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To evaluate clinical nurses' perceptions and acceptability of procedure videos developed to support them during rare clinical procedures. In addition, a secondary aim was to investigate whether these videos reduce anxiety and enhance clinical reasoning.
A descriptive multi-methods study within a pre-post-implementation evaluation design.
Seven locally developed procedure videos (non-invasive ventilation (n = 2), temporary cardiac pacing (n = 3) and pericardiocentesis (n = 2)) were evaluated using questionnaires before and after a 6-month implementation period at a local health district in Australia. Participants self-rated their clinical reasoning skills in response to video procedures, mapped against the Clinical Reasoning cycle stages. The Spielberger State–Trait Anxiety Inventory (STAI) assessed anxiety towards rare procedures. Data from open-ended questions were analysed using inductive content analysis.
A total of 247 participants completed the pre-implementation questionnaire, and 133 completed the post-implementation questionnaire. Before implementation, many reported feeling heightened anxiety when faced with rare or infrequent procedures, reporting levels that exceeded commonly accepted clinical thresholds for concern. Content analysis revealed persistent concerns among participants, including the need for support during new procedures and a fear of making errors. Before implementation, participants reported searching online for videos to support undertaking new procedures. Following implementation, most participants reported that viewing the videos enhanced their learning experience and improved their clinical reasoning. Perceived anxiety towards undertaking rare procedures was not significantly different from post-implementation.
This study highlights the need for timely support during infrequent clinical procedures, as participants reported anxiety about them. It also demonstrates that procedure videos are valued tools for nurses before rare clinical procedures.
Rare procedures are linked to nurse anxiety and mixed emotions, some of which may be eustress. Organisations can enhance clinical resources for nursing staff by providing online videos tailored to local practices and context, which many nurses find helpful for improving clinical reasoning when undertaking rare procedures.
This study highlights the anxiety nurses experience before rare procedures and the significance of incorporating multimedia resources, especially online videos, in nursing professional development for rarely performed procedures. Additionally, it informs employers about nursing staff preferences.
SQUIRE 2.0 reporting was adhered to.
None.
To explore the prescribing practices and behaviours of Advanced Practice Nurses (APN) and pharmacist prescribers in Singapore, assess their confidence in key prescribing competencies, examine their use of information sources, and understand their views on the consequences of prescribing errors.
Cross-sectional national survey.
A census survey of all registered APN and pharmacist prescribers in Singapore was conducted from February to May 2024 using a validated 96-item instrument. The survey assessed prescribing practices, confidence in prescribing competencies, use of information sources, and prescribing safety. Descriptive statistics were used for analysis.
Ninety-one prescribers (54 APNs, 37 pharmacists) responded (32% response rate), most of whom worked in public medical/surgical settings. Prescribing comprised a median of 75% of their practice. Most time was spent prescribing continued medications, with less on initiating new medicines. Participants reported high confidence in communication, therapeutic partnerships, and working within professional standards. Greatest confidence was seen in educating patients, legal prescribing, and monitoring treatment response. Lower confidence was noted in complementary medicine-related tasks. Professional literature and colleagues were the most valued information sources. Most participants acknowledged the serious consequences of prescribing errors, though many believed such errors would likely be intercepted.
APNs and pharmacists demonstrate strong competencies in safe, holistic prescribing. However, cultural factors may limit patient engagement, highlighting the need to strengthen shared decision-making and collaborative practice.
Refining governance structures, adopting tiered prescriber autonomy, and enhancing training in complex prescribing are essential. Standardising deprescribing, improving access to decision-support tools, and promoting interprofessional collaboration and patient involvement can strengthen care quality and team-based delivery.
This study offers the first national insight into Singapore's Collaborative Prescribing Framework and informs training, policy, and workforce development for non-physician prescribers locally and in similar international contexts.
STROBE checklist.
This study did not include patient or public involvement in its design, conduct, or reporting.
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