Evaluating a patient safety course for undergraduate nursing students: A quasi-experimental study

BackgroundAlthough it has long been recognised that prelicensure education is essential for preparing nurses with the necessary patient safety competencies, patient safety education tends to be inadequately addressed in nursing curricula in South Korea and elsewhere.AimThis study examined the effectiveness of a recently developed 8-week standalone course on patient safety by comparing the patient safety competencies, knowledge, and attitudes of students who attended and did not attend the course, after controlling for baseline levels of each outcome measure.MethodsThe study used a quasi-experimental pretest-posttest design with a non-equivalent comparison group, with 40 undergraduate nursing students in the intervention group, and 67 in the comparison group. Outcomes included the total score and six subscale scores measured with the Health Professional Education in Patients Safety Survey, and the Patient Safety Attitude scale developed by the WHO patient safety program. Additionally, there was an objective measure of patient safety knowledge using 15 multiple-choice questions.FindingsAfter adjusting for baseline scores, Time 2 scores on all outcome measures were significantly higher in the intervention group than the comparison group, indicating the intervention's effectiveness. We found that the largest effect of the course accrued to patient safety knowledge. Overall, the students’ assessment of the course was highly positive.DiscussionOur patient safety course could be a model for teaching patient safety in undergraduate nursing curriculum.ConclusionThis study shows the potential for a standalone patient safety course to increase undergraduate nursing students’ patient safety competencies, knowledge, and attitudes towards patient safety.     

The effects of high-fidelity simulation training on empathy and attitudes toward older people among undergraduate nursing students: A quasi-experimental study

AimTo evaluate the effects of high-fidelity simulation training on attitudes towards older people and empathy among undergraduate nursing students.BackgroundPeople worldwide are living longer and, consequently, the number of older people is increasing globally. Geriatric syndromes are highly prevalent and associated with increased morbidity and mortality in this population. Positive attitudes towards older people and high levels of empathy are necessary for the provision of high-quality nursing care, which will contribute towards improving the quality of life of older patients affected by these syndromes.MethodsA quasi-experimental study was conducted using a longitudinal design with a single group and a pre- and post-intervention evaluation. The development of attitudes towards older people and empathy skills were evaluated using high-fidelity simulation-based training, comparing the levels obtained in these skills at baseline and after the simulation experience. The simulated scenarios recreated the great geriatric syndromes in older patients: instability, immobility, intellectual impairment and incontinence.ResultsAfter the simulation sessions, nursing students significantly improved their total scores for both attitudes toward older people and empathy, moreover, improvements were found in the three subscales of empathy. The effect size was large for the total scores of both the attitudes towards older people and the empathy scales and the ‘perspective taking’ subscale. The obtained effect size was small for the ‘compassionate care’ subscale, whereas for the ‘standing in the patient’s shoes’ subscale, the obtained effect size was medium.ConclusionsOur high-fidelity simulation-based training allows undergraduate nursing students to improve their empathy levels and positive attitudes toward older people. The development of these skills may provide benefits directly related to high-quality care for older patients. Therefore, the inclusion of simulation training programs in geriatric nursing study plans is necessary to train nursing students in the care of older people and to prepare them for real clinical practice.     

实习对本科护生患者安全知识影响的调查研究

目的调查本科护生实习前后的患者安全知识、态度和技能现状,为更好地开展护生患者安全教育提供依据。方法以皖南医学院护理学院实习前后本科护生为研究对象,进行"患者安全知识、态度、技能"问卷的匿名调查。采用EpiData 3.0软件录入数据,SPSS 17.0软件进行统计分析。结果实习前共发放问卷451份,收回有效问卷435份(96.45%)。实习后共发放问卷418份,收回有效问卷412份(98.56%)。与实习前相比,实习后女护生"医疗差错相关知识"和"医疗差错发生后我应该怎么做"两个维度的得分显著增高(P<0.000),"医疗差错发生后的情感"(P=0.002)和"有关患者安全你的意向/打算"得分显著降低(P=0.006);而男护生仅在"医疗差错发生后我应该怎么做"方面得分显著增高(P=0.046)。结论实习能显著提升护生的患者安全知识,减轻护生发生医疗差错后的负面情感反应。     

Use of a flipped classroom in ophthalmology courses for nursing,dental and medical students: A quasi-experimental study using a mixed-methods approach

BackgroundTraditional teaching is associated with dilemmas, such as low motivation to learn and passive learning. In contrast, use of a flipped classroom with the proper learning design has the potential to promote accelerated learning, bolster transmission of competencies (i.e., critical thinking, communication and problem-solving skills) and improve teamwork capacity, all of which are of great significance in professional healthcare practice, including nursing, dentistry and medicine.ObjectiveThe aim of the study was to examine the effects of using a flipped classroom in ophthalmology courses for undergraduate nursing students, dental students and higher vocational medical students.DesignA quasi-experimental design was used with an intervention (n = 100) and a comparison group (n = 100), pre-/post-testing measures and a mixed-methods approach.SettingA university in China.ParticipantsA total of 200 students were included.MethodsStudents' self-rated learning ability was measured before and after the courses, and skill exams were performed after the courses. In addition, interviews were conducted with the clinical medical students concerning their experiences of the flipped classroom.ResultsStudents' self-rated learning ability improved significantly more in the intervention than in the comparison group, for the total scale and the three factors ‘learning goals’, ‘self-efficacy and social learning’ and ‘problem-solving’. Skill exam scores were statistically significantly better in the intervention than in the comparison group. On the whole, the clinical medicine students felt the flipped classroom had a positive impact and improved their learning ability as well as knowledge in ophthalmology.ConclusionsUse of a flipped classroom for nursing, dental and clinical medical students in ophthalmology courses shows promising results in the form of students' skill exam scores and self-rated learning ability.     

The effect of a brief mindfulness-based stress reduction program on strengthening awareness of medical errors and risks among nursing students

InformationHealthcare professionals' awareness of medical errors and risks results in effective medical error reporting and patient safety. Mindfulness has positive effects on strengthening attention and awareness. However, little is known about the use of mindfulness in patient safety education among nursing students. This study aimed to examine if a brief mindfulness-based stress reduction program would have a beneficial impact on (a) medical error attitudes, (b) the number of medical errors and risks in a simulation environment, and (c) self-confidence and satisfaction among nursing students.MethodsA quasi-experimental design with a control group was conducted with 78 third-year nursing students at a private, accredited, nursing program in Istanbul, Türkiye.ResultsThere was a statistically significant improvement in the intervention group between the pre-test and post-test for medical error attitudes (p < 0.001), and the number of medical errors and risks in a simulation environment (p < 0.001). There was no statistical difference in the intervention and control groups for self-confidence and satisfaction (p > 0.05).ConclusionThese results suggest that a brief mindfulness-based stress reduction program positively strengthens nursing students' awareness of medical errors and risks.     

实习前临床医学生与护理学生患者安全知识调查与比较分析

目的调查并比较实习前本科临床医学生和护理学生关于患者安全知识、态度和技能的现状,为开展患者安全教育提供依据。方法以皖南医学院实习前五年制临床医学本科生和护理本科生为研究对象,进行＂患者安全知识、态度、技能＂问卷的匿名调查。采用EpiData 3.0软件录入数据,并用SPSS 17.0软件进行统计分析。结果共发放771份问卷,收回有效问卷755份,包括临床医学生320份,护理学生435份。结果显示：护理学生和临床医学生患者安全知识、态度和技能总分均较低;护理学生在＂医疗差错相关知识＂（P=0.012）、＂医疗差错发生后的情感＂（P=0.000）、＂患者安全的个人态度＂（P=0.001）和＂有关患者安全你的意向/打算＂（P=0.000）4个模块的得分均显著高于临床医学生;临床医学女生和护理女生在＂医疗差错发生后的情感＂得分上也均显著高于男生（P=0.028和0.000）。结论实习前护理学生和临床医学生患者安全知识均不足,后者更差,应加强针对他们的患者安全知识教育。     

First-year nursing students’ attitudes towards artificial intelligence: Cross-sectional multi-center study

AimTo assess the attitudes of nursing students toward artificial intelligence.BackgroundPossible applications of artificial intelligence-powered systems in nursing cover all aspects of nursing care, from patient care to risk management. Although the final acceptance of artificial intelligence in practice will depend on positive 'nurses' attitudes toward artificial intelligence, those attitudes have gained little attention so far.DesignA cross-sectional multicenter study.MethodsThe study was performed at nursing schools of four Croatian universities, surveying a total of 336 first-year nursing students (response rate 69.7%) enrolled in 2021. A validated instrument, the General Attitudes towards Artificial Intelligence Scale, consisting of 20 Likert-type items, was chosen for the study. Where applicable, the items were contextualized for nursing. Four sub-scales were identified based on the outcomes of the factor analysis.ResultsThe average attitude score was (mean ± standard deviation) 64.5 ± 11.7, out of a maximum of 100, which was significantly higher than the neutral score of 60.0 (p < 0.001). The attitude towards AI did not differ across the universities and was not associated with students’ age. Male students scored slightly higher than their female colleagues. Scores on subscales “Benefits of artificial intelligence in nursing”, “Willingness to use artificial intelligence in nursing practice”, and “Dangers of artificial intelligence” were favorable of artificial intelligence-based solutions. However, scores on the subscale “Practical advantages of artificial intelligence” were somewhat unfavorable.ConclusionsFirst-year nursing students had slightly positive attitudes towards artificial intelligence in nursing, which should make it easier for the new generations of nurses to embrace and implement artificial intelligence systems. Reservations about artificial intelligence in daily nursing practice indicate that nursing students might benefit from education focused specifically on applications of artificial intelligence in nursing.     

A mixed method study to determine the attitude of Australian emergency health professionals towards patients who present with deliberate self-poisoning

IntroductionDeliberate self-poisoning is one of the frequent presentation types to emergency departments. It has been reported that attitudes of emergency staff may have negative consequences for the wellbeing of the self-poisoning patient.AimDetermine the attitude of nursing and medical staff towards patients who present with deliberate self-poisoning and to identify if differences exist between the two groups.DesignMixed-method.MethodologyThe “Attitudes towards Deliberate Self-Harm Questionnaire” was distributed to all nursing and medical staff who had direct patient contact at three emergency departments (N = 410). Total and factor scores were generated and analysed against variables age, gender, length of experience working in the emergency department, level of education and by profession. Two open ended questions asked staff to write their perceptions and stories about patients who deliberate self-poison and were analysed using qualitative data analysis.ResultsForty-five percent of staff returned the questionnaire. The attitude of emergency nurses and doctors was positive towards patients who deliberately self-poison. Doctors had significantly higher total and Factor 2 ‘dealing effectively with the deliberate self-poisoning patient’ scores than nurses. After adjusting for length of time working in the emergency department only Factor 2 ‘dealing effectively with the deliberate self-poisoning patient’ remained statistically significant. Staff reported high levels of frustration, in particular to patients who represent.Conclusion/relevance to practiceThis information may be used to develop and implement educational strategies for staff to improve the experiences of and better support patients presenting to the emergency department who deliberately self-poison.     

Knowledge and attitudes towards patients with Alzheimer's disease across different educational levels of nursing and in different care settings: A cross-sectional study

AimTo evaluate Alzheimer’s disease (AD) knowledge and attitudes among Israeli nursing students and nurses with different educational backgrounds working in varied geriatric settingsBackgroundAlzheimer’s disease (AD) management and treatment relies on multidisciplinary care, providing comprehensive treatment to these patients. Nurses are vital to treatment provision. However, less nursing students are expressing interest to work with the geriatric population, including those with dementia.DesignThis was a cross-sectional study.MethodsParticipants were 231 nursing students and nurses of various educational backgrounds and from varied geriatric settings. Study measures included sociodemographic characteristics, the Alzheimer’s disease Knowledge Scale, and the Dementia Attitude Scale. Participants were recruited via social media, nursing administrations in medical facilities, and snowballing methods. Overall scores by educational background and correlations between the measures and select sociodemographic variables were evaluated.ResultsThe overall knowledge and attitudes towards dementia among Israeli nurses is moderate to high. The mean knowledge score was 23.32/30. The highest scores (for knowledge and attitude) were found among geriatric nurse practitioners. The lowest knowledge scores were found among registered nurses without a degree, while the lowest attitude scores was found among nursing students.ConclusionsDespite relatively high scores, there is still a need to minimize the gap in specific knowledge and attitude domains. There is a need for domain-specific training, such as risk factors related to dementia, and providing nurses of all educational backgrounds with the tools they need to feel comfortable in caring for AD patients.     

Patient safety competence for final-year health professional students: Perceptions of effectiveness of an interprofessional education course

As final-year medical and nursing students will soon play key roles in frontline patient care, their preparedness for safe, reliable care provision is of special importance. We assessed patient safety competencies of final-year health profession students, and the effect of a 1-day patient safety education programme on these competencies. A cross-sectional survey was conducted with 233 students in three colleges of medicine, nursing, and traditional medicine in Seoul. A before-and-after study followed to evaluate the effectiveness of the curriculum. Patient safety competency was measured using the Health-Professional Education for Patients Safety Survey (H-PEPSS) and an objective patient safety knowledge test. The mean scores were 3.4 and 1.7 out of 5.0, respectively. The communication domain was rated the highest and the teamwork domain was rated the lowest. H-PEPSS scores significantly differed between the students from three colleges. The 1-day patient safety education curriculum significantly improved H-PEPSS and knowledge test scores. These results indicated that strengthening patient safety competencies, especially teamwork, of students is required in undergraduate healthcare curricula. A 1-day interprofessional patient safety education programme may be a promising strategy. The findings suggest that interprofessional patient safety education needs to be implemented as a core undergraduate course to improve students’ safety competence.     

A cross-sectional survey of nursing students' patient safety knowledge

BackgroundKnowledge provides a foundation for safe and effective nursing practice. However, most previous studies have focused on exploring nursing students' self-reported perceptions of, or confidence in, their level of patient safety knowledge, rather than examining their actual levels of knowledge.ObjectiveThe overarching objective of this study was to examine final year nursing students' levels of knowledge about key patient safety concepts.DesignA cross-sectional design was used for this study. Data collection was undertaken during 2018 using a web-based patient safety quiz with 45 multiple choice questions informed by the Patient Safety Competency Framework for Nursing Students. A Modified Angoff approach was used to establish a pass mark or ‘cut score’ for the quiz.Setting and participantsNursing students enrolled in the final year of a pre-registration nursing program in Australia or New Zealand were invited to participate in the study.ResultsIn total, 2011 final year nursing students from 23 educational institutions completed the quiz. Mean quiz scores were 29.35/45 or 65.23% (SD 5.63). Participants achieved highest scores in the domains of person-centred care and therapeutic communication, and lowest scores for infection prevention and control and medication safety.Based on the pass mark of 67.3% determined by the Modified Angoff procedure, 44.7% of students (n = 899) demonstrated passing performance on the quiz. For eight of the institutions, less than half of their students achieved a passing mark.ConclusionsGiven the pivotal role that nurses play in maintaining patient safety, the results from this quiz raise important questions about the preparation of nursing students for safe and effective clinical practice. The institutional results also suggest the need for increased curricula attention to patient safety.     

Self-management support by final year nursing students: A correlational study of performance and person-related associated factors

BackgroundChronic conditions put a heavy burden on healthcare in every country. Supporting persons with a chronic illness to take an active role in the management of their condition is a core component in the Chronic Care Model. It implies confidence and good skills from professionals. To date, there is no evidence on final year nursing students’ performance in supporting patients’ self-management, nor on factors associated with this performance.ObjectivesTo explore self-reported performance of supporting patients’ self-management by final year nursing students, and person-related factors associated with this performance.DesignA correlational multi-centre study of final year nursing students (N = 256) from eight nursing schools.MethodsStudents were recruited from a convenience sample of eight nursing schools. All final year students were invited to participate. Data were collected between January 2015 and May 2016 using self-administered validated questionnaires. Theoretical behavioural frameworks were used to select hypothesized associated factors for self-management support: self-efficacy to perform self-management support and socio-structural factors (Social Cognitive Theory); needs for autonomy, competence and relatedness, and patient-invested contingent self-esteem (Self-Determination Theory); and attitudes towards supporting patients’ self-management (Theory of Planned Behaviour).ResultsFinal year nursing students (N = 256) reported an overall low level of performance in delivering self-management support during internship. Students lacked mainly competencies in collaborative goal setting and shared decision making. Students reported a significant gap between their confidence and their actual performance in self-management support (p < 0.001). About 33% of the variance in students’ performance is predicted by four person-related factors, i.e. self-efficacy to perform self-management support, general feeling of competency on internship, belief on patients’ knowledge about condition management, and contingency of a student’s professional self-esteem upon patients’ achievements.ConclusionFinal year nursing students are actually not ready to support patients’ self-management even though they will soon be in practice as qualified nurses. Nursing curricula should be further attuned to the complex competencies of self-management support. Special attention is needed to broaden the perspective on self-management support. Learning opportunities can be introduced in classroom activities and on internship.     

Attitudes and perceptions from nursing and medical students towards the other profession in relation to wound care

Lack of nurse?physician collaboration in wound care may result in prolonged healing times for patients. In order to facilitate future professional collaboration, undergraduate learning activities in interprofessional education (IPE) have been proposed. The aim of this study was to investigate nursing and medical students’ attitudes and perceptions towards each other’s future professions and interprofessional collaboration in wound care. Nursing and medical students took part in an interprofessional learning activity about wound care. Data were collected using the Jefferson Scale of Attitudes towards Physician?Nurse Collaboration questionnaire to student groups before and after an IPE activity (pooled n = 221). Focus groups were conducted to deepen the knowledge about students’ attitudes and perceptions. The results showed high scores on the attitude scale (mean 53.2, possible maximum = 60) both before and after IPE, indicating positive attitudes towards nurse?physician collaboration. Nursing students scored higher than medical students both pre-IPE (p < 0.001) and post-IPE (p = 0.006). However, no difference on scale scores could be identified between pre- and post-IPE. The following themes emerged in the analysis of focus group discussions: “Approaching patient care from different perspectives,” “Need for collaboration and clear professional roles in practice,” “Structures hindering future collaboration,” and “IPE as a tool for professional practice and roles.” The shared learning activity provided insights into the other profession’s competence. This kind of learning activity may increase future interprofessional collaboration, and thus, improve wound care.