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Aim: The aim of this scoping review is to synthesise current evidence around the clinical skill development of preregistration registered nurses (RNs) in Australia, United Kingdom (UK), Ireland, United States (US), Canada and New Zealand, to inform nurse education, policy and clinical practice. Background: Nursing is a practical profession, and registered nurses require specific skills, knowledge and attributes in order to care for patients safely. The context for health care delivery is shifting, and the education of nurses must adapt to effectively equip the registered nurse of the future. Design: A scoping review was conducted of clinical skill development in preregistration nurses. CINAHL Plus, MEDLINE, Health Source (Nursing/Academic edition) and Scopus were searched. Included studies were primary Australian studies and international literature reviews, which focussed on preregistration nursing education. Papers were written in the English language and focussed on clinical skill development. Results were synthesised narratively. The review is reported here in accordance with the Preferred Reporting Items for Systematic Review and Meta‐analyses Scoping Review extension (PRISMA‐ScR) guidelines. Results: One hundred fifty‐five Australia studies and 89 international reviews were included in the review. Six key themes were identified, namely clinical skills, approaches to teaching and learning, interprofessional education, assessment of learning, clinical placement and simulation. Conclusion: There is substantial variation in strategies and programmes to facilitate clinical skill development both within Australia and internationally, indicating a genuine shift away from traditional didactic pedagogy. New graduate registered nurses were expected to be "work‐ready," albeit at a novice level, when they enter the workplace. Future research should consider measures of impact on actual clinical practice and focus on developing work‐ready graduates for the range of clinical settings in which they may practice. Educators, policymakers and educational institutions can use these findings to inform curriculum developments to ensure that clinical skill development is evidence‐based. [ABSTRACT FROM AUTHOR]

Background: The role of stroke nurses in patient selection and administration of recombinant tissue plasminogen activator (rt‐PA) for acute ischaemic stroke is evolving. Objectives: To compare differences in stroke nurses' practices related to rt‐PA administration in Australia and the United Kingdom (UK) and to examine whether these differences influence rt‐PA treatment rates. Methods: A cross‐sectional, self‐administered questionnaire administered to a lead stroke clinician from hospitals known to provide rt‐PA for acute ischaemic stroke. Chi‐square tests were used to analyse between‐country differences in ten pre‐specified rt‐PA practices. Non‐parametric equality of medians test was used to assess within‐country differences for likelihood of undertaking practices and association with rt‐PA treatment rates. Reporting followed STROBE checklist. Results: Response rate 68%; (Australia: 74% [n = 63/85]; UK: 65% [n = 93/144]). There were significant differences between countries for 7/10 practices. UK nurses were more likely to: request CT scan; screen patient for rt‐PA suitability; gain informed consent; use telemedicine to assess, diagnose or treat; assist in the decision for rt‐PA with Emergency Department physician or neurologist; and undergo training in rt‐PA administration. Reported median hospital rt‐PA treatment rates were 12% in the UK and 7.8% in Australia: (7.8%). In Australia, there was an association between higher treatment rates and nurses involvement in 5/10 practices; read and interpret CT scans; screen patient for rt‐PA suitability; gain informed consent; assess suitability for rt‐PA with neurologist/stroke physician; undergo training in rt‐PA administration. There was no relationship between UK treatment rates and likelihood of a stroke nurse to undertake any of the ten rt‐PA practices. Conclusion: Stroke nurses' active role in rt‐PA administration can improve rt‐PA treatment rates. Models of care that broaden stroke nurses' scope of practice to maximise rt‐PA treatment rates for ischaemic stroke patients are needed. Relevance to clinical practice: This study demonstrates that UK and Australian nurses play an important role in thrombolysis practices; however, they are underused. Formalising and extending the role of stroke nurses in rt‐PA administration could potentially increase thrombolysis rates with clinical benefits for patients. [ABSTRACT FROM AUTHOR]

Aims: To explore the experiences of strategic leads for nurse education as they sought to respond to the COVID‐19 pandemic. Design: We utilised a qualitative interpretative approach to explore education leaders' experiences of leading during the early months of the pandemic. Methods: Nineteen leaders with significant strategic responsibility for nurse education in Australia, Canada, New Zealand, Singapore and the United Kingdom were identified via purposive sampling and agreed to participate. Interviews were held between May and July 2020. Results: Four overarching themes arose from the analysis: (1) Crisis driven adaptability & flexibility; (2) Responsive, complex and changing communication; (3) Making decisions for student and staff safety; (4) Looking to the future; stronger partnerships. Conclusion: Internationally, while nursing education leaders faced different problems, they shared a common goal amidst the crisis to remain student‐centred. They demonstrated they were able to face major challenges, respond to large scale logistical problems and make decisions under significant and ongoing pressure. Impact: In responding to the pandemic, nurse leaders shared knowledge and offered mutual support. This bodes well for future collaboration. The move to online learning accelerated an existing trend and it seems likely that this will continue. Given the pressures they experienced over an extended period, the sector may wish to consider how it prepares and supports existing and future leaders. [ABSTRACT FROM AUTHOR]