Nurses' Perspectives on the Implementation of Knowledge in Clinical Practice: A Qualitative Study.

Objective: Nursing education institutions globally have issued calls for mentorship to address the nursing faculty shortage; however, little is known about the current state of mentorship for faculty members in Canadian schools of nursing. The purpose of this study is to describe the current state of mentorship in Canadian schools of nursing and explore definitions and goals of mentorship programs, mentorship models and components, and mentorship evaluation.Methods: A qualitative descriptive study was conducted. Within the Canadian Association of Schools of Nursing there are 81 English-speaking schools of nursing and 2,284 permanent faculty members spread over four regions. Participants were recruited from the 81 schools of nursing through the CASN newsletter list serve and publically accessible email addresses. Inclusion was limited to English speaking faculty. Purposive sampling aimed to capture variation across rank and tenure, school, size and areas within Canada. Semi-structured interviews were utilized to explore the participant’s (n = 48) perspectives and involvement with mentorship. Interviews were audio-recorded and transcribed verbatim. NVivo was used to code and analyze the data for significant statements and phrases, which were organized into themes and sub-themes.Results: Mentorship remains largely informal in nursing academia without common definitions or goals. Current mentorship in nursing academia employed dyad, peer, group, constellation, and distance mentorship models. Common mentorship program components included guidelines, training, professional development workshops, purposeful linking of mentors and mentees, and mentorship coordinators. Evaluation of mentorship in nursing academia, where it exists, remains mostly descriptive, anecdotal, and lacks common evaluative metrics.Conclusions: Our results confirm mentorship in Canadian schools of nursing remains largely informal. In developing mentorship programs, academic leaders need to consider the mentorship models and components to meet their specific needs. Further rigorous evaluation of mentorship programs and components is needed to identify if mentorship programs are achieving specified goals.

Objective: In this study, we evaluated the feasibility of monthly insulin dose adjustments for students with type 1 diabetes mellitus (T1DM) through collaboration between pediatric diabetes clinic and school nurses. Methods: We conducted a single-arm adaptive feasibility trial with 30 students from a culturally diverse low-income community. School nurses were trained to download glucose meters and insulin pumps. Outcomes measures included the rate of glucose meter/insulin pump downloads occurred versus planned. We conducted 2 focus groups (N = 23) to seek feedback from school and clinic nurses on the collaboration and used content analysis to identify common themes. Results: The rate of glucose meter/insulin pump downloads was 27%. Feasibility obstacles were grounded in lack of time for nurses and psychosocial stressors in the community. We found a trend toward better diabetes control during the school year versus summer. We identified better communication between the school and clinic nurses and ongoing diabetes education for school nurses as strengths of the pilot. Conclusion: We propose shared clinic visits, care coordination, and behavioral health support as directions for future programs. Our findings provide directions for policy development to strengthen school nurse collaboration with diabetes clinics and improve care of students with T1DM from culturally diverse low-income communities.

ABSTRACTObjective:To identify factors that can be targeted to promote the standardized management of proper limb positioning and improve the rehabilitation outcomes of patient.Method:A qualitative descriptive study was conducted using semi-structured face-to-face in-depth interviews with 24 clinical nurses working in stroke-related departments between April and May 2024. Based on the COM-B model, the data were analyzed by employing the deductive content analysis method using the NVivo12 software and manual coding.Results:Analysis revealed 11 themes and 22 sub-themes associated with the four domains of the COM-B model, including 15 barriers and 7 facilitators.Conclusion:Clinical nurses' adherence to proper limb positioning is dynamic and positioning should address barriers related to capability, opportunity, and motivation, such as prioritize knowledge and skills training for clinical nurses, improved compliance among patients and caregivers, establish robust systems and supervisory mechanisms, and support scientific research and innovation to explore intelligent management solutions.

Who is sensitising whom? A participatory interview guide development as an awareness tool within a health care research project

To define the criteria for the continuity of care to elderly people submitted to arthroplasty. This is a qualitative study, inserted in the constructivist paradigm, whose methodological option fell on research-action. The participants were the health professionals of an orthopedic service and of the community care teams in the area of the hospital. The different techniques allowed us to identify the difficulties in the safe transition from the hospital to the community. At this level, two categories of criteria for continuity of care emerged: criteria associated with the risk of ineffective management of the therapeutic regimen, and criteria associated with the knowledge and level of competence of the informal caregiver. An elderly person undergoing arthroplasty (hip or knee) has functional alterations that affect their capacity for self-care and may lead to dependence, our findings allowed the design of an algorithm to facilitate clinical decision making and promote a safe hospital-community transition.

BackgroundConfident Body, Confident Child (CBCC) is an innovative, evidence-based program providing parenting strategies to promote healthy eating, physical activity and body satisfaction in children aged 2–6 years. This study aimed to explore Child Health Nurse (CHN) experiences with using CBCC in their community health clinics with parents of young children. This work is part of a larger study involving tailoring, implementing and evaluating CBCC in a community child health setting.MethodsThis qualitative descriptive study was conducted within community child health centres at a public health service in Queensland, Australia. Participants included CHNs who had recently attended a tailored CBCC training workshop providing training/education, group activities/discussions and CBCC resources for CHN use in clinical practice. Semi-structured interviews were conducted to explore CHN perceptions of CBCC training, content and resources; and how CBCC was used in practice. Interviews were recorded and transcribed verbatim and analysed thematically.ResultsEleven CHNs participated in interviews, with three themes emerging from the data. In Theme 1, High CHN satisfaction with CBCC messages, resources and utility, nurses expressed CBCC was highly valuable, useful and easy to enact in their practice. In Theme 2, Effects of CBCC on CHN knowledge, behaviour and practice, CHNs said they experienced increased awareness around body image, improved confidence in addressing issues with clients, and positive changes in their own behaviour and practice after attending CBCC training. In Theme 3, CHNs discussed Ideas for future implementation of CBCC, including challenges and considerations for practice, ongoing education/training for CHNs and broadening the target audience for wider CBCC dissemination.ConclusionsThis study found CHNs were highly accepting of CBCC as it was useful and valuable in practice, increased their awareness and confidence around body image issues, and positively affected their attitudes and behaviours. CHNs’ suggestions for making CBCC delivery more efficient and broadening its reach in the community were valuable and will likely inform local policy and future research. Further research is required on the wider dissemination of CBCC to parents of young children for promoting positive body image and healthy eating, ultimately for the long-term prevention of eating disorders.

This study aims to explore and evaluate postgraduate student experiences of a perinatal mental health education programme and to explore the value of collaborative learning within an interprofessional group. Evidence highlights the need for accessible mental health care during the perinatal period from educated and skilled healthcare professionals. Until recently, there has been a lack of emphasis on perinatal mental health care provision and a subsequent lack of education and training in the area for healthcare professionals. A qualitative descriptive research study was conducted to evaluate an interprofessional approach to perinatal mental health education. A purposive sample of postgraduate healthcare professionals (n = 10) who completed the first year of the Master of Science in Perinatal Mental Health programme or who had completed relevant standalone modules, at a Higher Education Institute in Ireland, participated in the study. Data collection were conducted via four online small-group discussions and thematic analysis was utilised to analyse the narrative data. Three themes illustrate participants' experiences of the perinatal mental health programme: Learning with other professionals, Enhanced confidence for clinical practice and Challenges of the programme. By undertaking the perinatal mental health programme/modules participants were provided with opportunities to engage in interprofessional education. The programme offered opportunities for developing networking relationships which continued into clinical practice. Participants acknowledged the benefits of the programme in acquiring specialist knowledge and skills regarding the spectrum of perinatal mental health enhancing clinical assessment, communication, and confidence in care provision.

The purpose of this methodology paper is to describe an approach to qualitative design known as qualitative descriptive that is well suited to junior health sciences researchers because it can be used with a variety of theoretical approaches, sampling techniques, and data collection strategies. It is often difficult for junior qualitative researchers to pull together the tools and resources they need to embark on a high-quality qualitative research study and to manage the volumes of data they collect during qualitative studies. This paper seeks to pull together much needed resources and provide an overview of methods. A step-by-step guide to planning a qualitative descriptive study and analyzing the data is provided, utilizing exemplars from the authors' research. This paper presents steps to conducting a qualitative descriptive study under the following headings: describing the qualitative descriptive approach, designing a qualitative descriptive study, steps to data analysis, and ensuring rigor of findings. The qualitative descriptive approach results in a summary in everyday, factual language that facilitates understanding of a selected phenomenon across disciplines of health science researchers.

To describe nurses and ward managers' experiences with nursing leadership in the implementation of evidence-based practice. The implementation of evidence-based practice requires to identify the most suitable styles of nursing leadership for the successful application. A qualitative descriptive study. The study was carried out with 57 nurses (clinical nurses and ward managers) in eight focus groups from five public hospitals. Template analysis, using the Promoting Action on Research Implementation in Health Services framework, was used. The Consolidated Criteria for Reporting Qualitative Research guide was followed in planning and reporting this research. Three types of nursing leadership were identified: traditional leadership, medium leadership and transformational leadership. Traditional leadership was the most frequent, with a predominance of bureaucratic tasks for ward managers, so implementation of evidence-based practice is difficult. Nurses do not feel empowered and they perceive the changes as an imposition. In the absence of strong leadership for evidence-based practice, a natural leader emerges. Clinical nurses demand more empowerment for decision-making, and ward managers need clarity of roles. To create an environment favourable to evidence-based practice, it is necessary consider the role of the transformational leader.

BackgroundSurviving children born at 23 gestational weeks are a growing population. As many of these children face developmental challenges during childhood and adolescence, more knowledge is needed about the everyday life of this group. The parental perspective is important, as developmental problems often pose a challenge for the parents. The aim of this qualitative study was to explore mothers’ experiences of parenting children born at 23 gestational weeks and of the children’s everyday lives.MethodsThis was a qualitative descriptive study conducted with mothers of children born at 23 weeks of gestation. These purposively sampled eight mothers were interviewed using a semi-structured interview. Thematic analysis was used to analyse the interviews.ResultsSeven themes were formed on the basis of the interview data and they are presented in three dimensions: 1) the child seen from maternal perspective included themes ‘emphasizing strengths in the midst of challenges’, ‘relations with peers and siblings’, and ‘emotional well-being and active life’; 2) the parenting experience included themes ‘intensive mothering’ and ‘gratitude’; 3) the support included themes ‘support from the social network’ and ‘support from society’.ConclusionsThe mothers described how the lives of their children were active and rich. The mothers were dedicated to motherhood and they also expressed feelings of gratitude. Mothers received support from social networks and from society. This qualitative study provided an important complementary perspective to the discussion on extremely premature children’s quality of life. It also highlighted the importance of parental perspectives in assessing neonatal care and its outcomes.

Patients play a crucial role in healthcare, and their involvement before surgery has been associated with shorter intensive care unit (ICU) stays and faster recovery following cardiac surgery. To explore the experiences and perspectives of patients and nurses regarding patient involvement in the cardiovascular surgery ICU using a qualitative descriptive approach. This qualitative descriptive study was conducted in the cardiovascular surgery ICU of a regional hospital between September and November 2024. The study included 12 postoperative patients and 12 nurses selected through purposive sampling. Data were collected through in-depth interviews, semi-structured interviews guided by the COREQ (Consolidated Criteria for Reporting Qualitative Research) checklist. To ensure rigor and trustworthiness, strategies such as investigator triangulation, peer debriefing, reflexivity, and field notes were used during data collection and analysis. Data were analyzed using Creswell’s five-step thematic analysis framework. The analysis of interviews with patients and nurses revealed five main themes: (1) barriers to patient involvement (2), impact on patient health outcomes (3), impact on nurses (4), practices to enhance patient involvement, and (5) recommendations to improve patient involvement. Patients’ previous passive roles in hospital settings and vulnerability in the ICU hindered their active participation. This study revealed that patient involvement in care within the cardiovascular surgery intensive care unit is strengthened by effective communication, trust, collaboration, and nursing support. The findings emphasize the importance of adopting participatory approaches in nursing practice to enhance patient-centered care.

IntroductionThe Quality Improvement in Colonoscopy (QIC) study was a region wide service improvement study that aimed to improve adenoma detection rate (ADR), and thusly quality in colonoscopy, through implementation of...

Chinese oncology nurses’ experience on caring for dying patients who are on their final days: A qualitative study

Explore leadership self-perception of clinical nurses at the bedside and their perception of leadership on patient care and outcomes. According to Institute of Medicine Future of Nursing Report, nurses are called to exhibit leadership at every level. Published research on nursing leadership is primarily focused on formal leaders. Research examining leadership at the clinical nurse level has either tested application of a particular leadership model or studied nurses who have been identified as informal clinical leaders. We took an inductive approach without any prior knowledge if participating clinical nurses viewed themselves as leaders. Descriptive qualitative method was used. Four focus groups were conducted with a total of 20 clinical nurses from 2 hospitals within an integrated health system using a convenience sampling method until saturation was reached. The Consolidated criteria for Reporting Qualitative research (COREQ) was used to report findings. All participants identified qualities they admired in leaders. Fifty percent did not initially view themselves as leaders until they realised that they often demonstrated those same leadership qualities in providing nursing care to patients and families. Participants struggled to make a connection between their leadership at the bedside and patient outcomes. Clinical nurses assume a formal title is required to be a leader. Findings from this study imply that leadership attributes required at point of care are embedded in the nursing practice and look similar to servant leadership. Leadership is in the nature of nursing practice, and more work is required to increase awareness that every nurse is a leader. Further efforts need to be pursued to help clinical nurses become self-aware they are leaders in order to impact patient outcomes and transform health care from bottom-up and inside-out.

Marian K. Shaughnessy, DNP, RN