The role of nurse education in improving patient outcomes and patient satisfaction with nursing care: A multiple case study of nursing teams in three hospitals across Ireland and Germany.

Background: International large-scale research has found that nurse education at degree level contributes to reduced mortality and failure-to-rescue rates. The influences of hospital and national contexts and of different types of nurse education levels towards improved patient care seem often overlooked. Aim and objectives: The aim of this study was to explore the role of nurse education in improving patient outcomes and patient satisfaction with nursing care, taking into account different types of nurse education levels within different hospital-based and country-specific contexts. The objectives were: (1) to explore and compare nurse education levels, hospital and nurse structures, care processes and patient-related outcomes for selected nursing teams from the Irish and German arms of the RN4CAST project (2) to explore factors other than nurse education affecting patient outcomes, including country-specific factors. Methodology: A multiple case study design was utilised to conduct an in-depth exploration of the findings generated from the Irish and German arms of the RN4CAST (Nurse Forecasting: Human Resources Planning in Nursing) project. Three nursing teams, with different proportions of degree (pre-registration, post-registration and international degree) and apprenticeship trained nurses working in hospitals in Ireland and Germany were selected. Data were explored and compared based on Donabedian’s (2005) Structure-Process-Outcome model for health care practice. Patient outcomes included falls with injury, medication errors and pressure ulcers developed after admission. Patients rated nurse communication, pain control and discharge information provided. Findings: Findings suggest that degree level education, and type of degree, play a role in improving patient-related outcomes. The team with both degree and apprenticeship trained nurses reported the best patient outcomes, which were also attributed to better working conditions and lower levels of hospital bed occupancy. Country-specific factors such as nurse-to-patient ratios and skill mix further affected the care provided by the nursing teams. Conclusion: This study provides new insights into the role of nurse education in improving patient-related outcomes. It also provides new information about hospital-based and country-specific contexts, within which nurses with different educational backgrounds provide care

Effectiveness of simulation on promoting student nurses management skills

The purpose of this study was to explore the effectiveness of simulation on promoting student nurses management skills. A review of the literature suggests that newly qualified nurses are not adequately prepared for their role as staff nurse. Deficits in management skills are the main areas of concern for both newly qualified staff and hospital employers. Consequently, all involved in students’ clinical learning environment are charged with the responsibility to devise sound innovative and effective teaching methodologies to prepare students for their role as staff nurse upon registration. A simulation exercise was conducted in Dublin City University by the Clinical Education Centre project team for fourth year general undergraduate student nurses. The main focus of the simulation was to promote consolidation of knowledge in the areas of organisation and management of patient caseload, clinical practice, and communication, legal, ethical and professional issues. A qualitative and quantitative approach was used for this study. Ninety students participated in the simulation exercise and 68 completed the questionnaire. Six focus group interviews were conducted with 15 students in each group. Results identified that simulation is a realistic and enjoyable way of learning and helped prepare students for their clinical role as staff nurse. Students indicated that they felt the exercise had helped them to consolidate their previous knowledge, felt more confident and were able to determine their own learning needs. However, participating in the simulation exercise was also seen as a stressful experience for some students. In conclusion, simulation used as an educational strategy running parallel and closely linked with clinical experience, is a powerful tool to prepare students for their role as staff nurse. It allows students to reflect on and learn from their strengths and weakness promoting improvement on their management skills and enhancing nursing services

Report of the Irish RN4CAST Study 2009-2011: A nursing workforce under strain

Foreword: The RN4CAST consortium research study, funded by the European Commission, has provided a unique opportunity to gain insight into both organisational and nurse staffing issues across the acute hospital sector in Ireland. As part of the RN4CAST (Ireland) study, for the first time, both hospitals and medical and surgical units within thirty out of a possible thirty-one acute hospitals (with over one hundred beds) have been surveyed. Data were collected in 2009-2010. The work of the international consortium also enables comparisons of Irish findings with key findings internationally. For example it has proved possible to compare such issues as patient – to - nurse ratios and patient - to health care-staff ratios across the 12 partner countries of the consortium. This is also the case, for example, for nurse burnout levels, job satisfaction and nurse perceptions of safety and quality of care. RN4CAST (Ireland) provides a portrayal of the Irish acute hospital sector as operating in a context of dynamic challenge and change from both internal and external drivers. There is considerable evidence of significant strain on the nursing staff working in the sector. Nursing staff indicate concern regarding aspects of the quality and safety of patient care and the availability of sufficient staff and resources to do their job properly. We are of the view that unless these and a number of other issues raised in this report are managed effectively, there will be detrimental impacts on patient care, patient safety and retention and recruitment of high quality nursing staff for our health service

An exploration of the levels of clinical autonomy of advanced nurse practitioners: a narrative literature review

Aims and Objectives The aims of the review are to synthesise current evidence about advanced nurse practitioner clinical autonomy and consider how this may inform clinical practice and research. Background Clinical autonomy is one of the cornerstones of advanced nursing practice globally, yet there is limited synthesis of clinical autonomy in the literature. Design This is a narrative literature review. Data sources The databases Cumulative Index to Nursing and Allied Health Literature, EBSCO host, Cochrane Library, CINAHL and MEDLINE were searched for publications between 2005 and 2020 inclusive. Review methods A systematic approach was used to analyse the literature reviewed. Two reviewers undertook quality appraisal. Results Nineteen articles were selected. Four major themes emerged: (1) ‘ANP Stepping Up’—moving into and accepting advanced nursing practice roles and clinical responsibilities; (2) ‘ANP Living It’—ANPs' ability to act independently including an understanding of task mastery and self-determination; (3) ‘ANP Bounce-back ability’—depicted in challenges that threaten their ability to practice clinically autonomously; (4) ‘ANP Setting in Motion’—indirect care activities and service-level improvements. Conclusion A clearer understanding of advanced nurse practitioner clinical autonomy could help develop more in-depth knowledge. Research of advanced nurse practitioners' clinical autonomy would improve full utilisation in clinical practice

Psychometric testing of the facilitative student–patient relationship scale within six EUROPEAN countries

Aim: The aim of the study was to test the psychometric properties of the Facilitative Student-Patient Relationship (FSPR) Scale in clinical practicum in hospital settings within six European countries.Design: A multi-country, cross-sectional survey design was applied.Methods: A convenience sample of graduating nursing students (N = 1,796) completed the FSPR Scale. Psychometric testing was carried out through explorative factor analysis and confirmatory factor analysis. Internal consistency was assessed using Cronbach's alpha.Results: Both validity and reliability of the scale were confirmed. The explorative factor analysis yielded a two-factor construct explaining 47.7% of the total variance, identifying two sub-scales: caring relationship and learning relationship. Confirmatory factor analysis confirmed the two-factor structure. The Cronbach alpha coefficients (0.8-0.9) indicated acceptable reliability of the scale.Keywords: clinical; education; nursing; psychometric; student-patient relationship; students; surveys.</p

Nurse managers’ assessments about nursing education and work life's competence demands : A European multi-country cross-sectional survey

Funding Information: The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This work was supported by the Turun Yliopistollinen Keskussairaala, and Academy of Finland (grant no. 11087, 310145). Publisher Copyright: © The Author(s) 2023.As future employers, nurse managers are in a key position to assess the correspondence between the competence of graduating nursing students and work life demands. The aim of the present study was to assess the competence of graduating nursing students from the perspective of managers, and analyze the factors linked to it. Among European managers in six countries, a cross-sectional survey design with a convenience sample was applied. Data were collected using the Nurse Competence Scale. The study was reported using the STROBE guidelines. Managers (n = 538, 65.8%) assessed the level of competence of graduating nursing students as good, but there were statistically significant differences between countries. In a multivariable analysis, managers who had a Doctoral/Master's degree and were dissatisfied with the nursing program in their country assessed the level of competence as lower. Overall, graduating nursing students seem to meet the competence demands of current work life rather well. Further research is needed to confirm the connection between the managers’ competence assessment and their individual background factors.Peer reviewe

The level of competence of graduating nursing students in 10 European countries—Comparison between countries

AimTo analyse graduating nursing students’ self‐assessed competence level in Europe at graduation, at the beginning of nursing career.DesignAn international cross‐sectional evaluative design.MethodsData were collected in February 2018–July 2019 from graduating nursing students in 10 European countries. Competence was assessed with a validated instrument, the Nurse Competence Scale (NCS). The sample comprised 3,490 students (response rate 45%), and data were analysed statistically.ResultsIn all countries, graduating nursing students assessed their competence as good (range 50.0–69.1; VAS 0–100), albeit with statistically significant differences between countries. The assessments were highest in Iceland and lowest in Lithuania. Older students, those with working experience in health care, satisfied with their current degree programme, with excellent or good study achievements, graduating to 1st study choice and having a nursing career plan for future assessed their competence higher.</p

The role of nurse education in improving patient outcomes and patient satisfaction with nursing care: A multiple case study of nursing teams in three hospitals across Ireland and Germany.

Background: International large-scale research has found that nurse education at degree level contributes to reduced mortality and failure-to-rescue rates. The influences of hospital and national contexts and of different types of nurse education levels towards improved patient care seem often overlooked. Aim and objectives: The aim of this study was to explore the role of nurse education in improving patient outcomes and patient satisfaction with nursing care, taking into account different types of nurse education levels within different hospital-based and country-specific contexts. The objectives were: (1) to explore and compare nurse education levels, hospital and nurse structures, care processes and patient-related outcomes for selected nursing teams from the Irish and German arms of the RN4CAST project (2) to explore factors other than nurse education affecting patient outcomes, including country-specific factors. Methodology: A multiple case study design was utilised to conduct an in-depth exploration of the findings generated from the Irish and German arms of the RN4CAST (Nurse Forecasting: Human Resources Planning in Nursing) project. Three nursing teams, with different proportions of degree (pre-registration, post-registration and international degree) and apprenticeship trained nurses working in hospitals in Ireland and Germany were selected. Data were explored and compared based on Donabedian’s (2005) Structure-Process-Outcome model for health care practice. Patient outcomes included falls with injury, medication errors and pressure ulcers developed after admission. Patients rated nurse communication, pain control and discharge information provided. Findings: Findings suggest that degree level education, and type of degree, play a role in improving patient-related outcomes. The team with both degree and apprenticeship trained nurses reported the best patient outcomes, which were also attributed to better working conditions and lower levels of hospital bed occupancy. Country-specific factors such as nurse-to-patient ratios and skill mix further affected the care provided by the nursing teams. Conclusion: This study provides new insights into the role of nurse education in improving patient-related outcomes. It also provides new information about hospital-based and country-specific contexts, within which nurses with different educational backgrounds provide care

The International Council of Nurses Nurse Practitioner/Advanced Practice Nurse Network

This chapter introduces the International Council of Nurses Nurse Practitioner/Advanced Practice Nurse Network which was established as a formal network almost 25 years ago. The International Council of Nurses Nurse Practitioner/Advanced Practice Nurse Network is a long-standing voluntary network committed to reporting on trends, developments in advanced practice nursing as well as providing tools, resources, and expertise to the International Council of Nurses. The network governance, management structure, and oversight as well as its current work, activities, and accomplishments will be presented in this chapter. The relationship between the International Council of Nurses and the network’s leadership (The Core Steering Group) is strong and works in collaboration with the International Council of Nurses Chief Nurse, network subgroups, and academy leaders to continue advancing projects, research and knowledge dissemination strategies related to the global development of advanced practice nursing. Numerous publications and resources have been developed by the network over the years and demonstrate global development of the advanced practice nurse role. The biennial conference is an example of successful leadership and impact from the network. The network represents a unique opportunity to bring nurse practitioners and advanced practice nurses and leaders together to debate on solutions for health challenges