Comparison of nurses self-directed learning activities J D Emblen, G T Gray The Journal of Continuing Education in Nursing Vol21 (March/April 1990) 56-6 1
Excellence in nursing depends on continuing educationalAearning activities after formal education has been completed. The role of the nurse educator can be augmented by understand- ing the specific learning patterns of nurses.
In this research study, nurses self-directed learning (SDL) practices were surveyed. The purpose of this study was to (1) compare the SDL practices of masters- and baccalaureate-prepared nurses, (2) determine the learning time spent on professional and nonprofessional content areas, and (3) investigate variations in SDL activities of nurses of different ages. Motivation, benefits, and factors affecting job-related learning also were examined to help identify differences in nurses learning patterns. The adult learning theory was used as the conceptual framework (ie, focusing on adult personal needs of self-esteem and personal and professional motivation).
The literature review revealed that the majority of research in this area has been directed toward the general adult populations learning habits. It indicated the need for further study focusing on the learning practices of professional nurses.
Eighty study participants were randomly selected from 1,500 nurses working at a large metropolitan medical center. Forty participants had baccalaureate degrees and 40 had masters degrees. Each participant was interviewed using
an adaptation of Toughs instrument for a nurse population. Questions related to the number and nature of SDL projects, motivation, resources, and enthusiasmhenefit perceived.
Descriptive analysis indicated that profession- ally related projects accounted for approximately two thirds of the time spent on independent learning projects by all participants. The mean number of total annual hours spent on SDL projects was 313 for study participants. Compared to other studies, this was more than for physicians (181) and pharmacists (266) but was less than hours spent by professors, politicians, and individuals in traditional male occupations.
Two-way analysis of variance compared the participants age and degree to (1) annual professional project hours and (2) annual number of different professional projects. Degree earned and age were identified as the independent variables. The findings indicate that degree relates to the number of learning hours and number of projects (ie, masters degree nurses were more involved with SDL activities). The participants age was not a significant factor in the time or number of SDL projects.
The study results also show that the key SDL motivator is knowledge update (42%) for the nurses with baccalaureate degrees and professional development (53%) for the nurses with masters degrees. The study also found that factors facilitating job-related learning are flexible self- study materials, easy access to learning materials, time, and more resource people.
Perioperative nursing implications. Periop- erative nurse educators are responsible for using adult learning theory and must be familiar with the learning practices of perioperative nurses. Perioperative nurses needs must be assessed by
AORN JOURNAL JANUARY 1991, VOL. 53, NO 1
nurse educators before they develop educational activities. This study shows that the motivation for learning was different between the baccalaureate- and masters-prepared nurses. Nurse educators should design educational programs to meet the needs of the targeted audience.
The study implies that baccalaureate-prepared perioperative nurses may be more motivated by educational activities related to new surgical techniques, equipment, and instrumentation. Masters-prepared perioperative nurses may be more motivated by activities dealing with networking, presentations, and publishing. Perioperative nurse educators should identify specific factors that will facilitate learning. These include (1) time required for the activity, (2) self- study programs, (3) easy access to educational materials and information, and (4) adequate resource people. Most perioperative nurses have limited time to devote to professional learning activities. Educators can be supportive by establishing an area in the operating room for educational materials. Materials that can be taken home may promote SDL activity participation. Well-planned, appropriate perioperative educa- tional strategies can motivate perioperative nurses to engage in self-directed learning activities.
JANE H. JOHNSON, RN, MSN, CNOR NURSING RESEARCH COMMITTEE
Ritual and risk R Carter Nursing Times Vol86 (March 28-April 3, 1990) 63-64
This study on the current practice of wearing overshoes (ie, shoe covers) was based on a recommendation by the Leicestershire (England) Health Authority that overshoes no longer be worn as an infection control measure. The recommen- dation was based on the theory that hands were contaminated when donning or removing shoe covers and that contamination is a hazard to patients.
The researchers observed current practice and traffic patterns and tested subjects hands for contamination. Two trials were conducted; one had 10 subjects and the other had eight subjects. Finger impressions were obtained on blood agar plates and examined for aerobic spore-bearing bacillus (ASB). Floors were cultured in the clean and dirty corridors during the two separate trials, 14 days apart. The soles of six subjects shoes were cultured before donning covers, and the shoe covers were cultured before they were removed. The researchers also observed handwashing practices following shoe cover removal. This aspect of the study was repeated two weeks after the initial trial.
Results of the study show only 48% of staff complied with current policy of wearing shoe covers. Microbiological testing of hands revealed ASBs on every subjects hands after donning or removing shoe covers in the first trial and an increase in total number of colonies in the second trial.
Investigation of the soles of shoe covers revealed a higher bacterial count than on shoes in the first trial and a lower count in the second. The investigators attribute this discrepancy to the possibility that shoe covers were worn for a shorter time in the second trial. The clean corridor floor actually showed higher colony counts than the dirty floor in both trials.
Staff members indicated that they wore shoe covers for infection control, but 79% reported it was not common practice to wash their hands after contact with their shoes. Few operating theatres provide handwashing facilities at entrance and exit points. Other studies have shown that 70% alcohol is a valuable hand disinfectant when proper handwashing facilities are unavailable.
The authors conclude that the study clearly reveals a contrast between what practitioners thought they were doing and actual practice. Therefore, if shoe covers play no role in control of infection their use is ritual and should be discontinued.
Perioperative nursing impiications. Wear- ing shoe covers as an infection control measure is a sacred cow that should be put out to pasture once and for all. The AORN recommended