Interprofessional simulation-based learning used to prepare perioperative nursing students for acute situations

Background: Perioperative nursing focuses on care for patients with life-threatening crisis, illness or injury undergoing planned or acute surgery, treatment and/or examination. Performing care requires advanced knowledge and skills to ensure safe outcomes for surgical patients. Perioperative nurses work in interprofessional surgical teams and must develop team skills, such as communication and interprofessional collaboration, as teamwork is an essential component of patient safety. Therefore, perioperative nurses need a distinct form of higher education that builds a close relationship between higher education, science and the profession’s occupational field. Interprofessional simulation-based learning is a pedagogical approach that integrates learning as a task performance, communication technique and collaboration. It involves higher-level learning, such as analysis and problem-solving in problematic scenarios or care settings. Although interprofessional simulation-based learning is an often-used pedagogical approach in nursing programmes, it still seems under-researched and under-theorised, especially in educating perioperative nurses. Therefore, there appears to be a need for explorative research on arranging interprofessional simulation-based learning to facilitate perioperative nursing students’ learning, create good learning processes and obtain attended learning outcomes. Furthermore, there is a need for more in-depth knowledge about the learning processes in interprofessional simulation-based learning. There also seems to be scarce knowledge concerning students’ transfer of professional competence to clinical practice and how interprofessional simulation-based learning influences future practice. Aim: The overarching aim of this PhD thesis is to gain knowledge and insight into perioperative nursing students’ learning and development of professional competence using interprofessional simulation-based learning as a pedagogical approach. Conclusion: Interprofessional simulation-based learning is an essential pedagogical approach in perioperative nursing education, as it develops professional competence and self-efficacy in meeting acute clinical situations. It is vital to use effective pedagogical approaches to build competencies that are transferable to clinical practice and to improve perioperative nurses’ performance as recent graduates. Therefore, it is crucial to implement interprofessional simulation-based learning in perioperative nursing education.publishedVersio

Perioperative Preceptor Education in an Agency Preceptor Workshop

There is a critical shortage of perioperative nurses and the demand in the United States (US) is growing steadily by 1% to 2% each year. It is estimated that nearly 20% of registered nurses (RNs) currently working in the perioperative area will retire in the next five years. In the perioperative area, when using the 6 to 12-month orientation time frame, as outlined in the Association of PeriOperative Registered Nurses (AORN) orientation calculator, the cost of orienting a new RN can exceed $100,000. A preceptorship workshop is one strategy that has been shown as an evidence-based intervention to decrease RN turnover rates, increase job satisfaction, and have a positive effect on new nurse role transition and intent to stay. Perioperative preceptor education as a component of an agency-wide workshop was developed and implemented with the purpose to improve RN preceptor performance and proficiency, and increase perioperative RN orientee satisfaction and intent to stay. A pre- and post-intervention design was implemented in a 391-bed Magnet designated facility to evaluate these outcomes. Using eta square, mean preceptor performance and proficiency scores indicated a moderate effect size, which demonstrated clinical significance and a positive impact on the nurse practice environment

The influence of a preoperative information brochure on the experience of patients undergoing awake surgery in private hospitals

A dissertation submitted to the Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, in fulfillment of the requirements for the degree of Master of Science in Nursing Johannesburg, 2018.Undergoing surgery without having general anaesthesia has become an option for many surgical patients. Awake patients are able to communicate with the surgical team which allows the surgical team to gain understanding of the patient’s experience. This is an important aspect of perioperative care and is in line with the theory of Human Becoming according to Parse, (2011). Literature suggests that patients who have received information preoperatively about their planned perioperative journey experience less anxiety and fear relating to their surgery. The purpose of this study was to explore the perioperative experiences and needs of patients undergoing awake surgery. A qualitative exploratory descriptive three step design of data collection was implemented for this study. In step one an integrative review identified patient experiences of the perioperative journey. The literature was critically analysed for relevance and inclusion. This information formed the basis for inclusion in step two. Step two explored the perioperative experience of participants who had undergone awake surgery by interviewing a group of participants using interviews and probe questions extracted from the literature. The information gleaned from the interviews was grouped for content similarity and was used to create an information pamphlet which informed participants about their perioperative journey. In step three the information pamphlet was handed to participants preoperatively and the same participants rated the usefulness of the information pamphlet postoperatively by answering a dichotomous question. Participants had the opportunity to add comments. The population for this study was all patients who were scheduled for ophthalmic, orthopaedic, urological or plastic, surgery using awake surgery in four large private hospitals in Gauteng and Mpumalanga. Patients younger than 18 years of age as well as those receiving sedation or general anaesthesia were excluded from the population. This study showed that participants had positive experiences of being awake during surgery. A number of participants found the experience of being awake during surgery interesting and enjoyed being able to ask questions and participate in dialogue. Participants rated the information pamphlet as useful. Two areas of concern was elicited, namely communication and nursing care within the operating theatre environment. The objectives for this study were met. Key words: perioperative journey, awake surgery, regional and local anaesthesia, nursingLG201

Advances in Teaching & Learning Day Abstracts 2006

Proceedings of the Advances in Teaching & Learning Day Regional Conference held at The University of Texas Health Science Center at Houston in 2006

The Professional Portfolio: An Evidence-Based Assessment Method

Competency assessment is critical for a myriad of disciplines, including medicine, law, education, and nursing. Many nurse managers and educators are responsible for nursing competency assessment, and assessment results are often used for annual reviews, promotions, and satisfying accrediting agencies\u27 requirements. Credentialing bodies continually seek methods to measure and document the continuing competence of licensees or certificants. Many methods and frameworks for continued competency assessment exist. The portfolio process is one method to validate personal and professional accomplishments in an interactive, multidimensional manner. This article illustrates how portfolios can be used to assess competence. One specialty nursing certification board\u27s process of creating an evidence-based portfolio for recertification or reactivation of a credential is used as an example. The theoretical background, development process, implementation, and future implications may serve as a template for other organizations in developing their own portfolio models

Perceptions of Basic Knowledge Needed by Perioperative Registered Nuses for Competency

This paper is a study of current perceptions of perioperative nurses view of competency in the operating room. Perioperative education, competency standards, and competency assessment have been used to guide clinical and professional nursing behaviors. The need for a standardized education program and competency assessment tool has been identified, but inconsistencies and disagreement about the components that should be included for these areas still remains. A review of current literature was conducted to include topics involving perioperative education, competency assessment, and nursing perceptions regarding competency. A survey of current practicing perioperative nurses was also conducted; both qualitative and quantitative data was collected and analyzed. From the analysis of available literature and a survey of perioperative nurses, three themes were identified: perioperative nurse competency is essential for patient safety, communication and teamwork were perceived as strong characteristics of competency traits, and subspecialty education programs and the educational level of the nurse were not perceived as valuable for achieving competence. These findings indicate that teamwork and communication should be incorporated into perioperative nursing competency standards. Current accepted standards from the Association of perioperative Nurses does not currently address teamwork and communication as indications of perioperative nursing competency. It also revealed that the need for further research related to competency and the standardization of perioperative educatio

Improving Perioperative Communication Through the Use of a Nurse Navigator: An Integrative Review

Patient-centered communication practices are critical for ensuring that patients have optimal care experiences and clinical outcomes. Unfortunately, today’s health care environment often presents numerous barriers to consistent and clear information exchange. These barriers are magnified in dynamic and fast-paced care environments such as the perioperative setting, where numerous interactions and communication exchanges must occur. The purpose of this integrative review is to examine the value of the nurse navigator role within the perioperative setting and evaluate whether it can improve patient and family satisfaction with communication and the care experience. The review includes the identification and appraisal of relevant literature to substantiate the impact of a nurse navigator in overcoming environmental barriers, enhancing patient education, decreasing patient and familial anxiety, and improving patient satisfaction. The analysis of current literature provides strong evidence for the value of a nurse navigator within the unique perioperative care setting. This review will help inform patient- and family-centered communication processes that can lead to improved care quality and outcomes

Evaluating the use of narrative pedagogy in person-centred care and human factors in perioperative practice education

Background: There is an international effort to develop understanding from human factors theory and implement this in healthcare to improve person-centred care and patient safety. Aim: This project aimed to evaluate the use of narrative pedagogy to teach human factors to perioperative personnel in the workplace. Methods: Using the action research model, an interactive learning session based on lessons from serious incidents was developed and delivered to perioperative staff in an NHS Trust within a practice development programme. Data were collected in the form of questionnaires and peer reviews to evaluate the learning session, and thematically analysed. Findings: The use of narrative pedagogy to explore human factors theory empowered participants to speak up, and this influenced the workplace safety culture. Conclusion: Narrative pedagogy reconnects healthcare employees with compassionate approaches to person-centred care, and this provides powerful motivation to improve the safety culture. Further studies should focus on different applications of narrative pedagogy in workplace learning, and creative approaches to teaching human factors. Implications for practice: • Narrative pedagogy can be a conduit to develop person-centred practice • Engaging staff through interactive practice development sessions can encourage expansive learning about human factors and their application in practice • Narrative pedagogy motivates healthcare staff to improve the safety culture in practic

Succession Planning and the Identification of Future Perioperative Leaders: A Mixed Methods Study

Purpose: The purposes of this study were to determine if there is a relationship between succession planning and the identification of future perioperative leaders; if there is a relationship between mentoring for leadership and the identification of future perioperative leaders; to understand the current state of leadership in the operating room (OR), and to determine what methods are being used to identify perioperative nurse leaders. Background: An impending nursing shortage is expected to occur in the next decade, particularly within the specialty of perioperative practice and leadership. Providing access to surgical care is a major challenge for meeting the nation’s health needs and is a concern of the Institute of Medicine (IOM). Perioperative registered nurse orientation involves almost a year of competency-based mentoring and training while the perioperative nurse leader orientation may take even longer. The nursing shortage combined with the extensive training needed for leadership positions may contribute to a reduction of active ORs during the time period that nurses are undergoing training. The inability to staff the OR may in turn have a negative effect for the remaining five concerns of the IOM aims of quality, safety, equality, efficiency, and cost. Solutions to successfully close the gap between the supply and demand of perioperative nurses and nurse leaders need to be identified