Changing nursing practice through continuing education: a tool for evaluation

In light of the current cost-orientated, rapidly changing health service, continuing education providers are challenged to achieve the greatest benefits for the service. Given this culture it is argued that it is essential for nurses to acquire the skills to continually learn, and that for managers there is seen to be a measurable change in a recommended practice or behaviour. To meet these challenges it is essential that continuing educators plan, implement and evaluate programmes in partnership with clinicians and managers. A literature review revealed that most evaluations did not address whether continuing education has resulted in a change in practice. This paper describes a study on the use of goal attainment scaling as an evaluation tool to measure changes in learner behaviour and as a means of promoting self-determination among the participants. It is proposed that goal attainment scaling can be used to measure changes in participant behaviour following an educational programme. In addition, this analysis of participant interviews indicates the tool's usefulness as a self-reporting instrument and this appears to foster the skills of self-assessment and appraisal of performance.     

Mental health literacy of Australian Bachelor of Nursing students: a longitudinal study

Many students have poor mental health literacy when they finish Bachelor of Nursing courses. This paper presents the findings of a longitudinal study of Australian Bachelor of Nursing students' mental health literacy about the effectiveness of interventions for people with schizophrenia. The 'Attitudes and Beliefs about Mental Health Problems: Professional and Public Views' questionnaire was used with a non-probability sample of nursing students. A time series approach to data collection was used, with data collected on three occasions between 2005 and 2007. Ethics approval was obtained from a university ethics committee. Data were analysed using SPSS Version 15.0. The students' views about the helpfulness of interventions showed a significant and positive improvement as they progressed through the course. There were significant differences over time in their views about the helpfulness of professional and lay interventions, their opinions about the helpfulness of mental health and other medications, and the usefulness of activity and non-pharmacological interventions. Because nursing students need to be mental health literate when they complete their course, mental health nursing content should be incorporated earlier in comprehensive undergraduate curricula and incrementally increased in each year of study.     

Willingness to provide care and treatment for patients with HIV/AIDS

This paper is derived from the findings of a larger study which examinies nurses' and doctors' attitudes towards mainstreaming of hospital inpatient services for individuals with HIV/AIDS in general hospital wards. The aim of this paper is to discuss the factors which influence nurses' and doctors' willingness to provide care and treatment for patients with HIV/AIDS. Two methods of study are used in this researc — a survey questionnaire and semi-structured interviews. The findings of this study provide several themes abouth the positive attributes associated with caring for and treating patients with HIV/AIDS. These include: that caring for and treating is personally and professionally rewarding; the need to be non-judgemental and accepting of others; that previous work or social experience is related to willingness to work with patients; the influence of family and colleague support in the work environment; and having a duty of care.     

Project to develop an autonomous practitioner programme

The early 1990s has seen a rapid expansion in the nature of clinical roles in health care in response to a number of changes. Throughout 1996, The Oxford Radcliffe Hospital National Health Service (NHS) Trust, in partnership with Oxford Brookes University, School of Health Care, and the Royal College of Nursing (UK) have been collaborating to develop an educational programme at degree and masters level, to support new and evolving clinical roles in acute and primary care, across most professional health registration areas and clinical specialities. To ensure the proposed programme was 'fit for purpose'the Trust commissioned a Training Needs Analysis by the University of Birmingham and a Role Analysis by The Royal College of Nursing. Nurses and Midwives with expertise in practice, management, education and research, have collaborated to develop an innovative educational programme which enables a wide range of public and private health care professionals across acute and community settings to develop their autonomous practice. The programme is fully supported by development of policies which are appropriate to service delivery, support professional practice, multi- professional relationships, risk management and patient safety. The issue of contractual and professional responsibilities related to career development have been debated and a proactive strategy agreed. To ensure there is thorough evaluation of the area of practice, research projects to evaluate outcomes for patients as well as practitioners have been designed. This will additionally promote a culture of evidence-based practice.     

Facilitating the development of moral insight in practice: teaching ethics and teaching virtue

Abstract The teaching of ethics is discussed within the context of insights gleaned from ancient Greek ethics, particularly Aristotle and Plato and their conceptions of virtue (arete, meaning excellence). The virtues of excellence of character (moral virtue) and excellence of intelligence (intellectual virtue), particularly practical wisdom and theoretical wisdom, are considered. In Aristotelian ethics, a distinction is drawn between these intellectual virtues: experience and maturity is needed for practical wisdom, but not for theoretical wisdom. In addition to this, excellence of character is acquired through habitual practice, not instruction. This suggests that there is a need to teach more than theoretical ethics and that the ethics teacher must also facilitate the acquisition of practical wisdom and excellence of character. This distinction highlights a need for various educational approaches in cultivating these excellences which are required for a moral life. It also raises the question: is it possible to teach practical wisdom and excellence of character? It is suggested that virtue, conceived of as a type of knowledge, or skill, can be taught, and people can, with appropriate experience, habitual practice, and good role models, develop excellence of character and become moral experts. These students are the next generation of exemplars and they will educate others by example and sustain the practice of nursing. They need an education which includes theoretical ethics and the nurturing of practical wisdom and excellence of character. For this purpose, a humanities approach is suggested.     

Nurse migration: the effects on nursing education

This paper is an opinion piece based on experience and supported where possible with literature, which addresses an issue of both national and international interest. It focuses on one aspect of the multifaceted social phenomenon of nurse migration, i.e. nurse education.
Background:  Much has been written about the direct effects of nurse migration on the nurse migrant, the delivery of health care in the countries that supply the nurses, and the countries that receive them. However, there is little information regarding the direct effects of migration on nurse education within the literature.
Aim:  The aim of this paper is to raise awareness of the positive and negative effects of nurse migration on nurse education both in the countries that supply nurses and those which receive them.
Methods:  Both scholarly and 'grey' literature is used to support the discussion on the 'real' challenges faced by nurse educators and clinical nurses in those countries that supply or receive nurses. In addition, practical recommendations for nurse educators are presented. Furthermore, the nursing profession is challenged to become politically active, to become involved and to take responsibility for the decisions made about nurse education in order to protect the integrity of nurse education and patient safety.
Conclusion:  The quality of nurse education in many countries has been undermined as a result of rapid, mass migration. There is an urgent need to take practical steps to maintain the integrity of nurse education and the nurse's preparation for practice in order to protect patients' safety.     

Communication between nurses and nurse managers: a case study from an NHS Trust

The role of effective communication in promoting organizational efficiency and effectiveness is being increasingly recognized. This paper proposes a communication audit methodology as a useful means of examining the quality of communication between nurses and their managers. Utilizing a case study methodology, results from an exploratory study are presented and discussed. These data suggest that significant problems in this field currently exist. The general applicability of the findings throughout the NHS are considered, and proposals on how relationships and communication could be improved are examined.     

Preparation for management: an exploratory study to ascertain perceptions of F grade nurses and clinical nurse managers

This paper reviews relevant literature and discusses the results of a small study designed to investigate how nurses are responding to the changes in the structure of the NHS which have reduced their role in management. The findings suggest that nurses who are currently at F grade level and their clinical nurse managers (CNM) are aware of the need for nurses seeking career progression to participate in education and training programmes related to nursing and management, particularly those which provide recognized qualifications, and that many are currently striving to achieve this. The findings also suggest that nurses want support to enable them to undertake further study, but that due to increasing pressure of work it is becoming more and more difficult for CNMs to provide the level of support they consider helpful. Nurses and CNMs urge those developing courses in management to ensure that courses are flexible to enable varying types of participation and tailoring to individual needs.