Lynn L. Wiles

Integrative simulation: a novel approach to educating culturally competent nurses.

Nursing education faces many challenges as a result of the population ’s increased cultural diversification. Of primary importance is the need to prepare culturally competent nurses to provide care in both urban and remote rural areas. This paper presents a HRSA funded program that utilises simulations to provide culturally diverse learning opportunities for both university-based and distance learning students. Cases are developed using focus groups and individual interviews. The information is used with standardised patients to develop vignettes that are loaded into a web-based virtual hospital where students conduct interviews with culturally diverse patients. The information obtained during the interview is then used to provide hands-on care to a high performance simulator (simulated mannequin). The encounters are videotaped for use in debriefing sessions with the students, for educational programs in the classroom, and for video-streaming to web-based distance students. Students in the debriefing sessions and classroom participate in a review of the videotape using the Personal Response System to respond to question. Through the culturally enhanced integrated simulation, students have an opportunity to address clinical situations and the impact of culture in a relatively safe non-threatening environment where the impact of their biases can be explored.

Management of Respiratory Syncytial Virus With Lower Respiratory Tract Infection in Infants and Children

Respiratory syncytial virus (RSV) is the leading cause of lower respiratory tract infection in infants and children requiring pediatric hospitalizations. Infants with chronic lung, cardiac, or neuromuscular conditions are at increased risk for RSV infection. Early RSV is associated with subsequent diagnosis of reactive airway disease. The management of RSV with lower respiratory track infection in infants and children remains controversial. Bronchodilators may have some short-term benefit, but are not recommended as standard practice for infants and children. Antiviral therapy may be used for high-risk and severely ill patients. Corticosteroids may be effective in cases of moderate to severe RSV with lower respiratory track infection. Monoclonal antibodies have shown some promise in achieving passive immunity for those at greatest risk, including preterm infants younger than 1 year or infants younger than 2 years with chronic lung disease. Emergency management remains primarily supportive, with vigilant monitoring of oxygenation and hydration status. Interventions include supplemental oxygen therapy, ventilation, and fluid and nutrition therapy. Respiratory syncytial virus prophylaxis for high-risk patients includes intramuscular injections of palivizumab (Synagis) each month during RSV season, from November through April. Prevention strategies include washing hands, cleaning environment surfaces, and isolating infants and children with RSV in the emergency care area.

Bringing Learning to Light: Innovative Instructional Strategies for Teaching Infection Control to Nursing Students

Abstract Infection control practices are at the forefront of education and compliance monitoring. A university-funded grant allowed faculty and instructional designers to create an experience that increased student awareness, application, and appreciation of infection-control concepts. Computer-based instruction modules are used to provide content, and students participate in a simulation that allows them to apply their newly learned skills in a realistic, immersive environment with a biosphere used to visually depict infectious spread. Student feedback suggests the usefulness of this methodology as a teaching strategy that reinforces evidence-based practice, critical thinking, and clinical judgments.

Keep It Clean: A Visual Approach to Reinforce Hand Hygiene Compliance in the Emergency Department

PROBLEM Although hand hygiene strategies significantly reduce health care-associated infections, multiple studies have documented that hand hygiene is the most overlooked and poorly performed infection control intervention. METHODS Emergency nurses and technicians (n = 95) in a 41-bed emergency department in eastern Virginia completed pretests and posttests, an education module, and two experiential learning activities reinforcing hand hygiene and infection control protocols. RESULTS Posttest scores were significantly higher than pretest scores (t (108) = -6.928, P = .048). Hand hygiene compliance rates improved at the conclusion of the project and 3 months after the study (F (2, 15) = 9.89, P = .002). IMPLICATIONS FOR PRACTICE Interfaces with staff as they completed the interactive exercise, as well as anecdotal notes collected during the study, identified key times when compliance suffered and offered opportunities to further improve hand hygiene and, ultimately, patient safety.

The APN-PLACE Telehealth Education Network: Legal and Regulatory Considerations

Telehealth technology can enhance nursing clinical education by allowing for virtual site visits, preceptor support, preceptor education, and student oversight. The Advance Practice Nurse-Preceptor Link and Clinical Education (APN-PLACE) Telehealth Education Network is a new and innovative video communication system that connects schools of nursing to preceptors and clinical practice sites. Specific areas of focus include preceptor education and support, student assessment, and clinical experiences when implementing a telehealth education network. As with in-person, or traditional, clinical education, it is important to consider the legal and regulatory issues related to the use of telehealth programs in clinical education. This article presents a telehealth preceptor support network and provides an overview of the associated legal and regulatory issues surrounding its use in advanced practice registered nurse clinical education.

The promise and perils of a weekend nursing program.

In 1996, a weekend nursing program was created as an addition to the traditional weekday schedule to accommodate an increased number of qualified applicants seeking admission to the baccalaureate nursing program. Five years after the inception of the program, a comprehensive evaluation study was conducted to examine the impact of the weekend course schedule on students and faculty. The opportunities and challenges associated with the implementation of an alternative program schedule for entry-level nursing students are presented.