A phenomenological study exploring pediatric hospitalization: The voices of accompanied and unaccompanied hospitalized children.

PURPOSE: Most children go through their childhood without being hospitalized. For a child, being hospitalized may be a disturbing and unfamiliar experience. Pediatric institutions promote parental presence and family-centered care, yet not all parents are able to stay with their children. Holding the child's voice central to the phenomenon, the aim of this study was to explore how parental accompaniment and absence shape a child's hospitalization experience. DESIGN AND METHODS: A phenomenological study was implemented, and children ages 7-11 years old were included if they were in the hospital for at least 24 h with a parent present or 12 h without a parent present. Deriving from the interviews of children, themes were identified to unearth the meaning of children's lived experiences. RESULTS: Twelve school-age children shared their hospitalization experiences. The findings of this study are organized around the following themes: (a) participating in care; (b) being on the road to recovery; (c) being a kid, still; (d) being accompanied - having a familiar face; and (e) being unaccompanied - yearning but understanding. CONCLUSIONS: Being in the hospital was not significantly different when parents were absent, but children preferred their parents to stay. Being in the hospital was not a negative experience. Hospitalized children were attentive, independent, understanding, and resilient. PRACTICE IMPLICATIONS: Children in this study illuminate the need to listen to children's voices. Understanding the experiences of hospitalized children provides pediatric nurses with insight on supporting the patients and families they care for.

Incorporating Rapid Cycle Deliberate Practice Cardiac Arrest Simulation Program Into Nursing Staff Continuing Professional Development.

BACKGROUND: The Rapid Cycle Deliberate Practice (RCDP) is an innovative team-based simulation method that has been shown to be effective particularly in cardiac arrest education. Via a partnership between an educational institution and a hospital, the RCDP cardiac arrest simulation program was developed to improve nurses' cardiac arrest response preparation. METHOD: A pre- and posttest educational intervention study design was used. Participants included staff nurses (n = 89) who underwent a 2-hour RCDP simulation. The adapted version of the Simulation Effectiveness Tool-Modified and a five-question pre- and posttest knowledge survey were used to assess the effectiveness of the intervention. RESULTS: The simulation program increased participants' knowledge of cardiac arrest response (p < .05) and improved their confidence in communication (p = .036) and assessment skills (p = .029). CONCLUSION: The RCDP cardiac arrest simulation is an effective strategy for increasing nurses' confidence and knowledge in cardiopulmonary resuscitation delivery. [J Contin Educ Nurs. 2021;52(6):274-279.].

Enhancing the undergraduate nursing education experience with clinical elective courses.

The nursing faculty, in concert with the University's vision of personalized learning for undergraduate students, sought creative opportunities for nursing students to explore distinctive career specialty paths. The development, implementation, and evaluation of three undergraduate clinical electives developed by a School of Nursing (SON) is described here, in collaboration with three clinical practice partners. These nursing elective courses were designed to meet student requests for additional content in specialty nursing practice areas, enhance new nurse career readiness, and meet practice partner staffing needs for nurses with additional knowledge and skills in specific identified specialties. These nursing specialties included perioperative nursing, neonatal intensive care nursing, and oncology nursing. The SON faculty and each practice partner co-developed unique specialty-nursing elective courses that provide foundational specialty knowledge and skills in each practice arena. Project outcomes include enhanced relationships between the SON and practice partners, high levels of satisfaction of students and employers, and subsequent recruitment and employment of these students as new graduate nurses by our practice partners.

Unaccompanied Hospitalized Children: An Integrative Review.

PROBLEM: A child's hospitalization is often associated with stress that is exacerbated when the child is left unaccompanied by parents/caregivers. Parental presence, as part of a family-centered approach to care, is a strategy to mitigate the stressors and negative effects of hospitalization. However, due to a variety of circumstances, some children continue to remain unaccompanied in the hospital. This integrative review explored the phenomenon of unaccompanied hospitalized children. ELIGIBILITY CRITERIA: Relevant articles available in full-text and written in English were identified through electronic searches of CINAHL, PubMed, and PsycINFO and through hand searches of reference lists. SAMPLE: Eleven studies were included, analyzed, and synthesized into themes. Study quality was assessed using Bowling and Pearson's appraisal checklists. RESULTS: Distress of hospitalized children is evident when children are unaccompanied in the hospital and left to experience the stressors of hospitalization alone. The compounding effects of hospitalization and separation can cause distress and psychological trauma during and after the hospitalization period. Pediatric nurses strive to provide care to unaccompanied children that lessens these negative effects. CONCLUSIONS: Unaccompanied hospitalized children represent a vulnerable population. While the literature provides some insight into the experiences, research does not adequately explore the unaccompanied hospitalized child's experience. IMPLICATIONS: Pediatric nurses hold a position that enable them to support the physical and psychosocial needs of unaccompanied hospitalized children. By recognizing and addressing the stressors and distress unaccompanied children experience, nurses can help alleviate the subsequent effects resulting from separation and hospitalization.

Developing Interprofessional Competence: Results of Embedding TeamSTEPPS® in All Semesters of an Accelerated and Traditional BSN Program.

This study assessed the effectiveness of a curriculum designed to teach interprofessional communication and teamwork skills to traditional and accelerated baccalaureate nursing students. The curriculum was designed to incorporate TeamSTEPPS concepts using incremental learning experiences and a variety of instructional techniques throughout all clinical program semesters; more than 200 students representing four cohorts were enrolled in the study. Three tools were used to evaluate program effectiveness. Both accelerated and traditional groups demonstrated varying degrees of improvement on all tools. The curriculum design positively influenced students' communication and teamwork skills, advancing their interprofessional competency.

A Collaborative Academic-Practice Approach to Meeting Educational and Workforce Needs.

This article describes an innovative academic-practice partnership designed to promote new nurse competency and meet employer needs for graduates with in-demand knowledge and competencies in specialty patient populations. Three practice partners identified areas of need and with the school of nursing developed specialty nursing elective courses with precepted clinical experiences.

Transgender Standardized Patient Simulation: Management of an Oncological Emergency.

Introduction: This article describes the development process of Transgender Standardized Patient Simulation (TSPS) as an innovative cultural competence education and its pilot testing as part of the students' program of study. The multidimensional education strategy, TSPS, aimed to improve students' knowledge, skills, attitudes, and confidence in providing culturally sensitive care to a transgender patient experiencing an oncological emergency. Methodology: The design of the TSPS followed the cultural competence and confidence model and international simulation guidelines. Content validity of the TSPS was established. As our usual simulation assessment survey, the adapted simulation effectiveness tool-modified was used to evaluate if the TSPS met with students' learning need. Results: Participants (n = 32) strongly agreed that the TSPS met with their learning expectations and needs and improved their ability to provide culturally sensitive care. Discussion: Training and practice in this area is much needed and well-received by nursing students and faculty.

Replacing Smartphones With Mini Tablet Technology: An Evaluation.

Handheld technology allows students to access point-of-care resources throughout the clinical experience. To assess the viability of replacing student smartphones with tablets, an evaluation project was undertaken. Overall, students were equally dissatisfied with the 2 types of tablets that were evaluated. Students saw the potential usefulness of tablets to manage clinical assignments, interact with the learning management system, and communicate with faculty, but not for retrieving information currently accessible on their phones.

"Nursing Students Assaulted": Considering Student Safety in Community-Focused Experiences.

Community nursing experiences for undergraduate students have progressed beyond community-based home visits to a wide array of community-focused experiences in neighborhood-based centers, clinics, shelters, and schools. Our Bachelor of Science in Nursing program chose to use sites situated within neighborhoods close to campus in order to promote student and faculty engagement in the local community. These neighborhood sites provide opportunities for students to deliver nursing services to underserved and vulnerable populations experiencing poverty and health disparities. Some of these neighborhoods are designated as high crime areas that may potentially increase the risk of harm to students and faculty. There is a need to acknowledge the risk to personal safety and to proactively create policies and guidelines to reduce potential harm to students engaged in community-focused experiences. When a group of baccalaureate nursing students was assaulted while walking to a neighborhood clinic, the faculty was challenged as how to respond given the lack of policies and guidelines. Through our experience, we share strategies to promote personal safety for students and recommend transparency by administrators regarding potential safety risks to students engaged in community-focused fieldwork activities.

Case Report: Inflammatory Bowel Disease and Thrombosis.

Patients with inflammatory bowel disease (IBD) have a greater risk for developing venous thromboembolism (VTE). Patients admitted to the hospital with IBD flares often require insertion of long-term venous access devices, such as peripherally inserted central catheters (PICCs), to provide access for medications, blood draws, fluid management, and nutrition. PICCs have been associated with an increased risk for upper extremity deep vein thrombosis. In this case study analysis, 2 patients with IBD and PICCs who developed VTE are examined. The case report includes a thorough discussion of medical history, symptomology, PICC insertion, and events leading to VTE development. A review of acquired risk factors for IBD patients and a comparison of risk factors that predisposed each to VTE are explored. These cases highlight the need for nurses and physicians to heighten surveillance and engage in proactive strategies to prevent VTE in this population of patients.

Risk factors associated with catheter-related upper extremity deep vein thrombosis in patients with peripherally inserted central venous catheters: a prospective observational cohort study: part 2.

This is the second part of a 2-part series that reports on the results of a prospective observational cohort study designed to examine risk factors associated with symptomatic upper extremity deep vein thrombosis (UEDVT) in patients with peripherally inserted central catheters (PICCs). Part 1, published in the May/June 2014 issue of the Journal of Infusion Nursing, provided an extensive review and critique of the literature regarding risk factors associated with catheter-related UEDVT and identified 28 suspected risk factors. A study was undertaken to examine each of the risk factors among 203 acute care patients with PICCs, 13 of whom experienced a UEDVT, yielding an incidence of 6.4%. The most common reason for admission was infection (33.5%), and the primary reason for insertion of the PICC was venous access (58.6%). Hypertension (P = .022) and obesity (P = .008), defined as a body mass index ≥30, were associated with UEDVT. The clinical symptoms of edema (P < .001) and a 3-cm or more increase in arm circumference (P < .001) in the PICC arm after PICC placement were associated with UEDVT. All other variables were not statistically significant. The results suggest that patients who are obese and hypertensive may be at greater risk for the development of UEDVT and that the physical finding of edema and increased arm circumference in the PICC arm are possibly suggestive of UEDVT.

Risk factors associated with catheter-related upper extremity deep vein thrombosis in patients with peripherally inserted central venous catheters: literature review: part 1.

This is part 1 of a 2-part series of articles that report on the results of a prospective observational cohort study designed to examine the risk factors associated with symptomatic upper extremity deep vein thrombosis (UEDVT) in patients with peripherally inserted central catheters. This article provides an extensive review and critique of the literature that serves to explicate what is currently known about risk factors associated with catheter-related UEDVT. Risk factors such as anticoagulant use, cancer, infection, hypertension, catheter tip placement, and catheter size were identified most frequently in the literature as being associated with UEDVT development. Other risk factors--such as obesity, smoking history, surgery, and presence of pain or edema--were examined in a limited number of studies and lacked consistent evidence of their impact on UEDVT development. The subsequent study that evolved from the review of the literature investigates the relationship between identified risk factors and UEDVT development.

Clinical nurse specialists leading research to improve practice in the use of ankle blood pressure readings.

PURPOSE: The purpose of this article is to describe Clinical Nurse Specialist (CNS) practice as it relates to leadership in clinical research through the presentation of a study on ankle blood pressure (BP) measurements led by the CNS. BACKGROUND: Under the direction of the CNS, staff nurses engaged in the EBP process to explore the association between arm and ankle BP measurements. This EBP project led to a research study which was directed and led by the CNS. RATIONALE: CNS practice requires leadership in the areas of evidence-based practice and research. CNS leadership was critical to the success of the research project. DESCRIPTION: A descriptive study was undertaken which examined the agreement between upper extremity BP readings and ankle BP readings by comparing a series of three simultaneous ankle and arm BP readings on 174 subjects. CONCLUSION: Leading the research project elevated the CNS's visibility and influence within the organization by clearly demonstrating the value of the CNS in the research process and the impact nursing research has on nursing practice and patient outcomes.

The effect of high-fidelity patient simulation on the critical thinking and clinical decision-making skills of new graduate nurses.

This study was conducted to determine whether the addition of high-fidelity patient simulation to new nurse orientation enhanced critical thinking and clinical decision-making skills. A pretest-posttest design was used to assess critical thinking and clinical decision-making skills in two groups of graduate nurses. Compared with the control group, the high-fidelity patient simulation group did not show significant improvement in mean critical thinking or clinical decision-making scores. When mean scores were analyzed, both groups showed an increase in critical thinking scores from pretest to posttest, with the high-fidelity patient simulation group showing greater gains in overall scores. However, neither group showed a statistically significant increase in mean test scores. The effect of high-fidelity patient simulation on critical thinking and clinical decision-making skills remains unclear.

Concept mapping. Does it improve critical thinking ability in practical nursing students?

Critical thinking is an essential skill taught at all levels of nursing education. This article reports on a study designed to determine if concept mapping is superior to traditional care planning as a teaching method for practical nursing students. Specifically, the study evaluated the effects of concept mapping as a teaching methodology on the development of critical thinking skills. A control group consisting of students taught through the traditional methodology was compared to two groups of students taught with concept mapping. Data were collected using the National League for Nursing Critical Thinking in Clinical Nursing Practice/PN Examination. Results indicated that students who were taught the nursing process using the traditional care planning method scored statistically significantly better on the examination than students taught with the concept mapping method.

The student perspective on RN-Plus-10 legislation: a survey of associate degree and diploma nursing program students.

This article reports on a survey of associate degree and diploma nursing students in Pennsylvania designed to elicit their future educational goals and opinions regarding proposed educational advancement legislation. Results indicated the majority of respondents (86.3 percent) planned to pursue the bachelor's degree in nursing; most (94.8 percent) hoped to be enrolled in a BSN program within four years of graduation. The majority (78.9 percent) indicated that even if they were mandated to complete the bachelor's degree in nursing within 10 years, they would still enroll in their current associate degree or diploma program. Asked if 10 years is a reasonable amount of time to complete the BSN, 79.4 percent agreed it is. If money were not an obstacle, 95.8 percent of participants indicated they would pursue a BSN or higher. The results of this survey suggest that the vast majority of associate degree and diploma nursing students value and hope to pursue higher education in nursing.