Background In postgraduate intensive care nursing courses, high-fidelity simulation is useful to prepare students to guarantee safe and quality care of critically ill patients. Surprisingly, this issue has not attracted sufficient attention in the literature, and it is not clear whether the linear application of the traditional high-fidelity simulation method based on prebriefing, the simulation session and debriefing, can serve as empirical reference in postgraduate students’ education. The aim of this study was to investigate the lived experiences of postgraduate students receiving multiple exposures to an innovative high-fidelity simulation design based on Kolb’s Experiential Learning Theory. Methods A phenomenological study was conducted at an Italian University involving a purposive sample of 15 nursing students attending the postgraduate intensive care course. Audio-recorded face-to-face in-depth interviews were held by a researcher in a dedicated room complemented with non-verbal communication outlined in the field notes. Thematic analysis was used to analyse the transcribed data. Results Three themes and ten categories were derived from the data analysis. The themes included pragmatic learning experience, the emotional path, and confidence. Conclusions Multiple exposure to high-fidelity simulation was lived as a pragmatic learning experience enhancing the students’ ability to apply theory into practice. This novel approach also contributed to the transition from negative to positive feelings and improved students’ confidence about technical and non-technical skills when caring for a critically ill patient.

Background: The best application modality of high-fidelity simulation in graduate critical care nursing courses is still rarely investigated in nursing research. This is an important issue since advanced nursing skills are necessary to effectively respond to critically ill patients’ care needs. The aim of the study was to examine the influence of a modified teaching model based on multiple exposures to high-fidelity simulations on both the learning outcomes and the perceptions of graduate students enrolled in a critical care nursing course. Methods: A multimethod study involving a sample of graduate critical care nursing students was conducted. A theoretical teaching model focused on multiple exposures to high-fidelity simulations is currently applied as a teaching method in an Italian critical care nursing course. According to the Kirkpatrick model for evaluating training programs, the performance, self-efficacy, and self-confidence in managing critically ill patients were considered learning outcomes, while satisfaction with learning and students’ lived experiences during the experimental phases were considered students’ perceptions. Results: Multiple exposures to high-fidelity simulations significantly improved performance, self-efficacy, and self-confidence in managing virtual critically ill patients’ care needs. The satisfaction level was high, while lived experiences of participants were positive and allowed for better explanation of quantitative results of this study. Conclusions: Multiple exposures to high-fidelity simulations can be considered a valuable teaching method that can improve the learning outcomes of graduate nurses enrolled in an intensive care course.

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AimsTo explore the impact of 12 American Nurses Association recognized standardized nursing terminologies (SNTs) on patient and organizational outcomes.BackgroundPrevious studies reported an effect of SNTs on outcomes, but no previous frameworks nor meta‐analyses were found.DesignSystematic review and meta‐analyses.Review MethodsPubMed, Scopus, CINAHL, and OpenGrey databases were last consulted in July 2021. All abstracts and full texts were screened independently by two researchers. The review included primary quantitative studies that reported an association between recognized SNTs and outcomes. Two reviewers independently assessed the risk of bias and certainty of evidence for each meta‐analyzed outcome using the “Grading of Recommendations, Assessment, Development and Evaluation” (GRADE) approach.ResultsFifty‐three reports were included. NANDA‐NIC‐NOC and Omaha System were the most frequently reported SNTs used in the studies. Risk of bias in randomized controlled trials and not‐randomized controlled trials ranged from high to unclear, this risk was low in cross‐sectional studies. The number of nursing diagnoses NANDA‐I moderately correlated with the intensive care unit length of stay (r = 0.38; 95% CI = 0.31–0.44). Using the Omaha System nurse‐led transitional care program showed a large increase in both knowledge (d = 1.21; 95% CI = 0.97–1.44) and self‐efficacy (d = 1.23; 95% CI = 0.97–1.48), while a reduction on the readmission rate (OR = 0.46; 95% CI = 0.09–0.83). Nursing diagnoses were found to be useful predictors for organizational (length of stay) and patients' outcomes (mortality, quality of life). The GRADE indicated that the certainty of evidence was rated from very low to low.ConclusionsStudies using SNTs demonstrated significant improvement and prediction power in several patients' and organizational outcomes. Further high‐quality research is required to increase the certainty of evidence of these relationships.Clinical relevanceSNTs should be considered by healthcare policymakers to improve nursing care and as essential reporting data about patient's nursing complexity to guide reimbursement criteria.

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