Sheila Grossman

Integrating Spirituality into Undergraduate Nursing Curricula

Nursing programs have done a commendable job keeping pace with the rapid advances in disease management. Yet, spirituality has received far less attention in nursing curricula (Keefe, 2005) and nursing students often do not have a strong foundation in this area. The purpose of this project was to integrate spirituality into the undergraduate nursing curricula and measure student outcomes related to spiritual knowledge and attitudes. Nursing faculty participated in a spirituality education program and followed this with sessions focused on integration of spiritual content into individual nursing courses. Student pre and post-tests were administered using a standard instrument to evaluate the effectiveness of the program. Significant differences in spirituality knowledge and attitudes among senior-level nursing students (t = -3.059, p = .004) were revealed. As the healthcare system becomes increasingly complex, providing students with tools to identify and strengthen inner resources is essential to patient care.

Integration of End-of-Life Care Content in Undergraduate Nursing Curricula: Student Knowledge and Perceptions

Studies indicate that nurses spend more time with patients at the end of life than any other health care discipline (K. M. Foley & H. Gelband, 2003). So it is imperative that nurses be educated so they can provide this high-quality end-of-life care. The purpose of this project was to provide a current state of end-of-life nursing education in the literature and to report on end-of-life knowledge and experiences of two groups of nursing students in one small, liberal arts university. A total of 111 undergraduate students (61 sophomores and 50 seniors) were administered a 50-item, multiple-choice test to determine their baseline knowledge about end-of-life care. Sophomore scores ranged from 20% to 86% with a mean of 60.98 (SD = 11.83). Senior pretest scores ranged from 70% to 96% with a mean of 83.26 (SD = 6.6). An independent samples t test was conducted to determine if there was a difference in group mean knowledge between sophomore and senior students. Levenes test for equality of variance was significant (F = 4.22, P < .05); thus, a t test with equal variance assumed revealed a significant difference between sophomore and senior group means (t = -10.44, P < .001). The review of literature and student knowledge and experience assessment resulted in the development of a model of end-of-life curriculum integration implemented at the university and sets the stage for future program evaluation studies.

Validation of the End-of-Life Nursing Education Consortium Knowledge Assessment Test: An Abbreviated Version

The need for improved nursing knowledge about end-of-life care is well documented; however, efficient measures to evaluate knowledge attainment from end-of-life training programs are lacking. The authors tested a 50-item version of an original 109-item knowledge assessment tool developed by the End-of-Life Nursing Education Consortium. Items with highest item-to-total correlations were selected to represent each of the nine domains in the original instrument. One hundred forty-one graduate and undergraduate nursing students pretested the shorter version. Thirty graduate students also completed the original version. Item analysis, equivalence, and internal consistency estimates were conducted to evaluate the validity of the 50-item version. Scores on the 109-item and 50-item versions were highly correlated (r = 0.92), and the total scale internal consistency estimate for the 50-item version surpassed the 0.80 standard (Kudar Richardson [KR] 20 = 0.84). Item difficulty and discrimination indices suggest that the revised version should discern knowledge attainment across varied achievement levels. Pretest scores were well below the 80% target for mastery among graduate students in practice and support the ongoing need for end-of-life education. The results support the utility of the shorter version to assess baseline end-of-life knowledge. Further testing is needed to demonstrate its usefulness in end-of-life program evaluation.

Managing the Threat of Methicillin- Resistant Staphylococcus Aureus in Home Care

Severe fatal complications such as pneumonia, cutaneous abscesses, empyema, necrotizing fasciitis, and sepsis can result from methicillin-resistant Staphylococcus aureus (MRSA) even for healthy people. An overview of managing the threat of MRSA in home care is presented. The home healthcare nurse can be proactive with MRSA infections by following and teaching strict medical asepsis while assessing the slightest signs and symptoms indicating that a patient is deteriorating or not responding to the prescribed antibiotic or wound care. This article aims to increase awareness of community-acquired (CA)-MRSA, to offer suggestions for preventing CA-MRSA, and to describe methods for managing this infectious process in the home.

Development of the palliative care of dying critically Ill patients algorithm: implications for critical care nurses

Critical care nurses need more practice in caring for dying critically ill patients because most have had little experience. Fifty senior nursing students during their critical care nursing course participated in simulations and case study analyses regarding dying critically ill patients/families. Findings indicate that mean posttest scores from the End-of-Life Nursing Education Consortium-Knowledge Assessment Test were statistically significantly higher than the pretest scores (t = 11.31; P < .0001). Ten (20%) of the students had dying critically ill patients whom they cared for in their concurrent rotations, and 25 (50%) additional students gave palliative care to chronically ill terminal patients on other units. The average perceived level of comfort working with patients likely to die doubled by the end of the course. The Palliative Care of Dying Critically Ill Patients Algorithm, consisting of 10 steps (from identifying an advanced directive to communicating a patient plan), was developed to assist nurses in providing comprehensive palliative care. In addition, 3 complex case studies are presented for use in critical care educational programs. Simulation, case study analyses with expert feedback, and role play can facilitate both student nurses’ and critical care nurses’ improved comfort in caring for critically ill patients who will likely die.

Transforming Doctoral Education Through the Clinical Electronic Portfolio

The DNP is a terminal degree focusing on the preparation of expert clinicians with advanced leadership, evidence-based practice, and systems management skills. An electronic clinical portfolio (e-portfolio) allows students to showcase their individual experiences, provides an objective measure of their achievement, and demonstrates integration of the core doctoral competencies within each specialty. The purpose of this article was to describe the development of an e-portfolio and provide general guidelines for successful implementation and evaluation.