The threshold of rural placement frequency and duration: A repeated cross-sectional study examining rural career aspirations among student nurses.

AIM: This study aimed to explore what changes rural placement had on the perceptions of nursing students and the impact of placement frequency and duration on student considerations for rural practice. BACKGROUND: A strong rural healthcare workforce is a global concern and has led countries to look for creative ways to address this challenge. One approach is to train more health professionals, however, nursing students who grew up or lived in metropolitan or urbanised areas are suggested to be less inclined to pursue a rural career. As such it is posited that recurrent exposure to rural settings may exert a positive impact on future intention for rural practice. However, there is a need to explore the specific thresholds related to both the frequency and duration of rural placement exposure, as well as the cumulative impact multiple rural placements may have on the intention to engage in rural practice. DESIGN: A repeated cross-sectional design. METHODS: All nursing students from an Australian regional university were invited to complete an online questionnaire between 2019 and 2023. Demographic and placement specific questions were included. A modified version of the Nursing Community Apgar tool also measured the importance of key variables in rural career decision-making. Data were analysed using independent sample t-tests and one-way ANOVAs. Significance was determined at two-tailed p≤.05. RESULTS: Among the 835 respondents (response rate 15.4%), the average number and duration of rural placements was 2.45 placements and 3.01 weeks respectively. Rural placements did not have an impact on students who resided rurally or regionally. However, among metropolitan students who had experienced more than three rural placements, or more than sixteen cumulative weeks of placement, were significantly more likely to consider rural employment. Greater number of rural placements and longer cumulative duration had the greatest impact. CONCLUSION: Issues related to the nursing rural workforce are dynamic and complex. Understanding the unique drivers that improve the rural experiences among students, particularly metropolitan students, can have an impact on decision-making to pursue employment in rural environments. Importantly, whilst professional and clinical motivation and experiences are influential factors, the socialisation, environment and community features are essential elements that influence students' decisions to pursue a career in rural practice. Undertaking a nuanced approach that facilitates rural practice understanding among students may help shape future employment decision-making.

Mixed Methods Study Integration: Nursing student experiences and opinions of intentional rounding.

AIMS: To explore pre-registration nursing students' understandings and experience of intentional rounding in education and clinical sectors. Intentional rounding is a patient safety intervention used in clinical settings to regularly check and document patients' welfare and environment throughout the course of a shift. DESIGN: An explanatory sequential mixed methods design using convenience sampling was used for this study, with an underlying pragmatic paradigm. Integration occurred in the design, methods, implementation and reporting phases of the study. METHODS: Data were collected between August 2017 and August 2018 using a previously validated Nursing Perceptions of Patient Rounding quantitative online survey followed by individual qualitative interviews using the same cohort. RESULTS: Using the Pillar Integration Process, this paper displays and discusses the final results. The integration and mixing throughout the study generated insights into the perceived benefits of intentional rounding for nursing students and patients but also indicated a theory-practice gap that affects nursing students' confidence in undertaking this intervention. CONCLUSION: Students find this patient safety intervention helpful, but further clarity in the education surrounding it is required. IMPACT: This study addresses pre-registration nursing students' understanding and perceptions of intentional rounding. Intentional rounding benefits nursing students as a patient safety strategy and organization tool. Educational opportunities around the topic could be enhanced, reducing the ongoing theory-practice gap. Clinicians, academics and educators who support pre-registration nursing students in clinical and tertiary education settings can benefit from this work.

Intentional rounding - An integrative literature review.

AIMS: To establish current knowledge about the efficacy and acceptance of intentional rounding in current practice, from the perspective of nurses, patients, patient satisfaction and safety indicators. BACKGROUND: Intentional rounding is a formal means of nursing staff checking care needs of patients in hospital settings on a regular basis. DESIGN: An integrative literature review conducted following the Joanna Briggs Institute manual. DATA SOURCES: A literature search from 2000 - 2017 was conducted using the following electronic databases: The Cumulative Index to Nursing and Allied Health Literature, ProQuest, PubMed, Informit, Sage and Scopus. REVIEW METHODS: Articles were assessed for quality and rigor using the Critical Appraisal Skills Program tool and the Effective Public Health Practice Project Quality Assessment tool for Quantitative Studies. A sequential explanatory mixed studies approach was used to combine qualitative and quantitative evidence in a single review. In-depth parallel reviews of the quantitative and qualitative evidence were undertaken, and then a synthesis of the combined qualitative and quantitative evidence conducted. RESULTS: Intentional rounding has positive outcomes on patient satisfaction and safety. Nurses perceive benefits related to intentional rounding; however, some nurses perceive it as an additional, unnecessary task. The effectiveness of intentional rounding is influenced by external factors including leadership and formal rounding education, workload, ward layout, staffing and experience level. CONCLUSION: Intentional rounding is a positive intervention in patient safety and satisfaction generally, but needs further research and consideration about actual impact, staff delegation, education and engagement, student nurse involvement, documentation and specializing the structure of intentional rounding.