Continue nursing education: an action research study on the implementation of a nursing training program using the Holton Learning Transfer System Inventory.

OBJECTIVE: To address the gap in effective nursing training for quality management, this study aims to implement and assess a nursing training program based on the Holton Learning Transfer System Inventory, utilizing action research to enhance the practicality and effectiveness of training outcomes. METHODS: The study involved the formation of a dedicated training team, with program development informed by an extensive situation analysis and literature review. Key focus areas included motivation to transfer, learning environment, and transfer design. The program was implemented in a structured four-step process: plan, action, observation, reflection. RESULTS: Over a 11-month period, 22 nurses completed 14 h of theoretical training and 18 h of practical training with a 100% attendance rate and 97.75% satisfaction rate. The nursing team successfully led and completed 22 quality improvement projects, attaining a practical level of application. Quality management implementation difficulties, literature review, current situation analysis, cause analysis, formulation of plans, implementation plans, and report writing showed significant improvement and statistical significance after training. CONCLUSION: The study confirms the efficacy of action research guided by Holton's model in significantly enhancing the capabilities of nursing staff in executing quality improvement projects, thereby improving the overall quality of nursing training. Future research should focus on refining the training program through long-term observation, developing a multidimensional evaluation index system, exploring training experiences qualitatively, and investigating the personality characteristics of nurses to enhance training transfer effects.

Justice, Equity, Diversity, Inclusion, and Belonging (JEDI-B) in Transition to Practice Programs.

Justice, equity, diversity, inclusion, and belonging (JEDI-B) are essential for creating safe and productive professional environments. Clear definitions of JEDI-B terms are essential for collective understanding and organizational buy-in. Institutional and transition to practice program efforts should focus on the development of inclusive cultures, diverse curriculum, and data-driven evaluation of JEDI-B policies, processes, and practices. Engagement in bias recognition and the unlearning of those biases is also vital. Despite current legislative challenges, the integration of JEDI-B principles remains a vital component in enhancing health care experiences for patients and fostering inclusive workplaces. [J Contin Educ Nurs. 2024;55(6):273-275.].

Inspiring and Nurturing Human-Centered Leaders: The Vital Role of Mentorship.

Because health care is a relational profession, logic suggests the structures, processes, and outcomes of nursing leadership and mentoring should be strongly grounded in relational concepts. Human-Centered Leadership in Healthcare™ provides an evidence-based, contemporary structure to carry out the vital process of mentoring for future leaders to deliver on patient and team member outcomes. [J Contin Educ Nurs. 2024;55(6):276-278.].

Values and Ethics Domain for Professional Identity in Nursing.

A crucial domain of professional identity in nursing is the area of values and ethics. Comprising a set of core values and principles, values and ethics are used to guide nurse conduct. Professional development specialists can use the nursing code of ethics and organizational structure and examples to teach nurses the values and ethics domain of professional identity in nursing. [J Contin Educ Nurs. 2024;55(6):279-281.].

Enhancing clinical reasoning for management of non-communicable diseases: virtual patient cases as a learning strategy for nurses in primary healthcare centers: a pre-post study design.

BACKGROUND: In Rwanda, nurses manage all primary care at health centres, and therefore are their clinical reasoning skills important. In this study, a web-based software that allows the creation of virtual patient cases (VP cases) has been used for studying the possibility of using VP cases for the continuous professional development of nurses in primary health care in Rwanda. Previous studies in pre-service education have linked VP cases with the enhancement of clinical reasoning, a critical competence for nurses. This study investigated the feasibility of continuous professional development through VP cases to further train in-service nurses in clinical reasoning. METHOD: The study used a pre-post test design. Initially, seventy-six participants completed a questionnaire as part of the pre-test phase, subsequently invited to engage with all four VP cases, and finally responded to the post-test questionnaire evaluating clinical reasoning skills. Fifty-six participants successfully completed the entire study process and were considered in the analysis. The primary outcomes of this study were evaluated using a paired t-test for the statistical analysis. RESULTS: The results show that the mean score of clinical reasoning increased significantly from the pre-test to the post-test for all four illness areas (p < 0.001). The study findings showed no statistically significant difference in participants' scores based on demographic factors, including whether they worked in urban or rural areas.  CONCLUSION AND RECOMMENDATION: Utilizing VP cases appears to significantly enhance the continuous professional development of nurses, fostering a deliberate learning process that enables them to reflect on how they manage cases and, in turn, refine their clinical reasoning skills. This study strongly recommends incorporating VP cases in the continuous professional development of nurses at the primary health level (health centers). This is especially pertinent in a context where nurses are required to perform diagnostic processes similar to those employed by physicians.

Preceptor Development: Using the American Nurses Credentialing Center Outcome-Based Continuing Education Model©.

Preceptors play a vital role in shaping the growth of every nurse. Effective preceptors lead to better patient outcomes as new nurses are better equipped to deliver high-quality care under the guidance of experienced mentors. Providing a supportive preceptor experience increases job satisfaction and retention rates among new and tenured nurses, ultimately benefiting health care organizations. When designing preceptor development programs, health care institutions should incorporate the Outcome-Based Continuing Education Model© (OB-CE Model©) from the American Nurses Credentialing Center. This column explores how to use the OB-CE Model© to enhance the competency and human skills of preceptors as learners, thereby fostering their development effectively. [J Contin Educ Nurs. 2024;55(5):212-216.].

Development of a Collaborative Online International Learning (COIL) Activity.

Global mobility has made global health a priority within nursing curricula and health care organizations. A collaborative online learning activity could promote international perspectives of health care delivery. Including a collaborative online international learning activity in continuing education for practicing nurses is a viable strategy that is consistent with the internationalization at home movement. Use of a qualitative descriptive evaluation approach when teaching prelicen-sure nursing students and educating practicing nurses provides effective international collaboration, promotes a global mindset, and provides an exemplar for professional development specialists to teach practicing nurses. [J Contin Educ Nurs. 2024;55(5):220-223.].

Translating Person-Centered Care Policy Into Practice: A Pre-Post Study of a Work-Based Learning Intervention for Nurses.

BACKGROUND: Person-centered care is critical to quality health care, but difficult to implement. This challenge is attributed to cultural factors derived from group values about work practices. Work-based educational interventions allow nurses to develop shared meanings of practice, in this case, promoting the value of person-centered care. METHOD: A 30-minute, work-based educational intervention incorporating reflection on videorecorded practice scenarios was evaluated with a quasi-experimental pre-post design. Nurses (N = 119) completed a survey, including a subset of 16 items from the Person-Centred Practice Inventory-Staff, before and immediately after the intervention. RESULTS: Nurses' awareness of what patients value about their care, the importance of connecting with the patient, and the value of integrating human elements into actions increased after the intervention. Nurses' perceptions of how they would include patients and their preferences in care decisions did not significantly change. CONCLUSION: Educational techniques that allow nursing teams to reflect on practice may help with implementation of person-centered care. [J Contin Educ Nurs. 2024;55(6):303-308.].

An Innovative Use of the Logic Model for a Qualitative Analysis Framework.

BACKGROUND: Qualitative analysis can be a daunting and time-consuming task for those who are attempting to code qualitative data for the first time. METHOD: This article presents select secondary data analysis from a previously published study to demonstrate the applicability and usefulness of implementing a logic model approach to provide a framework for qualitative analysis. RESULTS: The use of the logic model provided systematic organization during the analysis process, efficiency for analytical tasks, and enhanced trustworthiness by documenting each analysis step. The model allowed for easier visualization of data that facilitated a richer and more focused analysis. CONCLUSION: With qualitative data that are focused on processes or outcomes, implementing a logic model framework to categorize and organize data can be useful and efficient, particularly for a novice analyst whether analyzing qualitative text for quality improvement, evidence-based practice, program evaluation, or formal research. [J Contin Educ Nurs. 2024;55(6):297-301.].

Preceptor Boot Camp: Basic Training for Novice Preceptors.

BACKGROUND: A clinical preceptor (CP) provides the vital link to apply didactic learning in clinical practice for nurse practitioner (NP) students. A nationwide shortage of CPs continues. The goal of this pilot project was to evaluate a model for developing preceptors from the school of nursing alumni that addressed modifiable academic barriers to precepting. METHOD: Six NP alumni from the school of nursing participated in a comprehensive novice CP training program based on Kolb's experiential learning theory and unparalleled faculty support through regularly scheduled contact. Pre- and posttests, site visits, and focus groups were used to assess the participants' progress. RESULTS: Participants' self-reported ability to teach and manage time when working with NP students improved, and 83.9% showed improved knowledge of precepting skills. CONCLUSION: Foundational skills and communication are essential elements to support novice CPs. This support may enhance both student and CP experience as well as increase retention of CPs. [J Contin Educ Nurs. 2024;55(6):283-288.].

Education for Health Care Providers on Implementation of Trauma-Informed Care in Practice.

BACKGROUND: Traumatic experiences can adversely affect a child's health. These effects often continue into adulthood, especially when trauma is not addressed. Although the evidence shows benefits with addressing trauma earlier in life, trauma-informed care of children is underused in primary care. Health care providers (nurses, nurse practitioners, physicians) report gaps in knowledge of trauma-informed care and in their comfort level addressing trauma in primary care. METHOD: This project investigated the use of continuing education sessions to increase health care providers' knowledge and readiness to implement trauma-informed care into their practice. RESULTS: The education sessions improved health care providers' knowledge and comfort with trauma-informed care. CONCLUSION: This intervention improved providers' readiness to implement trauma-informed care into their primary care practice. [J Contin Educ Nurs. 2024;55(5):246-252.].

Nurse Upskilling During Crisis: Collaborating for Continuing Education.

BACKGROUND: As rates of coronavirus disease 2019 (COVID-19) reached pandemic levels in early 2020, the need for intensive care unit (ICU) nurses with mechanical ventilator knowledge increased. In response to the pandemic, hospital systems with limited resources reported moving ICU nurse educators to direct patient care roles and reassigning non-ICU nurses to work in the ICU. With fewer resources to educate non-ICU nurses and many newly assigned nurses reporting feeling unprepared for work in the ICU, the need for an accessible and scalable introduction to ICU nursing became clear. METHOD: Our team responded by creating a free, online, self-paced, asynchronous course introducing the ICU nursing setting. RESULTS: More than 4,000 learners worldwide have enrolled in the course, with 94% of survey respondents expecting the course to positively impact their institution. CONCLUSION: Our project shows an approach to effective collaboration among clinical partners, instructional designers, and nursing experts to address critical needs in continuing education in nursing. [J Contin Educ Nurs. 2024;55(5):257-260.].

Supporting Nurse Professional Development Practitioners Through an Academic-Practice Pilot Initiative.

BACKGROUND: Nurse professional development practitioners (NPDPs) support licensed nurses as they transition into practice. The NPDPs themselves benefit from opportunities to grow professionally in their role as educators. METHOD: A nursing school and hospital leadership pilot initiative was conducted to support staff development for NPDPs at a Midwestern health system. Four sessions were developed by academic educators and presented to NPDPs: educational theory, backward curricular design, active learning strategies, and assessment and evaluation principles. RESULTS: The NPDPs who attended the seminar indicated that the program objectives were met and identified at least one change they planned to make in planning, course design, or evaluation. In addition, they requested future professional development opportunities. Planning and implementation of this pilot educational seminar provided valuable content for NPDPs. CONCLUSION: This pilot model can strengthen academic-practice partnerships and support ongoing staff development. [J Contin Educ Nurs. 2024;55(5):253-256.].

How Implementing a Digital Competency Management System Reduced Nurse Training Cost and Improved NPD Practitioner Satisfaction in a Pediatric Hospital.

BACKGROUND: Traditional competency evaluations and manual tracking created a problem within one organization. Subjective competency assessments and inconsistent recordkeeping resulted in increased organizational costs. These factors increased the workload of nursing professional development (NPD) practitioners, leading to job dissatisfaction and turnover. METHOD: The project lead evaluated how implementing a digital competency management system (CMS) affected nurse training costs and assessed NPD practitioners' satisfaction after the digital CMS conversion. RESULTS: A cost analysis compared training costs before and after implementation of a digital CMS. A pre- and postsurvey compared NPD practitioners' satisfaction before and after digital implementation. A digital CMS provided a centralized repository and educational platform, which saved $500,000 in training costs and increased NPD practitioners' job satisfaction by decreasing workload and creating meaningful mechanisms to accurately assess staff knowledge and skills. CONCLUSION: The NPD practitioners showed tangible outcome measures and return on investment by combining adult learning and technology. [J Contin Educ Nurs. 2024;55(5):239-245.].

Finding Your Voice: A Large-Scale Nursing Training in Speaking up and Listening Skills.

BACKGROUND: Training in speaking up skills for nursing professionals provides the groundwork for promoting a culture of curiosity and inquiry. At the foundation of speaking up is psychological safety for team members to disagree, offer alternative ideas, and ask questions. METHOD: A large-scale training session, Finding Your Voice: Speaking Up & Listening Skills, was designed and delivered to 1,306 nurses at an academic medical center. RESULTS: Most participants reported that the session met the training goals (97%). There was an increase in participants' confidence in speaking up (pretraining 69% ± 19%; posttraining 73% ± 15%; p < .0001), and listening (pretraining 68% ± 19%; post-training 74% ± 15%; p < .0001). Leaders showed greater increases in confidence in listening and responding to nurses speaking up (leaders 5.6% vs. nonleaders 4.2%, p < .00001). CONCLUSION: Nurses benefited from an interactive educational experience by practicing strategies for speaking up and listening. [J Contin Educ Nurs. 2024;55(6):309-316.].

GridlockED as an Intervention for Nurses (GAAIN) Study.

BACKGROUND: GridlockED (The Game Crafter, LLC) is a serious game that was developed to teach challenges that face nursing and medical professionals in the emergency department (ED). However, few studies have explored nurses' perceptions of the utility, fidelity, acceptability, and applicability of the serious game modality. This study examined how ED nurses view GridlockED as a continuing education platform. METHOD: This single-center observational study explored how nurses engage with and respond to Grid-lockED. The convenience sample included participants recruited from a local continuing nursing education day. Participants completed a presurvey, engaged in a full game play session with the GridlockED game for approximately 45 minutes, and immediately completed a post-game play survey. RESULTS: Of the 48 participants (11 male, 37 female; 44 of 48 were RNs), most (91%) agreed that the workflow reflected in the game was equivalent to the flow in a typical ED. Almost all (96%) found the cases in the game reflective of real ED patients, and most (92%) found the game a useful educational tool to prepare new nurses to transition into the ED environment. CONCLUSION: The GridlockED game shows potential as a serious game to support nursing education, particularly for new ED nurse orientation and transition to ED practice. [J Contin Educ Nurs. 2024;55(5):231-238.].

Time Is Survival: Continuing Education on Sepsis for Neurosurgical Critical Care Nurses.

BACKGROUND: Early identification of sepsis among neurosurgical critical care patients is a significant challenge because of the many possible confounding variables that lead to altered mental status in this specific patient population. Nurses' knowledge, attitudes, confidence, and practices related to the early identification and management of sepsis are crucial to patients' survival. METHOD: This evidence-based intervention project implemented continuing education for neurosurgical critical care nurses on the early signs and symptoms of sepsis and the management of sepsis according to the Surviving Sepsis Campaign (SSC) Guidelines. RESULTS: Continuing education on sepsis increased neurosurgical critical care nurses' knowledge of the SSC 1-hour sepsis bundle, reported confidence in the management of sepsis, and likelihood of assessing for sepsis. CONCLUSION: Continuing education for neurosurgical critical care nurses on the signs and symptoms of sepsis and the SSC Guidelines is necessary and may improve patient outcomes. [J Contin Educ Nurs. 2024;55(5):224-230.].

Preparing for patients with high-consequence infectious diseases: Example of a high-level isolation unit.

INTRODUCTION: Patients with high-consequence infectious diseases (HCID) are rare in Western Europe. However, high-level isolation units (HLIU) must always be prepared for patient admission. Case fatality rates of HCID can be reduced by providing optimal intensive care management. We here describe a single centre's preparation, its embedding in the national context and the challenges we faced during the severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2) pandemic. METHODS: Ten team leaders organize monthly whole day trainings for a team of doctors and nurses from the HLIU focusing on intensive care medicine. Impact and relevance of training are assessed by a questionnaire and a perception survey, respectively. Furthermore, yearly exercises with several partner institutions are performed to cover different real-life scenarios. Exercises are evaluated by internal and external observers. Both training sessions and exercises are accompanied by intense feedback. RESULTS: From May 2017 monthly training sessions were held with a two-month and a seven-month break due to the first and second wave of the SARS-CoV-2 pandemic, respectively. Agreement with the statements of the questionnaire was higher after training compared to before training indicating a positive effect of training sessions on competence. Participants rated joint trainings for nurses and doctors at regular intervals as important. Numerous issues with potential for improvement were identified during post processing of exercises. Action plans for their improvement were drafted and as of now mostly implemented. The network of the permanent working group of competence and treatment centres for HCID (Ständiger Arbeitskreis der Kompetenz- und Behandlungszentren für Krankheiten durch hochpathogene Erreger (STAKOB)) at the Robert Koch-Institute (RKI) was strengthened throughout the SARS-CoV-2 pandemic. DISCUSSION: Adequate preparation for the admission of patients with HCID is challenging. We show that joint regular trainings of doctors and nurses are appreciated and that training sessions may improve perceived skills. We also show that real-life scenario exercises may reveal additional deficits, which cannot be easily disclosed in training sessions. Although the SARS-CoV-2 pandemic interfered with our activities the enhanced cooperation among German HLIU during the pandemic ensured constant readiness for the admission of HCID patients to our or to collaborating HLIU. This is a single centre's experience, which may not be generalized to other centres. However, we believe that our work may address aspects that should be considered when preparing a unit for the admission of patients with HCID. These may then be adapted to the local situations.