Search

Objectives To evaluate knowledge, beliefs, and practices regarding delirium of physicians, nurse practitioners ( NPs), and registered nurses ( RNs). Design Anonymous cross-sectional paper survey. Setting New York metropolitan area tertiary care hospital. Participants RNs, NPs, and physicians (N = 164). Measurements The survey assessed knowledge, beliefs, and practices regarding delirium and prior delirium or geriatric training. Results Of the 200 surveys distributed, 164 were completed (82% response rate). Of these, 61.7% were RNs, 13.6% were NPs, and 20.7% were physicians. Mean participant age was 36.3. The majority (80.1%) were female; 56.5% were white, 18.1% Asian, 8.7% Hispanic, 8.0% black, and 8.7% other. Of the seven potential barriers to delirium screening assessed, the three most frequently reported were lack of conceptual understanding of delirium (48.0%), similarity of delirium and dementia (41.4%), and the fluctuating nature of delirium (38.1%). Physicians were more likely than NPs and RNs to report being confident in identifying delirium ( P = .002) and to score higher on the delirium knowledge assessment ( P < .001). Participants who received geriatrics training were significantly more likely than those who did not to be confident in identifying delirium ( P = .005) and to score higher on overall delirium knowledge assessment ( P = .003). Conclusion Geriatric training is associated with more confidence in delirium screening and higher delirium knowledge scores. There is an urgent need to broaden the approach to delirium education of nurses and physicians caring for hospitalized older adults using comprehensive multidisciplinary geriatric educational models. [ABSTRACT FROM AUTHOR]

Background/aim The successful development and maintenance of professional identity is associated with professional development and retention in the health workforce. This paper explores students' perspectives on the ways pre-entry experiences and curricula content shape professional identity. Methods An online cross-sectional survey was sent to students enrolled in the final year of entry-level programmes in five countries. Descriptive statistical analyses of data were completed. Results The results reflect the perceptions of 319 respondents from five countries. Respondents identified professional education (98%) and professional socialisation during placement (92%) as curricula components with the greatest influence on professional identity formation. Discipline-specific knowledge such as, occupation-focussed models and occupational science were ranked lower than these aspects of practice. The students' length of programme and level of entry-level programme did not impact on these results. Conclusion When designing curricula educators need to be mindful that students perceive practice education and professional socialisation have the greatest affect on professional identity formation. The findings reinforce the need for curricula to provide students with a range of practice experiences, which allow the observation and application of occupation-based practices. It highlights a need for educators to provide university-based curricula activities, which better prepare students for a potential dissonance between explicit occupation-based curricula and observed practice education experiences. The study indicates the need for further research into the role curricula content, and in particular practice education, plays in the multidimensional formation of professional development within entry-level programmes. [ABSTRACT FROM AUTHOR]

ABSTRACT Background Nurse-led (protocol-directed) ventilation weaning ( NLVW) is utilized in adult intensive care and has shown to be safe and reduce ventilation times. Our paediatric intensive care unit ( PICU) implemented a NLVW (and extubation) protocol in 2004, yet it was observed that some NLVW-trained nurses were not undertaking the role in practice. Aims To explore PICU nurses' and doctors' perceptions of and barriers to NLVW on a UK PICU, with the aim of facilitating more NLVW on our PICU by reducing these barriers. Methods A cross-sectional electronic survey was used to collect data from both nurse ventilation weaners and all medical staff and advanced nurse practitioners ( ANPs) on one PICU. Results Our survey response rates were 90% (36/40) nursing and 54% (20/37) medical. The four top reasons cited for nurses not being able to wean by protocol were not being allocated to a 'weanable' patient, being in an in-charge or runner role, high clinical workload and a perceived lack of support from medical staff/ ANPs. The restrictive nature of our protocol also emerged as a key issue by all staff. The medical survey revealed an overwhelming positive response to NLVW with 90% believing that experienced PICU nurses should be allowed to wean ventilation. In contrast to the nurses perceived lack of support or encouragement for NLVW, medical staff rated their encouragement for the nurses to undertake this role as high. Conclusions NLVW is a complex process, and factors that impair or facilitate this process relate not only to the weaning protocol itself, but also organizational processes and structural factors in a PICU. Relevance to clinical practice This paper highlights the complexities involved in instituting and establishing a nurse-led, protocol-driven ventilation weaning process within a PICU. Further, in depth research is required to examine both PICU nurses and doctors attitudes to NLVW both in the UK and across Europe. [ABSTRACT FROM AUTHOR]