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.     

Incorporating medication administration safety in undergraduate nursing education: A literature review

ObjectiveThe purpose of this review was to identify methods for incorporating medication administration safety in undergraduate nursing education.DesignThe Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines directed this review.Data SourcesA search of four electronic databases (Cumulative Index to Nursing and Allied Health Literature, Education Resources Information Center, Google Scholar, and MedLine/PubMed MedLine/PubMed) as well as hand searches were conducted to identify original research published between 2005 and 2018.Review MethodsOriginal empirical research describing a method for incorporating medication administration safety concepts in nursing education and examining its effectiveness on undergraduate nursing students' outcomes were selected for review. Articles describing medication safety education for graduate students, students other than those in nursing, and practicing nurses were excluded.ResultsTwelve original research articles were included for review. Three methods for incorporating medication administration safety in undergraduate nursing education were identified: simulation experiences, technology aids, and online learning modules. Most studies were conducted in North America. The use of different interventions as well as different outcome measures was noted as a limitation to the collective body of research in this area. Also, there was a lack of information regarding psychometric properties of instruments used among the studies reviewed.ConclusionSimulation experiences, use of technology aids, and online learning modules helped increase medication safety competence of nursing students. However, simulation equipment, select technology aids, and online learning may not be available for all nursing programs; therefore, educators should consider developing and testing classroom-based educational interventions. Moreover, future researchers should use or develop psychometrically sound instruments to measure nursing students' outcomes including competencies about medication administration safety.     

Designing and implementing reflective practice programs – Key principles and considerations

This paper reports on an educational evaluation study that sought to identify key principles that could inform the design and implementation of undergraduate nursing reflection programs and thereby enhance the potential that nursing students will develop sound reflective practice. Semi-structured interviews were conducted with nursing graduates to explore their perceptions of an undergraduate Bachelor of Nursing reflection subject and explicate the factors that could enhance the implementation of this subject. Subsequent validation and refinement of these factors was managed by correlating the factors with students' qualitative feedback, gathered through a formal subject evaluation of the undergraduate reflective practice subject. The correlation analysis, ascertained three principles that are posited as highly significant in the design and implementation of undergraduate reflective practice nursing programs. These principles, which are explained in this paper, despite being conceptualised in an Australian University have relevance and are appropriate across national and discipline boundaries and could be used in the design and implementation of any reflection subject, particularly those in undergraduate programs.     

Exploring undergraduate nursing students' perceptions of working in aged care settings: A review of the literature

ObjectivesTo explore undergraduate nursing students' perceptions of working in the aged care setting through a review of the literature.DesignA review of available literature relating to undergraduate nursing students' attitudes, perceptions and experiences in the aged care setting, or in the care of older adults.Data sourcesCINAHL Plus with Full Text was the primary database used. Other databases include PsycINFO and Health Source: Nursing/Academic Edition.Review methodsStudies focused on undergraduate nursing students and their experiences in the aged care setting and on the perceptions and attitudes of nursing students toward older adults, were included. Studies that did not present an original study or those that did not meet the aim of the study were excluded from the review.ResultsFollowing removal of duplicates and exclusion of articles not meeting the aim of this paper, 24 articles remained. Three main themes emerged from the review of the literature: perceptions of aged care placement, attitudes to working in aged care, and experiences in aged care.ConclusionThe experiences of nursing students employed as undergraduate AINs in the aged care setting can provide an immersive clinical learning experience in preparation for their new graduate (NG) year. Furthermore, it is an opportunity to challenge ageist attitudes and instil core nursing values in novice nurses such as promoting compassionate care.     

Factors contributing to undergraduate nursing students' satisfaction with a video assessment of clinical skills

BackgroundClinical skill assessment via Objective Structured Clinical Assessment (OSCA) has many challenges for undergraduate nursing students. These include high levels of anxiety that can compromise performance during the assessment, inconsistency with assessor reliability and is inconsistent with clinical skills performance in the real world. The implementation of a Video Assessment of Clinical Skills (VACS) that integrates formative feedback may be a way to address the challenges posed by OSCA assessment.ObjectivesThe aim of this study was to examine the acceptability, utility, and nursing student satisfaction with a formative feedback strategy – the Video Assessment of a Clinical Skill (VACS).DesignA cross sectional survey.SettingsUndergraduate Bachelor of Nursing degree students from a large Australian University.ParticipantsThird year undergraduate nursing students (final year) enrolled in a Bachelor of Nursing Program.MethodsParticipants were recruited via purposive sampling. A pre-survey (prior to VACs assessment) and post-survey (after VACS assessment) were completed. This paper reports on the open-ended responses in the post-survey that explored students' insights and perceptions into formative feedback and its impact on their learning for the VACS assessment.ResultsA total of 731 open-ended responses were analysed with findings being organised into 3 major themes; (i) Flexibility and reflexivity, (ii) Editing and repeated attempts, and (iii) Working together.ConclusionsVideo Assessment of a Clinical Skill has demonstrated good utility, acceptability, and satisfaction among undergraduate nursing students.     

Enhancing patient safety: The importance of direct supervision for avoiding medication errors and near misses by undergraduate nursing students

Reid‐Searl K, Moxham L, Happell B. International Journal of Nursing Practice 2010; 16 : 225–232
Enhancing patient safety: The importance of direct supervision for avoiding medication errors and near misses by undergraduate nursing students Medication errors have been the focus of considerable research attention in nursing; however, the extent to which nursing students might contribute to errors has not been researched. Using a grounded theory approach, in‐depth semi‐structured interviews were conducted with undergraduate nursing students based in a university in Queensland to explore their experiences of administering medication in the clinical setting. Almost a third of the participants reported making an actual medication error or a near miss. Where medication errors occurred, participants described not receiving direct and appropriate supervision by a registered nurse. Medication errors by nursing students have the potential to impact significantly on patient safety, quality of health care, and on nursing students' perceptions of their professional competence. Ensuring direct supervision is provided at all times must become an urgent priority for undergraduate nursing education.     

Students' perceptions of interventions designed to foster empathy: An integrative review

ObjectiveEmpathy is assumed to be an important element of nursing care, and nursing educators are attempting to find ways to effectively foster empathy in their students. The purpose of this review is to gain a deeper grasp of what undergraduate nursing students are learning from interventions educators have designed to cultivate empathy by synthesizing qualitative data.Review methodsUtilizing the review methodology proposed by Whittemore and Knafl, a survey of the CINAHL, Web of Science, PubMed, and PsychINFO databases was undertaken to answer the question: What are undergraduate nursing students' perceptions of interventions designed to foster empathy?ResultsA thematic synthesis of the students' perceptions from the 17 articles meeting inclusion criteria revealed five themes: Understanding the other's experience, embodying the other's experience, becoming aware of self, informing the role of the nurse, and learning or transforming.ConclusionsAlthough additional conceptual work remains to create a coherent, complete, and parsimonious definition of empathy, the results indicate that the students are gaining many of the facets assumed to be part of the concept of empathy through these educational interventions. Immersive simulations that put students in the role of the “other” were particularly impactful, especially if they created a disorienting dilemma followed by guided reflection. These findings can help nursing educators tailor their interventions for their specific intended learning outcomes.     

Medication math dosage assessment anxiety in undergraduate nursing students: A systematic review

BackgroundMedication calculation assessment is commonplace in undergraduate nursing programs. A test is routinely used to assist in the determination of safe medication administration practice in a clinical setting. Multiple factors negatively impact student performance.AimThe aim of this article is to analyze current literature related to medication calculation assessment and undergraduate nursing student anxiety.MethodA systematic review was performed using the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. Articles included were peer-reviewed publications focused on undergraduate nursing student anxiety related to medication dosage calculation.FindingsAnxiety related to medication calculation assessments can stem from students' personal lives and previous math experiences. Interventions related to increasing self-efficacy can impact student performance on assessments.ConclusionA variety of interventions to assist undergraduate nursing students increase performance on assessments were indicated in the literature. Advances in educational technologies allow for more assessment options to facilitate safe medication practices.     

Ref: NET_2019_1563: Working while studying: The impact of term-time employment on undergraduate nursing students' engagement in the Republic of Ireland: A cross-sectional study

BackgroundGlobally, there is evidence that tertiary education students are increasingly combining full time study with paid term-time employment. Despite this dual participation, little is known about the impact of working for pay during term on students' engagement with activities, both academic and social, that are associated with learning and development.ObjectivesTo measure undergraduate nursing students' term-time employment commitments and the impact of those commitments on nursing students' engagement.DesignCross-sectional survey design.SettingsFour Higher Education Institutions (HEIs) in the Republic of Ireland - comprising of two Universities and two Institutes of Technology.ParticipantsFirst and final year undergraduate students (n = 634) enrolled in a four-year Bachelor of Science Nursing (honours degree).MethodsThe College Student Report – National Survey of Student Engagement (NSSE) self-report questionnaire was utilised. This collects data on core activities associated with student engagement along with how students spend their time in and out of class. The statistical software package SPSS version 21 was used to analyse data.ResultsOver two-thirds of undergraduate nursing students (n = 423) engaged in term-time employment, working on average 15 h per week, with non-traditional students (i.e. mature-aged, those with children, those who did not enter college based on second level school results) working most hours. Term-time employment had limited impact on student engagement, however, students in employment had increased student faculty interaction compared to students who were not employed but engaged in less time studying (Mean = 7.2, SD 5.9) than those who were employed (Mean = 8.7, SD = 7.6; t(316) = 2.46; p = .014).ConclusionsOverall, engaging in term-time employment was not negatively associated with student engagement, but it did reduce the number of hours students studied. Non-traditional students were more likely to be employed and consequently impacted by combining work and educational demands.     

Student engagement in higher education: A cross-sectional study of nursing students' particpation in college-based education in the republic of Ireland

BackgroundStudent achievement within the Higher Education Sector is predicated upon engagement with college/university life and engagement is identified as having a major impact on the acquisition of knowledge and cognitive growth. Evidence within the higher education sector identifies factors which impact positively and negatively on student engagement. However, the direct application of this evidence to nursing students whose programmes of study are fundamentally different to other non-professional degrees has not, as yet, been examined.ObjectivesTo explore undergraduate nursing students' engagement in college-based education and their perceptions of how their institutions support student engagement.DesignCross-sectional survey design.SettingsFour Higher Education Institutions (HEIs) in the Republic of Ireland.ParticipantsNursing students in first and final year (n = 634) undertaking a four-year Bachelor of Science Nursing (honours degree).MethodsThe National Survey of Student Engagement (NSSE) self-report questionnaire, which collects data on four core areas related to student engagement, was used. The statistical package SPSS version 21 was used to analyse the data. Independent t-tests were used to compare differences in engagement between students, depending on year of study (first and final year), institution type, and age.ResultsStudents engaged most in activities that are considered core to higher education: higher order learning, collaborative learning and effective learning strategies. Although students perceived that lecturers engaged in effective teaching practices, they reported limited out of class interaction with lecturers.ConclusionsThe insight gained from this study of the educational realities of contemporary nursing students will provide clarity for nurse educators, regulators, and policymakers in their efforts to support and enhance student engagement.     

Graduating nurses' self-efficacy in palliative care practice: An exploratory study

BackgroundEducational institutions and the health care industry agree that graduates from professional programs need to be “work ready” and capable of delivering competent and confident nursing care. One measure of program success is the student's self-efficacy in meeting expected graduate capabilities. In this study student's self-efficacy is related to palliative care graduate capabilities.AimTo explore graduating Bachelor of Nursing Science (BNSc) students' self-efficacy in caring for palliative care patients.DesignA qualitative design using semi-structured face-to-face interviews.SettingA regional Australian university.ParticipantsA purposive sample of 10 students in their final semester of study in a Bachelor of Nursing Science degree program.MethodSemi-structured face-to-face interviews were conducted. Interview questions were informed by published palliative care graduate capabilities. Interview data were transcribed verbatim and coded by capability. The coded data were then analysed to determine evidence of self-efficacy in caring for palliative care patients.ResultsAll participants had experiences in caring for palliative care patients. However, the responses did not consistently reflect high degrees of self-efficacy in four documented palliative care graduate capabilities required to care for persons with a life-limiting illness.ConclusionsThe findings support others that have identified gaps between curriculum and health care industry requirements in terms of students' beliefs about their empowerment to deliver nursing care as graduates. Education interventions and approaches to program evaluation require further development to better support students' growth of self-efficacy in undertaking their graduate roles.     

Proactive personality,professional self-efficacy and academic burnout in undergraduate nursing students in China

BackgroundAcademic burnout can affect nursing students' academic performance and psychological well-being. Little is known about the associations between proactive personality, professional self-efficacy and academic burnout.PurposeTo assess the prevalence of academic burnout in undergraduate nursing students and to explore the associations between proactive personality, professional self-efficacy and academic burnout among nursing students in China.MethodsThis study used a cross-sectional design. Undergraduate nursing students were recruited from five medical schools in China to participate in an online survey from April to May 2020. The Proactive Personality Scale, Professional Self-Efficacy Scale for Nursing Students and Academic Burnout Scale were used to measure students' proactive personality, professional self-efficacy and academic burnout.ResultsA total of 1219 nursing students completed the questionnaire. The prevalence of academic burnout was 31.5% in nursing students, and improper behaviour showed the highest subscale score. Proactive personality, professional self-efficacy and academic year were negatively associated with nursing students' academic burnout.ConclusionsAcademic burnout is prevalent in undergraduate nursing students in China. This study contributes to the understanding of the associations between proactive personality, professional self-efficacy and academic burnout in nursing students. Nursing educators should develop strategies to enhance students' proactivity and professional self-efficacy to decrease their academic burnout.     

Nursing students' reflections on the learning experience of a unique mental health clinical placement

IntroductionThere exists a need for innovative thinking to identify new clinical placement opportunities for nursing students. Recovery-based clinical placements for mental health nurse students remain unique and require investigation.AimTo examine the learning experience of Bachelor of Nursing students who undertook an innovative mental health clinical placement known as Recovery Camp.DesignThis study incorporated qualitative analysis of written reflections. Using Braun and Clarke's (2006) six phases of thematic analysis the corpus of student reflections were reviewed by three members of the research team independent to each other.FindingsFour themes emerged. The theme of Pre-placement Expectations incorporates participant foci on pre-conceptions of Recovery Camp. The theme of Student Learning incorporates the ways in which participants recognised the experience of Recovery Camp influenced learning. Reflections themed under the title Placement Setting include discussion of the Recovery Camp as a clinical placement. The theme of Future Practice incorporates students' reflections on how they plan to practice as nurses as a result the learning experiences of Recovery Camp.ConclusionsAn immersive clinical placement such as Recovery Camp can influence students' perceptions of people with mental illness, have a positive impact on student learning and influence students' decisions about future practice. The learning experience of nursing students whom attend unique, recovery-orientated clinical placements can be both positive and educative.     

Desperately seeking consistency: Student nurses' experiences and expectations of academic supervision

BackgroundAcademic supervision - the support available to students when writing assignments - is a fundamental element in the provision of support within nurse education. Not only can it underpin high levels of academic achievement, but it also has a role in enhancing the retention of students. Despite its importance, there is little investigation of undergraduate academic supervision within the nursing literature.ObjectivesTo explore students' experiences and expectations of academic supervision as part of an undergraduate programme of nurse education.DesignA qualitative approach to explore student perceptions.SettingThe research was undertaken at a Higher Education Institution in the United Kingdom. The institution offers undergraduate nurse education programmes to approximately 800 students.ParticipantsEight pre-registration nursing students from a Bachelor of Science programme participated in a focus group interview. All were in the first semester of their final year.MethodsData were collected using focus group interviewing, based around a semistructured question framework. The focus groups explored students' expectations and previous experiences of academic supervision. The focus group was recorded, responses were transcribed and thematic analysis was undertaken to identify key findings.ResultsThree themes were identified from the data: relationship with supervisor, variation between supervisors, and the link between supervision and marking. Overall, students identified frustration with variability in the provision of academic supervision.ConclusionsEffective academic supervision depends on a strong relationship between student and supervisor - something that can be difficult to achieve if supervision is only for a short period of time. Equally, students crave a consistent approach to supervision, in terms of both the amount and content of feedback. Students are able to identify and articulate a clear link between effective supervision and academic achievement.     

Undergraduate nursing students' perceptions of the effectiveness of clinical teaching behaviours in Malaysia: A cross-sectional,correlational survey

BackgroundClinical teachers are a critical determinant of the quality of nursing students' clinical learning experiences. Understanding students' perceptions of clinical teachers' behaviours can provide the basis for recommendations that will help improve the quality of clinical education in clinical settings by developing better clinical teachers.ObjectivesTo understand clinical teaching behaviours and their influence on students' learning from the perspective of undergraduate nursing students.DesignA cross-sectional, correlational survey.SettingA nursing faculty in Kuantan, Pahang, Malaysia.ParticipantsA sample of 120/154 (78%) students from Year 2–Year 4 were recruited according to set criteria.MethodsA self-administered questionnaire was employed to collect demographic data, and students' perceptions of clinical teaching behaviours and their impact on learning using the Nursing Clinical Teaching Effectiveness Inventory (NCTEI).ResultsYear 3 and 4 students perceived faculty clinical teaching behaviours positively. There was a significant association between clinical teaching behaviours and their influence on students' clinical learning. Teachers' competence rated as the most significant influential factor, while teachers' personality rated as least influential.ConclusionParticipants were able to identify the attributes of good clinical teachers and which attributes had the most influence on their learning. Overall, they perceived their teachers as providing good clinical teaching resulting in good clinical learning. Novice clinical teachers and nursing students can use this positive association between teaching behaviours and quality of clinical learning as a guide to clinical teaching and learning.     

Does self-efficacy for medication administration predict clinical skill performance in first-year nursing students? An inception-cohort study

BackgroundMedication administration is an essential skill which is integrated in all nursing curricula to prepare nursing students for safe clinical practice. Although self-efficacy is linked to performance, little is known about its relationship to medication administration.AimTo examine the relationship between nursing students' self-efficacy in medication administration and actual performance.MethodA pre-and post-test design was used to assess the relationship between nursing students' self-efficacy and performance in medication administration. Undergraduate nursing students (n=715) enrolled in a first-year nursing skill unit between June to October 2017 at a multi-campus university in Australia, participated in the study. Data were collected at three time-points: i) baseline, including assessing pre-instruction medication administration self-efficacy; ii) 7-week follow-up; including assessing post-instruction medication administration self-efficacy; and open-ended items; iii) retrieval of grades one week later.FindingsAlthough there was no significant association between medication administration self-efficacy and achieving a satisfactory grade in the medication administration assessment, skill performance was linked to perceptions of clinical skills practice sessions.ConclusionsThis study identified that factors other than self-efficacy such as the practice environment and tutor support need to be considered to ensure student success in medication administration.     

Nursing students' changing orientation and attitudes towards nursing during education: A two year longitudinal study

BackgroundPrevious studies have shown that nursing students' perceptions of nursing change over time. Little research has been undertaken in the Netherlands of students entering nursing programmes and of how they progress.ObjectivesThe aims of this study were to explore whether nursing students' orientation and attitudes towards nursing changed over time, when these changes occurred, and what factors influenced the changes. We also aimed to identify the factors which prompted them to consider leaving their programmes, and what factors affected their motivation to stay.DesignThe study used a longitudinal quantitative design.ParticipantsQuestionnaires were administered to all students enrolled in a Bachelor's of Nursing programme at four nursing universities of applied sciences in the Netherlands (n = 1414). The data for this study were collected during the first two years of the programme, from September 2011 to June 2013. A total of 123 respondents completed the survey each year and this group was used to examine changes over time.MethodsAt four time intervals respondents completed a survey consisting of 1) the Nursing Orientation Tool, 2) the Nursing Attitude Questionnaire and 3) background characteristics. Non-parametric tests were used to explore changes in factor scores over time.ResultsThe results showed an improvement in the students' orientation and attitudes towards knowledge, skills and the professional roles of nurses, while empathic behaviour decreased over time. Although the changes showed non-linear patterns over time, the results showed clear effects between the different time points. The reasons for attrition (24%) proved to be related both to problems with the educational programme and to personal problems. An important motivator for students to stay in the course was their passionate desire to become nurses, suggesting that the positive aspects of a nursing career dominated the problems they encountered.ConclusionsTutors and mentors should pay more attention to the individual perceptions and problems of first and second-year students, both in the classroom and during clinical placements. Knowledge of the students' perceptions from the very beginning could be vital to study success.