Journal for Nurses in Professional Development

Published by Lippincott, Williams & Wilkins
Print ISSN: 2169-9798
Nurses care for increasing numbers of patients requiring cardiac monitoring. Ability to identify cardiac rhythms is a key element in nurses' ability to promote patient safety. A quasi-experimental pilot study using a stratified random sample of 32 medical-surgical nurses examined accuracy of cardiac rhythm interpretation. Findings showed a statistically significant disparity in performance between registered nurses and licensed vocational nurses. These findings suggest a need to improve staff development in the area of cardiac rhythm interpretation.
Nursing Professional Development (NPD) specialists frequently design test items to assess competence, to measure learning outcomes, and to create active learning experiences. This article presents six valuable tips for improving test items and using test results to strengthen validity of measurement. NPD specialists can readily apply these tips and examples to measure knowledge with greater accuracy.
Nursing certification is recognized as advanced competency and knowledge beyond basic preparation, thus empowering nurses to contribute to improved outcomes by demonstrating expertise in their specialties. It has been recognized that nurses do not seek certification because of identified barriers. Through a structured Certification Achievement Program that reduced barriers, a cohort of nurses was able to achieve certification in medical-surgical nursing.
Disruption of circadian rhythm has a significant impact on the physical, psychosocial, and professional lives of night shift nurses. How night shift nurses learn the coping techniques they employ to adapt to this disruption was examined in a qualitative, cross-sectional survey of 42 nurses. A template analysis technique was used to categorize the responses, which were then compared to industry "best practices" in fatigue countermeasures. Results documented the variety of sleep/wake routines nurses employ to cope with circadian disruption as well as a wide-ranging variety of behaviors related to driving while fatigued.
This study describes oncology nurses' knowledge of new chemotherapy safety standards and satisfaction with education using simulated electronic learning vignettes. A quasi-experimental longitudinal, one-group pretest-posttest design was used to examine satisfaction and chemotherapy errors over time. Findings showed the mean number of error scores differed significantly across time points, indicating follow-up should occur to reinforce new standards. Nurse educators also may require more education about innovative educational strategies.
Higher patient acuities and more novice nurses on medical-surgical units have Educators focused on achieving positive outcomes with changes in patient condition. An educational program was developed to enhance nurses' knowledge, skill, and confidence in assessing hemodynamics, recognizing early signs of instability, and administering vasoactive medications. The program was successful with significant knowledge improvement as well as an increased use of the Medical Emergency Team while maintaining a low number of code calls.
A nontraditional approach to leadership development promoted successful transition of new graduate RN residents to professional nurses. Utilizing an outdoor adventure program increased nurses' feelings of competence by boosting their confidence, facilitating an environment where leadership at the bedside became an ingrained part of their nursing practice. RN residents at a Midwestern medical center represented only 17% of the nursing population but reshaped the culture of the entire organization by becoming dynamic "everyday" leaders.
This article introduces the role of nursing professional development specialists in serving as a resource for both patient and staff advocacy regarding cultural and linguistic matters. The impact of changing demographics, support for civil rights, and established policy related to culture and linguistics is emphasized. An overview of policy at local, state, and national levels is suggested to promote nursing professional development in the interest of culturally and linguistically compliant nursing practice.
Christiana Care Health System implemented a Care Management Guideline for Alcohol Withdrawal Symptom Management, which provided direction for inpatient screening for alcohol withdrawal risk, assessment, and treatment. Nurses educated on its use expressed confusion with the use of the assessment tools, pharmacokinetics, and pathophysiology of alcohol withdrawal and delirium tremens. Reeducation was provided by nursing professional development specialists. Pre- and postsurveys revealed that nurses were more confident in caring for patients with alcohol withdrawal.This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License, where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially.
Changes in chemotherapy delivery from inpatient to outpatient settings and transition from intravenous to oral administration threaten the competency level of chemotherapy nurses. To standardize care and demonstrate competency across five hospital campuses and four outpatient infusion centers, one health system developed a hands-on competency evaluation for chemotherapy nurses based on a scenario approach. Results included improved confidence, competence, identification of variation, and standardization of equipment, process, and policy.
Professional portfolios allow staff to document their participation in areas of education, certification, shared governance councils, national nursing organizations, and community outreach. In this study, nurses tracked their professional development in a virtual electronic portfolio. A preperception/postperception questionnaire for both staff and unit directors revealed that nursing portfolios proved to be a valuable tool during annual performance reviews to acknowledge accomplishments and encourage continued professional growth of individual direct-care staff nurses.
Nursing presence, the ''doing for'' and ''being with'' patients, embodies the holistic work of the registered nurse. However, nursing presence is seldom reflected in hospital orientation curricula. Programs traditionally orient nurses to policies and psychomotor tasks but exclude emphasizing how to ''be with'' patients. This article describes how one Midwestern academic medical center incorporated both the art and science of nursing into orientation. Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins. Unauthorized reproduction of this article is prohibited.
This multi-site, quasi-experimental study examined the performance outcomes of nurses (n = 152) in a military nurse transition program. A modified-performance instrument was used to assess participants in two high-fidelity simulation scenarios. Although results indicated a significant increase in scores posttraining, only moderate interrater reliability results were found for the new instrument. These findings have implications for nurse educators assessing performance-based outcomes of new nurses completing transition programs.
This study evaluated the quality of multiple-choice questions used in a hospital's e-learning system. Constructing well-written questions is fraught with difficulty, and item-writing flaws are common. Study results revealed that most items contained flaws and were written at the knowledge/comprehension level. Few items had linked objectives, and no association was found between the presence of objectives and flaws. Recommendations include education for writing test questions.
One institution's registered nurse preceptor training curriculum was revised to include preceptors' input to ensure their learning needs were being met. A descriptive study design was used to answer the following research questions: (a) what knowledge, skills, and attitudes do nurses believe they need to have to be a preceptor; (b) when, in the course of their development, do preceptors believe they need this information; and (c) in what manner(s) do preceptors prefer to learn this information? Thirteen topics that preceptors believed were important were identified. The results of this study were used to successfully revise the preceptor training curriculum.
CNA education survey response to a single question.
Educational Offerings Provided in Response to Needs Assessment Topics
Certified nursing assistants (CNAs) are important partners in the delivery of quality care to patients. Nurse educators are challenged with providing "just-in-time" education to CNAs within the constraints of a fast-paced clinical environment. This article will discuss a successful CNA training program and lessons learned for improving just-in-time education to assistive personnel.
This collaborative study explored nurses' knowledge, attitudes, and skills related to the evidence-based practice (EBP) process. It also explored the nurses' perceptions of the barriers and facilitators that they face related to fully using EBP in the workplace. Findings will afford the healthcare system the information to develop, plan, and restructure the educational services to meet the demand of enhancing EBP strategies and utilization.
A focus group study was conducted to describe bachelor of science-prepared registered nurses' (n = 10) use of research in their everyday practice. Results indicate that participants feel prepared to use research upon entry into the workforce and do so to better patient care. However, research use is both positively and negatively affected by nursing leadership and the research culture of the workplace. The author includes implications for nursing professional development specialists and educators.
Nurse educators are encouraged to use evidence to guide their teaching strategies. However, evidence is not always available. How can educators make decisions regarding strategies when data are limited or absent? Where do innovation and creativity fit? How can innovation be balanced with evidence? This article provides a discussion regarding other sources of evidence, such as extrapolations, theories and principles, and collective expertise. Readers are encouraged to review the options and then analyze how they might be applied to innovation in education.
The purpose of this project was to describe the benefits and components of successful nurse residency programs, as well as gain insight into the perceptions of staff nurses, nurse educators, and nurse leaders regarding value, feasibility, and barriers to implementing nurse residency programs in acute care settings. This study has important implications for implementing an effective residency program.
With national emphasis on increasing baccalaureate-prepared nurses, the role of the staff development educator of promoting lifelong learning is ideal for advising and mentoring non-bachelor's-prepared nurses to return to school. However, an understanding of the motivators and barriers for nurses to return to school is essential for success. A descriptive correlational research study was completed to determine the motivators and barriers of returning to school for registered nurses without a bachelor's degree.
Enculturation of evidence-based practice (EBP) is a continuing challenge. This article describes a novel pathway for staff development educators to fast track the teaching-learning of the EBP skills set and the immediate full cycle application of the EBP process at point of care. The pathway, called EBP Literacy, offers an asynchronous stepwise approach to learning EBP in an iterative process from the bedside to bench side and back to the bedside.
In the pediatric critical care setting, change of shift report/handoff does not traditionally occur at the bedside. During report, the nurses share important information that promotes patient safety and continuity of care. The goal of educating the nursing staff about family-centered care and shift report at the bedside is to promote better communication, a more comprehensive handoff, enhanced patient safety, engagement of the patient/family, and increased patient/family and staff satisfaction.
Disruptive behaviors are common among hospitalized patients with psychiatric and substance abuse behaviors. Nurses working on nonpsychiatric units, however, may lack competencies to care for patients with such behaviors. A survey was developed and administered to 844 nurses across three hospital settings that revealed a lack of nurse confidence to intervene in situations that require de-escalation techniques and crisis communication. This study provides direction for further research and interventions in hospital settings with similar professional development needs.
Novice post-licensure nurses are frequently exposed to microethical nursing practice problems during their first 24 months of formative practice. Often, novice nurses trust the advice of experienced nurse coworkers, deferring to such advice even when they know the advice contradicts evidence-based practice. This study revealed the prevalence of deference behaviors and associated rationale. Study findings emphasize the importance of incorporating conflict management, effective communication techniques, ethical frameworks, and EBP standards within pre- and post-licensure education.
A large urban academic medical center installed a telemetry system that increased patient monitoring hospital-wide, which required staff to learn basic electrocardiogram dysrhythmia interpretation. This article outlines the course development, implementation, and evaluation of this electrocardiogram dysrhythmia education.
Web 2.0 technologies such as blogs are increasingly used in academic settings; however, they are not widely used in hospital settings. This project explored the effectiveness of using a blog to enhance reflective learning in a nurse manager leadership development course of a tertiary care hospital setting. Differences in reflective learning between the blog group and traditional learning group were measured post training using a Reflective Learning and Interaction Questionnaire. Although the groups did not differ significantly on any reflective learning dimension (p < .05, n = 11), the mean scores showed that both groups identified a reflective learning experience. Findings from this study inform the practice of other nurse educators contemplating to incorporate blogs into their learning strategies to enhance reflective learning.
This systematic review identifies the significance of the preceptor role in affecting new graduate nurse retention. Findings from 20 research studies provide support that nurse preceptors receiving continuing education and perceiving reward and recognition from the preceptor position positively affect new graduate nurse retention. Hospital administration, nurse managers, nurse educators, preceptors, and new graduate nurses each play a role in the successful implementation of a preceptor support system.
Horizontal violence and bullying are pervasive throughout nursing. New graduate nurses are at higher risk. Challenged with the task of making the transition from student to practitioner, new graduates often lack the confidence and social connectivity that may ward off interpersonal conflict. Continued interpersonal violence directed at new graduates may lead to negative physical and psychological consequences, high turnover rates, or abandonment of the profession. This article describes possible strategies to break the chain of violence.
This qualitative descriptive study explored nurses' experience of being bullied and examined their coping strategies. A purposive sample of 18 registered nurses who self-identified as being targets of bullying behavior was used. The authors found that nurses used a variety of coping strategies. An understanding of these strategies can assist staff development educators to develop interventions to eliminate this pervasive problem.
Many organizations have recently launched new goals, which provide strategic opportunities for nursing professional development specialists. Nursing professional development specialists are key to advancing nursing practice and are in unique positions to influence and leverage our expertise to promote the provision of safe quality care. We are transformational leaders.
A randomized controlled study assessed a self-paced, online educational course addressing the complex nursing care of hospitalized patients on basal-bolus insulin. Interactive quizzes and scenarios were used to reinforce learning. Knowledge in the intervention group increased significantly and was retained 3-months postintervention. Nursing professional development educators will find this article useful regarding methods for annual competency evaluation and for increasing staff's knowledge as part of a system approach for safely caring for patients with diabetes.
The purpose of this mixed method study was to evaluate effects of a reflective practice intervention on the attitudes, knowledge, and interventions of nurses who care for hospitalized older adults. The study showed the potential of using a reflective practice intervention as a professional development approach to improve nurses' attitudes toward older adults.
The job satisfaction of assisted living facility staff was examined as part of an evaluation study of a restorative care training program. Participants completed a job satisfaction survey at registration (before the training) and again at follow-up 3 months after registration (1 month after the conclusion of the training). Researchers examined the effects of training on job satisfaction. Researchers found a high level of job dissatisfaction at registration. At follow-up, responses were more positive on most of the items suggesting a slight but significant change to a more positive attitude toward their jobs. Improving staff job satisfaction in the assisted living environment is an important goal and needs further investigation. Providing staff with inservice training may be one way to help nurse educators achieve that goal.
To support evidence-based practice changes in long-term care, we used a practice development approach with interactive workshops to engage teams from 10 organizations in participatory change. Data from postworkshop surveys and subsequent semistructured interviews indicated that participants felt empowered to identify a priority challenge and initiate change. Notably, the workshop intervention enhanced collaboration between professional and unregulated staff, fostered the development of shared vision, and provided the impetus to tackle workplace barriers to change.
Rural nurses are expected to be competent and confident caregivers for patients of all ages and disease states. Rural nurse educators are challenged with creating appropriate learning environments to assess and maintain nursing competencies in resource-limited areas. This project describes and evaluates the utilization of a simulation manikin from a local community college to provide a hands-on learning environment for rural nurses working with pediatric patients in respiratory distress. Copyright
Preceptor Program Gap Analysis
Watson's Caritas Processes
Preceptor Program Outline
This Magnet hospital embraces Jean Watson's (2008) theory of caring; its preceptor program acts as a vehicle to bring to life a professional nursing model, going beyond patient care. The program offers dynamic content that engages staff, promotes the use of innovative learning methods, and provides strategies to deal with difficult situations. The program has successfully influenced staff to adopt more caring behaviors toward themselves, preceptees, and others.
To provide quality patient care and achieve positive patient outcomes, it is widely recognized that organizations must develop a supportive environment that encourages individuals to practice from a research- and evidence-based framework. This article describes a Web-based professional educational program designed to teach principles of evidence-based practice to nurses in rural hospitals. Nurses working in staff development will find this useful for designing educational programs for staff in rural hospitals.
The goal of the Nurse Professional Development specialist is to utilize the most effective educational strategies when educating staff nurses about pressure ulcer prevention. More information is needed about the effect of computer-based learning and traditional classroom learning on pressure ulcer education for the staff nurse. This study compares computer-based learning and traditional classroom learning on immediate and long-term knowledge while evaluating the impact of education on pressure ulcer risk assessment, staging, and documentation.
Empathy plays an important role in comprehensive nursing care. Empathy outcome research shows that exposure to an empathetic person has a palliative and even healing effect on patients. Teaching nurses how to communicate with empathy is crucial to unleash the true potential that empathy has to transform and heal. Four active listening skills and six compassion-based skills are defined. A suggested training rubric appropriate for use in multiple training contexts is provided.
First-year turnover of newly licensed registered nurses is reported as high as 40%-60%. Turnover can be reduced to 10% or less with a nurse residency program. This study compared three best practices within a single health system. The three aims were to determine first-year turnover of newly licensed registered nurses for three sites, compare outcomes after one-year posthire, and examine intent to stay. Although there were only a few statistically significant differences, the trend was positive for the site with a nurse residency program.
Clinical ladders provide a framework for professional nursing development and have shown increased personal and professional satisfaction. This article describes a standardized approach for clinical ladder implementation. Managers' and staff nurses' knowledge of the model must align for important stakeholders to perceive the clinical ladder as valuable. Understanding differences and perspectives can be useful as the basis for education and further clinical ladder refinement augmenting the potential for increased nursing satisfaction and professional development.
Nursing competency validation must be effective to ensure safe and quality patient care. In this article, the authors discuss the components of an organizational validation strategy that includes clear definitions, selection of competencies, and responsibilities for initial and continuing competency assessment. Recommendations are made to assist nursing professional development specialists in implementing strategies to improve the assessment and validation of nursing competency. Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins. Unauthorized reproduction of this article is prohibited.
Clinical nurses are increasingly responsible for facilitating and providing diabetes education in the acute care setting. However, research suggests that the lack of awareness about the psychosocial factors that influence diabetes self-management impairs the nurse's ability to effectively and comprehensively support the patient's self-management efforts. This mixed-methods design of the research study describes how transformative learning, in conjunction with critical reflection, enhanced graduate nurses' understanding of the psychosocial aspects of diabetes self-management and improved their ability to provide patient-centered care.
The integration of educational technology into nursing continuing education in the form of online learning involves a shift in thinking from traditional views of nursing education. With advances in technology and increased comfort with the Internet, more professional development staff are offering online continuing education courses. Considerations for professional development staff include transition of roles for the educator and the learner, structure of course offerings, and whether to use synchronous or asynchronous formatting.
Innovations in health care call for fresh approaches to continuing nursing education that support lateral relationships, teamwork, and collaboration. To foster this transformation, we devised the following education principles: Everyone teaches, everyone learns; embrace probability; information is dynamic; and trust professionals to practice professionally. These principles guided the development of seven independent, practice-specific, evidence-based continuing nursing education programs totaling 21.5 contact hours for casual-status nurses who practiced as childbirth educators. The programs were popular, promoted teamwork, and increased communication about evidence-based practice.
Top-cited authors
Joan Warren
  • University of Maryland, Baltimore
Judith Bowling
  • Baptist Health South Florida
Elizabeth Cotter
  • Molloy College
Cory Church
  • Texas Woman's University
Patricia Dwyer
  • Boston Children's Hospital