Cristina Petrucci

European nursing students' academic success or failure: A post-Bologna Declaration systematic review

OBJECTIVES The aim of this systematic review is to synthesise the available evidence in the European scientific literature produced after the Bologna Declaration and to evaluate studies that quantify and examine the factors associated with the academic success or failure of nursing students. DESIGN A systematic review of the literature was conducted. DATA SOURCES Major health literature databases were searched for studies published from 2000 to 2011. REVIEW METHODS This review includes only European observational studies that were submitted to a quality assessment by two researchers before inclusion. RESULTS Only five studies were included in this review. There are discordant results regarding the predictors of success or failure, which were common objects of study (gender, age, qualification on entry, ethnic group). other factors were studied individually (student personality, gendered view of nursing careers, intention to leave, family commitments, working while on course, student performance, clinical learning environment) need to be confirmed in additional studies. Although the predictors may be relevant at the local level, given their low external validity and the conflicting results, it is not possible to state with certainty that these factors are effectively predictive of success or failure in the context of post-Bologna Declaration Europe. CONCLUSIONS This review showed that over the last ten years, in the European context, only a few high-quality observational studies have been performed. In this regard, given the small number and heterogeneity of the available studies, there is little useful evidence available for Higher Education Institutions (HEIs) to effectively address the problem. In the future, European researchers should focus not only on the documentation of the predictors but also on the documentation of the outcomes produced by the HEI strategies that have been implemented to prevent avoidable academic failure and contain physiological academic failure.

Percutaneous and mucocutaneous exposures in nursing students: an Italian observational study.

PURPOSE To investigate occupational exposures to biological material potentially infected by blood-borne viruses in nursing student population during the course years. DESIGN AND METHODS An observational retrospective study was designed. Data were collected in May 2007. Two-thousand-two-hundred-fifteen nursing students from the 3 years of degree course were enrolled in the four Italian universities. A structured questionnaire was constructed and was given out unannounced to nursing students in four universities on a randomly chosen day. The likelihood of association between nursing student exposure and certain assumed risk factors was measured. FINDINGS The exposure risk is associated with each study year of nursing students. Specifically, the probability of accidental exposure is reduced significantly with the increase of clinical skills during the training period. The risk for exposure in the 1st year students appears significantly higher than in those of the next years (odds ratio [OR] 1.465; 95% confidence interval [CI] 1.105-1.943). Data highlighted a gradual increase of bio-safety knowledge in nursing students from the 1st to the 3rd years of study. However, a statistically significant association exists only between awareness of a correct use of gloves and exposure risk (OR 0.435; 95%CI 0.227-0.834). Mucocutaneous exposures are more frequent than percutaneous exposures (62.2%), and the hollow-bore needle is the device most often involved. In 42.5% of cases, accidental exposures occurred when nursing students are working alone in a medical ward or surgery area. CONCLUSIONS During their clinical training, nursing students can encounter a real risk for percutaneous and mucocutaneous exposures to blood potentially infected with blood-borne viruses. However, this risk is reduced with an increase in clinical skills. CLINICAL RELEVANCE Results show that some new strategies are necessary for exposure risk reduction such as development of simulation laboratories for nursing practice and the adequate presence of tutors in clinical training education.

Academic success or failure in nursing students: Results of a retrospective observational study

BACKGROUND Nursing student academic failure is a phenomenon of growing international interest, not only because of its economic impact but also because it negatively affects the availability of future nurses in different healthcare systems. To recruit the students with the highest probability of academic success, an open challenge for universities is to recruit students who have previously demonstrated superior scholastic aptitudes that appear to be associated with a greater likelihood of academic success. Documenting the relationship between the selection methods used when selecting nursing students and academic failure will contribute to the international debate concerning the optimisation of the selection strategies. OBJECTIVES The principal aim of this study was to investigate the role in predicting nursing student academic success of (1) the upper-secondary diploma grades and (2) the score obtained by students in the nursing degree program admission test. DESIGN A retrospective observational study was conducted. PARTICIPANTS AND METHODS Five cohorts of nursing students, matriculated in consecutive academic years from 2004 to 2008, in an Italian bachelors degree program were observed retrospectively. RESULTS Overall, 61.2% of the 1006 considered students concluded their degree within the legal duration allowed for the nursing degree. Students who failed were those who had lowest grades associated with their upper-secondary diploma coursework (p=0.000) and were male (p=0.000). The grades associated with the upper-secondary diploma coursework, unlike the admission test score, correlates positively with the final degree grade and the average value of degree program examination scores. No correlation was found between the upper-secondary diploma coursework grades and the scores obtained in the test for the nursing degree program admission test (r=-0.037). CONCLUSIONS These results suggest that upper-secondary diploma coursework grades are a parameter that should receive great consideration, especially in cases where there are planned numbers of incoming nursing degree students.

Ethical difficulties in nursing, educational needs and attitudes about using ethics resources:

Ethical difficulties arise in healthcare practices. However, despite extensive research findings that demonstrate that most nurses are involved in recurrent ethical problems, institutions are not always able to effectively support nursing care professionals. The limited availability of ethics consultation services and traditional nursing training fails to meet the frequent and strong requests by health workers to support their ethical dilemmas. A questionnaire was administered to 374 nurses attending a specialist training and a lifetime learning programme in Italy. The respondents reported a high frequency of ethically sensitive situations, and they described the poor development of ethics support and a scarcity of ethics training programmes. The results suggest the importance of promoting ethics services that include consultation and ethics training. A need for systematic ethics educational activities was identified for improving the capacity of nurses to manage ethical issues in patient care.

Empathy in health professional students: A comparative cross-sectional study

BACKGROUND It has been shown that empathy strengthens the relationship between patients and health professionals and also improves patient and health professional satisfaction, which helps promote the best clinical outcomes. Empathy is considered an essential prerequisite for a nurse to effectively care for a patient and for a holistic understanding of a patients perspective in a student population. OBJECTIVES The main aim was to compare empathy levels between health professional students attending different university courses. DESIGN A comparative study with a cross-sectional approach was conducted in two successive academic year cohorts of 1st year health professional students at a public Italian university. PARTICIPANTS AND METHODS A sample of 1st year health professional students at a public Italian university was investigated using the Jefferson Scale of Empathy Health Professional Students version (JSE-HPS). RESULTS Overall, 502 health professional students were included in the study. The students in nursing showed significantly higher empathy levels than the students in other health professions. Furthermore, the female students were found to exhibit significantly more overall empathy than the male students were. CONCLUSIONS The undergraduate nursing students showed a significantly higher mean score of empathy measured by the Jefferson Scale of Empathy Health Professional Students version (JSE-HPS) than the students attending other health undergraduate courses. This could mean that a particular aptitude in establishing a help-relationship with other people exists among the students that choose to become a nurse.

Literature-Based Analysis of the Potentials and the Limitations of Using Simulation in Nursing Education

“Simulation,” in terms of its application in nursing education, is the imitation and replication of some of, or nearly all, the fundamental aspects of a clinical situation to strengthen comprehension and teach best practices.

Sleep and Quality of Life in People With COPD: A Descriptive-Correlational Study.

Sleep disorders are very common in patients with chronic obstructive pulmonary disease (COPD). However, it is not clear how sleep disorders and quality of life (QoL) affect each other in the different stages of disease progression. This descriptive-correlational study investigated the relationship between QoL, quality of sleep, and degree of disease progression in 102 outpatients with COPD. The results showed that the QoL in patients with COPD is compromised and worsens with disease progression, and the quality of sleep is significantly associated with QoL and worsened as the disease progressed. The early identification of a risk of alteration of the quality of sleep, especially in nursing care, could facilitate a preventive approach for COPD patients that could positively affect their QoL.

Complexity of care: a concept analysis.

BACKGROUND In spite of the high number of tools designed to measure the complexity of care, there is still great diversity in the meaning of this concept. METHODS The study was carried out using the concept analysis method as described by Beth Rodgers; 27 international papers were selected using PubMed, Web of Science and CINAHL data sets, without any time constraints. RESULTS A number of similar concepts relating to multiplicity, intensity of care and workload were selected. The antecedents were classified according to personal and clinical features of patients, the characteristics of care, the social and organizational features; the tools that emerged measure the risk of complexity of care. Among the consequences, those that emerged were related to patients, operators and organization. The two attributes of complexity of care are connected with measurement, on the one side, and uncertainly, on the other. CONCLUSIONS As difficult as it is to define complexity of care, the analysis states that its classification should be targeted at redefining hospital organization.

The concept of care complexity: a qualitative study.

Background: Hospital organisations based on the level of care intensity have clearly revealed a concept, that of care complexity, which has been widely used for decades in the healthcare field. Despite its wide use, this concept is still poorly defined and it is often confused with and replaced by similar concepts such as care intensity or workload. This study aims to describe the meaning of care complexity as perceived by nurses in their day-to-day experience of hospital clinical care, rehabilitation, home care, and organisation. Design and methods Fifteen interviews were conducted with nurses belonging to clinical-care areas and to heterogeneous organisational areas. The interview was of an unstructured type. The participants were selected using a propositional methodology. Colaizzi’s descriptive phenomenological method was chosen for the analysis of the interviews. Results: The nurses who were interviewed predominantly perceive the definition of care complexity as coinciding with that of workload. Nevertheless, the managerial perspective does not appear to be exclusive, as from the in-depth interviews three fundamental themes emerge that are associated with the concept of care complexity: the patient, the nurse and the organisation. Conclusions: The study highlights that care complexity consists of both quantitative and qualitative aspects that do not refer only to the organisational dimension. The use of the terminology employed today should be reconsidered: it appears to be inappropriate to talk of measurement of care complexity, as this concept also consists of qualitative – thus not entirely quantifiable – aspects referring to the person being cared for. In this sense, reference should instead be made to the evaluation of care complexity, which would also constitute a better and more complete basis for defining the nursing skills required in professional nursing practice. Significance for public health In recent years, reference to the concept of complexity has become increasingly frequent in the management of healthcare systems. This interpretation of reality and of knowledge reflects the increasing use of a multi-disciplinary approach, in both clinical and research fields, that re-evaluates the importance of the environment and the preferences of the individual. The influence of the epistemological theory of complexity in healthcare can also be identified in discussions on the role and methods of epidemiology and public health; in breaking the walls between the exact sciences and the humanities; in the appreciation of qualitative methods of research and the Bayesian approach to biostatistics.

The public perception of nurses. An Italian cross-sectional study

Abstract Background and aim: The public opinion about the nursing profession can influence health service users, the work performance of nurses, health policies, and the choice to become a nurse. The aim of this study was to investigate the perception of nursing in modern society. Methods: A cross-sectional study was conducted with a sample of 398 participants belonging to four population groups: Very Important Persons (VIPs), general population, upper-school students, and nursing students. This phenomenon was assessed through the Nursing Attitude Questionnaire (NAQ) and several additional items. Results: The results highlighted that general population and nursing students showed a significantly better image of nurses than did VIPs and upper-school students. Conclusions: Overall, the sample acknowledged nurses fundamental connotations and functions, although secondary school students poorly recognized nurses’ professional autonomy, and VIPs’ judgements seemed to be more sensitive to the image of nurses given by mass media.