Effect of “Four Passes” Training and Assessment of Nurse Specialty Knowledge on the Cultivation of Core Competence of Clinical Nurses

Background: With the development of high quality nursing service, hospitals put forward higher requirements for nurses’ service level. In recent years, the number and quality of specialized nurses remain to be improved despite the remarkable achievements in the construction of specialized nurses. Objective: This study intended to explore a standardized training mode for nurses oriented by training and assessment of nursespecialty knowledge and to summarize the practical experience of this mode. Methods: The training and assessment program was formulated by starting from the objectives of training clinical front-line nursing staff in our hospital, and the standard training and assessment were carried out from four aspects: the specialized disease knowledge, the condition observation and reporting ability, emergency and severe disease nursing, and perioperative accelerated rehabilitation guidance. These four items are hereinafter referred to as “Four Passes” training and assessment, and it was practiced in the assessment and training of nurses in our hospital from 2020 to 2022. Results: A total of 915 front-line caregivers were surveyed in our study, including 772 nurses and 143 doctors. After two years of implementation, the self-evaluation of nurses increased from (2.96 ± 0.79) points to (3.64 ± 0.78) points, and the evaluation score by doctors increased from (3.94 ± 0.74) points to (4.26 ± 0.72) points. The core competence of specialty increased from (69.22 ± 16.53) points to (85.42 ± 14.44) points. The scores of all dimensions after training were higher than those before training, with statistical significances. Conclusion: The “Four Passes” training and assessment of nurse specialty knowledge can fully mobilize the enthusiasm of managers and nurses in all departments, ensure solid specialty knowledge, improve nurses’ core competence, improve nursing quality, and create a harmonious relationship between nurses and patients as well as between doctors and patients.

Development and application of an online testing system for clinical nurses

The online assessment is a new examination system which has a broad application in many research fields such as medical science and has been proved to be effective,reliable,and robust.The aim of this study was to establish an online testing system for clinical nurses and to assess its effectiveness compared with traditional paper-based tests in China.A randomized controlled trial was performed,a total of 1802 nurses were recruited and randomly assigned to take either the paper-formatted test or the online test.Then the paper quality,examinee's performance and nurses'assessments of online testing system were evaluated.The results shown that online assessment system for clinical nurses had a comparable examination effects with traditional paper-based format,and the nurse spoke highly of its effectiveness and efficiency.These data suggest that online nursing assessments should be considered a dependable replacement for paper test.

Organizational Citizenship Behavior and Organizational Commitment among Clinical Nurses in Bangladesh

Organizational citizenship behavior becomes one of the significant factors that enhance the organizational efficiency. Organizational citizenship behavior has been defined as behaviors that an employee voluntarily engages in organization that promote the effectiveness of clearly rewarded by the organization. However organizational commitment is very beneficial for the organization because it reduces the absenteeism rate and turnover ratio and enhances the organization productivity. In all of the organization, organizational commitment exerts a positive effect on the nurses’ performance. The aim was to assess the relationship between organizational citizenship behavior and organizational commitment among nurses. The descriptive correlational design was used to explore the relationship between organizational citizenship behavior and organizational commitment among nurses. Simple random sampling was used and sample size was 164. Data were collected by a self-structured questionnaire during November 2019 to December 2019 at Dhaka Medical College Hospital. Data were analyzed using SPSS version 21. The result showed that average age of the participants was 34.19 years old. There were statistically positive significant relationships between organizational citizenship behavior with organizational commitment (r = 0.82, p = 0.000), organizational citizenship behavior with working ward (F = 6.31, p = 0.000) and organizational commitment with working ward (F = 4.45, p = 0.002). Based on the results of this study, it is indicated that lack of OCB & OC among nurses’ is moderate level. The findings of this study will suggest reducing organizational hazard, and developing citizenship behavior and organizational commitment that enhance high outcome in health care organizations & quality of care. So hospital should provide in-service training for nurses’ and all departments are equally. Predictive study of factors related to OCB & OC is recommended for future study.

Spiritual care perceptions, spiritual health and their relationships with spiritual care competence among clinical nurses in China: A cross-sectional quantitative study

Objective:To investigate the status quo of spiritual care competence and assocaited influencing factors among clinical nurses in China,and examine the relationships among spiritual care perceptions,spiritual health and spiritual care competence,and the mediating role of spiritual health between spiritual care competence and spiritual care perceptions,in order to provide reference for the construction of spiritual care education intervention program to improve the spiritual care competence of clinical nurses in China.Methods:A total of 1454 clinical nurses from 17 hospitals in Tianjin were selected by convenience sampling method,and were investigated with sociodemographic characteristics questionnaire,the Chinese version of Spiritual Care Competence Scale(C-SCCS),the Chinese Version of the Spiritual Care-Giving Scale(C-SCGS)and the Spiritual Health Scale Short Form(SHS-SF).Results:The scores of spiritual care competence of nurses was(57.52±16.02).The results of multiple linear regression showed that nurses'spiritual care competence was influenced by 9 sociodemographic characteristics such as educational background and nursing age,as well as spiritual care perceptions and spiritual health factors,which accounted for 67.2%of the total variation.And spiritual care competence was positively correlated with spiritual care perceptions(r=0.639,P<0.01)and spiritual health(r=0.596,P<0.01).Besides,spiritual health played a mediating role between between other two variables,accounting for 27.5%of the indirect effect.Conclusions:The scores of spiritual care competence of clinical nurses was in the lower middle level,which needs to be further improved.It is recommended that nurse managers and educators should pay attention to the spiritual care education of nurses,and improve spiritual care perceptions and spiritual health level of nurses in multiple ways,at multiple levels,so as to improve their spiritual care competence and to maximize the satisfy spiritual care needs of patients.

Clinical Nurses’Research Capacity Building in Practice—A Systematic Review

The aim of this study was to identify and evaluate evidence of clinical nurses’ research capacity building in practice. A systematic review of studies of nurses’ research capacity building in practice was performed. The quality of the articles was evaluated and reflected on in accordance with the Quality Assessment and Validity Tool for Correlation Studies. The literature searches identified a total of 4748 abstracts and titles. Eight quantitative studies were included in the evaluation. Three themes emerged from the analysis: Failure to ensure research quality and standards, Developing a research culture and Collaboration and organization of research utilization. The first theme has one sub-theme: Lack of knowledge about how to increase research utilization. The second theme is based on three sub-themes: Ability to identify clinical problems, changing nurses’ attitudes to research and research supervision. Finally, the third theme has one sub-theme: Funding as a success factor. In conclusion, research capacity building requires the development of research competence to generate knowledge that enhances quality and patient safety. Nurse leaders are essential for establishing evidence-based practice and a research culture, thus enhancing nurses’ scientific attitudes and capacity.

Investigation and Analysis on the Management Standard of Blood Glucose Monitoring for Clinical Nurses in Nyingchi Region of Tibet

Background: In participating in the medical support work in the Nyingchi area of Tibet, the author found that the medical education resources in this area are scarce, and the clinical nurses in this area have relatively insufficient knowledge about blood glucose monitoring and management. Accurately understanding the knowledge-attitude/belief-practice (KAP) level of nurses in Nyingchi area on blood glucose management is of great significance to the development of blood glucose monitoring management guidance for nurses in this area. Therefore, this study investigated the current status of the management of blood glucose monitoring management standards for clinical nurses in Nyingchi, Tibet. Objective: To investigate and analyze the current situation of clinical nurses in Nyingchi region of Tibet to grasp the regulation of blood glucose monitoring and guide the implementation of the norm of blood glucose monitoring for clinical nurses. Methods: The research survey was carried out from March to April 2020. Random sampling method was used to select 134 clinical in-service nurses in Nyingchii, Tibet. The self-designed knowledge-attitude/belief-practice survey questionnaire for clinical nurses’ blood glucose monitoring and management in Tibet was used. Nurses’ blood glucose monitoring management “KAP” scores and related influencing factors are analyzed. Results: Blood sugar monitoring and management knowledge score is (36.78 ± 6.80), attitude dimension is (42.48 ± 6.42), practice dimension is (61.87 ± 10.24) and total score is (304.73 ± 36.24). The nurse’s department and whether to participate in diabetes training are the main influencing factors of the blood glucose monitoring management norms, knowledge and behavior (both P < 0.05). Conclusion: The standard knowledge of blood glucose monitoring and management of clinical nurses in Nyingchi region of Tibet is at the middle level, positive attitude and unsatisfactory behavior. Nursing managers should conduct standardized training for clinical nurses in blood glucose monitoring, develop the training mode of diabetes specialty nursing talents in Nyingchi area, and construct a complete management system of diabetes specialty nursing.

A Research About the Current Situation of Insulin Injection Provided by Clinical Nurses Under Kap Model on Linzhi, Tibet

Objective:to investigate the current situation of insulin injection provided by clinical nurses under KAP(Knowledge-Attitude-Practice)model on Linzhi,Tibet,and to discuss and analyse the influence factors.Methods:using a selfdesign questionnaire a questionnaire about the current situation of insulin injection provided by clinical nurses under KAP model on Linzhi,Tibet to investigate 268 clinical nurses in Linzhi,Tibet,who were chosen through random sampling method,in order to analyse the‘KAP’scoring and the influencing factors.Results:The scoring of‘Knowledge’is(65.642±10.313),the scoring of‘Attitude’is(55.478±8.099),the scoring of‘Practice’is(42.493±6.647),the total scoring is(163.612±19.292).The related influence factors,including hospital,department,academic credentials,professional qualifications and whether receiving diabetes specialized training,have statistical significance(P value<0.5).Conclusion:The KAP of insulin injection provided by clinical nurses in Linzhi,Tibet is on middle level.For nursing managers,it is strongly advised that a normative.

Enhancing competency of clinical research nurses:A comprehensive training and evaluation framework

The Sun et al's training program for clinical research nurses(CRNs)in the World Journal of Clinical Cases is a comprehensive and scientific approach.It includes structured frameworks for CRN training,aiming to improve CRN competency.This program emphasizes practical abilities,updates training content,and improves evaluation methods.The cultivation of CRN talents focuses on enhancing the training system,establishing a multifaceted evaluation framework,and continuously refining the training programs.Regular feedback and evalua-tion are essential to improve CRNs'competency in practical settings.

Clinical competency:perceptions of nursing interns and clinical mentors

Objective:To assess the clinical competency of nursing interns and the perception of clinical nurse mentors toward student nurses'clinical competency.Methods:A study was carried out among 104 nursing interns and 26 clinical nurse mentors using the purposive sampling technique.A self-repor ted perception scale was used to collect the data.Results:In general,most nursing interns perceived themselves as clinically competent during the internship.The clinical nurse mentors too repor ted that the current internship is helping the nursing interns in becoming competent.Conclusions:Frequent clinical evaluation,buddy system,provision of stipends,good leadership,and coordination between the academic institute and hospital are repor ted as the critical motivating factors for improving the clinical competency of student interns.

Application of Seminar Teaching Method Combined with Case-Based Learning and Problem-Based Learning Teaching Models in Oral Clinical Nursing Teaching

Purpose:To analyze the role of the seminar teaching method+case-based learning(CBL)teaching method+problem-based learning(PBL)teaching method in oral clinical nursing teaching.Methods:13 undergraduate nursing students who entered the department from September 2020 to September 2021 were selected as the control group,adopting conventional nursing teaching methods;13 undergraduate nursing students who entered the department from September 2021 to August 2022 were selected as the observation group,adopting the seminar+CBL+PBL teaching method.The teaching effects were compared between the two groups.Results:All assessment scores of the observation group were higher than those of the control group;all teaching satisfaction levels were higher than those of the control group(P<0.05).Conclusion:Adopting the seminar+CBL+PBL teaching method during oral clinical nursing teaching can improve nursing students’assessment scores,strengthen their core competencies,and enhance teaching satisfaction.

Mediating effect of self-efficacy in relationship between emotional intelligence and clinical communication competency of nurses

Objective:This study investigates the emotional intelligence(EI),self-efficacy,and clinical communication ability of clinical nurses to explore the correlation among these three variables,and verify the mediating effect of self-efficacy on relationship between EI and communication skills.Methods:A total of 865 nurses were recruited and investigated using Wong and Law's Emotional Intelligence Scale,General Self-Efficacy Scale,and nurse clinical communication scale.Results:The scores for EI and self-efficacy of nurses were 14.23±2.61 and 25.36±5.67,respectively,which were lower than the international norm(p<0.01).The score for clinical communication ability of nurses was 4.14±0.53.The clinical communication competency of nurses was positively correlated with EI and general self-efficacy.Furthermore,selfefficacy played an intermediary role between EI and clinical communication commitment.Conclusion:Nursing administrators can improve the clinical communication ability of nurses by enhancing their self-efficacy and EI.

Current status of clinical nursing specialists and the demands of osteoporosis specialized nurses in China's Mainland

The clinical nursing specialist(CNS)is an expert who applies an expanded range of practical,theoretical,and research-based competencies to the care of patients within in a specialty clinical area within the larger discipline of nursing.A large number of studies consistently conclude that the CNS is a valuable healthcare resource that provides highquality clinical and evidence-based nursing practice and improves patient outcome.The CNS has been involved in healthcare practices for many years,with an increasingly diverse role.However,the training for the CNS in China is only in a preliminary developmental stage.The aim of this article is to review the history and development of the CNS role.Furthermore,the epidemiologic status of osteoporosis,as well as the feasibility and necessity of developing training programs in China for the osteoporosis CNS,will be discussed.

Application of Clinical Nursing Pathway in the Peri-Treatment Period of Immunoadsorption Therapy for Rheumatic Immune Diseases

Objective: The paper aims to investigate the clinical nursing pathway (CNP) in the application of immunosorption therapy in patients with rheumatic immune disease. Methods: Convenience sampling method was used to select inpatients who received immunoadsorption therapy from January 2020 to December 2022 in the rheumatology and Immunology department of a 3A hospital in Jingzhou City. 30 patients from January 2020 to June 2021 were selected as control group, and 30 patients from July 2021 to December 2022 were selected as observation group. The control group was given routine nursing. On the basis of the control group, the observation group used a clinical nursing pathway for intervention during the perioperative period of immunosorbent therapy. The incidence of adverse reactions, patient satisfaction, and nurse satisfaction during immunosorbent therapy between the control group and the observation group were compared. Results: After intervention, the incidence of adverse reactions in the observation group was significantly lower than that in the control group, while patient satisfaction and nurse satisfaction in the observation group were significantly higher than those in the control group. The results are all statistically significant (P Conclusion: Clinical nursing pathway is beneficial to reduce the incidence of adverse reactions in patients with immunoadsorption during peri-treatment and improve the satisfaction of patients and nurses.

The Latest Research Progress in the Application of MEWS Scoring System in Clinical Nursing

This paper summarizes the background of the formation of the Modified Early Warning System(MEWS)evaluation system,its current status of clinical teaching applications in different fields of hospitals,and its significance on the medical and nursing career,aiming to provide specific theoretical basis for medical staff and lay a foundation for continuing to carry out related work on MEWS.

A review of the development and current status of wound ostomy continence nurses in the mainland of China

Wound ostomy continence nurses(WOC nurses),developed as an important part of clinical nurse specialists play an indispensable role in the management of ostomy,all kinds of chronic wounds and incontinent dermatitis.However,there exists a gap compared with developed countries and regions.This paper provides an overview of WOC nurses in China including origin and development,training and accreditation system,roles,values and management,in order to provide references for the development of WOC nurses in China.

A systematic review of the effectiveness of clinical nurse specialist interventions in patients with chronic obstructive pulmonary disease(COPD)

Objective： This review aimed to examine the effectiveness of clinical nurse specialist （CNS） interventions in patients with chronic obstructive pulmonary disease （COPD）. COPD significantly affects people＇s health worldwide. With the development in nursing, CNSs are playing increasingly important roles in different departments. However, the studies on the effectiveness of CNSs in COPD are not as well organized as the studies on the effectiveness of CNSs in bronchiectasis and asthma. Therefore, this review aims to find some updated evidence on the CNS interventions for patients with COPD and on whether these interventions are effective.Methods： A narrative analysis of the data was performed for the eligible studies. Four databases were chosen： CINAHL, MEDLINE, British Nursing Index, and Cochrane Library. Other websites such as the National Institute for Health and Clinical Excellence, National Health Service Evidence, Association of Respiratory Nurse Specialists, and National Association of Clinical Nurse Specialist were searched as well. Two reviewers performed study identification independently, and all the retrieved articles were stored using the EndNote X7 software. The risk of bias in the included studies was assessed using the Cochrane Collaboration＇s risk of bias tool. Results： A total of nine studies were included in this review. There were five current interventions by CNSs for patients with COPD. These interventions were home nursing support, CNS]s supported discharge, multidisciplinary cooperation programs, nurse-led care programs, and self-care management education. The effectiveness of these five interventions was evaluated individually. There is low- to moderate-quality evidence indicating that home nursing support interventions may have a positive effect on mortality and quality of life. No significant difference in quality of life has been found between the CNS-supported discharge intervention and the usual service. The multidisciplinary cooperation program probably had a positive effect on quality ot life in patients with COPD. Both nurse-led care and self-care management education intervention had a positive effect on mortality of patients with COPD.Conclusions： The findings of this review provide updated evidence on the effectiveness of CNS interventions for patients with COPD. Although nine trials were included and five types of interventions were identified, there is still lack of high-quality evidence.

A proposed model for best practice in nursing clinical teaching in China

Objective To explore a corresponding model that would bridge the gap between the practice of clinical teaching of nursing students in clinical settings in China and the clinical instructors' standard teaching of nursing students in clinical settings in the Philippines. Methods A phenomenological-qualitative,non-experimental type of research was utilized to recruit 27 staff nurses/clinical teachers in China. Data was collected by using audio-tapes and taking notes in the interviews. Results A content analysis was conducted and the sorted into four themes:(1) The things that they were able to teach their students;(2) The things that they were not able to teach their students;(3) The difficulties encountered in doing Clinical Teaching for their students;(4) Suggestions to improve Clinical Teaching. Conclusion According to the findings,the "CP's Proposed Nursing Clinical Teaching Model"should be introduced into the clinical set-up for staff nurses/clinical teachers handling nursing students in China.

Active Learning Improves Nursing Student Clinical Performance in an Academic Institution in Macao

Objective： To assess the outcome of the application of active learning during practicum among nursing students using clinical assessment and evaluation scores as a measurement. Methods： Nursing students were instructed on the basics of active learning prior to the initiation of their clinical experience. The participants were divided into 5groups of nursing students （ n = 56） across three levels （years 2-4） in a public academic institute of a bachelor degree program in Macao. Final clinical evaluation was averaged and compared between groups with and without intervention. Results： These nursing students were given higher appraisals in verbal and written comments than previous students without interventian. The groups with the invention achieved higher clinical assessment and evaluation scores on average than comparable groups without the active learning intervention. One group of sophomore nursing students （year 2） did not receive as high of evaluations as the other groups, receiving an average score of above 80. Conclusions＂ Nursing students must engage in active learning to demonstrate that they are willing to gain knowledge of theory, nursing skills and communication skills during the clinical practicum.

Observation on the Application of“Online+Offline”Mixed Teaching Mode in Clinical Nursing Teaching

Objective:To observe the application effect of“online+offline”mixed teaching mode in clinical nursing teaching.Methods:A total of 72 clinical nursing workers,who work in PLA General Hospital and participated in the experiment from March 2019 to March 2021,were selected as the subjects of this study.According to the odd numbers assigned to the participants’names,the participants were divided into two groups:the experimental group and the control group,with 36 cases in each group.The experimental group received“online+offline”hybrid teaching,whereas the control group received traditional offline teaching.In order to evaluate the efficacy and safety of the two groups of nursing workers,their assessment scores,teaching satisfaction scores,and teaching evaluation indicators were observed.Results:The experimental group was significantly better than the control group in terms of assessment scores,teaching satisfaction scores,and teaching evaluation indicators(P<0.05).Conclusion:In clinical nursing teaching,the“online+offline”mixed teaching mode plays a unique role in improving students’scores and teaching quality;thus,it should be promoted.

Visualization analysis of the study of fund-sponsored clinical nursing papers

Objective： The aims of this study were to understand the status quo of authors, collaborations between institutions, research hotspots, and research frontiers of fund-sponsored clinical nursing papers and to provide a reference for Chinese scholars to conduct clinical nursing studies in the future.Methods： The visualization software CiteSpace was used to analyze fund-sponsored clinical nursing papers published between 2012 and 2016 in 12 core journals of nursing.Results： In the clinical nursing field, there are many co叩erative author groups; however, the collaborations between institu加 not close and exist mainly within the same province or city. High-frequency keywords have revealed the four clinical nursing research hotspots of population, diseases, nursing intervention, and others. Chinese medicine nursing, prevention, treatment and nursing, and new technology-aided nursing of ventilator-associated pneumonia are the study frontiers of clinical nursing.Conclusions： Clinical nursing studies are rich in content and cover a wide range of areas, and their hotspots and frontiers are closely related to the requirements of clinical nursing. Collaborations across regions, provinces, and cities are not adequate; there is an urgent need to strengthen the cross-regional exchanges and collaborations to promote the further development of clinical nursing.