Nurses' critical thinking and clinical decision-making abilities are correlated with the quality of nursing handover

Strategies employed by developed countries to facilitate the transition of internationally qualified nurses specialty skills into clinical practice: An integrative review

BACKGROUND

Recruitment of internationally qualified nurses as a labour source is a long-standing human resource strategy being implemented to address the current and increasing global nursing shortage. Internationally qualified nurses transitioning into the health workforce of developed countries following immigration often possess specialty skills. A lack of a clear pathway of specialty skill utilisation makes recognising and using these specialty skills complex for many nurses. The ability for nurses to transition between countries and maintain specialty practice demands immediate attention in the current atmosphere of the global pandemic and the predictions to recruit more specialist nurses from overseas.

AIM

To identify and synthesise strategies taken by various developed countries in transitioning specialist internationally qualified nurses into practice.

METHODS

An integrative review was conducted to identify common themes, patterns, and best practices in order to inform policy development and improve the successful integration of internationally qualified nurses into the healthcare systems of developed countries. The study employed the Whittemore and Knafl five-stage integrative review approach. To conduct a comprehensive search, four electronic databases, namely Medline, CINAHL Complete, ProQuest Health, and EMBASE, were systematically searched in October 2021. The search was updated in March 2022 to ensure the inclusion of the most recent literature. Additionally, Google Scholar was utilised to avoid overlooking any important articles. Prior to the full-text review, three reviewers independently evaluated titles and abstracts. The included papers' quality was determined using the JBI critical appraisal tools.

RESULTS

This study included 10 papers, comprising three studies and seven reports. However, none of these documents provided information on how internationally qualified nurses could transfer their specialty skills acquired overseas to developed countries after immigrating. The guidelines and policies reviewed only offered generic advice on becoming a specialist nurse. Although some countries mentioned that post-graduate qualifications were not mandatory for nurse specialists, the majority of documents in this review emphasised the need for a national framework of education at level eight or higher (equivalent to a post-graduate level) to attain the status of a nurse specialist. Moreover, the included documents did not provide clear information on whether an international specialisation degree would be recognised during the registration process. As a result, confusion persists regarding the requirement of post-graduate qualifications for nurses aiming to specialise and the recognition of international specialisation degrees during the registration process.

DISCUSSION

The lack of consistency in defining nurse specialty and the skill transferability among institutions and state borders were evident in this review. According to all the 10 documents analysed, developed countries appear to have minimum policies on the transfer of internationally qualified nurse's specialty skills. Recommendations for policymakers, employers, and aspirant migrants have been proposed. Limited research has been done on how developed countries used their internationally qualified nurses' overseas-acquired specialist skills after immigration, indicating a lack of a distinct specialist skill transition pathway.

CONCLUSIONS

This review presents data to support the need for greater research in this area to better utilise the abilities that internationally qualified nurses bring from their home country and put them to constructive use in the host country, especially in the context of a global pandemic.

Differences in Critical Thinking and Decision Making among Critical Care and Non-Critical Care Nurses

Critical thinking and decision-making are essential for nurses to identify and analyze judgments for nursing care. Hence, this study aims to determine critical thinking and clinical decision-making among critical and non-critical care nurses. A cross-sectional study was conducted among 237 nurses using a self-administered questionnaire. This study discovered that critical and non-critical care nurses had a modest level of critical thinking and clinical decision-making. The findings of this study can serve as a guide for nursing administration employees in implementing effective techniques to enhance the critical thinking skills of nurses in on-the-job training and orientation programs for nursing staff.

The effect of evidence-based nursing education on nurses' clinical decision making: A randomized controlled trial

Introduction

Nurses are the largest group of health-care providers and their clinical decisions have an essential role in patients' clinical condition. Evidence-based nursing has been proposed as a health-care method based on the latest findings and evidence. Therefore, we aimed to determine the effect of evidence-based nursing education on dialysis nurses' clinical decision-making.

Material and Methods

This single-blind experimental study conducted in 2021 at dialysis wards of teaching hospitals affiliated to Urmia University of Medical Sciences. In this study, a total of 60 dialysis nurses were recruited using convenience sampling and allocated to two groups of intervention (n = 30) and control (n = 30). Data were collected at three time points of before, 1 week after, and 1 month after the intervention using a demographic questionnaire and the Lauri and Salantera Clinical Decision-Making Questionnaire (LSCD-MQ). Nurses in the intervention group received 12 sessions of evidence-based nursing education, while nurses in the control group received no intervention.

Results

The results showed the mean score of clinical decision-making had a significant decreasing trend over time (p < 0.001) so that it decreased significantly 1 week after the intervention (72.83 ± 4.90) compared with before the intervention (69.5 ± 67.34) in the intervention group. Moreover, participants' decision-making moved toward analytical decision-making. The results also indicated there was a significant difference between the baseline mean score of clinical decision-making and the postintervention mean scores obtained 1 week (p = 0.025) and 1 month (p = 0.001) after the intervention. However, this difference was not found to be significant in the control group (p = 1.000).

Conclusions

The study results indicate the positive effect of evidence-based education on nurses' clinical decision-making. Therefore, nurses are recommended to apply evidence-based education methods to improve their level of clinical decision-making. Health officials are also recommended to hold in-service evidence-based workshops to update nurses' knowledge.

Nursing management of the critical thinking and care quality of ICU nurses: A cross-sectional study

AIM

To explore the effectiveness of a digital learning management system in enhancing intensive care unit nurses' critical care knowledge and critical thinking tendency.

BACKGROUND

Learning intensive care unit knowledge and skills is essential for the continuing education of nurses, and impacts patient health outcomes. Enhancing intensive care unit nurses' critical care abilities is a medical care quality concern in clinical practice.

METHODS

A cross-sectional study was conducted with 212 participants to investigate the effects of a digital learning system on care quality.

RESULTS

After the implementation of the digital learning system, intensive care unit nurses' critical care knowledge and critical thinking skills increased significantly. High-level nurses had higher critical thinking scores. All participants associated critical care knowledge with improved quality of care.

CONCLUSION

The digital learning management system enhanced intensive care unit nurses' critical care knowledge. Optimizing nursing care safety and quality requires that nursing staff to be at an adequate level, which improves their critical care ability.

IMPLICATIONS FOR NURSING MANAGEMENT

A well-designed digital learning management system with structured classes may allow intensive care unit nurses to learn effectively and can be used for continuing education. These results are of interest to nursing management staff who want to invest in the continued professional development of intensive care unit nurses to improve critical care knowledge, critical thinking skills, care quality, and health care value.

Evaluation of emergency service nurses' patient handover and affecting factors: A descriptive study

AIM

The aim of the study was to determine the patient handover efficacy level of emergency room nurses and the influencing factors.

METHOD

This descriptive, cross-sectional study was completed with (n = 120) emergency room nurses of two different state hospitals from April 26 to May 26, 2021. The "Nurses descriptive information form" and "Handover Evaluation Scale" were used as data collection forms.

RESULTS

The mean age of the nurses was 29.53(6.327 years, 70.8% of them were female, and 76.7% of them had a bachelor's degree. The mean number of handovers was 3.25 (SD = 3.17) for one nurse in a shift, and the mean handover duration for a patient was 10.16 (SD = 9.23) minutes. More than half of the nurses (61.7%) carried out oral handover at the bedside. The mean score of the handover evaluation scale was 53.31 (SD = 9.55). The mean score of the nurses who performed the handover with all the nurses on the shift (spelling and relieving) together was 56.47 (SD = 9.21) and higher than that of the nurses who performed the handover in small groups 49.84 (SD = 9.70), (p = 0.012).

CONCLUSION

The results of this study may contribute to promoting patient safety and improving patient handover processes in emergency rooms. It is recommended that standardized and comprehensive written handover forms be used, that all emergency room nurses should attend the handover process, and that further observational and interventional studies should be conducted.