Effects of high-fidelity simulation on self-efficacy in undergraduate nursing education regarding family systems care and early palliative care

Objective: Family systems care and palliative care are main topics in nursing education and practice. Self-efficacy of undergraduate nursing students is strengthened by high-fidelity simulation. The aim of this study was to explore the effects of high-fidelity simulation on the self-efficacy of undergraduate nursing students regarding family systems care and early palliative care in an adult setting. Methods: A quasi-experimental study design with repeated measures was conducted. Self-Efficacy was measured using the Family Nursing Practice Scale (FNPS) and the Self-Efficacy-Subscale of the Bonner Palliativwissenstest (BPW) before the start of the theoretical family systems care and palliative care courses (t1), after completion of the courses (t2), immediately after high-fidelity simulation (t3) and 3 months after high-fidelity simulation (t4). A linear mixed model was performed to evaluate the difference of self-efficacy between the times of measurement. Results: A total of 46 undergraduate nursing students participated in the study. There were statistically significant differences regarding the FNPS between t1 and t3 (p = .0019) as well as t1 and t4 (p = .0198), and regarding the BPW between t1 and t3 (p ≤ .0001), t1 and t4 (p = .0012), as well as t2 and t3 (p = .0112). Between the other times of measurement, no statistically significant differences were found. Conclusions: High-fidelity simulation in combination with traditional learning methods can have a short- and long-term effect on undergraduate nursing students’ self-efficacy regarding family systems care and early palliative care in hospitalized adult patients

German nursing shortage in hospitals – Homemade by Profititis?

The shortage of nursing staff in Germany compromises public healthcare in deference to profits explaining why this is on the daily political and media agenda. In Germany, over a 22 year period, significant savings were achieved by decreases in: (1) hospital beds by −29.3% saving 119 000 beds, (2) patient care and treatment days by −23% saving 43.1 million patient days, and (3) length of hospital stay in days by −39% saving 4.7 days. This occurred together with the parallel increase of treated patient cases by +26.5% with an additional burden of 4.1 million patients. Since 2010, as birth rates increase again treatment cases will also increase. In parallel, the percentage of total nurses has decreased (−2.1%) as well as that of registered nurses in hospitals between 1999 (325 539) and 2009 (324 337) have decreased (−0.4%), in conjunction with nurses employed in preventive and rehabilitation facilities (+15.1%) and/or in outpatient care facilities (+41.1%) and/or nursing homes (+24.8%) and/or nurses working in retirement homes (+77.9%). This “profititis” endangers both patient care and detracts from people joining the nursing profession. It might even be a short-sighted tightrope act which, in the end, might counteract the marketing strategy of “patient safety” by risking quality of patient care. Maybe healthcare politics would be well-advised to re-think the fact that as the population gets older and as birth rates and immigration increases, these factors could result in increased patient caseloads in hospitals which need to be addressed now so as to avert a future crisis