Undergraduate nursing students’ stigma and recovery attitudes during mental health clinical placement: A pre/post‐test survey study

Undergraduate nursing students have been reported to hold negative and stigmatizing attitudes towards mental health consumers and to be under‐prepared for mental health clinical placement. This study aimed to investigate undergraduate nurses’ stigma and recovery attitudes to mental illness, and describe their understandings of personal recovery on entry and exit to traditional mental health clinical placement. A pre/post‐test survey was administered to N = 249 nursing students in Australia. Demographic data, attitudes towards mental health nursing and clinical placement, the Opening Minds Scale for Healthcare Providers (OMS‐HC), Recovery Attitudes Questionnaire (RAQ‐7), and an open‐ended question on understandings of personal recovery from mental illness were collected on entry (T1) and exit (T2) to placement. At T1, students reported moderate stigma and positive attitudes towards recovery (OMS‐HC mean = 34.6; RAQ‐7 mean = 4.0). At T2, there was a reduction in stigma (social distance P = 0.02, d = 0.26) and improvement in recovery attitudes (P < 0.01, d = 0.40). Attitudes towards mental health nursing and placement also improved (P < 0.01). Having a family member with mental illness predicted improvements in stigma and recovery attitudes. On entry to placement, most students described accurate understandings of personal recovery, which were maintained during placement. The findings indicate that mental health clinical placements are effective in improving students’ mental health stigma and recovery attitudes and provide a prime opportunity to attract students into the field. Co‐produced or consumer‐led education provided by peer workers during clinical placements may improve students’ stigmatizing attitudes and stimulate their interest to work in the field.     

Placement replacement: A conceptual framework for designing simulated clinical placement in occupational therapy

Simulation is increasingly used to supplement clinical placement in preregistration health professional programs. However, there are no conceptual frameworks to guide the design of these learning experiences when replacing a clinical placement. In the present study, the conceptual framework for simulated clinical placements (CF‐SCP) is presented. Evolving from an iterative process of synthesizing learning and simulation theory, findings from the empirical literature, and the perspectives and ideas from experts in occupational therapy practice, education and simulation‐based learning, the CF‐SCP aligns principles and processes of workplace and simulation learning. The application of the CF‐SCP is described in the context of a 1 week full‐time SCP. The CF‐SCP provides a structure for organizing, understanding, and applying the principles and processes to design a simulated placement to be a “placement replacement” experience. Articulating a conceptual framework for the design of simulated placement experiences to replace actual clinical placement hours in the allied health sector is important if these experiences are to be tested for validity, efficacy, and transferability to a range of occupational therapy practice areas and other health disciplines.     

Experiences after international clinical placement as nursing students in a paediatric ward

AimThe aim of this study is to investigate nurses’ experiences after participating in an international clinical placement programme as nursing students while staying for one to three weeks in a paediatric ward.BackgroundStudent mobilisation is expected to increase the quality of education. Hence, offering international clinical placement programme in low- and high-income countries is a commonly used learning activity in bachelor programmes in nursing. Many studies have mainly examined the general experiences gained from international clinical placement programme but have not specifically focussed on the setting of paediatric wards in hospitals. Nursing students are required to acquire knowledge of paediatric nursing with children as patients.Design and methodIn this qualitative study, a hermeneutic, phenomenological approach was adopted. Data were collected through individual interviews with eight nurses after they participated in an international clinical placement programme as nursing students in a paediatric ward.ResultsMeetings with children’s destinies as patients were overwhelming, being an observer provided insights into and an overview of paediatric nursing, access to the resources required for treating children is limited, nurses had a different role and parents had an extended caring role.ConclusionAll participants gained knowledge of children as patients at a hospital and also gained knowledge of the parents’ and nurses’ roles and the treatment methods of various diseases that are relevant to paediatric nursing. This helped provide them with the cultural knowledge, awareness and sensitivity required, given the contrasting situation at their home country.     

护理本科生临床急救能力评价指标的构建

目的构建护理本科生临床急救能力评价指标,为测评护生临床急救能力水平提供依据。方法运用德尔菲法对28名专家进行两轮问卷函询,并确定各级指标的权重。结果两轮函询问卷有效回收率分别为93.33%、85.71%;专家的总体权威系数为0.89;两轮函询肯德尔和谐系数分别为0.25、0.30(P<0.01)。最终形成具有5个一级指标、24个二级指标的护理本科生临床急救能力的评价指标。结论两轮专家咨询结果可靠,专家一致性好,为评估护理本科生临床急救能力提供了科学、系统的工具。     

基于SERVQUAL模型的口腔护理临床教学服务质量评估体系的构建

[目的]:构建基于SERVQUAL模型口腔护理临床教学质量评价体系。从而能够更为客观而全面的评价教学质量，充分体现护生在培训过程中期望与真实感知的差距。[方法]:课题小组通过查阅文献，整理分析后初步拟定基于SERVQUAL模型的问卷框架。并通过小组讨论形成初步设定质量评价的各项指标，运用Delphi法对15名专家进行咨询，通过两轮咨询，构建最终口腔护理临床教学的质量评价体系。[结果]:形成包含5个一级指标、12个二级指标、28个三级条目的评估体系。经2轮专家咨询问卷回收率分别为93.7%和100%，专家权威系数为0.90，第2轮肯德尔和谐系数0.228，高于第1轮0.160。RI值为1.667，CR值为0.000<0.1。[结论]:本研究构建的基于SERVQUAL模型的口腔护理临床教学质量评估体系具有较强的科学性、可靠性和实用性，可为提升临床护理带教质量提供参考。     

Protocol-driven care in the intensive care unit: a tool for quality

Advances in organization and patient management in the intensive care unit (ICU) have led to reductions in the morbidity and mortality suffered by critically ill patients. Two such advances include multidisciplinary teams (MDTs) and the development of clinical protocols. The use of protocols and MDTs does not necessarily guarantee instant improvement in the quality of care, but it does offer useful tools for the pursuit of such objectives. As ICU physicians increasingly assume leadership roles in the pursuit of higher quality ICU care, their knowledge and skills in the discipline of quality improvement will become essential.     

Medication administration evaluation and feedback tool: Inter-rater reliability in the clinical setting

AimsThis study assessed the inter-rater reliability, acceptability and usability of the Medication Administration Evaluation and Feedback Tool for nurses in the clinical setting.BackgroundMedication administration is a complex nursing task requiring multiple steps to ensure safe and accurate delivery of medications to patients. Currently, registered nurses are not routinely provided the opportunity for regular review of their practice. The Medication Administration Evaluation and Feedback Tool has been previously validated in the simulated environment.MethodsFour nurse observers were trained to use the tool. Thirty nurses participated to be observed in the clinical setting. Each nurse was assessed simultaneously by two observers. Inter-rater reliability was assessed using Fleiss’ Kappa coefficient. A postobservation survey was conducted to assess user acceptability. The Guideline for Reporting Reliability and Agreement Studies Enhancing the Quality and Transparency of Health Research was used.ResultsThe observed agreement between observers using the Medication Administration Evaluation and Feedback Tool in clinical practice was 0.90 and Fleiss’ kappa coefficient was 0.77 demonstrating excellent agreement and inter-rater reliability. Both nurses and observers reported the tool was useful and practical for use in evaluating medication administration practice in the clinical environment.ConclusionsInter-rater reliability testing of the Medication Administration Evaluation and Feedback Tool in the clinical environment demonstrated it is a reliable and valid tool when used by different observers. Both nurses and observers found using the tool a positive and useful experience when evaluating medication administration practice.     

客观结构化临床考试在本科护生临床综合能力评价中的应用

[目的]对本科护生进行客观结构化临床考试(OSCE),探讨OSCE在本科护生临床综合能力评价中的应用.[方法]对我院3年级、4年级护理本科生进行OSCE,分析考试结果.[结果]4年级学生考试成绩明显高于3年级(F=23.153,P＜0.001),护生OSCE考察了学生的真实水平.[结论]护生OSCE明确了两个年级学生的差异之处,体现了考试的客观性、规范性和可重复性,应进一步推广.     

客观结构化临床考试在本科护生临床综合能力评价中的应用

[目的]对本科护生进行客观结构化临床考试（OSCE），探讨OSCE在本科护生临床综合能力评价中的应用。[方法]对我院3年级、4年级护理本科生进行OSCE，分析考试结果。[结果]4年级学生考试成绩明显高于3年级（F=23．153，P〈0．001），护生OSCE考察了学生的真实水平。[结论]护生僦明确了两个年级学生的差异之处，体现了考试的客观性、规范性和可重复性，应进一步推广。     

护理专业本科生临床实习质量评价指标体系研究

目的:构建一套科学、实用、客观的护理专业本科生临床实习质量评价指标体系。方法:采用文献分析法、专家访谈法初步确定指标草案,采用德尔菲法对指标进行专家咨询筛选。结果:确定了一级指标4个,二级指标11个,三级指标44个。结论:初步形成了护理本科生临床实习质量评价指标体系。