Tool (PSAT). A content validity index (CVI) survey was completed by 11 subject matter experts to determine relevance of items on the PSAT. RESULTS: The Scale-Level CVI (S-CVI) for the instrument was 0.91, and the items CVI ranged from 0.45 to 1.0; most were above 0.78. One item was dropped and three were collapsed, leaving the final number of items at 64. CONCLUSION: The items on the PSAT have undergone content validity and have been found to be highly relevant. Pilot testing in a large sample of preceptors is warranted to further refine the items on the tool. [J Contin Educ Nurs. 2020;51(10):469-476.].

A clinical nurse leader competency framework: Concept mapping competencies across policy documents.

To ensure Clinical Nurse Leaders (CNL) are prepared to function to the full scope of their master's level education, the American Association of Colleges of Nursing published a 2007 White Paper and a 2013 update articulating expected end-of-education and CNL practice competencies. The Commission on Nurse Certification published a CNL job analysis in 2016, which identified a core set of knowledge, skills, and abilities for entry-level practicing CNLs, as the basis for the CNL certification exam. While all share core themes, the language and organization of competencies differs across the three policy documents, resulting in potential ambiguity about expected CNL knowledge and practices, and how they differ from other nursing roles. This effort identified, analyzed and synthesized CNL education and practice concepts listed in each document to refine understanding about CNL competencies and harmonize concepts across documents. The product of this effort is a cohesive CNL competency framework that aligns across the education-to-practice trajectory. The CNL competency framework can be used to guide CNL curriculum and certification review, and may have use in implementing and evaluating CNL practice integration.

Perceptions of nurse preceptors of students and new graduates with learning difficulties and their willingness to precept them in clinical practice (Part 2).

The aim of this study was to describe the perceptions of nurse preceptors of nursing students and new graduate nurses with learning disabilities in clinical settings. Learning disabilities pose potential challenges in nursing education, especially in clinical settings when working with preceptors. Preceptors (N = 166) who attended a state-wide preceptor workshop responded to an electronic survey that assessed their perceptions. Four concepts were explored: preceptor perceived level of preparedness; preceptor perceived confidence in implementation of their role; preceptor beliefs regarding the potential of learners with learning disabilities; and preceptor agreement with provision of accommodations for learners with learning disabilities. Preceptors felt unprepared and lacked confidence in their ability to implement their role as preceptor for those with learning disabilities. Those who had exposure to learning disabilities reported feeling more prepared, however they had expectations for the learner to work hard, have strategies and accommodations in place, ask for help when needed, and take responsibility for their learning. Preceptors reported they are willing to precept nurses with learning disabilities, and they expect support for those with learning disabilities. Educational modules and support to increase preceptor preparedness and confidence should be incorporated into preceptor training.

Experiences of Master's Prepared Clinical Nurse Leaders at Three Years Post-Graduation.

Direct Entry Master of Science in Nursing programs that incorporate Clinical Nurse Leader (CNL) education are relatively new in the United States. Little is known about the transition to practice experience of Master's prepared CNL graduates. This evaluation explored how Direct Entry Master of Science in Nursing CNL graduates perceived their transition to practice experience three years post-graduation. All graduates (n = 21) of an inaugural Direct Entry CNL program were invited to be interviewed 3 years after graduation; 16 (76%) opted to participate. Major findings from the semi-structured interviews included educational satisfaction, challenges in transition to practice, uneven use of CNL education, and anxiety about student debt. Satisfaction with their education and their early application of leadership skills were overshadowed by their frustrations with student debt and the preponderance of bullying experienced in the workplace.

Advocating for Early-Career Nurse Innovators: Modeling the Institute of Medicine Report.

The Future of Nursing: Leading Change, Advancing Health was published by the of Medicine (IOM) of the National Academies in 2011. The Missouri Nurses Foundation and Missouri nurses modeled a sustainable project, the Early Career Nurse Innovator Project, exemplifying the intent of that report. The Missouri Nurses Foundation Executive Board comprises experienced nurses, nurse educators, nurses in other leadership roles, retired nurses, public members of the board, and administrative support staff. This article describes a project that was developed, implemented, and evaluated to recognize and encourage early-career nurses who have designed and led innovations to improve and promote the health of Missourians. Five of these early-career nurses were the recipients of monetary awards to encourage future innovations; the second recognition cycle is in the planning phase. Through the work of the Missouri Nurses Foundation, the scholarship of bedside nurses was recognized.

Clinical education of nursing students with learning difficulties: An integrative review (part 1).

Schools of Nursing have witnessed an increase in the number of nursing students who struggle with learning difficulties. Support and accommodations are available in academic settings. Because nursing is a practice profession students also learn in clinical settings, which may not have similar support and accommodations. The compatibility of the clinical setting for the education of students with learning difficulties has not been studied. Staff nurses responsible for the clinical education of students and new nurses receive little preparation for their role as educator, and may not feel supported to meet the needs of those with learning difficulties. This is part one in a series of articles about the clinical education of nursing students with learning difficulties. This paper provides a framework and literature review for the development of a study (part 2) exploring the issue from the perspective of the nurse preceptors who educate students and new graduates with learning difficulties.

Preceptors' Perception of Role Competency.

BACKGROUND: Many variables contribute to the success of nursing students and new nurses in their transition to practice. Clinical orientation and training usually falls to staff nurse preceptors. Inherent in this dynamic is the assumption that staff nurses are prepared and able to assume this responsibility. Ideal characteristics and attributes of preceptor competency have not been conclusively defined. METHOD: This qualitative study explored the defining attributes of preceptor role competency as described by preceptors who attended one of 44 continuing education preceptor academies over 9 years in Missouri. RESULTS: Analysis revealed that communication, expertise, flexibility, evaluation skills, and patience are among the most important competencies of nurse preceptors. CONCLUSION: Understanding role expectations would benefit both preceptors and nurse educators who select, train, and support nurse preceptors. Identification of essential preceptor competencies can inform preceptor preparation courses and identify needs for continuing education of preceptors. J Contin Educ Nurs. 2018;49(5):233-240.

Review of State Boards of Nursing Rules and Regulations for Nurse Preceptors.

BACKGROUND: The clinical education of undergraduate nursing students relies heavily on the use of staff nurses who assume the preceptor role. The best and most efficient utilization of preceptors is unknown. METHOD: This study reviewed Board of Nursing rules and regulations for all 50 states, the District of Columbia, and the U.S. territories for their published requirements regarding preceptors. Specifically, this review focused on preceptor-student and faculty-student ratios, role responsibilities, and requirements of preceptors and faculty in undergraduate precepted clinical experiences. RESULTS: Although some commonalities were noted, such as eligibility (RN licensure), degree requirements (baccalaureate), and years of experience (1 to 3), 11 states had no documented regulations. The existing documents appear to lack depth, specificity, and consistency. CONCLUSION: Because preceptors are utilized to such a great extent, the eligibility, selection, preparation, and expectations of preceptors and faculty who work with them should be more explicit. [J Nurs Educ. 2018;57(3):134-141.].

The Certified Clinical Nurse Leader in Critical Care.

Challenges of the current health system in the United States call for collaboration of health care professionals, careful utilization of resources, and greater efficiency of system processes. Innovations to the delivery of care include the introduction of the clinical nurse leader role to provide leadership at the point of care, where it is needed most. Clinical nurse leaders have demonstrated their ability to address needed changes and implement improvements in processes that impact the efficiency and quality of patient care across the continuum and in a variety of settings, including critical care. This article describes the role of the certified clinical nurse leader, their education and skill set, and outlines outcomes that have been realized by their efforts. Specific examples of how clinical nurse leaders impact critical care nursing are discussed.

Aging muscles and joints: mobilization.

Critical illness can impose immobility in older patients, resulting in loss of strength and functional ability. Many factors contribute to immobility, including patients' medical conditions, medical devices and equipment, nutrition, use of restraint, and staff priorities. Early mobilization reduces the impact of immobility and improves outcomes for older patients. Several important components make up successful mobility programs, including good patient assessment, a core set of interventions, and use of the interprofessional health care team. Nurses can lead in improving the mobilization of older critical care patients, thus reducing clinical risk in this vulnerable population.

Development of an online orientation course for preceptors in a dedicated education unit program.

The dedicated education unit (DEU) is an emerging model of nursing education. Instead of an instructor-led clinical group, students are partnered with a unit staff nurse for precepted learning. These experiences in learning typically begin with early clinical courses. Precepting nursing students in a DEU is different from precepting newly hired staff nurses and traditional clinical students. This article describes the DEU model implemented at one university, the challenges associated with preparing staff nurses to precept nursing students, the development of a face-to-face DEU preceptor orientation, and progression to an innovative online orientation course.