Conceptualizing collaboration in nursing

Academic-clinical collaborative partnerships: A qualitative exploration of facilitators and barriers from the perspectives of nurse academics, clinicians, and students

BACKGROUND

Collaborative partnerships are crucial for strengthening nursing education and practice, particularly in rapidly changing healthcare environments. Promoting collaborative academic-clinical partnerships that encourage unity of purpose among partners improves shared decision-making, enhances undergraduate education, and advances patient care. However, further research is required to discover more about the involvement of all partners in academic-service collaborations.

PURPOSE

The aim of the study was to identify the barriers to and facilitators of collaboration between nursing faculty and a university hospital.

DESIGN

The study reported here was conducted using a descriptive design within a qualitative methodological framework.

METHODS

Interviews were held with 36 participants between January and July 2023. Data were collected using semi-structured, in-depth individual interviews (n = 36), which continued until data saturation was achieved. Inductive content analysis was used to interpret data from three groups: academics, clinicians, and students. The Consolidated Criteria for Reporting Qualitative Research (COREQ) guidelines were followed.

RESULTS

Two main themes and seven sub-themes emerged from the interviews, indicating four facilitators of collaboration: "togetherness contributing to development," "viewing each member as part of the team," "motivating through constructive feedback," and "willingness." Three barriers were identified: "inadequate triad partner interaction," "planning issues," and "nursing shortage."

CONCLUSIONS

Promoting togetherness, considering all members as integral parts of the team, providing constructive feedback, and encouraging their contributions can facilitate and strengthen successful partnerships. Facilitators can help overcome barriers to planning, staff shortages, and limited interaction by being open to alternative approaches, learning from past experiences, and, use this information to (re)organize educational and clinical processes.

IMPLICATIONS

The results indicate how collaboration can be strengthened. This involves maintaining clear and effective communication, close and regular contact between partners, and frequent interaction. Therefore, to ensure the best healthcare processes and education are sustained, it is essential to foster collaboration between partners by implementing these facilitatory practices to overcome barriers.

PATIENT OR PUBLIC CONTRIBUTION

The nurses and students were active in identifying the topics covered during interviews.

Effectiveness of virtual clinical learning in nursing education: a systematic review

BACKGROUND

With the development of technology in education, simulations, virtual and online technologies are being incorporated into nursing education, especially for clinical education. This was especially necessary when an event occurred that did not necessarily allow for face-to-face contact, such as Covid-19, disasters like typhoons and others. However, limited resources for clinical education of nurses can contribute to the challenges of incorporating and appropriately utilizing virtual clinical learning technologies. Nursing education has been driven by the use of virtual learning technologies such as virtual reality, augmented reality, immersive virtual reality simulation, mixed reality, among others, which are delivered using tablets, phones or computers to create a lived experience for an intended learning outcome. This review aims to examine their effectiveness in terms of core professional competencies, problem solving, nursing process and communication skills.

METHODS

This systematic review was conducted in accordance with the guidelines of the Preferred Reporting Items for systematic reviews and Meta-Analysis. Experimental peer-reviewed articles (randomized controlled trials, and quasi-experimental studies with one to two or more groups (pre-/post-test) using e-simulation technology for nursing education and assessment were included. PubMed, Embase, PsycINFO and Web of Science were searched. The search duration was from inception to 30th April 2024.

RESULTS

Virtual simulation technologies could be used for the practical teaching of nursing students. These technologies have been shown to significantly improve problem-solving skills (effect size 0.2 to 0.9), communication skills (effect size 0.4-0.7), and core professional competencies (effect size 0.3 to 0.9) with a small to large effect size.

CONCLUSION

The results indicate that virtual simulation technologies have important benefits for students' learning when integrated into clinical nursing education and practice. Educators should consider the use of virtual learning technologies when revising nursing curricula. It is important that nursing education policy makers integrate the use of virtual simulation into nurse education, and adapting this pedagogical approach could help improve student readiness for effective healthcare delivery.

Collaboration in Occupational Health Nursing: A Concept Analysis Review

OBJECTIVES

Establishing collaboration with occupational health staff is essential to support workers and organizations in the field of occupational health. Accordingly, occupational health nurses (OHNs) have recognized the need to collaborate with other professionals, including non-health care professionals. This review aimed to examine the components of collaboration in OHNs.

METHODS

This review was conducted using Walker and Avant's eight-step analysis method on 267 papers (174 in Japanese and 93 in English) identified through an extensive literature review.

RESULTS

Key attributes, antecedents, consequences, and empirical referents helped shape an operational definition of the concept of collaboration. Collaboration among OHNs is a process that integrates individuals, organizations, and systems. Further, OHNs are responsible for ensuring that employers and workers collaborate to actively promote and facilitate occupational health activities. In addition, OHNs assess the health status of individuals and organizations to determine whether collaboration is needed through the occupational nursing process. The quality and outcomes of collaboration are influenced by social trends and the health culture of each organization. Through collaboration with various stakeholders, OHNs contribute to making the workplace a better environment, improving labor efficiency, increasing worker productivity, and ensuring health and safety.

CONCLUSIONS

This review provides a comprehensive understanding of collaboration in occupational health nursing. Collaboration among OHNs is notably characterized by its "integration." OHNs can facilitate collaboration between employers and employees in occupational health activities, potentially benefiting both businesses and health care. The clarification of collaboration in this review has the potential to enhance OHN practices and guide future research.

Exploring nurses' leadership and resilience in a complex daily work environment: a qualitative study

BACKGROUND

The contemporary healthcare system is inherently complex, necessitating organizational and ward-level changes to address challenges. Continuous adaptations in daily practices are essential to meet unexpected patient needs. These dynamic changes require resilience from healthcare staff, including nurses. This paper explores how nurses show leadership in response to changes within a complex work environment that demands resilience in their daily practices.

METHODS

An empirical qualitative study was employed. Non-participatory observations were conducted in February and March 2022 (n = 60 h), providing thick descriptions of nurses working across various shifts. Subsequently, two semi-structured group interviews were held: the first with nurses only and the second with multidisciplinary healthcare professionals. The interview transcripts and thick descriptions were analyzed using thematic analysis. Descriptive statistics were used to summarize participant characteristics.

RESULTS

Responding to a changing work environment requires resilience from nurses who exhibit leadership showing four distinct behaviors: proactive, patient-centered care; investigative problem-solving; reflective learning; and profession-based approaches.

CONCLUSION

Collaboration is a key factor in resilient nurse leadership, both among nurses, and in interaction with patients, other healthcare professionals, and management. This research highlights how nurses' considerations, beliefs, and interactions, make their leadership behavior visible in a context that demands situated, structural, and social resilience.

Obstacles and opportunities for care collaboration through the utilisation of a preventive care process for frail older adults: a study protocol for a mixed methods study design

BACKGROUND

Frail older adults constitute a significant vulnerable group with complex healthcare needs requiring collaboration between various care providers and professions. Despite this requirement, there are considerable knowledge gaps in how to achieve effective collaboration. Preventive measures such as addressing pressure ulcers, falls, malnutrition and poor oral health often receive low priority compared with treating diseases or injuries. This study aims to enhance our understanding of how care collaboration in the preventive care process (PcP) using the Senior alert (SA) register could improve patient safety and equality of care for frail older adults in Sweden.

METHODS

This study, conducted over 4 years, employs an explanatory mixed methods design, divided into three phases. The study protocol comprises the two first phases. PHASE 1 QUANTITATIVE: Data from SA (2019-2021) will be analysed to compare municipalities regarding the quality of registration in the PcP. Municipalities with high and low compliance indices will be identified and analysed together with data on demographics, socioeconomics and organisation from Statistics Sweden. PHASE 2 QUALITATIVE: Focus group interviews will be conducted in residential care units in the municipalities identified in phase 1 with interprofessional teams and older persons/next of kin. Additionally, 30 semi-structured individual interviews with residential care managers and other relevant stakeholders will explore obstacles and opportunities for effective care collaboration.

DISCUSSION

We foresee that the results will contribute to the development of a model for effective PcP and care collaboration that can be used to improve patient safety and quality of care for frail older adults. This model can be tested and upscaled to achieve a more effective and equitable healthcare system.

ETHICS AND DISSEMINATION

The study has been approved by the Swedish ethical review authority. Dissemination plans involve publications, data deposition and engagement with healthcare stakeholders to ensure the practical application of the findings.

Effectiveness of the Pediatric Nursing Excellence Model on Nurses' Knowledge and Practice in Pediatric Orthopedic Surgery Care: A Randomized Controlled Trial

BACKGROUND

Pediatric orthopedic nursing requires specialized competencies to optimize patient outcomes, particularly in the complex realm of pediatric surgery. This study explores the effectiveness of the Pediatric Nursing Excellence (PNE) Model in enhancing nurses' knowledge and clinical practice in providing perioperative care for pediatric orthopedic patients in tertiary care inpatient settings.

METHODS

A double-blind, randomized controlled trial was conducted from February to July 2024, involving 100 nurses from two tertiary care hospitals in Tanta, Egypt. Participants were randomly assigned to receive PNE Model training (n = 50) or routine care (n = 50). Nurses' knowledge, practical skills, and adherence to PNE principles were assessed at baseline, immediately post-intervention, and after one, three, and six months using validated tools.

RESULTS

The intervention group showed significantly greater improvements in knowledge (20.62 ± 6.7 vs. 8.16 ± 5.5, p < 0.001) and practice scores (62.28 ± 4.1 vs. 40.06 ± 14.7, p < 0.001) post-intervention, sustained over six months. Path analysis revealed that the PNE Model enhanced nursing practice directly (β = 0.25, p < 0.001) through improvements in engagement and adherence to excellence principles and indirectly (β = 0.53, p < 0.001) by significantly enhancing nurses' knowledge (β = 0.70, p < 0.001), which in turn positively influenced their clinical practice (β = 0.75, p < 0.001). Post-intervention, 82% of nurses in the intervention group achieved high levels of professional excellence, compared to 8% at baseline (p < 0.001).

CONCLUSIONS

The PNE Model demonstrates robust effectiveness in enhancing nurses' knowledge, clinical practice, and professional excellence in pediatric orthopedic surgery care, with sustained long-term benefits. This evidence supports implementing specialized nursing education models to improve pediatric care quality in orthopedic settings.

Level of nurse-nurse collaboration and influencing factors in Türkiye and Italy: a mixed-methods study

Background

Collaboration between nurses is crucial in improving quality in healthcare and plays a key role in increasing nurses' job satisfaction.

Objectives

Our study aimed to investigate the level of collaboration between nurses working in Turkey and Italy and its related factors. The study also deepened the point of view of clinical nurses and nurse managers on this topic.

Methods

This study was carried out as mixed-methods research including both qualitative and quantitative methods. The study's quantitative sample included 348 clinical nurses. The Nurse-Nurse Collaboration Scale was used to collect quantitative data. Five open-ended questions were used to analyse the nurses' point of view about intraprofessional collaboration. Individual interviews were conducted with 10 clinical nurses and 10 nurse managers.

Results

Nurse-nurse collaboration was above the cut off value in both countries. However, significant inter-country differences were found in the collaboration subscales. Qualitative results emphasised that personal characteristics, a specific training in collaboration, the opportunities for comparison and mutual consultation during working shifts may affect the level of collaboration. Nurse managers argued that factors such as manpower planning, suitable working conditions, sufficient materials, empathy, job satisfaction, motivation and effective communication affect collaboration.

Conclusion

Greater efforts should be made to implement collaboration between nurses in healthcare settings. Our results help healthcare services in implementing new collaboration policies.

Development of an Assessment Tool to Measure the Quality of Life Goal Setting for Cancer Survivors: A Content Validity Study

INTRODUCTION

An initial version of the Reengagement Life Goal Assessment Tool for Cancer Survivors (ReGAT-C) was designed to measure the quality of life goal-setting practice conducted by responsible healthcare professionals along with nonterminal cancer survivors undergoing inpatient cancer treatment. This study aimed to test content validity of the ReGAT-C and revise it.

METHODS

Eleven experts and nine healthcare professionals participated in this study. Content validity assessments using questionnaires and focus group interviews were conducted with experts. Cognitive interviews were conducted with healthcare professionals. The content validity index was calculated based on expert questionnaires, and these interview data were analyzed by inductive and deductive approaches. When the ReGAT-C was substantially revised, it was retested through questionnaires.

RESULTS

The initial version of the ReGAT-C was substantially revised and three new items were added, resulting in the development of a revised version of the ReGAT-C with 21 items. All participants re-evaluated the ReGAT-C, and the revised version was verified to have content validity.

CONCLUSIONS

The revised ReGAT-C would contribute to enabling healthcare professionals to assess whether they are based on collaboration with cancer survivors and multidisciplinary teams by reflecting on their own life goal-setting practice.

Peer Collaborative Clinical Decision Making in Nursing Simulation: A Theoretical Framework

BACKGROUND

Collaboration and decision making among nursing students are essential competencies in nursing education. However, how students collaborate and make decisions in simulation is a complex phenomenon and not well understood. This study aimed to develop a framework that describes peer collaborative clinical decision making (PCCDM) among nursing students in simulation.

METHOD

Charmaz's constructivist grounded theory method was used. The sample included 32 participants (16 dyads) from two nursing programs.

RESULTS

The PCCDM framework described three interrelated functional domains (cognition, behavior, and emotion) experienced through three interrelated processes (awareness, communication, and regulation), alternating between individual and collaborative spaces and changing across time according to the simulation's acuity levels.

CONCLUSION

The PCCDM framework provides a model that reflects how these processes unfold over time in simulations, which can be applied in nursing simulation, classroom, and clinical settings that require students to make collaborative decisions. [J Nurs Educ. 2024;63(7):435-443.].

Development and validation of a quality of healthy work environment instrument for shift nurses

BACKGROUND

As the importance of a healthy work environment for nurses' good practice and patient safety has been recognized, there is a need to assess nurses' perceptions of the quality of a healthy work environment.

METHODS

A conceptual framework and construct components were extracted through a literature review and in-depth interviews with shift nurses. The initial items of the instrument were developed according to the conceptual attributes, and the items were selected through content validity by ten experts. Two hundred and forty-seven shift nurses participated in this study through face-to-face surveys to test the reliability and validity of the instrument. The evaluation was used for item and confirmatory factor analyses to assess the criterion-related validity and internal consistency of the instrument. Test-retest reliability was analyzed using data from thirty-two nurses.

RESULTS

The final instrument consisted of 23 items with five components identified through confirmatory factor analysis. Criterion-related validity was established using the K-PES-NWI (r = .54). Cronbach's alpha for the total items was 0.85, and test-retest reliability was 0.73.

CONCLUSION

The quality of the healthy work environment instrument developed in this study was considered reliable and valid. The instrument developed in this study can be used to measure the quality of a healthy work environment as perceived by shift nurses and to identify preventive measures needed to improve the quality of the work environment.

The Conceptual Analysis of Collaboration in the Occupational Therapy by Combining the Scoping Review Methodology

BACKGROUND

Collaboration is an important concept in goal-setting in occupational therapy. However, this concept is not stable due to various definitions. The purpose of this study was to clarify the concept of collaboration in occupational therapy.

METHOD

A scoping review was used to search for all articles related to occupational therapy and collaboration. PubMed, Web of Science, CINAHL, and OT Seeker searches were conducted using predetermined keywords. Three examiners independently reviewed and assessed the quality of each study using Walker and Avant's concept analysis method.

RESULTS

Results of the database searches yielded 1873 studies, 585 of which were deemed eligible to include in this review. Results showed five attributes ("active participation for the common objective", "existence of something to share", "matured communication and interaction", "relationship founded on the respect and trust" and "complementing each other") and two antecedents and several consequences.

CONCLUSIONS

Our findings may contribute to collaborative goal-setting and occupational therapy.

Nurses' Organization of Work and Its Relation to Workload in Medical Surgical Units: A Cross-Sectional Observational Multi-Center Study

INTRODUCTION

Work contexts can affect nurses' work and work outcomes. Work context factors of nurses, patients, or workflow can modulate nurses' organization of work and determine increased workloads.

AIM

The aim of this research was to analyze relationships between factors regarding the patient, the nurse, workflow, and nurses' work organization, to investigate whether work organization is related to physical, mental, and emotional workloads, and to explore whether one dimension of workload influences the other dimensions.

METHODS

We used a cross-sectional design based on the Job Demand-Resources theory. We asked registered nurses, working in nine medical-surgical wards across three hospitals in Italy, to self-report on work organization and workloads regarding randomized shifts over three consecutive weeks. Four scales from the QEEW 2.0 questionnaire were used on an online survey for data collection. multivariable linear regressions with structural equation modelling were tested. The study was approved by the three local Ethics Committees.

RESULTS

We received 334 questionnaires regarding 125 shifts worked. Patient complexity (β = 0.347), patient specialties (β = 0.127), adequacy of staffing (β = -0.204), collaboration with colleagues (β = -0.155), unscheduled activities (β = 0.213), supply search (β = 0.141), and documentation (β = 0.221) significantly influenced nurses' work organization. Nurses' work organization was significantly related to physical, mental, and emotional nursing workloads.

CONCLUSIONS

the patient, the nurse, and workflow aspects influence nurses' work organization and workloads. Healthcare organizations, managers, and nurses should explore work settings to identify work turbulences early and implement strategies to improve nursing work conditions and workloads.

The SPN Pediatric Nursing Excellence Model: Differentiating pediatrics

The question of what makes an "excellent" pediatric nurse has been asked frequently by both pediatric and non-pediatric nurses for many years. Longevity in the practice setting, increased formal education in the care of children and families, positive satisfaction surveys post encounter, quantity of professional presentations and publications, and specialty certification are often listed when discussing pediatric nursing excellence. However, pediatric nursing excellence (PNE) is not well defined. Current recognition mechanisms such as clinical ladders, Magnet© and Pathways© programs, and Benner's stages of clinical competence are not specific for pediatric nursing practice. Once the characteristics of pediatric nursing excellence are determined, they can be used as the basis for identifying pediatric-specific quality indicators. In 2020, SPN initiated a project to define the construct of "pediatric nursing excellence". Two years later, SPN published its Pediatric Nursing Excellence Model, consisting of a visual depiction accompanied by definitions of 16 concepts that comprise the PNE Model. This article presents the five stages of the development process, the components of a model of pediatric nursing excellence, and the potential uses of such a model.

An academic and regional nurse research collaborative: Implications for nursing research

INTRODUCTION

A diverse group of nurses and research Network Coordinators formed a collaboration to advance nursing research within Johns Hopkins Clinical Research Network, a partnership of academic and community hospitals in the mid-Atlantic region. The purpose of the Nurse Research Collaborative (NRC) is to provide mentoring, mutual growth, and assist the health care organizations to fulfill nursing research requirements.

BACKGROUND

We created a multiinstitutional nursing research organization with diversity of member participants and health care facilities. The NRC structure allowed nonacademic facilities to engage in a variety of nursing research projects. This allows for increases in study sample sizes of diverse populations to support and expand nursing research. The NRC is modeled after a physician clinical research network with an aligned mission, vision, goals, and strategic priorities across member organizations.

MAIN IDEAS

To strengthen multiinstitutional nursing research capability, the NRC developed an infrastructure of leadership, regular meetings, and formal educational presentations. The NRC completed three research studies, facilitating the Institutional Review Board application process, reviewing documents and contracts, providing individual institutional support, and coordinating site leader functions.

CONCLUSION

A research collaboration of nurses, across multiple hospitals provides efficiencies and expertise not otherwise available in every organization.

The Mediating Effect of Self-Regulated Learning on the Relationships Among Emotional Intelligence, Collaboration, and Clinical Performance in Korean Nursing Students

BACKGROUND

Clinical performance is an important competence for nursing students to achieve. However, little is known about the degree to which self-regulated learning mediates the relationships among emotional intelligence, collaboration, and clinical performance in nursing students.

PURPOSE

This study was designed to investigate the mediating effect of self-regulated learning on clinical performance.

METHODS

A cross-sectional, descriptive, correlational design was used, and a convenience sample of 302 nursing students in Years 3 and 4 of a bachelor's degree program were recruited as participants from five universities in South Korea. Information on participant characteristics, emotional intelligence, collaboration, self-regulated learning, and clinical performance was collected from the participants using self-reported questionnaires from September to October 2019. Partial least squares structural equation modeling was used to evaluate the research model.

RESULTS

Emotional intelligence, collaboration, and self-regulated learning were found to be statistically significantly related to clinical performance. Moreover, self-regulated learning was identified as a full mediator of the relationship between emotional intelligence and clinical performance (accounting for 62.0% of the variance) and a partial mediator of the influence of collaboration on clinical performance (accounting for 25.4% of the variance).

CONCLUSIONS/IMPLICATIONS FOR PRACTICE

Nursing educators should encourage self-regulated learning among their students and provide a collaborative learning environment to enhance their students' clinical performance.

High-fidelity simulation in undergraduate nursing education: A meta-analysis

OBJECTIVES

To explore the effectiveness of high-fidelity simulation (HFS) in undergraduate nursing education.

DESIGN

A meta-analysis of randomized controlled trials and quasi-experiment.

DATA SOURCES

Web of Science, PubMed, Embase, Cochrane Library, WANFANG, and CNKI were searched for eligible articles published in English and Chinese until May 28, 2021.

REVIEW METHODS

The Quality Appraisal Check-list for Quantitative Intervention Studies was applied to the quality evaluation. Standard mean differences (SMD) were pooled using a random effects model. The results of the individual and combined intervention effects estimation of was displayed in a forest plot, with weight, SMD, its corresponding 95% confidence interval (CI), Z-test, p, I².

RESULTS

Thirty-eight studies were included and 37 were analyzed. High-fidelity simulation (HFS) revealed significantly larger effect sizes for knowledge (SMD = 0.89, 95% CI [0.54 to 1.23]), skill (SMD = 0.93, 95% CI [0.69 to 1.17]), collaboration (SMD = 0.52, 95% CI [0.26 to 0.78]), caring (SMD = 1.40, 95% CI [0.23 to 2.58]) and learning interest (SMD = 0.85, 95% CI [0.00 to 2.04]) when compared with other teaching methods. However, no significant difference between HFS and other teaching methods in critical thinking (SMD = 0.46, 95% CI [-1.12 to 1.58]), self-confidence (SMD = 0.22, 95% CI [-0.32 to 0.75]) and learning satisfaction (SMD = 0.58, 95% CI [-0.25 to 1.41]) was shown.

CONCLUSIONS

High-fidelity simulation (HFS) can more effectively cultivate knowledge, skills, collaboration, caring, and learning interest of undergraduate nursing students. Since the effect of HFS is equivalent to other teaching methods in cultivating undergraduate nursing students' critical thinking, self-confidence and learning satisfaction, nursing educators can choose the most appropriate methods to achieve the intended learning outcomes according to the actual situation.

Nurse-nurse collaboration and performance among nurses in intensive care units

BACKGROUND

An essential element for offering high-quality care in the intensive care units (ICUs) is the intraprofessional collaboration among nurses, which facilitates the exchange of knowledge and information and hence improves performance. More research is needed to understand the relationship between the nurse-nurse collaboration and job performance in the ICUs due to the multidimensionality of both concepts, the complexity of the ICU environment, and the lack of studies.

AIM

To examine the relationship between nurse-nurse collaboration and self-perceived nurse performance among Jordanian nurses in ICUs.

DESIGN

Descriptive, correlational cross-sectional design was used.

METHODS

Data were collected through an online survey including the demographic questionnaire, the nurse-nurse collaboration scale, and six-dimensions scale for nursing performance.

RESULTS

In total, 155 critical care nurses participated (response rate = 46.97%). Self-perceived job performance was significantly associated with gender (t = -3.189, P = .002), age (r = -0.301, P < .01), workplace (F = 28.20, P = .001), the type of ICU (F = 17.70, P = .001), and the number of assigned patients (r = 0.407, P < .01). Among all nurse-nurse collaboration subscales, only the conflict management subscale was an independent significant predictor of self-perceived nursing performance (t = 3.06, B = 3.066, P = .003).

CONCLUSIONS

Effective conflict management is associated with better nurse performance, which could ultimately improve patient care in ICUs.

RELEVANCE TO CLINICAL PRACTICE

Conflict resolution is an important dimension of optimal nurse-nurse collaboration and has an important effect on nursing performance. Nurses and nurse managers in ICUs need to attend workshops and training programs in conflict management.

The professional relationship forms the base: Swedish child health care nurses' experiences of encountering mothers exposed to intimate partner violence

PURPOSE

This study aimed to explore child health care nurses' clinical experiences from encounters with mothers exposed to intimate partner violence (IPV), as little research has explored this topic.

METHOD

Nine child health care nurses from two Swedish regions were interviewed. The interviews were analysed using thematic analysis.

RESULTS

The narratives depicted the nurses' strong commitment to, and professional relationship with, the exposed mothers. The experience of working as a nurse and having encountered IPV in clinical practice made the nurses more confident, which impacted their performance and attitude towards this topic. The ability to uphold the professional relationship was threatened by lack of support and interprofessional collaborations.

CONCLUSIONS

The professional relationship was central to the encounters, yet could impose an emotional burden on the nurses. While the nurses wanted to improve their knowledge of the process around the mother and child, they were happy to pass the primary responsibility over to other professionals. The findings highlight the challenge in establishing sustainable support for nurses, and building a transparent collaboration process between the health care sector and the social services, serving the well-being and safety of the mother and child.

Social-Emotional Competence and Academic Achievement of Nursing Students: A Canonical Correlation Analysis

This study was conducted to investigate the correlations between social–emotional competence (SEC) and academic achievement (AA) among nursing students and to compare students’ level of each core skill of SEC (critical thinking disposition, self-directed learning, creativity, emotional intelligence, problem-solving, and collaboration) and academic achievement (clinical performance and subjective academic achievement). A cross-sectional design was adapted. Data were collected from 195 nursing students in the junior and senior years who had participated in clinical practicum from four universities in South Korea. General characteristics, levels of critical thinking disposition, self-directed learning, creativity, emotional intelligence, problem-solving, collaboration, and academic achievement were collected via self-reported questionnaire. Canonical correlation analysis was performed to evaluate the relationship between SEC and AA. The canonical correlation coefficient between SEC and AA was 0.762. Critical thinking disposition (Rs = 0.89), problem-solving (Rs = 0.86), and cooperation (Rs = 0.80) made the most important contributions to SEC. Clinical performance (Rs = 0.95) and subjective AA (Rs = 0.57) were correlated with AA. SEC should be addressed to improve the AA of nursing students. All core skills of SEC should be regularly promoted. It is particularly urgent for nursing students to improve their creativity.

Nurse-to-nurse collaboration between nurses caring for older people in hospital and primary health care: A cross-sectional study

AIMS AND OBJECTIVES

To assess the level of nurse-to-nurse collaboration during the transfer of older people between hospital and primary health care and to evaluate the psychometric properties of the newly developed Nurse-to-Nurse Collaboration Between Sectors Instrument.

BACKGROUND

Nurse-to-nurse collaboration is required when older people transfer between hospital and primary health care to enhance the safety and continuity of care to patients. There is a lack of evidence about the nature and level of this collaboration.

DESIGN

A cross-sectional survey design was used. This study adhered to the STROBE checklist.

METHODS

A sample of 443 nurses (university hospital n = 240, primary health care n = 203) participated in the study from October 2017 to June 2018. Nurses completed the Nurse-to-Nurse Collaboration Between Sectors Instrument (86 items, 7-point Likert-type scale), the Nurse-Nurse Collaboration Scale and the Patient-Centred Competency Scale.

RESULTS

Nurses rated the overall level of nurse-to-nurse collaboration moderately high (mean=4.49, standard deviation=0.83, maximum 7.00). Nurses considered collaboration an important and confidential process, gaining older people's trust in their care. Lower scores were given to the agreement of mutual objectives, policies and guidelines in collaboration, opportunities for job rotation and interacting and networking during the collaboration process. The internal consistency reliability of the newly developed instrument was acceptable.

CONCLUSIONS

Nurses collaborate with competence and confidentiality during the transfer of older people between care settings. However, there is a need for more opportunities to collaborate, to obtain mutual agreement about objectives, policies and practices, and better understand other nurse's roles and responsibilities in collaboration. The reliability and validity of the Nurse-to-Nurse Collaboration Between Sectors Instrument were acceptable though the number and wording of items will be reviewed and further tested.

RELEVANCE TO CLINICAL PRACTICE

Nurses need opportunities to collaborate, and there is a need to develop agreed objectives, practices, roles and responsibilities in this collaboration.

Student's Experiences on Learning Therapeutic Relationship: A Narrative Inquiry

Despite the importance of the therapeutic relationship on nursing practice, the literature regarding teaching and learning therapeutic relationship is limited. This paper discussed how an undergraduate nursing student learned therapeutic relationship in an acute care setting. Narrative inquiry was applied as a research methodology. The student's reflection served as the narrative in this paper. Collaboratively, researchers conducted data analysis, common themes were drawn, and a summative narrative was presented. Based on the student's narrative, a three-dimensional model, including practical knowledge, theory, and reflection, has been created as our summative narrative. This model suggests that, to facilitate a learning process on creating therapeutic nurse-patient relationship, practical knowledge is the foundation, theory is a leading guide, and constant reflection is a learning tool which transforms learning into a reflective and meaningful experience. To promote learning on therapeutic relationship, nurse educators should emphasize the importance of both practical knowledge and theory. Constant reflection as a learning tool should be encouraged and embedded in nursing curriculum. Diverse approaches of reflection should be promoted.

Diabetic foot ulcer care: a concept analysis of the term integrated into nursing practice

BACKGROUND

Diabetic foot ulcer care demonstrates a beneficial approach to overcoming problems in patients with diabetes. This approach is frequently given but is not always successfully implemented due to its fragmentation amid healthcare providers. What's more, there are a number of different understandings, interchangeable languages and an absence of uniformity overlapping terminologies of meaning for diabetic foot ulcer care. Therefore, analysing the concept of diabetic foot ulcer care is important to provide a wider nursing knowledge, synthesise a greater theoretical model and drive more effective care of diabetic foot ulcer.

OBJECTIVE

This article aimed to analyse how the concept of diabetic foot ulcer care is clearly defined in the relevant evidence as it has several implications in nursing practice.

METHOD

Walker and Avant's (1995) method of concept analysis was systematically used in this study.

FINDINGS

Three critical attributes of diabetic foot ulcer care were determined consisting of assessment, intervention and evaluation. Constructed cases are also presented to differentiate the concept of diabetic foot ulcer care from other concepts. This concept analysis results in the critical attributes of diabetic foot ulcer care, defines an operational definition and describes common goals that improve clarity, consistency and understanding of the concept amid healthcare professionals along with researchers.

CONCLUSION

Effective implementation of the concept of DFU care into clinical nursing practice may undoubtedly improve patient outcomes and prevent the complexities of DFU in the years to come. Future research needs to be developed for evaluating the current use of this concept.