<p> The Dedicated Education Unit (DEU) is a model of clinical teaching which has gained widespread acceptance and national recognition as an innovative method of clinical education for undergraduate nursing students (Robert Wood Johnson Foundation, 2010; Warner &amp; Burton, 2009). The primary goals and benefits of the DEU for schools of nursing are expansion of educational capacity within a nursing faculty shortage and increased clinical placements while providing a high quality experiential learning environment (Murray, Crain, Meyer, McDonough, &amp; Schweiss, 2010). Registered nurses (RNs) are the key component in the DEU clinical teaching model and serve as preceptors and valuable role models. Nurse preceptors are caught in challenging situations where they experience significant pressures to deliver quality nursing care under heavy workloads and are responsible for teaching and supervising students. The current quasi-experimental, investigational study reveals the relationships between the DEU model and the quality of patient care. Utilizing the nursing sensitive indicators of nursing hours per patient day &mdash; Registered Nurse, hospital acquired pressure ulcer rates, patient fall rates, and medication error rates, the study found no negative impact on the quality of patient care provided on DEUs despite the increased workload for precepting registered nurses.</p>

<p> Nursing leaders continue to voice concerns over new nurse graduates&rsquo; performance problems. Gaps in new nurse graduate practice and performance problems have been identified primarily using nursing theoretical models. The key objective of this research was to examine new nurse performance through the lens of a human performance model. Using Gilbert&rsquo;s (1978) updated Behavior Engineering Model (Chevalier, 2003), this study examined the performance of acute pediatric new nurse graduates with 3-15 months of experience in an urban Northeast United States hospital. The New Graduate Nurse Performance Survey (The Nurse Executive Center, 2007) and the updated PRObing BEhavior (Chevalier &amp; Hersey, 2005) questionnaire were used to assess how new nurse graduates rated their performance, work environment, and individual behavior, as well as to identify the environmental and individual factors that support and inhibit their performance. Using a mixed method design, quantitative and qualitative data were collected by means of a web-based survey. Findings revealed new nurse graduates were satisfied with their clinical performance and clinical skills and rated their work environment and individual behavior as satisfactory. Communication, receiving adequate resources, a supportive work setting, and organizational incentives supported new nurse graduates&rsquo; work environment. Inadequate feedback, in addition to challenges with preceptors and patient care technicians, inhibited new nurse graduates&rsquo; performance. Clinical training programs were found to support new nurse graduates&rsquo; performance, whereas difficulties with managing job-related stress, lack of self-care, and strained working relationships with support staff, inhibited their performance. Implications from this study are that nursing leaders and nursing educators should assess the unique needs of their new nurse graduates. This would allow healthcare organizations to design and implement tailored strategies and programs to support their novice nurses&rsquo; specialized needs. In addition, nursing leaders can tackle barriers to their new nurse graduates&rsquo; nursing practice and role transition. Further studies could explore the hardships new nurse graduates experienced with support staff during their transition by looking at the dynamics, interactions, and working relationships between novice nurses and support staff. Future studies using Gilbert&rsquo;s BEM (1978), Chevalier&rsquo;s updated BEM (2003), Gilbert&rsquo;s PROBE model (1982, as cited in Hersey and Chevalier, 2005), and Hersey and Chevalier&rsquo;s updated PROBE Model (2005), or other human performance models could be used in the nursing field to investigate different aspects of new nurse graduates&rsquo; performance, role, and workflow. Another area for future consideration is examining pediatric nurses at other stand-alone pediatric acute care hospitals and non-specialty acute care hospitals among general clinical nurses to determine what work factors present challenges for them within the work environment. </p>

Nursing assessment is the foundation of the nursing process. The focus and type of data collected, during such assessment is central to the effectiveness of the diagnostic process and subsequent planned nursing interventions. Whilst there is a multiplicity of factors that impact upon the diagnostic process, eminent nurse theorists espouse a relationship between assessment formats and diagnostic accuracy. This study evaluates the effectiveness of two types of assessment formats by addressing the following questions. When student and registered nurses use a Gordons Functional Health Pattern (GFHP) assessment format compared to using a Review of Biological Systems (ROBS) assessment format is there a difference in: (1) the number and type of diagnoses identified? and (2) the number of criteria achieved within the Standards for Nursing Care (ANF, 1989)?A developed case study with verified diagnoses was used. Professional actors played the part of the client and followed a standard script. Volunteer student and registered nurses (N=100) were randomly assigned to the two types of assessment formats. They were required to conduct an assessment of the client and state the nursing diagnoses. Data were analysed using Multivariate Analysis of Variance.Results indicated that when both groups of nurses used the GFHP format they stated significantly more correct and more diverse categories of diagnoses and significantly fewer diagnoses which were classified as being incorrect and medical, than when they used the ROBS format. In addition, when student and registered nurses used the GFHP format, they elicited significantly more information that complied with the criteria outlined within the Standards for Nursing Care (ANF, 1989), than when they used the ROBS format.The findings of this study indicate that both student and registered nurses are guided by the cues on the assessment ++ / format. Therefore, the choice and design of nursing assessment forms are critical as they affect diagnostic accuracy.

<p> The problem addressed in this study was the need for evidence-based teaching strategies that prepare nursing students to enter practice at graduation with the competencies to provide safe patient care. The purpose of the study was to investigate whether the addition of a patient safety focused human patient simulation (PS-HPS) learning activity during the final senior semester of a nursing program in southeast Michigan changes students&rsquo; perceptions of patient safety competence learning. For the pre-test post-test quasi-experimental study, a convenience sample of 48 undergraduate senior nursing students who engaged in the simulation was compared to 50 senior nursing students from the previous semester that did not receive the intervention. The Health Professional Education in Patient Safety Survey (H-PEPSS) was administered to both groups of nursing students during the second week of the final semester of a baccalaureate nursing program and again at the end of the semester. For the first research question, the ANCOVA test determined that there was no significant difference in post-test classroom learning scores between the comparison and treatment groups, controlling for pre-test classroom learning H-PEPSS scores, F (1, 95) = .000, p = .983, partial eta squared = .000. For the second research question, the ANCOVA test determined that there was no significant difference in post-test clinical learning H-PEPSS scores between the comparison and treatment groups, controlling for pre-test clinical learning scores, F (1, 95) = .496, p = .483, partial eta squared = .005. Implications for nursing education practice include: (a) simulation learning may not be more effective than traditional classroom learning strategies and (b) educators should continue to explore both classroom and clinical teaching strategies to advance students&rsquo; patient safety competence learning. One recommendation is to replicate the study with other nursing students from different locations. Secondly, the simulation scenario presented in this study could be modified by other instructors to effectively facilitate students&rsquo; patient safety learning. Additionally, a mixed methods research design may yield student responses that better reflects student learning within simulation. The proposed study adds to the nursing educational research about the effectiveness of simulation for students&rsquo; patient safety competence learning.</p>

<p> Multiple-choice questions (MCQs) are widely used to measure student achievement in prelicensure nursing education. However, little is known regarding the use of recommended practices in test construction and administration. This study explored New York State (NYS) nurse educators&rsquo; self-reported testing practices, as related to nurse educator characteristics (educational preparation, age, years teaching nursing), and institutional characteristics (program type, program size, policies). It also described the prevalence of use of MCQs. </p><p> A 49-question online survey of testing practices and program characteristics was administered to 1559 nurse educators who taught in prelicensure nursing education programs in NYS. The response rate was 19 percent. </p><p> Sixty-five percent of the respondents indicated that at least 80% of the typical course grade was derived from testing; MCQs comprised a mean of 81% of the questions on a typical test. Testing constituted a greater proportion of course grades in associate degree programs (<i>p</i> &lt; 0.05). Nurse educators engaged in a mean of 7.3 of 12 recommended testing practices. Nurse educator characteristics and nursing education program characteristics did not affect use of recommended practices. Respondents in programs with written testing policies engaged in more recommended practices (<i>p </i> &lt; 0.05). Mentoring and professional development activities were the most important source of faculty learning about measurement of student achievement. </p><p> Because MCQ testing is so widely used, leaders in nursing education should ensure the existence of and adherence to written testing policies, and that educators are well prepared through mentoring and professional development to use tests to measure student achievement.</p><p>

Introdução: A Sistematização da Assistência de Enfermagem (SAE) é uma ferramenta que fornece embasamento para a organização da assistência de enfermagem e a gerência do cuidado, aumentando a qualidade da assistência. O processo de enfermagem (PE) é o método utilizado para realizar a SAE no Brasil. Considerando que o diagnóstico situacional é essencial para fundamentar o planejamento de uma intervenção, o objetivo deste estudo é descrever como é realizada a SAE no uma Unidade Básica de Saúde (UBS) e identificar a percepção da equipe de enfermagem sobre a realização da mesma. Método: Trata-se de um estudo descritivo-exploratório de abordagem quantitativa realizado em uma UBS de Campinas, São Paulo. Para a coleta dos dados foi utilizada a técnica de questionário estruturado com escala tipo likert que foi validado por especialistas e aplicado aos profissionais de enfermagem da unidade. Os dados foram avaliados por meio de análise descritiva, utilizando tabelas e gráficos. Resultados: Os resultados possibilitaram a construção e validação de um questionário para diagnóstico situacional da SAE por meio da percepção da equipe de enfermagem. A aplicação do questionário mostrou que a implantação da SAE e PE é incipiente na unidade. A equipe possui entendimento razoável sobre o tema e aponta que a formação profissional não prepara para a realização da SAE e PE na atenção primária, mostrando necessidade de educação permanente para sua efetivação. As principais dificuldades para aplicação dessa metodologia estão relacionadas à falta de estrutura institucional. Foram apontados como facilitadores para implantação da SAE/PE na unidade: a adoção de protocolos, capacitação para equipe, envolvimento com o trabalho, elaboração de impressos e a adoção de uma nomenclatura padronizada. Conclusão: É necessário interesse institucional pela proposta da SAE/PE para sua viabilidade prática a fim de proporcionar melhorias na assistência ao paciente. O presente estudo pode contribuir para a implantação da SAE nesta unidade, pois oferece subsídios para reflexão dos enfermeiros e gestão, a fim de buscar um caminho para efetivar o cuidado de forma sistematizada, atendendo a legislação vigente. / Introduction: The Systematization of Nursing Assistance is a tool that provides basis for the organization of nursing care and care management, increasing the quality of care. The nursing process is a method, used in Brazil, to perform the Systematization of Nursing Assistance. Considering the situational diagnosis as an essential step to support the planning of an intervention, the objective of this study is to describe how the Systematization of Nursing Assistance is performed at a Basic Health Unit and to identify the perception of the health team on dealing with this tool. Method: This is a descriptive-exploratory study with a quantitative approach carried out at a basic health unit in Campinas, São Paulo. For data collection, it was used a structured questionnaire with a Likert type scale that has been validated by experts and applied to the unit nursing professionals. The data was analyzed through descriptive analysis using charts and graphs. Results: The results enabled the construction and validation of a questionnaire for situational diagnosis of the Systematization of Nursing Assistance through the perception of the nursing team. The questionnaire showed that the implementation of the Systematization of Nursing Assistance and nursing process is incipient in the Basic Health Unit. The team has a reasonable understanding of the subject and points out that generation nursing formation does not prepare for the realization of Systematization of Nursing Assistance and nursing process in primary care, showing the need for continuing education for their enforcement. The principal difficulties for the application of this methodology are related to the lack of institutional structure. The adoption of protocols, training for staff, job involvement, printed guidelines and the adoption of a standardized nomenclature were appointed as facilitators to implement the Systematization of Nursing Assistance / nursing process in the drive. Conclusion: Institutional engagement in the proposal of Systematization of Nursing Assistance is necessary to promote practical viability in order to provide improvements in patient care. This study may contribute to the implementation of the Systematization of Nursing Assistance in this unit since it offers subsidies for reflection of nurses and managers in order to seek a way to perform patient care in a systematic manner, in accordance with the current legislation.

The Diploma thesis is focused on evaluation and innovation of a mentor course. Based on the analysis of 11 educational programmes in certificated courses we found out that the courses are not unified. We chose one of the analysed mentor courses called ``Supervisor of clinical practice`` at the Faculty of Health Care Studies of the University of West Bohemia in Pilsen. The main goals of our research were: 1. to find out the opinions of the mentor course gradutes on the course, 2. to identify possible shortcomings of the courses for clinical practice mentors, 3. to suggest innovation of the current courses. The empiric part of the Diploma thesis was worked on a quantitative research technique to find information required. The data collected through semi-structured interviews were formed into casuistries and subsequently categorised in the tables. Respondents praised the length, the number of participants and the overall structure of their course but they considered the practical part of the course to be insufficient in the extent and the lack of experienced clinical mentors. So a draft proposal of the course was prepared. Our research found some shortcomings of the courses and resulted into a course innovation. The analysis used by the Ministry of Health should help unify educational programmes of mentor courses.

Introdução: A Sistematização da Assistência de Enfermagem (SAE) é uma ferramenta que fornece embasamento para a organização da assistência de enfermagem e a gerência do cuidado, aumentando a qualidade da assistência. O processo de enfermagem (PE) é o método utilizado para realizar a SAE no Brasil. Considerando que o diagnóstico situacional é essencial para fundamentar o planejamento de uma intervenção, o objetivo deste estudo é descrever como é realizada a SAE no uma Unidade Básica de Saúde (UBS) e identificar a percepção da equipe de enfermagem sobre a realização da mesma. Método: Trata-se de um estudo descritivo-exploratório de abordagem quantitativa realizado em uma UBS de Campinas, São Paulo. Para a coleta dos dados foi utilizada a técnica de questionário estruturado com escala tipo likert que foi validado por especialistas e aplicado aos profissionais de enfermagem da unidade. Os dados foram avaliados por meio de análise descritiva, utilizando tabelas e gráficos. Resultados: Os resultados possibilitaram a construção e validação de um questionário para diagnóstico situacional da SAE por meio da percepção da equipe de enfermagem. A aplicação do questionário mostrou que a implantação da SAE e PE é incipiente na unidade. A equipe possui entendimento razoável sobre o tema e aponta que a formação profissional não prepara para a realização da SAE e PE na atenção primária, mostrando necessidade de educação permanente para sua efetivação. As principais dificuldades para aplicação dessa metodologia estão relacionadas à falta de estrutura institucional. Foram apontados como facilitadores para implantação da SAE/PE na unidade: a adoção de protocolos, capacitação para equipe, envolvimento com o trabalho, elaboração de impressos e a adoção de uma nomenclatura padronizada. Conclusão: É necessário interesse institucional pela proposta da SAE/PE para sua viabilidade prática a fim de proporcionar melhorias na assistência ao paciente. O presente estudo pode contribuir para a implantação da SAE nesta unidade, pois oferece subsídios para reflexão dos enfermeiros e gestão, a fim de buscar um caminho para efetivar o cuidado de forma sistematizada, atendendo a legislação vigente. / Introduction: The Systematization of Nursing Assistance is a tool that provides basis for the organization of nursing care and care management, increasing the quality of care. The nursing process is a method, used in Brazil, to perform the Systematization of Nursing Assistance. Considering the situational diagnosis as an essential step to support the planning of an intervention, the objective of this study is to describe how the Systematization of Nursing Assistance is performed at a Basic Health Unit and to identify the perception of the health team on dealing with this tool. Method: This is a descriptive-exploratory study with a quantitative approach carried out at a basic health unit in Campinas, São Paulo. For data collection, it was used a structured questionnaire with a Likert type scale that has been validated by experts and applied to the unit nursing professionals. The data was analyzed through descriptive analysis using charts and graphs. Results: The results enabled the construction and validation of a questionnaire for situational diagnosis of the Systematization of Nursing Assistance through the perception of the nursing team. The questionnaire showed that the implementation of the Systematization of Nursing Assistance and nursing process is incipient in the Basic Health Unit. The team has a reasonable understanding of the subject and points out that generation nursing formation does not prepare for the realization of Systematization of Nursing Assistance and nursing process in primary care, showing the need for continuing education for their enforcement. The principal difficulties for the application of this methodology are related to the lack of institutional structure. The adoption of protocols, training for staff, job involvement, printed guidelines and the adoption of a standardized nomenclature were appointed as facilitators to implement the Systematization of Nursing Assistance / nursing process in the drive. Conclusion: Institutional engagement in the proposal of Systematization of Nursing Assistance is necessary to promote practical viability in order to provide improvements in patient care. This study may contribute to the implementation of the Systematization of Nursing Assistance in this unit since it offers subsidies for reflection of nurses and managers in order to seek a way to perform patient care in a systematic manner, in accordance with the current legislation.

Aggressive hospital discharge policies adopted in the 1990s led to an influx of patients recovering from acute illness accessing post-acute home care services. Performance of the post-acute home care program in the Saskatoon Health Region was examined using formative program evaluation methods. Brief surveys of clients and nurse providers captured: care objectives and service outcomes; patient-centeredness; trust in providers; health improvement/decline; emotional/social functioning; functional status; injury avoidance; and overall quality. For clients, perceptions of quality were significantly affected by patient centeredness and experiencing unexpected health complications, which accounted for 83.0% of the variation. For nurse providers, overall quality of care was significantly related to patient centeredness, service outcomes, team communication and injury avoidance. Analysis revealed for clients with complex needs, the service period could be extended from 60 to 97 days which would cover 50.0% of clients. The research examining administrative data predicted the dependent variable Log of Total Care Hours (TCH) to enable analysis using General Linear Modelling. The results showed post-acute home care clients referred from Emergency Departments received approximately 84.2 % more TCH; post-acute home care clients referred from Surgical wards received approximately 42.1% more TCH; and post-acute home care clients referred from Cardiology received approximately 66.3% more TCH than clients referred from the community. Furthermore, single clients received more TCH than married clients. Nursing chart reviews of post-acute home care clients with wound care also predicted the Log of TCH to enable analysis using General Linear Modelling. Post-admission, 11.3% of post-acute home care clients receiving wound care displayed clinical signs and symptoms of emerging infection, while 19.7% displayed clinical signs and symptoms of acquired infection. Post-acute home care clients receiving wound care experiencing injury, trauma or harm while admitted to home care received approximately 53.3% TCH; and post-acute home care clients who acquired an infection after admission received approximately 70.2% TCH. The implications of this research suggest there is room to improve post-acute home care services to address client re-hospitalisation, unexpected health symptoms/complications, and wound care.