Day 1 :
- Nursing Education
Session Introduction
Barbara L. Wilson
University of Utah College of Nursing
Title: Lessons learned from Human Factors Engineering: Enhancing the quality and safety of nursing care
Biography:
Dr. Wilson is the Associate Dean of Academic Affairs and an associate professor at the University of Utah College of Nursing. In her role, she provides academic leadership in the planning, implementation, and evaluation of baccalaureate, masters, and doctorate of nursing practice programs of study, as well as the Gerontology Interdisciplinary Program. She has been a research consultant for several non-profit hospitals in addition to her career in the healthcare setting. Since 2005, Dr. Wilson has worked in the academic setting and carries an active program of research. She enjoys working with practicing clinicians to translate evidence into practice and conducting patient-centered outcomes research. Her current research seeks to examine the impact of labor and delivery nurse staffing patterns on adverse maternal and newborn outcomes. Dr. Wilson also has an interest in Human Factors Engineering (HFE), and healthcare workforce research, notably nursing shortages and gender wage disparities.
Abstract:
The identification and elimination of preventable patient safety errors has emerged as one of the most significant quality issues in health caresince the Institute of Medicine’s (IOM) report of errors in healthcare nearly 20 years ago. IOM’s report profoundly heightened concerns over the quality of health care and propelled professional and consumer groups into action, leading to a concentrated focus on various patient safety initiatives. Health care was challenged to create systems that were better able to recognize and respond to error, preventing adverse patient outcomes.
Human factors engineering (HFE) is a science that attempts to better understand which human vulnerabilities lead to mistakes, and then engineer systems that reduce the likelihood of error and allow for recovery and survival when errors do occur. Applied in the healthcare setting, HFE is a method that allows the evaluation of both provider and system-level factors that contribute to patient harm.
Clearly, nurses play a pivotal role in error reduction and patient safety. As the healthcare provider most continuously present with patients, nurses often serve as the last layer of defense in error occurrence. The incorporation of HFE into the clinical setting can both mitigate adverse outcomes and allow for the prompt identification of system-level designs that can contribute to provider error.
This presentation presents and describes 10 HFE strategies that can be easily incorporated into the clinical setting to minimize patient harm (e.g., reduce reliance on memory, reduce reliance on vigilance, minimize handoffs, simplify tasks and processes, provide for reversibility, etc.).
The insurgence of patient safety initiatives has heightened awareness of system and human factors that lead to mistakes in hospitals and other healthcare settings. By understanding and incorporating HFE into the clinical setting, nurses and other healthcare leaders can significantly mitigate adverse patient outcomes.
Biography:
Kerri Arcus is Academic Leader, Postgraduate Nursing Studies, School of Health, Whitireia Community Polytechnic, NZ. Kerri has research interests in a range of nursing education topics including teaching cultural safety, the education and transition of Internationally Qualified Nurses, building research capacity in nursing, graduate nurse education, and curriculum design.
Abstract:
This research reports on what Internationally Qualified Nurses (IQN) ‘bring’ to their postgraduate studies, examined from the different perspectives of the IQNs themselves and their nursing lecturers. The complexities of transition and integration for IQN into nursing workforces of a newly adopted country is under scrutiny internationally. However, when these nurses progress their careers via postgraduate studies, little attention has been paid to this transition.
This study explored the transition of IQNs into postgraduate courses and the factors that supported their success. The research was undertaken in partnership between nursing faculty and Poutama: Learning Support Services. Ethics approval was gained, and an online invitation to participate was sent to all postgraduate nurse students across two semesters in 2016-2017. Postgraduate teaching staff were invited to answer a similar survey.
Nine IQNs responded who were predominantly from the Philippines but whose foundational nursing education was in English. Eight of the nine academic staff respondents were experienced tertiary teachers of eight or more years.
The IQNs identified their prior nursing knowledge and experience as the predominant skill that would support their success but expected to further this through postgraduate studies. Academic staff also considered IQN prior nursing knowledge a strength, and also identified their apparent motivation and resilient approach to learning. Academic staff valued the IQNs cultural contribution, but identified their need to develop an understanding of the NZ cultural-professional context and advance their academic scholarship.
Entering postgraduate education requires a transition to higher level study. For these IQN, they must also transition to a new educational approach. This double transition must occur quickly for academic success within course timeframes. The findings of this small study can inform nursing education to promote strategies for success for IQN advancing their nursing careers in their newly adopted countries.
Aristos Neocleous
Whitireia New Zealand,
Title: Peer mentoring: Promoting leadership in a nursing role
Biography:
Ari Neocleous has a background in paediatric and community health nursing. He emigrated to New Zealand in 2006 where he worked as a community paediatric nurse before moving into nurse education in 2009. Ari teaches in the Bachelor of Nursing programme at Whitireia where he helped develop a peer mentoring programme that would enhance the learning for year one and final year nursing students. Promotion of peer mentorship prepares students for transition to practice.
Abstract:
This presentation will describe and explain how peer mentoring promotes leadership in a nursing role.
Background
A qualitative research study utilising focus groups was undertaken in 2016/17 to explore the impact of peer mentoring on final year Bachelor of Nursing students’ transition to nursing workforce. Seven new graduate registered nurses who had been in a peer mentoring programme participated in the study. Leadership in a nursing role was highlighted as an area of nursing practice enhanced as a result of participation in a peer mentoring programme.
Results
Peer mentorship has strong links to professional development and in turn the development of nurse leaders (Krause-Parello et al., 2013). Peer mentoring further encourages nursing students to ask questions (Edmunds & Brown, 2010) which increases awareness of nursing roles and responsibilities. There are many benefits of peer mentoring including an increase in reflection, critical thinking and role modelling along with development of leadership skills (Brannagan et al., 2013; Ford, 2015; Ramm, Thomson, & Jackson, 2015). Participants in peer mentoring programmes are better prepared to problem solve and introduce innovation through leadership (Hooker, 2013). Peer mentoring opportunities in undergraduate nursing education enhances learning for peer mentors and peer mentees.
Conclusion
Peer mentoring increases nursing student engagement with peers, enhances learning and promotes leadership in nursing roles, thus facilitating nurses’ transition to nursing practice.
Cynthia M A Baluyot
Met- Oslo Metropolitan University
Title: Challenges in assessment situations of nursing students in clinical studies
Biography:
Cynthia M A Baluyot has her expertise in knowledge-based practice within the sociocultural learning approach. She developed the figure presentation above as a model in her teaching when she submitted her portfolio and qualified her for DNS in 2014 at Oslo Met- Oslo Metropolitan University (earlier Oslo & Akershus University College). She has built this model after years of experience in nursing practice & administration, teaching, evaluation and research. The foundation is based on Vygotsky`s teaching philosophy (1996) and Knowledge-based practice (Nortvedt, M. W., Jamtvedt, G., Graverholt, B., Nordheim, L. V. & Reinar, L.M. 2012). In the application of sociocultural learning theory, learning promotes students` progress & development, headlining the importance of didactics and clinical experiences to which the students are exposed. It emphasizes social interaction in the construction of knowledge and integration of knowledge-based practice in theoretical and clinical studies.
Multicultural nursing is also a field of expertise by Cynthia M A Baluyot, where she has three articles in 2001-2003 and 2014.
Abstract:
Problem statement: How mentors in the community home-based care services experience the use of Learning Outcome Assessment tool (Norwegian National Framework for Higher Education Qualifications) and its relationship to learning situations in bachelor nursing clinical studies?
Background for research: The Norwegian National framework for Higher Education Qualifications (2005), which is based on the European Credit Transfer & Accumulation System (ECTS, 2003-2008) has been used for 3-4 years now of the Oslo Met- Oslo Metropolitan University, Faculty of Health Sciences, Department of Nursing & Health Promotion. However, the framework needs evaluation on how mentors in clinical areas experience the Learning Outcome Assessment Tool and its relationships to learning situations in clinical studies in nursing.
Purpose of the study: To describe mentors` experiences in using the Learning Outcome Assessment Tool and to develop appropriate criteria and common understanding of the framework in relation to learning situations and assessment of nursing students` learning outcome in clinical studies in the community home-based care services
Methodology: Explorative qualitative study through focus group interview is used. Data analysis is done through Kvale`s level of interpretation.
Theoretical Orientation: Knowledge Based Practice within a Sociocultural Learning Approach.
Findings: Mentors in the community home based care services encounter some challenges in understanding and using the framework. The research recommends concrete translations of the Learning Outcome Assessment Tool to fit into learning situations in clinical studies and increase knowledge and understanding of the framework by mentors in the community home-based care services.
Dr Julia E Hollis
Unitec – Institute of Technology, Auckland, New Zealand.
Title: Carers’ experience of caring for a family member with an enduring mental health problem
Biography:
Dr Julia E Hollis (née Pelle) works as a nurse educator/nurse researcher with a focus on the lived experience of family carers of relatives with enduring mental health problems (Pelle, 2012; 2014 & 2016); the impact of culture, ethnicity and diversity on mental health and physical health assessment in mental health practice. Previously she worked as an acute in-patient mental health nurse before moving into health and social care education.
Abstract:
Statement of the Problem: Government reports indicate that there is a high incidence of enduring mental health problems in the African and African Caribbean communities living in the UK. Although research has explored the experience of service users from both these communities, little is known about how family carers experience caring for a relative with an enduring mental health problem from the same communities. The purpose of this study was to explore the lived world of caring as experienced by African and African Caribbean carers, who cared for a relative or spouse with psychosis living in the United Kingdom.
Methodology and Theorectical Orientation: Van Manen’s hermeneutical phenomenological approach was used to explore the lived caring experience of a seven African and African Caribbean carers who cared for a relative or spouse with psychosis. Hermeneutical interviews were audio-taped and transcribed verbatim. A hermeneutic data analysis framework was used to enable prolonged emersion in the data and to gain an understanding of the phenomenon of caring.
Findings: The context of the caring relationship between carer and the cared for person revealed five essential themes. Being there and staying there; the experience of losing oneself and re-discovering self, particularly when the cared for person was in crisis; keeping an on-going dialogue with other family members who are joint carers and also partnering with mental health services. Carers expressed a conscious awareness of cultural stereotypes about Black African and Black Caribbean people, which they experienced when engaging with mental health services. For all carers there was the experience of becoming increasingly resilient and sustaining hope, particularly when they considered the achievements of the cared for person.
Conclusion and Significance: This research highlights the need for mental health and social care services to engage carers at the point of engagement and assessment and to ensure their involvement at each stage of the service user journey. More recognition of carers in their role as part of their familial duty, but also acknowledgement of their need for respite from their caring role and time to care for themselves and other family members.
Implications for Practice: Mental health and social care services in the UK and internationally need to develop a partnership relationship with family carers to support service user recovery and carer’s adjustment to their care role. Developing education and training for mental health nurses which enhances knowledge of cultural values and perceptions and experiences of mental health, mental illness and well-being of our diverse communities.
Biography:
Yi-Jiun Chou is a professional with 13+ years in critical intensive care and 2+ years in administrative, a Registered Nurse, with ACLS certificate, and BLS instructor in Taiwan. Diversely experienced in conducting clinical assessments. Skilled and highly motivated nursing professional on critical care. Created the clinical care standard, and work to the improvement of care quality.
Abstract:
Introduction: In recent years, therapeutic hypothermia (TH) has been used to improve outcomes in patients who have received TH after resuscitation from out-of-hospital cardiac arrest (OHCA). Patients received TH after resuscitation from cardiac arrest are more dependent on continuous and intensive nursing care. It involves many difficult steps, especially achieving target body temperature and maintaining temperature. To our best knowledge, there is no consensus or recommended standard on nursing practice of TH.
Objectives: To increase the completion rate of nursing care at therapeutic hypothermia and achieve consistent care.
Methods: The project members first investigated the cognition of the nursing staffs and then observed the integrity of the nursing care. From the application of Cause-and-Effect analysis (Figure 1), we found the reason of incompletion on nursing care during therapeutic hypothermia. And we took five measurements: (1) Amended nursing standard of therapeutic hypothermia; (2) Amended TH checklist items into nursing records; (3) Established monitor procedure; (4) Designed each TH care reminder cards in each period; (5) Provided in-service training sections of TH for ICU nursing staffs.
Results: The completion rate of nursing care in therapeutic hypothermia increased from 81.3% to 92.3%.
Conclusion: The project team not only increased the completion rate but also improved patient safety, care quality, consistency with doctors, and improved professional level of nursing staffs. We recommend this result to be applied in complex care procedures: providing consistent care standard and checklist, as well as ongoing education and training to improve the feasibility and care quality of clinical care.