Implementing an acuity-adaptable care model in a rural hospital setting.

OBJECTIVE: This study examined the effects of an acuity-adaptable care model in a rural hospital setting on nurse satisfaction, patient satisfaction, patient safety, and quality indicators (events, falls, and medication errors), patient length of stay (LOS), and worked hours per patient-day (WHPPD). BACKGROUND: Acuity-adaptable care models have been implemented as a nursing strategy to improve workflow through the elimination of unit-to-unit patient handoffs. However, to our knowledge, this model of care has not been studied in a rural hospital setting. METHODS: A descriptive, comparative design with repeated measures was utilized for this study. A professional nurse survey was created to measure staff satisfaction; separate t tests for percentages were utilized to evaluate patient satisfaction and patient safety/quality indicators. Financial data were examined to perform the analysis of patient LOS and WHPPD. RESULTS: The nurse satisfaction survey demonstrated a decrease in weekly floating and cancellations due to low census. There was a statistically significant improvement in patient satisfaction for overall rating and willingness to recommend the hospital. No significant difference was noted in patient quality indicators or LOS; however, there was a favorable trend for all events and medication errors. This study also found a decrease in WHPPD, with a corresponding salary expense reduction reported. CONCLUSION: Acuity-adaptable units may be a viable strategy for rural facilities.

Oh, the things you will learn: taking undergraduate research to the homeless shelter.

Teaching research to undergraduate students has been described as a challenge. This article describes how a small group of students participated in a service-learning research project that culminated in the development of an educational intervention for volunteers who staff homeless shelters in the local community. By interacting with the homeless population and the volunteer staff who provide their care, students developed a greater understanding of the needs of the homeless, recognized some mental health disorders, and interacted with volunteer staff to assess their educational needs. Students were able to learn the research process through their participation in this collaborative project. The students' learning exceeded typical outcomes, as they displayed leadership skills and advocacy in areas of social justice and made compassionate connections with this vulnerable population. These students also forged new territory for future students who will be working with homeless populations and those who minister to them.

Reclaiming the essence of nursing: the meaning of an immersion experience in Honduras for RN to bachelor of science students.

Cultural immersion experiences incorporated in baccalaureate nursing programs have yielded positive short- and long-term effects on the personal and professional lives of the participants. Despite this evidence, little is known about how immersion experiences affect the RN student returning to school. The purpose of this phenomenological study was to uncover the meaning of a week-long immersion in Honduras for RN students (N = 8) and its impact on their professional practice upon return from Honduras. Data were analyzed through reflective journals and two focus groups conducted postimmersion experience. Transcripts were analyzed, and four themes emerged: from the outside looking in, struggling with dissonance, searching for meaning, and from the inside looking out. These themes combined to form the essence of the meaning of the experience: reclaiming the essence of nursing. Implications for practice, education, and research are addressed.

Teaching undergraduate research from a process perspective.

Educators continue to struggle to find ways to teach nursing research to undergraduate students in a meaningful and engaging manner. The purpose of this article is to describe the development of an undergraduate nursing research course that incorporates a clinical practicum as a foundation for learning research concepts and the research process. By incorporating a clinical component into the research course, students more fully appreciate the connection between research and practice, more readily understand theoretical concepts discussed in class, and become more actively engaged in the learning process. The development of the collaborative clinical research project is described from a process perspective.

The effect of a metacognitive intervention on approach to and self-regulation of learning in baccalaureate nursing students.

There is little empirical support in the nursing education literature related to the process of learning. This quasi-experimental study examined the effect of a metacognitive intervention (concept mapping) on approach to learning and self-regulation of learning in a sample of baccalaureate nursing students. Significant group differences were found in the concept mapping group, with an increase in deep approach to learning and adaptive control belief mean scores at the end of the semester. Students in the control group experienced a decrease in the deep approach to learning mean score and an increase in the surface approach to learning mean score at the end of the semester. Therefore, students who used concept mapping demonstrated an increase in deep approach to learning and the self-regulation of that learning, compared with students who did not use concept mapping. The results of this study provide empirical support for the use of concept mapping as a metacognitive intervention.