Accident & Emergency Nursing Assessment of Deliberate Self Harm. Exploring the Impact of Introducing a Suicide Education Programme and a Suicide Intent Scale into A&E/MAU Nursing Practice: A Pilot Study

A proposal to pilot nursing assessment of self harm in Accident and Emergency Departments (A&E) was developed by key stakeholders in nurse education and suicide prevention in the South East and submitted to the National Council for the Professional Development of Nursing and Midwifery in April 2002.The proposal included the introduction of a suicide intent scale. Following an initial training programme, a suicide intent scale was utilised by nursing staff in A&E and the Medical Assessment Unit (MAU),Wexford General Hospital and evaluated over a period of nine months. Four months into the study the National Suicide Research Foundation (NSRF) was invited to collaboratively prepare a successful submission to the Health Research Board (HRB) as part of ‘Building Partnerships for a Healthier Future Research Awards 2004’. The NSRF undertook independent scientific evaluation of the outcomes of the suicide awareness programme. The study is in line with priorities determined by Reach Out, the National Strategy for Action on Suicide Prevention 2005-2014 (HSE, 2005) and the HSE-South East Suicide Prevention Programme through raising nursing staff awareness of the public health issue of suicide/deliberate self harm and by improving the efficiency and quality of nursing services offered to persons who present to acute hospitals with deliberate self harm. The study findings indicate evidence to positively support nursing assessment of DSH using a suicide intent scale in terms of assessing behavioural characteristics of individual clients and their suicide risk. Enhanced confidence levels of nursing personnel in caring for suicidal clients was demonstrated by staff who participated in an education programme related to risk assessment and specifically the use of a suicide intent scale.This resource was contributed by The National Documentation Centre on Drug Use.

Gerontology course in the nursing undergraduate curricula

Objective To explores nursing faculty members’ attitudes towards older people, their thoughts about gerontological nursing education. Method Five focus groups and a survey were used with nursing faculty members 132 at the three nursing schools to explore their attitudes towards the care of older people and the perceived status of gerontological nursing education. The survey was given to 132 faculty members, including 76 clinical instructors, 40 associate professors and 16 professors. The nursing faculty in general had a positive attitude toward older people (M=3.36, SD 0.25), and teachers’ attitudes were higher than those of their nursing students (M=3.18, SD0.29). Results This study results suggests that Saudi nursing curricula should include more extensive gerontology content and clinical experience with older people. Conclusion This is the first time in Saudi Arabia that research has listened to their voices and examined their commitments toward gerontology education.


Distance education in neonatal nursing scenarios: a systematic review

OBJECTIVE Identify resources that support learning mediated by technology in the field of neonatal nursing. METHOD Systematic review with searches conducted in MEDLINE, LILACS and SciELO. Titles and abstracts were independently evaluated by two experts. RESULTS Of the 2,051 references, 203 full-text articles were analyzed, resulting in the inclusion of nine studies on semiotics and semiology, cardiopulmonary resuscitation, general aspects of neonatal care, diagnostic reasoning and assessment of pain. Only two articles addressed the development of educational strategies and seven papers described the assessment of these strategies by experts and/or users. CONCLUSION Distance education is an important resource for education, and its improvement and updating, and it particularly adds advantages for neonatal nursing by approximating teaching and real-life situations and by minimizing the exposure of newborns for teaching purposes. The lack of educational initiatives mediated by technology suggests the need for the development, evaluation and dissemination of educational resources focused on nursing care of newborns and their families.

Technological competencies in cardiovascular nursing education

Abstract OBJECTIVE To identify the perception of the coordinators of the Specialization Courses in Cardiovascular Nursing about inserting content from Information and Communication Technology (ICT) and analyze them in relation to the technological competencies and regarding its applicability, relevance and importance in assisting, teaching and management. METHOD Descriptive study with 10 coordinators of the Specialization course in Cardiologic Nursing, who replied to the questionnaire for the development of technological competency adapted from the Technology Initiative Guidelines Education Reforms (TIGER), and analyzed using the Delphi technique for obtaining consensus and scored according to the relevance, pertinence and applicability using Likert scale according to degree of agreement. RESULTS Six courses developed ICT content. The contents of the TIGER were considered relevant, pertinent and applicable. CONCLUSION The coordinators recognize the need for technological competencies of the Cardiovascular Nurse for healthcare applicability.

Clinical reasoning in undergraduate nursing education: a scoping review

Abstract OBJECTIVE This study aimed at analyzing the current state of knowledge on clinical reasoning in undergraduate nursing education. METHODS A systematic scoping review through a search strategy applied to the MEDLINE database, and an analysis of the material recovered by extracting data done by two independent reviewers. The extracted data were analyzed and synthesized in a narrative manner. RESULTS From the 1380 citations retrieved in the search, 23 were kept for review and their contents were summarized into five categories: 1) the experience of developing critical thinking/clinical reasoning/decision-making process; 2) teaching strategies related to the development of critical thinking/clinical reasoning/decision-making process; 3) measurement of variables related to the critical thinking/clinical reasoning/decision-making process; 4) relationship of variables involved in the critical thinking/clinical reasoning/decision-making process; and 5) theoretical development models of critical thinking/clinical reasoning/decision-making process for students. CONCLUSION The biggest challenge for developing knowledge on teaching clinical reasoning seems to be finding consistency between theoretical perspectives on the development of clinical reasoning and methodologies, methods, and procedures in research initiatives in this field.

Adoption of information technology based patient education in psychiatric nursing

The overall goal of the study was to describe adoption of information technology (IT)-based patient education (PE) developed for patients and nurses use in psychiatric nursing. The data were collected in three phases during the period 2000-2006 in a variety of psychiatric settings in Finland. Firstly, the development process of IT-based PE for patients with schizophrenia spectrum psychosis was described. Secondly, nurses’ adoption of IT-based PE and the variables explaining adoption were demonstrated. Moreover, use of daily IT-based PE in clinical practice and factors associated with use were identified and described. And thirdly, nurses’ experiences of the IT-based PE after one year clinical use were evaluated. IT-based PE program was developed in several stages based on users’ needs and it included information and multimedia applications. Altogether, almost 500 IT-based PE sessions were carried out by the nurses on the study wards and revealed nurses’ activity in educating patients using IT to vary and depend on the hospital in which they worked. Almost 80% of all the possible IT-based PE sessions involved 93 patients and 83 nurses. Less than 2% of the IT-based PE sessions were interrupted and less than 10% suffered disturbances due to the patients or external causes. Moreover, the patients whose education took more days had poorer mental status than those whose education was carried out over a shorter period. After a year’s experience, advantages and disadvantages were described by the nurses for both patients and nurses of the IT-based PE. IT-based PE can be used even on closed acute psychiatric wards with patients with serious mental health disorders. However, technology adoption requires time, and therefore, it must fit in with clinical practice. Collaboration between users and developers is needed when developing user-centered methods in the area of mental health services. Moreover, it is important to understand factors that affect IT adoption in healthcare settings. IT-based PE is one option in interactive and co-operative health care practice between patients and nurses. Therefore the staff should begin to refer patients to established, credible and well-maintained Internet sites that provide information on common psychological problems. Even if every nurse should be trained and engaged to carry out IT-based PE, by targeting the training especially for the most active nurses aids them to support the less active ones. Adoption should also be understood from a perspective that includes aspects related to the context where it is implemented and examine how and in what circumstances it works.

Finnish doctoral dissertations of nursing education research

Nursing education research has confirmed its place in the discipline of nursing and caring sciences being one of the most central research areas. However, extensive and systematic analysis of nursing education research has been lacking both nationally and internationally. The aim of this study was to describe the focus of nursing education research in Finnish doctoral dissertations in the field of nursing and caring sciences between the years 1990–2014. In addition, the characteristics (i.e. methods, study informants and reporting of validity, reliability, and research ethics) of the dissertations were described. Also, international reviews (N=39) focusing on nursing education research were analysed for a background literature. A literature review was carried out. Altogether 51 (=N) Finnish doctoral dissertations of nursing and caring sciences in the field of nursing education research were included in the final analysis. The data for this research was collected from the open publication lists of each university offering education in nursing and caring sciences in Finland. The dissertations were published in 1990–2014. The data were analysed by content analysis both deductively and inductively. This study consists of a scientific article manuscript and a background literature review. Nursing education research has focused both nationally and internationally on four main areas: structural factors in nursing education, nurse teacherhood, teaching activities, and learning and learning outcomes in nursing education. In Finland, the most central focus area was learning (84.3 %) whereas nurse teacherhood and structural factors in nursing education were studied the least. Students were the predominant study informant group while nurse staff including nurse mentors were next and nurse educators only the third. Surveys and interviews were the most common data collection methods. In the findings there were a lot of similarities with international reviews of nursing education research. Finnish nursing education research has been very student-centred yet studies focusing on the education of other nursing based professions or different levels of education are rare. Future research about nurse teacherhood, curricula and structural factors in nursing education is recommended. There is also a need for experimental designs. In addition, nursing education research should focus on the central phenomena of nursing education and working life. All in all, more nursing education research is needed. Nursing education dissertations cover only 12.3 % of all the dissertations of nursing and caring sciences in Finland.

Nursing Students’ Learning about an Empowering Discourse In Patient Education

The main purpose of this study was to describe and evaluate nursing students' learning about an empowering discourse in patient education. In Phase 1, the purpose was to describe an empowering discourse between a nurse and a patient. In Phase 2, the purpose was first to create a computer simulation program of an empowering discourse based on the description, and second, the purpose was to evaluate nursing students’ learning of how to conduct an empowering discourse using a computer simulation program. The ultimate goal was to strengthen the knowledge basis on empowering discourse and to develop nursing students’ knowledge about how to conduct an empowering discourse for the development of patient education. In Phase I, empowering discourse was described using a systematic literature review with a metasummary technique (n=15). Data were collected covering a period from January 1995 to October 2005. In Phase 2, the computer simulation program of empowering discourse was created based the description in 2006–2007. A descriptive comparative design was used to evaluate students’ (n=69) process of learning empowering discourse using the computer simulation program and a pretest–post-test design without a control group was used to evaluate students’ (n=43) outcomes of learning. Data were collected in 2007. Empowering discourse was a structured process and it was possible to simulate and learned with the computer simulation program. According to students’ knowledge, empowering discourse was an unstructured process. Process of learning empowering discourse using the computer simulation program was controlled by the students and it changed students’ knowledge. The outcomes of learning empowering discourse appeared as changes of students’ knowledge to more holistic and better-organized or only to more holistic or better-organized. The study strengthened knowledge base of empowering discourse and developed students to more knowledgeable in empowering discourse.

Interprofessional Collaboration: The Experience of Nursing and Medical Students’ Interprofessional Education

In this hermeneutic phenomenological study, we examined the experience of interprofessional collaboration from the perspective of nursing and medical students. Seventeen medical and nursing students from two different universities participated in the study. We used guiding questions in face-to-face, conversational interviews to explore students’ experience and expectations of interprofessional collaboration within learning situations. Three themes emerged from the data: the great divide, learning means content, and breaking the ice. The findings suggest that the experience of interprofessional collaboration within learning events is influenced by the natural clustering of shared interests among students. Furthermore, the carry-forward of impressions about physician–nurse relationships prior to the educational programs and during clinical placements dominate the formation of new relationships and acquisition of new knowledge about roles, which might have implications for future practice.

Challenges for nursing education in Angola: the perception of nurse leaders affiliated with professional education institutions

Background: Angola is one of the African countries with the highest morbidity and mortality rates and a devastating lack of human resources for health, including nursing. The World Health Organization stimulates and takes technical cooperation initiatives for human resource education and training in health and education, with a view to the development of countries in the region. The aim in this study was to identify how nurses affiliated with nursing education institutions perceive the challenges nursing education is facing in Angola. Methods: After consulting the National Directory of Human Resources in Angola, the nurse leaders affiliated with professional nursing education institutions in Angola were invited to participate in the study by email. Data were collected in February 2009 through the focus group technique. The group of participants was focused on the central question: what are the challenges faced for nursing education in your country? To register and understand the information, besides the use of a recorder, the reporters elaborated an interpretative report. Data were coded using content analysis. Results: Fourteen nurses participated in the meeting, most of whom were affiliated with technical nursing education institutions. It was verified that the nurse leaders at technical and higher nursing education institutions in Angola face many challenges, mainly related to the lack of infrastructure, absence of trained human resources, bureaucratic problems to regularize the schools and lack of material resources. On the opposite, the solutions they present are predominantly centered on the valuation of nursing professionals, which implies cultural and attitude changes. Conclusions: Public health education policies need to be established in Angola, including action guidelines that permit effective nursing activities. Professional education institutions need further regularizations and nurses need to be acknowledged as key elements for the qualitative enhancement of health services in the country.

Interprofessional Education in Anatomy: Learning Together in Medical and Nursing Training

Teamwork and the interprofessional collaboration of all health professions are a guarantee of patient safety and highly qualified treatment in patient care. In the daily clinical routine, physicians and nurses must work together, but the education of the different health professions occurs separately in various places, mostly without interrelated contact. Such training abets mutual misunderstanding and cements professional protectionism, which is why interprofessional education can play an important role in dismantling such barriers to future cooperation. In this article, a pilot project in interprofessional education involving both medical and nursing students is presented, and the concept and the course of training are described in detail. The report illustrates how nursing topics and anatomy lectures can be combined for interprofessional learning in an early phase of training. Evaluation of the course showed that the students were highly satisfied with the collaborative training and believed interprofessional education (IPE) to be an important experience for their future profession and understanding of other health professionals. The results show that the IPE teaching concept, which combines anatomy and nursing topics, provides an optimal setting for learning together and helps nurses and doctors in training to gain knowledge about other health professionals’ roles, thus evolving mutual understanding.