The purpose of this study was to determine the effect of an international service-learning experience in Honduras on the cultural competence of the participants. The study included a quantitative portion in which participants utilized the Cultural Competence Assessment instrument as a pretest-posttest evaluation of change in cultural competence, and a qualitative portion in which students discussed their feelings about the experience. The quantitative portion showed an increase in cultural competence behaviors following the experience. The qualitative portion resulted in four themes that emerged from the interviews: a) stepping outside my world, b) connecting with culturally different people, c) awe of community, and d) learning innovation. These results indicate that the international service-learning experience was successful in increasing the participants' ability to provide culturally congruent care.
The Script Concordance Test (SCT) has been used successfully in medical schools to assess clinical reasoning in medical students, but it has not been widely used in nursing education. The purpose of this study was to provide additional evidence of the validity and reliability of the SCT in evaluating clinical reasoning in nursing students by replicating a previous study. The test was administered to 48 first-year Bachelor of Science in Nursing students. A scoring grid was developed using the aggregate scores method based on the modal responses of 13 panel members. The reliability of the scores was measured by Cronbach's alpha coefficient, and the scores of the students and the panel were compared using a t test. The difference between the panel's and the students' scores was statistically significant, and the reliability of the scores is high. The SCT provides a reliable, standardized, and easy-to-administer method of evaluating clinical reasoning in nursing students.
The aim of this review is to evaluate the application of value-added processes in healthcare, with an emphasis on their effects on bedside nursing. Literature relevant to Lean methodology and inpatient care was reviewed, excluding all research related to other service lines (i.e., surgical services, emergency services, laboratory, radiology, etc.). Increased value is also an important tenet of transforming care at the bedside (TCAB), an initiative launched by the Institute for Healthcare Improvement (IHI) and the Robert Wood Johnson Foundation (RWJF). Therefore, articles concerning TCAB were also included in this review. A systematic study of the literature revealed varied applications of Lean principles in practice, ranging from the implementation of a single tool, to full organizational restructuring. All articles reviewed reported positive results, although the majority lacked strong supporting evidence for claims of improvement. Even though there is some indication that the application of Lean principles to nursing processes is successful in improving specific outcomes, the authors cannot conclude that the implementation of Lean methodology or TCAB greatly influences direct patient care, or increases time spent at the bedside.
Stakeholders include: hospital administrators, nurse leaders, direct-care nurses, acute care and primary care clinicians, patients, caregivers, community agencies, health sciences educators and insurers.
Introduction: The Emergency Nurses Association and the American Heart Association support family presence during adult resuscitation (FPDAR). The purpose of this study was to evaluate the attitudes of registered nurses and staff regarding FPDAR in the emergency department (ED). Methods: A convenience sample of ED registered nurses and staff was carried out using a questionnaire-based survey. The survey queried respondents on experience with family presence during invasive procedures, including resuscitation, and perceived barriers and facilitators to FPDAR in the ED. Results: Seventy-nine surveys were analyzed. Sixty-five percent of the respondents had participated in FPDAR in the past year and 82% indicated they supported FPDAR. Barriers included families interference during resuscitation and increased levels of stress on the emergency resuscitation team. Discussion: Despite fear of families interfering and increased stress, most ED registered nurses and staff support FPDAR. There is a need for education to increase understanding of FPDAR.
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