Graduate Projects (Nursing)

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Person-centered approach to nursing practice in a heart function clinic: An integrative literature review
(2016-01-07) Kerr, Susan; Young, Lynne
The management of heart failure (HF) is complex, both for those experiencing HF and for those caring for people in an outpatient setting such as a Heart Function Clinic (HFC). Since the Institute of Medicine (IOM) (2001) identified patient-centered care as an essential foundation for quality and patient safety, much has been written about this type of care; however, it is not a new approach to nursing. In order to synthesize published literature examining the relationship between a person-centered care approach and the self-management of people living with HF, an integrative literature review was undertaken. Appropriate articles published between January 2001 and June 2014 were identified using CINAHL, Medline, Cochrane Database of Systematic Reviews, and Google Scholar. People present along their journey to self-management at different stages, which are related to certain life challenges that can affect an individual’s ability to adjust to living with HF. Supported by nursing theory and competency tools, such as the heart failure competency assessment, planning, and evaluation (HF-CAPE) tool, the nursing approach at each stage varies to support the person living with HF and their family. Following an integrative review of HF self-care literature with a person-centered care approach, the data were reduced until five themes were identified. These themes are (1) communication, (2) fostering understanding, (3) encouraging problem-solving, (4) sharing decision-making, and (5) setting person-defined goals. While the overarching theme of communication, including building of relationships, underpins the other four themes, the remaining themes are not mutually exclusive; they are interconnected but not in a linear fashion.
Examining the barriers and facilitators that impact adult end-of-life conversations and decision-making in hospital: An integrative literature review
(2015-12-01) Forster, Jennifer; Starzomski, Rosalie
In acute care, end-of-life (EOL) communication is limited between healthcare providers (HCP)s and recipients suffering progressive, life-limiting-illnesses, who appear to be at the end of their lives. Few researchers have demonstrated how increasingly sicker and aging patients affect the quality of EOL care, or have evaluated the effectiveness of the current EOL care in hospitals. Ineffective communication is a major source of poor, overall EOL experiences. In this integrative literature review (ILR) project, I explore the barriers and/or facilitators in relation to EOL communication, particularly conversations about EOL decision-making, and identify what factors prevent HCPs from engaging in EOL decision-making with patients and families. Communication barriers and facilitators identified in this review include: (a) HCP factors such as intrapersonal and professional issues, ethical and learner factors; (b) interdisciplinary factors such as teamwork, hierarchies, and divergent EOL paradigms; (c) hospital system factors such as policy, education, and resource allocation; and (d) recipient factors such as knowledge, attitudes, age, and illness type. Nurses care for, spend significant amounts of time with patients and their families in acute care, and are well positioned to improve EOL communication practices.
Patient and public engagement in healthcare system policy: An integrative review
(2015-11-18) Harper, Caryl; MacDonald, Marjorie
The need for greater patient and public engagement (PPE) in policy-making in the healthcare system has garnered significant attention from governments (Lewin, Lavis & Fretheim, 2009). Patient and public involvement (PPI) has been at the core of the United Kingdom’s (UK) British National Health Service (NHS) and was accelerated by the Health and Social Care Act 2001 (Tritter & Koivusalo, 2013). In the UK PPI is implemented to create a national mechanism for holding policy-makers in governments and health-care provider organizations accountable for planning and delivering health services. One of the ongoing challenges of engaging the public or patients is how best to involve patients and the public in health policy and decision-making (Thurston, et al., 2005). In this paper, I explore the findings from my review on PPE policy to understand if PPE policy makes a difference within the healthcare system. I have included qualitative and secondary sources, grey literature, and mixed methodology literature published between 2002 and 2015 (January to March). I conducted an integrative review and organised the findings using the Services Management (SM) and Service-Dominant (SD) Theory (Osborne, Radnor & Nasi, 2012). The following three themes were identified in the findings benefits of PPE policy, challenges for policymakers, and governments’ role in PPE policy. An analysis of the key themes revealed a number of policy challenges and recommendations for policy makers, healthcare and nursing leaders specific to PPE. The Advanced Practice Leadership (APL), Master of Nursing, University of Victoria program includes policy competencies. I developed an Integrated PPE Framework for Public Service and Nurse Leaders that includes APL competencies, theoretical concepts and the findings in this review. Future efforts in PPE should include research on how PPE is linked to accountability, translated into policy and practice, and evaluated using standardized, valid, reliable, and appropriate measurement systems.
Strengths-based pedagogy: Opening the door of possibility for faculty development
(2015-09-23) Juby, Brenda; Pauly, Bernie
The complexities and insecurities that are facing nursing today are causing uncertainty in what educators know or do not know, with what is considered right or good. It is during uncertainty that a sense of self-awareness and particular way of being needs to be fostered, and how we approach knowledge and knowing needs to shift to an ontological orientation. Taking an ontological turn in education shifts the relationship between epistemology and ontology. Specifically, epistemology is put to the service of ontology (Dall’Alba & Barnacle, 2005; Thomson, 2001). Using a strengths-based pedagogy is an orientation that is grounded in an ontological turn, and allows us to teach in the space between certainty/uncertainty, and promotes the integration of knowing, acting, and being as an educator. The purpose of this project was to develop a faculty workshop that explores the practical application of a strengths-based pedagogy and its potential use in nursing education. The project is located in a constructivist paradigm where student’s previous knowledge and learning is acknowledged, while integrating and drawing on the literature of the ontological turn (Barnett, 2012; Dall’Alba & Barnacle, 2007). The project specifically draws upon a strengths-based pedagogy for the theoretical orientation as well as relational inquiry tools to address the how. Using relational inquiry tools, learning experiences are explored within the intrapersonal, interpersonal, and contextual domains; and informed by five ontological capacities (5 Cs) – compassion, being curious, commitment, being competent, and corresponding may provide insight into how these values can enhance teacher/student relationship and students’ academic success. The faculty development workshop consists of two parts: a 4-hour workshop that provides educators the opportunity, through active learning strategies, to open the relational space to explore a strengths-based approach in their practice to recognize what is working or not and relearn and how this approach can work in their practice; and 11-weeks of 1-hour follow-up sessions that continue the strengths-based conversation and provide support. In the design of the workshop and the learning goals, Finks taxonomy of significant learning was used which is congruent with strengths-based and nursing education. The overall goal of the project was that educators would develop a more comprehensive understanding of a strengths-based approach and how they can use or enhance this approach in their practice within nursing education. The project has potential to change the template in which educators and students in the Bachelor of Nursing (BN) program view their practice and their experiences. Using a strengthsbased pedagogy opens up the possibility for educators to explore their strengths; revise the story of their teaching and learning from one of deficits and challenges to opportunity and potential; increase their confidence and belief in who they are as an educator; and for enhancing student/teacher relationship and academic success. Ultimately, it is a starting point to opening the door to changing educators’ perspectives of students to one of privilege and possibility.
The effects of geriatric depression training on registered nurses: An integrative review
(2015-09-23) Kwadzovia, Edna; Sheets, Debra
Background: With an aging population, the numbers of older adults with depression are increasing. Improving the care of the depressed older adult requires strategies and skills in mental health care. The research literature indicates that healthcare workers, including nurses, often do not recognize depression in their geriatric clients. Efforts have been made to improve detection, yet the problem persists. Training nurses about geriatric depression to improve detection is a strategy proposed to address the issue. An integrative review that examines the effects of geriatric depression training for nurses would provide useful information to guide clinical educators and advanced practice nurses developing geriatric depression training programs for their organizations. Data sources: A comprehensive search of CINAHL, EBCSO, Web of Science, Ageline and MEDLINE databases was conducted. Method: An integrative review was conducted using Whittemore and Knafl’s (2005) framework. Results: Twelve peer-reviewed published studies of depression training workshops that include registered nurses (RNs) were selected for the review. Results indicate that training nurses about geriatric depression can improve knowledge, confidence (i.e., self-efficacy) as well as changing attitudes. Conclusion: This review supports the importance of geriatric depression training for nurses. Findings indicate that depression training increases knowledge, improves self-efficacy and changes the attitudes of nurses. However, current evidence on the effects of geriatric depression training needs more rigorous evaluation that goes beyond self-report to strengthen findings. In addition, at present the longer-term impact of training on nursing practice and detection of geriatric depression remains unclear.
The long-term care needs of geriatric patients in a psychiatric unit
(2015-09-23) Horton, Cecilia; Sheets, Debra
The length of hospital stay varies widely between geriatric patients, particularly those waiting for long-term care placement. A number of studies attempt to predict which hospitalized older adults are likely to require long-term care placement, but few studies examine the factors that affect the length of time for geriatric patients with psychiatric diagnoses to be discharged from hospital to long-term care. This retrospective chart review examines the characteristics of 925 geriatric patients discharged to long-term care over a 3 year period from a Vancouver Island urban hospital. This paper compares geriatric patients from general units versus those in psychiatric units who are discharged to long-term care. Analyses focus on: 1) describing differences in physical function and mental status between the 2 groups of geriatric patients (i.e. general versus psychiatric); and 2) identifying factors that may affect the length of time for discharge from hospital to nursing home. Findings indicate that frail, elderly women are discharged relatively quickly from hospital to long-term care facilities. However, geriatric patients in psychiatric units are a distinct subset which is more likely to be male and to have behavioural and psychological symptoms of dementia (BPSD) that present challenges to long-term care placement and contribute to delays in discharge. Recommendations include providing long-term care staff the necessary education and training to care for those with dual mental health and geriatric diagnoses who have more challenging care needs as well as increasing the availability of long-term care facilities with the necessary design features (e.g., single occupancy rooms, secure units) for this population.
Mapping select theoretical and empirical contributions to understanding the relationship between caring in nursing and technology
(2015-09-01) McFadden, Janice; Young, Lynne
Although there is a long history of technology used in the healthcare environment, recent advances in healthcare technology, as well as the visibility of the technology at the patient’s bedside, have initiated a debate about how technology today impacts the nurse-patient relationship. The opinions range from one group that views technology as important in creating a safe and efficient environment for patients, to another group that believes technology interferes with a nurse’s ability to maintain caring therapeutic relationships with her or his patient. The ongoing inability to define who nurses are and what we do is highlighted as I explore the relationship between caring in nursing and technology in the clinical setting. This literature review, using the hermeneutic approach, has given me the opportunity to move through iterative cycles, gaining insight into my topic and clarifying information while raising more questions to be answered. As a result, other explanations emerge as to why technology and caring at present coexist in what at times appears to be an adversarial relationship. It is clear that more research into this topic is needed to help nurses achieve the balance between therapeutic caring relationships with their patients while meeting the challenges that technology creates in this environment.
An integrative review of nurses' perspectives of family-centered care practice in the level III NICU: Addressing persisting barriers
(2015-09-01) Khan, Shaara; Marcellus, Lenora
Family-centered care (FCC) remains a challenge to integrate in the Level III(+) NICU by bedside nurses. The goal of this integrative literature review is to identify barriers/ facilitators to shed light on neonatal nurse perspectives of FCC and more effectively implement FCC practices in the NICU. This study aims to determine recommendations that better support the knowledge translation of FCC to nurses and its integration at the bedside by nurses. An integrative literature review was conducted using a methodological approach of constructivist grounded theory to uncover unique perspectives of NICU nurses and identify and address the issues surrounding FCC integration. General themes of barriers/ facilitators were compared to neonatal nurse perceptions of barriers/ facilitators to FCC and two main categorical differences are now identified: 1) nurses describe a need for change in unit/ organization culture rather than focusing on unit design and policy; 2) nurses identify an existing lack of skill and knowledge to integrate FCC into practice, rather than viewing staff attitudes or practices as a barrier. A model based on FCC facilitators identified by NICU nurses was constructed (i.e. The Knowledge Translation Model for Family-Centered Care in the NICU) as a strategic approach to improve integration and support of FCC in the NICU. Recommendations were made for nurses, healthcare team members, decision-makers and Nurse Educators based on this model, for development of FCC education curriculum and sustaining an FCC culture in the NICU. Limits of this study include that findings were not generalizable for many of the articles included in the review, conducting this review as a single graduate student, limits of the critical appraisal tool employed, and small number of studies included due to lack of available research in this area. A lack of literature about how to effectively translate and integrate necessary FCC skills and knowledge into NICU nursing practice indicates that this integrative literature review can significantly contribute to knowledge in this field.
An informational resource to enhance nursing care for patients with problematic alcohol use
(2015-09-01) Romano, Barbara; Pauly, Bernadette
Nurses often feel uncomfortable, unprepared, and unsure of how to proceed when they must assess patients hospitalized for alcohol-related problems in order to be able to discuss alcohol consumption and improve health outcomes. Due to lack of education and training combined with societal attitudes, nurses may not have the requisite skills and knowledge to practice alcohol screening and brief intervention in hospital settings. Alcohol screening and brief interventions have been proven to be successful in different practice settings when they are implemented. The goal of this project is to develop an informational resource for nurses to encourage critical reflection and a holistic approach when caring for patients hospitalized for alcohol-related problems and their families or support persons. This informational resource can be used in hospital care units to assist nurses to overcome obstacles and barriers they face in caring for these patients. The intent of the informational resource is to improve nurses’ knowledge and skills in alcohol screening and brief interventions, to give nurses a greater understanding of the physical, social, psychological, and physiological effects of alcohol dependency. Also, the informational resource can improve nurses’ comfort and confidence level in approaching patients and families in order to have open and often difficult discussions about alcohol use and dependency. The theoretical perspective utilized to guide the process of developing the informational resource is Newman’s Theory of Health as Expanding Consciousness. Drawing on Newman’s theory and my knowledge of advanced nursing practice, I was able to create an informational resource based on nursing knowledge, theory, research, and clinical experiences. The informational resource can contribute to nurses’ comfort and confidence level in approaching patients and families in order to have open and often difficult discussions about alcohol use and dependency. Finally, the informational resource can increase nurses’ awareness of the resources available in their community to assist people with problematic alcohol use.
Mental health, illness, and distress in undergraduate nursing students: A selected review of the literature
(2015-08-12) Morton, Joanne; McDonald, Carol
The start of postsecondary education may mark the beginning of a period in which students experience significant changes including those related to developmental tasks, self-identify and the formation of values. Postsecondary education may provide many opportunities for positive growth, however, it also is a time when students are faced with many new challenges, some of which may negatively impact their mental health. Nursing students may have increased risk for mental health issues as they are often required to face challenges not typically found in other programs. Unfortunately, there are postsecondary students who may not have the required coping skills and/or a reliable support system needed to help them navigate the challenges that postsecondary education engenders. Even more disturbing is the fact that many students will go on to develop mental health issues or have an exacerbation of previously identified mental illness for which they will not seek help due to fears of discrimination, stereotyping, and/or reprisal. Although, there has been a number of studies published on student mental health there is little research addressing nursing students and the educators that educate them, particularly in English speaking countries. Given this lack of information, I have conducted a selected literature review on what is currently known about nursing student mental health using nursing and non-nursing sources. These findings are enmeshed with general mental health discussions forming an atypical literature review format. Drawing upon the work of Barker and Buchanan-Barker’s Tidal Model, nursing student mental health is discussed as well as some potential recommendations that may prove helpful in the promotion of nursing student mental health.
A concept map development: articulation of the alignment between relational nurse leadership & team building strategies in order to support RN team leader practice
(2015-05-25) Vording, Nancy; Doane, Gweneth
Canadian RNs have recently been faced with the new challenge of being removed from the bedside in order to fulfill the position of team leader. However, as the majority of frontline RNs may not be equipped with the skills, traits, or abilities necessary to execute such a role (Eddy et al., 2009; Heller et al., 2004; Pate, 2013), this MN project was undertaken as a way to help me grasp how the skills, traits, and abilities promoted within some relational nurse leadership works and within some team building tools and strategies, aligned with one another. In order to uncover alignment between these two areas, I employed Novak and Gowin’s (1984) systematic concept mapping methodology as a way to develop two concept maps that explicitly articulated the skills, traits, and abilities endorsed within the resources reviewed on relational nurse leadership and team building. Then, the theory of the relational work of nurses (Terrizzi DeFrino, 2009) was enlisted as a way to help me analyze how the skills depicted on my two maps aligned and reflected the three main theoretical assertions described by Terrizzi DeFrino (2009). In doing this, I was able to locate nine main aligning skill sets that were then illustrated within a visual spider map (All, Huycke & Fisher, 2003). I believe that this spider map could one day be used or tailored by hospital nurse leaders, clinicians, or educators as a way to help inform or guide RN team leaders for their new practice roles.
Preparing new graduate nurses for pediatric nursing practice: a literature review and curriculum blueprint
(2015-04-29) Sieuraj, Jaime; Young, Lynne
The transition from student to professional practice nurse is difficult to navigate. New graduates are expected to enter independent practice with little extra support. Due to the nursing shortage and current economic realities, new graduates are being recruited into specialty areas such as pediatrics. It is important that adequate support is maintained so these nurses are retained in the healthcare system. The goal of this project was to develop an orientation curriculum for new graduate nurses entering practice at a tertiary care children’s hospital. A thematic analysis of the literature was performed that identified four major themes related to the new graduate transition process and pediatric orientation programs. These themes were: challenges new graduates face with transition to a new role; the requirement of a supportive environment for new graduate nurses; the importance of skill and knowledge attainment; and retention and turnover of new graduates. This thematic analysis informed the development of a new graduate orientation program. A theoretical framework of social constructivism and Fink’s taxonomy of significant learning were used to direct the curriculum development. The intent of designing a blueprint of an orientation program for this group of nurses is to provide guidance to educators responsible for supporting the transition of new graduate nurses from new graduate to practicing specialized pediatric nurse to ensure that they develop the requisite skills, knowledge, and attitudes required to practice in a safe, competent manner.
Health care professionals' experiences after making errors in practice: an integrative review of the literature
(2015-04-29) Mants, Tara; Banister, Elizabeth
There is a common expectation among health care professionals to "do no harm" and, while this is the ideal, it is not the reality. Despite the best intentions of health care professionals, errors do occur. The objectives of this review were to explore how health care professionals were affected by their involvement in adverse events and to determine the types of support health care professionals required after making an error. An integrative literature review of eleven research articles was conducted to explore common themes. These eleven studies included four quantitative studies, six qualitative studies, and one mixed-methods study. The results of this literature review indicate that following an error, health care professionals experience emotional distress on both a personal and a professional level. Health care professionals require individual as well as organizational support to help them cope with the error. The findings of the integrative literature review have important implications for nursing practice, nursing leaders and advanced practice nursing.
New nursing graduates’ relationships with experienced nurses in practice: an integrative literature review
(2015-04-29) Faulkner, Julian; Banister, Elizabeth
New nurses entering practice for the first time are faced with adjusting quickly to the requirements of the workplace. Support during this period of adjustment is essential. To obtain support new nurses must form interpersonal relationships with their experienced peers. This integrative literature review follows the guidelines set out by Whittemore and Knafl (2005) and examines how intraprofessional relationships with experienced nurses influence new nursing graduates’ transition into practice. A total of 15 research articles focusing on new nursing graduates were chosen for this integrative review. Qualitative studies were evaluated using an adaptation of Ryan, Coughlan, and Cronin’s (2007) critique and quantitative studies were critiqued using Coughlan, Cronin, and Ryan’s (2007) framework. The findings are presented in three themes: weaving into the fabric, navigating the landscape, and playing the game. Peplau’s Theory of Interpersonal Relations was used to inform the discussion. The findings are significant to Advance Practice Nursing (APN) in both academic and clinical settings. Nursing students need assistance to improve their interpersonal skills and increase self-awareness. Nurse educators should use teaching strategies that help nursing students feel empowered. In the clinical setting nurse educators should create strategies which build an esprit-de-corps between nurses, assist with teambuilding, and improve nurse-to-nurse communication. Recommendations for future research include how intraprofessional relationships between new nurses and experienced nurses in community settings influence new nurses transition into practice; how gender influences new nurses and experienced nurses relationships during role transition; and finally how intraprofessional relationships between different category of nurse [RN or RPN] may influence new nurse role transition.
Narrative pedagogies for perinatal nursing education
(2015-04-29) Beck, Claire; MacKinnon, Karen
Creating and providing core perinatal education to nurses within a health system can be challenging. Preparing nurses for complex and unpredictable situations requires innovative approaches to make learning meaningful, effective, and inspire deeper thinking. The purpose of this project is to demonstrate how I have incorporated what I have learned within the Nurse Educator (NUED) program into my practice as a nurse educator. The aims of this project include: 1) showing how caring theories, within the practice model of Relationship Based Care, (RBC) are utilized within a perinatal course offering to create a safe student-centered learning environment and 2) where narrative pedagogies are used to promote experiential learning and active engagement. An underlying premise of using narrative pedagogy is that learning occurs in mutual discussion between the students and teacher(s). The narrative approach, through the use of case studies and story-based learning (SBL), promote understanding by addressing the meanings of the participants' social interactions, which emphasize situation, context, and the multiple cognitive constructions that individuals create in everyday activities.
An integrative literature review on patient and family centred care in adult intensive care units
(2015-04-23) Parsons, Shannon; Starzomski, Rosalie
Patients admitted into the Intensive Care Unit (ICU) face severe medical emergencies that are associated with complex interventions and high mortality rates (Angus et al., 2004). As patient acuity increases, the patient’s ability to interact with health care providers often declines as patients face intubation, mechanical ventilation, sedation, and other interventions and medical circumstances that limit communication. With a patient’s limited ability to communicate needs and wishes, health care providers increasingly depend upon family members to make difficult decisions. Nurses are often in the best position to act as liaisons between patients and their families as families are faced with making treatment decisions for their family members who are receiving care in the ICU. My purpose, in this project, was to locate the most evidence informed methods for integrating patient and family centred care in adult ICU’s. An integrative literature review was completed to determine recommendations for nursing practice for family inclusion in the ICU. My analysis revealed four themes; consultation, collaboration, presence, and communication. These themes, derived from the literature review, were then considered from a relational inquiry perspective and recommendations were formulated for best practice nursing in adult ICU’s.
Continuing education in pediatric emergency management: literature review and curriculum development
(2015-04-23) Scarisbrick, Shannon; Young, Lynne
There are few situations health care providers will encounter that are more stressful than the resuscitation of a pediatric patient. Pediatric resuscitations are relatively uncommon events and are generally associated with dismal patient outcomes despite efforts to implement pediatric-specific resuscitation guidelines (Donoghue et al, 2010; Hunt, Walker, Shaffner, Miller & Pronovost, 2008; Mikrogianakis et al., 2008). The purpose of this project is to present an integrative literature review and curriculum blueprint for pediatric emergency management to address the continuing education needs of nurses caring for pediatric patients. Thematic analysis of the literature was undertaken as well as a needs assessment of local nurses to discover what gaps in pediatric emergency management education exist currently. The proposed curriculum is informed by Benner’s model of novice to expert (Benner, 1982; Benner, 2001), and Fink’s taxonomy of significant learning (Fink, 2013). The theoretical foundation of the curriculum is constructivism, a perspective which acknowledges the previous knowledge and experience of the learners, and ensures that the curriculum remains learner-centred.
Exploring the impact of anonymity on cyberbullying in adolescents: an integrative literature review
(2015-04-22) Mascotto, Brooke; Ronan, James
Adolescents are vulnerable to the risks associated with failing to protect their online privacy and becoming involved with risky online behaviours such as cyberbullying. The ability to remain anonymous on Social Networking Sites when committing acts of cyberbullying is a major influencing factor on adolescents’ motives and response to cyberbullying. An integrative literature review explores the perceptions of adolescents aged 10-19 regarding anonymity in their online behaviours in order to understand its impact on cyberbullying. The author presents the results using Albert Bandura’s Social Learning Theory (1977) and John Suler’s Online Disinhibition Effect (2005). Anonymity is found to alter adolescent coping strategies and increase the perceived distress of the incident. Anonymity impacts the environment by blurring intention and reception, creates dissociation, and reduces empathy in adolescents. Anonymity alters adolescent behavior through the perceived minimization of consequences, the creation of a power imbalance and encourages bystander participation in cyberbullying further increasing distress. Recommendations for Advanced Practice Nurses are made using a health promotion perspective that includes: building capacity for adolescent resilience and providing education regarding online risks and management. In addition, the importance of advocating for standardized legislation and nation wide anti-bullying policies and programs designed to reduce the incidence and impact of cyberbullying in adolescents will be discussed.
Using technology to engage the millennial nursing student: an integrative review of the literature
(2015-04-22) Sheane, Vanessa; McDonald, Carol
Nursing education programs are heavily comprised of students from the technologically savvy millennial generation. Millennial learners want and expect the use of technology in their courses. This integrative literature review synthesizes and presents the findings from existing literature that inform the use of educational technology by nursing faculty to engage millennial learners. Six primary research articles were selected after a search of the CINAHL, ERIC, MEDLINE, and PubMed electronic databases with keywords and inclusion/exclusion criteria. Using thematic analysis three patterns were identified: technological tools, professional consumption versus personal creativity, and enhancing and supplementing content. This review suggests that nursing faculty should implement technology in nursing education that is congruent with the generational traits of millennial learners. Educators should seek recommendations and evaluation feedback about technology from the millennial learners. The use of educational technology captivates the interest of millennial nursing students. Nursing faculty working with millennial learners must stay on the educational technology wave to facilitate maximum student engagement. This review of the literature reveals the need for further research in this area of nursing education. However, a number of practical findings can be easily integrated into nursing faculty’s teaching practice.
Justifying oncology nurse navigator roles in Canada: an integrative literature review on quality indicators, evaluation metrics, and measurable patient outcomes
(2015-03-02) Hartzell, Renee; Thoun, Deborah
Research has demonstrated that patient navigation interventions that have been led by nurse navigators are an effective way of improving continuity of care and the overall quality of care delivery to persons living with cancer. However, Canadian cancer programs struggle to justify the need for more nurse navigator positions. The purpose of this literature review was to explore the patient navigation movement and the known quality indicators and measurable patient outcomes available to measure the impact of implementing patient navigation initiatives that have been led by nurses. The current state of the science examining patient navigation interventions and evaluation metrics was reviewed following the integrative literature review framework. The findings are summarized in five overarching meta-themes: system efficiency, patient satisfaction, healthcare usage, return on investment, and survival. Oncology nurse navigators engender positive outcomes in oncology care. The identification of quality ambulatory oncology nursing indicators, evaluation metrics, and measurable patient outcomes may help facilitate discussions concerning the value of oncology nurse navigators and provide organizations with the tools to measure the impact of implementing nurse navigators. Patient navigation is understudied and more nursing research is needed to define oncology nursing navigator interventions and associated outcomes.

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