Exploring knowledge and skills on HIV in student nurses and midwives

A cross-sectional survey design using a self-administered questionnaire was sent to a sample of 62 final-year student nurses and midwives to describe their knowledge of, skills related to, and attitudes towards, human immunodeficiency virus/acquired immune deficiency syndrome. Out of the 47 respondents who return the questionnaire, only 53% stated that they had received class instruction on the topic and 63.8% claimed to have increased their knowledge mainly from reading professional journals. Although only 32% said that they had cared for a patient or knew of a family member or another person with the disease, 91% indicated that they were willing to care for such patients. Overall, the respondents demonstrated positive attitudes towards this group of patients and a good level of knowledge about the subject, although some gaps were evident. However, a large majority stated that their skills to cater for the physical and psychological needs of this group of patients were deficient and would like further training.

Numeracy skills for nurses: revision and review

Introduces a revision and working examples of the numeracy skills key to the role of nurses working with older people in nursing and residential homes.

The assessment and development of drug calculation skills in nurse education: a critical debate

The drug calculation skill of nurses continues to be a national concern. The continued concern has led to the introduction of mandatory drug calculation skills tests which students must pass in order to go on to the nursing register. However, there is little evidence to demonstrate that nurses are poor at solving drug calculation in practice. This paper argues that nurse educationalists have inadvertently created a problem that arguably does not exist in practice through use of invalid written drug assessment tests and have introduced their own pedagogical practice of solving written drug calculations. This paper will draw on literature across mathematics, philosophy, psychology and nurse education to demonstrate why written drug assessments are invalid, why learning must take place predominantly in the clinical area and why the key focus on numeracy and formal mathematical skills as essential knowledge for nurses is potentially unnecessary.

Can effective teaching and learning strategies help student nurses to retain drug calculation skills?

Student nurses need to develop and retain drug calculation skills in order accurately to calculate drug dosages in clinical practice. If student nurses are to qualify and be fit to practise accurate drug calculation skills, then educational strategies need to not only show that the skills of student nurses have improved but that these skills have been retained over a period of time. A quasi-experimental approach was used to test the effectiveness of a range of strategies in improving retention of drug calculation skills. The results from an IV additive drug calculation test were used to compare the drug calculation skills of student nurses between two groups of students who had received different approaches to teaching drug calculation skills. The sample group received specific teaching and learning strategies in relation to drug calculation skills and the second group received only lectures on drug calculation skills. All test results for students were anonymous. The results from the test for both groups were statistically analysed using the Mann Whitney test to ascertain whether the range of strategies improved the results for the IV additive test. The results were further analysed and compared to ascertain the types and numbers of errors made in each of the sample groups. The results showed that there is a highly significant difference between the two samples using a two-tailed test (U=39.5, p<0.001). The strategies implemented therefore did make a difference to the retention of drug calculation skills in the students in the intervention group. Further research is required into the retention of drug calculation skills by students and nurses, but there does appears to be evidence to suggest that sound teaching and learning strategies do result in better retention of drug calculation skills.

Student nurses need more than maths to improve their drug calculating skills

Nurses need to be able to calculate accurate drug calculations in order to safely administer drugs to their patients (NMC, 2002). Studies have shown however that nurses do not always have the necessary skills to calculate accurate drug dosages and are potentially administering incorrect dosages of drugs to their patients (Hutton, M. 1998. Nursing Mathematics: the importance of application. Nursing Standard 13(11), 35–38; Kapborg, I. 1994. Calculation and administration of drug dosage by Swedish nurses, Student Nurses and Physicians. International Journal for Quality in Health Care 6(4), 389–395; O’Shea, E. 1999. Factors contributing to medication errors: a literature review. Journal of Advanced Nursing 8, 496–504; Wilson, A. 2003. Nurses maths: researching a practical approach. Nursing Standard 17(47), 33–36). The literature indicates that in order to improve drug calculations strategies need to focus on both the mathematical skills and conceptual skills of student nurses so they can interpret clinical data into drug calculations to be solved. A study was undertaken to investigate the effectiveness of implementing several strategies which focussed on developing the mathematical and conceptual skills of student nurses to improve their drug calculation skills. The study found that implementing a range of strategies which addressed these two developmental areas significantly improved the drug calculation skills of nurses. The study also indicates that a range of strategies has the potential ensuring that the skills taught are retained by the student nurses. Although the strategies significantly improved the drug calculation skills of student nurses, the fact that only 2 students were able to achieve 100% in their drug calculation test indicates a need for further research into this area.

A written assessment is an invalid test of numeracy skills

Nurses need good clinical numeracy skills to aid them in their clinical practice. There is some concern, however, that the calculation skills learned during pre-registration nurse education have little practical application to nurses. This article discusses the Fitness for Practice initiatives from the Nursing and Midwifery Council which aim to ensure new registrants are numerate. The article argues that written numeracy assessment tools are not a valid test of the numeracy skills candidates will require for clinical practice and that nurse education needs to focus on researching and examining how best to support, assess and develop the numeracy skills of nursing students within their clinical practice placements to ensure that at the point of registration they are fit for practice.

Bridging the gap with teamwork: collaborative leadership for communities of practice in the learning and skills sector

Collaborative approaches in leadership and management are increasingly acknowledged to play a key role in successful institutions in the learning and skills sector (LSS) (Ofsted, 2004). Such approaches may be important in bridging the potential 'distance' (psychological, cultural, interactional and geographical) (Collinson, 2005) that may exist between 'leaders' and 'followers', fostering more democratic communal solidarity. This paper reports on a 2006-07 research project funded by the Centre for Excellence in Leadership (CEL) that aimed to collect and analyse data on 'collaborative leadership' (CL) in the learning and skills sector. The project investigated collaborative leadership and its potential for benefiting staff through trust and knowledge-sharing in communities of practice (CoPs). The project forms part of longer-term educational research investigating leadership in a collaborative inquiry process (Jameson et al., 2006). The research examined the potential for CL to benefit institutions, analysing respondents' understanding of and resistance to collaborative practices. Quantitative and qualitative data from senior managers and lecturers was analysed using electronic data in SPSS and Tropes Zoom. The project aimed to recommend systems and practices for more inclusive, diverse leadership (Lumby et al., 2005). Collaborative leadership has increasingly gained international prominence as emphasis shifted towards team leadership beyond zero-sum 'leadership'/ 'followership' polarities into more mature conceptions of shared leadership spaces, within which synergistic leadership spaces can be mediated. The relevance of collaboration within the LSS has been highlighted following a spate of recent government-driven policy developments in FE. The promotion of CL addresses concerns about the apparent 'remoteness' of some senior managers, and the 'neo-management' control of professionals which can increase 'distance' between leaders and 'followers' and may de-professionalise staff in an already disempowered sector. Positive benefit from 'collaborative advantage' tends to be assumed in idealistic interpretations of CL, but potential 'collaborative inertia' may be problematic in a sector characterised by rapid top-down policy changes and continuous external audit and surveillance. Constant pressure for achievement against goals leaves little time for democratic group negotiations, despite the desires of leaders to create a more collaborative ethos. Yet prior models of intentional communities of practice potentially offer promise for CL practice to improve group performance despite multiple constraints. The CAMEL CoP model (JISC infoNet, 2006) was linked to the project, providing one practical way of implementing CL within situated professional networks.The project found that a good understanding of CL was demonstrated by most respondents, who thought it could enable staff to share power and work in partnership to build trust and conjoin skills, abilities and experience to achieve common goals for the good of the sector. However, although most respondents expressed agreement with the concept and ideals of CL, many thought this was currently an idealistically democratic, unachievable pipe dream in the LSS. Many respondents expressed concerns with the 'audit culture' and authoritarian management structures in FE. While there was a strong desire to see greater levels of implementation of CL, and 'collaborative advantage' from the 'knowledge sharing benefit potential' of team leadership, respondents also strongly advised against the pitfalls of 'collaborative inertia'. A 'distance' between senior leadership views and those of staff lower down the hierarchy regarding aspects of leadership performance in the sector was reported. Finally, the project found that more research is needed to investigate CL and develop innovative methods of practical implementation within autonomous communities of professional practice.