Scholarly Teaching Strategies

State of the SciencePAMELA DOZIER

NUED 580: WASHINGTON ADVENTIST UNIVERSITYDR. E. MIZE

Research Statement

Identification of learning needs of nurses as it relates to discharge planning in the Neonatal Intensive Care Unit.

MethodsElectronic databases: CINAHL, Medline and PubMed (2000-2012)Search words:

◦ discharge planning, ◦ neonatal intensive care unit, ◦ staff development, ◦ complex care, ◦ medically fragile child and ◦ nursing education, student nurses◦ experience and collaboration.

Articles reviewed: Qualitative

Introduction

The Center for Disease Control and Prevention

◦ To reduce the recidivism rate it would be beneficial to evaluate the discharge planning process.

◦ Identify and assess the learning needs of nurses to determine their level of skill and comfort level with providing education to parents.

Burt, McCraig, and Simon (2008)

Purpose: Literature ReviewLee and Emerson (2006)

Study: Qualitative Study/Level V,VI Evidence Hierarchy

Purpose: Identify discharge training needs of nurses using the DTNA tool.

Method: Questionnaire/DTNA tool (Discharge Training Needs Analysis)

Sample: Nurses

Setting: Nursing ward

Theme: Behavior, Knowledge, Decision-making

Findings: Implementation of DTNA tool allows for staff assessment needs, and continued monitoring through annual overview and audits.

Purpose: Literature Review Petersson et al. (2009)

Study: Qualitative/Level V, VI Evidence Hierarchy

Purpose: Generate new ideas for development of a quality process for discharge planning.

Method (s): Study dialogue/Participation Action Research (local theory)

Sample: Interprofessional groups (nurses/physicians/social worker)

Setting: hospital/social/health care

Theme: Patient participation, practitioner’s competence and organizational support

Findings: Story telling creates an opportunity to seek insight into staff’s everyday practice with d/c planning which allows for better understanding of patients’ issues (confidence and continuity)

Purpose: Literature Review Tilus (2002)

Study: Qualitative/ Level V, VI Evidence Hierarchy

Purpose: To explore the effects of education and experience on knowledge and perceptions of collaborative discharge planning among nurses.

Method: Survey (multiple choice knowledge questions & perceptions statements (scale 1-5)

Sample: Convenient/ nurses, charge nurses/ LPNs, RNs( Diploma, ADN, BSN)

Setting: Med/Surg unit (population-elderly) hospital

Theme: Knowledge of collaborative d/c planning, and nurses’ perception of collaborative d/c planning.

Findings: Educational level had no significance re: to knowledge about d/c planning; educ. preparation nor experience influenced perceptions.

Summary: Literature ReviewLees Emerson, Petersson et al. and Tilus Studies

◦ Similarities: Convenience sampling (nurses, physicians etc.) & no sampling from patients Surveys/Questionnaires/Story dialogue Trustworthiness

◦ Contrasts: Petersson et al. –Can findings be transferred from one context to another? As oppose to Lee and Emerson (DTNA) tool and Questionnaire/Survey used in Tilus’ study-more

applicable to clinical setting.

◦ Evidence Hierarchy: sameLevel V, VI

Research Results Although research identified the need for nurses to be educated on discharge planning there is minimal research indicating healthcare institutions implementation of any practice change for nursing education in this area.

Suggestion of a staff satisfaction survey focused on( the overall d/c process):

documentation,

perceptions of whether families were prepared for discharge,

timeliness of prescriptions and medication teaching,

preparation of home equipment, and

cardiopulmonary resuscitation education

clear understanding of roles involved in the process and suggestions for improvement.

Sims, Jacob, Mills, Fett, & Novak (2006)

Discussion

The concern for inadequate quality training of nurses only perpetuates the inadequate training and potential miscommunication of information given to parents of these medically fragile infants. This area of lack of structured discharge training for nurses poses a challenge for safe, efficient and effective delivery of nursing care.

Implications for Nursing Research

The implications for nursing research is that more research is needed regarding nurses perceptions of their role in discharge planning and nurses expectations of education regarding discharge planning and there remains a gap between research and practice.

Implications for Nursing Practice

The implications to nursing practice as an advanced practice educator are to identify the discharge learning process and recognize challenges in this process.

As an educator, it is my responsibility to prepare competent nurses and facilitate education that will assist students to recognize areas of weaknesses in their practice and develop ways to improve nursing practice with evidence-based training.

Referenceso Burns, K.H., Casey, P. H., Lyle, R.E., Mac Bird, T., Fussel, J.J. and Robbins, J.M. 2010 Increasing Prevalence of Medically

Complex Children in US Hospitals. Pediatrics 126:647-655.

oBurns, K.H., Casey, P. H., Lyle, R.E., Mac Bird, T., Fussel, J.J. and Robbins, J.M. 2010 Increasing Prevalence of Medically

Complex Children in US Hospitals. Pediatrics 126:647-655

oBurt, Catherine W., McCaig, L.F. and Simon, A.E. (2008) Emergency Department Visits by Persons Recently Discharged

from U.S. Hospitals National Health Statistics Report. U.S Department of Health and Human Services vol.6 (pp.

1-10).

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Nursing (Great Britain): 1987, 20(29), 47-51.

o Petersson, P., Springett, J., & Blomqvis, K., (2009). Telling stories from everyday practice to see a better picture: a

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ReferencesoSims, D., Jacob, J., Mills, M., Fett, P., & Novak, G. (2006). Evaluation and development of potentially better practices to

improve the discharge process in the neonatal intensive care unit. Pediatrics, 118 Suppl 2S115-S123.

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oSumner, J. (2011) Ethics and Nursing Research (2nd ed). Introduction to Nursing Research: Incorporating Evidence Based

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Referenceso Tilus, S. (2002). The influence of nursing education on collaborative discharge planning. Journal For Nurses In Staff

Development: JNSD: Official Journal Of The National Staff Development Organization, 18(5), 274-281.

o Willis,V. (2008). Parenting Premies. A Unique Program for Family Support and Education After NICU Discharge.

Advances in Neonatal Care vol. 8:4 (pp. 221-230).