Evaluating Virtual Simulation to Augment Undergraduate Nurses' Clinical Practice.

BACKGROUND: Due to the lack of clinical placements during the pandemic, virtual simulation was used to augment student practice experiences. METHOD: Using Kirkpatrick's evaluation model, a program evaluation study using a mixed-methods design was implemented to assess student and faculty satisfaction and usefulness of virtual simulation, the effectiveness of meeting learning needs, and the effects of the virtual simulation resource on the development of clinical judgment (n = 70). RESULTS: Virtual simulation was rated as moderately useful with an overall mean of 1.7 (SD = 0.66, range 1 to 3). Only 21% to 49% of the students found online simulation either met or well met the various areas of learning needs. Qualitative data highlighted the benefits of this strategy as well as implementation factors that affected students' experience. CONCLUSION: Virtual simulation can be used in clinical courses to augment learning when implemented in a way that addresses students' needs. [J Nurs Educ. 2024;63(7):470-477.].

Effectively Communicating Practice Changes to Frontline Nurses.

PURPOSE/OBJECTIVES: Communication of practice changes to frontline nurses across an organization can be difficult. Frequent daily communication to all nursing staff can be ineffective and lead to email fatigue and information overload. The purpose of this article is to further describe the communication intervention developed to disseminate practice changes and the critical modifications made over time to ensure its continued success and sustainability. DESCRIPTION OF THE PROJECT/PROGRAM: In 2019, this team from a multisite institution developed a monthly email correspondence, called the Evidence-Based Practice Update, sent to local leaders to disseminate important policy and practice updates and reminders to more than 3400 nurses. This strategy was initially successful in reaching the nurses yet lacked a method to ensure accountability that each nurse has read the content. A quick response code was added to track monthly readership, and clinical nurse specialists were leveraged to ensure practice changes reached, reviewed, and understood by nurses across the institution. OUTCOME: Metrics were tracked for quick response code scans and demonstrated an increase in readership over time. By combining various alerts into the single correspondence, fewer daily notifications to staff were sent. The EBP Update email dissemination structure involving local leaders was well received. CONCLUSION: This article describes how a standardized communication strategy coupled with thoughtful leadership engagement improved uptake of important practice information by nurses across a vast institution.

A Tool to Teach and Assess Clinical Nurse Specialist Student Prescribing Competency: A Pilot Study.

PURPOSE/AIMS: The purpose of this study was to assess the usefulness of a tool designed to develop and evaluate clinical nurse specialist (CNS) student competency and confidence in prescribing therapeutic agents. Specifically, the aims were to identify students' perceptions of the tool's (1) helpfulness in learning to prescribe, (2) impact on confidence as a prescriber, and (3) recommended use in CNS education. DESIGN: An exploratory design was used. METHODS: Students used the tool in patient care with a supervising mentor during clinical rotations. Students completed surveys after using the tool at 2 points in time. Data were analyzed using descriptive statistics. RESULTS: Of the 18 students, 5 students completed the survey at time 1 and 6 students at time 2. The aims were met in that students perceived the tool to be helpful during CNS prescribing activities, felt confident about prescribing after using the tool, and agreed the tool should be used in CNS education. CONCLUSION: Replication of the study with larger samples of CNS students and psychometric analyses of the tool is recommended by the study's findings to support its use in CNS education beyond the study site.

A Multidisciplinary Approach to Enhancing Sterilization Processes for Pleuravideoscopes in a Pulmonary Clinic.

PURPOSE/OBJECTIVES: The Centers for Disease Control and Prevention has highlighted the strong association between healthcare-associated infections and the reprocessing of flexible endoscopes. This process improvement project provided an evidence-based workflow analysis of pleuravideoscope reprocessing to validate and implement safe practices in the pulmonary clinic and sterile processing department. DESCRIPTION OF THE PROJECT/PROGRAM: A multidisciplinary team created an audit tool to complete infection control risk assessment using Lean Six Sigma methodology. OUTCOME: The risk assessment identified gaps in clinical practice, prompting corrective measures using a shared decision-making approach. The organization updated standard operating procedures, provided training and competency assessments, and purchased single-use pleuravideoscopes. These initiatives addressed the deficiencies and reinforced a culture of continuous process improvement and patient safety. CONCLUSION: Multidisciplinary teams should perform comprehensive reviews of facility processes and assess the risks related to infection control to identify optimal pleuravideoscope workflows for the healthcare institution. The involvement of a clinical nurse specialist is advantageous, as they possess the expertise necessary to facilitate collaborative efforts among team members spanning various departments. By leveraging the insights and skills of diverse professionals, healthcare organizations can optimize their reprocessing programs and enhance patient safety.

Outcome Evaluation of a Health System Clinical Nurse Specialist Fellowship Program.

PURPOSE: Healthcare is a complex adaptive system, requiring agile, innovative leaders to transform care. Clinical nurse specialists (CNSs) are uniquely positioned to influence change and achieve high-quality outcomes. Nurse leaders need strategies to onboard and retain CNSs considering high demand across the nation. The purpose of this program evaluation was to describe the core components and outcomes of CNS fellowship programs. DESIGN: This program evaluation used the Kirkpatrick Model as a framework to assess learning and knowledge translation. METHODS: The study was conducted within 3 Indiana healthcare organizations. Clinical nurse specialist leaders from each organization identified fellowship core components and analyzed team composition (ie, percentage of CNS team that was current/past fellows). Current and past CNS fellows were invited to participate in a survey evaluating program effectiveness, impact on role transition, project leadership, and outcomes achieved. RESULTS: Overlap was identified among 85% (17/20) of the core components, team composition was 71% (25/35) past/current fellows, and retention was 100% (12/12). Of the 23 invited, 18 (78%) participated in the program evaluation. Program effectiveness was evaluated as very/extremely effective by 94% (17/18) of participants. Themes salient to independent practice transition were applying learning, achieving influence, and developing relationally, contributing to incremental gain of the CNS perspective (ie, CNS values and guiding principles influencing critical thinking and behavior). CONCLUSION: Nurse leaders should consider fellowship implementation to recruit and retain CNS talent within organizations.

Work With ChatGPT, Not Against: 3 Teaching Strategies That Harness the Power of Artificial Intelligence.

BACKGROUND: Technological advances have expanded nursing education to include generative artificial intelligence (AI) tools such as ChatGPT. PROBLEM: Generative AI tools challenge academic integrity, pose a challenge to validating information accuracy, and require strategies to ensure the credibility of AI-generated information. APPROACH: This article presents a dual-purpose approach integrating AI tools into prelicensure nursing education to enhance learning while promoting critical evaluation skills. Constructivist theories and Vygotsky's Zone of Proximal Development framework support this integration, with AI as a scaffold for developing critical thinking. OUTCOMES: The approach involves practical activities for students to engage with AI-generated content critically, thereby reinforcing clinical judgment and preparing them for AI-prevalent health care environments. CONCLUSIONS: Incorporating AI tools such as ChatGPT into nursing curricula represents a strategic educational advancement, equipping students with essential skills to navigate modern health care.

Factors Associated With Sleep Quality Among Undergraduate Nursing Students During Clinical Practicums.

BACKGROUND: Limited evidence exists on factors influencing nursing students' sleep quality during clinical practicums. PURPOSE: This study examined the sleep quality of nursing students and factors that affect sleep quality during clinical practicums. METHODS: Undergraduate nursing students (n = 135) enrolled in clinical practicums in 3 universities completed questionnaires including sociodemographics and the Pittsburgh Sleep Quality Index (PSQI). Stepwise linear regression evaluated factors predicating sleep quality. RESULTS: Seventy percent of nursing students reported poor sleep quality. Weekly work hours and clinical hours were significant factors in predicting global PSQI scores, subjective sleep quality, sleep duration, sleep efficiency, and daytime dysfunctions. The students' race was related to sleep latency and sleeping medication. Clinical hours and living on campus were associated with sleep disturbances. CONCLUSION: Knowing the factors that influence nursing students' sleep during clinical practicums, nurse educators can help students improve sleep health and clinical experience.

Competency-Based Education in RN to BSN Programs.

BACKGROUND: The call for nursing education reform has never been louder. National organizations recognize the urgent need to prepare nursing students to practice competently, moving away from traditional teaching and curricula and to competency-based education (CBE) strategies to prepare future nurses for independent clinical practice. PROBLEM: The 2021 American Association of Colleges of Nursing Essentials do not account for the competencies achieved in registered nurse (RN) associate degree and diploma programs. This presents a challenge for RN to bachelor of science in nursing (BSN) program administrators and faculty when designing curricula to meet the new Essentials . APPROACH: The Essentials crosswalk created by the National RN-Baccalaureate Faculty Forum serves as a foundational guide for the development of the template models discussed in this article. CONCLUSION: This article provides a template of instructional models for implementing CBE in RN to BSN programs.

Ensuring Advanced Practice Nursing Students Meet the 2023 Drug Enforcement Agency Requirements.

BACKGROUND: All advanced practice nursing students in the doctor of nursing practice program at Johns Hopkins School of Nursing are required to complete 3 core courses (pathophysiology, pharmacology, and physical assessment). As of June 2023, the Drug Enforcement Agency (DEA) required all prescribers of controlled medications to attest to at least 8 hours of substance use training. PURPOSE: To quantify the amount of time advanced practice nursing students learn substance use-related content and engage in teaching/learning activities across the 3 courses as a basis for meeting the DEA requirement. METHODS: Lead course faculty teaching identified content related to substance use disorders, including reading assignments and skill-building activities, and the minimum amount of time that students spend in those teaching/learning experiences. RESULTS: Advanced practice nursing students complete a total of 14 hours of substance use-related content in the 3 core courses. CONCLUSIONS: This article describes substance use-related content and strategies that can be integrated in advanced practice nursing programs for students to meet the new DEA requirement.

Virtual Reality Simulation Integration in a Prelicensure Nursing Program: Lessons Learned.

BACKGROUND: Simulation, whether conducted live or through virtual technologies, provides students with experiential learning by replicating realistic clinical experiences that can develop learner competencies in a safe environment. Virtual reality simulation may provide the same level of effective and engaging experiential learning in a fully immersive learning environment without many of the limitations inherent to traditional live simulation environments, such as simulation equipment and designated labs. PROBLEM: While there are vendor-provided resources and a new tool kit covering immersive technology simulation implementation in nursing, a lived example to contextualize the implementation process is missing from the literature. APPROACH: This article discusses the selection and implementation of virtual reality simulations in a nursing undergraduate program and lessons learned in the process. CONCLUSIONS: Nurse educators seeking such experiences for their students may benefit from the insights shared in this article.