Developing and Testing the Standard of Practice and Evaluation of Critical-Care-Nursing Tool (SPECT) for Critical Care Nursing Practice

Developing the Next Generation of Nursing Disciplinary Leaders in Higher Education: Protocol for a Sequential Mixed Methods Study

BACKGROUND

Leading nurse education and research in the higher education (HE) sector has become increasingly challenging over the last decade with many universities in Australia and New Zealand having undergone academic restructuring. The future of HE faces many challenges including recruitment of suitably qualified staff to lead teaching and research and advance professional disciplines. Increasing cultural diversity of the Nursing workforce and the communities' nurses serve, and the identification of cultural attributes in the context of racial inequities exposed by the pandemic and the climate emergency suggest different forms of leadership may be required in the future by those leading nurse education in the HE sector. Currently, there is a dearth of research evidence that identifies the qualities, behaviors, and characteristics (collectively identified as core attributes) required by nurse academic leaders.

OBJECTIVE

This research aims to identify an evidenced based set of core attributes that are required to lead the discipline of Nursing in the Australian and New Zealand HE sectors.

METHODS

This research is using a 2-phase sequential mixed methods design incorporating a scoping review; and Delphi technique. In phase 1, a scoping review will be undertaken to identify the qualities, behaviors, and characteristics that can influence the evolution of the next generation of academic nurse leaders. A set of draft statements and questions will be prepared based on analysis of findings from the review. Phase 2 uses Delphi technique consisting of e-survey rounds with experts in leading nursing faculties in Australia and New Zealand. An Expert Advisory Group will consider the initial set of draft statements and questions from phase 1. Consistent with Delphi technique, a series of "rounds" will then occur using an e-survey method. Established leaders (Professors and Associate Professors who are members of the Council of Deans Australia and New Zealand) will rate their level of agreement to statements on the qualities, behaviors, and characteristics required to lead the discipline of nursing in the HE sector in Australia and New Zealand.

RESULTS

The findings of the scoping review will identify what is currently known about the qualities, behaviors, and characteristics of academic nurse leaders. Quantitative and qualitative results from the Delphi study will initially be reported in separate manuscripts for publication. It is projected that a final paper will be prepared from aggregated research data and outline how the findings can inform the preparation of future academic nurse leaders.

CONCLUSIONS

The generation of an evidenced-based set of core attributes will serve to inform the next generation of academic nurse leaders including informing recruitment processes and postgraduate nurse leadership programs. It is anticipated that the data sets and findings will be transferrable to other disciplines within HE to aid in future-proofing discipline-based expertise and leadership in the context of academic restructure.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

PRR1-10.2196/40677.

Assessment methods and tools to evaluate postgraduate critical care nursing students' competence in clinical placement. An integrative review

AIM

To provide an overview of assessment methods and tools to evaluate postgraduate critical care nursing students' competence in clinical placement and to identify recommendations for future assessment methods.

BACKGROUND

The purpose of postgraduate critical care nursing education is to educate professional, competent and caring critical care nurses and high-quality assessment strategies in clinical placement are of most importance.

DESIGN

An integrative review following Whittemore and Knafl's framework and Prisma 2020 guidelines for systematic reviews.

METHODS

Systematic searches were performed in June 2020 with an update in April 2021 using the following: Academic Search Premier, British Nursing Index, CINAHL, MEDLINE, SveMed+, Web of Science and the Joanna Briggs Institute databases. The systematic literature search and hand search yielded 380 studies. After screening and checking for eligibility, fifteen studies published between 2005 and 2020 were included in this review. The included studies were critically appraised using the Mixed Methods Appraisal Tool for empirical studies and the Joanna Briggs Institute Critical Appraisal tool for literature reviews.

RESULTS

Four qualitative, six quantitative, three mixed-methods and two literature review studies were included in this review. We identified that competence in postgraduate critical care nursing is a multidimensional concept and it is recommended to use a combination of assessment methods like self-assessment, observation and mentor evaluation. It is necessary to have discussions and reflections between the student, preceptor and lecturer, as well as written self- and mentor evaluation to provide formative and summative feedback to the students. The need to provide consistency and objectivity resulted in the development of competency assessment tools and they were mostly developed and validated as a collaboration between clinical sites and educational institutions. Most of the assessment tools consisted of domains reflecting holistic nursing, including both technical and non-technical skills. Domains reflecting evidence-based nursing practice were less common.

CONCLUSIONS

We need valid and reliable instruments to assess postgraduate critical care nursing student's competence in placement. Innovation and further research regarding effective and accessible assessment methods, such as digital assessment tools, are needed to meet future needs. This may also stimulate collaboration to improve the international inconsistency in critical care nursing educations. We should be working towards common, international educational competence descriptions and assessment tools that are in line with the ever-changing critical care environment, including holistic nursing and continuous learning.

A two phase study to revise the Australian Practice Standards for Specialist Critical Care Nurses

BACKGROUND

Observational work to develop the ACCCN Competency Standards was undertaken more than 20 years ago. Since then the landscape of critical care nursing as a specialty has changed and it is not known if the Competency Standards reflected contemporary practice.

OBJECTIVES

To revise the ACCCN Competency Standards for Specialist Critical Care Nurses to ensure they continue to meet the needs of critical care nurses and reflect current practice.

METHODS

A two-phased project was undertaken. In Phase I focus groups were held in all states. Thematic analysis was conducted using two techniques. The standards were revised based on the main themes. Phase II consisted of an eDelphi technique. A national panel of critical care nurses responded to three survey rounds using a 7 point likert-type scale to indicate their level of agreement with the revised standards. A 70% agreement level for each statement was determined a priori.

RESULTS

Phase I: 12 focus groups (79 participants) were conducted. Phase II: A panel of specialist critical care nurses (research, management, clinical practice and education) responded to round 1 (n=64), round 2 (n=56), and round 3 (n=40). Fifteen practice standards with elements and performance criteria were grouped into four domains (professional practice, provision and coordination of care, critical thinking and analysis, collaboration and leadership). The revised Practice Standards for Specialist Critical Care Nurses build upon and are additional to the Nursing & Midwifery Board of Australia National Competency Standards for Registered Nurses. The standards reflect contemporary critical care nurse practices using an expanded range of technologies to care for complex critically ill patients across the lifespan in diverse settings.

CONCLUSION

The national study has resulted in the 3rd edition of the Practice Standards for Specialist Critical Care Nurses. There was input from stakeholders and agreement that the revised standards capture contemporary Australian critical care nursing practice.

Minimum standards of clinical practice for physiotherapists working in critical care settings in Australia and New Zealand: A modified Delphi technique

OBJECTIVE

Achieving competency in critical care in entry-level physiotherapy courses across Australia and New Zealand is not essential, and accredited training for qualified physiotherapists working in critical care units is lacking. As a result, practice standards and training may vary. The objective was to establish consensus-based minimum clinical practice standards for physiotherapists working in critical care settings in Australia and New Zealand.

DESIGN

A modified Delphi technique, which consisted of three rounds of questionnaires, was used to obtain consensus on items.

SETTING

Australian and New Zealand critical care settings.

PARTICIPANTS

A panel (n = 61) was invited from a pool of eligible physiotherapists throughout Australia and New Zealand (n = 93). Eligibility criteria were defined a-priori on the basis of possession of expertise and experience in the practice and teaching of critical care physiotherapy clinical skills.

MAIN OUTCOME MEASURE

Questionnaires were disseminated electronically (either via email, or SurveyMonkey^®). Items were designated by participants as being 'Essential/Unsure/Not Essential'. Consensus for inclusion was achieved when items were ranked 'Essential' by more than 70% of participants.

RESULTS

Fifty physiotherapists consented and participated in the initial Delphi round, of whom 45 (90%) completed all rounds. Consensus was reached on 199 (89%) items. The panel agreed that 132 (58%) items were 'Essential' items for inclusion in the final framework.

CONCLUSIONS

This is the first study to develop a consensus framework of minimum standards of practice for physiotherapists working in critical care. The clinical utility of this framework now requires assessment.