Nursing Commons^™

Evaluating Chain-Of-Command Self-Efficacy Through High Fidelity, Student-Directed, Obstetrical Simulation, Michelle Mcewen-Campbell

Nursing Theses and Capstone Projects

The purpose of this quasi-experimental capstone project was to evaluate the impact of high fidelity, student-directed, obstetrical simulation upon chain-of-command self-efficacy of baccalaureate nursing students. The convenience sample, composed of 48 junior nursing students, was randomly divided into four simulation groups, and then further randomly divided into active or observational status. Active participants planned interventions and participated in high fidelity obstetrical simulations related to patient safety and chain-of-command initiation. Active and observational students participated in a combined debriefing session. A pretest posttest design utilizing the General Self-Efficacy Scale (GSES) was utilized to measure chain-of-command self-efficacy in relation to both active …

The Impact Of Simulation-Based Learning Experience On Student Satisfaction, Perceived Self-Confidence, And Anxiety, Michelle Britt Warren

Nursing Theses and Capstone Projects

Nurse educators are faced with the challenges of facilitating student learning in shorter time frames along with decreasing student opportunities to further their learning experiences in real-world clinical situations (LaFond & Van Hulle Vincent, 2012; Smith & Barry, 2013). There is an identifiable need for safe environments where students can practice and apply the knowledge they have learned in the didactic component of the course to the clinical situations (LaFond & Van Hulle Vincent, 2012; McClure & Gigliotti, 2012). The capstone project, "The impact of simulation based learning experience on student satisfaction, perceived self-confidence and anxiety" examined the implementation of …

Incorporating Simulation Into Advanced Cardiac Life Support, Lorraine Calwile

Nursing Theses and Capstone Projects

The knowledge and practical skills of the Basic Life Support (BLS) and the Advanced Cardiac Life Support (ACLS) are among the most important determining factors of the cardiopulmonary resuscitation (CPR) success rates. Every year there are millions of healthcare workers that dread coming to ACLS class for fear of failure of the written exam or the mega code. Many of these participants haven’t participated in a code situation since they left class the previous two years. Participants sit in class for two days listening to lectures and going through practice mega codes to prepare them for the final mega code. …

Improving Attitudes Toward Interdisciplinary Collaboration Between Nursing And Medical Students In Simulation, Kristy H. Williams

Nursing Theses and Capstone Projects

This capstone project assessed whether a curriculum change for senior nursing students could have an impact on improving attitudes toward physician-nurse collaboration. A convenience sample of 60 senior level nursing students and eight residents were enrolled in the study. The nursing students and residents participated in a high-fidelity simulation scenario, and were given a pretest and posttest using the Jefferson Scale of Attitudes Toward Physician-Nurse Collaboration. There was strong evidence (t= -1.971, p=.05) that the attitudes of physician-nurse collaboration improved for nursing students through a simulation based scenario with residents. The confidence interval for the difference was (-0.22, 0.002). Although …

The Effectiveness Of Combining Simulation And Role Playing In Nursing Education, Shari Lynn Redden

Walden Dissertations and Doctoral Studies

The profession of nursing is affected by a nursing and nursing faculty shortage that is impacting the ability to produce adequate numbers of nurse graduates to address the healthcare needs of the future. Nursing schools are increasingly using simulation and/or role-playing to supplement the decreased number of nurse faculty and clinical sites in order to be able to continue to enroll nursing school applicants. The purpose of this phenomenological study was to examine the experiences of nursing students with role-playing and simulation and the extent to which role-playing with simulation is perceived by students as beneficial for learning within the …

Recent Graduates' Perspective On The Efficacy Of Nursing Simulation Laboratory Experiences, Holli Sowerby

Walden Dissertations and Doctoral Studies

It has become progressively difficult to find suitable clinical placement for nursing students. To help meet this need, local schools of nursing are turning to high-fidelity simulation manikins to substitute for clinical experience. There is a lack of research that explores recently graduated nurses' perceptions about the efficacy of simulation experiences. Guided by the constructivist theory, this qualitative case study identified how recent RN graduates viewed simulation experiences and whether associate's-degree RN program graduates and bachelor's-program RN graduates viewed simulation differently. Nine recent graduates participated in individual face-to-face interviews. The data were coded and grouped into 5 major themes in …

Effects Of A Mental-Health Clinical Simulation Experience Using Standardized Patients And Two Debriefing Styles On Prelicensure Nursing Students' Knowledge, Anxiety, And Therapeutic Communication And Psychiatric Assessment Skills, Debrayh Gaylle

Doctoral Dissertations

The purpose of this quasi-experimental pretest-posttest study was to compare the effects of two debriefing styles (insimulation and postsimulation) on (a) students’ knowledge of psychiatric assessment and therapeutic communication, (b) students’ performance of a psychiatric assessment using therapeutic communication, (c) students’ perceived anxiety related to a clinical rotation in psychiatric mental-health, and (d) students’ perceptions of the efficacy of the insimulation debriefing. The participants (n = 67) were senior, prelicensure nursing students enrolled in a baccalaureate degree program. Students were assigned randomly to either the treatment or the compression group and participated in a series of simulated interviews using student …

A Comparative Evaluation Of The Learner Centered Grading Debriefing Method In Nursing Education, Marisa J. Belote

USF Tampa Graduate Theses and Dissertations

The nursing discipline lacks a consensus on a best practice method for debriefing students following simulation-based training. A recognized, standardized method does not exist and various methods are utilized within the domain. The similarities between aviation and healthcare are well documented. Training members of both disciplines require standardization and methods of best practice. The aviation industry through the Federal Aviation Administration has found Learner Centered Grading (LCG) to be a successful educational format. The utilization of the LCG Debriefing method in simulation-based training is the standardized debriefing format for a technologically dynamic industry.

The aim of this research was to …

Specimen Labeling Improvement Project: Slip, Traci Hoiting

Doctor of Nursing Practice (DNP) Projects

Blood specimens are labeled at the time of acquisition in order to identify and match the specimen, label, and order to the patient. While the labeling process is not new, it is frequently laden with errors (Brown, Smith, & Sherfy, 2011). Wrong blood in tube (WBIT) poses significant risk. Multiple factors contribute to mislabeling errors, including lax policies, limited technological solutions, decentralized labeling processes, multi-tasking, distraction from the clinician, and insufficient education and training of staff. To reduce blood specimen labeling errors, a large academic medical center implemented an innovative technological solution for specimen labeling that integrates patient identification, physician …

Using An Educational Module And Simulation Learning Experience To Improve Medication Safety, Barbara Lynn Durham

Doctor of Nursing Practice (DNP) Projects

The purpose of this evidence-based change in practice project was to provide nurses with an experiential learning opportunity, using simulation, to identify and report near miss events during the medication administration process related to patient-controlled analgesia (PCA) usage. Despite extensive in-service training on a Medical/Surgical (Med/Surg) floor in an acute care hospital, inconsistent, inaccurate and incomplete documentation with use of the new PCA pumps continued to be problematic. A conceptual framework of just culture was used with the quality improvement method of the Plan-Do-Study-Act (PDSA) cycle for testing change. Medication safety education was a valid andragogical strategy to decrease rates …

Using Video Simulation To Enhance Rn-Pca Communication, Boris Chang

Master's Projects and Capstones

The purpose of this project was to develop a video simulation exercise to enhance communication between Registered Nurses (RNs) and Patient Care Assistants (PCAs). From a general microsystem assessment initially performed on an urban hospital medical-surgical unit, 75% of respondents noted that the most pertinent issue to address was improving communication between RNs and PCAs. Literature review of evidence-based practices found several studies that support the use of human clinical simulation to promote teamwork and interdisciplinary communication. RNs (n = 24) and PCAs (n = 9) were then individually interviewed with surveys and responses scored based on the …

High-Stakes Evaluation: Five Years Later, Tonya Rutherford-Hemming, Suzan Kardong-Edgren, Teresa Gore, Patricia K. Ravert, Mary Anne Rizzolo

Faculty Publications

This article compares the International Nursing Association of Clinical Simulation and Learning (INACSL) memberships' thoughts and discussions about the use of simulation for high- stakes evaluation in nursing education to a similar town hall discussion, five years ago. Data on the topic of high-stakes testing were collected through a survey before the INACSL conference in June 2014. During a town hall meeting at the conference, the survey data was presented, attendees shared their thoughts and reacted to prepared comments by selected simulation leaders. Half of the town hall attendees favored high stakes testing before the survey findings and discussion. This …

Best Practices In High Fidelity Patient Simulation To Enhance Higher Order Thinking Skills, Kathryn S. Mock

Theses and Dissertations

Undergraduate nursing education has begun to use very expensive and time intensive high fidelity simulation activities without making full use of the ability to build higher order thinking skills in students. Current research in high fidelity patient simulation has tended to be subjective and focus on critical thinking. However, reflective thinking habits of mind must be in place before full use can be made of critical thinking skills. A comprehensive search of all reflective thinking literature used in conjunction with simulated patient experiences by healthcare students was undertaken. A guideline

was created for nurse faculty to use that outlined current …

Reducing "Failure To Rescue" Occurrences: A Pilot Project Incorporating High-Fidelity Simulation During Mock Codes, To Enhance Pediatric Nurses' Clinical Knowledge And Skills, Denise Dawkins

Doctoral Projects

Thanks to advances in technology, the survival rate of infants and children with critical illnesses has improved. One consequence has been an increase in the acuity levels of hospitalized pediatric patients, which may heighten the risk of in-hospital cardiopulmonary arrest. Patient safety can be compromised by nurses who do not detect subtle clinical changes in a patient's condition, do not perform accurate interventions, or do not apply critical thinking (failure to rescue). The Institute of Medicine (10M) in 1999 estimated that approximately 100,000 people died each year as the result of poor care.

Patients and families place great trust in …

Electronic Medical Record In The Simulation Hospital: Does It Improve Accuracy In Charting Vital Signs, Intake, And Output?, Carel M. Mountain

Doctoral Projects

The introduction of electronic health records has created a shift in the way nursing care is delivered (McBride, Delaney, & Tietze, 2012; Furukawa, Raghu, & Shao, 2010). A factor which heavily influences a nurse’s ability to navigate and utilize EMR is adequate education in the use of computerized documentation (McBride, et al., 2012). There is an increased risk for error at the bedside without the correct knowledge and skills regarding EMR documentation (Kelly, Brandon, & Docherty, 2011). This skill should be introduced during the pre-licensure education of the nurse.

Two groups of associate degree nursing students attending a small community …

A Safety Mnemonic For Pediatric Oncology Patients: Knowledge, Confidence And Skills Accuracy During Simulation, Luanne Linnard-Palmer, Barbara Ganley

Collected Faculty Scholarship

Cancer is the second leading cause of death in the United States, surpassed only by heart disease [1]. Approximately 1.6 million Americans will receive treatment for a variety of cancers annually [2]. This increase in oncology nursing care opportunities highlights the need to ensure that nurses have the skills, knowledge, and tools that allow them to safely provide care. Because Undergraduate nursing education often does not provide in-depth coverage of the principles of safe oncology nursing care required for children or adults, this study addressed protocols used when caring for chemotherapy pediatric patients using a chemotherapy mnemonic. The purpose of …

Nursing Students' Perceptions Of Mental Health Patients And Mental Health Nursing, Susan Furr

Nursing Theses and Capstone Projects

This Capstone project evaluated the impact of a simulation-based learning experience on nursing students' anxiety levels, preparedness for psychiatric practicum, and stereotypical views towards individuals with mental illness. A sample of 15 bachelor level nursing students was utilized. The experimental group (n=8) was exposed to a four-hour simulation-based learning experience prior to the beginning of their clinical experience. The control group (n=7) began their clinical rotation without any simulation exposure. A pretest, posttest design utilizing the Mental Health Nursing Survey Part 1 (MHN-1) and the Mental Health Nursing Survey Part 2 (MHN-2) was used to measure the students' stereotypical views, …

Utilizing Early Simulation To Increase Clinical Confidence In Novice Nursing Students, Dana R. Martin

Nursing Theses and Capstone Projects

The purpose of this project was to determine if early simulation would increase the clinical confidence of novice nursing students. A convenience sample of 20 junior nursing students in their first semester of a baccalaureate nursing program within a small, rural university participated in the project prior to their first clinical experience. The students were administered the Confidence Scale as a pre-test prior to the early simulation experience which consisted of a scenario comparable to what the students would experience in the clinical setting. After the simulation, the primary investigator facilitated a debriefing exercise and then administered the Confidence Scale …

The Innovation Of Simulation Laboratories And The Novice Nurses In The Clinical Setting, Brenda Washington Moore

Walden Dissertations and Doctoral Studies

The push to generate professional nurses has raised questions about the competency level of the novice nurses that are entering the workforce. Utilization of simulation laboratories is being viewed as an option for bridging the gap for the shortage of nurses, nurse educators, and clinical sites. The theory of goal attainment was used to guide this project, which aimed to develop and validate an ER simulation scenario that mimics a clinical setting as a tool for measuring nursing skills. An additional purpose, to be accomplished after graduation, will be to implement a pilot project to determine the impact of the …

Effectiveness Of A Structured Curriculum Focused On Recognition And Response To Acute Patient Deterioration In An Undergraduate Bsn Program, Patricia L. Hart, Jane D. Brannan, Janice M. Long, Mary Beth R. Maguire, Lois R. Robley

Faculty Articles

The study purpose was to evaluate the effectiveness of a structured education curriculum with simulation training in educating undergraduate Baccalaureate of Science in Nursing (BSN) students to recognize and respond to patients experiencing acute deterioration as first responders. Researchers have demonstrated a lack of adequate clinical reasoning skills in new graduate nurses is a factor in critical patient incidents. A mixed methods design using a quasi-experimental, repeated measures and a descriptive, qualitative approach was used. A convenience sample of 48 BSN students was recruited. Statistically significant increases were shown in knowledge, self-confidence, and perceptions of teamwork. Six categories emerged from …

Lean Management Principles To The Creation Of Postpartum Hemorrhage Care Bundles, Bethan Faulkner

Doctor of Nursing Practice (DNP) Projects

Postpartum hemorrhage (PPH) is the number one cause of pregnancy-related death in the US. The Maternity local improvement team (LIT), co-led by an Obstetrician and Board Certified Clinical Nurse Specialist found that each month the maternity unit averages 40 PPHs with 1-2 resulting in an emergency. Over a 6-month period, the LIT decreased response time for emergencies significantly. Supply retrieval time decreased by 99.9%, MD response time decreased by 81%, and Family Centered Care increased by 100%. They recently turned their attention to prevention. Given the lack of literature on preventing PPH in postpartum units, the team developed a PPH …

The Creation And Implementation Of Interprofessional Simulation Leadership Scenarios, Angeline C. Delucas

Doctor of Nursing Practice (DNP) Projects

Healthcare is in a historical state of change creating an era that requires superior leadership skills. Leaders face burgeoning challenges in a competitive environment ensconced in reform. Today’s dynamic healthcare environment demands that nurse and interprofessional leaders be astute in a variety of areas including: fiscal responsibility and accountability, organizational politics, interpersonal skills, human resources, communication, conflict resolution, and emotional intelligence. Some areas such as fiscal management are considered hard skills, or skills which can be taught, while others such as conflict resolution are referred to as soft skills, or skills that are learned through experience. Though soft …

Nln/Jeffries Simulation Framework: State Of The Science Summary, Patricia K. Ravert, Julie Mcafoees

Faculty Publications

In summer 2011, a research task force from the International Association of Clinical Simulation and Learning (INACSL), in consultation with Dr. Pamela Jeffries, invited international nursing researchers and educators to participate in a project to evaluate state-of-the-science and existing research regarding the simulation model/framework (Jeffries, 2005, Jeffries, 2007). The model/framework was developed to define simulation education variables and provide an organized guide. The 21 researchers and educators worked on one of five teams, one for each of the five existing major model/framework constructs (Teacher, Student, Educational Practices, Outcomes, and Simulation Design Characteristics).

Student Perception Of How Simulation Applies To Clinical Experience, Brooke Alleger, Dr. Debra Wing

Journal of Undergraduate Research

For students in the nursing program at Brigham Young University, lab time in the Nursing Learning Center in the basement of the Spencer W. Kimball Tower is a regular part of the classroom experience. In this lab, nursing skills such as assessments, starting IVs, inserting catheters and cleaning wounds are taught and practiced. Once basic skill sets are taught, students are challenged with real-life scenarios requiring them to think critically and practice a subset of learned skills on a mannequin during simulation labs.

Psychometric Properties Of Standardized Patient And Faculty Rater's Evaluations Of Pre-Licensure Nursing Student Competencies, Karen A. Macauley Phd, Dnp, Fnp-Bc, Gnp, Bc

Dissertations

The use of simulation as a teaching modality has been rooted in the military, aviation, space, and engineering for centuries (Bradley, 2006). Clinical simulation allows for training of healthcare providers that might be too costly, risky, or hazardous in the clinical setting (Bradley, 2006). A variety of simulation modalities are used including virtual learning, task trainers, mannequins, and standardized patients (SPs). External demands for improved accountability of clinical performance is requiring nursing educators to reevaluate methods of teaching and how we measure nursing competence (Nehring & Lashley, 2010). Standardized patients have been used in medical school curricula to teach and …

Structured Debriefing And Students' Clinical Judgment Abilities In Simulation, Bette Mariani, Mary Ann Cantrell, Colleen H. Meakim, Patricia Prieto, Kristina Dreifuerst

College of Nursing Faculty Research and Publications

Background

Debriefing is a critical component of clinical simulation, yet there are limited studies that demonstrate the outcomes of debriefing on learners' clinical judgment.

Method

Using the Lasater Clinical Judgment Rubric, this mixed-method study examined the effects of structured debriefing after 2 clinical simulation experiences on 86 junior-level baccalaureate nursing students' clinical judgment. Debriefing for Meaningful Learning© was the method used for the structured debriefing sessions.

Results

The mean clinical judgment scores of the intervention group were higher and improved more over time compared with the mean scores of those in the control group; however, the differences were not statistically …

The Effect Of A Simulation Experience On Student Perception Of Self Confidence, Ginny N. Little

Nursing Theses and Capstone Projects

The aim is to determine if participation in a high-fidelity simulation increases student levels of self-confidence. Thirty-eight first year associate degree nursing students enrolled in a medical-surgical course in a southeastern community college participated in a diabetes simulation as part of their course. Students then voluntarily completed a survey indicating self-confidence following the simulation. Descriptive statistics were used to determine the overall mean of student responses to each question on the National League for Nursing (NLN) Student Satisfaction and Self Confidence in Learning Tool. Students rated the teaching helpful and effective with a mean score of 4.47 (sd = .951). …

The Bus Stops Here: Mobile Education Program, Katie Juskewitch

Theses and Graduate Projects

Medical knowledge and technology are rapidly evolving. Nurses need to continuously adapt their practice to provide the best care for their patients and to meet the financial incentives being applied to hospitals. The need for continuous nursing education is apparent since healthcare continues to advance. A project to the develop an alternative method of continuing nursing education for hospital nurses called "bus stop education" was designed to optimize the retention of new knowledge by addressing the needs of the adult learner. The framework of a hands-on learning approach guided by Malcolm Knowles classic theory on andragogy of learning, Watson's theory …

High Fidelity Simulation Effectiveness In Nursing Students’ Transfer Of Learning, Tera R. Kirkman

Nursing

Background: Members of nursing faculty are utilizing interactive teaching tools to improve nursing student’s clinical judgment; one method that has been found to be potentially effective is high fidelity simulation (HFS). The purpose of this time series design study was to determine whether undergraduate nursing students were able to transfer knowledge and skills learned from classroom lecture and a HFS clinical to the traditional clinical setting.

Method: Students (n ¼ 42) were observed and rated on their ability to perform a respiratory assessment. The observations and ratings took place at the bedside, prior to a respiratory lecture, following the respiratory …

Patient Safety Competencies In Rural Asn Students: An Evidence-Based Curricular Innovation, Janeen Berndt

Evidence-Based Practice Project Reports

Hospital clinical experiences are important events in prelicensure nursing education. Benefits include the opportunity for students to experience actual nursing responsibilities, immersion into environment, and professional socialization. However, challenges in finding appropriate clinical experiences include competition over clinical sites, decreasing patient acuity, and high student-faculty ratios. Rural schools of nursing have these challenges and those inherent in rural environments such as limited health care access, restricted critical access hospitals, and limited resources. The purpose of this evidence-based practice project was to plan, implement, and evaluate the use of a series of patient care simulations as an educational intervention to improve …