Contextual factors influencing patients' experiences of acute deterioration and medical emergency team (MET) encounter : a grounded theory study
- Authors: Chung, Catherine , McKenna, Lisa , Cooper, Simon
- Date: 2022
- Type: Text , Journal article
- Relation: Journal of Advanced Nursing Vol. 78, no. 12 (2022), p. 4062-4070
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- Description: Aim: This paper explores the personal, social and structural factors that influence patients' experiences of acute deterioration and medical emergency team (MET) encounter. Background: Patient experience is recognized as a means of assessing healthcare delivery with a positive experience being linked to high-quality healthcare, improved patient safety and reduced length of stay. The experience of acute deterioration is unique, extensive and complex. However, little is known about this experience from the patient's perspective. Design: Constructivist grounded theory, informed by Kathy Charmaz, was used to explore the personal, social and structural factors that influence patients' experiences of acute deterioration and MET encounter. Methods: Using a semi-structured interview guide, in-depth individual interviews were conducted with 27 patients from three healthcare services in Victoria, Australia. Data were collected over a 12-month period from 2018 to 2019. Interview data were analysed using grounded theory processes. Findings: Contextual factors exert a powerful influence on patients' experiences of acute deterioration and MET encounter. The most significant factors identified include patients' expectations and illness perception, relationship with healthcare professionals during MET call and past experiences of acute illness. The expectations and perceptions patients had about their disease can condition their overall experience. Healthcare professional–patient interactions can significantly impact quality of care, patient experience and recovery. Patients' experiences of illness and healthcare can impact a person's future health-seeking behaviour and health status. Conclusion: Patients' actions and processes about their experiences of acute deterioration and MET encounter are the result of the complex interface of contextual factors. Impact: The findings from this study have highlighted the need for revised protocols for screening and management of patients who experience acute deterioration. © 2022 The Authors. Journal of Advanced Nursing published by John Wiley & Sons Ltd.
An evidence-based checklist for improving scoping review quality
- Authors: Cooper, Simon J. , Cant, Robyn , Kelly, Michelle , Levett-Jones, Tracy , McKenna, Lisa
- Date: 2021
- Type: Text , Journal article
- Relation: Clinical Nursing Research Vol. 30, no. 3 (2021), p. 230-240
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- Description: A scoping review aims to systematically explore and map the research available from a wide range of sources. The objective of this study was to produce a scoping review checklist to guide future scoping studies to enable rigorous review and critique of phenomena of interest. The methods used included a review of literature, expert consensus group meetings, a modified Delphi survey and, finally, verification against recent scoping study examples. Results showed that the checklist was able to identify key elements of scoping reviews. The 22-item Scoping Review Checklist (SRC), which includes two optional stakeholder consultation items, has been developed using rigorous recommended approaches. The checklist can be used to guide the conduct and critique of scoping studies. **Please note that there are multiple authors for this article therefore only the name of the first 5 including Federation University Australia affiliate “Simon Cooper and Robyn Cant” is provided in this record**
Undergraduate health professional students’ team communication in simulated emergency settings : a scoping review
- Authors: Bourke, Sharon , Cooper, Simon , Lam, Louisa , McKenna, Lisa
- Date: 2021
- Type: Text , Journal article , Review
- Relation: Clinical Simulation in Nursing Vol. 60, no. (2021), p. 42-63
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- Description: Team communication problems have been reported to be responsible for up to 80% of medical errors in healthcare settings. Although simulation is a recognized means to learn communication skills, little is known about students’ team communication in a simulated setting. This review sought to explore what is known about undergraduate health professionals team communication in simulated emergency settings. The Joanna Briggs Institute framework was used to identify studies through five databases. After titles and abstracts and full texts review, 22 studies were identified for analysis and synthesis using inductive thematic analysis. Three key themes emerged: the context of simulation, teamwork and communication, and student interpretations. Simulation is a successful tool to experience communication and teamwork for students. Non-technical skills enhanced students’ performance of clinical skills based on expert rating and in understanding shared values, collaboration, and respect for each other, and improving confidence. Simulation is a suitable approach to measure and enhance team communication and teamwork. Exploration of gender, age, and ethnicity and other factors to assess their impact on communication should be the focus of future research in this area. © 2021
A cross-sectional survey of nursing students' patient safety knowledge
- Authors: Levett-Jones, Tracy , Andersen, Patrea , Bogossian, Fiona , Cooper, Simon J. , Guinea, Stephen , Hopmans, Ruben , McKenna, Lisa , Pich, Jacqui , Reid-Searl, Kerry , Seaton, Philippa
- Date: 2020
- Type: Text , Journal article
- Relation: Nurse Education Today Vol. 88, no. (2020), p.
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- Description: Background: Knowledge provides a foundation for safe and effective nursing practice. However, most previous studies have focused on exploring nursing students' self-reported perceptions of, or confidence in, their level of patient safety knowledge, rather than examining their actual levels of knowledge. Objective: The overarching objective of this study was to examine final year nursing students' levels of knowledge about key patient safety concepts. Design: A cross-sectional design was used for this study. Data collection was undertaken during 2018 using a web-based patient safety quiz with 45 multiple choice questions informed by the Patient Safety Competency Framework for Nursing Students. A Modified Angoff approach was used to establish a pass mark or ‘cut score’ for the quiz. Setting and participants: Nursing students enrolled in the final year of a pre-registration nursing program in Australia or New Zealand were invited to participate in the study. Results: In total, 2011 final year nursing students from 23 educational institutions completed the quiz. Mean quiz scores were 29.35/45 or 65.23% (SD 5.63). Participants achieved highest scores in the domains of person-centred care and therapeutic communication, and lowest scores for infection prevention and control and medication safety. Based on the pass mark of 67.3% determined by the Modified Angoff procedure, 44.7% of students (n = 899) demonstrated passing performance on the quiz. For eight of the institutions, less than half of their students achieved a passing mark. Conclusions: Given the pivotal role that nurses play in maintaining patient safety, the results from this quiz raise important questions about the preparation of nursing students for safe and effective clinical practice. The institutional results also suggest the need for increased curricula attention to patient safety. © 2020 Elsevier Ltd
Patients’ experiences of acute deterioration : A scoping review
- Authors: Chung, Catherine , McKenna, Lisa , Cooper, Simon J.
- Date: 2020
- Type: Text , Journal article
- Relation: International Journal of Nursing Studies Vol. 101, no. (2020), p.
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- Description: Background: Patient experience is recognised as a means of assessing healthcare delivery with organisations in many countries now gathering patient experience or satisfaction data. It is well documented that the benefits of improving a patients' experience include increased satisfaction, reduced length of stay, improved patient outcomes and reduction of costs. The experience of acute clinical deterioration is unique, extensive and complex as well as being a difficult experience for all involved. However, little is known about this experience from the patient's perspective. Aim: To explore what is known about the experiences of acute deterioration from the perspective of the patient. Design: A scoping review of international, peer-reviewed research studies and grey literature published between the years of 2000 and 2018. This review was guided by the three-step search strategy recommended by the Joanna Briggs Institute (JBI). Data sources: A range of databases were searched, including CINAHL, Medline, Health Source, Joanna Briggs Institute, PsycINFO, Embase via Ovid, Cochrane library, Ovid Emcare, Scopus as well as grey literature, reference lists and the search engine Google Scholar. Review methods: Joanna Briggs Institute (JBI) scoping review framework was utilised to identify patients' experiences of acute deterioration. Ten databases were searched, and 249 articles were retrieved. After screening the titles and abstracts, 102 articles were assessed in full text for eligibility, and finally 23 articles were further analysed and synthesised using inductive thematic analysis. Results: 19 qualitative studies, three quantitative and one mixed methods study met the inclusion criteria. Seven key themes emerged related to patients' experience of acute deterioration: (1) transformation of perception: memories of factual events; (2) psychological transformation: emotional distress and well-being; (3) physiological transformation: physical distress; (4) facing death; (5) the severity of acute deterioration: from the perspective of the patient; (6) relationship with healthcare professionals and the clinical environment; and (7) the value of relationships: the support of family and friends. Conclusions: Participants had considerable recall of their experiences and hospital admissions. The themes highlight the important issues patients face during their own acute physiological deterioration. This review has highlighted that further research is needed to specifically explore the patients' experience of acute deterioration and the emergency management they receive, for example from a hospital's rapid response team (RRT) or medical emergency team (MET). © 2019
Clinical placements in contemporary nursing education: Where is the evidence?
- Authors: McKenna, Lisa , Cant, Robyn , Bogossian, Fiona , Cooper, Simon J. , Levett-Jones, Tracy , Seaton, Philippa
- Date: 2019
- Type: Text , Journal article , Editorial
- Relation: Nurse Education Today Vol. 83, no. (2019), p.
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- Description: Clinical practice is fundamental to the learning of undergraduate and entry-level nursing students. It provides the milieu whereby students apply classroom theory and simulated practice to the real world of nursing and become socialised into the profession. In contemporary nursing education, there is often competition among tertiary education providers to locate quality, appropriate placements; substantial costs may be incurred to access suitable placements.
The influence of anxiety on student nurse performance in a simulated clinical setting : A mixed methods design
- Authors: Al-Ghareeb, Amal , McKenna, Lisa , Cooper, Simon J.
- Date: 2019
- Type: Text , Journal article
- Relation: International Journal of Nursing Studies Vol. 98, no. (2019), p. 57-66
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- Description: Background: Anxiety has a powerful impact on learning due to activation of anxiety hormones, which target related receptors in the working memory. Experiential learning requires some degree of challenge and anxiety. Patient simulation, as a form of experiential learning, has been an integrated component of health professional education internationally over the last two decades, especially in undergraduate nursing education. Little information is available to determine if and how anxiety impacts nursing students’ clinical performance during simulation. Objectives: To investigate physiological and psychological anxiety during emergency scenarios in high-fidelity simulation and understand the effect of anxiety on clinical performance. Design: First2Act was the model for the simulation intervention. Second and third year undergraduate nursing students attended a two-hour simulation session and completed a demographic questionnaire plus pre-simulation self-reported psychological anxiety scale. A heart rate variability monitor was attached to each student's chest to measure heart rate variability (as a sign of anxiety) before engaging in two video-recorded simulated emergency scenarios (cardiac and respiratory) with a professional actor playing the patient. Performance was rated by a clinician followed by video-assisted debriefing. Finally, heart monitors were removed and students repeated self-reports of psychological anxiety. Results: Students’ psychological anxiety was high pre-simulation and remained high post-simulation. With regard to physiological anxiety, students were anxious at the start of the simulation but became more relaxed toward the end as they gained familiarly with the simulation environment (p < .007). Clinical performance increased significantly in the second scenario (p < .001). Factors found to positively affect clinical performance were length of enrolment in the nursing degree (p = .001), current employment in a nursing or allied healthcare field (p = .030), and previous emergency experience (p = .047). The relationship between physiological anxiety and clinical performance was statistically not significant, although there was an indication that low level anxiety led to optimal performance. Conclusion: High-fidelity patient simulation has the capacity to arouse novice nurses psychologically and physiologically while managing emergency situations. Indicative outcomes suggest that optimal performance was apparent when anxiety levels were low, indicating that they had received insufficient training to deal with situations that induced moderate to high anxiety levels.
Why articles continue to be cited after they have been retracted : An audit of retraction notices
- Authors: Gray, Richard , Al-Ghareeb, Amal , McKenna, Lisa
- Date: 2019
- Type: Text , Journal article
- Relation: International Journal of Nursing Studies Vol. 90, no. (2019), p. 11-12
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- Description: Background: Papers continue to be cited by authors even after they have been retracted. Retraction notices provide readers with information about retracted papers and may help minimise post-retraction citation. To date, a review of the quality of retraction notices in nursing science has not been reported. Design: An audit of retraction notices associated with 29 retracted manuscripts published in nursing science journals. Methods: Retraction notices were reviewed again using the Committee on Publication Ethics (COPE) guidelines. Results: In total, 28 retraction notices were retrieved and reviewed (one retracted paper did not have a retraction notice). Details of the retracted manuscripts were included in all reviewed notices and, in all but two, author names were reported. Details of the time between a paper being published and retracted were not reported and generally there was a little information in notices about how the retraction decisions were made. All retraction notices were freely available. Seven notices stated who had made the decision to retract. Twenty-two (77%) notices stated the reason for retraction. Notices were brief and contained factual information. The webpages of three retracted articles did not clearly indicate that the paper had been retracted. Conclusion: More detailed and informative retraction notices will inform readers and may help reduce post- retraction citation.
Are we there yet? Graduate readiness for practice, assessment and final examinations
- Authors: Missen, Karen , McKenna, Lisa , Beauchamp, Alison
- Date: 2018
- Type: Text , Journal article
- Relation: Collegian Vol. 25, no. 2 (2018), p. 227-230
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- Description: Background This paper reports on one aspect of a larger doctoral project which investigated the perceptions of qualified nurses on the abilities of newly registered nursing graduates. Aims To explore qualified nurses’ perceptions on national examinations for registration in Australia.
Best practice in clinical simulation education − are we there yet? A cross-sectional survey of simulation in Australian and New Zealand pre-registration nursing education
- Authors: Bogossian, Fiona , Cooper, Simon J. , Kelly, Michelle , Levett-Jones, Tracy , McKenna, Lisa , Slark, Julia , Seaton, Philippa
- Date: 2018
- Type: Text , Journal article
- Relation: Collegian Vol. 25, no. 3 (2018), p. 327-334
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- Description: Background: Simulation is potentially a means of increasing clinical education capacity. Significant investments have been made in simulation but the extent to which this has improved uptake, quality and diversity of simulation use is unclear. Aim: To describe the current use of simulation in tertiary nursing education programs leading to nurse registration Australia and New Zealand, and determine whether investments in simulation have improved uptake, quality and diversity of simulation experiences. Methods: A cross sectional electronic survey distributed to lead nursing academics in programs leading to nurse registration in Australia and New Zealand. Findings: 51.6% of institutions responded and reported wide variation in allocation of program hours to clinical and simulation learning. Simulation was embedded in curricula and positively valued as an adjunct or substitute for clinical placement. While simulation environments were adequate, staff time, training and resource development were barriers to increasing the quality, amount and range of simulation experiences. Quality assurance and robust evaluation were weak. Discussion: Simulation program hours are inconsistently reported and underutilized in terms of potential contribution to clinical learning. Benefits of capital investment in simulation physical resources have been realised, but barriers persist for increasing high quality simulation in nursing programs. Conclusion: Transitioning components of clinical education from the clinical to tertiary sectors has resource implications. Establishment of sustainable, high quality simulation experiences requires staff training, shared resources, best practice and robust evaluation of simulation experiences in nursing curricula. © 2017 Australian College of Nursing Ltd
Exploring young Australian adults’ asthma management to develop an educational video
- Authors: Coombs, Nicole , Allen, Louise , Cooper, Simon J. , Cant, Robyn , Beauchamp, Alison , Laszcyk, Jacki , Giannis, Anita , Hopmans, Ruben , Bullock, Shane , Waller, Susan , McKenna, Lisa , Peck, Blake
- Date: 2018
- Type: Text , Journal article
- Relation: Health Education Journal Vol. 77, no. 2 (2018), p. 179-189
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- Description: Objective: This study explored young university students’ (aged 18–24 years) health literacy, asthma experiences and help-seeking behaviours to inform the development of a web-based asthma education intervention relevant to this age group. Design: Exploratory mixed-methods design incorporateing a health literacy survey and interviews, plus the development of a web-based educational video. Setting: Participants were students at two universities in the state of Victoria, Australia. Method: In total, 20 asthma sufferers were interviewed by trained pairs of university students. Interpretative phenomenology underpinned the narrative analysis and enabled the description of the participants’ lived experience. A branching e-simulation video was developed. Results: A number of key themes were identified: ‘Life with asthma’, including ‘A life of vigilance’ regarding asthma triggers, lifestyle limitations and heightened sensitivities; ‘Asthma management – call Mum’, a lack of knowledge and support systems with substantial maternal reliance; ‘Health literacy: family and Dr Google’, denoting low health literacy levels with passive reluctant involvement in personal health management; and ‘Information gathering – one size doesn’t fit all’ – in the form of the need for immediate gratification and resource variety. Based on interviewees’ words and terminology, we designed an interactive branching educational video for YouTube portraying a young person (an actor) during an asthma flare-up. Conclusion: Young adults lacked insight into their condition and even after moving away from home, relied on Google searches and/or parents’ advice. To enhance health-seeking behaviours, interactive programmes with smartphone access may be valuable. Our open access programme Help Trent Vent provides an educational resource for young people with asthma and for health education teams, to reinforce asthma knowledge. © 2017, © The Author(s) 2017.
Anxiety and clinical performance in simulated setting in undergraduate health professionals education : An integrative review
- Authors: Al-Ghareeb, Amal , Cooper, Simon J. , McKenna, Lisa
- Date: 2017
- Type: Text , Journal article , Review
- Relation: Clinical Simulation in Nursing Vol. 13, no. 10 (2017), p. 478-491
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- Description: Background Undergraduate health professionals clearly experience anxiety during simulation. However, little is known regarding learners’ physiological and psychological responses and the influence of these responses on performance. Method An integrative review was undertaken to provide a comprehensive understanding of the influence of anxiety on undergraduate health professionals’ performance during simulation, and to review the tools and measurements reported in the healthcare literature. Result Eleven articles were included showing simulation aroused learners physiologically and psychologically, either improving or declining clinical performance. Conclusion Two contrasting perceptions emerged, which are indicative of the current lack of understanding regarding the effects of anxiety on performance in a simulation setting. © 2017 International Nursing Association for Clinical Simulation and Learning
Interprofessional simulation of birth in a non-maternity setting for pre-professional students
- Authors: McLelland, Gayle , Perera, Chantal , Morphet, Julia , McKenna, Lisa , Hall, Helen , Williams, Brett , Cant, Robyn , Stow, Jill
- Date: 2017
- Type: Text , Journal article
- Relation: Nurse Education Today Vol. 58, no. (2017), p. 25-31
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- Description: Background Simulation-based learning is an approach recommended for teaching undergraduate health professionals. There is a scarcity of research around interprofessional simulation training for pre-professional students in obstetric emergencies that occur prior to arrival at the maternity ward. Objectives The primary aims of the study were to examine whether an interprofessional team-based simulated birth scenario would improve undergraduate paramedic, nursing, and midwifery students' self-efficacy scores and clinical knowledge when managing birth in an unplanned location. The secondary aim was to assess students' satisfaction with the newly developed interprofessional simulation. Design Quasi-experimental descriptive study with repeated measures. Setting Simulated hospital emergency department. Participants Final year undergraduate paramedic, nursing, and midwifery students. Methods Interprofessional teams of five students managed a simulated unplanned vaginal birth, followed by debriefing. Students completed a satisfaction with simulation survey. Serial surveys of clinical knowledge and self-efficacy were conducted at three time points. Results Twenty-four students participated in one of five simulation scenarios. Overall, students' self-efficacy and confidence in ability to achieve a successful birth outcome was significantly improved at one month (p < 0.001) with a magnitude of increase (effect) of 40% (r = 0.71) and remained so after a further three months. Clinical knowledge was significantly increased in only one of three student groups: nursing (p = 0.04; r = 0.311). Students' satisfaction with the simulation experience was high (M = 4.65 / 5). Conclusions Results from this study indicate that an interprofessional simulation of a birth in an unplanned setting can improve undergraduate paramedic, nursing and midwifery students' confidence working in an interprofessional team. There was a significant improvement in clinical knowledge of the nursing students (who had least content about managing birth in their program). All students were highly satisfied with the interprofessional simulation experience simulation. © 2017 Elsevier Ltd
Facilitators and barriers to evidence-based practice : Perceptions of nurse educators, clinical coaches and nurse specialists from a descriptive study
- Authors: Malik, Gulzar , McKenna, Lisa , Plummer, Virginia
- Date: 2016
- Type: Text , Journal article
- Relation: Contemporary Nurse Vol. 52, no. 5 (2016), p. 544-554
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- Description: Background: Implementation of evidence-based practice (EBP) is a major initiative within health care settings to ensure clinical and policy decisions incorporate best available evidence. Aims: This paper reports findings from a descriptive study exploring nurse educators’, clinical coaches’ and nurse specialists’ perceptions of factors associated with using EBP. Methods: Data was collected from a senior group of nurses working in a tertiary health care network in Victoria, Australia by employing a questionnaire that was distributed to a total of 435 people, of whom 135 responded. Data Analysis:Descriptive statistics for each questionnaire item were determined using SPSS (Statistical Package for Social Sciences version 17). Thematic analysis was performed for the qualitative part of the questionnaire. Results Findings revealed that organisational support, sufficient resources, and access to continuing education were perceived as factors promoting acceptance of EBP. Barriers to such acceptance in health care settings were identified as lack of knowledge and skills, poor time allowance, limited support, and insufficient resources. Conclusion: The reported findings create evidence-based information for organisational strategic planning. Organisations need to develop educational programs to promote EBP and employ strategies to overcome barriers to implementation. © 2016 Informa UK Limited, trading as Taylor & Francis Group.
Graduate nurse program coordinators' perspectives on graduate nurse programs in Victoria, Australia : A descriptive qualitative approach
- Authors: Missen, Karen , McKenna, Lisa , Beauchamp, Alison
- Date: 2016
- Type: Text , Journal article
- Relation: Collegian Vol. 23, no. 2 (2016), p. 201-208
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- Description: Aims: The purpose of this study was to describe the formal preparation nursing graduates are given throughout their first year of nursing in terms of educational structure and content of work-based year-long graduate nurse programs, from the perspectives of Graduate Nurse Program Coordinators. Background: In Australia, graduate nurse programs aim to provide a supportive learning environment, assisting nursing graduates in applying their theory to practice and supporting them in becoming safe, competent and responsible professionals. Internationally, research has demonstrated an increase in the job satisfaction and more importantly retention rates of newly qualified nurses who are supported in their first year of employment in some type of transition program. Method: Using a descriptive qualitative approach, individual semi-structured interviews were used. These interviews were audio recorded, transcribed verbatim and thematically analysed to reveal themes and sub-themes. Results: The interviews provided an insight into the various aspects of preparation that nursing graduates are given in their first year of practice with the main theme to emerge from analysis, nature of transition programs. The three subthemes associated with nature of transition programs consisted of composition of rotations and study days and supernumerary strategies. Findings indicate variation in pedagogical models underpinning graduate nurse programs across Victoria. Clinical rotations varied between three to twelve months, the number of study days offered were between four and thirteen days and there was variation in supernumerary time and strategies within the programs investigated. © 2015 Australian College of Nursing Ltd.
Qualified nurses' perceptions of nursing graduates' abilities vary according to specific demographic and clinical characteristics. A descriptive quantitative study
- Authors: Missen, Karen , McKenna, Lisa , Beauchamp, Alison , Larkins, Jo-Ann
- Date: 2016
- Type: Text , Journal article
- Relation: Nurse Education Today Vol. 45, no. (2016), p. 108-113
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- Description: Background: Evidence from the literature and anecdotally from clinical settings suggests that newly graduated nurses are not fully prepared to be independent practitioners in healthcare settings. Aims and Objectives: The aim of this studywas to explore perceptions of qualified nurses in relation to the practice readiness of newly registered nursing graduates and determine whether these views differ according to specific demographic characteristics, clinical settings, and geographical locations. Design: A descriptive quantitative design was used. Methods: An online survey tool was used to assess how qualified nurses (n = 201) in Victoria, Australia, rated newly graduated nurses' abilities on 51 individual clinical skills/competencies in eight key skill areas. A composite score was calculated for each skill area and a comparative analysis was undertaken on the various cohorts of participants according to their demographic and clinical characteristics using one-way ANOVA and post hoc tests. Results: Newly graduated nurses were found to be lacking competence in two key skill areas and were rated as performing adequately in the remaining six skill areas assessed. Significant differences (p ≤ 0.05) in performance were found according to the age of the nurse, number of years registered, the educational setting in which they undertook their nurse education, their role, and the clinical area inwhich theyworked. There were no significant differences according to whether the nurse worked in the private or public healthcare sector. Few differences were found between nurses working in a metropolitan vs. regional/rural healthcare setting. Conclusion: This is the first study to quantify the scale of this problem. Our findings serve as a reference for both nurse education providers and healthcare settings in better preparing nursing graduates to be competent, safe practitioners in all clinical areas.
Qualified nurses' rate new nursing graduates as lacking skills in key clinical areas
- Authors: Missen, Karen , McKenna, Lisa , Beauchamp, Alison , Larkins, Jo-Ann
- Date: 2016
- Type: Text , Journal article
- Relation: Journal of Clinical Nursing Vol. 25, no. 15-16 (2016), p. 2134-2143
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- Description: Aims and objectives: The aim of this study was to explore perceptions of qualified nurses on the abilities of newly registered nursing graduates to perform a variety of clinical skills. Background: Evidence from the literature suggests that undergraduate nursing programmes do not adequately prepare nursing students to be practice-ready on completion of their nursing courses. Design: A descriptive quantitative design was used. Methods: Participants were recruited through the Australian Nursing and Midwifery Federation, Victorian branch. A brief explanation of the study and a link to the survey were promoted in their monthly e-newsletter. A total of 245 qualified nurses in the state of Victoria, Australia participated in this study. A survey tool of 51 clinical skills and open-ended questions was used, whereby participants were asked to rate new nursing graduates' abilities using a 5-point Likert scale. Results: Overall participants rated new nursing graduates' abilities for undertaking clinical skills as good or very good in 35·3% of skills, 33·3% were rated as adequate and 31·4% rated as being performed poorly or very poorly. Of concern, essential clinical skills, such as critical thinking and problem solving, working independently and assessment procedures, were found to be poorly executed and affecting new registered nurses graduates' competence. Conclusion: The findings from this study can further serve as a reference for nursing education providers to enhance nursing curricula and work collaboratively with healthcare settings in preparing nurses to be competent, safe practitioners on completion of their studies. Relevance to clinical practice: Identifying key areas in which new nursing graduates are not yet competent means that educational providers and educators from healthcare settings can focus on these skills in better preparing our nurses to be work ready.
Registered nurses' perceptions of new nursing graduates' clinical competence : A systematic integrative review
- Authors: Missen, Karen , McKenna, Lisa , Beauchamp, Alison
- Date: 2016
- Type: Text , Journal article
- Relation: Nursing and Health Sciences Vol. 18, no. 2 (2016), p. 143-153
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- Description: Over the past decade, many questions have been raised about graduates' clinical competence and fitness for practice upon completion of their undergraduate education. Despite the significance of this issue, the perspectives of registered nurses have rarely been examined. This systematic review explores the perceptions of experienced registered nurses regarding the clinical competence of new nursing graduates. Original research studies published between 2004-2014 were identified using electronic databases, reference lists, and by searching "grey literature." Papers were critically reviewed and relevant data extracted and synthesized using an approach based on Preferred Reporting Items for Systematic Reviews and Meta-Analysis. From 153 studies initially identified, 15 original research papers were included. Four main research themes were identified: clinical/technical skills, critical thinking, interaction/communication, and overall readiness for practice. Areas of concern in relation to the clinical competence of new nursing graduates specifically related to two themes: critical thinking and clinical/technical skills. Further research is required on strategies identified within the literature with the ultimate aim of ensuring new nursing graduates are safe and competent practitioners.
A trial of e-simulation of sudden patient deterioration (FIRST2ACT WEB
- Authors: Bogossian, Fiona , Cooper, Simon J. , Cant, Robyn , Porter, Joanne , Forbes, Helen , McKenna, Lisa , Kinsman, Leigh , Endacott, Ruth , Devries, Brett , Philips, Nicole , Bucknall, Tracey , Young, Susan , Kain, Victoria
- Date: 2015
- Type: Text , Journal article
- Relation: Nurse Education Today Vol. 35, no. 10 (2015), p. e36-e42
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- Description: Background: High-fidelity simulation pedagogy is of increasing importance in health professional education; however, face-to-face simulation programs are resource intensive and impractical to implement across large numbers of students. Objectives: To investigate undergraduate nursing students' theoretical and applied learning in response to the e-simulation program-FIRST2ACT WEBTM, and explore predictors of virtual clinical performance. Design and setting: Multi-center trial of FIRST2ACT WEBTM accessible to students in five Australian universities and colleges, across 8 campuses. Participants: A population of 489 final-year nursing students in programs of study leading to license to practice. Methods: Participants proceeded through three phases: (i) pre-simulation-briefing and assessment of clinical knowledge and experience; (ii) e-simulation-three interactive e-simulation clinical scenarios which included video recordings of patients with deteriorating conditions, interactive clinical tasks, pop up responses to tasks, and timed performance; and (iii) post-simulation feedback and evaluation.Descriptive statistics were followed by bivariate analysis to detect any associations, which were further tested using standard regression analysis. Results: Of 409 students who commenced the program (83% response rate), 367 undergraduate nursing students completed the web-based program in its entirety, yielding a completion rate of 89.7%; 38.1% of students achieved passing clinical performance across three scenarios, and the proportion achieving passing clinical knowledge increased from 78.15% pre-simulation to 91.6% post-simulation.Knowledge was the main independent predictor of clinical performance in responding to a virtual deteriorating patient R2=0.090, F(7, 352)=4.962, p<0.001. Discussion: The use of web-based technology allows simulation activities to be accessible to a large number of participants and completion rates indicate that 'Net Generation' nursing students were highly engaged with this mode of learning. Conclusion: The web-based e-simulation program FIRST2ACTTM effectively enhanced knowledge, virtual clinical performance, and self-assessed knowledge, skills, confidence, and competence in final-year nursing students. © 2015 Elsevier Ltd.
Perceived knowledge, skills, attitude and contextual factors affecting evidence-based practice among nurse educators, clinical coaches and nurse specialists
- Authors: Malik, Gulzar , McKenna, Lisa , Plummer, Virginia
- Date: 2015
- Type: Text , Journal article
- Relation: International Journal of Nursing Practice Vol. 21, no. S2 (2015), p. 46-57
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- Description: Evidence-based practice (EBP) in the clinical setting is recognized as an approach that leads to improved patient outcomes. Nurse educators (NEs), clinical coaches (CCs) and nurse specialists are in key positions to promote and facilitate EBP within clinical settings and have opportunities to advance practice. Therefore, it is important to understand their perceptions of factors promoting EBP and perceived barriers in facilitating EBP in clinical settings, before developing educational programmes. This paper reports findings from a study that aimed to explore NEs' , CCs' and nurse specialists' knowledge, skills and attitudes associated with EBP. This study used a questionnaire containing quantitative and a small number of qualitative questions to capture data collected from NEs, CCs and nurse specialists working at a tertiary health-care facility in Victoria, Australia. The questionnaire was distributed to a total of 435 people, of whom 135 responded (31%). Findings revealed that the three senior nurse groups relied heavily on personal experience, organizational policies and protocols as formal sources of knowledge. Furthermore, they had positive attitudes towards EBP. However, participants demonstrated lack of knowledge and skills in appraising and utilizing evidence into practice. They indicated a desire to seek educational opportunities to upskill themselves in the process of EBP.