Registered - Nursing and Midwifery Board of Australia
Masters focus: "Multitasking whilst medicating: exploring how undergraduate student nurses respond to simulated interruption"
UTS Vice-Chancellor’s Learning and Teaching Grants
2012. Power, T., Kelly, M., Gray, J., Virdun, C., White, H., Hayes, C., Disler, R., Stanton, R., Van-Houten, J., Keller, J. ($5,000). Flipped onto their feet: online audio-visual resources to facilitate engagement with simulation and the optimum use of time in the laboratory learning spaces.
2012. Catling-Paull, C., Homer, C., Gray, J., Cummins, A., Hogan, R., White, H., Power, T., Hayes, C., Lee, M. ($5,000). The Virtual Tutor: Improving clinical practice skills for nursing and midwifery students in the clinical laboratories.
Hayes, C., Jackson, D., Davidson, P.M., Daly, J. & Power, T. 2017, 'Calm to chaos: Engaging undergraduate nursing students with the complex nature of interruptions during medication administration.', Journal of Clinical Nursing.View/Download from: UTS OPUS or Publisher's site
AIMS AND OBJECTIVES: To describe undergraduate student nurse responses to a simulated role-play experience focussing on managing interruptions during medication administration. BACKGROUND: Improving patient safety requires that we find creative and innovative methods of teaching medication administration to undergraduate nurses in real-world conditions. Nurses are responsible for the majority of medication administrations in health care. Incidents and errors associated with medications are a significant patient safety issue and often occur as a result of interruptions. Undergraduate nursing students are generally taught medication administration skills in a calm and uninterrupted simulated environment. However, in the clinical environment medication administration is challenged by multiple interruptions. DESIGN/METHODS: A qualitative study using convenience sampling was used to examine student perceptions of a simulated role-play experience. Data were collected from 451 of a possible 528 student written reflective responses and subject to thematic analysis. RESULTS: Students reported an increased understanding of the impacts of interruptions while administering medications and an improved awareness of how to manage disruptions. This study reports on one of three emergent themes: "Calm to chaos: engaging with the complex nature of clinical practice." CONCLUSIONS: Interrupting medication administration in realistic and safe settings facilitates awareness, allows for students to begin to develop management strategies in relation to interruption and increases their confidence. Students were given the opportunity to consolidate and integrate prior and new knowledge and skills through this role-play simulation.
Hayes, C.J., Jackson, D., Davidson, P.M., Daly, J. & Power, T. 2017, 'Pondering practice: Enhancing the art of reflection', Journal of Clinical Nursing.View/Download from: UTS OPUS or Publisher's site
Aims and objectives
The aim of this study was to describe the effect that immersive simulation experiences and guided reflection can have on the undergraduate nurses' understanding of how stressful environments impact their emotions, performance and ability to implement safe administration of medications.
Patient safety can be jeopardised if nurses are unsure of how to appropriately manage and respond to interruptions. Medication administration errors are a major patient safety issue and often occur as a consequence of ineffective interruption management. The skills associated with medication administration are most often taught to, and performed by, undergraduate nurses in a controlled environment. However, the clinical environment in which nurses are expected to administer medications is often highly stressed and nurses are frequently interrupted.
This study used role-play simulation and written reflections to facilitate deeper levels of student self-awareness. A qualitative approach was taken to explore students' understanding of the effects of interruptions on their ability to undertake safe medication administration. Convenience sampling of second-year undergraduate nursing students enrolled in a medical–surgical subject was used in this study. Data were obtained from 451:528 (85.42%) of those students and analysed using thematic analysis.
Students reported increasing consciousness and the importance of reflection for evaluating performance and gaining self-awareness. They described self-awareness, effective communication, compassion and empathy as significant factors in facilitating self-efficacy and improved patient care outcomes.
Following a role-play simulation experience, student nurses reported new knowledge and skill acquisition related to patient safety, and new awareness of the need for empathetic and compassionate care during medication administration. Practicing medication administration in realis...
Chen, H., Kelly, M., Hayes, C., van Reyk, D. & Herok, G. 2016, 'The use of simulation as a novel experiential learning module in undergraduate science pathophysiology education', ADVANCES IN PHYSIOLOGY EDUCATION, vol. 40, no. 3, pp. 335-341.View/Download from: UTS OPUS or Publisher's site
Power, T., Virdun, C., White, H., Hayes, C., Parker, N., Kelly, M., Disler, R. & Cottle, A. 2016, 'Plastic with personality: Increasing student engagement with manikins.', Nurse education today, vol. 38, pp. 126-131.View/Download from: Publisher's site
Simulation allows students to practice key psychomotor skills and gain technical proficiency, fostering the development of clinical reasoning and student confidence in a low risk environment. Manikins are a valuable learning tool; yet there is a distinct lack of empirical research investigating how to enhance engagement between nursing students and manikins.To describe student perspectives of a layered, technology enhanced approach to improve the simulation learning experience.Tanner's Model of Clinical Judgment underpins the entire curriculum. This study additionally drew on the principles of narrative pedagogy.Across ten teaching weeks, five separate case studies were introduced to students through short vignettes. Students viewed the vignettes prior to their laboratory class. In the labs, manikins were dressed in the props used in the vignettes.The innovation was trialed in a second year core subject of a Bachelor of Nursing program in a large urban university in the autumn semester of 2014.Following ethics approval, students were emailed a participant information sheet. A focus group of nine students was held. The discussion was digitally recorded and transcribed verbatim prior to being subject to thematic analysis. Students' comments (143) about the vignettes in their standard subject specific student feedback surveys were also considered as data.Four themes were identified: Getting past the plastic; knowing what to say; connecting and caring; and, embracing diversity. The feedback indicated that these measures increased students ability to suspend disbelief, feel connected to, and approach the manikins in a more understanding and empathetic fashion.In addition to achieving increased engagement with manikins, other advantages such as students reflecting on their own values and pre-conceived notions of people from diverse backgrounds were realized.
Hayes, C., Jackson, D., Davidson, P.M. & Power, T. 2015, 'Medication errors in hospitals: a literature review of disruptions to nursing practice during medication administration.', Journal of clinical nursing, vol. 24, no. 21-22, pp. 3063-3076.View/Download from: Publisher's site
The purpose of this review was to explore what is known about interruptions and distractions on medication administration in the context of undergraduate nurse education.Incidents and errors during the process of medication administration continue to be a substantial patient safety issue in health care settings internationally. Interruptions to the medication administration process have been identified as a leading cause of medication error. Literature recognises that some interruptions are unavoidable; therefore in an effort to reduce errors, it is essential understand how undergraduate nurses learn to manage interruptions to the medication administration process.Systematic, critical literature review.Utilising the electronic databases, of Medline, Scopus, PubMed and CINAHL, and recognised quality assessment guidelines, 19 articles met the inclusion criteria. Search terms included: nurses, medication incidents or errors, interruptions, disruption, distractions and multitasking.Researchers have responded to the impact of interruptions and distractions on the medication administration by attempting to eliminate them. Despite the introduction of quality improvements, little is known about how nurses manage interruptions and distractions during medication administration or how they learn to do so. A significant gap in the literature exists in relation to innovative sustainable strategies that assist undergraduate nurses to learn how to safely and confidently manage interruptions in the clinical environment.Study findings highlight the need for further exploration into the way nurses learn to manage interruptions and distractions during medication administration. This is essential given the critical relationship between interruptions and medication error rates.Better preparing nurses to safely fulfil the task of medication administration in the clinical environment, with increased confidence in the face of interruptions, could lead to a reduction in errors and concom...
Hayes, C., Power, T., Davidson, P.M., Daly, J. & Jackson, D. 2015, 'Nurse interrupted: Development of a realistic medication administration simulation for undergraduate nurses.', Nurse education today, vol. 35, no. 9, pp. 981-986.View/Download from: UTS OPUS or Publisher's site
BACKGROUND: Medication errors are a global phenomenon. Each year Australia-wide there are up to 96,000 preventable medication errors and in the United States there are approximately 450,000 preventable medication errors. One of the leading causes of errors is interruption yet some interruptions are unavoidable. In the interest of patient safety, nurses need to not only understand the impact of interruptions, but also be empowered with the knowledge and skills required to develop effective interruption management strategies. Well-planned simulation experiences have the potential to expose students to authentic clinical cases, otherwise unavailable to them, building critical thinking and clinical reasoning skills and preparing them for practice. AIM: This paper describes a simulated role-play experience that was developed to enable undergraduate nurses to experience, reflect on and analyse their responses to interruptions during medication administration. METHODS: The simulation design presented in this paper was underpinned by both nursing and educational theorists, in combination with established simulation frameworks. SETTING AND PARTICIPANTS: Embedded within a clinical subject in 2013, the simulation experience was run over two campuses within a large Australian University. Participants included 528 second year undergraduate nursing students and 8 academic teaching staff. OUTCOME MAPPING: To stimulate reflective learning debriefing immediately followed the simulation experience. Written reflections were completed and submitted over the following 4weeks to extend the reflective learning process and review the impact of the experience from the student perspective. CONCLUSIONS: Undergraduate student nurses often have limited experiential background from which to draw knowledge and develop sound clinical judgements. Through exposure to clinical experiences in a safe environment, simulation technologies have been shown to create positive learning experiences and imp...