The purpose of this study is to, based on the structure questionnaire, explore the relationships between the role, role stress, social support, organizational commitment and intention to leave of clinical nursing faculty. The study population was composed of the full-time clinical nursing faculty obtained from two universities of technology, three colleges of technology, and two institutes of technology located in the middle and southern part of Taiwan. 173 completed and qualified questionnaires were received. This yielded a response rate of 70.6%. The measuring instruments deployed in this study were the scale of role clinical nursing faculty, the scale of role stress, the scale of social support, the scale of organizational commitment. The Cronbach's Alpha reliabilities, according to orders, are .923, .862, .882, .767. The analytical implement in this study consisted of factor analysis, reliability analysis, descriptive statistics, independent t test, one way ANOVA, Pearson product-moment correlation coefficient, multiple regression, and logistic regression analysis. The results indicated: the role stress and organizational commitment of clinical nursing faculty were significantly influenced by partial demographic variables. The more important the role of researcher or patient care provider was considered, the less role stress clinical nursing faculty would perceive. Role stress demonstrated negative influences to organizational commitment in the direction predicted explaining 24.4% of the variances. Social support was able to reduce role stress, enforce organizational commitment, and mitigate the negative effects to organizational commitment entailed by role stress. Among all kinds of social support, school support boasted the most powerful buffer effect. The critical factor of intention to leave was the affection commitment, which was found to be 91% correctly classified. According to this research, in terms of clinical nursing faculty, we suggest: 1. Improve the professional and research ability of clinical nursing faculty. 2. Improve the clinical nursing faculty's ability to take care of patients. In terms of schools: 1. Make plans to initiate curriculums aiming to improve the teaching ability of clinical nursing faculty. 2. Bring in knowledge management as a link between clinical teaching and in-class teaching. 3. Invent strategies to cultivate the human resources of clinical nursing faculty. 4. Construct full-fledged systems for advanced study. 5. School should enhance the supports toward clinical nursing faculty. 6. Construct supportive network among clinical nursing faculty. In terms of the clinical practice unit: 1. Arrange clinical nurses to assist clinical teachings. 2. Assist clinical nursing faculty to get familiar with the environment.

The problem of this study was to ascertain (a) the teaching practices of medical-surgical nursing teachers in the clinical laboratory of baccalaureate nursing schools in the State of Texas, and (b) some variables possibly associated with these practices.

No description available.

Introduction  In contemporary higher education systems, interactive learning tool such as simulation, has been widely adopted in clinical studies as an effective learning tool to help students to gain both near and far transferable learning skills in a controlled setting, where parameters are defined, and an alternate reality generated. There is a dearth of knowledge on how simulation designers can support learners to transfer learning from simulation settings to clinical settings, by focusing on improving the design of simulation sessions.  Aim of the Study The aim of conducting this qualitative metasynthesis was to identify significant elements of simulation design that are necessary to support learning transfer to clinical settings.   Methodology A qualitative metasynthesis was adopted as a rigorous method to examine the findings of the original 15 qualitative studies to offer new interpretations and insights on the concept of learning transfer. Inductive thematic analysis was used to synthesize the data  Results  Six key findings we identified that include authentic setup, immersive learners’ role, learner’s cognitive boost, positive formative feedback, timing, and learner’s confidence. The findings represent elements of simulation design that can be improved by simulation session designers to support learning transfer from simulation to the clinical setting. Conclusion The result suggests that learning transfer from simulation sessions cannot be assumed to occur spontaneously in clinical settings but as a product of various factors. Therefore, the designers of simulation settings need to focus on replicating reality while provoking learners’ deeper thinking skills in the actual clinical setup, lay efforts in all aspects of the design to achieve higher levels of authenticity and transferability, consider incorporating observers actively and  eliminate categorization bias. This with a view to learners to transfer near and far learning from simulation settings to clinical settings.

Thesis (MCur)--Stellenbosch University, 2011. / ENGLISH ABSTRACT: The quality of care nurses provide to patients is done with the expectation that skills and knowledge of each registered nurse will result in quality patient care. Compliance statistics for quality indicators (level of service indicators) or (LSI’s) in the tertiary health care institution in Saudi Arabia varies, raising the following questions: “Do nurses understand the importance of quality indicators in clinical nursing and do they know how to use them to improve patient care?” No studies done on registered nurses’ knowledge and opinions of quality indicators could be found thus indicate the necessity of a research study to determinine the knowledge and opinions of registered nurses on quality indicators in clinical nursing in the tertiary healthcare system in Saudi Arabia. This is the focus of this research. The objectives of the study were: - To determine the current knowledge and opinions of the professional nurses regarding quality indicators in a tertiary hospital in Saudi Arabia - To identify the factors that influence identification of quality indicators in clinical nursing - To identify the need for a training program regarding nurse sensitive quality indicators Data was collected through a questionnaire handed to more than 200 nurses working in general wards and intensive care areas in a single Saudi Arabian hospital. Participants were selected through a randomised list. The registered nurses who have participated in the pilot study’s responses were excluded from the final data analysis. No patients were included or involved in the study. A descriptive design with a quantitative approach was applied to investigate the professional nurses’ knowledge and opinions on quality indicators (level of service indicators) or (LSI’s) in clinical nursing in Saudi Arabia. Research data suggests that the knowledge and opinions of registered nurses in the tertiary health care institution in Saudi Arabia are not supporting the expectations of quality assurance in clinical nursing. Registered nurses have strong opinions of quality indicators in clinical nursing but do not have the knowledge to support those opinions. Improving initial and recurring training on quality indicators provided to nursing staff with diverse backgrounds and high turnover was recommended as an essential component in using quality indicators to drive improvements in patient care. / AFRIKAANSE OPSOMMING: Die kwaliteit verpleegsorg wat verpleegkundiges op ‘n daaglikse basis aan kliente bied gaan gepaard met die verwagting dat hulle oor die kennis en bevoegtheid moet beskik om kwaliteit verpleegsorg aan te wend wat ‘n langdurige positiewe uitkoms met verwysing na pasientsorg kan bied. Die kwaliteits aanwyser statistieke in die tersiere gesondheidsorg sisteem verskil maandeliks en het die navorser geinspireer om ‘n studie te doen om te bepaal of geregistreerde verpleegkundiges verstaan wat die belangrikheid van kwaliteits aanwysers is en of hulle die kennis het oor die gebruik daarvan, in watter opsigte dit gebruik kan word en wat die voordele inhou wanneer kennis en applikasie daarvan vir kliniese verpleging toegepas word. Literatuur met betrekking tot vorige studies omtrent kennis en opinies van geregistreerde verpleegkundiges tot kwaliteits aanwysers in kliniese verpleeging kon nie deur die navorser gevind word wat gebruik kon word as agtergrond of ondersteuning tot die studie nie. Die fokus van die navorsings studie was om geregistreerde verpleegkundiges se kennis en opinies te bepaal met betrekking tot kwaliteits aanwysers in kliniese verpleging in die tersiere gesondheidsorg sisteem in Saudi Arabie. Die doelwitte van die studie was om: - Die huidige kennis en opinies van geregistreerde verpleegkundiges met betrekking tot kwaliteits aanwysers in die tersiere gesondheidsorg sisteem in Saudi Arabie te bepaal - Om faktore wat ‘n invloed op identifikasie van kwaliteits aanwysers het te identifiseer - Om die nodigheid van ‘n opleidings program met betrekking tot kwaliteits aanwysers te bepaal Die data van die studie was ingesamel deur middel van ‘n vraelys wat aan die geregistreerde verpleegkundiges meesal werksaam is in algemene sale of intensiewe sorgeenhede. Deelnemers was gekies deur middel van ‘n alternatiewe lys. Die deelnemers aan die loots studie was ge-ellimineer van die finale data analise. Geen pasiente was betrokke by die studie nie. ‘n Beskrywende ontwerp met ‘n kwantitatiewe benadering was toegepas om geregistreerde verpleegkundiges se kennis en opinies omtrent kwaliteits aanwysers in kliniese verpleging in die tersiere gesondheidsorg sisteem in Saudi Arabie te toets. Die navorsing het bewys dat die kennis en opinies van geregistreerde verpleegkundiges in die tersiere gesondheidsorg sisteem in Saudi Arabie nie op ‘n aanvaarbare standard kan geklassifiseer word nie asook nie die nodige kwaliteits versekering in kliniese verpleging ondersteun nie. Die studie bewys dat geregistreerde verpleegkundiges beskik oor genoegsame opinies omtrent kwaliteitaanwysers maar nie noodwendig oor die kennis om hulle opinies daaroor te ondersteun nie. Die studie is ook uitkoms gebaseerd omtrent die nodigheid van ‘n opleidings program met betrekking tot kwaliteits versekering in kliniese verpleegkunde te implimenteer, insluitend die vakgebied van kwaliteits aanwysers in kliniese verpleeging.

The purpose of this research study was to improve the nursing care of intravenous catheters by providing evidence on the effects of prolonged duration of intravenous administration set use. Intravenous therapy is a vital part of modern health care. However, its invasive nature can result in infection, with high associated morbidity and mortality. The highest infection rates are displayed in intensive care patients with central venous catheters. The duration of intravenous administration set use may have an impact on infection rates,however the current practice usage and the optimum duration of use is unknown. Previous studies of central venous catheters have reported equal infection rates with 1 to 4 days of administration set use; however few patients have been evaluated with administration sets used beyond this time. Previous research has been limited by the inadequacy of available definitions for Catheter-Related Infection. A prospective, randomised, controlled clinical trial was performed to assess the infection risk of using administration sets for prolonged periods. In the developmental phase prior to the clinical trial; definitions of Catheter-Related Bloodstream Infection (CRBSI) were developed; a nursing practice survey was undertaken to establish the current duration of administration set use; and laboratory experiments were executed to assess the impact of prolonged use on administration set physical integrity and performance. Central venous catheters were randomised to have their administration sets used for 4 days (n = 203) or 7 days (n = 201). Percutaneous central venous catheters were enrolled into the study from two adult intensive care units at a metropolitan, tertiary-referral, teaching hospital. Catheters were multiple-lumen, chlorhexidine-gluconate and silver-sulphadiazine coated lines, both inserted and removed in the intensive care unit. Catheters were cultured for microbial colonisation on removal using the Maki roll-plate technique. Patients were assessed for CRBSI using the developed definitions consisting of categories: definite, probable (type I and II), possible and absent. Prior to the clinical trial, a practice survey questionnaire was administered, and laboratory experimentation was performed. Normality of distribution for continuous variables was assessed using the Kolmogorov- Smirnov statistic. The distribution between groups of variables considered risk factors for Catheter-Related Infection were tested to assess for bias using Chi-square and T-test. Logistic regression modelling was performed to analyse the influence of potentially confounding variables. The incidence of catheter colonisation and CRBSI was tested between groups using Kaplan-Meier survival curve with Log-rank test. Paired T-tests were performed to test for difference in programmed and delivered volumes of administration sets. A general linear model (ANOVA)± a Scheffe post hoc test to isolate difference was fitted to the standardised values of delivered volumes to determine the effects of day of measurement and volume delivery rate on the accuracy of volume delivery. There were 10 colonised tips in the intervention group and 19 in the control group. This difference was not statistically significant (Kaplan Meier survival analysis, Log Rank = 0.87, df = 1, p = 0.35). There were 3 cases of CRBSI per group and the difference in survival from CRBSI was not statistically significant (Kaplan Meier with Log Rank test, p = 0.86). The pre-clinical trial phases of the research programme established that current clinical practice was 3 to 7-day use of administration sets; that administration sets were physically intact and delivered clinically accurate volumes after 7 days of use; and developed useful definitions of CRBSI. Prolonged intravenous administration set use of 7 days was found to have no significant impact on patient infection indicators or physical performance of the sets. This finding is congruent with previous research and trends in current clinical practice. In conclusion, the research findings support the use of intravenous administration sets for 7 days.

Thesis (Ph.D.)--Indiana University, 2009. / Title from screen (viewed on August 28, 2009). School of Nursing, Indiana University-Purdue University Indianapolis (IUPUI). Advisor(s): Pamela Ironside, Anna McDaniel. Includes vita. Includes bibliographical references (leaves 177-197).

The study attempted to identify R425 diplomates' perceptions of their psychiatric competencies. An exploratory descriptive survey investigated specific strengths and weaknesses of the R425 diplomates in the psychiatric clinical units in the KwaZulu-Natal Province, as perceived by the diplomates themselves. The diplomates were reportedly competent in performing numerous, but not all cognitive, psychomotor and affective skills addressed by this survey. The R425 diplomates perceived themselves to be incompetent in designing and implementating rehabilitation programmes/workshops, managing community projects, conducting research and managing crises in psychiatric nursing units. / Health Sciences / M.A. (Health Studies)

A major focus in nursing education is on the judgement of clinical performance, and it is a complex process due to the diverse nature of nursing practice. Difficulties in the development of valid and reliable assessment measures in nursing competency continue to pose a challenge in nursing education. A holistic approach in the assessment of competency comprises knowledge, skills and professional attitudes, wherein the notion of competency incorporates professional judgement and management skills in the clinical situation. Therefore, the thesis aims to develop a holistic clinical assessment tool with a reasonable level of validity and reliability to meet the needs of clinical education. The conceptual framework underlying this research is formed by establishing a theoretical connection between the practice of learning, and of pedagogy and assessment. This research consists of five studies. In Study I, a systematic review was conducted to explore the current assessment practices and tools for nursing undergraduates. In Studies II, III and IV, a qualitative approach with focus group discussions was adopted to explore the views of final-year undergraduate nursing students, preceptors, clinical nurse leaders and academics on the clinical assessment. Based on the multiple perspectives, it therefore addresses concerns in clinical assessment. In Study V, a holistic clinical assessment tool was developed, for which a psychometric testing was conducted. The systematic review indicated that limited studies adequately evaluate the psychometric properties of the assessment instrument. The qualitative studies have raised an awareness of professional and educational issues in relation to clinical assessment. Workload, time, availability of resources, adequate preparation of preceptors, and availability of valid and reliable clinical assessment tools were deemed to influence the quality of students’ clinical learning and assessment. In addition, the presence of support systems and formal educational programs for preceptors influenced their preparation and self-confidence. Nursing leaderships in hospitals and educational institutions have a joint responsibility in shaping the holistic clinical learning environment and making holistic clinical assessment for students. The involvement of all stakeholders in the development of a valid and reliable assessment tool for clinical competency is also essential to the process. The Holistic Clinical Assessment Tool (HCAT) was developed by the author based on the systematic review, qualitative findings and the core competencies of registered nurse from the professional nursing boards. The HCAT consists of 4 domains and 36 assessment items. Furthermore, testing of the psychometric properties indicated that the HCAT has satisfactory content validity, construct validity, internal consistency and test-retest reliability. In conclusion, the HCAT is meritorious in that it carries the potential to be used as a valid measure to evaluate clinical competency in nursing students, and provide specific and ongoing feedback to enhance the students’ holistic clinical learning experience. The HCAT not only functions as a tool for self-reflection for the students, but also guides the preceptors in clinical teaching and assessment. In addition, the HCAT can be used for peer-assessment and feedback. It is imperative that the clinical and academic institutions establish various levels of ongoing support for both students and preceptors in the process of clinical assessment.

L'enseignement, l'apprentissage et l'évaluation du raisonnement clinique en sciences infirmières est un défi pour les éducateurs de cette profession et leurs étudiants. Depuis plusieurs décennies, les chercheurs et les éducateurs dans le domaine des sciences de la santé ont travaillé pour élaborer des instruments d'évaluation dans le but de pouvoir mesurer le raisonnement clinique (Charlin, Bordage & Van der Vleuten, 2003). Plusieurs études semblent appuyer le test de concordance de script (TCS) en termes de validité, fiabilité, faisabilité et applicabilité pour plusieurs disciplines et différents contextes (Carrière & al, 2009). Deschênes et ses collaborateurs (2006; Deschênes, Charlin, Gagnon & Goudreau, 2011) ont mis au point et validé un TCS spécifiquement pour le raisonnement clinique en sciences infirmières (RCI). Comme l'évaluation a un impact important sur les stratégies d'apprentissage des étudiants (Sibert et al, 2001; Durak, Caliskan & Bor, 2007), les outils d'évaluation valides et fiables qui permettraient l'identification des problèmes spécifiques dans le développement du raisonnement clinique en sciences infirmières seraient très utiles pour guider les décisions concernant l'éducation (Gierl, 2007). Nous avons donc mené une étude pour explorer le potentiel diagnostique des questions d'un TCS. La question de recherche est la suivante: «Dans quelle mesure chaque question d’un TCS visant à évaluer le RCI peut-elle être reliée à des catégories et des stratégies de pensée spécifiques?" Avec une sous-question: «Comment peut-on décrire le potentiel diagnostique d’un TCS pour évaluer le RCI?". Nous avons fait une deuxième analyse de contenu des données qui ont été obtenues dans une étude précédente dans laquelle cinq vignettes (15 questions) du TCS de Deschênes (2006) ont été utilisées. Les résultats ont montré les catégories et stratégies de pensées utilisées pour répondre à certaines questions du TCS selon les groupes de participants. Aussi, nos résultats ont permis de découvrir des disparités importantes entre les groupes, notamment que le RCI des expertes est si différent des étudiantes, qu’il ne peut servir de référence. Enfin, cette étude démontre que le TCS a un potentiel diagnostique niveau par niveau (1ère, 2e, 3e année et expertes) et non d’un niveau à un autre. / Teaching, learning and assessing clinical nursing reasoning is a challenge for both nurse educators and their students. For several decades, researchers and educators in the field of health sciences, worked to develop assessment instruments that would effectively measure clinical reasoning (Charlin, Bordage & Van der Vleuten, 2003). Several studies seem to support the script concordance test (SCT) in terms of validity, reliability, feasibility and applicability in different disciplines and contexts (Carrière & al, 2009). Deschênes and her collaborators (2006; Deschênes, Charlin, Gagnon & Goudreau, 2011) developed and validated one SCT specifically for clinical nursing reasoning. Since evaluation has a great impact on students’ learning strategies (Sibert & al, 2001; Durak, Caliskan & Bor, 2007), valid and reliable assessment instruments that would allow the identification of specific problems in the development of clinical nursing reasoning would be very useful to guide educational decisions (Gierl, 2007). We therefore conducted a study to explore the diagnostic potential issues of SCT. The research question is: "To what extent each issue of SCT to assess clinical nursing reasoning can it be linked to categories and specific thinking strategies?" with a sub-question: "How can we describe the diagnostic potential of SCT to evaluate the clinical nursing reasoning?”. We did a second content analysis on think aloud data that were obtained in a previous study in which five vignettes (15 items) from Deschênes’ (2006) SCT were used. The results showed categories thoughts and strategies used to address issues of TCS by groups of participants. Thus, our results revealed significant differences between the groups, such that the clinical nursing reasoning is so different from expert students, it can’t serve as a reference. Finally, this study demonstrates that TCS has a diagnostic potential but level by level (1st, 2nd, 3rd year and experts).