Due to a steady rise in cultural and linguistic diversity in healthcare settings and evident challenges associated with this diversity, there is an urgent need to address cultural competency of ...nurses. Ongoing, continuing professional development is needed to ensure nurses can provide culturally congruent nursing care.
The aim of this systematic review was to identify current best evidence on the types of educational interventions that have been developed to improve nurses’ self-assessed cultural competence and on the effectiveness of these interventions.
A systematic literature review.
Four electronic databases (PubMed, CINAHL, Medic, Eric) were searched for studies using a quasi-experimental design or randomised controlled trial published between January 2000 and June 2018.
Guidelines from the Centre for Review and Dissemination and the Joanna Briggs Institute guided the review. Two researchers independently assessed the eligibility of the studies by title, abstract and full-text and the methodological quality of the studies. Data tabulation and narrative analysis of study findings was performed.
Six studies met criteria for inclusion in the review. Studies used a quasi-experimental study design (n = 5) and a randomised controlled trial (n = 1). The participants (n = 334) were mainly nurses and interventions were conducted in various healthcare settings. Cultural competence education was offered through traditional contact teaching (n = 5) or web-based modules (n = 1) and ranged from one to 17 hours in length. Learning was enhanced through lectures, group discussions, case studies, reflective exercises and simulations. In two studies, following cultural competence interventions, participants in the intervention group had statistically significantly increased levels of competence in culture-related outcomes when compared to the control group. The four remaining studies did not include control group comparisons. Effect sizes (Cohen’s d) of the studies varied from small (d = 0.22) to very large (d = 1.47).
There continues to be a need for high quality studies investigating educational interventions to develop nurses’ cultural competence. Further research should focus on reporting specific components of interventions that result in an increase in cultural competence.
To analyze the publications that focus on distance education in nursing in Brazil from 2010 to 2016.
Integrative review of the literature with data collection in June 2016 in the following databases: ...LILACS, MEDLINE via PUBMED, CINAHL and SCOPUS. For the data analysis and interpretation, the thematic categorization was chosen.
We selected 18 articles for discussion, whose textual analysis permitted the construction of three thematic categories: use of virtual technologies for distance education in nursing; construction of virtual learning environments with the aid of virtual technologies for distance education in nursing; and evaluation of the learning process through virtual technologies for distance education of nurses.
Distance Education stands out as an effective teaching-learning strategy in this type of education in Brazilian nursing, focused mainly on the improvement and complement of traditional teaching.
to analyze the implication of the training/continuing education process of professionals of the Expanded Nucleus of Family Health and Basic Care (Portuguese acronym: Nasf-AB) for their ...interprofessional performance.
a qualitative case study performed with Nasf-AB teams representative of four macro-regions of health of the state of Santa Catarina. Participation of 43 professionals, who answered collective interviews. The results were later submitted to thematic analysis.
the training is strongly influenced by the Biomedical Model, which acts as an obstacle to interprofessional performance, given the challenges in the daily routine of Nasf-AB professionals. Continuing education emerges as a potential for the successful collaborative work among teams, and between the teams and Family Health professionals.
there are important limits in the training of professionals. However, the constant interprofessional development promoted by strategies of continuing education contributes to broaden the support and collaborative practices that qualify services and strengthen Basic Care.
Aim
To synthesize qualitative and quantitative evidence of front‐line staff acceptance of the use of telehealth technologies for the management of Chronic Obstructive Pulmonary Disease and Chronic ...Heart Failure.
Background
The implementation of telehealth at scale is a governmental priority in countries including the UK, USA and Canada, but little research has been conducted to analyse the impact of implementation on front‐line nursing staff.
Data sources
Six relevant data bases were searched between 2000–2012.
Design
Mixed‐method systematic review including all study designs.
Review methods
Centre for Reviews and Dissemination approach with thematic analysis and narrative synthesis of results.
Results
Fourteen studies met the review inclusion criteria; 2 quantitative surveys, 2 mixed‐method studies and 10 using qualitative methods, including focus groups, interviews, document analysis and observations. Identified factors affecting staff acceptance centred on the negative impact of service change, staff–patient interaction, credibility and autonomy, and technical issues. Studies often contrasted staff and patient perspectives, and data about staff acceptance were collected as part of a wider study, rather than being the focus of data collection, meaning data about staff acceptance were limited.
Conclusion
If telehealth is to be implemented, studies indicate that the lack of acceptance of this new way of working may be a key barrier. However, recommendations have not moved beyond barrier identification to recognizing solutions that might be implemented by front‐line staff. Such solutions are imperative if future roll‐out of telehealth technologies is to be successfully achieved.
Telehealth is viewed as a major strategy to address the increasing demand for care and a shrinking care professional population. However, most nurses are not trained or are insufficiently trained to ...use these technologies effectively. Therefore, the potential of telehealth fails to reach full utilization. A better understanding of nursing telehealth entrustable professional activities (NT-EPAs) and the required competencies can contribute to the development of nursing telehealth education.
In a four-round Delphi-study, a panel of experts discussed which NT-EPAs are relevant for nurses and which competencies nurses need to possess to execute these activities effectively. The 51 experts, including nurses, nursing faculty, clients and technicians all familiar with telehealth, were asked to select items from a list of 52 competencies based on the literature and on a previous study. Additionally, the panelists could add competencies based on their experience in practice. The threshold used for consensus was set at 80%.
Consensus was achieved on the importance of fourteen NT-EPAs, requiring one or more of the following core competencies; coaching skills, the ability to combine clinical experience with telehealth, communication skills, clinical knowledge, ethical awareness, and a supportive attitude. Each NT-EPA requires a specific set of competencies (at least ten). In total, 52 competencies were identified as essential in telehealth.
Many competencies for telehealth, including clinical knowledge and communication skills, are not novel competencies. They are fundamental to nursing care as a whole and therefore are also indispensable for telehealth. Additionally, the fourteen NT-EPAs appeared to require additional subject specific competencies, such as the ability to put patients at ease when they feel insecure about using technology. The NT-EPAs and related competencies presented in this study can be used by nursing schools that are considering including or expanding telehealth education in their curriculum.
•The study presents fourteen nursing telehealth activities to support patients.•Nurses need 32 ‘new’ telehealth specific competencies for the provision of telehealth.•The competencies discovered can strengthen the development of telehealth education.
Background:
Patients’ rights are universal values that must be respected; however, it is not easy to put such values and principles into effect as approaches and attitudes differ from individual to ...individual, from society to society, and from country to country. If we want to reach a general conclusion about the status of patient rights in the world as whole, we should examine the situation in individual countries.
Objective:
To study the effect of training sessions for nurses about patients’ rights on the perceptions of nurses and patients in two Egyptian hospitals.
Methods:
Quasi-experimental with pre- and posttest design was used in this study. Two groups of participants were included in the study: the first with 97 nurses and the second with 135 patients. A questionnaire sheet was used for nurses and patients to assess their perceptions about patients’ rights before starting sessions. The training sessions were developed based on the baseline information gathered in the assessment phase and related literature. After the implementation of the sessions, a posttest was immediately conducted for nurses, while for patients the posttest was conducted 1 month after implementation to evaluate the effect of the nurses’ training sessions on the patients’ perceptions. The same tools were used in pretest and posttest.
Ethical considerations:
Written approval was sought and obtained from the administrators of the studied hospitals prior to conducting the study. Oral consent was obtained from nurses and patients willing to participate. Confidentiality and anonymity of the participants were strictly maintained through code numbers on the questionnaires.
Results:
The improvement in nurses’ knowledge and perceptions about patients’ rights after implementation of the training sessions was remarkable. Moreover, an improvement in patients’ perceptions regarding their rights was reported.
Conclusion:
Repetition of the training sessions is suggested to achieve continuous improvement. Provision of posters and booklets about a bill of patient rights within the hospitals and conduction of further study to examine nurses’ performance and patients’ satisfaction based on code of ethics are recommended.
Purpose
Genomics is increasingly relevant to health care, necessitating support for nurses to incorporate genomic competencies into practice. The primary aim of this project was to develop, ...implement, and evaluate a year‐long genomic education intervention that trained, supported, and supervised institutional administrator and educator champion dyads to increase nursing capacity to integrate genomics through assessments of program satisfaction and institutional achieved outcomes.
Design
Longitudinal study of 23 Magnet Recognition Program® Hospitals (21 intervention, 2 controls) participating in a 1‐year new competency integration effort aimed at increasing genomic nursing competency and overcoming barriers to genomics integration in practice.
Methods
Champion dyads underwent genomic training consisting of one in‐person kick‐off training meeting followed by monthly education webinars. Champion dyads designed institution‐specific action plans detailing objectives, methods or strategies used to engage and educate nursing staff, timeline for implementation, and outcomes achieved. Action plans focused on a minimum of seven genomic priority areas: champion dyad personal development; practice assessment; policy content assessment; staff knowledge needs assessment; staff development; plans for integration; and anticipated obstacles and challenges. Action plans were updated quarterly, outlining progress made as well as inclusion of new methods or strategies. Progress was validated through virtual site visits with the champion dyads and chief nursing officers. Descriptive data were collected on all strategies or methods utilized, and timeline for achievement. Descriptive data were analyzed using content analysis.
Findings
The complexity of the competency content and the uniqueness of social systems and infrastructure resulted in a significant variation of champion dyad interventions.
Conclusions
Nursing champions can facilitate change in genomic nursing capacity through varied strategies but require substantial training in order to design and implement interventions.
Clinical Relevance
Genomics is critical to the practice of all nurses. There is a great opportunity and interest to address genomic knowledge deficits in the practicing nurse workforce as a strategy to improve patient outcomes. Exemplars of champion dyad interventions designed to increase nursing capacity focus on improving education, policy, and healthcare services.
We created a multicomponent intervention to improve pain management in the immediate postoperative period with the goal of improving the quality of patient recovery.
A multicomponent intervention to ...improve pain management in the immediate postoperative period with the goal of improving the quality of patient recovery.
Pain management education of postanesthesia recovery room nurses through a practical intervention has the potential to improve patient pain experience, especially in those with a history of opioid tolerance.
Postanesthesia recovery nurses/postanesthesia patients.
The intervention included two components: a clinical pain pathway on multimodal analgesia for both opioid-naïve and opioid-tolerant patients undergoing surgery and an educational program on pain management for frontline clinical nurses in the postanesthesia care unit (PACU). We measured the intervention's impact on time to pain relief, PACU length of stay, and patient satisfaction with pain management, as measured by self-report.
Patient PACU surveys indicated a decrease in the percent of patients with opioid tolerance who required more than 60 minutes to achieve adequate pain relief (from 32.7% preintervention to 21.3% postintervention). Additionally, after the intervention, the average time from a patient's PACU arrival to his or her discharge criteria being met decreased by 53 minutes and PACU stay prolongation as a result of uncontrolled pain for opioid-tolerant patients decreased from 45.2% to 25.7%. The sample size was underpowered to perform statistical analysis of this improvement.
After the combined intervention of a clinical pain pathway and interactive teaching workshop, we noted shortened PACU length of stay, reduced time to reach pain control, and improved overall patient satisfaction. Although we could not determine statistical significance, our findings suggest improved management of acute postoperative pain, especially for patients who are opioid tolerant. Because of the paucity of data, we were not able to conduct the analysis needed to evaluate quality improvement projects, as per SQUIRE 2.0. could be adopted by any institution.
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