Purpose
To compare skills acquired by undergraduate nursing students enrolled in a medical‐surgical course. To compare skills demonstrated by students with no previous clinical practice ...(undergraduates) and nurses with clinical experience enrolled in continuing professional education (CPE).
Design
In a nonrandomized clinical trial, 101 undergraduates enrolled in the “Adult Patients 1” course were assigned to the traditional lecture and discussion (n = 66) or lecture and discussion plus case‐based learning (n = 35) arm of the study; 59 CPE nurses constituted a comparison group to assess the effects of previous clinical experience on learning outcomes.
Methods
Scores on an objective structured clinical examination (OSCE), using a human patient simulator and cases validated by the National League for Nursing, were compared for the undergraduate control and intervention groups, and for CPE nurses (Student's t test).
Findings
Controls scored lower than the intervention group on patient assessment (6.3 ± 2.3 vs 7.5 ± 1.4, p = .04, mean difference, ‐1.2 95% confidence interval (CI) ‐2.4 to ‐0.03) but the intervention group did not differ from CPE nurses (7.5 ± 1.4 vs 8.8 ± 1.5, p = .06, mean difference, ‐1.3 95% CI ‐2.6 to 0.04). The CPE nurses committed more “rules‐based errors” than did undergraduates, specifically patient identifications (77.2% vs 55%, p = .7) and checking allergies before administering medication (68.2% vs 60%, p = .1).
Conclusions
The intervention group developed better patient assessment skills than the control group. Case‐based learning helps to standardize the process, which can contribute to quality and consistency in practice: It is essential to correctly identify a problem in order to treat it. Clinical experience of CPE nurses was not associated with better adherence to safety protocols.
Clinical Relevance
Case‐based learning improves the patient assessment skills of undergraduate nursing students, thereby preparing them for clinical practice.
Background
Nursing theory‐guided practice helps improve the quality of nursing care because it allows nurses to articulate what they do for patients and why they do it. However, the usefulness of ...nursing theory‐guided practice has been questioned and more emphasis has been placed on evidence‐based nursing and traditional practice. Therefore, an examination of experimental studies was undertaken to analyse the extent of use and usefulness of nursing theories in guiding practice. We reviewed experimental studies because in this era of evidence‐based practice, these designs are given more weightage over other research designs. This examination would corroborate the usefulness of nursing theory‐guided practice compared to traditional practice.
Methods
An integrative review was conducted. Literature search was performed within multiple databases, and 35 studies were reviewed and appraised.
Results
Majority of the studies were from Iran, the United States and Turkey and used Orem's self‐care model, Roy's adaptation model and Peplau's theory of interpersonal relations. The effect of theory‐guided interventions was evaluated in improving quality of life, self‐efficacy, self‐care and stress of patients with chronic, acute, cardiac and psychological illnesses. The quality rating was judged to be strong for three studies, moderate for 25 studies and weak for seven studies. All of the strongly rated studies found nursing theory‐guided interventions useful. Overall, nursing theory‐guided interventions improved all of studied outcomes in 26 studies and at least one outcome in nine studies. None of the studies reported that nursing theory‐guided interventions as not useful.
Conclusion
Nursing theories have guided practice in both eastern and Western countries, and theory‐guided practice has been found useful compared to traditional nursing practice. Therefore, nurses should continue to guide their nursing practice through the lens of nursing theories and should continue to evaluate the effectiveness of nursing theory‐guided practice.
This is the ninth in a series of articles to help readers increase their knowledge, and in the process, enhance their skill and confidence in appraising, synthesizing, interpreting, and ultimately, ...deciding if a given piece of evidence should be incorporated into practice. This article describes four non-probability (non-random) sampling designs researchers use in selecting a study sample.
Every day for the next twenty years, more than 10,000 people in the United States will turn 65. With life expectancies increasing as well, many of these Americans will eventually require ...round-the-clock attention-and we have only begun to prepare for the challenge of caring for them. InLabors of Love, Jason Rodriquez examines the world of the fast-growing elder care industry, providing a nuanced and balanced portrait of the day-to-day lives of the people and organizations that devote their time to supporting America's aging population.
Through extensive ethnographic research, interviews with staff and management, and analysis of internal documents, Rodriquez explores the inner workings of two different nursing homes-one for-profit and one non-profit-to understand the connections among the administrative regulations, the professional requirements, and the type of care provided in both types of facilities. He reveals a variety of challenges that nursing home care workers face day to day: battles over the budget; the administrative hurdles of Medicaid and Medicare; the employees' struggle to balance financial stability and compassionate care for residents. Yet, Rodriquez argues, nursing home workers give meaning and dignity to their work by building emotional attachments to residents and their care. An unprecedented study,Labors of Lovebrings new insight into the underlying structures of a crucial and expanding sector of the American health care system.
ABSTRACT Objective: to translate and cross-culturally adapt the Resilience at Work Scale for the Brazilian context. Method: Methodological study comprising the stages of conceptual, item, semantic, ...and operational equivalences. Resilience at Work Scale is composed of 25 items (long version) and 20 items (short version), rated on a seven-point Likert scale. A test-retest was applied to a sample of 45 educators and health workers. Quadratic weighted Kappa and intraclass correlation were used. Result: The adaptation of the 25 items followed the phases of translation, back translation, external assessment, expert committee, pre-tests, test-retest reliability, and equivalence between the original and adapted versions. Two items initially showed less than 90% comprehensibility, but satisfactory results were obtained in a new pre-test after adjustments. The overall Intraclass correlation coefficient was 0.83. Conclusion: The final version of the Resilience at Work Scale 25-Brasil was properly adapted to the Brazilian culture to measure resilience at work. It is an Emancipatory Technology as it enables the implementation of knowledge that contributes to thinking, reflecting, and acting in the face of the individual or collective health-disease continuum.
RESUMO Objetivo: realizar a tradução e adaptação transcultural da Resilience at Work Scale para o contexto brasileiro. Método: estudo metodológico, em que foram executadas as etapas da equivalência conceitual, de itens, semântica e operacional. A Resilience at Work Scale é uma escala Likert de sete pontos, composta por 25 itens em sua versão longa e 20 itens na versão curta. O teste-reteste foi aplicado a uma amostra de 45 docentes e trabalhadores da saúde. Para esta avaliação, utilizou-se o coeficiente Kappa ponderado com ponderação quadrática, e correlação intraclasse. Resultados: a adaptação dos 25 itens da Resilience at Work Scale pautou-se nas fases tradução, retrotradução, avaliação externa, comitê de especialistas, pré-testes e confiabilidade teste-reteste, verificando as equivalências entre o instrumento original e o adaptado. Dois itens, inicialmente, apresentaram clareza inferior a 90%. Eles foram reajustados e novo pré-teste indicou resultado satisfatório. O coeficiente de correlação intraclasse geral da Resilience at Work Scale foi de 0,83. Conclusão: a versão final da Resilience at Work Scale 25 - Brasil mostrou-se promissora e com adaptação adequada à cultura brasileira para mensuração da resiliência no trabalho. Trata-se de uma Tecnologia Emancipatória, pois possibilita concretizar conhecimentos que contribuem quanto ao pensar, ao refletir e ao agir diante de um processo de saúde/doença, seja individual ou coletivo.
RESUMEN Objetivo: realizar la traducción y adaptación transcultural de la Resilience at Work Scale para el contexto brasileño. Método: estudio metodológico, en el cual fueron realizadas las etapas de equivalencia conceptual, de ítems, de semántica y operacional. La Resilience at Work Scale es una escala Likert de siete puntos, compuesta por 25 ítems en su versión larga y 20 ítems en la versión corta. El test-retest fue aplicado a una muestra de 45 docentes y trabajadores de la salud. Para esta evaluación, se utilizó el coeficiente Kappa ponderado con ponderación cuadrática y correlación intraclase. Resultados: la adaptación de los 25 ítems de la RAW siguió las fases de traducción, retrotraducción, evaluación externa, comité de especialistas, pre-pruebas y confiabilidad test-retest, verificando las equivalencias entre el instrumento original y el adaptado. Inicialmente, dos ítems presentaron clareza inferior a 90%. Ellos fueron reajustados y un nuevo pretest indicó un resultado satisfactorio. El coeficiente de correlación intraclase general de la RAW fue de 0,83. Conclusión: la versión final de la Resilience at Work Scale 25-Brasil se mostró promisora y con adaptación adecuada a la cultura brasileña para medir la resiliencia en el trabajo. Se trata de una Tecnología Emancipadora, ya que posibilita concretizar conocimientos que contribuye en lo que se refiere a pensar, reflexionar y actuar delante de un proceso de salud/enfermedad, sea este individual o colectivo.
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