Nurses Perceptions regarding Current Skills in Minimizing Patient Aggression at a selected Psychiatric hospital in Lesotho

Background: Meta-analysis of international literature indicate high frequencies of aggression in a mental health setting. Several studies indicate that among professional health workers, nurses are more likely than other staff members to experience aggressive incidences from patients. Furthermore, based on cause, nurses apply a range of interventions in managing aggression, however, despite the perceived value of their intervention in managing aggression, no single intervention is sufficient for handling aggressive patients to stay in control in wards. Despite high priority placed on patient aggression management, insufficient research studies have been conducted on nurses perceptions regarding current skills in minimizing patient aggression. Objectives: The purpose of the study was to describe nurses perceptions regarding current assessment skills in minimizing patient aggression at a selected Psychiatric hospital. Methodology: Non-experimental, exploratory, descriptive research design was used to guide the research process. An all-inclusive sampling method was used with 119 nurses as respondents. Data was collected by means of a questionnaire, analyzed using SPSS version 25. Descriptive statistics procedure was used to present the findings of the study. Results: A minority of respondents, (n=27) 22.7% agreed that their current assessment skills for minimizing patients aggression were good compared to the majority of respondents, (n=92) 77.3%, who expressed a different opinion. This suggests that there are limited current assessment skills in identifying high-risk aggressive patients in a selected Psychiatric hospital. Conclusion: The findings of the study indicate that there are limited current assessment skills in minimizing patients aggression at selected Psychiatric hospital. Therefore, there is a need to provide comprehensive information on nurses current skills in minimizing patients aggression to obtain richer information.

Making waves: nurse-led urgent community response

Anyone in England over 18 whose health or wellbeing suddenly deteriorates at home will have access to an urgent community response (UCR) team within 2 hours by April 2022. Community nursing services are providing the core service model to provide these crisis response services. Nurse leads from three UCR accelerator sites (Kirklees, Warrington and Bromley) elaborate on how they are making waves of change for the better, using their clinical skills and building key relationships with other health services. Acutely unwell patients are being seen by practitioners with advanced assessment skills, which keeps eight out of 10 patients at home safe, avoiding hospital admission.

proposal for developing mathematics self-study capabilities in Vietnam highschool

In terms of general learning and Mathematics study, in particular, self-study ability is a fundamental element to promote learning efficiency. The research objective focuses on Proposing specific measures for developing the math self-study ability of high school students. Secondly, the research result reveals 5 methods for developing math self-study ability of high school students in Vietnam, including (1) Fostering motivation, attitude, sense of self-study, nurturing passion and forming knowledge about Math self-studying for students through field trips or extra-curricular activities; (2) Applying objective tests as a tool to examine and evaluate students' self-study at home; (3) Training and developing students' self-instructed math skills in terms of finding and reading documents of the specific content of Mathematics and skills in listening, communicating and taking notes in class; (4) Designing and organizing for students learning activities in the direction of practising scientific research; (5) Fostering and improving student’s self-assessment skills, mistakes correction after each process of studying a specific content. The final part of the study will discuss several issues and solutions that need to be considered when putting these teaching Mathematics measures into practice at Vietnamese high schools.

Blended learning in a health assessment course: A mixed-methods study

Objective: The purpose of this study was to get students’ perceptions about changes made to the health assessment course delivery format from face to face to blended learning (BL). Health assessment is a foundational course in nursing undergraduate programs. Research has suggested that students have high levels of satisfaction with a blended learning format.Methods: A survey was used to gather students’ perceptions about changing a health assessment course from face-to-face delivery format to a blended learning format. All second year BSN students who were registered for the course (N = 88) were invited to participate in the survey at the end of the semester.Results: Most students in this study preferred face to face course delivery. Qualitative results were grouped together into themes: 1) Engagement, 2) E-learning tool, and 3) Confidence. Opinions were mixed concerning the e-learning materials that were used. Overall, students felt they were confident in their assessment skills as they prepared to enter the clinical environment.Conclusions: Findings from this study will impact methods of teaching health assessment and other nursing courses in the future.

Exploring hospital nurses’ transitional medication management for older patients with multi-morbidity: An ethnographic study

Transitional medication management, in which individual needs are balanced against organizational priorities, is crucial for safe discharge processes. The aim of this study was to explore hospital nurses’ transitional medication management in the discharge of older patients with multi-morbidity. Using an ethnographic approach the data were collected through participant observations at a mixed medical ward at a Danish university hospital for two weeks. The participants were five registered nurses, responsible for nursing care of 23 patients with multi-morbidity and planned for discharge. The data comprised field notes that were analysed using iterative processes of domain, taxonomic and component analysis. The reporting adhered to the COREQ checklist. Hospital nurses’ transitional medication management was characterized by unpredictability and inconsistency in patient situations, fragmentation and discontinuity in working processes and complexity in communication systems. Special attention to nurses’ needs assessment skills and clinical decision making in caring for patients with multi-morbidity in a single focused healthcare system is required.

Hospice Care for Veterans: A Community Education Program

The impact of trauma on care at end of life and the social isolation of the COVID-19 pandemic highlighted a critical gap in care of terminally ill veterans. It is estimated that 30% of Vietnam Veterans suffer from PTSD, suicide rates are 49% higher in older veterans than nonveterans, and 41% of veterans surveyed report post traumatic guilt. A survey of non-VA hospice agencies revealed many do not screen for PTSD, but desired training in this area. The VA responded to these challenges implementing an initiative to educate community caregivers on PTSD, suicide, and moral injury with expanded tele mental health services. Several VA sites were supported to participate in training focusing on PTSD, suicide, and moral injury and Telemental health. In Northeast Ohio, from 2019-20, 11 community hospice agencies participated in training, including 283 providers,120 (42%) nurses, 100 (35%) social workers, 29 (10%) volunteers, and 34 (12%) other. A majority of participants post-training (n=160) (84%-94%) reported enhanced knowledge, skills, or attitudes related to resources, education, and communication. Participants rated changes for assessment skills lowest for moral injury (34%), PTSD (41%), and suicide (56%). An analysis of telemental health visits (N=50) revealed that, 56% addressed spiritual support, (22%) family support, (10%) resources/referrals, and (8%) confusion. The majority of telehealth visits were VA initiated (84%), and 10% were hospice initiated Continued education regarding PTSD, suicide, and moral injury assessment skills is still needed for hospice care providers of veterans. These findings support the use of telemental health for care and consultation.

Improving Student Pharmacists' Learning Through the Use of Pediatric Simulation

OBJECTIVE The purpose of this study was to assess the effect of low-fidelity simulation on students' confidence, knowledge, and skills in pediatric physical assessments, and to compare students' interest ratings of topics and effectiveness of learning activities between students' who experienced simulation and those who did not. METHODS Within a pediatric elective, a vital signs and physical assessment activity was re-designed to incorporate a low-fidelity heart and breath sounds simulator. Students rated their confidence in completing 9 different physical assessment skills before and after the activity and assessment. Students' perspectives of the activity were also assessed. Course evaluation surveys were compared with prior course offerings (without simulation) to determine a change in students' interest ratings of the topic and effectiveness of learning activities. The Wilcoxon signed rank test, thematic analysis, and descriptive statistics were used to analyze outcomes. RESULTS All 106 second professional year students in the elective completed the pre- and post-simulation surveys and course evaluations for 3 offerings. Students' post-simulation average confidence scores increased statistically on all 9 skills compared with pre-simulation scores. All students agreed or strongly agreed “the lecture and simulation activity done in class helped me overcome challenges I had with learning the skill.” Students (98%) successfully demonstrated competency on the formal assessment. Compared with previous course offerings, students reported higher interest ratings in the topics and instruction effectiveness when simulation was incorporated into the activity. CONCLUSIONS Low-fidelity simulation is an effective teaching and learning approach to increase students' confidence, knowledge, and interest in pediatric vital signs and physical assessment.

Nursing students’ development of using physical assessment in clinical rotation—a stimulated recall study

Background The overall aim of this study was to explore third-year bachelor nursing students’ stimulated recall reflections on their physical assessment competence development. The choice of learning strategies in nursing education seems to have great impact on nursing students’ use of physical assessment skills while in clinical rotation. There is a need to explore nursing students’ learning processes related to the use of physical assessments. Methods Explorative qualitative design using a triangulation of data collection methods. Nine final-year nursing students’ physical assessment performances during patient encounters were audio-taped and observed. Shortly after, an individual stimulated recall interview based on the audio-recorded patient encounter and observation notes was conducted. A two-fold analysis was conducted: 1) analysis of students’ performed assessments, and 2) a meaning condensation analysis of the stimulated recall interviews. Results 1) Students’ assessments shifted from a checklist approach to a symptom-based approach, and they emphasized conversation as part of their assessments. 2) Through the stimulated recall interviews, students described reasons for using physical assessments in patient encounters, how the learning environment facilitated or hindered their use of physical assessments, and their own learning strategies. Conclusions Findings contribute a novel, in-depth description of what influenced nursing students’ learning processes of using physical assessment during clinical rotation. This study reveals the importance of designing and implementing learning activities in practical and theoretical courses to support and strengthen students’ learning processes. Further, findings suggest that stimulated recall as a reflective practice should be used systematically to enhance clinical reasoning skills and thus provide deep learning. A more targeted course design for physical assessment— building on and emphasizing nursing students’ prior knowledge and competence—may lead to more confident registered nurses and promote patient safety in different health care contexts.