Other Nursing Commons^™

Pediatric Simulation And Emergency Nurse Confidence, Katherine E. Wright

Student Scholarly Projects

Practice Problem: Nurses working in a general emergency department (GED) with a low (3.3%) pediatric patient volume expressed a lack of confidence caring for complex pediatric patients.

PICOT: In general emergency department nurses (P), how does participating in a pediatric simulation event (I), compared to current practice (C), affect nurse confidence scores caring for pediatric patients (O) over 6 weeks (T)?

Evidence: A review of over 17 evidence-based resources found good quality evidence that suggested participating in a simulation event can improve nurse confidence.

Intervention: Over six weeks, GED staff members participated in a pediatric simulation event. The simulation utilized …

All Clear For Virtual Simulation In Transition To Practice, Stephanie Barrett Msn, Rn, Onc

Posters

A knowledge gap in emergency management was identified through transition to practice program (TTPP) data and discussions with new nurses and nurse leaders. In response an Emergency Management Virtual Simulation (EMVS) was implemented. This evidence based educational method is engaging and is shown to increase confidence and learning outcomes. Virtual simulation gives new graduate nurses an opportunity to collaborate, critically think in stressful situations, and “experience the real-life chaos” in a safe learning environment.

Situation Awareness And Cognitive Load In Nursing Students Managing A Computer-Based Virtual Reality Simulated Deteriorating Patient, Tracy Chesney

Electronic Theses and Dissertations

Background: When a patient’s baseline clinical state shifts to a worse clinical state requiring a transfer to a higher level of care within the healthcare system, it is the hallmark of a deteriorating patient situation. Up to 37% of newly licensed nurses fail to identify and manage a deteriorating patient partly due to inexperience and a lack of expertise, contributing to lower situation awareness (SA), specifically in cue perception. Long-term memory schema development leads to expertise that allows individuals to develop higher SA necessary to identify and effectively manage patient deterioration. Expert nurses access long-term memory schema in managing deteriorating …

Using Specially Designed Software To Create A Simulation Space Design Assignment, Desiree A. Díaz, Mindi Anderson, Kathleen Bastedo, Corey Peterson

FDLA Journal

A college of nursing at a large southern university created a completely online graduate degree and online certificate related to healthcare simulation. In the organizational and operations simulation course, a paper/pencil assignment course was replaced with the use of an innovative online specialty software, i.e., widget, which allowed students the opportunity to design to scale a simulation space. The collaborative team of nursing and university technology and learning faculty jointly designed and created the widget. The purpose of this study was to describe the assignment and widget development and then to discuss the study to determine the usability and student …

Dnp Final Report: Developing Competence And Improving Patient Safety With Documentation Training In The Simulated Environment, Laura Zebreski

DNP Final Reports

With the advent of electronic health records, nursing documentation has declined in quality. Poor documentation exposes patients to safety risks. Nursing documentation is subject to legal standards set by the Texas State Board of Nursing. A DNP scholarly project was designed to create a learning and safety intervention to train student nurses to provide correct documentation before entering clinical settings. The goal of this project was to prepare nursing students to provide quality documentation that fulfills the legal standard to attempt to correct the current deficiencies seen in practice and promote patient safety. For this project, the students took a …

Mid-Simulation Debriefing: The Impact On Confidence And Clinical Judgement Of Nursing Students In A Baccalaureate Mother Baby Course, Tonya Broughton

Graduate Theses, Dissertations, and Capstones

Debriefing is a crucial aspect of healthcare simulation. This portion of the simulation experience encompasses the vast majority of student learning and reflection that takes place, and increases skills such as communication, clinical reasoning, and critical thinking. Traditionally debriefing is performed at the end of a clinical simulation experience after the simulation experience has concluded. In the maternal-newborn setting, there are often two phases of simulation. First is the care of the laboring mother and second is the delivery and care of the newborn. This study explored the effects of completing a mid-simulation debriefing in a maternal newborn simulation at …

Implementing Immersive Virtual Reality Into A Nursing Curriculum, Sue A. Schuelke, Krystal Davis, Sue Barnason

Innovations in Health Sciences Education Journal

Due to workforce demands, new undergraduate nurses are hired directly into fast-paced units and are expected to manage complex patients with rapidly changing conditions and respond to time-sensitive situations. It is important for nurse educators to prepare undergraduate nurses for transition into clinical practice upon graduation. Simulation has been a valuable tool to provide experiential learning and promote clinical decision-making. The next iteration of improving clinical simulation as an experiential learning modality for nursing students is Immersive Virtual Reality (IVR): a realistic, immersive simulation in a 3-dimensional environment that is experienced by body movements and hand controllers. IVR can incorporate …

Nursing Students' Moral Courage Development Through Incivility Simulation Education, Melissa Madden

Nursing Theses and Dissertations

Objectives: The purpose of this study was to determine if the use of an incivility simulation intervention and incivility educational module would increase nursing students’ perceived moral courage more than an incivility educational module alone.

Hypotheses: Nursing students’ moral courage scores would increase more in response to an incivility simulation intervention and educational module than for those who received the incivility educational module intervention alone.

Methods: The NLN Jeffries Simulation Theory framed the proposed intervention using a quasi-experimental pre-test-post-test comparison group design. A convenience sample of 66 students was utilized from one university across two classes. The Moral Courage …

Promoting Civility In The Workplace: Addressing Bullying In New Graduate Nurses Using Simulation And Cognitive Rehearsal, Sandy Phan

Doctoral Projects

Bullying continues to be a widespread, devastating problem in nursing. Research indicates that bullying has a negative, rippling impact on nurses, organizations, and patient care. This evidence-based practice project aimed to enhance new graduate nurses’ abilities to identify and respond to bullying behaviors. The intervention used a mixed educational methodology of didactic, simulation role-play, and cognitive rehearsal. The project was implemented at a large academic healthcare system in Northern California. Outcomes were evaluated using Kirkpatrick levels 1-4 and the Clark Workplace Civility Index (CWCI). Participants reported that the educational intervention met intended learning objectives, enabled them to apply learned behaviors …

Introducing A New 12 Week Education & Simulation Program To Optimize Financial Performance Of Nurse Managers, Melissa Hathcoat

Master's Projects and Capstones

Problem: Several nurse executives (Waxman 2018; Massarweh, 2017; Hunt, 2018) agree that in today's increasingly complex health care environment, the reality of decreasing reimbursements and increasing focus on value-based metrics reflects a crucial knowledge base for nurse managers. Therefore, it is imperative for unit-based nurse leaders to receive education and support to attain and maintain the requisite business competencies to achieve both fiscal and quality targets in their microsystem (McFarlan, 2020). In an integrated managed care delivery system in northern California, no education curriculum exists for nurse managers and assistant nurse managers that addresses gaps in financial knowledge, skills, and …

Simulation: An Effective Tool For Mentoring The Novice Nursing Faculty, Charlene B. Smith, Jeanne Hamner, Carol Hession, Cari Granier, Travis "Pete" Lewis, Ashley Thibodeaux

Journal of Interprofessional Practice and Collaboration

Abstract

The American Association of Colleges of Nursing (AACN) (2019) reported in 2018-2019, U.S. nursing schools turned away more than 75,000 qualified applicants from baccalaureate and graduate nursing programs due to insufficient numbers of faculty and clinical sites. Two-thirds of the nursing schools related a shortage of nursing faculty and/or clinical preceptors as a reason for not admitting qualified applicants (AACN, 2019).

There is a triad of challenges facing nursing today. The evolving triad is a nursing shortage, a lack of clinical facilities and nursing faculty. Nursing education must increase enrollment to fulfill the upcoming nursing shortage. Nursing schools are …

Measuring Learning And Engagement During Debriefing: A New Instrument, Shelly Jensen Reed

Faculty Publications

Background: Debriefing is considered to be where the bulk of learning takes place. Examination of debriefing is needed to help determine if facilitation methods effectively contribute to the learning process. More instruments are needed to evaluate all key debriefing elements, and no tools exist that evaluate participant engagement in the learning process.

Method: Kolb’s experiential learning theory was used to inform tool development. The focus of the new instrument is behaviors that indicate engagement with the learning process as the learner moves through Kolb’s learning cycle. A qualitative study of debriefing facilitators was performed, and a behaviorally anchored instrument was …

Pilot Project: Developing A Standardized Evidence-Based Education Process For Nurses To Enhance New Medication Eduction Of Hospitalized Patients With Heart Failure, Michele Ann Crotteau

Doctor of Nursing Practice Projects

Problem Description: Research has shown that health information is difficult for the average adult to understand while clear communication helps patients feel involved and increases adherence to treatment. The Joint Commission recommends Health Literacy (HL) assessment and the use of the Teach Back Method (TBM). Medication errors that occur between the RN and elderly patient are preventable when the RN communicates effectively about the patient’s medications. A paucity of research exists evaluating TBM for nurse-patient communications. This Quality Improvement (QI) Pilot Project (PP) took place over 3-months, aimed to improve new medication education to elderly patients with Heart Failure (HF). …

Local Anesthesia Before Intravenous Cannula Insertion: Recommendations For Registered Nurses In Practice, Vera Campbell-Jones

Electronic Theses and Dissertations

Abstract

Administering local anesthetics, such as intradermal, should become standard practice for RNs in pretreatments for pain control prior to intravenous insertion. Peripheral venous cannulation has provoked the most fear and anxiety in adult patients about everyday practice in hospitals. Adult patients often state that this procedure causes considerable discomfort. Local anesthesia for cannulation is usually not offered to adult patients who are on general medical units. Evidence has indicated inconsistency in the use of pain management strategies during these procedures. The researcher’s goal in this project was to educate RNs about the intradermal pretreatment procedure, provide education on the …

Collaborative Care Best Practices Model (Ccbpm) Development For Nursing And Occupational Therapy Assistant Interprofessional Simulation, Carrie M. O'Reilly, Lisa P. Simmons, Mary L. Romanello

The Open Journal of Occupational Therapy

The use of simulation as a teaching and learning stratagem is well supported in the professional literature. The development of a collaborative care best practices model (CCBPM) was undertaken to help the creation and implementation of an interprofessional education (IPE) learning strategy between occupational therapy assistant (OTA) and pre-licensure nursing students at a private liberal arts college. The project goals and outcomes involved faculty development, CCBPM development, and OTA and nursing novice student competency acquisition in their respective professions. Twenty-three students (10 OTA and 13 nursing) completed the IPE learning simulation exercise. A mixed-method approach to data analysis was used …

Patient Deterioration Simulation Education And New Graduate Nurses' Self-Confidence And Competence, Heather B. Norris

Doctor of Nursing Practice Projects

Inconsistent identification and intervention for patient deteriorations has been identified as a global healthcare issue that has a profound effect on patient outcomes. Failure to rescue (FTR) rates are influenced by the quality of care a hospital provides in the event of patient deterioration. Rapid Response Teams (RRTs) are summoned to the bedside in the event of a patient deterioration to assess the patient and intervene quickly. Efficient use of RRTs prevents cardiopulmonary arrests and decreases hospital mortality, thirty-day morality, and length of stay. Patient deterioration simulation education can improve the use of RRTs and positively influence patient outcomes. New …

Evaluation Of Self-Efficacy And Confidence Levels Among Newly Graduated Nurses Exposed To An End-Of-Life Simulation: A Comparison Study, Catherine Edwards

DNP Projects

Purpose: The purpose of this project is to compare self-efficacy and confidence levels among a cohort of newly graduated nurses (defined as nurses who have had no nursing experience and are participating in a new graduate nursing residency) who will participate in an EOL simulation with another cohort of nurses who have been practicing for a year or more, but have not participated in an end-of-life simulation.

Methods: The study included two parts. The first portion included a pre and post-test evaluation of an end-of-life (EOL) simulation intervention with newly graduated nurses (Group One, n= 22), as part of their …

The Effect Of Poverty Simulation Participation On Attitudes Toward Children Living In Poverty For Baccalaureate Nursing Students, Amanda Moore, Leah Struhsaker, Kaylee Gutschow

Williams Honors College, Honors Research Projects

Poverty is a major issue in the United States. Because perceived discrimination can impact health and willingness to seek care, it is important for healthcare providers to be educated on and exposed to issues that poverty presents to individuals who are poor. The purpose of this study was to examine the effect of a poverty simulation on attitudes of undergraduate nursing students towards children living poverty. The study was guided by Albert Bandura’s social learning theory and used a longitudinal, quasi-experimental design and convenience sampling of undergraduate nursing students enrolled in a community health nursing course. Attitudes were measured at …

Cultivating A Culture Of Compassion Among Newly Graduated Registered Nurses: An Evidence-Based Mobile Learning Toolkit, Benson Yeung

Doctor of Nursing Practice (DNP) Projects

Empathy, kindness, and compassion are some of the humanistic values essential to nursing practice particularly in today’s patient and family-centric healthcare environment. A genuinely empathetic and caring relationship between a nurse and a patient not only enhances the quality and safety of care but also contributes to patient satisfaction, compliance to treatment, and overall health outcomes. Debate amongst educators and researchers continues to grow as to whether these uniquely humanistic values are innate or if they can be taught. How do nurses acquire the knowledge, skills, and attitudes towards the delivery of compassionate patient care? What strategies are best suited …

Pilot Test Of Communication With A ‘Rapid Fire’ Technique, Desiree A. Díaz, Candace Pettigrew, Christine Dileone, Meredith Dodge, Deborah Shelton

Journal for Evidence-based Practice in Correctional Health

Abstract

An innovative communication training technique, ‘Rapid Fire’, was created to enhance communication and was incorporated into the debrief component of a simulation designed for correctional nurses to promote learning and engagement. The term ‘Rapid Fire’ was used to expose the critical time element that appears in the first five minutes of many crisis situations, where a quick relay of information and problem solving is essential; such as in a cardiac arrest or other rapidly deteriorating patient situations. This technique consists of a five-minute session prior to the structured debrief. During the ‘Rapid Fire’ portion of the debrief, all learners …

Curriculum Development Of California Correctional Institution (Cci) Nursing Staff Performance During Simulation Training Related To Cardiac Emergency Response, Dina Wang

Doctoral Projects

The Cycle 4 OIG medical reports published in January 2016 for California Correctional Institution (CCI) noted emergency medical response (EMR) inadequacies. Nursing was specifically called out for EMR care deficits. Chest pain and respiratory distress were amongst the top signs and symptoms identified as having substandard nursing care issues within the report. The cycle 4 OIG medical inspection report gives specific incidences of patient care inadequacies.

As a result of the EMR portion results of the cycle 4 OIG reports, there was a need for improvement planned interventions. The Doctor in Nurse Practice (DNP) project is a quantitative quasi-experimental study …

The Effect Of Simulations On Nursing Students’ Ethical Reasoning Confidence In Disasters: A Pilot Study, Sara E. Greco

Senior Honors Projects, 2010-2019

This study measured the effect of a disaster nursing simulation and debriefing session on senior BSN students’ perceived ethical reasoning confidence and their belief in the importance of ethical reasoning. Using a quasi-experimental design, this study compared participants’ responses before and after the interventional activities using the Survey of Ethical Reasoning. Post-test results demonstrated an increase in students’ perceived ethical reasoning confidence, perceived importance of ethical reasoning, and utilization of James Madison University’s Eight Key Questions Ethical Reasoning Framework.

A Comparison Of Educational Approaches To The End-Of-Life-Nursing Education Consortium (Elnec) Course, Jennifer L. Bodine

Doctoral Projects

Purpose: The purpose of this project was to compare the effectiveness of two different educational approaches to teaching the End of Life Nursing Education Consortium course.

Background: Terminally ill patients frequently visit the emergency department for palliative care. However, various references show that staff does not have the knowledge base necessary to provide quality end-of-life care in the emergency setting.

Method: Participants from the emergency department at a Level I Trauma Center were recruited. A quantitative, cross-sectional pilot study was conducted to investigate whether lecture or lecture with simulation was more effective in increasing the knowledge base of participants regarding …

Use Of Simulation Involving Standardized Patients As An Education Program To Increase Nurse Confidence In Caring For Patients With Drug And Alcohol Problems, Brandy G. Mathews

DNP Projects

Purpose: The purpose of this pilot project was to test the effectiveness of a simulation exercise using standardized patients on nurses’ perceived confidence in caring for patients with drug and alcohol problems.

Method: The project was a mixed methods pre-test and posttest design to assess whether simulation using standardized patients was effective in improving nurses’ confidence in caring for patients with problematic drug and alcohol use issues. Qualitative data was obtained by interviewing participants using a semi structured interview.

Results: All nurses reported a positive experience as a result of participating in the simulation exercises. Use of simulation as …

Written Debriefing: Evaluating The Impact Of The Addition Of A Written Component When Debriefing Simulations, Shelly Jensen Reed

Faculty Publications

Debriefing, the reflective period following a simulation, is said to be where the bulk of simulation learning takes place. Many expert opinions regarding debriefing exist, but evidence-based best practices have yet to be identified. Written debriefing is one of these practices; experts state learning can be extended through the addition of a written component to the debriefing process, but no evidence exists to support this. This study compares three debriefing types: discussion alone, and discussion followed by journaling or blogging. Undergraduate nursing students participating in a simulation were randomized as a simulation group to one of these three debriefing types. …

The Effect Of Worked Out Modeling In Nursing Simulation, Jayne Josephsen

Boise State University Theses and Dissertations

This study provides a research framework that incorporates cognitive load theory (CLT) into simulation design and implementation, as well as providing a pilot tool to measure cognitive load specific to nursing simulation. The pedagogy of CLT is based in an understanding of cognitive architecture, which includes working memory, long-term memory, various types of cognitive load, and schema development. A quasi-experimental quantitative design was used with a convenience sample of senior baccalaureate nursing students who participated in simulation as part of their coursework. The treatment group received a worked out modeling intervention, designed upon the CLT instructional intervention of the worked …

Nursing Students’ Experiences With High-Fidelity Simulation, Rana Halabi Najjar, Bret Lyman, Nick Miehl

Faculty Publications

Research has revealed the effectiveness of simulation for facilitating student development of self-efficacy, knowledge, clinical judgment, and proficiency in technical skills. This grounded theory study was conducted to describe the experience of nursing students in high-fidelity simulation and develop a model which explicates the experience of nursing students in simulation. Focus group interviews were conducted with three cohorts of students enrolled in a baccalaureate nursing program who experienced simulation four to twelve times per academic year. Five prominent themes emerged during analysis Emotional Processing; Anxiety; Making Connections; Fidelity; and Learning. The Simulation Learning Model – Student Experience (SLM-SE) was developed …

Shifting The Paradigm Of Classroom Nursing Orientation, Mary Leyk

Nursing Posters

Purpose Statement: The purpose of the Evidence-Based Practice Nursing Orientation Project is to find evidence to support a change in teaching strategy for newly hired RNs (both New Grads as well as experienced nurses), from the current process in order to improve outcomes of clinical competence, independence and nurse confidence, and retention.

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 …