Search results for: control over nursing practice
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 15100

Search results for: control over nursing practice

15040 The Effect of Nursing Teamwork Training on Nursing Teamwork Effectiveness

Authors: Manar Ahmed Elbadawy

Abstract:

Background: Empirical evidence suggested that improving nursing teamwork (NTW) may be the key to reducing medical error. The functioning nursing teams require open communication, mutual respect, and shared mental models to activate quality patient care. The complexity and the high demands for specialized nursing knowledge and skill also require nursing staff to consult with one another and work in teams regularly. The current study aimed to evaluate the effect of the nursing teamwork training program on nursing teamwork effectiveness. Design: A quasi-experimental (one group pretest-posttest) design was utilized. Three medical intensive care units at a teaching hospital affiliated to Cairo University Hospital, Egypt. Subjects: A convenient sample of 48 nursing staff worked at the selected units. The Nursing Teamwork Observational Checklist was used. Results: Total (NTW) mean scores exhibited quite elevation post-program implementation compared to preprogram and showed little decrease 3 months later ( = 2.52, SD = ± 0.27, mean % =51.98, = 2.72, SD = ± 0.20, mean %=72.45, = 2.67, SD = ± 0.11, mean %= 67.48 respectively). Conclusion: Implementation of (NTW) training program had a positive effect on increasing (NTW) effectiveness. Regular and frequent short-term teamwork training is important to be introduced as well as sustainable monitoring is required to ensure nursing attitudes, knowledge and skills’ change about teamwork effectiveness.

Keywords: effectiveness, nursing, teamwork, training

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15039 Developing Telehealth-Focused Advanced Practice Nurse Educational Partnerships

Authors: Shelley Y. Hawkins

Abstract:

Introduction/Background: As technology has grown exponentially in healthcare, nurse educators must prepare Advanced Practice Registered Nurse (APRN) graduates with the knowledge and skills in information systems/technology to support and improve patient care and health care systems. APRN’s are expected to lead in caring for populations who lack accessibility and availability through the use of technology, specifically telehealth. The capacity to effectively and efficiently use technology in patient care delivery is clearly delineated in the American Association of Colleges of Nursing (AACN) Doctor of Nursing Practice (DNP) and Master of Science in Nursing (MSN) Essentials. However, APRN’s have minimal, or no, exposure to formalized telehealth education and lack necessary technical skills needed to incorporate telehealth into their patient care. APRN’s must successfully master the technology using telehealth/telemedicine, electronic health records, health information technology, and clinical decision support systems to advance health. Furthermore, APRN’s must be prepared to lead the coordination and collaboration with other healthcare providers in their use and application. Aim/Goal/Purpose: The purpose of this presentation is to establish and operationalize telehealth-focused educational partnerships between one University School of Nursing and two health care systems in order to enhance the preparation of APRN NP students for practice, teaching, and/or scholarly endeavors. Methods: The proposed project was initially presented by the project director to selected multidisciplinary stakeholders including leadership, home telehealth personnel, primary care providers, and decision support systems within two major health care systems to garner their support for acceptance and implementation. Concurrently, backing was obtained from key university-affiliated colleagues including the Director of Simulation and Innovative Learning Lab and Coordinator of the Health Care Informatics Program. Technology experts skilled in design and production in web applications and electronic modules were secured from two local based technology companies. Results: Two telehealth-focused APRN Program academic/practice partnerships have been established. Students have opportunities to engage in clinically based telehealth experiences focused on: (1) providing patient care while incorporating various technology with a specific emphasis on telehealth; (2) conducting research and/or evidence-based practice projects in order to further develop the scientific foundation regarding incorporation of telehealth with patient care; and (3) participating in the production of patient-level educational materials related to specific topical areas. Conclusions: Evidence-based APRN student telehealth clinical experiences will assist in preparing graduates who can effectively incorporate telehealth into their clinical practice. Greater access for diverse populations will be available as a result of the telehealth service model as well as better care and better outcomes at lower costs. Furthermore, APRN’s will provide the necessary leadership and coordination through interprofessional practice by transforming health care through new innovative care models using information systems and technology.

Keywords: academic/practice partnerships, advanced practice nursing, nursing education, telehealth

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15038 Quality Improvement Template for Undergraduate Nursing Education Curriculum Review and Analysis

Authors: Jennifer Stephens, Nichole Parker, Kristin Petrovic

Abstract:

To gain a better understanding of how students enrolled in a Bachelor of Nursing (BN) program are educated, faculty members in the BN program at Athabasca University (AU) in Alberta, Canada, developed a 3-phase comprehensive curriculum review project. Phase one of this review centered around hiring an external curriculum expert to examine and analyze the current curriculum and to propose recommendations focused on identifying gaps as well as building on strengths towards meeting changing health care trends. Phase two incorporated extensive institutional document analysis as well as qualitative and quantitative data collection in reciprocated critical reflection and has yielded insights into valuable processes, challenges, and solutions inherent to the complexities of undertaking curriculum review and analysis. Results of our phase one and two analysis generated a quality improvement (QI) template that could benefit other nursing education programs engaged in curriculum review and analysis. The key processes, lessons, and insights, as well as future project phase three plans, will be presented for iterative discussion and role modelling for other institutions undergoing, or planning, content-based curriculum review and evaluation.

Keywords: curriculum, education, nursing, nursing faculty practice, quality improvement

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15037 Effects of Gratitude Practice on Relationship Satisfaction and the Role of Perceived Superiority

Authors: Anomi Bearden, Brooke Goodyear, Alicia Khan

Abstract:

This repeated-measures experiment explored the effects of six weeks of gratitude practice on college students (N = 67) on relationship satisfaction and perceived superiority. Replicating previous research on gratitude practice, it was hypothesized that after consistent gratitude practice, participants in the experimental group (n = 32) would feel increased levels of relationship satisfaction compared to the control group (n = 35). Of particular interest was whether the level of perceived superiority would moderate the effect of gratitude practice on relationship satisfaction. The gratitude group evidenced significantly higher appreciation and marginally higher relationship satisfaction at post-test than the control group (both groups being equal at pre-test). Significant enhancements in gratitude, satisfaction, and feeling both appreciative and appreciated were found in the gratitude group, as well as significant enhancements in gratitude, satisfaction, and feeling appreciated in the control group. Appreciation for one’s partner was the only measure that improved in the gratitude group and not the control group from pre-test to post-test. Perceived superiority did not change significantly from pre-test to post-test in either group, supporting the prevalence and stability of this bias within people’s overall perceptions of their relationships.

Keywords: gratitude, relationship satisfaction, perceived superiority, partner appreciation

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15036 Applying Simulation-Based Digital Teaching Plans and Designs in Operating Medical Equipment

Authors: Kuo-Kai Lin, Po-Lun Chang

Abstract:

Background: The Emergency Care Research Institute released a list for the top 10 medical technology hazards in 2017, with the following hazard topping the list: ‘infusion errors can be deadly if simple safety steps are overlooked.’ In addition, hospitals use various assessment items to evaluate the safety of their medical equipment, confirming the importance of medical equipment safety. In recent years, the topic of patient safety has garnered increasing attention. Accordingly, various agencies have established patient safety-related committees to coordinate, collect, and analyze information regarding abnormal events associated with medical practice. Activities to promote and improve employee training have been introduced to diminish the recurrence of medical malpractice. Objective: To allow nursing personnel to acquire the skills needed to operate common medical equipment and update and review such skills whenever necessary to elevate medical care quality and reduce patient injuries caused by medical equipment operation errors. Method: In this study, a quasi-experimental design was adopted and nurses from a regional teaching hospital were selected as the study sample. Online videos instructing the operation method of common medical equipment were made and quick response codes were designed for the nursing personnel to quickly access the videos when necessary. Senior nursing supervisors and equipment experts were invited to formulate a ‘Scale-based Questionnaire for Assessing Nursing Personnel’s Operational Knowledge of Common Medical Equipment’ to evaluate the nursing personnel’s literacy regarding the operation of the medical equipment. From March to October 2017, an employee training on medical equipment operation and a practice course (simulation course) were implemented, after which the effectiveness of the training and practice course were assessed. Results: Prior to and after the training and practice course, the 66 participating nurses scored 58 and 87 on ‘operational knowledge of common medical equipment,’ respectively (showing a significant statistical difference; t = -9.407, p < .001); 53.5 and 86.3 on ‘operational knowledge of 12-lead electrocardiography’ (z = -2.087, p < .01), respectively; 40 and 79.5 on ‘operational knowledge of cardiac defibrillators’ (z = -3.849, p < .001), respectively; 90 and 98 on ‘operational knowledge of Abbott pumps’ (z = -1.841, p = 0.066), respectively; and 8.7 and 13.7 on ‘perceived competence’ (showing a significant statistical difference; t = -2.77, p < .05). In the participating hospital, medical equipment operation errors were observed in both 2016 and 2017. However, since the implementation of the intervention, medical equipment operation errors have not yet been observed up to October 2017, which can be regarded as the secondary outcome of this study. Conclusion: In this study, innovative teaching strategies were adopted to effectively enhance the professional literacy and skills of nursing personnel in operating medical equipment. The training and practice course also elevated the nursing personnel’s related literacy and perceived competence of operating medical equipment. The nursing personnel was thus able to accurately operate the medical equipment and avoid operational errors that might jeopardize patient safety.

Keywords: medical equipment, digital teaching plan, simulation-based teaching plan, operational knowledge, patient safety

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15035 Effects of a Nursing Intervention Program Using a Rehabilitation Self-Management Workbook on Depression, Motivation and Self-Efficacy of Rehabilitation Inpatients

Authors: Young Ae Song, So Yun Kim, Nan Ji Kim, So Young Jang, Yun Mee Park, Mi Jin Lee, Ji Yeon Lee

Abstract:

Background & Purpose: Many patients have psychological problems such as depression and anxiety during the rehabilitation period. Such psychological instability affects the prognosis of the patient in the long term. We develop a nursing intervention program for rehabilitation inpatients using a rehabilitation self –management note and evaluate the effects of the program on depression, motivation, and self-efficacy. Methods: The study was conducted using a nonequivalent control group non-synchronized design. Participants were rehabilitation inpatients, 27 patients in the control group and 20 in the experimental group. Questionnaires were completed three times (pretest, 5 days, 10 days) Final data for 40 patients were analyzed, 23 patients in the control group and 17 in the experimental group. Data were analyzed using x2-test, t-test, and repeated measure ANOVA. Results: Depression in the experimental group decreased compared to the control group, but it was not significant. The motivation for the experimental group changed significantly (F=3.90, p=.029) and self-efficacy increased, but not significantly (F=0.59, p=.559) Conclusion: Results of this study indicate that nursing intervention programs for rehabilitation inpatients could be useful to decrease depression and to improve motivation and self-efficacy.

Keywords: depression, motivation, self-efficacy, rehabilitation inpatient, self-management workbook

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15034 Perception of Nursing Care of Patients in a University Hospital

Authors: Merve Aydin, Mağfiret Kara Kaşikçi

Abstract:

Aim: To determine the perceptions of inpatients about care at Farabi Hospital in KTU. Material and Method: This research was conducted by using the universe known examples of formulas and probability selected by sampling method with 277 chosen patients in the hospital at least 14 days in other internal and surgical clinics except for pediatric, psychiatry, and intensive care unit services between January-March 2014 in KTU Farabi Hospital. The data was collected through the forms of nursing care perception scale of patients and defining characteristics of patients. In the evaluation of data, percentage, mean, Mann Whitney U, Student t and Kurskall Wallis tests were applied. Results: The average point the patients got in nursing care perception scale is 62.64±10.08’dir. 48.7 % of patients regard nursing care well and 36.8 % of them regard it very well. 19 % of the patients regard nursing care badly. When the age, sex, occupation, marital status, educational background, residential place, income level, hospitalization period, hospitalization clinic and having a hospital attendant were compared with nursing care perception average point, the difference among point averages was not found meaningful statistically (p > 0.05). The average point of nursing care perception was found greater in those having chronic disease (p < 0.05). Conclusion: The perception point of patients about nursing care is above the average according to the average of the lowest and highest points. The great majority of patients regard nursing care well or very well.

Keywords: hospital, patient, perception of nursing care, nursing care

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15033 The Perception on 21st Century Skills of Nursing Instructors and Nursing Students at Boromarajonani College of Nursing, Chonburi

Authors: Kamolrat Turner, Somporn Rakkwamsuk, Ladda Leungratanamart

Abstract:

The aim of this descriptive study was to determine the perception of 21st century skills among nursing professors and nursing students at Boromarajonani College of Nursing, Chonburi. A total of 38 nursing professors and 75 second year nursing students took part in the study. Data were collected by 21st century skills questionnaires comprised of 63 items. Descriptive statistics were used to describe the findings. The results have shown that the overall mean scores of the perception of nursing professors on 21st century skills were at a high level. The highest mean scores were recorded for computing and ICT literacy, and career and leaning skills. The lowest mean scores were recorded for reading and writing and mathematics. The overall mean scores on perception of nursing students on 21st century skills were at a high level. The highest mean scores were recorded for computer and ICT literacy, for which the highest item mean scores were recorded for competency on computer programs. The lowest mean scores were recorded for the reading, writing, and mathematics components, in which the highest item mean score was reading Thai correctly, and the lowest item mean score was English reading and translate to other correctly. The findings from this study have shown that the perceptions of nursing professors were consistent with those of nursing students. Moreover, any activities aiming to raise capacity on English reading and translate information to others should be taken into the consideration.

Keywords: 21st century skills, perception, nursing instructor, nursing student

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15032 The Difficulties Male Nurses Facing up Due to the Nurse Degree which has the Meaning of ‘Sister’ in Turkish

Authors: Hacer Erdöl, Merve Aydın, Hacer Kobya Bulut, Kıymet Yeşilçiçek Çalık

Abstract:

Like all occupations, nursing is significantly influenced by the society which it serves and it also affects it. Social structure affects attitudes of nurses, nursing practice, society's attitudes towards nursing and those who have chosen nursing as a profession. People who choose nursing schools take the views of the society’s they live in on nursing to nursing school. Until the 1960s, many nursing schools had not accepted men as students and women had received nursing education and profession had been carried out by women. In our country, in 2007 an amendment to article eight of Nursing Law was passed and with these changes men also began to be able to choose the nursing as a profession. In Turkish, nurse means 'sister'. Hence, in this study to determine the problems that male nursing students likely encounter at the clinic, non-clinical environment and in their private life regarding the title of nurse, among qualitative research methods phenomenological research design was used. Using purpose sampling method, a total of 18 voluntary male students-13 in third grade and 5 in fourth grade at nursing school- were taken to the study. Data were collected through interviews and by the ethical principles much attention was paid to ensure the confidentiality and to protect participants’ identity. During the interviews lasting 30-40 minutes on average, nine pre-configured standard questions were asked and when necessary free questions were also used in order to ensure the clarity of the responses. With pre- configured standard questions, the reasons why students chose the profession, the problems they had in clinical and non-clinical environment and the potential problems they might encounter in their private lives regarding the title of nurse were questioned. Content analysis was performed on data collected and three main themes were obtained. According to the findings of the evaluation of data, it was found that almost all the students preferred the profession due to possible work opportunities, there were students who did not bother nurse title as well as the ones who did bother and as the most important problem they might encounter in their private lives was to feel worried if their kids had to answer "What does your father" question as "my dad is a nurse" and being ridiculed afterwards. The results of this study show that studies should be done to change the social judgment stemmed from the recognition of nursing as a female profession and take advantage of media through creating public spotlight to accomplish this.

Keywords: choice of profession, the title of the profession, title problems, nursing

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15031 A Case Study on Experiences of Clinical Preceptors in the Undergraduate Nursing Program

Authors: Jacqueline M. Dias, Amina A Khowaja

Abstract:

Clinical education is one of the most important components of a nursing curriculum as it develops the students’ cognitive, psychomotor and affective skills. Clinical teaching ensures the integration of knowledge into practice. As the numbers of students increase in the field of nursing coupled with the faculty shortage, clinical preceptors are the best choice to ensure student learning in the clinical settings. The clinical preceptor role has been introduced in the undergraduate nursing programme. In Pakistan, this role emerged due to a faculty shortage. Initially, two clinical preceptors were hired. This study will explore clinical preceptors views and experiences of precepting Bachelor of Science in Nursing (BScN) students in an undergraduate program. A case study design was used. As case studies explore a single unit of study such as a person or very small number of subjects; the two clinical preceptors were fundamental to the study and served as a single case. Qualitative data were obtained through an iterative process using in depth interviews and written accounts from reflective journals that were kept by the clinical preceptors. The findings revealed that the clinical preceptors were dedicated to their roles and responsibilities. Another, key finding was that clinical preceptors’ prior knowledge and clinical experience were valuable assets to perform their role effectively. The clinical preceptors found their new role innovative and challenging; it was stressful at the same time. Findings also revealed that in the clinical agencies there were unclear expectations and role ambiguity. Furthermore, clinical preceptors had difficulty integrating theory into practice in the clinical area and they had difficulty in giving feedback to the students. Although this study is localized to one university, generalizations can be drawn from the results. The key findings indicate that the role of a clinical preceptor is demanding and stressful. Clinical preceptors need preparation prior to precepting students on clinicals. Also, institutional support is fundamental for their acceptance. This paper focuses on the views and experiences of clinical preceptors undertaking a newly established role and resonates with the literature. The following recommendations are drawn to strengthen the role of the clinical preceptors: A structured program for clinical preceptors is needed along with mentorship. Clinical preceptors should be provided with formal training in teaching and learning with emphasis on clinical teaching and giving feedback to students. Additionally, for improving integration of theory into practice, clinical modules should be provided ahead of the clinical. In spite of all the challenges, ten more clinical preceptors have been hired as the faculty shortage continues to persist.

Keywords: baccalaureate nursing education, clinical education, clinical preceptors, nursing curriculum

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15030 Knowledge, Awareness and Practices Concerning of Breast Cancer among Nursing Students in Sri Lanka

Authors: Vimarshi Sandamali Godigamuwa

Abstract:

Background: Breast cancer is the leading cause of cancer mortality in women worldwide. Its incidence is increasing and young women affected more than ever. Nursing students are the future nurses who will have the opportunity to encourage and influence women to be aware of breast cancers. Objectives: To determine the level of knowledge, awareness and practices concerning of breast cancer among Sri Lankan student nurses. Methods: A descriptive cross sectional study was conducted on 150 nursing students who are in their 2nd and 3rd year studies by distributing a standard self-administered questionnaire. The completed questionnaire were retrieved, graded and scored. Results: Mean age of the respondents was 24.27; (SD=1.66) years and ranged from 20-30 years. Most of the students were female which was 85%. 32% of nursing students scored below 55% for the questionnaire and only 7.3% had good overall knowledge and awareness of breast cancer. Out of 128 female students 89.9% were answered that they know how to perform Breast Self Examination (BSE), out of which 37% of them performed BSE regularly. Only 33% were aware of recommended age for BSE and 10% were knew the recommended age for mammography. 9.3% were aware of frequency for Clinical Breast Examination on 20-39 years of age group. Of the female participants, 11.7% reported positive family history of breast cancer. Conclusion: Nursing students should explore to health educational programs on regular basis on breast cancer and its screening methods. Further studies are needed to identify reasons for not practicing BSE.

Keywords: breast cancer, student nurses, knowledge, awareness, practice, BSE

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15029 Examining Factors Influencing Career Choice Among Young Muslim Arab Women in Nursing

Authors: Merav Ben Natan, Miriam Abo El Hadi, Fardus Zoubi

Abstract:

Aim: This study investigates the factors that motivate young Muslim Arab women to pursue nursing careers, focusing on the impact of nurse uniforms, the COVID-19 pandemic, and perceptions of nurses and the nursing profession. The aim is to draw insights that can inform policy strategies. Background: The global shortage of nursing professionals is a pressing concern, even in regions like Israel. Attracting and retaining young Muslim Arab women in nursing is essential for addressing this shortage. To better understand their career decisions, it is crucial to examine the influence of nurse uniforms, the pandemic, and perceptions related to nurses and the nursing profession. Methods: This cross-sectional study employed digital questionnaires, which were administered to 200 Muslim Arab women between the ages of 20 and 30 in Israel. Results: Only 29.2% of the participants indicated an interest in pursuing a nursing career. The study findings revealed a noteworthy positive correlation between the pandemic's impact and the intention to pursue nursing. Further analysis, using linear regression, elucidated the role of factors such as the white nurse uniform, perceptions of nurses, and the image of the nursing profession in influencing career choices in nursing. Discussion: This study underscores the significance of nurse uniforms, the image of nurses, and the perception of the nursing profession in shaping the career choices of young Muslim Arab women in nursing. Policy interventions should prioritize raising awareness about diverse nursing roles, expanding nurses' responsibilities, and highlighting their invaluable contributions to society.

Keywords: nursing image, uniform, nursing career, nurse profession

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15028 Effect of Simulation on Anxiety and Knowledge among Novice Nursing Students

Authors: Suja Karkada, Jayanthi Radhakrishnan, Jansi Natarajan, Gerald, Amandu Matua, Sujatha Shanmugasundaram

Abstract:

Simulation-based learning is an educational strategy designed to simulate actual clinical situations in a safe environment. Globally, simulation is recognized by several landmark studies as an effective teaching-learning method. A systematic review of the literature on simulation revealed simulation as a useful strategy in creating a learning environment which contributes to knowledge, skills, safety, and confidence. However, to the best of the author's knowledge, there are no studies on assessing the anxiety of the students undergoing simulation. Hence the researchers undertook a study with the aim to evaluate the effectiveness of simulation on anxiety and knowledge among novice nursing students. This quasi-experimental study had a total sample of 69 students (35- Intervention group with simulation and 34- Control group with case scenario) consisting of all the students enrolled in the Fundamentals of Nursing Laboratory course during Spring 2016 and Fall 2016 semesters at a college of nursing in Oman. Ethical clearance was obtained from the Institutional Review Board (IRB) of the college of nursing. Informed consent was obtained from every participant. Study received the Dean’s fund for research. The data were collected regarding the demographic information, knowledge and anxiety levels before and after the use of simulation and case scenario for the procedure nasogastric tube feeding in intervention and control group respectively. The intervention was performed by four faculties who were the core team members of the course. Results were analyzed in SPSS using descriptive and inferential statistics. Majority of the students’ in intervention (82.9%) and control (89.9%) groups were equal to or below the age of 20 years, were females (71%), 76.8% of them were from rural areas and 65.2% had a GPA of more than 2.5. The selection of the samples to either the experimental or the control group was from a homogenous population (p > 0.05). There was a significant reduction of anxiety among the students of control group (t (67) = 2.418, p = 0.018) comparing to the experimental group, indicating that simulation creates anxiety among Novice nursing students. However, there was no significant difference in the mean scores of knowledge. In conclusion, the study was useful in that it will help the investigators better understand the implications of using simulation in teaching skills to novice students. Since previous studies with students indicate better knowledge acquisition; this study revealed that simulation can increase anxiety among novice students possibly it is the first time they are introduced to this method of teaching.

Keywords: anxiety, knowledge, novice students, simulation

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15027 Investigation of the Opinions and Recommendations of Participants Related to Operating Room Nursing Certified Course Program

Authors: Zehra Gencel Efe, Fatma Susam Ozsayın, Satı Tas

Abstract:

Background and Aim: It is not possible to teach all the knowledge related to operating room nursing in the nursing education process. Certified courses are organized by the Ministry of Health to compensate the lack of postgraduate training and the theoretical and practical training needs of working nurses. In this study; It is aimed to investigate the participants’ opinions and recommendations attending the certified course of operating room nursing that organized in İKCU AtaturkTraining and Research Hospital. Method: Two operating room nursing courses were organized in 2016. The 1st Operating Room Nursing Certified Course Program was organized between March 07, 2016 and April 6, 2016and the 2nd Operating Room Nursing Certified Course Program was organized between 07 November 2016 - 06 December 2016 at the İKCU Ataturk Training and Research Hospital. The first program was accepted for 29 participants, the second program was accepted for 30 participants. In the collection of the data, the 'Operating Room Nursing Certified Training Program Evaluation Form', 'Operating Room Nursing Certified Training Program Theoretical Training Evaluation Form' were used. Three point Likert-type scale is used for responses in the 'Operating Room Nursing Certified Training Program Evaluation Form’ (1=verygood, 2=good, 3=poor). Data is collected in five areas related to training program, operation room practice, communication, responsibility, experiences of learning. Four point Likert-type scale is used for responses in the 'Operating Room Nursing Certified Training Program Theoretical Training Evaluation Form' (1=verysatisfied, 2=quitesatisfied, 3=satisfied, 4=dissatisfied). Data is collected in two areas include presentation and content. Data were analyzed with SPSS 16 program. Findings and Conclusion: It was found that 93,22% of participants were female in addition, 62,7% had bachelor degree. It was seen that 33,87% of the work group had 1-5 years of experience in their field. It was found that; 88% of trainees participating in the first group to the operating room nursing-certified course program stated the training program was very good, 12% of them stated the training program was good. Nobody was signed the ‘poor’ choice. 81% of the trainees who participated in the 2nd group to the operating room nursing-certified course program stated the training program was very good, 19% of them stated the training program was good. Nobody was signed the ‘poor’ choice. It was found that there was no meaningful difference between the achievement ratios of the trainees and the learning status of the trainees when compared with the t test in the groups with success level of the operating room nursing certified course program according to the learning status of the participants (p ˃ 0,05). The trainees noted that the course was satisfied with theoretical and practical steps but the support services (lunch, coffee breaks etc.) were in adequate.

Keywords: certified courses, nursing certified courses, operating room nursing, training program

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15026 The Developmental of Ethical Behavior of Nursing Students in Borommarajonani College of Nursing, Suratthani, Thailand

Authors: Ubonrattan Phophatanachai, Phensri Thongphet, Weerawan Kerdtong

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The purposes of this study were to compare the ethical behavior regarding responsibility and polite manners of nursing students of Boromarajonani College of Nursing, Suratthani, Thailand before and after providing the activity session of ethical behavior development. The samples consisted of 103 sophomores in the academic year 2006. The tools were tested for reliability and content validity. The reliability of the Ethical Behavior Questionnaire measured by Cronbach’s alpha coefficient was 0.94. Data were analyzed using means, standard deviations, and dependent t-test. The findings were as follows: a) after the activity session, the mean scores of ethical behavior regarding responsibility and polite manners of nursing students increased from middle level to high level; b) mean scores of responsibilities and polite manners after the activity session were significantly higher than those before the session (t =28.36, p < .001; t =23.9, p < .001, respectively).

Keywords: development of ethical behavior, nursing students, health, nursing informatics

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15025 A Comparison between Virtual Case-Based Learning and Traditional Learning: The Effect on Undergraduate Nursing Students’ Performance during Covid-19: A Pilot Study

Authors: Aya M. Aboudesouky

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Covid-19 has changed and affected the whole world dramatically in a new way that the entire world, even scientists, have not imagined before. The educational institutions around the world have been fighting since Covid-19 hit the world last December to keep the educational process unchanged for all students. E-learning was a must for almost all US universities during the pandemic. It was specifically more challenging to use online case-based learning instead of regular classes among nursing students who take practical education. This study aims to examine the difference in performance and satisfaction between nursing students taking traditional education and those who take virtual case-based education during their practical study. This study enrolls 40 last-year nursing undergraduates from a mid-sized university in Western Pennsylvania. The study uses a convenient sample. Students will be divided into two groups; a control group that is exposed to traditional teaching strategy and a treatment group that is exposed to a case-based teaching strategy. The module designed for this study is a total parenteral nutrition (TPN) module that will be taught for one month. The treatment group (n=20) utilizes the virtual simulation of the CBL method, while the control group (n=20) uses the traditional lecture-based teaching method. Student evaluations are collected after a month by using the survey to attain the students’ learning satisfaction and self-evaluation of the course. The post-test is used to assess the end of the course performance.

Keywords: virtual case-based learning, traditional education, nursing education, Covid-19 crisis, online practical education

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15024 Awareness in the Code of Ethics for Nurse Educators among Nurse Educators, Nursing Students and Professional Nurses at the Royal Thai Army, Thailand

Authors: Wallapa Boonrod

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Thai National Education Act 1999 required all educational institutions received external quality evaluation at least once every five years. The purpose of this study was to compare the awareness in the code of ethics for nurse educators among nurse educators, professional nurses, and nursing students under The Royal Thai Army Nurse College. The sample consisted of 51 of nurse educators 200 nursing students and 340 professional nurses from Army nursing college and hospital by stratified random sampling techniques. The descriptive statistics indicated that the nurse educators, nursing students and professional nurses had different levels of awareness in the 9 roles of nurse educators: Nurse, Reliable Sacrifice, Intelligence, Giver, Nursing Skills, Teaching Responsibility, Unbiased Care, Tie to Organization, and Role Model. The code of ethics for nurse educators (CENE) measurement models from the awareness of nurse educators, professional nurses, and nursing students were well fitted with the empirical data. The CENE models from them were invariant in forms, but variant in factor loadings. Thai Army nurse educators strive to create a learning environment that nurtures the highest nursing potential and standards in their nursing students.

Keywords: awareness of the code of ethics for nurse educators, nursing college and hospital under The Royal Thai Army, Thai Army nurse educators, professional nurses

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15023 Developing the Involvement of Nurses in Determining Health Policies

Authors: Yafa Haron, Hanna Adami

Abstract:

Background: World Health Organization emphasizes the contribution of nurses in planning and implementing health policies and reforms. Aim: To evaluate nursing students’ attitudes towards nurses’ involvement in health policy issues. Methods: Mixed-methods; qualitative and quantitative – a descriptive study. Participants - nursing students who were enrolled in their last year in the undergraduate program (BSN). Qualitative data included two open-ended questions: What is health policy and what is the importance of studying health policy, and 18 statements on the Likert Scale range 1-5. Results: Qualitativeanalysisrevealed that the majority of students defined health policy as a set of rules and regulations that defined procedures, borders, and proper conduct. 73% of students responded that nurses should be active in policymaking, but only 22% thought that nurses were currently involved in political issues. 28% thought that nurses do not have the knowledge and the time needed (60%) for political activity. 77% thought that the work environment did not encourage nurses to be politically active. Nursing students are aware of the importance towards nurses’ involvement in health policy issues, however, they do not have role models based on their low evaluation regarding nurses’ involvement in the health policy decision making process at the local or national level. Conclusions: Results emphasize the importance and the need of implementation the recommendation to include “advance policy changes” as core competency in nursing education and practice.

Keywords: health policy, nursing education, health systems, student perceptions

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15022 Comparative Study on Inhibiting Factors of Cost and Time Control in Nigerian Construction Practice

Authors: S. Abdulkadir, I. Y. Moh’d, S. U. Kunya, U. Nuruddeen

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The basis of any contract formation between the client and contractor is the budgeted cost and the estimated duration of projects. These variables are paramount important to project's sponsor in a construction projects and in assessing the success or viability of construction projects. Despite the availability of various techniques of cost and time control, many projects failed to achieve their initial estimated cost and time. The paper evaluate the inhibiting factors of cost and time control in Nigerian construction practice and comparing the result with the United Kingdom practice as identified by one researcher. The populations of the study are construction professionals within Bauchi and Gombe state, Nigeria, a judgmental sampling employed in determining the size of respondents. Descriptive statistics used in analyzing the data in SPSS. Design change, project fraud and corruption, financing and payment of completed work found to be common among the top five inhibiting factors of cost and time control in the study area. Furthermore, the result had shown some comprising with slight contrast as in the case of United Kingdom practice. Study recommend the adaptation of mitigation measures developed in the UK prior to assessing its effectiveness and so also developing a mitigating measure for other top factors that are not within the one developed in United Kingdom practice. Also, it recommends a wider assessing comparison on the modify inhibiting factors of cost and time control as revealed by the study to cover almost all part of Nigeria.

Keywords: comparison, cost, inhibiting factor, United Kingdom, time

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15021 Relationship between Deliberate Practice of Dribbling and Self-Regulatory Behavior of Male Basketball Players

Authors: Daud Abdia, Aqsa Shamim, Farhan Tabassum

Abstract:

In order to achieve specific goals, basketball players have to use different skills to enhance their motivation, one such skill is deliberate practice. The aim of this study was to explore the relationship between deliberate practice of dribbling and self-regulatory behavior of male basketball players. For this purpose, a sample of 108 basketball players using stratified sampling was taken from public and private sector universities. Sample was divided into two groups that are experimental (n=54) and control group (n=54) using comparative experimental design. Experimental group was involved in the training of deliberate practice of dribbling for 5 weeks. Amounts of weekly practice activity and Self-Regulation of Learning Self-Report Scale (SRL-SRS) were used for self-regulatory behavior to collect data after the deliberate practice. The reliability of amounts of weekly practice activity was found to be 0.852, whereas SRL-SRS was found to be 0.890. The results of the study indicated a strong positive correlation between deliberate practice of dribbling and self-regulatory behavior (r=0.755, n=54, p=.000). Whereas, paired sample t-test; t(53)=1.37, p < 0.005 shows statistically significant improvement in the self-regulatory behavior after the training program of deliberate practice from 3.02 ± 0.64m to 3.21 ± 0.75m (p < 0.005). It was concluded that in order to enhance the self-regulatory behavior of basketball players we should work on the deliberate practice of the players.

Keywords: self-regulatory behavior, deliberate practice, dribbling, basketball

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15020 Virtual Simulation as a Teaching Method for Community Health Nursing: An Investigation of Student Performance

Authors: Omar Mayyas

Abstract:

Clinical decision-making (CDM) is essential to community health nursing (CHN) education. For this reason, nursing educators are responsible for developing these skills among nursing students because nursing students are exposed to highly critical conditions after graduation. However, due to limited exposure to real-world situations, many nursing students need help developing clinical decision-making skills in this area. Therefore, the impact of Virtual Simulation (VS) on community health nursing students' clinical decision-making in nursing education has to be investigated. This study aims to examine the difference in CDM ability among CHN students who received traditional education compared to those who received VS classes, to identify the factors that may influence CDM ability differences between CHN students who received a traditional education and VS classes, and to provide recommendations for educational programs that can enhance the CDM ability of CHN students and improve the quality of care provided in community settings. A mixed-method study will conduct. A randomized controlled trial will compare the CDM ability of CHN students who received 1hr traditional class with another group who received 1hr VS scenario about diabetic patient nursing care. Sixty-four students in each group will randomly select to be exposed to the intervention from undergraduate nursing students who completed the CHN course at York University. The participants will receive the same Clinical Decision Making in Nursing Scale (CDMNS) questionnaire. The study intervention will follow the Medical Research Council (MRC) approach. SPSS and content analysis will use for data analysis.

Keywords: clinical decision-making, virtual simulation, community health nursing students, community health nursing education

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15019 Analysis of the Interventions Performed in Pediatric Cardiology Unit Based on Nursing Interventions Classification (NIC-6th): A Pilot Study

Authors: Ji Wen Sun, Nan Ping Shen, Yi Bei Wu

Abstract:

This study used Nursing Interventions Classification (NIC-6th) to identify the interventions performed in a pediatric cardiology unit, and then to analysis its frequency, time and difficulty, so as to give a brief review on what our nurses have done. The research team selected a 35 beds pediatric cardiology unit, and drawn all the nursing interventions in the nursing record from our hospital information system (HIS) from 1 October 2015 to 30 November 2015, using NIC-6th to do the matching and then counting their frequencies. Then giving each intervention its own time and difficulty code according to NIC-6th. The results showed that nurses in pediatric cardiology unit performed totally 43 interventions from 5394 statements, and most of them were in RN(basic) education level needed and less than 15 minutes time needed. There still had some interventions just needed by a nursing assistant but done by nurses, which should call for nurse managers to think about the suitable staffing. Thus, counting the summary of the product of frequency, time and difficulty for each intervention of each nurse can know one's performance. Acknowledgement Clinical Management Optimization Project of Shanghai Shen Kang Hospital Development Center (SHDC2014615); Hundred-Talent Program of Construction of Nursing Plateau Discipline (hlgy16073qnhb).

Keywords: nursing interventions, nursing interventions classification, nursing record, pediatric cardiology

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15018 Status and Image of the Nurse as Perceived by the Public

Authors: Salam Hadid, Mohammad Khatib

Abstract:

The International Council of Nurses-ICN defined nursing as a sphere integrating autonomous and collaborative care intended for the individual, family and community within and outside of the care setting. Nursing as a care profession has developed broadly over recent decades in terms of its essentials, expertise and primarily academically. Despite the impressive growth of the profession, there is still extreme diversity in the public’s perceptions and opinions of the profession and its professionals and in the knowledge on the fundamentals of its true function and spheres of engagement. The current study examines the existing knowledge among the general population regarding the nursing profession. The population consisted of 498 respondents, 236 women and 262 men, age 18-81. The respondents noted that nursing focuses on the technical, and the emotional aspects and promotion of health for the patient are not the nurse’s responsibility. Most of the respondents saw nurses working mainly in hospital and community-based clinic settings. They considered nursing to be a high prestige profession in general, but less prestigious among respondents exposed to healthcare provision. Most of the respondents considered nursing to be a humane profession but without independence and with no need for academic studies. The findings are incompatible with the definition of nursing and its spheres of action as defined in the ICN Code of Ethics. Two suggestions are to work through nursing schools addressing the student nurses, as ambassadors for the profession. The second is using the healthcare encounter between the nursing staff and the public to improve the image of nurses.

Keywords: ethics, nurse image, public, nursing

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15017 Scoping Review of the Barriers and Facilitators to Enabling Scholarly Activity within Canadian Schools of Nursing

Authors: Christa Siminiuk, Morgan Yates, Paramita Banerjee, Alison Curtis, Lysbeth Cuanda

Abstract:

This review looked at current evidence regarding barriers and facilitators to nursing scholarship within the content of Canadian Schools of Nursing. Nursing scholarship mainly referred to research, though other activities as described by Boyer’s Model were also discussed. This scoping review was done to assist the Langara School of Nursing in developing an evidenced-based plan to enhance scholarly work among its faculty members. The scoping review identified 10 articles which detailed barriers and facilitators in both Canadian and international contexts. Barriers and facilitators in these articles were extracted and they were also critically appraised. The identified barriers and facilitators fell into three main areas; personal attributes, facility factors and system challenges. The three area will be discussed further in the presentation as well as strategies identified to overcome these barriers.

Keywords: barriers, facilitators, nursing education, scholarship

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15016 Effectiveness of Clinical Practice Guidelines for Jellyfish Stings Treatment at the Emergency Room of Songkhla Hospital Thailand

Authors: Prataksitorn Chonlakan, Tiparat Wongsilarat

Abstract:

The traditional clinical practice guideline used at the emergency room at Songkhla Hospital in caring for patients who come in contact with jellyfish venom took a long time for the pain to reduce to the level that patients can cope with. To investigate the effectiveness of clinical practice guidelines by comparing the effectiveness of a newly developed clinical practice guideline with the traditional clinical practice guideline in the following aspects: 1) pain reduction, 2) length of pain, 3) the rate of patient’s re-visit, 4) the rate of severe complications such as anaphylactic shock, and cardiac arrest, and death, and 5) patient satisfaction. This study employed a quasi-experimental research design. Thirty subjects were selected with purposive sampling from jellyfish-sting patients who came for treatment at the Emergency Room of Songkhla Hospital. The subjects were divided using random assignment into two groups of 15 each: an experimental group, and the control group. The control group was treated using the traditional clinical practice guideline consisting of rinsing the affected area with 0.9% normal saline, using a cloth soaked with vinegar to press against the affected area, and controlling pain using tramadol or diclofenac intramuscular injection. The data were analyzed using descriptive statistics and paired t-test at the significance level p < 0.05. The results of the study revealed the following. The pain level in the experimental group was significantly lower than that of the control group (the average pain score of the experimental group was 3.46 while that of the control group was 6.33) (p < 0.05).The length of pain in the experimental group was significantly lower than that of the control group (the average length of pain in the experimental group was 48.67 minutes while that of the control group was 105.35 minutes) (p < 0.05). The rate of re-visit within 12 hours in the experimental group was significantly lower than that of the control group (the rate of re-visit within 12 hours of the experimental group was 0.07 while that of the control group was 0.00) (p < 0.05).No severe complications such as anaphylactic shock, and cardiac arrest were found in the two groups of subjects.The rate of satisfaction among the subjects in the experimental group was significantly higher than that of the control group (the rate of satisfaction among the subjects of the experimental group was 90.00 percent while that among the control group was 66.33 percent) (p < 0.05). The newly develop clinical practice guideline could reduce pain and increase satisfaction among jellyfish-sting patients better than the traditional clinical practice guideline.

Keywords: effectiveness, clinical practice guideline, jellyfish-sting patients, cardiac arrest

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15015 Unfolding Simulations with the Use of Socratic Questioning Increases Critical Thinking in Nursing Students

Authors: Martha Hough RN

Abstract:

Background: New nursing graduates lack the critical thinking skills required to provide safe nursing care. Critical thinking is essential in providing safe, competent, and skillful nursing interventions. Educational institutions must provide a curriculum that improves nursing students' critical thinking abilities. In addition, the recent pandemic resulted in nursing students who previously received in-person clinical but now most clinical has been converted to remote learning, increasing the use of simulations. Unfolding medium and high-fidelity simulations and Socratic questioning are used in many simulations debriefing sessions. Methodology: Google Scholar was researched with the keywords: critical thinking of nursing students with unfolding simulation, which resulted in 22,000 articles; three were used. A second search was implemented with critical thinking of nursing students Socratic questioning, which resulted in two articles being used. Conclusion: Unfolding simulations increase nursing students' critical thinking, especially during the briefing (pre-briefing and debriefing) phases, where most learning occurs. In addition, the use of Socratic questions during the briefing phases motivates other questions, helps the student analyze and critique their thinking, and assists educators in probing students' thinking, which further increases critical thinking.

Keywords: briefing, critical thinking, Socratic thinking, unfolding simulations

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15014 Effect of Rehabilitative Nursing Program on Pain Intensity and Functional Status among Patients with Discectomy

Authors: Amal Shehata

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Low back pain related to disc prolapse is localized in the lumbar area and it may be radiated to the lower extremities, starting from neurons near or around the spinal canal. Most of the population may be affected with disc prolapse within their lifetime and leads to lost productivity, disability and loss of function. The study purpose was to examine the effect of rehabilitative nursing program on pain intensity and functional status among patients with discectomy. Design: Aquasi experimental design was utilized. Setting: The study was carried out at neurosurgery department and out patient's clinic of Menoufia University and Teaching hospitals at Menoufia governorate, Egypt. Instrument of the study: Five Instruments were used for data collection: Structured interviewing questionnaire, Functional assessment instrument, Observational check list, Numeric rating Scale and Oswestry low back pain disability questionnaire. Results: There was an improvement in mean total knowledge score about disease process, discectomy and rehabilitation program in study group (25.32%) than control group (7.32%). There was highly statistically significant improvement in lumbar flexibility among study group (80%) than control group (30%) after rehabilitation program than before. Also there was a decrease in pain score in study group (58% no pain) than control group (28% no pain) after rehabilitation program. There was an improvement in total disability score of study group (zero %) regarding effect of pain on the activity of daily living after rehabilitation program than control group (16%). Conclusion: Application of rehabilitative nursing program for patient with discectomy had proven a positive effect in relation to knowledge score, pain reduction, activity of daily living and functional abilities. Recommendation: A continuous rehabilitative nursing program should be carried out for all patients immediately after discectomy surgery on regular basis. Also A colored illustrated booklet about rehabilitation program should be available and distributed for all patients before surgery.

Keywords: discectomy, rehabilitative nursing program, pain intensity, functional status

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15013 Nurses' Knowledge and Practice Regarding Care of Patients Connected to Intra-Aortic Balloon Pump at Cairo University Hospitals

Authors: Tharwat Ibrahim Rushdy, Warda Youssef Mohammed Morsy, Hanaa Ali Ahmed Elfeky

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Background: Intra-aortic balloon pump (IABP) is the first and the most commonly used mechanical circulatory support for patients with acute coronary syndromes and cardiogenic shock. Therefore, critical care nurses not only have to know how to monitor and operate the IABP, but also to provide interventions for preventing possible complications. Aim of the study: To assess nurses' knowledge and practices regarding care of patients connected to IABP at the ICUs of Cairo University Hospitals. Research design: A descriptive exploratory design was utilized. Sample: Convenience samples of 40 nurses were included in the current study. Setting: This study was carried out at the Intensive Care Units of Cairo University Hospitals. Tools of data collection: Three tools were developed, tested for clarity, and feasibility: a- Nurses' personal background sheet, b- IABP nurses' knowledge self-administered questionnaire, and c- IABP Nurses' practice observational checklist. Results: The majority of the studied sample had unsatisfactory knowledge and practice level (88% & 95%) respectively with a mean of 9.45+2.94 and 30.5+8.7, respectively. Unsatisfactory knowledge was found regarding description and physiological effects, nursing care, indications, contraindications, complications, weaning, and removal of IABP in percentage of 95%, 90%, 72.5%, and 57.5%, respectively, with a mean total knowledge score of 9.45 +2.94. In addition, unsatisfactory practice was found regarding about preparation and initiation of IABP therapy, nursing practice during therapy, weaning, and removal of IABP in percentages of (97.5%, 97.5%, and 90%), respectively. Finally, knowledge level was found to differ significantly in relation to gender (t = 2.46 at P ≤ 0.018). However, gender didn't play a role in relation to practice (t = 0.086 at P≤ 0.932). Conclusion: In spite of having vital role in assessment and management of critically ill patients, critical care nurses in the current study had in general unsatisfactory knowledge and practice regarding care of patients connected to IABP. Recommendation: updating knowledge and practice of ICU nurses through carrying out continuing educational programs about IABP; strict observation of nurses' practice when caring for patients connected to IABP and provision of guidance to correct of poor practices and replication of this study on larger probability sample selected from different geographical locations.

Keywords: knowledge, practice, intra-aortic balloon pump (IABP), ICU nurses, intensive care unit (ICU), introduction

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15012 Nurses' Assessments of Their Work Environments

Authors: Manar Aslan, Selver Gokdemir, Chatitze Chousein

Abstract:

This research was conducted to evaluate the factors affecting the working environment of nurses working in three state hospitals. A favorable working environment contributes to increased job satisfaction of nurses and improved working conditions that affects the quality of the work done in a positive way. The population of the study was composed the three largest state hospitals in the region of Thrace in Turkey and 931 nurses working in there. In this research was not used any sampling method. The sampling was composed of nurses who accepted to take part in this research from three hospitals. It was used nursing work index-the practice work environment scale (Turkish version) for data collection (Cronbach alpha: 0.94).When the total scale scores of the nurses in the research were examined, it was determined that they evaluated the working environment below the average. It was also determined that the adequacy of human and other resources, dimensions of the physician-nurse communication scores were low. As in every profession group, the working environment in nursing has an importance to provide quality health and nursing care. A favorable working environment will increase nurses' performance and satisfaction with their work. Identifying the factors affecting the working environment and carrying out the remedial work for them will increase the quality of the health service.

Keywords: work environment, work index, nursing, hospitals

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15011 Method of Nursing Education: History Review

Authors: Cristina Maria Mendoza Sanchez, Maria Angeles Navarro Perán

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Introduction: Nursing as a profession, from its initial formation and after its development in practice, has been built and identified mainly from its technical competence and professionalization within the positivist approach of the XIX century that provides a conception of the disease built on the basis of to the biomedical paradigm, where the care provided is more focused on the physiological processes and the disease than on the suffering person understood as a whole. The main issue that is in need of study here is a review of the nursing profession's history to get to know how the nursing profession was before the XIX century. It is unclear if there were organizations or people with knowledge about looking after others or if many people survived by chance. The holistic care, in which the appearance of the disease directly affects all its dimensions: physical, emotional, cognitive, social and spiritual. It is not a concept from the 21st century. It is common practice, most probably since established life in this world, with the final purpose of covering all these perspectives through quality care. Objective: In this paper, we describe and analyze the history of education in nursing learning in terms of reviewing and analysing theoretical foundations of clinical teaching and learning in nursing, with the final purpose of determining and describing the development of the nursing profession along the history. Method: We have done a descriptive systematic review study, doing a systematically searched of manuscripts and articles in the following health science databases: Pubmed, Scopus, Web of Science, Temperamentvm and CINAHL. The selection of articles has been made according to PRISMA criteria, doing a critical reading of the full text using the CASPe method. A compliment to this, we have read a range of historical and contemporary sources to support the review, such as manuals of Florence Nightingale and John of God as primary manuscripts to establish the origin of modern nursing and her professionalization. We have considered and applied ethical considerations of data processing. Results: After applying inclusion and exclusion criteria in our search, in Pubmed, Scopus, Web of Science, Temperamentvm and CINAHL, we have obtained 51 research articles. We have analyzed them in such a way that we have distinguished them by year of publication and the type of study. With the articles obtained, we can see the importance of our background as a profession before modern times in public health and as a review of our past to face challenges in the near future. Discussion: The important influence of key figures other than Nightingale has been overlooked and it emerges that nursing management and development of the professional body has a longer and more complex history than is generally accepted. Conclusions: There is a paucity of studies on the subject of the review to be able to extract very precise evidence and recommendations about nursing before modern times. But even so, as more representative data, an increase in research about nursing history has been observed. In light of the aspects analyzed, the need for new research in the history of nursing emerges from this perspective; in order to germinate studies of the historical construction of care before the XIX century and theories created then. We can assure that pieces of knowledge and ways of care were taught before the XIX century, but they were not called theories, as these concepts were created in modern times.

Keywords: nursing history, nursing theory, Saint John of God, Florence Nightingale, learning, nursing education

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