Hand hygiene practices: nursing students' perceptions

Aims and objectives. The present study examines nursing students’ perceptions of hand hygiene practices in clinical settings. The objectives were to investigate any factors that affect students’ perceptions of their own and healthcare workers’ (HCWs) hand hygiene compliance, and to make recommendations for future practice and hand hygiene training in preregistration nursing courses. Background. Effective hand hygiene decontamination can lower the prevalence of healthcare‐associated infections (HCAIs); unfortunately, the prevalence of HCAIs continues to rise and so poses challenges to healthcare providers to reduce such infections. Previous studies have shown that hand hygiene compliance in HCWs is generally low and that any increase in compliance is difficult to sustain. Several barriers to hand hygiene compliance have been identified in the literature. Design. A qualitative interpretive design was used to examine nursing students’ perceptions of hand hygiene practices. Methods. Ten preregistration students participated in semi‐structured qualitative interviews, which were analysed thematically. Results. Hand hygiene compliance was perceived to be effected by specific barriers which included: time and busyness; clinical procedure; skin condition; lack of knowledge and glove use. Importantly, students perceived other HCWs as being the influencing factor for hand hygiene compliance resulting from the perception that they should ‘fit in’ with those working in the clinical area. Conclusions. The findings support previous literature and found that respondents emphasised the importance of fitting into the clinical area and role models in shaping hand hygiene compliance. Relevance to clinical practice. For nursing students, the influence of other HCWs as role models should not be underestimated.     

Fourth year nursing students' perceptions of their educational preparation in medication management: An interpretative phenomenological study

BackgroundMedication safety is an integral aspect of patient safety. Nurses, as advocates of patient safety, actively consider medication safety in the course of their daily work. Hence, it is important to consider the educational preparation of nursing students in medication management, as future caregivers. There are inherent links between nurses' undergraduate educational preparation in medication management and patient safety.ObjectiveThis research study identifies fourth-year nursing students' perceptions of their educational preparation in medication management.DesignAn interpretative phenomenological methodological approach underpinned this research study.SettingThis study was conducted at a University in the West of Ireland.ParticipantsParticipants were final year students of three undergraduate nursing programmes, Bachelor of Science in Nursing (General), Bachelor of Science in Nursing (Intellectual Disability) and Bachelor of Science in Nursing (Mental Health).MethodsFourteen semi-structured, face-to-face interviews were conducted with students on a one-to-one basis. Data were analysed using thematic content analysis.ResultsThe voices and interpretations of the participants in this study were fundamental to understanding nursing students' perceptions of their preparation in medication management and provided the foundation for this research. These perceptions were captured in the format of four themes: developing an understanding, embedding knowledge in practice, engaging in practice and accepting professional responsibility.ConclusionsFindings point to the important role of the university and the clinical placement settings in nursing students' medication management education and the need for further collaboration and development across both settings. Teaching and learning strategies which promote the integration of theory and practice throughout the four years of the undergraduate degree programme should be encouraged, such as technology enhanced learning and simulation.     

Building workplace social capital: A longitudinal study of student nurses' clinical placement experiences

Quality clinical placement experiences have been associated with nurses' workplace social capital. Social capital is broadly understood as the social organisation of trust, norms and networks that benefit society. Building social capital in the workplace may benefit experiences of staff and students. The aim of this study was to assess the impact of building workplace social capital on student nurse perceptions of clinical learning experiences. A quality improvement process was measured through repeated student surveys. First, second, third year students (n = 1176) from three universities completed a validated Student Clinical Learning Culture Survey (SCLCS) following their placement, at the commencement of quality improvement initiatives and five years later. The SCLCS measured students' perceptions of social affiliation, their motivation, satisfaction and dissatisfaction with clinical contexts. The first year of systematic changes focused on increasing student numbers along with improving communication, trust and knowledge sharing, antecedents to workplace social capital. No change was evident after the first year. Six years after commencement of building workplace social capital differences across all subscales, except dissatisfaction, were significant (p < 0.001). Leadership that promotes open communication and connections across staff and students to achieve common goals can build workplace social capital that enhances student placement experiences.     

Clinical reasoning of nursing students on clinical placement: Clinical educators' perceptions

Graduate nurses may have knowledge and adequate clinical psychomotor skills however they have been identified as lacking the clinical reasoning skills to deliver safe, effective care suggesting contemporary educational approaches do not always facilitate the development of nursing students' clinical reasoning. While nursing literature explicates the concept of clinical reasoning and develops models that demonstrate clinical reasoning, there is very little published about nursing students and clinical reasoning during clinical placements.Semi-structured interviews were conducted with ten clinical educators to gain an understanding of how they recognised, developed and appraised nursing students' clinical reasoning while on clinical placement. This study found variability in the clinical educators' conceptualisation, recognition, and facilitation of students' clinical reasoning. Although most of the clinical educators conceptualised clinical reasoning as a process those who did not demonstrated the greatest variability in the recognition and facilitation of students' clinical reasoning. The clinical educators in this study also described being unable to adequately appraise a student's clinical reasoning during clinical placement with the use of the current performance assessment tool.     

Nursing students' perceptions of the qualities of a clinical facilitator that enhance learning

There is a wealth of research investigating the role of the clinical facilitator and the student experience of clinical education. However, there is a paucity of recent research reviewing the students' perspectives of facilitators' qualities that influence their learning. This paper explores undergraduate nursing students' perceptions of the qualities of a clinical facilitator that enhanced their learning. The study was designed as a cross-sectional survey. A total of 452 third year nursing students at one Australian University were invited to participate. A total of 43 students completed the survey and were analysed; thus, the response rate was 9.7%. Results of the study indicate that nursing students perceive availability, approachability and feedback from the clinical facilitator to be highly influential to their learning in the clinical setting. The relational interdependence of these is discussed. Clinical facilitators have an important role in student learning. The findings of this study can be used in the development of clinical facilitator models, guidelines and in continuing education.     

Clinical instructors' knowledge and perceptions about nursing care of older people: A pilot study

With an aging population, the majority of nurses will spend their careers working with older people. Currently, there is scant research about clinical instructors' knowledge and perceptions about nursing care of older people despite their instrumental role in preparing nurses for practice. The purpose of this study was to explore clinical instructors' knowledge and perceptions about nursing care of older people. A mixed methods approach was used. Fifteen clinical instructors and 15 nurse educators employed on specialized units for older people completed questionnaires. Independent t-tests were administered. Five of the clinical instructors also participated in semi-structured interviews, which were analyzed using thematic analysis. Findings indicated that clinical instructors had significantly lower scores on knowledge and perceptions about nursing care of older people than practice-based nurse educators. Further, clinical instructors found it difficult to integrate specialized knowledge about nursing care of older people along with other aspects of their teaching. They also reported that it was challenging to support learning about best practices for older people within the current clinical context, which was complex and fast-paced. This study reinforces the need for professional development opportunities for clinical instructors to support their instrumental role in preparing students for practice with older people.     

Happy to help/happy to be here: Identifying components of successful clinical placements for undergraduate nursing students

IntroductionThe clinical placement learning environment is a critical component of nursing education where Australian nursing students spend a minimum of 800 h. Identifying components of successful clinical placements for undergraduate nursing students is therefore paramount.PurposeTo assess nursing students' views of the learning environment during clinical placement with an emphasis on the pedagogical atmosphere, leadership style of the ward manager, and premises of nursing on the unit or ward.Material and MethodsThe study used Clinical Learning Environment, Supervision and nurse teacher (CLES + T) questionnaire to examine 150 final year undergraduate students' perceptions of the clinical placement learning environment. The questionnaire was anonymous and completed by the students at the end of their clinical placement. The statistical program SPSS v22 was used. Principal components analysis (PCA) for data reduction was run on the 42-question section of the first dimension (‘pedagogical atmosphere on the ward’) of the questionnaire that measured the perceptions of the learning environment of the clinical placement of the 150 final-year undergraduate nursing students. The comments sections of the factors were subjected to interpretive content analysis to create the themes for the two components.ResultsPrinciple Component Analysis revealed two components that had eigenvalues greater than one: ‘Happy to Help’ Component 1 and ‘Happy to be Here’ Component 2. These components were statistically significant (p < 0.0005), using Bartlett's Test of Sphericity indicating that the data was likely factorizable. These components scored higher than any other related factors.ConclusionsStudent nurses value a welcoming workplace where staff and educators are happy to help and have a positive attitude to student presence on the wards. More than any other factors these ward-based factors appear to have the strongest influence on student satisfaction.     

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.     

Nursing profession and nurses' contribution to nursing education as seen through students' eyes: A qualitative study

The behavior of clinical instructors, as observed by students, deeply influences their professional development. When instructors behave unprofessionally, they risk undermining the professional growth students gain from their clinical placement experience. Clinical instructors need to be aware of how their behavior can affect the students' learning process and the contributions they make to clinical nursing education. A qualitative study was performed to describe the nursing profession as perceived by students who observed their clinical instructors' behaviors during the clinical experience. In‐depth interviews of nursing students were conducted until data saturation was attained. Sixteen interviews were analyzed using an inductive content analysis methodology. The nursing profession was described by the participants through five themes as follows: the helping relationship, technical role, professional growth, working group, and contradictions and conflicts. Several examples of unprofessional behaviors on the part of the clinical instructors were reported by the respondents. The nursing profession, as perceived by nursing students, does not always reflect their expectations and their ideas related to professionalism. Universities and schools of nursing should ascertain that clinical instructors are prepared to educate students. Faculty should clearly state to students what they can expect from the clinical experience, namely, preparing students to face real working environments that do not always reflect educational philosophies.