Challenges Experienced by Nurse Educators in Promoting Acquisition of Clinical Reasoning Skills by the Undergraduate Nursing Students: A Qualitative Exploratory Study

Background: Clinical reasoning is an essential skill for nursing students since it is required to solve difficulties that arise in complex clinical settings. However, teaching and learning clinical reasoning skills is difficult because of its complexity. This study, therefore aimed at exploring the challenges experienced by nurse educators in promoting acquisition of clinical reasoning skills by undergraduate nursing students. Methods: A qualitative exploratory research design was used in this study. The participants were purposively sampled and recruited into the study. Data were collected using semi-structured interview guides. Thematic analysis method was used to analyze the collected data The principles of beneficence, respect of human dignity and justice were observed. Results: The findings have shown that clinical learning environment, lacked material and human resources. The students had no interest to learn the skill. There was also knowledge gap between nurse educators and clinical nurses. Lack of role model was also an issue and limited time exposure. Conclusion: The study revealed that nurse educators encounter various challenges in promoting the acquisition of clinical reasoning skills among undergraduate nursing students. Training institutions and hospitals should periodically revise the curriculum and provide sufficient resources to facilitate effective teaching and learning of clinical reasoning. Nurse educators must also update their knowledge and skills through continuous professional development if they are to transfer the skill effectively.

Assessing the Levels of Clinical Reasoning Skills Using Self-Assessment of Clinical Reflection and Reasoning in Undergraduate Nursing Students: A Descriptive Comparative Study

Background: Clinical reasoning is a critical cognitive skill that enables undergraduate nursing students to make clinically sound decisions. A lapse in clinical reasoning can result in unintended harm to patients. The aim of the study was to assess and compare the levels of clinical reasoning skills between third year and fourth year undergraduate nursing students. Methods: The study utilized a descriptive comparative research design, based on the positivism paradigm. 410 undergraduate nursing students were systematically sampled and recruited into the study. The researchers used the Self-Assessment of Clinical Reflection and Reasoning questionnaire to collect data on clinical reasoning skills from third- and fourth-year nursing students while adhering to ethical principles of human dignity. Descriptive statistics were done to analyse the level of clinical reasoning and an independent sample t-test was performed to compare the clinical reasoning skills of the student. A p value of 0.05 was accepted. Results: The results of the study revealed that the mean clinical reasoning scores of the undergraduate nursing students were knowledge/theory application (M = 3.84;SD = 1.04);decision-making based on experience and evidence (M = 4.09;SD = 1.01);dealing with uncertainty (M = 3.93;SD = 0.87);reflection and reasoning (M = 3.77;SD = 3.88). The mean difference in clinical reasoning skills between third- and fourth-year undergraduate nursing students was not significantly different from an independent sample t-test scores (t = −1.08;p = 0.28);(t = −0.29;p = 0.73);(t = 1.19;p = 0.24);(t = −0.57;p = 0.57). Since the p-value is >0.05, the null hypothesis (H0) “there is no significantno significant difference in clinical reasoning between third year and fourth year undergraduate nursing students”, was accepted. Conclusion: This study has shown that the level of clinical reasoning skills of the undergraduate nursing students was moderate to low. This meant that the teaching methods have not been effective to improve the students clinical reasoning skills. Therefore, the training institutions should revise their curriculum by incorporating new teaching methods like simulation to enhance students’ clinical reasoning skills. In conclusion, evaluating clinical reasoning skills is crucial for addressing healthcare issues, validating teaching methods, and fostering continuous improvement in nursing education.

Clinical Value of Predictive Nursing Intervention on Deep Venous Thrombosis of Lower Extremities after Cesarean Section

[Objectives]To explore the clinical nursing value of predictive nursing intervention in patients with deep venous thrombosis of lower extremities after cesarean section.[Methods]From December 2022 to April 2023,105 pregnant and lying-in women who were hospitalized in the Gynecology Department of Pingquan Hospital and underwent cesarean section and met the inclusion criteria were included as the study objects.According to the medical records,they were divided into observation group(n=52 cases)and control group(n=53 cases).The clinical experimental subjects were divided into two groups.One group was the control group with routine nursing,and the other group was the observation group with predictive nursing intervention.The number of cases of deep venous thrombosis of lower extremities in the two groups was recorded to evaluate the clinical value.[Results]The incidence of deep venous thrombosis of lower extremities in the two groups after cesarean section was compared,and it was suggested that the incidence of the observation group was lower than that of the control group(P<0.05).[Conclusions]Special predictive nursing intervention can greatly reduce the incidence of deep venous thrombosis of lower extremities after cesarean section,improve nursing satisfaction,and improve clinical efficacy,which is worthy of recommendation.

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.

The Application of Psychological Nursing in Pediatric Clinical Nursing

Objective:To study the application effect of psychological nursing in pediatric clinical nursing.Method:100 pediatric patients who underwent treatment in our hospital from January 2019 to December 2020 were selected as the research subjects.They were randomly divided into a control group and an observation group,with 50 cases in each group.The control group received routine nursing care,while the observation group received psychological care based on routine nursing care.The nursing compliance,incidence of adverse events,and parental satisfaction of the two groups of pediatric patients were compared and analyzed.Result:Through psychological nursing intervention,it was found that the observation group had better nursing compliance,incidence of adverse events,and parental satisfaction than the control group,P<0.05,the differences are statistically significant.Conclusion:The application of psychological nursing in pediatric clinical nursing can improve the compliance of pediatric care,reduce the incidence of adverse events,enhance parental satisfaction,and have clinical promotion and application value.

Evaluation of the Effect of Endoscopic High- Frequency Electrocoagulation Electrodesiccation of Intestinal Polyps in the Clinical Nursing Pathway

Objective: To evaluate the effect of endoscopic high-frequency electrocoagulation electrodesiccation (HFEE) of intestinal polyps in the clinical nursing pathway. Method: A total of 120 patients who underwent HFEE of intestinal polyps were randomly divided into two groups of 60 cases. The control group received conventional nursing care while the observation group received the clinical nursing pathway of HFEE. Results: The average length of hospitalization, hospitalization costs, and mastery of the three health education of the observation group was lower than that of the control group (P < 0.01). The satisfaction of care in the observation group was significantly better than the control group (P <0.01). Conclusion: The clinical care path was suitable for HFEE of intestinal polyps, which shortened the patient’s length of hospitalization, improved their awareness of health education, improved their satisfaction with care, reduced medical disputes, and promoted the good development of nurse-patient relationships .

Study on the Construction and Evaluation System of Clinical Midwifery Teaching Faculty under the New Nursing Model

Objective:To explore the impact of the construction of a clinical midwifery teaching faculty and the development of an evaluation system under the new nursing model on the current teaching quality.Methods:From July 2022 to March 2023,10 clinical teaching teachers and 20 midwifery interns from Beijing Anzhen Hospital affiliated with Capital Medical University were selected as the subjects of this study.The clinical teaching teachers and midwifery interns were divided into an observation group and a control group,with each group including 5 clinical teaching teachers and 10 midwifery interns.The observation group received daily management and evaluation under the new nursing model,while the control group received management and evaluation under the traditional nursing model.The teaching quality evaluation of clinical midwifery teaching teachers by midwifery interns,the exit exam scores of midwifery interns,and the scores of clinical teaching teachers’internship lectures and teaching rounds were compared between the two groups.Results:In the observation group,the scores for teaching attitude,teaching skills,and teaching management in the teaching quality evaluation of clinical midwifery teaching teachers were higher than those in the control group.The professional theory scores(91.28±3.64)and overall nursing comprehensive scores(92.56±4.38)of midwifery interns in the observation group were higher than those of midwifery interns in the control group(81.58±2.27 and 80.29±3.33,respectively).The scores for internship lectures(89.32±4.15)and teaching rounds(90.64±5.52)in the observation group were also significantly higher than those in the control group(80.46±3.28 and 81.24±4.38,respectively),and the differences were statistically significant(P<0.05).Conclusion:The management of the clinical midwifery teaching faculty under the new nursing model effectively improved the quality of clinical teaching.It significantly enhanced the teaching effectiveness of clinical teaching teachers and the proficiency of midwifery interns in clinical operations,making it worthy of promotion and use.

A Study on Aligning Nursing Curriculum with Hospital Clinical Competency Requirements

The purpose of this study is to coordinate the alignment between the nursing curriculum and hospital clinical competencies,identify the reasons for the gaps,evaluate the impact of these gaps on the nursing profession,and propose strategies to bridge these gaps.This study will help strengthen nursing education,improve nursing students’skills,and help students adapt to complex clinical environments.

Clinical Nursing for Patients Undergoing Prone-Position Laparoscopic Partial Nephrectomy

Objective:To explore effective nursing strategies for patients undergoing prone-position laparoscopic partial nephrectomy.Methods:A total of 19 patients undergoing prone-position laparoscopic partial nephrectomy were selected,with hospital admission spanning from January 2024 to June 2024.Patients were randomly divided into the study group(n=10)and the control group(n=9).The control group received basic nursing care,while the study group received comprehensive high-quality nursing care.The recovery period,length of hospital stay,complication rates,SCL-90 scores,and nursing quality scores were compared between the two groups.Results:The recovery period and hospital stay were significantly shorter in the study group compared to the control group(P<0.05).The complication rate in the study group was lower than that in the control group(P<0.05).After the nursing intervention,the SCL-90 scores of the study group were lower than those of the control group(P<0.05).Nursing quality scores were higher in the study group than in the control group(P<0.05).Conclusion:Comprehensive high-quality nursing intervention for patients undergoing prone-position laparoscopic partial nephrectomy can shorten the recovery period and hospital stay,reduce the complication rate,improve mental health,and enhance nursing quality,making it suitable for wider application in medical institutions.

Observation of the Clinical Effects of Detailoriented Nursing in Health Checkups at a Health Management Center

Objective:To observe the clinical effects of detail-oriented nursing in health checkups at a health management center.Methods:A total of 240 individuals undergoing health checkups at the hospital’s health management center from June 2023 to June 2024 were enrolled and randomly divided into two groups according to a random number table method.The control group received routine nursing care,while the observation group received detail-oriented nursing care,with 120 cases in each group.Differences in checkup quality and nursing risk incidence were compared.Results:The form submission rate,project completion rate,and one-time checkup completion rate in the observation group were higher than those in the control group,while the checkup time was shorter(P<0.05).The incidence of nursing risks such as item loss,falls,and patient-nurse disputes was lower in the observation group compared to the control group(P<0.05).Conclusion:Applying detail-oriented nursing in health checkups at a health management center can effectively improve checkup quality and reduce the occurrence of nursing risks.

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.

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.

Knowledge and Attitudes of Oncology Nurses Toward Clinical Trials-A Secondary Publication

Purpose:The purpose of this study was to identify the knowledge and attitudes of oncology nurses toward clinical trials and to provide evidence for the development of clinical trial education programs for oncology nurses.Methods:The study was conducted on 142 nurses who had more than six months of nursing experience working with cancer patients at a tertiary hospital in Seoul,Korea.A structured questionnaire was used to measure the knowledge and attitudes of oncology nurses toward clinical trials.Results:The participants scored an average of 15.03±3.52 out of 19 in terms of knowledge about clinical trials.In terms of attitudes toward clinical trials,the participants scored an average of 5.91±1.37 out of 8.There was a significant positive correlation between the knowledge and attitudes of the participants toward clinical trials(r=0.23,P=0.007).Conclusion:This study found that there was a relationship between the knowledge and attitudes of oncology nurses toward clinical trials.To improve the competency of oncology nurses and provide high-quality care to patients participating in clinical trials,more systematic and sustainable education is required.

A cross-sectional study on the nurses’attitude towards rapid response system activation for clinically deteriorated patients

Background:Hospitals have reported that implementing rapid response system activation(RRS)activation has increased patient safety.As a result,there has been growing interest in identifying factors that lead to successful RRS activation.While introducing an automated RRS activation system has prompted nurses to be more vigilant about monitoring vital signs,it has not necessarily encouraged them to conduct thorough patient assessments to identify early signs of deterioration.Purpose:The current study aimed to assess nurses’attitudes towards RRS activation for clinically deteriorated patients in the clinical units of King Abdul-Aziz Hospital.Methods:A descriptive cross-sectional research design was utilised in the study,and 144 nurses working in the medical and surgical units of King Abdul-Aziz Hospital were recruited to participate using a convenient non-probability sampling technique.Results:The study’s findings reported that nurses have a positive attitude towards RRS benefits(Mean=3.70;SD=0.70).Their overall attitude towards RRS activation among clinically deteriorated patients is still low positive(Mean=2.71;SD=0.61).The nurses’attitudes towards RRS benefits significantly differ among nationalities and the clinical area/unit where they were assigned,with a P-value of 0.0194 and 0.000,respectively.Attitudes towards RRS barriers significantly differ among nationality(P-value=0.0037),education level(P-value=0.0032),area of assignment(P-value=0.020),and whether they have a good understanding of abnormal observations(P-value=0.0122).Regarding the nurses’attitude towards management belief,the significant result is only with the clinical area/unit of assignment with a P-value of 0.000.Conclusion:The current study found a low positive attitude towards RRS activation among ward nurses,especially given that monitoring vital signs is critical to their job.Nurses may fear being perceived as clinically inept for redundant activations caused by poor quality,but their attitude towards activating the RRS in clinical deterioration is still largely negative.This is because most RRSs rely on ward nurses to recognise clinical deterioration and manually alert responders through phone calls,hospital communication systems,or face-to-face communication.

Establishment and Clinical Application of Multidisciplinary Collaborative Rapid Rehabilitation Nursing Pathway in Perioperative Period of Brucellosis Spondylitis

Objective: To study the establishment and clinical application of multidisciplinary collaborative rapid rehabilitation nursing model in patients with brucellosis spondylitis during the perioperative period. Method: From January 2009 to January 2013, 39 patients diagnosed with brucellosis spondylitis were treated with focal clearance combined with posterior pedicle internal fixation. Nursing was randomly divided into 2 groups: 19 cases of routine nursing as the control group (group A);20 cases of implementation of the nursing path as the intervention group (group B). In the intervention group, analgesic nursing plan, daily activity ability training path, medication compliance and health education path were used to effectively intervene on the evaluation parameters affecting rapid recovery and clinical efficacy (VAS score, daily activity ability mastery, Oswestry disability index and medication Morisky-Green index). The nursing effect and clinical evaluation of the two groups were compared. Results: As time went by, VAS pain score, mastery of daily activity ability, Oswestry disability index and medication compliance between the two groups at the same time point were significantly different (P Conclusions: The nursing path of brucellosis spondylitis is positively correlated with rapid recovery and clinical efficacy. Compared with routine nursing, it has a significant effect on accelerating postoperative rehabilitation and clinical efficacy.

Perception of Male Nursing Students about Their Maternity Clinical Practice: A Cross-Sectional Survey from a Nursing College

The aim of this study was to explore the perception of male nursing students’ experiences and challenges in maternity clinical practice. A quantitative cross-sectional survey design was used. The self-administered questionnaire included 18 items 5-point Likert scale to identify the challenges experienced by male nursing students in their maternity clinical practice, and 14 items to assess comfort level in performing procedures in maternity clinical areas. Participants were 93 male nursing students who had completed their maternity clinical posting in different maternity clinical areas as a part of their nursing program, at the College of Nursing, Kuwait. Results showed that male nursing students are not very keen on undergoing maternity clinical training (Chi-square analysis χ2 = 96.939;P χ2 = 108.638;P χ2 = 5.297;P = 0.021). In conclusion, this study showed that being treated differently and being refused to provide care to clients were the main challenges faced by male nursing students during their maternity practice. The participants had a strong belief that they will not be accepted by maternity clients because of the gender difference and cultural influence. There is a need to design strategies in both academic and clinical settings to overcome barriers to male nursing students’ engagement in the various maternity care areas. Our findings also indicate the need to embrace gender diversity in maternity clinical practice and call for professionalism, gender and cultural awareness creation, and advocacy.

Clinical Utilization of Nursing Process in Improving Patient’s Outcome and Its Associated Factors: A Cross-Sectional Study among Nurses and Midwives Working at Njombe Regional Referral Hospital, Tanzania

Background: Improvement of patient care in any hospital depends primarily on the quality of nursing care. Nursing care is enhanced by the nursing process, which outlines the nursing activities to be provided for a patient. Methods and Materials: A cross sectional design employing quantitative methods was conducted in Njombe RRH in December 2021. Quantitative data were collected from nurses and midwives from all wards by simple random sampling techniques using a sample-size calculator. SPSS version 26.0 was used to analyse data whereby a p-value of 0.05 was considered a decision mark for the significance of the result;Chi-square and Logistic regression respectively were used to find out the association and its strength between variables. Result: Majority of the respondents, 41 (85.4%), had inadequate knowledge and 33 (68.8%) found them people with a negative attitude to the nursing process. Significantly, there is an association between knowledge and clinical utilization (AOR 2.24;95% CI: 1.6 - 2.5;P 0.04), attitude and clinical utilization (AOR 4.32;95% CI: 1.8 - 3.7;P Conclusion: A knowledge gap in relation to the utilization of the nursing process and a negative attitude were noted to be associated significantly with the utilization of the nursing process among nurses and midwives. It is recommended on-job training, supportive supervision, and Value Clarification and Attitude Transformation (VCAT) are the best interventions to address the knowledge gap and negative attitudes respectively.

Progress of clinical decision support systems in stroke nursing care

Stroke is characterized by high incidence,high recurrence,high disability,and high morbidity and mortality in China,resulting in a heavy social and clinical burden.A clinical decision support system,as an intelli-gent computer system,can assist nurses in decision-mak-ing to collect information quickly,make the most suitable personalized decisions for patients,and improve nurses’decision-making judgment and quality of care.Promoting the development and application of decision support sys-tems in stroke nursing significantly enhances the nursing staff’s work quality and patients’prognosis.Therefore,this paper reviews the research progress of domestic and international clinical decision support systems in stroke nursing care to provide other researchers with specific research directions for developing and applying decision support systems in stroke nursing care.

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.

Call for papers-Journal of Clinical and Nursing Research

Dear Researchers,Journal of Clinical and Nursing Research(JCNR)is an international,peer reviewed and open access journal that seeks to promote the development and exchange of knowledge which is directly relevant to all clinical and nursing research and practice.Articles which explore the meaning,prevention,treatment,outcome and impact of a high standard clinical and nursing practice and discipline are encouraged to be submitted as original article,review,case report,short communication and letters.