Psychometric Testing of the Presence of Nursing Scale: Measurability of Patient Perceptions of Nursing Presence Capability of Nurses in an Academic Medical Center

Introduction: Nursing presence occurs when nurses expend themselves on the behalf of a unique patient. This phenomenon requires further research to develop instruments. The Presence of Nursing Scale (PONS) measures the patient’s perspective (Kostovich, 2012). Psychometric testing of PONS-Revised using exploratory factor analysis is warranted to further develop a reliable and valid measure of nursing presence. Contextual workplace variables need exploration in inpatient settings for correlation with nursing presence. Method(s): A convenience sample of 122 adult inpatients from ten acute-care nursing units in a Southeastern Magnet hospital were surveyed to conduct the first psychometric testing of this revised instrument using exploratory factor analyses. Seven research questions evaluated potential correlations between the PONS-R, patient satisfaction using nurse-sensitive measures of HCAHPS, nursing unit-specific workforce factors and patient demographic factors. Results: PONS-R demonstrated high internal consistency reliability (r = .974), test-retest reliability (statistically significant at the .01 level) and divergent validity (p=.002). PONS-R compared to nurse HCAHPS measures was statistically significant at the .01 level, (r = .736). EFA revealed one factor (eigenvalues over 1), with a weak secondary factor centered on intimacy factors suggesting addition of items and repeated study with a larger sample size to further psychometrically develop the instrument. Unexpected negative correlations were found with unit-workforce factors including average RN experience level (r= -.185, significant at the .05 level), and average RN age (r = - .218). An unexpected positive correlation was found - percentage of Associate degree nurses (r = .269, statistically significant at the .05 level. The Triangle region was correlated with a higher PONS-R score (p = .038; n=4), otherwise no statistically significant correlations were found for PONS-R and patient demographics nor patient-specific variables such as estimated number of RN providing care, nor length of stay on the unit. Discussion & Conclusions: Further psychometric testing is indicated with larger samples and perhaps with the inclusion of intimacy factor items. Additional correlational studies focused on other patient quality outcomes measures with expansion of nurse demographics is indicated to explore for confounding variables

Psychometric Testing of the Presence of Nursing Scale: Measurability of Patient Perceptions of Nursing Presence Capability of Nurses in an Academic Medical Center

Introduction: Nursing presence occurs when nurses expend themselves on the behalf of a unique patient. This phenomenon requires further research to develop instruments. The Presence of Nursing Scale (PONS) measures the patient’s perspective (Kostovich, 2012). Psychometric testing of PONS-Revised using exploratory factor analysis is warranted to further develop a reliable and valid measure of nursing presence. Contextual workplace variables need exploration in inpatient settings for correlation with nursing presence. Method(s): A convenience sample of 122 adult inpatients from ten acute-care nursing units in a Southeastern Magnet hospital were surveyed to conduct the first psychometric testing of this revised instrument using exploratory factor analyses. Seven research questions evaluated potential correlations between the PONS-R, patient satisfaction using nurse-sensitive measures of HCAHPS, nursing unit-specific workforce factors and patient demographic factors. Results: PONS-R demonstrated high internal consistency reliability (r = .974), test-retest reliability (statistically significant at the .01 level) and divergent validity (p=.002). PONS-R compared to nurse HCAHPS measures was statistically significant at the .01 level, (r = .736). EFA revealed one factor (eigenvalues over 1), with a weak secondary factor centered on intimacy factors suggesting addition of items and repeated study with a larger sample size to further psychometrically develop the instrument. Unexpected negative correlations were found with unit-workforce factors including average RN experience level (r= -.185, significant at the .05 level), and average RN age (r = - .218). An unexpected positive correlation was found - percentage of Associate degree nurses (r = .269, statistically significant at the .05 level. The Triangle region was correlated with a higher PONS-R score (p = .038; n=4), otherwise no statistically significant correlations were found for PONS-R and patient demographics nor patient-specific variables such as estimated number of RN providing care, nor length of stay on the unit. Discussion & Conclusions: Further psychometric testing is indicated with larger samples and perhaps with the inclusion of intimacy factor items. Additional correlational studies focused on other patient quality outcomes measures with expansion of nurse demographics is indicated to explore for confounding variables

State Of The Science Of Nursing Presence Revisited: Knowledge For Preserving Nursing Presence Capability

Nursing presence has been a central focus for theorists, researchers, educators, and practicing professional nurses for over a half a century. Knowledge development and measurement of this experience is crucial at a time when human communication is becoming more impersonal, and nursing presence capability is potentially declining. A literature search was conducted using Cumulative Index to Nursing and Allied Health Literature and other discipline-specific databases. Extensive manual review of all relevant journals, reference lists, and additional publications were explored and synthesized. This article provides an updated state of the science report on nursing presence in regard to cross-discipline conceptual comparison, nursing theoretic model development, and instrument development

Mastering The Journey To Continuous Compliance: Process Improvements For Excelling At CCNE Accreditation

The accreditation process of a nursing program requires self-assessment, peer evaluation, and identifying areas of improvement. In 2008, the Commission on Collegiate Nursing Education (CCNE) began offering a 10-year accreditation with a Continuous Improvement Progress Report (CIPR) at the fifth year. This article focuses on an in-depth analysis of a system in which the school of nursing utilized an ad hoc committee to complete the CIPR. Reports generated by the ad hoc committee concluded that need for improvement was warranted related to policy review. An action plan for continuous compliance generated implementation of policy software and the creation of an academic support specialist position. An ad hoc committee completed the CIPR rather than paying faculty overload hours; policy was an exemplar. Faculty development, team performance, and accountability resulted in a plan for continual compliance that can be adopted in other nursing schools to meet CCNE accreditation

Perinatal Nurses Respond To Shared Decision-Making Education: A Quasi-Experimental Study

Women describe a loss of autonomy during childbirth as a contributing factor to labor dissatisfaction. Shared decision-making with choice, option, and decision talk may improve satisfaction. Nurses (n = 29) received education on supporting women's autonomy with a standardized communication tool (SUPPORT) to facilitate shared decision-making and create an evolving birth plan. This quasi-experimental pre-/post-test design evaluated participant responses to the education module. Participants supported the use of the SUPPORT tool for shared decision-making and developing evolving birth plans. Most recommended initiation between 13- and 26-weeks' gestation. Nurses' willingness to advocate for women's autonomy increased significantly after education (p = .022). Shared decision-making with standardized perinatal communication may support a woman's perinatal education and her satisfaction with labor. Women enter the hospital birthing center with expectations for their labor experience (Cook & Loomis, 2012). Postpartum women report greater satisfaction with their labor and birth experience when their goals are met; they have a voice in their care and they participate in shared decision- making (Reed et al., 2017). Additionally, evidence suggests that mothers and their newborns have better mental and physical outcomes when the mother's labor expectations and goals are achieved (Hidalgo-Lopezosa et al., 2017). Shared decision-making benefits from facilitated communication between the laboring woman, nurses, and others involved in her care. The SUPPORT tool was created to involve the expectant mother in shared decision- making. Any women's health-care provider can use the SUPPORT tool to facilitate communication in preparation for labor and birth. Specifically, a registered nurse (RN) can use the SUPPORT tool to discuss and educate pregnant women about interventions commonly used during labor by the health-care team and laboring women. To promote shared decision-making with the use of the SUPPORT tool, an educational module designed for women's health nurses was developed. This pre-/post-test quasi-experimental research study reports on the women's health nurses' responses to the education module and the nurses' recommendations for the use of the SUPPORT tool in practice

'Yeah that made a big difference!': The importance of the relationship between health professionals and fathers who have a child with Down Syndrome

Evidence suggests that medical services do not reflect the increased involvement of fathers in childcare, a discrepancy that can often lead to feelings of exclusion and inequality. Fathers who have a child with Down syndrome may encounter many different health professionals during their child’s life, therefore it is important to consider this relationship, and investigate the factors that influence their experiences. This is particularly important because the limited research focusing on fathers suggest that those who have a child with Down syndrome can experience increased stress levels and lasting feelings of loss and grief. It is therefore important to address their relationships with health professionals, as these may be a significant resource to prevent these feelings. This study used interpretative phenomenological analysis (IPA) to explore the experiences of seven fathers who have a child with Down syndrome, focusing on their interactions with health professionals. The analysis showed that the major factors associated with negative experiences were feelings of exclusion, receiving overly negative information about the condition and a perceived lack of on-going support. Positive experiences were associated with being made to feel like an equal parent, being given direct/clear information and being congratulated on the birth of their child. These results provide an insight into what fathers expect in terms of their own and their child’s care and highlight that health professionals have an important and extensive role in influencing fathers’ experiences of Down syndrome

Mastering the Journey to Continuous Compliance

The accreditation process of a nursing program requires self-assessment, peer evaluation, and identifying areas of improvement. In 2008, the Commission on Collegiate Nursing Education (CCNE) began offering a 10-year accreditation with a Continuous Improvement Progress Report (CIPR) at the fifth year. This article focuses on an in-depth analysis of a system in which the school of nursing utilized an ad hoc committee to complete the CIPR. Reports generated by the ad hoc committee concluded that need for improvement was warranted related to policy review. An action plan for continuous compliance generated implementation of policy software and the creation of an academic support specialist position. An ad hoc committee completed the CIPR rather than paying faculty overload hours; policy was an exemplar. Faculty development, team performance, and accountability resulted in a plan for continual compliance that can be adopted in other nursing schools to meet CCNE accreditation