The increased anxiety experienced by nursing students during simulations can serve as a significant barrier to learning. The use of anxiety-reducing techniques such as autogenic training (AT) can mitigate the negative effects of anxiety and improve the overall learning experience. The investigators in this study sought to understand the effect of AT on student performance and self-efficacy during simulation experiences. The use of AT was an effective technique to decrease anxiety and increase performance among nursing students during nursing simulations. Reducing anxiety during simulations can improve the student learning experience.
This study sought to examine tai-chi as an anxiety-reducing method to increase self-efficacy and improve performance among baccalaureate nursing students experiencing a patient care simulation. The sample included 63 nursing students enrolled in a traditional or second-degree nursing program. The study used a randomized control group pretest-posttest design. Students in the experimental group experienced significant reductions in cognitive and somatic anxiety, along with an increase in self-efficacy and improved performance. Tai-chi can be an effective technique to reduce anxiety and improve self-efficacy and performance among nursing students in simulations.
Clinical learning in the first semester of nursing school is often challenging and difficult for students to assimilate multiple subjects while applying clinical skills. One college of nursing created a first semester simulation experience that helped students to enhance clinical reasoning by aligning content in multiple courses, allowing for application of information, and linked clinical skills learned each week to the concept of total patient care. The resulting change to course structure combined basic physical assessment and fundamental nursing care to one course allowing students to understand the application of assessment to nursing practice and skill.
Registered nurses (RNs) are national assets who provide quality patient care, especially during the corona virus disease 2019 pandemic. Currently, healthcare organizations are overwhelmed with ill patients who require RNs with specialty experiences. Curtailment and cancellation by healthcare organizations of civilian and military transition-to-practice programs for newly licensed RNs are at risk. If this phenomenon continues, current and future nursing shortages will prevail.
Background: COVIDTrach is a UK multi-centre prospective cohort study project evaluating the outcomes of tracheostomy in patients with COVID-19 receiving mechanical ventilation. It also examines the incidence of SARS-CoV-2 infection among healthcare workers involved in the procedure.
Method: An invitation to participate was sent to all UK NHS departments involved in tracheostomy in mechanically ventilated patients with COVID-19. Data was entered prospectively and clinical outcomes updated over time via an online database (REDCap). Clinical variables were compared with clinical outcomes using multivariable regression analysis, with logistic regression used to develop a prediction model for mortality. Participants recorded whether any of the operators tested positive for SARS-CoV-2 within two weeks of the procedure.
Findings: The cohort comprised 1605 tracheostomy cases from 126 UK hospitals. The median time from intubation to tracheostomy was 15 days (IQR 11, 21). 285 (18%) patients died following the procedure. 1229 (93%) of the survivors had been successfully weaned from mechanical ventilation at censoring and 1049 (81%) had been discharged from hospital. Age, inspired oxygen concentration requirement on the day of tracheostomy, PEEP setting, pyrexia, number of days of ventilation before tracheostomy, C-reactive protein and the use of anticoagulation and inotropic support independently predicticted mortality. Six reports were received of operators testing positive for SARS-CoV-2 within two weeks following the procedure.
Interpretation: Tracheostomy appears to be safe in mechanically ventilated patients with COVID-19 and to operators performing the procedure and we identified clinical indicators that are predictive of mortality. Optimal timing of the procedure remains to be determined.
Funding: The COVIDTrach project is supported by the Wellcome Trust UCL COVID-19 Rapid Response Award and the National Institute for Health Research.
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