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Education Program for Emergency Unit Nurses Essay


Introduction

The present portfolio contains the key elements of the educational program that was developed to educate twenty-six nurses working at the Emergency Unit of King Saud Medical City in Riyadh. The program covers three topics: Medication Errors (ME), Catheter Injection (CI), Technology Operation (TO). The nurses have various levels of education and experience, but they all report that they need additional training on the mentioned topics.

The key aims of the program consist of improving nurses’ knowledge and self-reported preparedness and confidence in managing the issues related to ME, CI, and TO. The following “specific, measurable, achievable, realistic, and timely” (SMART) objectives are proposed for the program (Murray, 2017, p. 347).

  1. By the end of the program, all the nurses will demonstrate good (or better) knowledge of the three topics as shown by the total mark, which will be determined with the help of the assessment rubric adopted by the program.
  2. By the end of the program, all the nurses will report improved preparedness to and confidence in managing the issues related to the three topics as evidenced by the self-reported preparedness element of the final test of the program.

The program development was guided by the conversational model (CM), which views the learning process as a complex of interactions between the learner, their peers, and the teacher (Atif, 2013; Stephens & Hennefer, 2013). Also, the information provided by the educational needs assessment (ENA) that specifically targeted the nurses of the Emergency Unit was used for the program. As a result of the employment of these tools, the program’s outline and content were developed along with evaluation strategies and resource considerations. The present portfolio introduces all these elements together with a reflection on the program development process.

Overview of the Program

Content Outline and Teaching plan

The twenty-six nurses of the Emergency Unit have assessed the educational gaps that they have, which allowed tailoring the program to the maximum benefit of the participants (Fairchild et al., 2013; Pilcher, 2016). As a result of ENA, the ME unit was divided into two parts: the theory module will take 8-10 hours, and the practice module will last for 4-5 hours. CI and TO units will be much shorter: the former will take 6-7 hours, and the latter will last for 4-5 hours. Additional time will be required for the review of the information, tests, and program evaluation.

Objectives/summaries for sessions

The program is going to include individual sessions devoted to the three topics. The following SMART objectives can be used to describe the content and learning outcomes of the sessions; they are developed by the program’s objectives.

  1. ME objectives.
    1. By the end of the unit, nurses will demonstrate good (or better) knowledge of the key aspects of ME as shown by the total mark and program’s rubric. The key ME aspects include ME classification, prevention strategies, reporting procedures, and the culture of medication safety (Bush, Hueckel, Robinson, Seelinger, & Molloy, 2015; CARNA Videos, 2014; O’Connell et al., 2016).
    2. By the end of the program, the nurses will report improved preparedness and confidence concerning ME as demonstrated by the self-assessment element of the final test.
  2. CI objectives.
    1. By the end of the unit, all the nurses must demonstrate good (or better) knowledge of CI topics as evidenced by the total mark and rubric. The CI topics are catheter use and safety considerations with different groups of patients (Abolfotouh, Salam, Mustafa, White, & Balkhy, 2014; Öztürk & Dinç, 2014; Wallis et al., 2014).
    2. By the end of the program, the nurses will report improved preparedness and confidence concerning TO as evidenced by the final test self-assessment element.
  3. TO objectives.
    1. By the end of the unit, the nurses will demonstrate good (or better) knowledge of TO topics as measured by the final mark and rubric. The topics include emergency unit technology classification, safety, and confidentiality considerations, and new approaches to technology use (O’Connell et al., 2016; Strudwick, 2015; Thompson, 2013).
    2. By the end of the program, the nurses should report improved preparedness and confidence concerning TO as evidenced by the final test self-assessment element.

Program content with rationale

The content outline of the program is presented in Table 1.

Table 1. Content Outline: Four-Week Teaching Program.
Week Topic Primary Activities Assessment Goals and objectives
1 (8-10 hours) ME: Theoretical Module. Introduction and significance (consequences), classification, reporting, analysis and reflection, prevention, the culture of safety Video, lectures, discussions, Q&A Participation rubric A and B (1.1 and 1.2)
2 (4-5 hours) ME: Practice Video, discussion, problem-solving, role-playing, individual and group tasks Participation rubric A and B
(1.1 and 1.2)
2 (1 hour) ME: Test Test ME test A (1.1)
2-3 (6-7 hours) CI: introduction and significance, review of principles, safety, specifics for different patients, demonstration (video), analysis. Video, lecture, discussion, Q&A Participation rubric A and B (2.1 and 2.2)
3 (1 hour) CI: Test Test CI test A (2.2)
3 (4-5 hours) TO: introduction and significance, the presence/use of technology in an emergency unit, review of safety/confidentiality measures, new applications of familiar technology. Video, lecture, brainstorming, discussion, Q&A Participation rubric A and B (3.1 and 3.2)
3 (1 hour) TO: Test Test TO test A (3.1)
4 (3-4 hours) Program review Q&A, discussion Participation rubric A and B (1.1-3.2)
4 (1 hour) Program Final Test Test; self-conducted preparedness assessment Final test A and B
(1.1-3.2)
4 (up to 10 hours) Program Evaluation Feedback, discussion, individual self-reflection None B (1.2, 2.2., 3.2)

Video presentations have been chosen by the nurses as a preferred method of education; also, it is a well-established method for nursing education that can result in improved motivation, attention, and information retention (Forbes et al., 2016; Holland et al., 2013; Parwanda et al., 2014). As a result, videos are included in every unit and almost every session. The videos would be expected to foster interaction (class and group discussions, questions, and answers) and reflection (brainstorming, individual, and group analysis tasks). Interaction and reflection, in turn, are major elements of CM that highlight the interconnections between individual and social learning (Knewstubb, 2014). This fact explains the use of multiple interactive activities in the program. At the same time, CM views individual assignments as another form of learning-related conversation that occurs between the educator and the learner (Atif, 2013; Holmberg, 2016). As a result, individual activities are also included in the program.

Active participation in the mentioned activities is the program’s major vehicle for learning. It is expected that the interaction between peers will foster knowledge exchange, which is especially likely due to the differences in the Unit’s nurses’ age and experience (Lin & Lo, 2015). Apart from that, the interaction is meant to promote collaboration and mutual support (Schmidt & Brown, 2016; Walji, Deacon, Small, & Czerniewicz, 2016). However, it is noteworthy that nurses may have different learning styles and traits that can make it more difficult for them to participate in certain activities (Li, Yu, Liu, Shieh, & Yang, 2014). For example, introverts are less likely to be engaged in a discussion then extraverts. This specific problem will be resolved in group discussions, in which every nurse will be provided with some time for the presentation of personal thoughts and their discussion. Moreover, the use of a variety of activities, including individual and group assignments, discussions, video analyses, brainstorming, and some others, should help the nurses with different learning styles to learn.

One Session Content and Plan

Several ME sessions will be dedicated to the topic of prevention strategies. Table 2 presents a plan and the in-depth content of the first of these sessions. It will employ a video presentation (CARNA Videos, 2014) to introduce the topic; the choice of the activity is explained by the fact that the nurses of the Unit have marked it as a preferred one. After that, the session will aim to promote reflection in nurses during the personal ME situation analysis (Brown & Schmidt, 2016).

Table 2. Session Plan and Content: The First Prevention Strategies Session for ME.
Time Content Teaching strategies Resources
5 minutes
  1. Topic introduction; session plan presentation.
  2. The introduction of the video by CARNA Videos (2014).
  3. Viewing the video (2:46).
Video presentation. Computer, projector; whiteboard.
10 minutes
  1. Discussion of the video.
    1. What could be done to prevent this ME?
    2. Transition to prevention strategies.
  2. Brainstorming prevention strategies.
    1. Examples of questions: what is safety culture (Bush et al., 2015)? What are the correct attitudes to ME? How can information technology be employed (O’Connell et al., 2016)?
Discussion, brainstorming. Whiteboard for key strategies.
Up to 5 minutes
  1. Individual assignment: preparing a short speech (1-2 minutes) on one’s personal or second-hand experience of ME or a hypothetical ME situation that can occur in one’s practice.
    1. Must include: Description of the situation, analysis, prevention considerations.
Individual work: reflection, analysis, problem-solving. Pens and paper or electronic devices if needed.
30 minutes
  1. Forming groups (4 people in each). Choosing group leaders.
  2. Explaining the details of the assignment.
  3. Group work.
    1. Nurses present their reflections and invite discussion. The leader keeps track of time (up to 6 minutes per person) and assesses the activity of every member.
Group work: presentation, discussion. Pens and paper or electronic devices if needed.
Up to 10 minutes
  1. Each group reports the strategies that they have discussed. New strategies (if any) are added to the whiteboard.
  2. Closure. A review of the key points of the discussion. Nurses are invited to write down the strategies and reminded them about the feedback questionnaire (Appendix A).
Presentation of results; short lecture. Whiteboard, pens, and paper, or electronic devices.

Then, the nurses will be invited to discuss their personal experiences or hypothetical ME situations to analyze the possible prevention strategies in small groups. The choice of this activity is guided by CM, which fosters interaction between learners, their peers, and teacher (Knewstubb, 2014). Also, the use of small (four-people) groups helps to fit the activity into the rather limited timeframe of the session and provides every participant with an opportunity to present their speech. The session will be concluded with the review of the prevention strategies mentioned during the lesson and a request to fill out the session feedback questionnaire, which can be found in Appendix A; the latter is required for the evaluation of the program. Finally, the evaluation strategy for the lesson involves the group leader rubric presented in Table 3, which will be complemented with the participation rubric that is shown in its short form in Table 4.

Table 3. Assessment Rubric for Group Leaders for the First Prevention Strategies Session (ME).
Nurse’s Name Described the situation? Analyzed the situation? Mentioned prevention strategies? Participated in the discussion? Mark

Evaluation Strategies and Tools

A mixed-methods evaluation strategy will be employed for the course. Tests are going to be introduced at the end of each unit (ME, CI, and TO) and the program (see Table 1). Each of the unit tests will contribute 10% to the total mark, and the final one will account for 30%. These tests will evaluate the knowledge obtained by the nurses; also, the final test will include a self-reflection module for assessing the achievement of the B-objective of the program. Tests are a well-established method of assessment that can be effective in determining the learner’s knowledge, but they also have some limitations, including their inability to capture the learner’s skill in analyzing, synthesizing, and applying information (Rosselli, Dennison, & Dempsey, 2014). As a result, 40% of the mark will be contributed by the nurses’ participation during the sessions, and this technique will be aimed at the assessment of the achievement of both A- and B-objectives of the course. The marking rubric is presented in Table 4; it is going to be provided to the nurses at the beginning of the program to help them to interpret their marks and employ the information for feedback and improvement. The participation in sessions is obligatory; if a significant event prevents a nurse from attending, the situation will be considered specifically.

Table 4. General Assessment Rubric.
Total Mark Tests Score Participation Marks Participation Rubric
Excellent 95-100% Excellent Exemplary participation; insightful comments that promote discussion and collaboration; the nurse demonstrates a notable understanding of the topics and applies the knowledge to personal practice and experiences.
Very good 85-94% Very good Active participation; the nurse demonstrates a notable understanding of the topics and applies the knowledge to personal practice and experiences.
Good 75-84% Good Frequent participation; the nurse demonstrates an understanding of the topics and occasionally applies the knowledge to personal practice and experiences.
Satisfactory 65-74% Satisfactory The nurse participates rarely, demonstrates a satisfactory understanding of the topics, and makes few attempts at applying the knowledge to personal practice and experiences.
Needs improvement 45-64% Needs improvement The nurse participates rarely, demonstrates little understanding of the topics, and makes few or no attempts at applying the knowledge to personal practice and experiences.
Poor <45% Poor The nurse does not participate.

An important aspect of evaluation is the solicitation of feedback, which is going to be carried out with the help of the tool located in Appendix A. As can be seen from the tool, the course is going to promote continuous feedback, encouraging the nurses to review the questionnaire after every session to ensure that their ideas are communicated to the educator. The significance of this form of feedback is rooted in the primary features of CM: as shown by Atif (2013), Holmberg (2016), Knewstubb (2014), and others, the collaboration and communication of CM contribute not only to the learner’s development but also to that of the educator, which, among other things, is manifested in the improvement of the teaching methods and tools. Thus, the employment of a variety of assessment tools will help both learners and the educator to receive feedback on their activities.

Resource Requirements and Costing

The costs of the program are going to be minimal or non-existent. The rooms for the sessions will be provided by the Emergency Unit, and it is also ready to assist in resolving any staffing issues that may occur. The key required equipment includes at least one computer, one projector, and one or more whiteboards, which are going to be provided by the Emergency Unit. Also, nurses may need pens and paper, which the Unit will deliver. However, the nurses will be encouraged to employ their mobile devices for making notes, which is in line with the modern perspectives on these devices as tools for learning (Şad & Göktaş, 2013). Moreover, the nurses have reported no difficulties in working with mobile and computing technology during the ENA activity, which makes this option more feasible. As a result, the nurses will be provided with all the materials for their sessions (feedback questionnaire, rubrics for reference and group leaders, and tests) in their electronic form. Printed versions of these materials will also exist, and they will be copied if needed, which may lead to certain expenses. However, the program can function with little or no funding.

Reflection

Gibbs’ reflective cycle is a framework for reflection that has been used for various aspects of nursing (Husebø, O’Regan, & Nestel, 2015). It is going to be employed in this portfolio to organize the information related to the experience of developing the program.

Description

The event can be described as the multistage development of an educational program for the nurses of the Emergency Unit of King Saud Medical City in Riyadh.

Feelings

I have been most enthusiastic about the event: I found the task interesting and challenging. Also, it is a pleasure to work with the Unit because its administration and nurses have been very cooperative. Overall, the event evokes positive feelings.

Evaluation

I would highlight the positive elements of the experience, including the extensive support of the Unit’s administration and the enthusiasm of the nurses: for example, the learning needs evaluation questionnaire resulted in a 100% response rate. Challenges were also present, including budgeting and staffing considerations, which were resolved with the help of the Unit’s administration. The process of designing the program, especially the choice of the activities for nurses with diverse needs, was challenging, but the CM tool, as well as the reviewed literature and ENA, helped me in the process.

Analysis

Gibbs suggests employing the experience for learning purposes. From the reviewed event, I learned the significance of ENA: this tool is most helpful in customizing educational programs. Similarly, I discovered the positive features of CM, as well as its value for nursing education, and learned to apply it to my practice. Also, I was provided with multiple examples of the positive effects that the collaboration of nurses can have on project development.

Conclusion

Overall, the experience is rather insightful and has had a positive impact on my knowledge, skills, and emotional well-being. Gibbs also suggests considering the aspects that could have been done differently; in my view, I could have included a brief learning style determination element in ENA to be more certain about appropriate activities. The future feedback of the nurses on the sessions should provide me with more extensive information for this part of reflection.

Action plan

In the future, I will always seek to forge working relationships with relevant stakeholders, especially participants and administration, and I will pay great attention to the ENA element of program development.

Conclusion

The present portfolio includes the major elements of the educational program aimed at improving the knowledge, preparedness, and confidence of the twenty-six nurses working at the Emergency Unit of King Saud Medical City in Riyadh concerning ME, CI, and TO. These primary aims have determined the key objectives and content of the program and individual sessions. Apart from that, the content and assessment strategies can be rationalized by other considerations, including ENA results and CM, which proved to be very helpful in guiding the program’s design. Finally, resource and time management were also taken into account along with some additional considerations. Overall, the process of program development has been a positive and insightful experience, which can be partially attributed to the participants’ willingness to collaborate. The lessons learned from this project will be used for future ones.

References

Abolfotouh, M., Salam, M., Mustafa, A., White, D., & Balkhy, H. (2014). A prospective study of incidence and predictors of peripheral intravenous catheter-induced complications. Therapeutics and Clinical Risk Management, 10, 993–1001. Web.

Atif, Y. (2013). Conversational learning integration in technology enhanced classrooms. Computers in Human Behavior, 29(2), 416-423. Web.

Brown, J., & Schmidt, N. (2016). Service–learning in undergraduate nursing education: Where is the reflection? Journal of Professional Nursing, 32(1), 48-53. Web.

Bush, P., Hueckel, R., Robinson, D., Seelinger, T., & Molloy, M. (2015). Cultivating a culture of medication safety in prelicensure nursing students. Nurse Educator, 40(4), 169-173. Web.

CARNA Videos. (2014). Reporting errors [Video file]. Web.

Fairchild, R., Everly, M., Bozarth, L., Bauer, R., Walters, L., Sample, M., & Anderson, L. (2013). A qualitative study of continuing education needs of rural nursing unit staff: The nurse administrator’s perspective. Nurse Education Today, 33(4), 364-369.

Forbes, H., Oprescu, F., Downer, T., Phillips, N., McTier, L., Lord, B., …Visser, I. (2016). Use of videos to support teaching and learning of clinical skills in nursing education: A review. Nurse Education Today, 42, 53-56. Web.

Holland, A., Smith, F., McCrossan, G., Adamson, E., Watt, S., & Penny, K. (2013). Online video in clinical skills education of oral medication administration for undergraduate student nurses: A mixed methods, prospective cohort study. Nurse Education Today, 33(6), 663-670. Web.

Holmberg, J. (2016). Applying a conceptual design framework to study teachers’ use of educational technology. Education and Information Technologies, 22(5), 2333-2349. Web.

Husebø, S., O’Regan, S., & Nestel, D. (2015). Reflective practice and its role in simulation. Clinical Simulation in Nursing, 11(8), 368-375. Web.

Knewstubb, B. (2014). The learning–teaching nexus: Modelling the learning–teaching relationship in higher education. Studies in Higher Education, 41(3), 525-540. Web.

Li, Y., Yu, W., Liu, C., Shieh, S., & Yang, B. (2014). An exploratory study of the relationship between learning styles and academic performance among students in different nursing programs. Contemporary Nurse, 48(2), 229-239. Web.

Lin, S. W., & Lo, L. Y. S. (2015). Mechanisms to motivate knowledge sharing: Integrating the reward systems and social network perspectives. Journal of Knowledge Management, 19(2), 212-235. Web.

Murray, E. (2017). Nursing leadership and management: For patient safety and quality care. Philadelphia, PA: FA Davis.

O’Connell, E., Pegler, J., Lehane, E., Livingstone, V., McCarthy, N., Sahm, L. J.,… Corrigan, M. (2016). Near field communications technology and the potential to reduce medication errors through multidisciplinary application. Mhealth, 2, 29-29. Web.

Öztürk, D., & Dinç, L. (2014). Effect of web-based education on nursing students’ urinary catheterization knowledge and skills. Nurse Education Today, 34(5), 802-808. Web.

Parwanda, G., Rajan, J., Malar, A., Chacko, N., Choudhary, P., & Andrews, S. (2014). Effectiveness of video assisted teaching vs demonstration method on female urinary catheterization in terms of knowledge and practice. International Journal of Nursing Care, 2(1), 13. Web.

Pilcher, J. (2016). Learning needs assessment. Journal for Nurses in Professional Development, 32(4), 185-191. Web.

Rosselli, J., Dennison, R., & Dempsey, A. (2014). Evaluation beyond exams in nursing education: Designing assignments and evaluating with rubrics. New York, NY: Springer Publishing Company.

Şad, S., & Göktaş, Ö. (2013). Preservice teachers’ perceptions about using mobile phones and laptops in education as mobile learning tools. British Journal of Educational Technology, 45(4), 606-618. Web.

Schmidt, N., & Brown, J. (2016). Service learning in undergraduate nursing education: Strategies to facilitate meaningful reflection. Journal of Professional Nursing, 32(2), 100-106. Web.

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Thompson, P. (2013). The digital natives as learners: Technology use patterns and approaches to learning. Computers & Education, 65, 12-33. Web.

Walji, S., Deacon, A., Small, J., & Czerniewicz, L. (2016). Learning through engagement: MOOCs as an emergent form of provision. Distance Education, 37(2), 208-223. Web.

Wallis, M., McGrail, M., Webster, J., Marsh, N., Gowardman, J., Playford, E., & Rickard, C. (2014). Risk factors for peripheral intravenous catheter failure: A multivariate analysis of data from a randomized controlled trial. Infection Control & Hospital Epidemiology, 35(1), 63-68. Web.

Appendix A

Session Feedback

You are taking part in an educational program for the nurses of the Emergency Unit of King Saud Medical City in Riyadh, which is devoted to the topics of Medication Errors, Catheter Injection, Technology Operation. The present questionnaire invites you to analyse the program and provide some feedback for its future improvement. Thank you for your help!

Session Analysis

Please read the questions below and respond to them in the second column. For rating questions, use the scale from 0 to 10; 0 stands for “very poor,” and 10 stands for “perfect.”

Question

Session Number:

Session Topic:

Rate topic coverage.

0= “not covered”

10= “covered perfectly”

Rate educator support.

0= “not supportive”

10= “perfectly supportive”

What flaws did the session have?

What was good/enjoyable about the session?

What could be improved?

What was difficult?

Other notes

Thank you for your input!

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