Explaining the Status of Clinical Nursing Education: A Qualitative Research in Iran

Background: Challenges and problems of clinical nursing education are the most important factor in determining the quality of nursing students' education. Frequent assessment of the quality of nursing education without considering the existing challenges is an ineffective activity in analyzing the situation of nursing education. Objectives: This study aimed to explain the status of clinical nursing education at Jahrom University of Medical Sciences in Iran. Methods: This qualitative study based on the conventional content analysis approach was conducted at Jahrom University of Medical Sciences in 2018 - 2019. Data were collected through holding 10 semi-structured face-to-face focus group discussions (FGDs) with 110 nurses, head nurses, instructors, and students. Purposeful sampling was used and the interviews were analyzed by Graneheim and Lundman method by MAXQDA Software. Results: We obtained 626 in-vivo codes, 46 primary codes, eight subcategories (lack of attention to the evaluation process, non-participative evaluation, low staff educational cooperation, ineffective instructors, non-educational clinical space, student educational deficits, students' confusion in the clinical setting, and non-participatory planning), and three main categories (planning challenges, implementing challenges, and evaluation challenges). Conclusions: Educational leaders are recommended to shift to three areas, including democratic planning, wise implementation with frequent monitoring, and the use of modern clinical evaluation methods based on the participation of learners and other stakeholders.

From clinical expert nurse to part-time clinical nursing instructor: design and evaluation of a competency-based curriculum with structured mentoring: a mixed methods study

Background Transition from a clinical expert nurse to a part time clinical nursing instructor (PTCNI) poses several challenges. Designing a professional development curriculum to facilitate the transition from a clinical expert nurse to a PTCNI is critical to effective education. A comprehensive competency-based curriculum was developed and implemented with structured mentoring to prepare clinical expert nurses as PTCNIs. Methods A mixed-methods study with a sequential-exploratory approach was conducted in Iran in 2019. In the qualitative phase, Saylor et al.’s (1981) seven-step model was used, consisting of (1) collecting evidence from a systematic review, (2) conducting interviews with learners, (3) setting goals and objectives, (4) design, (5) implementation, (6) evaluation, and (7) feedback. In the quantitative phase, curriculum domains were evaluated. Additionally, the effective professional communication skills module was implemented using a quasi-experimental study with a pre-test post-test single-group design for 5 PTCNIs in a pilot study. Results After integrating the findings of the literature review and field interviews in the analysis stage, a curriculum was developed with a total of 150 h, six modules, and 24 topics. Results of the pilot study showed a significant improvement in the confidence of PTCNIs as a result of the implementation of the effective communication skills module using the mentoring method (t = − 16.554, p = 0.0005). Conclusions This competency-based curriculum was based on the evidence and needs of PTCNIs and provides a complete coverage of their clinical education competencies. It is suggested that managers of educational institutes that offer nursing programs use this curriculum to prepare them in continuing education programs. Further studies are needed to thoroughly evaluate the learning outcomes for students.

Palatoplasty in children: nursing diagnoses and interventions related to the immediate postoperative period

Objective: To identify the main nursing diagnoses and interventions in children in the immediate postoperative period of palatoplasty. Method: Documentary and retrospective study, developed in a Brazilian public and tertiary hospital, between August and September 2020. Children who underwent only palatoplasty, between January and December 2019, aged between 10 and 24 months, were included. Those with medical syndromes and/or comorbidities were excluded. The Theoretical Framework of Basic Human Needs and the NANDA International and Nursing Interventions Classification Taxonomies were used. Data underwent descriptive statistical analysis. Results: The sample consisted of 126 children. Psychobiological needs such as oxygenation, hydration, nutrition, elimination, cutaneous-mucosal and physical integrity, pain and environmental perception predominated. Based on them, nine nursing diagnoses, with four focusing on the problem and five on risk, as well as 17 interventions, were identified. Conclusion: The use of standardized languages to identify affected human needs and, based on them, diagnoses and interventions, favored clinical reasoning for the construction and organization of clinical nursing practice.

The Application of Islamic Spiritual Methods in Nursing Program Curriculum at UIN Syarif Hidayatullah Jakarta and UIN Alauddin Makasar

<p class="abstrak">This research focuses on describing the implementation of Islamic spiritual care of the clinical nursing students at the State Islamic University (UIN). The implementation of Islamic spiritual care has not been done well by nurses. Clinical nursing students are the forerunners of nurses, but no one has examined the description of the application of Islamic spiritual care carried out by clinical nursing students in State Islamic University (UIN). This research method was descriptive quantitative. Samples were students of the clinical nursing students of UIN Jakarta and UIN Alauddin Makassar, 40 respondents. The results showed that most respondents applied Islamic spiritual care well (52.5%). The most well-implemented component is instilling optimism for healing that comes from God (60%). Students need to improve their self-competence in Islamic religious knowledge to become more competent in providing Islamic care to patients. The head of the clinical nursing program needs to emphasize efforts to increase Islamic spiritual competence in the clinical practice setting of learning guidelines through the guidance process and learning achievement targets.</p><p><em>Penelitian ini berfokus untuk mengetahui penerapan perawatan spiritual Islam mahasiswa Ners di Universitas Islam Negeri (UIN). Penerapan asuhan keperawatan secara holistik khususnya dalam aspek spiritual karena masih sangat minim </em><em>dilakukan oleh perawat di tatanan pelayanan keperawatan.</em><em> Mahasiswa merupakan cikal bakal perawat dan peneliti belum menemukan penelitian tentang penerapan perawatan Islam oleh mahasiswa Ners di lingkungan UIN.</em><em> </em><em>Metode yang digunakan yaitu deskriptif kuantitatif. Sampel yang digunakan yaitu mahasiswa Ners UIN Jakarta dan UIN Makassar masing-masing 40 responden. Hasil menunjukkan sebagian responden menerapkan perawatan spiritual Islam dengan baik (52,5%). Komponen yang paling banyak diterapkan dengan baik yaitu menanamkan optimisme kesembuhan yang datang dari Allah (60%). Mahasiswa perlu meningkatkan kompetensi diri dalam ilmu agama islam sehingga menjadi lebih kompeten dalam mebrikan perawatah islam kepada paeien, program studi Ners perlu lebih menekankan pada upaya peningkatan kompetensi spiritual islam pada tatanan praktik klini pedoman pembelajaran, melalui proses bimbingan maupu target capaian pembelajaran.</em></p>

Postoperative clinical nursing care pathway for patients with mucormycosis: An experience from a tertiary care hospital in Rajasthan, India

Background: The COVID-19 pandemic is a serious global health threat and it has numerous impacts on human life. India faced the problem of the second wave of COVID-19 and an unexpected new predicament in the form of mucormycosis has been added. The use of steroids drugs for long duration and comorbidity with COVID-19 infections are the risk factors of mucormycosis. It is important to understand the postoperative clinical pathway to assess and determine the policy and protocol, which help patients fasten their recovery, prevent further complications and readmission. Methods: A cross‑sectional descriptive design was used to conduct the study. We adopted the validated Immediate Post-Operative Recovery Assessment (IPR-PA) Scale to assess the postoperative clinical nursing care pathway for patients with mucormycosis. Results: The current study shows that patients had highest score in the physiology clinical recovery domain (75.25%) and the lowest post-operative clinical recovery score in psycho-social domain (20.83%). There was a significant positive correlation was found between all the domains. The medication status domains found significantly associated with participants’ age (P=.021) and physiological domains has shown significant association with received oxygen therapy during hospitalization (P=.046). Conclusion: Postoperative clinical nursing care pathway was effective to determine the progress of a patient. It helps us to know the parameter of different domains namely being physiological, physical, psycho-social and medication status. Patients required psycho-social support due to the epidemic and fear from disease.

The Clinical Nursing and Midwifery Dashboard (CNMD): A State-Wide Implementation

The clinical nursing and midwifery dashboard (CNMD) was built to provide a near real-time information and data visualisations for nurse unit managers (NUMs) and maternity unit managers (MUMs) within only a 5-15 minutes delay from when they enter data to the integrated electronic medical records (ieMR) system. The dashboard displays metrics and information about current adult inpatients in overnight wards. The aim is to support NUMs and MUMs to manage their daily workload and have continuous visibility of patients nursing risk and safety assessment documentation. A quantitative evaluation approach was conducted to measure the impact of the dashboard on key performance indicators. Statistical analysis was completed to compare risk assessment average completion times prior to and post CNMD implementation. The results of the evaluation were positive, and the statistical analysis shows significant reduction in the average time to complete different risk assessments with p-value<0.01.