Deliberate Practice of Critical Nursing Skills and Assessment of Competencies: A Multi-Site Study
Ginger Schroers PhD, RNC, CNE, Marcella Niehoff School of Nursing, Loyola University, Chicago
Summary:
Newly graduated registered nurses (NGRNS) are not practice-ready. Recent studies indicate that prelicensure nursing students have limited opportunities in clinical settings to practice and refine skills required for safe patient care. Incorporating deliberate practice (DP) (repetitive skill practice with expert instructional feedback) of frequently performed nursing skills, such as medication administration and handoff report, into education programs has the potential to improve new nurse practice readiness. There is scant evidence of DP of nursing skills with the exception of CPR.
Purpose:
Investigate the impact of DP on a) medication administration, b) handoff report and c) interruption management skills.
Problem: NGRNs are expected to enter complex healthcare environments competent in core nursing skills. However, recent evidence demonstrates that less than 10% of NGRNs demonstrate acceptable competency for a novice nurse. Students and NGRNS attribute lack of practice with skills to their lack of competence. In addition, interruptions are pervasive during core nursing skills, with rates as high as 94.5% during medication administration and 75% during handoff and associated with increased errors. Ideally, students would learn and practice strategies to manage interruptions, yet interruptions are seldom included in nursing curricula.
Design:
Multi-methods, repeated measures, pre-posttest design.
Methods:
A multi-site study will be conducted with prelicensure nursing students across two semesters. Using simulated contexts, participants will engage in DP of medication administration and interruption management during both study semesters. In the second study semester, students will also participate in DP of handoff report.
Timeline: November 2023 – November 2024.
Data Collection:
Outcomes to be investigated include a) medication errors and safety procedures, b) handoff quality and accuracy, and c) interruption management strategy use.
Quantitative data will be collected with validated tools via direct observation and analyzed with ANCOVA statistical tests. Qualitative data will be gathered via semi-structured interviews; content and thematic analyses will be performed.
Implications: DP of nursing skills during students’ educational preparation has the potential to develop skill competencies and increase new nurses’ readiness for practice. The study
findings can be used to guide educational methods that have an overall aim of improving patient safety and quality of care.
Plan for Your Leadership Development Portable Intercultural Module: Developing Leadership Capacity in Nursing Students
Janet Davis BSN, MSN, MBA, PhD, RN, CNE, Purdue University Northwest
The tragic global impact of the COVID-19 pandemic has driven home the need for transformational leadership in nursing. Transformational leadership embraces empowerment and values systems-based innovation that prepares nurses to continually enhance quality of care. Leadership development is a distinguishable area of competence for the profession. This descriptive, qualitative project will evaluate the outcomes of a promising strategy for leadership competency. The Plan for Your Leadership Development Portable Intercultural Module is built on the learner’s active role in constructing meaning through reflecting on prior experience and synthesizing new information. The student-centered module will be implemented academic year 2022-2023 at Purdue University Northwest with 50 prelicensure students as a required, non-graded assigned in the BSN nursing leadership and management course.
The module objectives are: Identify behaviors/characteristics of transformational leaders; Reflect on the application of transformational leadership; Design a personal leadership development plan. Three SWOT (Strengths, Weaknesses, Opportunities, Threats) matrix assignments engage the student in demonstrating these behaviors. In Self-Assessment Strengths and Weaknesses, the student reflects on transformational leadership competencies (Builds Trust, Acts with Integrity, Encourages Others, Encourages Innovative Thinking, Coaches & Develops People) as a personal strength or a weakness. In Environmental Assessment Opportunities and Threats, the student reflects on opportunities in the immediate and broader environments that support achieving transformational leadership competencies and threats blocking that achievement. In My Transformational Leadership Development Plan, the student designs a strategic leadership self-development plan to build on strengths by using environmental opportunities and to overcome weaknesses and environmental barriers. A qualitative, modified thematic analysis examines the assignment outcomes, and three open-ended questions gather participants’ overall opinions of the Plan for Your Leadership Development.
The following grants were awarded as part of the Public Health Nurse Academic Practice Partnership Project led by Robin Hannon, MSN, RN, the RWJF Public Health Nurse Leader, and were funded by RWJF. The Illinois Nurses Foundation served as the fiscal agent for the grant.
McKendree University/Lawrence County Health Department
Project Title: Building Public Health Acumen Within RN To BSN Students
Grant Collaborators: Jan Albers DNP, RN, PHNA-BC, Assistant Professor, McKendree University; Amy Marley, Administrator, Lawrence County Health Department
PI: Jan Albers
University of Illinois at Chicago/Vermilion County Health Department
Project Title: Development of a STD Toolkit for High Schools in Vermilion County
Grant Collaborators: Amanda Sperry MSN, RN, PEL-CSN, UIC; Krista Jones DNP, MSN, PHNA-BC, RN, Clinical Associate Professor, University of Illinois at Chicago; Julie Fruhling BSN, RN-BC, Community Health Educator, Vermilion County Health Department
PI: Amanda Sperry
Lewis University/Will County Health Department/MAPP Collaborative
Project Title: Implement a Poverty Simulation to Increase Interdisciplinary understanding of the Social Determinants of Health
Grant Collaborators: Nanci Reiland DNP, MSN RN PHNA-BC, Assistant Professor, Lewis University; Laura Wilmarth-Tyna, Director of Community Engaged Learning, Lewis University; Shawn West MBA, SPHR, Executive Director, Will-Grundy Medical Center, Nicole Garrett, MAPP Collaborative Coordinator, Will County Health Department
PI: Nanci Reiland
University of Illinois at Chicago/Altus Academy
Project Title: Health Education and Literacy Program (HELP)
Grant Collaborators: Robin Johnson DNP, APRN, PNP-PC, Clinical Assistant Professor, University of Illinois at Chicago; Susan Walsh DNP, APRN, PNP-PC, FAAN, Clinical Associate Professor and Director of the Pediatric Nurse Practitioner program, Acute and Primary Care, University of Illinois at Chicago; John P. Heybach, PhD., Founder & President Altus Academy
PI: Robin Johnson
Western Illinois University/Fulton County Health Department
Project Title: Increase Awareness of Public Health Services In Fulton County
Grant Collaborators: Dr. Patricia Eathington BSN, MS, DNP, RN, Associate Professor, Western Illinois University; Kati Lynn MPH, LEHP, REHS, Administrator, Fulton County Health Department
PI: Patricia Eathington
Lewis University/Bolingbrook Christian Health Center
Project Title: Practical Titration of Insulin in Type 2 Diabetes: Efficient Insulin Titration for Clinic Providers
Grant Collaborators: Dr. Daisy Sherry, Ph.D., CNP, RN, Associate Professor, Associate Dean, Director of DNP program, Lewis University; Dr. Susan Davis ND, APRN, FNP-BC, Executive Director, Bolingbrook Christian Health Center
PI: Dr. Daisy Sherry
CLINICAL JUDGMENT IN NEW GRADUATE NURSES: ADVANCING THE SCIENCE OF PRE-LICENSURE EDUCATION- Julie Kennedy PhD, RN, CMSRN
Current evidence reflects that new graduate nurses are not fully prepared to be successful in the practice environment. The purpose of this research study is to evaluate new graduate nurses’ clinical judgment upon transition to practice. This study will begin in the summer of 2021 after IRB approval and approval from appropriate healthcare organizations. Data will be collected through e-mail surveys from nurse leaders in the area. Data will include an evaluation of clinical judgment using an established rubric along with open-ended questions to provide further depth and context. Data collection will continue until an appropriate sample size is met with an estimated completion time of early fall 2021. An expert statistician will assist in analyzing the quantitative data. The qualitative data will be analyzed by two experienced researchers. Findings from this study will facilitate the identification of more effective teaching strategies for pre-licensure nursing students’ preparation for practice generating further scholarship. These findings will be disseminated through publication and/or presentation within a year of beginning the study and will assist other nurse educators in identifying appropriate interventions for their pre-licensure students as well.
NURSE BURNOUT, COLLECTIVE EFFICACY AND THE SOCIAL NETWORK OF A UNIT – Amy Kiefer MSN, RN
Background: Burnout affects greater than 50% of healthcare workers, with a higher prevalence found in newly licensed nurses, leading to a lower quality of patient care, higher reported missed care, and medication errors. Burnout is a syndrome caused by organizational stress and is characterized as feelings of exhaustion, cynicism, and inefficacy. Research has explored burnout at the individual level, and little is known about how unit-level variables affect or are related to burnout. The purpose of this study is to examine the effects of unit-level collective efficacy and nurses’ social network on burnout.
Methods: A descriptive, cross-sectional, survey method will be used to assess 75 interprofessional providers on a unit at a 547-bed, level I trauma center in the Midwestern United States. Data will be collected using surveys and analyzed using social network analysis and linear and multiple regression. The estimated timeline for this project is from July 1st, 2021 through June 30th, 2022.
Results: The findings from this study will help identify how interprofessional interactions, social support, and collective efficacy with nurse burnout. Potential implications for practice changes include creating interventions that strengthen interprofessional communication, daily interactions, and support. This study aims to identify how decreasing burnout may increase the efficacy of healthcare providers on the unit, potentially increasing patient quality of care. Results from this study will inform what education should be added for managers, physicians, and units in order to increase the perception of social support.
IMPLEMENTING A COMMUNITY WOUND CARE PROGRAM SERVING PEOPLE WHO INJECT DRUGS –
Michael Huyck BSN, RN-CEN, University of Illinois at Chicago, College of Nursing
People who inject drugs (PWID) are at an increased risk for developing chronic wounds in addition to skin and soft tissue infections (SSTI) which includes abscesses, and cellulitis. Healthcare access within the PWID community has been traditionally limited due to factors such as poverty, stigmatization, and fear of withdrawal. Consequently, chronic and acute wounds are often left untreated, self-treated, or present to Emergency Departments. The wound care program will increase healthcare access among PWID, expand the provider skillset, increase revenue for the Community Outreach Intervention Project (COIP) clinic, and standardize the provision of care. Evidenced-based wound care will increase COIP clinic sustainability and establish a blueprint for addressing wound related complications related to the opioid epidemic.
AN EXAMINATION OF NURSING PRACTICE DURING THE COVID-19 PANDEMIC
Shannon Simonovich PhD, RN – DePaul University
As an emerging topic, no known study to date has examined nurses’ experiences providing bedside care during the COVID-19 pandemic, how their institutions prepared them for working with this infectious disease, and what implications COVID-19 has had on their nursing practice and professional perspective. The purpose of this research is to describe the experiences of nurses during the COVID-19 pandemic and to conduct a thematic analysis to better understand the long-term impacts of the pandemic on the nursing profession and implications for public health. We hope what we learn will lead to an understanding of the long-term impact of the pandemic on the nursing profession and the health of our communities. It is possible that the research may help to inform guidelines and policy in the future.
DEVELOPING A NATIONAL SCHOOL NURSE CURRICULUM: PRIORITIZING KNOWLEDGE DOMAINS – Catherine Yonkaitis DNP, RN, MCSN, PHNA-BC – University of Illinois at Chicago, College of Nursing
Specialty knowledge is required for nurses to care for the physical, mental, and social needs of school-aged children, their families, and the school community. States, like Illinois, require certification or licensure in an effort to ensure nurses practicing in schools have the requisite preparation. However, there are no standardized education guidelines to assist states in establishing basic school nurse preparation requirements. The lack of guidelines has resulted in wide variation in the content, competencies, and program outcomes of school nursing certificate programs, which in turn, creates confusion over what employers can reasonably expect in a school nurse. Ultimately, this has implications for the quality of care delivered in school settings.
EXPANDING ACCESS TO NURSE-LED CARE FOR JUSTICE-INVOLVED PEOPLE
Charles Yingling DNP, FNP-BC, FAANP – University of Illinois at Chicago, College of Nursing
Incarceration negatively effects the health of incarcerated people. Post-incarceration, individuals face significant health challenges due to the nexus of unmet health needs, mistrust in the health system and difficulty accessing care. The UIC College of Nursing (UIC Nursing) and Safer Foundation partner to improve the health of justice-involved people. Safer Foundation operates two Adult Transitional Centers (ATCs) that provide housing and supports for community re-integration to ex-offenders. UIC Nursing provides primary care services to ATC residents at our nurse-led health center. Concurrent with our practice initiatives, UIC Nursing faculty and students conduct health education programs for ATC residents. This program will impact nursing practice by demonstrating an effective model for autonomous RN practice and will impact nursing education by providing training opportunities for RN students seeking roles in community health.
THE LIVED EXPERIENCE OF NOVICE PART-TIME CLINICAL NURSING FACULTY
Sara McPherson PhD, RN – University of Illinois at Chicago, College of Nursing
In the United States, there is not only a nursing shortage, but a nursing faculty shortage. The lack of nursing faculty prevents programs from increasing enrollments, leading to nursing programs turning away qualified students. One challenge nursing programs face is recruiting, hiring and retaining qualified nursing faculty. To fill this void, many programs hire part-time/adjunct faculty to cover crucial clinical teaching vacancies. Faculty hired into this role are often clinical experts who come into the position without formal education on how to teach. In many cases, these part-time/adjunct faculty do not understand the requirements, complexity and rigor involved in clinical teaching in academia. Little is known about what it is like for part-time faculty to assume the role of clinical instructor in schools and colleges of nursing. The purpose of this study is to learn from novice clinical nursing faculty what it is like to provide clinical supervision of students during faculty’s first year or two of teaching. IRB exemption was obtained, Protocol # 2020-1138. A qualitative, descriptive approach will be used. A purposive sample of 8-20 novice, part-time faculty will be recruited and interviewed. A seasoned qualitative researcher will conduct and audio-record all interviews, which will be professionally transcribed. Data will be reduced using naturalistic approaches; NVivo software will be used to manage the project and provide the opportunity for triangulation of the data. NVivo also manages the data trail, to assure credibility and trustworthiness of the findings. Codes and themes will be derived directly from the data. Understanding the lived experience of novice clinical faculty will provide information on why novice faculty choose to stay or leave in their academic role. This information may allow administrators to better understand the needs of novice faculty, in order to enhance their retention and satisfaction.
The following grants were awarded as part of the Public Health Nurse Academic Practice Partnership Project led by Robin Hannon, MSN, RN, the RWJF Public Health Nurse Leader, and were funded by RWJF. The Illinois Nurses Foundation served as the fiscal agent for the grant.
Trinity Christian College/ Restoration Ministries
Project Title: What Are Perceived Health Care Needs of Chicago South Suburban Residents Related To Health And Participation In Holistic Learning
Grant Collaborators: Kathryn Stefo, MSN, RN, CLC, Trinity Christian College; Karen Vrdolyak COO, Restoration Ministries
PI: Kathryn Stefo
Millikin University/ Crossing Healthcare
Project Title: Social Marketing: Crossing the Way to Health
Grant Collaborators: Jo Carter, EdD, RN, Associate Professor, Millikin University; Julie Standerfer, MSN RN, Instructor, Millikin University; Tanya Andricks, RN, MHA, Chief Executive Officer, Crossing Healthcare
PI: Jo Carter
Loyola University of Chicago, Niehoff School of Nursing/ ACCESS Community Health
Project Title: Nurse Internship In Primary Care Nursing Serving The Underserved
Grant Collaborators: P. Ann Solari-Twadell RN, PhD, MPA, FAAN, Associate Professor, Director, Global Experiences and International Studies Loyola University Chicago, Niehoff School of Nursing; Ann T. Lundy, RN, BSN, MBA, Chief Operating Officer, ACCESS Community Health
PI: P. Ann Solari-Twadell
Lakeview College of Nursing/ Vermilion County Health Department
Project Title: Community Collaboration for the Implementation of Vaccine Distribution
Grant Collaborators: Lanette Stuckey MSN RN CNE CMSRN, Dean of Nursing/Associate Professor, Lakeview College of Nursing; Rita Wallace MSN Ed, RN, Assistant Professor, Lakeview College of Nursing; Melissa Rome, BS, MBA CHES CERC, Emergency Planning and Response Coordinator/Community Liaison, Vermilion County Health Department
PI: Lanette Stuckey
The following grants were awarded as part of the Public Health Nurse Academic Practice Partnership Project led by Robin Hannon, MSN, RN, the RWJF Public Health Nurse Leader, and were funded by RWJF. The Illinois Nurses Foundation served as the fiscal agent for the grant.
St. Xavier University School of Nursing/Cook County Department of Public Health Oak Forest
Project Title: Increasing Intimate Partner Violence (IPV) Awareness Among Culturally Diverse Populations in Suburban Cook County
Grant Leads: Charlene Bermele, DNP, RN, CNE; Assistant Professor; Saint Xavier University; Kathy L. Dunn, MSN, RN, Clinic Coordinator, Cook County Department of Public Health
PI: Charlene Bermele
Southern Illinois University Edwardsville (SIUE)/Madison County Health Department
Project Title: Wellness Promotion and Screening Across the Lifespan in Madison County
Grant Collaborators: Amanda Pruitt, Madison County Health Department; Deborah Knoll, Personal Health Division Manager; Theresa Collins, Senior Services Plus.
PI: Ann M. Popkess, RN, PhD; Associate Professor and Department Chair, Family Health and Community Health; Southern Illinois University Edwardsville
Lewis University/Will Grundy Medical Clinic, Will County
Project Title: Salsacize Plus
Grant Collaborators: Linda Arnold, MS, RN; Assistant Professor, Lewis University College of Nursing and Health Professions; Parish Nurse, Trinity Lutheran Church, Lisle, Illinois; Nanci Reiland, MSN, RN, APHN-BC; Assistant Professor, Lewis University College of Nursing and Health Professions; Consultant, Will County Community Health Center
PI: Nanci Reiland
University of Illinois at Chicago (UIC) College of Nursing/UIC Mile Square Health Center Humboldt Park
Project Title: Innovative Patient-led Diabetes Support Group
PI: Kelly Vaez, DNP, FNP-BC, Clinical Assistant Professor, University of Illinois at Chicago (UIC) College of Nursing
St. John Fischer School/ St. Xavier University School of Nursing
Project Title: Saving Lives Through Undesignated EPI-PEN Training
PI: Mary Ann Wolfenson, RN, DNP, IL-PEL, Assistant Professor, St. Xavier University School of Nursing;
Lewis University College of Nursing and Health Professions/ Will County Community Health Center
Project Title: Partnering To Enhance Patient Coaching And Self-Management
Grant Collaborators: Nanci Reiland DNP, MSN RN PHNA-BC, Assistant Professor, Lewis University; Mary Maragos RN MSN APRN, CEO Will County Community Health Center
PI: Nanci Reiland
St. Xavier University School of Nursing/ St. John Fisher School
Project Title: Partnership In School-Based Health Clinic
Grant Collaborators: Michele Poradzisz PhD, RN, CNL, CNE Saint Xavier University; Jim Fornaciari, Principal, Saint John Fisher School
PI: Michele Poradzisz
Southern Illinois University Edwardsville (SIUE) Regional Nursing Program/ Jackson County Health Department
Project Title: Breast-Feeding Friendly Initiative
Grant Collaborators: Melodie Rowbotham PhD, RN, Associate Professor and Director of SIUE Regional Nursing Program; Karen Brown BSN, RN, CLC, Director of Nursing and Family Services, Jackson County Health Department
PI: Melodie Rowbotham
University of Illinois at Chicago, Urbana Regional Campus/ Vermillion County Health Department
Project Titles: Mental Health Initiative Provider Survey; Male Involvement and Adolescent Pregnancy Prevention Campaign; Emergency Preparedness
Grant Collaborators: Krista Jones DNP, MSN, PHNA-BC, RN, Director, Urbana Regional Campus, Clinical Associate Professor, University of Illinois at Chicago; Melissa Rome, BS, MBA CHES CERC, Emergency Planning and Response Coordinator / Community Liaison, Vermilion County Health Department
PI: Krista Jones
Western Illinois University, School of Nursing/ Fulton County Health Department
Project Titles: Interdisciplinary Collaboration: Public Health Department and Student Nurses Providing Education in A Rural County
Grant Collaborators: Dr. Patricia Eathington BSN, MS, DNP, RN Western Illinois University; Karol Herink, RN, Emergency Preparedness & Communicable Diseases Programs Manager
PI: Patricia Eathington
St. John’s College, Department of Nursing/ Department of Family and Community Medicine, SIUE, School Medicine
Project Title: Student Hot Spotting
Grant Collaborators: Dr. Gloria A. Brummer, DNP RN CNE CEN, Associate Professor St. John’s College; Dr. Tracey Smith DNP, PHCNS-BC, MS, Director of Medical Student Education, & Community Outreach Family & Community Medicine, Southern Illinois University, School of Medicine
PI: Gloria Brummer
The following grants were awarded as part of the Public Health Nurse Academic Practice Partnership Pilot Project led by Robin Hannon, MSN, RN, the RWJF Public Health Nurse Leader.
St. Xavier University School of Nursing/Cook County Department of Public Health Oak Forest
Project Title: Increase Adherence to Infant Immunization Between 12-18 Months of Age
Grant Leads: Glenda Morris Burnett, PhD, MUPP, RN, St Savier University/Debbie Brooks RN, Cook County Department of Public Health
PI: Glenda Morris Burnett
Rush University College of Nursing/Richard T. Crane Medical Preparatory High School/Chicago Public Schools
Project Title: After School Health Ambassadors Club Sexual Education Training, Primarily Increase HPV Immunizations
Grant Leads: Monique Reed, PhD, RN, Assistant Professor, Rush University College of Nursing; Fareeda Shabeez
PI: Monique Reed
The following grants were awarded as part of the Public Health Nurse Academic Practice Partnership Pilot Project led by Robin Hannon, MSN, RN, the RWJF Public Health Nurse Leader.
Olivet-Nazarene University/Kankakee County Health Department
Project Title: Infant Immunization
Grant Leads: Tawni Buente, MSN, RN, / Laura Sztuba, MSN, RN, APHN-BC, Kankakee County Health Department
PI: Tawni Buente
McKendree University/St. Clair County Health Department
Project Titles: STI Prevention and Promoting Employee Wellness
Grant Leads: Robin Hannon, St. Clair County Health Department (SCCHD); Jan Albers, McKendree University (MCK)
PI: Robin Hannon
McKendree University/Jackson County Health Department
Project Title: Chronic Respiratory Disease During Emergency or Disaster
Grant Leads: Jan Albers DNP, RN, PHNA-BC McKendree University/ Karen Brown BSN, RN Director of Nursing, Jackson County Health Department
PI: Karen Brown