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Solberg MT, Pedersen I, Mathisen C, Finnstrøm IJ, Lundin PK, Nes AAG. Professional competence required in advanced practice nursing in critical care: An exploratory qualitative study. Nurs Open 2023; 10:7839-7847. [PMID: 37818774 PMCID: PMC10643827 DOI: 10.1002/nop2.2032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Revised: 09/15/2023] [Accepted: 09/29/2023] [Indexed: 10/13/2023] Open
Abstract
AIM To identify the required competencies of advanced practice nurses (APNs) working with patients in critical care units in Norway. DESIGN An exploratory qualitative design. METHODS Four focus group interviews were performed with 18 nurses who worked in critical care units. The data were examined by inductive content analysis following Graneheim and Lundman's approach. FINDINGS Our study found that APNs in critical care require the following professional competencies to meet the needs of patients characterised by greater age, comorbidities and increased complexity: (1) intrapersonal skills as revealed in the subthemes of self-awareness; motivation and commitment; strong mental health and upholding ethical standards, (2) advanced clinical decision-making skills as identified in the subthemes of integration of theory and practice; complex practical and technical skills; dealing with increased delegated responsibility and taking the lead in managing increased practice complexity and (3) interpersonal skills, including peer guidance, practising collaboratively and the ability to position oneself.
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Affiliation(s)
| | | | - Cathrine Mathisen
- Lovisenberg Diaconal University CollegeDepartment for Postgraduate StudiesOsloNorway
| | | | - Per Kristian Lundin
- Intensive Care, Section 1, RikshospitaletDepartment of Postoperative and Intensive CareDivision of Emergencies and Critical CareOslo University HospitalOsloNorway
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Heradstveit SH, Larsen MH, Solberg MT, Steindal SA. Critical care nurses' role in the decision-making process of withdrawal of life-sustaining treatment: A qualitative systematic review. J Clin Nurs 2023; 32:6012-6027. [PMID: 37082871 DOI: 10.1111/jocn.16728] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Revised: 03/21/2023] [Accepted: 03/23/2023] [Indexed: 04/22/2023]
Abstract
AIM To synthesise the qualitative evidence regarding the role of critical care nurses in the decision-making process of withdrawing life-sustaining treatment in critically ill adults. DESIGN Qualitative systematic review. REVIEW METHODS This qualitative systematic review employed the guidelines of Bettany-Saltikov and McSherry. The review was reported according to the ENTREQ checklist. Pairs of authors independently assessed eligibility, appraised methodological quality and extracted data. Data were synthesised using thematic synthesis. DATA SOURCES CINAHL, MEDLINE and EMBASE were searched for studies published between January 2001 and November 2021. RESULTS Twenty-three studies were included. Three analytical themes were synthesised: performing ethical decision-making to safeguard patients' needs rights, and wishes; tailoring a supporting role to guide the family's decision-making process; and taking on the role of the middleman by performing coordination. CONCLUSION The role of the critical care nurses in the decision-making process in withdrawal of life-sustaining treatment requires experience and the development of the clinical perspective of critical care nurses. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE Enhanced knowledge of the decision-making process of withdrawing life-sustaining treatment can prepare critical care nurses to be more equipped to master this role and enhance their ability to handle the emotional and moral stress associated with this part of the critical care unit. IMPACT The literature reveals the complex and challenging role of critical care nurses during the decision-making process of withdrawing life-sustaining treatment. Critical care nurses perform ethical decision-making to safeguard patients' concerns, guide the family's decision-making process and take on the role of the middleman. The findings have implications for critical nurses working in critical care units in hospitals and for educators and students in training in critical care nursing. PATIENT OR PUBLIC CONTRIBUTION No patient or public contribution was included.
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Affiliation(s)
- Siri Hammersland Heradstveit
- Department for Postgraduate Studies, Lovisenberg Diaconal University College, Oslo, Norway
- Division of Emergencies and Critical Care, Pediatric Intensive Care, Oslo University Hospital, Oslo, Norway
| | - Marie Hamilton Larsen
- Department for Postgraduate Studies, Lovisenberg Diaconal University College, Oslo, Norway
| | - Marianne Trygg Solberg
- Department for Postgraduate Studies, Lovisenberg Diaconal University College, Oslo, Norway
| | - Simen A Steindal
- Department for Postgraduate Studies, Lovisenberg Diaconal University College, Oslo, Norway
- Faculty of Health Studies, VID Specialized University, Oslo, Norway
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Brekke SM, Halvorsen ST, Bjørkvoll J, Thorsby PM, Rønnestad A, Zykova SN, Bakke LH, Dahl SR, Haaland K, Eger SHW, Solberg MT, Solevåg AL. The association between infant salivary cortisol and parental presence in the neonatal intensive care unit during and after COVID-19 visitation restrictions: A cross-sectional study. Early Hum Dev 2023; 182:105788. [PMID: 37224589 DOI: 10.1016/j.earlhumdev.2023.105788] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Revised: 04/30/2023] [Accepted: 05/01/2023] [Indexed: 05/26/2023]
Abstract
OBJECTIVES Parent-infant interaction in the neonatal intensive care unit (NICU) promotes health and reduces infant stress. During the COVID-19 pandemic, however, NICUs restricted parent-infant interaction to reduce viral transmission. This study examined the potential relationship between pandemic visitation restrictions, parental presence and infant stress as measured by salivary cortisol. METHODS A two-NICU cross-sectional study of infants with gestational age (GA) 23-41 weeks, both during (n = 34) and after (n = 38) visitation restrictions. We analysed parental presence with and without visitation restrictions. The relationship between infant salivary cortisol and self-reported parental NICU presence in hours per day was analysed using Pearson's r. A linear regression analysis included potential confounders, including GA and proxies for infant morbidity. The unstandardised B coefficient described the expected change in log-transformed salivary cortisol per unit change in each predictor variable. RESULTS Included infants had a mean (standard deviation) GA of 31(5) weeks. Both maternal and paternal NICU presence was lower with versus without visitation restrictions (both p ≤0.05). Log-transformed infant salivary cortisol correlated negatively with hours of parental presence (r = -0.40, p = .01). In the linear regression, GA (B = -0.03, p = .02) and central venous lines (B = 0.23, p = .04) contributed to the variance in salivary cortisol in addition to parental presence (B = -0.04 p = .04). CONCLUSION COVID-19-related visitation restrictions reduced NICU parent-infant interaction and may have increased infant stress. Low GA and central venous lines were associated with higher salivary cortisol. The interaction between immaturity, morbidity and parental presence was not within the scope of this study and merits further investigation.
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Affiliation(s)
- Stine Marie Brekke
- Department of Master and Postgraduate Education, Lovisenberg Diaconal University College, Oslo, Norway; The Department of Pediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway.
| | - Silje Torp Halvorsen
- Department of Master and Postgraduate Education, Lovisenberg Diaconal University College, Oslo, Norway; The Department of Pediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway
| | - Julie Bjørkvoll
- Department of Master and Postgraduate Education, Lovisenberg Diaconal University College, Oslo, Norway; The Department of Pediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway
| | - Per Medbøe Thorsby
- Hormone laboratory, Department of Medical Biochemistry and Biochemical endocrinology and metabolism research group, Oslo University Hospital, Oslo, Norway
| | - Arild Rønnestad
- The Department of Pediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway; Institute for clinical medicine, Faulty of medicine, University of Oslo, Oslo, Norway
| | - Svetlana N Zykova
- Hormone laboratory, Department of Medical Biochemistry and Biochemical endocrinology and metabolism research group, Oslo University Hospital, Oslo, Norway
| | - Liv Hanne Bakke
- Hormone laboratory, Department of Medical Biochemistry and Biochemical endocrinology and metabolism research group, Oslo University Hospital, Oslo, Norway
| | - Sandra Rinne Dahl
- Hormone laboratory, Department of Medical Biochemistry and Biochemical endocrinology and metabolism research group, Oslo University Hospital, Oslo, Norway
| | - Kirsti Haaland
- The Department of Pediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway
| | - Siw Helen Westby Eger
- The Department of Pediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway
| | - Marianne Trygg Solberg
- Department of Master and Postgraduate Education, Lovisenberg Diaconal University College, Oslo, Norway
| | - Anne Lee Solevåg
- Department of Master and Postgraduate Education, Lovisenberg Diaconal University College, Oslo, Norway; The Department of Pediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway
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Skedsmo K, Nes AAG, Stenseth HV, Hofsø K, Larsen MH, Hilderson D, Smis D, Hagelin CL, Olaussen C, Solberg MT, Bingen HM, Ølnes MA, Steindal SA. Simulation-based learning in palliative care in postgraduate nursing education: a scoping review. BMC Palliat Care 2023; 22:30. [PMID: 36991463 DOI: 10.1186/s12904-023-01149-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Accepted: 03/20/2023] [Indexed: 03/31/2023] Open
Abstract
BACKGROUND Nurses require advanced competence in palliative care, but they face wide variations in education and a shortage in opportunities for clinical placement. Simulation-based learning (SBL) can enable students to develop clinical skills, critical thinking and confidence. No scoping reviews to date have mapped the use of SBL in palliative care within postgraduate nursing education. METHODS The aim of this scoping review was to systematically map published studies on the use of SBL in palliative care in postgraduate nursing education. A scoping review was conducted using Arksey and O'Malley's (Int J Soc Res Meth 8(1):19-32, 2005) methodological framework. A systematic and comprehensive search of the Cumulative Index to Nursing and Allied Health Literature (CINAHL), the Education Resources Information Center (ERIC), Ovid MEDLINE, Ovid EMBASE, Allied and Complementary Medicine and PsycINFO was performed for studies published between January 2000 and April 2022. Two authors independently assessed papers for inclusion and extracted data. Reporting followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) checklist. The protocol was registered on the Open Science Framework. RESULTS This review includes 10 studies. Three thematic groupings were identified: enhanced understanding of the importance of teamwork, interdisciplinarity and interpersonal skills; preparedness and confidence in one's ability to communicate during emotionally challenging situations; and impact and relevance to one's own clinical practice. CONCLUSIONS The use of SBL in palliative care in postgraduate nursing education seems to enhance students' understanding of the importance of teamwork and interdisciplinarity. The review shows contradictory results regarding whether SBL in palliative care increases students' confidence in their communication skills. Postgraduate nursing students experienced personal growth after participating in SBL. Because our findings indicate that limited research has been conducted within this field, future research should (1) explore postgraduate nursing students' experiences with SBL in palliative care with a focus on more practical content such as symptom management, (2) examine the relevance and application of SBL in clinical practice, and (3) be reported in line with recommendations on the reporting of simulation research.
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Affiliation(s)
- Karoline Skedsmo
- Lovisenberg Diaconal University College, Lovisenberggt. 15B, 0456, Oslo, Norway.
- Department of Otorhinolaryngology, Head and Neck Surgery, Oslo University Hospital, Oslo, Norway.
| | | | | | - Kristin Hofsø
- Lovisenberg Diaconal University College, Lovisenberggt. 15B, 0456, Oslo, Norway
- Department of Research and Development, Division of Emergencies and Critical Care, Oslo University Hospital, Oslo, Norway
| | | | | | | | - Carina Lundh Hagelin
- Department of Health Care Sciences, Palliative Research Centre, Marie Cederschiöld University, Stockholm, Sweden
- Department of Neurobiology, Care Sciences and Society, Division of Nursing, Karolinska Institutet, Stockholm, Sweden
| | - Camilla Olaussen
- Lovisenberg Diaconal University College, Lovisenberggt. 15B, 0456, Oslo, Norway
| | | | | | - Mia Alexandra Ølnes
- Lovisenberg Diaconal University College, Lovisenberggt. 15B, 0456, Oslo, Norway
| | - Simen A Steindal
- Lovisenberg Diaconal University College, Lovisenberggt. 15B, 0456, Oslo, Norway
- Faculty of Health Studies, VID Specialized University, Oslo, Norway
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Solberg MT, Sørensen AL, Clarke S, Nes AAG. Virtual Reflection Group Meetings as a Structured Active Learning Method to Enhance Perceived Competence in Critical Care: Focus Group Interviews With Advanced Practice Nursing Students. JMIR Med Educ 2023; 9:e42512. [PMID: 36951919 PMCID: PMC10131641 DOI: 10.2196/42512] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Revised: 02/27/2023] [Accepted: 03/05/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND Advanced practice nurses (APNs) are in high demand in critical care units. In Norway, APNs are educated at the master's degree level and acquire the competence to ensure the independent, safe, and effective treatment of patients in constantly and rapidly changing health situations. APNs' competence embraces expert knowledge and skills to perform complex decision-making in the clinical context; therefore, it is essential that educational institutions in nursing facilitate learning activities that ensure and improve students' achievement of the required competence. In clinical practice studies of APN education, face-to-face reflection group (FFRG) meetings, held on campus with the participation of a nurse educator and advanced practice nursing students (APNSs), are a common learning activity to improve the competence of APNSs. Although FFRG meetings stimulate APNSs' development of required competencies, they may also result in unproductive academic discussions, reduce the time that APNSs spend in clinical practice, and make it impossible for nurse preceptors (NPs) to attend the meetings, which are all challenges that need to be addressed. OBJECTIVE This study aimed to address the challenges experienced in FFRG meetings by implementing virtual reflection group (VRG) meetings and to explore the experiences of APNSs, NPs, and nurse educators in VRG meetings as an active learning method supported by technology to stimulate students' development of the required competence to become APNs in critical care. METHODS This study adopted a qualitative explorative design with 2 focus group interviews and used inductive content analysis to explore the collected data. RESULTS The main finding is that reflection group meetings supported by technology resulted in a better-structured active learning method. The VRG meeting design allowed APNSs to spend more time in clinical practice placements. The APNSs and NPs experienced that they participated actively and effectively in the meetings, which led to a perceived increase in competence. The APNSs also perceived an improved learning experience compared with their prior expectations. CONCLUSIONS Users perceived that the implemented novel teaching design supported by technology, the VRG meeting, was a more effective method than FFRG meetings on campus to develop APNSs' required competence in critical care. The VRG was also perceived as an improved method to solve the challenges encountered in FFRG meetings. Specifically, the APNSs felt that they were prepared to undertake complex decision-making with a higher level of analytic cognition in a clinical context and to lead professional discussions in the ward. This developed teaching design can easily be adapted to diverse educational programs at various levels of professional education.
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Affiliation(s)
| | | | - Sara Clarke
- Lovisenberg Diaconal University College, Oslo, Norway
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Kushniruk A, Zlamal J, Linnerud SCW, Steindal SA, Solberg MT. A Technology-Supported Guidance Model to Increase the Flexibility, Quality, and Efficiency of Nursing Education in Clinical Practice in Norway: Development Study of the TOPP-N Application Prototype. JMIR Hum Factors 2023; 10:e44101. [PMID: 36735289 PMCID: PMC9938443 DOI: 10.2196/44101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2022] [Revised: 12/29/2022] [Accepted: 01/12/2023] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND The challenges of nursing shortage in the nursing profession and of limited nursing educational capacity in nursing education in clinical practice need to be addressed to ensure supply according to the demand of these professionals. In addition, communication problems among nursing students, nurse educators, and nurse preceptors; variations in the guidance competence of nurse preceptors; and limited overview from nurse educators on nursing students' clinical practice are common challenges reported in several research studies. These challenges affect the quality of nursing education in clinical practice, and even though these problems have been highlighted for several years, a recent study showed that these problems are increasing. Thus, an approach is required to ensure the quality of nursing education in clinical practice. OBJECTIVE We aimed to develop a guidance and assessment application to meet the challenges reported in clinical practice. The application intended to increase the flexibility, quality, and efficiency of nursing education in clinical practice. Furthermore, it intended to increase interactive communication that supports guidance and ensure structured evaluation of nursing students in clinical practice. METHODS This study employed a multidisciplinary user-participatory design. Overall, 23 stakeholders from the project team (ie, 5 researchers, 2 software developers, 1 pedagogical advisor, and 15 user representatives [4 educators, 6 preceptors, and 5 students]) participated in a user-centered development process that included workshops, intervention content development, and prototype testing. RESULTS This study resulted in the creation of the Technology-Optimized Practice Process in Nursing (TOPP-N) guidance and assessment application for use as a supportive tool for nursing students, nurse preceptors, and nurse educators in clinical practice. The development process included the application's name and logo, technical architecture, guidance and assessment module, and security and privacy. CONCLUSIONS This study offers insights into the development of an evidence-based technological tool to support nursing students, nurse preceptors, and nurse educators in clinical practice. Furthermore, the developed application has the potential to meet several challenges reported in nursing education in clinical practice. After a rigorous development process, we believe that the TOPP-N guidance and assessment application prototype is now ready to be tested in further intervention studies.
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Affiliation(s)
| | | | | | - Simen A Steindal
- Lovisenberg Diaconal University College, Oslo, Norway.,Institute of Nursing, Faculty of Health Studies, VID Specialized University, Oslo, Norway
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Svendsen M, Steindal SA, Hamilton Larsen M, Trygg Solberg M. Comparison of the systematic Inflammatory response syndrome and the quick sequential organ failure assessment for prognostic accuracy in detecting sepsis in the emergency department: A systematic review. Int Emerg Nurs 2023; 66:101242. [PMID: 36571931 DOI: 10.1016/j.ienj.2022.101242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Revised: 11/07/2022] [Accepted: 11/19/2022] [Indexed: 12/25/2022]
Abstract
BACKGROUND Awareness and prompt recognition of sepsis are essential for nurses working in the emergency department (ED), enabling them to make an initial assessment of patients and then to sort them according to their condition s severity. The aim of this systematic review was to investigate prognostic accuracy in detecting sepsis in the emergency department by comparing the previous sepsis-2 screening tool, the Systemic Inflammatory Response Syndrome (SIRS) and the current sepsis-3 screening tool, the Quick Sequential Organ Failure Assessment (qSOFA). METHODS This systematic review used the guideline by Bettany-Saltikov and McSherry and was reported according to the Preferred Reporting Items for Systematic Reviews and meta-Analyses (PRISMA) 2020 checklist. The protocol was registered in PROSPERO. A systematic search was conducted using the CINAHL, EMBASE and MEDLINE databases. Study selection and risk of bias was performed independently by pair of authors. RESULTS Five articles were included. Overall, SIRS showed higher sensitivity than qSOFA, while qSOFA showed higher specificity than SIRS. The positive predictive value for qSOFA was superior, while there was a minor deviation in negative predictive value between qSOFA and SIRS. CONCLUSION The overall recommendation based on the included studies indicates that qSOFA is the better-suited screening tool for prognostic accuracy in detecting sepsis in the emergency department.
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Affiliation(s)
- Marius Svendsen
- Lovisenberg Diaconal University College, Department for postgraduate studies, Oslo, Norway; Emergency Medicine section Bærum Hospital, Norway.
| | - Simen A Steindal
- Lovisenberg Diaconal University College, Department for postgraduate studies, Oslo, Norway
| | - Marie Hamilton Larsen
- Lovisenberg Diaconal University College, Department for postgraduate studies, Oslo, Norway
| | - Marianne Trygg Solberg
- Intensive Care Nurse Specialist, Master of Nursing Sci., PhD. Lovisenberg Diaconal University College, Department for postgraduate studies, Oslo, Norway
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Høybakk JB, Nes AAG, Kvande ME, Solberg MT. Exploring the Impact of Virtual Reflection Groups on Advanced Practice Nurse Students During the COVID-19 Pandemic: Focus Group Study With Master’s Students. JMIR Nurs 2022; 5:e40418. [PMID: 36107492 PMCID: PMC9484484 DOI: 10.2196/40418] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Revised: 08/24/2022] [Accepted: 08/24/2022] [Indexed: 11/13/2022] Open
Abstract
Background In the master’s program of advanced practice nursing at a Norwegian university college, the learning activity reflection groups were converted into virtual reflection group (VRG) meetings during the COVID-19 pandemic. Regardless of the students’ clinical practices in different hospitals, they could participate in the same VRG meeting on the web together with the educator from the university college, and the clinical supervisors were invited to participate. The students were in the process of developing the core competence required in their role as advanced practice nurses (APNs), and they had increased responsibility in the implementation of the VRG meetings. Objective In this study, we aimed to explore how master’s students of advanced practice nursing experienced VRG meetings during the COVID-19 pandemic. Methods A qualitative exploratory design was adopted using focus group interviews. A group of students in the master’s program of advanced practice nursing participated in an interview that lasted for 60 minutes. They had experienced participating in the VRG meetings following a rigorous guide during their clinical practice. The data from the focus group were analyzed using qualitative content analysis. Results The main findings of this study highlighted the importance of structure in VRG meetings, the role of increased responsibility in students’ learning processes, the development of APN students’ competencies, and increased professional collaboration with clinical supervisors. The APN students and clinical supervisors also continued their discussions in the clinical setting afterward, which strengthened the collaboration between students’ education in the master’s program and their clinical practice. Conclusions VRG meetings gave the students the opportunity to lead professional discussions while reflecting thoroughly on the chosen patient cases from clinical practice. They experienced receiving feedback from fellow students, supervisors, and educators as stimulating their critical thinking development.
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Zlamal J, Roth Gjevjon E, Fossum M, Trygg Solberg M, Steindal SA, Strandell-Laine C, Hamilton Larsen M, Nes AAG. Technology-Supported Guidance Models Stimulating the Development of Critical Thinking in Clinical Practice: A Mixed Methods Systematic Review (Preprint). JMIR Nurs 2022; 5:e37380. [PMID: 35671078 PMCID: PMC9214617 DOI: 10.2196/37380] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Revised: 04/07/2022] [Accepted: 04/07/2022] [Indexed: 01/04/2023] Open
Abstract
Background Objective Methods Results Conclusions International Registered Report Identifier (IRRID)
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Affiliation(s)
- Jaroslav Zlamal
- Department of Bachelor Education in Nursing, Lovisenberg Diaconal University College, Oslo, Norway
| | - Edith Roth Gjevjon
- Department of Bachelor Education in Nursing, Lovisenberg Diaconal University College, Oslo, Norway
| | - Mariann Fossum
- Department of Health and Nursing Sciences, University of Agder, Kristiansand, Norway
| | - Marianne Trygg Solberg
- Department of Postgraduate Studies, Lovisenberg Diaconal University College, Oslo, Norway
| | - Simen A Steindal
- Department of Postgraduate Studies, Lovisenberg Diaconal University College, Oslo, Norway
- Faculty of Health Studies, VID Specialized University, Oslo, Norway
| | - Camilla Strandell-Laine
- Department of Bachelor Education in Nursing, Lovisenberg Diaconal University College, Oslo, Norway
- Faculty of Health and Welfare, Novia University of Applied Sciences, Åbo, Finland
| | - Marie Hamilton Larsen
- Department of Postgraduate Studies, Lovisenberg Diaconal University College, Oslo, Norway
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Stenseth HV, Steindal SA, Solberg MT, Ølnes MA, Mohallem A, Sørensen AL, Strandell-Laine C, Olaussen C, Aure CF, Riegel F, Pedersen I, Zlamal J, Martini JG, Bresolin P, Linnerud SCW, Nes AAG. Simulation-Based Learning Supported by Technology to Enhance Critical thinking in Nursing Students: Protocol for a Scoping Review (Preprint). JMIR Res Protoc 2022; 11:e36725. [PMID: 35373777 PMCID: PMC9016502 DOI: 10.2196/36725] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2022] [Revised: 02/13/2022] [Accepted: 02/21/2022] [Indexed: 01/26/2023] Open
Abstract
Background Critical thinking is a crucial skill in the nursing profession, so teaching strategies and methodology must be carefully considered when training and preparing nursing students to think critically. Studies on simulation-based learning supported by technology are increasing in nursing education, but no scoping reviews have mapped the literature on simulation-based learning supported by technology to enhance critical thinking in nursing students. Objective The proposed scoping review aims to systematically map research on the use of simulation-based learning supported by technology to enhance critical thinking in nursing students. Methods The proposed scoping review will use the framework established by Arksey and O’Malley and will be reported according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) extension for scoping reviews. A systematic, comprehensive literature search was performed in the LILACS, ERIC, MEDLINE, EMBASE, PsycINFO, and Web of Science databases. Pairs of authors independently selected the articles by screening titles, abstracts, full-text papers, and extract data. The data will be analyzed and thematically categorized. Results The development of a comprehensive and systematic search strategy was completed in June 2021. The database searches were performed in July 2021, and the screening of titles and abstracts was completed in September 2021. Charting the data began in February 2022. Analysis and synthesis will be performed sequentially, and the scoping review is expected to be complete by May 2023. Conclusions The results of this proposed scoping review may identify gaps in the literature and provide an overview of research on the topic of simulation-based learning supported by technology to enhance critical thinking in nursing students. The research may identify nursing students’ reported barriers and enablers for learning critical thinking skills through simulation-based learning supported by technology, and the results may help educators enhance their educational approach through knowledge of students’ firsthand experiences and further development of successful teaching strategies in nursing education. International Registered Report Identifier (IRRID) DERR1-10.2196/36725
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Affiliation(s)
| | - Simen Alexander Steindal
- Lovisenberg Diaconal University College, Oslo, Norway
- Faculty of Health Studies, VID Specialized University, Oslo, Norway
| | | | | | - Andrea Mohallem
- Faculdade Israelita de Ciências da Saúde Albert Einstein, São Paulo, Brazil
| | | | - Camilla Strandell-Laine
- Lovisenberg Diaconal University College, Oslo, Norway
- Faculty of Health and Welfare, Novia University of Applied Sciences, Turku, Finland
| | | | | | - Fernando Riegel
- Federal University of Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
| | | | | | | | - Paula Bresolin
- Federal University of Santa Catarina, Florianópolis, Santa Catarina, Brazil
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Sundstrøm M, Sverresvold C, Trygg Solberg M. Factors contributing to poor sleep in critically ill patients: A systematic review and meta-synthesis of qualitative studies. Intensive Crit Care Nurs 2021; 67:103108. [PMID: 34247939 DOI: 10.1016/j.iccn.2021.103108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Revised: 05/20/2021] [Accepted: 05/29/2021] [Indexed: 10/20/2022]
Abstract
OBJECTIVE To examine the causes of poor sleep in critically ill patients from nurses' experiences. REVIEW METHODOLOGY A meta-synthesis following the Enhancing Transparency in Reporting the Synthesis of Qualitative Research statement was conducted. Articles were searched systematically in the CINAHL, MEDLINE and Embase databases up to January 2020. Study selection and data extraction were performed by two authors working independently. Included articles were critically evaluated by both authors using the Critical Appraisal Screening Programme tool. FINDINGS The meta-synthesis resulted in four analytical themes: (1) Inherent factors of critical illness, (2) Lack of implementation of evidence-based practice, (3) Lack of relational collaboration, (4) Hospital organisation and culture. CONCLUSION This literature review indicates that promoting critically ill patients' sleep is difficult. Evidence-based interventions should be implemented into practice in order for nurses to be able to meet the patients' needs and improve sleep. Furthermore, the team surrounding the patient must have support from the health care organisation, and a culture change is necessary to improve communication between them to reach a shared goal to improve critically ill patients' sleep.
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Affiliation(s)
- Maria Sundstrøm
- Intensive Care Nurse Specialist, Master of Nursing Sci., Lovisenberg Diaconal University College, Department for Postgraduate Studies, Oslo, Norway; Oslo University Hospital, Oslo, Norway.
| | - Camilla Sverresvold
- Intensive Care Nurse Specialist, Master of Nursing Sci., Lovisenberg Diaconal University College, Department for Postgraduate Studies, Oslo, Norway; Oslo University Hospital, Oslo, Norway.
| | - Marianne Trygg Solberg
- Intensive Care Nurse Specialist, Master of Nursing Sci., Lovisenberg Diaconal University College, Department for Postgraduate Studies, Oslo, Norway.
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Branes H, Solevåg AL, Solberg MT. Pediatric early warning score versus a paediatric triage tool in the emergency department: A reliability study. Nurs Open 2021; 8:702-708. [PMID: 33570310 PMCID: PMC7877131 DOI: 10.1002/nop2.675] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Revised: 09/08/2020] [Accepted: 10/20/2020] [Indexed: 11/24/2022] Open
Abstract
AIM In the paediatric emergency department (PED), it is important to correctly prioritize children for physician assessment. The pediatric early warning score (PEWS), although not a triage tool, is often used for PED triage. The scandinavian Rapid Emergency Triage and Treatment System-pediatric (RETTS-p) is a reliability tested triage tool. We aimed to compare PEWS and RETTS-p in a Norwegian PED. DESIGN A reliability study. METHODS The PED nurse routinely did PEWS observations, while the principal investigator concomitantly made RETTS-p observations. Inter-tool agreement was calculated for the complete PEWS and RETTS-p and for vital signs scores, disregarding the RETTS-p emergency symptoms and signs (ESS). RESULTS Rapid Emergency Triage and Treatment System-pediatric assigned a higher urgency than PEWS. The inter-tool agreement between PEWS and RETTS-p was low (weighted kappa [95% confidence interval [CI] = 0.32 [0.24-0.40]]). Weighted kappa (95% CI) was 0.50 (0.41-0.59) for PEWS and RETTS-p without ESS, indicating that PEWS is not equivalent to five-level triage tools.
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Affiliation(s)
- Hanne Branes
- Lovisenberg Deaconal University CollegeOsloNorway
| | - Anne Lee Solevåg
- Lovisenberg Deaconal University CollegeOsloNorway
- The Department of Paediatric and Adolescent MedicineAkershus University HospitalLørenskogNorway
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13
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Maartmann-Moe CC, Solberg MT, Larsen MH, Steindal SA. Patients' memories from intensive care unit: A qualitative systematic review. Nurs Open 2021; 8:2221-2234. [PMID: 33611859 PMCID: PMC8363378 DOI: 10.1002/nop2.804] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Revised: 12/11/2020] [Accepted: 01/29/2021] [Indexed: 11/05/2022] Open
Abstract
AIM To identify and synthesize the evidence regarding adult patients' memories from their stay in the intensive care unit. DESIGN A qualitative systematic review and meta-synthesis. PROSPERO # CRD42020164928. The review employed the guideline of Bettany-Saltikov and McSherry and the Enhancing transparency in reporting the synthesis of qualitative research guidelines. METHODS Systematic search for qualitative studies published between January 2000 and December 2019 in Cumulative Index to Nursing and Allied Health, Medical Literature Analysis and Retrieval System Online, PsycINFO, and Excerpta Medica Database. Pairs of authors independently assessed eligibility, appraised methodological quality using Joanna Briggs's quality appraisal tool and extracted data. The analysis followed the principles of interpretative synthesis. RESULTS Sixteen papers from 15 studies were included in the review. Three themes emerged: (a) memories of surreal dreams and delusions, (b) care memories from sanctuary to alienation and (c) memories of being vulnerable and close to death.
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Affiliation(s)
- Charlotte C Maartmann-Moe
- Lovisenberg Diaconal University College, Oslo, Norway.,Emergency Department, Oslo University Hospital, Oslo, Norway
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14
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Zlamal J, Gjevjon ER, Fossum M, Solberg MT, Steindal SA, Strandell-Laine C, Larsen MH, Pettersen FS, Nes AAG. Technology-Supported Guidance Models Stimulating the Development of Critical Thinking in Clinical Practice: Protocol for a Mixed Methods Systematic Review. JMIR Res Protoc 2021; 10:e25126. [PMID: 33464214 PMCID: PMC7854029 DOI: 10.2196/25126] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2020] [Revised: 11/22/2020] [Accepted: 11/24/2020] [Indexed: 01/26/2023] Open
Abstract
BACKGROUND Critical thinking is an essential skill that nursing students need to develop. Technological tools have opened new avenues for technology-supported guidance models, but the challenges and facilitators of such guidance models, as well as how they stimulate the development of critical thinking, remain unclear. OBJECTIVE We developed a protocol for a mixed methods systematic review to investigate the use of technology-supported guidance models that stimulate the development of critical thinking in nursing education clinical practice. METHODS A convergent integrated design following the Joanna Briggs Institute Manual for Evidence Synthesis will be employed. A pair of authors will select the articles by screening titles and abstracts, and the methodological quality of the articles included in the review will be assessed by a pair of authors according to checklists for specific study designs. The data will be extracted using the standardized Joanna Briggs Institute mixed methods data extraction form and following a convergent integrated approach. The thematic synthesis for data transformation will be used. RESULTS Development of a comprehensive systematic search strategy was completed in October 2020. The database searches were performed on October 21, 2020. As of January 2021, analysis and synthesis is ongoing. Completion of this review is expected by January 2021. CONCLUSIONS By combining evidence from studies with varied methodological approaches, the results should provide broad insight into the use of technology-supported guidance models for clinical practice in nursing education with a focus on the development of nursing students' critical thinking. The results of this mixed methods systematic review can also be used to develop or improve current technology-supported guidance models for clinical practice in nursing education. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) PRR1-10.2196/25126.
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15
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Birkedal HC, Larsen MH, Steindal SA, Solberg MT. Comparison of two behavioural pain scales for the assessment of procedural pain: A systematic review. Nurs Open 2020; 8:2050-2060. [PMID: 34388865 PMCID: PMC8363347 DOI: 10.1002/nop2.714] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Revised: 09/23/2020] [Accepted: 11/05/2020] [Indexed: 01/15/2023] Open
Abstract
AIM To examine the clinical utility and measurement properties of the Critical-Care Pain Observation Tool and the Behavioural Pain Scale when used to assess pain during procedures in the intensive care unit. DESIGN A systematic review was conducted, guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses checklist. METHODS A systematic search was conducted in CINAHL, MEDLINE, EMBASE and PsychINFO (01 October 2019). Study selection, data extraction and assessment of methodological quality were performed by a pair of authors working independently. Different psychometric properties were addressed: inter-rater reliability, internal consistency, test-retest reliability, discriminant validity and criterion validity. RESULTS Eleven studies were included. Both Critical-Care Pain Observation Tool and the Behavioural Pain Scale showed good reliability and validity and were good options for assessing pain during painful procedures with intensive care unit patients unable to self-report on pain. The Critical-Care Pain Observation Tool is to be preferred since this tool was shown to have particularly good reliability and validity in assessing pain during procedures, but the Behavioural Pain Scale is an appropriate alternative.
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Affiliation(s)
- Hanne Cathrine Birkedal
- Department for Postgraduate Studies, Lovisenberg Diaconal University College, Oslo, Norway.,Diakonhjemmet Hospital, Oslo, Norway
| | - Marie Hamilton Larsen
- Department for Postgraduate Studies, Lovisenberg Diaconal University College, Oslo, Norway
| | - Simen A Steindal
- Department for Postgraduate Studies, Lovisenberg Diaconal University College, Oslo, Norway
| | - Marianne Trygg Solberg
- Department for Postgraduate Studies, Lovisenberg Diaconal University College, Oslo, Norway
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16
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Solberg MT, Hansen TWR, Bjørk IT. The need for predictability in coordination of ventilator treatment of newborn infants--a qualitative study. Intensive Crit Care Nurs 2015; 31:205-12. [PMID: 25617081 DOI: 10.1016/j.iccn.2014.12.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2014] [Revised: 10/27/2014] [Accepted: 12/28/2014] [Indexed: 01/09/2023]
Abstract
OBJECTIVE New strategies for interprofessional collaboration are needed to achieve best practice in the care of ventilated newborns. This study explores what physicians and nurses believe to be important to improve collaboration during ventilator treatment. METHODS Qualitative data collected from one focus group were analysed using Gittell's theory of relational coordination. RESULTS To optimise communication about and coordination of ventilator treatment, six strategies were needed: (1) a pathway toward the goal for each newborn, (2) regular meetings, (3) accurate communication following an established pattern in the rounds conference, (4) collaboration to improve interprofessional level of knowledge, (5) courage to communicate one's own point of view, and (6) flexible responsibility in extubation situations. CONCLUSION By identifying weak areas in collaboration, nurses and physicians were inspired to suggest and discuss concrete improvements of work practices in the neonatal intensive care unit. Nurses and physicians can coordinate ventilator treatment by using a pathway and at the same time enhance nurses' involvement and responsibility in order to increase the flexibility of job boundaries, allowing the professions to cover for each other's work.
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Affiliation(s)
- Marianne Trygg Solberg
- Lovisenberg Deaconal University College, Oslo, Norway; Department of Nursing Science, Faculty of Medicine, University of Oslo, Nedre Ullevål 9, Stjerneblokka, 0850 Oslo, Norway.
| | - Thor Willy R Hansen
- Department of Neonatal Intensive Care, Women's and Children's Division, Oslo University Hospital, Oslo, Norway; Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway.
| | - Ida Torunn Bjørk
- Department of Nursing Science, Faculty of Medicine, University of Oslo, Nedre Ullevål 9, Stjerneblokka, 0850 Oslo, Norway.
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Solberg MT, Bjørk IT, Hansen TWR. Adherence to oxygenation and ventilation targets in mechanically ventilated premature and sick newborns: a retrospective study. BMC Pediatr 2013; 13:126. [PMID: 23957599 PMCID: PMC3751654 DOI: 10.1186/1471-2431-13-126] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2013] [Accepted: 08/14/2013] [Indexed: 12/14/2022] Open
Abstract
Background Ventilator treatment exposes newborns to both hyperoxemia and hyperventilation. It is not known how common hyperoxemia and hyperventilation are in neonatal intensive care units in Norway. The purpose of this study was to assess the quality of current care by studying deviations from the target range of charted oxygenation and ventilation parameters in newborns receiving mechanical ventilation. Methods Single centre, retrospective chart review that focused on oxygen and ventilator treatment practices. Results The bedside intensive care charts of 138 newborns reflected 4978 hours of ventilator time. Arterial blood gases were charted in 1170 samples. In oxygen-supplemented newborns, high arterial pressure of oxygen (PaO2) values were observed in 87/609 (14%) samples. In extremely premature newborns only 5% of the recorded PaO2 values were high. Low arterial pressure of CO2 (PaCO2) values were recorded in 187/1170 (16%) samples, and 64 (34%) of these were < 4 kPa. Half of all low values were measured in extremely premature newborns. Tidal volumes above the target range were noted in 22% of premature and 20% of full-term newborns. Conclusions There was a low prevalence of high PaO2 values in premature newborns, which increased significantly with gestational age (GA). The prevalence of low PaCO2 values was highest among extremely premature newborns and decreased with increasing GA. Further studies are needed to identify whether adherence to oxygenation and ventilation targets can be improved by clearer communication and allocation of responsibilities between nurses and physicians.
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