Students’ evaluation of a computerized patient simulator in nursing education and its effect on the results of preclinical te

The aim of the study was two-fold: to evaluate nursing students’ experiences of active participation in the use of a-computerized simulation manikin during preclinical first-year Bachelor’s studies, and to evaluate the effect of active participation in simulation by comparing active students’ result with observers’ result on preclinical test. An evaluative case study design was used to evaluate simulation with a computerized manikin as a pedagogical learning method. A questionnaire was used to evaluate the active students’ experiences. The second part was a comparison between the active students’ and the observers’ preclinical test results. Findings indicated that the students thought simulation was beneficial, feedback from peers and lecturer was helpful and reflection during debriefing was beneficial. A significant difference was seen between those students who actively participated and those who observed in relation to the pass/fail preclinical test. Nursing students experienced simulation with a computerized manikin as being a beneficial pedagogical learning method, and active participation in a simulation situation can help students pass their preclinical test

Tverrprofesjonell klinisk praksis for helsefagstudenter som en del av den ordinære praksisperioden, En casestudie fra en akutt geriatrisk-, slag - og rehabiliteringsavdeling

Interdisciplinary Professional clinical practice for health sciences students as part of the regular work placement- a casestudy from an acute geriatric - stroke and rehabilitation department.This study describes students' experiences of interdisciplinary clinical practice (ICP) in an emergency department of geriatrics, stroke and rehabilitation in Norway. The purpose of this study was to investigate whether ICP has contributed to the students' knowledge of their own and other professional' expertise and expanded understanding of patients' rehabilitation needs. 19 students; nursing, occupational therapist, physiotherapist and social worker students were represented in the study. A model with various learning activities was developed in collaboration between two university colleges and the department. ICP lasted two weeks during a regular practice period. Students' experiences were evaluated through focus group interviews. The study concludes that collaboration in patient situations is essential for the students awareness of each other's disciplines, expanded perspective on own subjects and the patients need of rehabilitation. The short length of stay in the department led to increased focus on interaction early in the patient care

Nursing Intensity in Home Health Care

Background: As people get older, their health needs become more chronic and complex. In that the burden on health and long-term care systems and services will increase alongside the aging population, well-functioning municipal health care systems will be needed. Also, because of the shift from hospital and long-term settings to home health care, nurse leaders need systematic information about patients’ care needs for staff resources. To guarantee person-centered and safe care, the correct allocation of staff resources and acceptable nursing workload levels are essential. Consequently, reliable instruments for measuring nursing intensity are needed. Aims: The overarching aim of the thesis was to identify currently used patient classification systems (PCSs) developed and tested in HHC, with a special emphasis on validity, reliability and staff allocation, and to test the validity and reliability of the modified Oulu Patient Classification (OPCq) instrument. This also included describing nurses’ work experiences with and perceptions on the modified OPCq instrument’s usability when using it to classify nursing intensity (NI) in an HHC setting. Theoretical framework: The RAFAELA® system is based on a holistic view of patients and incorporates a nursing perspective with a caring and person-centered approach. In RAFAELA®, a balance is sought between each patient’s individual care needs and nursing resources. Developed from a humanitarian point of view, the OPCq instrument is used to measure a patient’s physical, social and spiritual/existential needs. Design, materials and methodology: The study was a part of a municipal research and development program in home health care and realized during 2012-2014 in collaboration with the University of South-Eastern Norway. The modified OPCq instrument was tested in two home health care units. To provide an overview and broader knowledge of the existing patient classification systems used in home health care, a scoping review was conducted. Paper I was a scoping review and included searches of the Cinahl, Medline, Embase and SweMed electronic databases, resulting in 1247 records being identified; an additional 56 records were identified through searches of the Google and Google Scholar databases and hand searches of key journals. After the removal of duplicates, 1040 records were screened (title and abstract), resulting in 55 records that were re-screened, with 39 being excluded. The remaining 16 full-text articles were assessed for eligibility, and three were excluded with reasons. Consequently, thirteen papers were included in the final review. In Paper II, a descriptive design was used and the study included a questionnaire comprised of a total of 13 questions with set answers and the possibility to comment on eight of the questions; ten questions had a five-point Likert scale. Descriptive analyses and simplified content analyses occurred. Participants, comprised of registered nurses, practical nurses and assistants, answered the questionnaire in spring 2013 and spring 2104. In Paper III, a reliability study, the interrater reliability of the modified OPCq instrument was tested using a new multiple parallel classification method for data collection. The guidelines for Reporting Reliability and Agreement Studies were followed when reporting the study. There were 2010 parallel classifications (335 x 6 sub-areas) conducted during the period November 2013 to February 2014, involving 53 patients. Participants were registered nurses, practical nurses, assistants and nursing students. In Paper IV a qualitative design was used, including focus group interviews to collect data. Four focus group interviews were conducted, two in April 2013 and two in May 2013. A total of 24 registered nurses and practical nurses were invited to participate in the study. Results: In Paper I, 13 patient classification systems used in home health care were reviewed. All were found to measure patients’ needs and/or nursing requirements. Five instruments were or had been tested for validity, five tested for reliability, and one validity and reliability tested and evaluated. How accurately the systems were described varied, with some very well described and others not. Specific information on staff allocation was missing from most of the systems. In Paper II, participants evaluated the OPCq instrument’s sub-areas 1-6 (M=2.98-3.11, MD=3, SD 0.77-0.96). About 80% of the participants evaluated sub-area 1 (planning and co-ordination of nursing care), sub-area 2 (breathing, blood circulation and symptoms of disease) and sub-area 4 (personal hygiene and secretion) as being very well/well or pretty well described in the instrument. The nursing intensity levels A-D described in the instrument’s sub-areas were also assessed (M=2.70-2.90, MD 3, ST= 0.88-0.97). Here the highest scores were given for sub-area 1 (planning and co-ordination of nursing care), sub-area 2 (breathing, blood circulation and symptoms of disease) and sub-area 6 (Teaching, guidance in care and follow up care, emotional support). In Paper III, consensus in percent in relation to the parallel classification of the OPCq instrument’s sub-areas 1-6 was undertaken and seen to be 64.78%-77.61%. Cohens’ kappa showed an interrater reliability of 0.49-0.69. Sub-area 4 (Personal hygiene and secretion) showed the highest consensus and sub-area 6 (Teaching, guidance in care and follow up care, emotional support) showed the weakest consensus. In Paper IV, three themes emerged from the focus group interviews: (a) Classifying the modified Oulu patient classification correctly; (b) Technological problems hinder the use of the instrument; (c) Classifying nursing intensity when time pressure dominates. The nurse participants expressed some uncertainty about the various levels in the OPCq instrument and where or how to classify some tasks or duties. There were also some technical problems with the registering of OPCq measurements. A lack of time during the work day was a significant stress factor when classifying. Conclusion: While various patient classification systems used in home health care were seen in the scoping review, few were validity and/or reliability tested or evaluated. How well and accurately the patient classification systems were described in the reviewed papers varied, and information about the allocation of staff was lacking. The OPCq instrument was considered to fulfill the requirements for validity and reliability. However, the OPCq manual should be improved to better suit a home health care setting, specifically sub-areas 1-6 and nursing intensity levels A-D and keywords. The OPCq instrument was considered useful in classifying nursing intensity in home health care, although there was uncertainty about where or how to classify non-patient factors

Fleksibel læring : utvikling av ny videreutdanning for sykepleiere: sår-forebygging, behandling og lindring : 15 studiepoeng : et pedagogisk og faglig utviklingsprosjekt

Denne rapporten beskriver det faglige og pedagogiske arbeidet i utvikling av en ny videreutdanning i Sår- forebygging, behandling og lindring. Det startede med at praksisfeltet våren 2007 tok kontakt med Høgskolen i Buskerud, avdeling helsefag med ønske om å heve kompetansen blant sykepleiere. Erfaringene fra sykehus og kommunehelsetjenesten var at det var stor mangel på systematisk kunnskap innen sårpleie. Rapporten gir leseren informasjon om hvordan samarbeidet med ulike kontakter har bidratt med kunnskap og erfaringer til å bygge opp en videreutdanning innen sår. Samarbeidet har vært med kliniske spesialister i sykehus og Norsk interessefaggruppe for Sårheling (NIFS). Flere skandinaviske og internasjonale spesialister innen sårpleie og behandling har vært til stor hjelp og gitt synspunkter under utviklingen av det faglige innholdet. Programmet anvender European Wound Management (EWMA) sine utdanningsmoduler. Rapporten har med en kortfattet beskrivelse av ofte forekommende sårtyper, årsaker og konsekvenser. Rapporten beskriver fleksibel læring som en kombinasjon av e-læring og faste samlinger. Denne læringsmodellen er inspirert av Gilly Salmon’s modell for undervisning og læring på nett. Nøkkelord: Fleksibel læring, videreutdanning, nettbasert undervisning, e-lærin

Evaluering av nettstøttet videreutdanning i sår for sykepleiere

Krav om effektivitet og faglig forsvarlig praksis fordrer at sykepleiere vedvarende må opprettholde og fornye sine kunnskaper. Tilbud om etter- og videreutdanninger er avgjørende for å kunne realisere målet om livslang læring. Med en økende mengde informasjon velger stadig flere utdanninger å kombinere tradisjonell undervisning og læringsaktiviteter på en digital læringsplattform (1,2,3). Det er imidlertid lite kunnskap om hvordan slike hybride læringsmodeller fungerer sett fra videreutdanningsstudentenes perspektiv, og hvordan de kan forbedres. Dette er derfor fokus i denne evalueringsstudien. Videreutdanning for sykepleiere med fokus på både forbyggende, lindrende og behandlende tiltak knyttet til sår har blitt etterspurt fra det kliniske fagmiljøet for å styrke kunnskapsnivået og den kliniske spesialkompetansen i sårbehandling (4). I samarbeid med interesserte fagpersoner utviklet Høgskolen i Buskerud (HiBu) derfor en ny videreutdanning for sykepleiere: «Sår – forebygging, behandling og lindring» med 15 studiepoeng fra studieåret 2008/2009. Videreutdanningen er tilrettelagt med nettstøttet læringsmiljø tilpasset studiets fokus, krav om evidens basert praksis samt studentenes behov for fleksibilitet for å kunne kombinere studier med arbeid, familie og andre forpliktelser (5). Studien vil belyse hvordan den digitale læreplattformen ble brukt i løpet av videreutdanningen, og studentenes vurderinger av egen læring i nettstøttet læringsmiljø og forslag til forbedringer i studiet

Patient classification systems used to classify nursing intensity and assess nursing staffing resources in home health care: A scoping review

Objectives To identify the patient classification systems used to classify nursing intensity in the assessment of nursing staffing resources currently used in home health care, with a special emphasis on validity, reliability and staff allocation. Design Scoping review of internationally published and grey literature, based on a methodological framework by Arksey and O’Malley. Data sources Searches of the electronic databases Cinahl, Medline, Embase and SweMed, the websites Google and Google Scholar and hand searches of reference lists occurred. Eligibility criteria included (A) a focus on patient classification systems measuring nursing intensity and workload in home health care and (B) published in English between January 2007 and March 2019. In level one testing two team members screened titles and abstracts, in level two testing two team members determined which papers should undergo a full text review. Data were extracted using structured extraction by one team member and verified by two other members. Results Thirteen peer-reviewed articles and grey literature documents were identified, from Canada, Ireland, the UK, the USA, Scotland, Turkey and the Netherlands. Four patient classification systems had been tested for both validity and reliability. Validity was tested through face validity, predictive validity, concurrent validity or content validity index. Reliability was tested through stability, internal consistency, observer agreement or inter rater reliability. One patient classification system had been tested only for reliability, through interrater reliability and observer agreement. Two patient classification systems had been evaluated through summative evaluation; one qualitatively through focus group interviews and one through semi-structured interviews. Only one patient classification system had been validity and reliability tested and evaluated. Overall, the patient classification systems in the included papers (13) were considered to have benefits and to be appropriate for the measurement of patients’ needs, workload and allocation of staff, although specific information was not always given. Conclusion Little has been published on validity or reliability tested patient classification systems linked to staffing allocation in home health care in the past decade. Limited research was seen where a patient classification system was considered to be fully operational in home health care

Using a new interrater reliability method to test the modified Oulu Patient Classification instrument in home health care

Aim To test the interrater reliability of the modified Oulu Patient Classification instrument, using a multiple parallel classification method based on oral case presentations in home health care in Norway. Design Reliability study. Methods Data were collected at two municipal home healthcare units during 2013–2014. The reliability of the modified OPCq instrument was tested using a new multiple parallel classification method. The data material consisted of 2 010 parallel classifications, analysed using consensus in per cent and Cohen's kappa. Cronbach's alpha was used to measure internal consistency. Results For parallel classifications, consensus varied between 64.78–77.61%. Interrater reliability varied between 0.49–0.69 (Cohen's kappa), the internal consistency between 0.81–0.94 (Cronbach's alpha). Analysis of the raw scores showed 27.2% classifications had the same points, 39.1% differed one point, 17.9% differed two points and 16.5% differed ≥3 points

Using a new interrater reliability method to test the modified Oulu Patient Classification instrument in home health care

Nursing Open published by John Wiley & Sons Ltd. This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.Aim: To test the interrater reliability of the modified Oulu Patient Classification instrument, using a multiple parallel classification method based on oral case presentations in home health care in Norway. Design: Reliability study. Methods: Data were collected at two municipal home healthcare units during 2013– 2014. The reliability of the modified OPCq instrument was tested using a new multiple parallel classification method. The data material consisted of 2 010 parallel classifications, analysed using consensus in per cent and Cohen’s kappa. Cronbach’s alpha was used to measure internal consistency. Results: For parallel classifications, consensus varied between 64.78–77.61%. Interrater reliability varied between 0.49–0.69 (Cohen’s kappa), the internal consistency between 0.81–0.94 (Cronbach’s alpha). Analysis of the raw scores showed 27.2% classifications had the same points, 39.1% differed one point, 17.9% differed two points and 16.5% differed ≥3 points.Using a new interrater reliability method to test the modified Oulu Patient Classification instrument in home health carepublishedVersio

Using a new interrater reliability method to test the modified Oulu Patient Classification instrument in home health care

Aim: To test the interrater reliability of the modified Oulu Patient Classification instrument, using a multiple parallel classification method based on oral case presentations in home health care in Norway. Design: Reliability study. Methods: Data were collected at two municipal home healthcare units during 2013– 2014. The reliability of the modified OPCq instrument was tested using a new multiple parallel classification method. The data material consisted of 2 010 parallel classifications, analysed using consensus in per cent and Cohen’s kappa. Cronbach’s alpha was used to measure internal consistency. Results: For parallel classifications, consensus varied between 64.78–77.61%. Interrater reliability varied between 0.49–0.69 (Cohen’s kappa), the internal consistency between 0.81–0.94 (Cronbach’s alpha). Analysis of the raw scores showed 27.2% classifications had the same points, 39.1% differed one point, 17.9% differed two points and 16.5% differed ≥3 points

Studenter i tverrprofesjonell klinisk praksis : et samarbeidsprosjekt mellom Seksjon for geriatri, slag og rehabilitering (GSR) ved Bærum sykehus, Vestre Viken Helseforetak, Høgskolen i Oslo og Akershus (HiOA) og Høgskolen i Buskerud (HiBu)

Tverrprofesjonell Klinisk Praksis (TKP) er et samarbeidsprosjekt mellom Seksjon for geriatri, slag og rehabilitering (GSR) ved Bærum sykehus, Vestre Viken Helseforetak, Høgskolen i Oslo og Akershus (HiOA) og Høgskolen i Buskerud (HiBu). Målet var å utarbeide et praksisopplegg der studenter får mulighet til tverrprofesjonell læring og samspill i praksis. Pasientgruppene var pasienter med hjerneslag, geriatriske – og nevrologiske sykdommer. Til forskjell fra andre tverrprofesjonelle avdelinger er GSR en akuttseksjon der pasientenes liggetid er kort og varierer. Studentgruppene som har deltatt er fysioterapeut- og ergoterapeutstudenter fra HiOA, sykepleierstudenter fra HiBu samt sosionomstudenter fra Diakonhjemmet Høgskole. Erfaringene fra prosjektet tilsier at TKP er nyttig for studentenes læring. Studentene lærer av hverandres kunnskaper og hvordan den kan anvendes. Samtidig utvider de perspektivet på egen rolle og erfarer hvordan samarbeid kan innvirke på pasientbehandlingen. Gjennom veiledning på tvers av profesjoner ble veiledernes tverrprofesjonelle perspektiv utvidet og veiledningskompetansen utviklet. En sentral erfaring er at ulike modeller for tverrprofesjonell studieopplegg bør tilpasses de lokale forhold samt at de forankres i alle ledd