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Publisher: RMIT Publishing   (Total: 400 journals)

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Showing 1 - 200 of 400 Journals sorted alphabetically
40 [degrees] South     Full-text available via subscription   (Followers: 2)
Aboriginal and Islander Health Worker J.     Full-text available via subscription   (Followers: 14)
Aboriginal Child at School     Full-text available via subscription   (Followers: 5)
About Performance     Full-text available via subscription   (Followers: 11)
Access     Full-text available via subscription   (Followers: 25)
ACCESS: Critical Perspectives on Communication, Cultural & Policy Studies     Full-text available via subscription   (Followers: 9)
Accounting, Accountability & Performance     Full-text available via subscription   (Followers: 15)
ACORN : The J. of Perioperative Nursing in Australia     Full-text available via subscription   (Followers: 17, SJR: 0.103, h-index: 4)
Adelaide Law Review     Full-text available via subscription   (Followers: 19)
Advocate: Newsletter of the National Tertiary Education Union     Full-text available via subscription   (Followers: 1)
Agenda: A J. of Policy Analysis and Reform     Full-text available via subscription   (Followers: 1)
Agora     Full-text available via subscription   (Followers: 3)
Agricultural Commodities     Full-text available via subscription   (SJR: 0.102, h-index: 8)
Agricultural Science     Full-text available via subscription   (Followers: 2)
AIMA Bulletin     Full-text available via subscription   (Followers: 4)
AJP : The Australian J. of Pharmacy     Full-text available via subscription   (Followers: 10, SJR: 0.102, h-index: 5)
Analysis     Full-text available via subscription   (Followers: 3)
Ancient History : Resources for Teachers     Full-text available via subscription   (Followers: 4)
Anglican Historical Society J.     Full-text available via subscription   (Followers: 3)
Annals of the Royal Australasian College of Dental Surgeons     Full-text available via subscription   (Followers: 4, SJR: 0.101, h-index: 11)
ANZSLA Commentator, The     Full-text available via subscription   (Followers: 3)
Appita J.: J. of the Technical Association of the Australian and New Zealand Pulp and Paper Industry     Full-text available via subscription   (Followers: 12, SJR: 0.18, h-index: 27)
AQ - Australian Quarterly     Full-text available via subscription  
Arena J.     Full-text available via subscription   (Followers: 1)
Around the Globe     Full-text available via subscription   (Followers: 1)
Art + Law     Full-text available via subscription   (Followers: 12)
Art Monthly Australia     Full-text available via subscription   (Followers: 10)
Artefact : the journal of the Archaeological and Anthropological Society of Victoria     Full-text available via subscription   (Followers: 3)
Artlink     Full-text available via subscription   (Followers: 5)
Asia Pacific J. of Clinical Nutrition     Full-text available via subscription   (Followers: 10, SJR: 0.672, h-index: 51)
Asia Pacific J. of Health Management     Full-text available via subscription   (Followers: 3)
Aurora J.     Full-text available via subscription  
Australasian Biotechnology     Full-text available via subscription   (Followers: 1, SJR: 0.1, h-index: 8)
Australasian Catholic Record, The     Full-text available via subscription   (Followers: 5)
Australasian Drama Studies     Full-text available via subscription   (SJR: 0.101, h-index: 2)
Australasian Epidemiologist     Full-text available via subscription  
Australasian Historical Archaeology     Full-text available via subscription   (Followers: 7)
Australasian J. of Early Childhood     Full-text available via subscription   (Followers: 4, SJR: 0.174, h-index: 1)
Australasian J. of Gifted Education     Full-text available via subscription   (Followers: 5, SJR: 0.115, h-index: 3)
Australasian J. of Human Security, The     Full-text available via subscription   (Followers: 1)
Australasian J. of Irish Studies, The     Full-text available via subscription   (Followers: 8)
Australasian J. of Regional Studies, The     Full-text available via subscription   (Followers: 1)
Australasian Law Management J.     Full-text available via subscription   (Followers: 7)
Australasian Leisure Management     Full-text available via subscription   (Followers: 1)
Australasian Musculoskeletal Medicine     Full-text available via subscription   (Followers: 2)
Australasian Music Research     Full-text available via subscription   (Followers: 4)
Australasian Parks and Leisure     Full-text available via subscription   (Followers: 2)
Australasian Plant Conservation: J. of the Australian Network for Plant Conservation     Full-text available via subscription   (Followers: 4)
Australasian Policing     Full-text available via subscription   (Followers: 5)
Australasian Public Libraries and Information Services     Full-text available via subscription   (Followers: 32)
Australasian Review of African Studies, The     Full-text available via subscription   (Followers: 2)
Australian Aboriginal Studies     Full-text available via subscription   (Followers: 10, SJR: 0.109, h-index: 6)
Australian Advanced Aesthetics     Full-text available via subscription   (Followers: 4)
Australian Ageing Agenda     Full-text available via subscription   (Followers: 6)
Australian and Aotearoa New Zealand Psychodrama Association J.     Full-text available via subscription  
Australian and New Zealand Continence J.     Full-text available via subscription   (Followers: 3)
Australian and New Zealand Sports Law J.     Full-text available via subscription   (Followers: 8)
Australian Art Education     Full-text available via subscription   (Followers: 7)
Australian Bookseller & Publisher     Full-text available via subscription   (Followers: 1)
Australian Bulletin of Labour     Full-text available via subscription   (Followers: 2)
Australian Canegrower     Full-text available via subscription   (Followers: 2)
Australian Coeliac     Full-text available via subscription   (Followers: 1)
Australian Cottongrower, The     Full-text available via subscription   (Followers: 1)
Australian Educational and Developmental Psychologist, The     Full-text available via subscription   (Followers: 8, SJR: 0.143, h-index: 4)
Australian Family Physician     Full-text available via subscription   (Followers: 3, SJR: 0.364, h-index: 31)
Australian Field Ornithology     Full-text available via subscription   (Followers: 4, SJR: 0.141, h-index: 6)
Australian Forest Grower     Full-text available via subscription   (Followers: 4)
Australian Forestry     Full-text available via subscription   (Followers: 2, SJR: 0.252, h-index: 24)
Australian Grain     Full-text available via subscription   (Followers: 2)
Australian Holstein J.     Full-text available via subscription   (Followers: 1)
Australian Humanist, The     Full-text available via subscription   (Followers: 3)
Australian Indigenous Law Review     Full-text available via subscription   (Followers: 19)
Australian Intl. Law J.     Full-text available via subscription   (Followers: 23)
Australian J. of Acupuncture and Chinese Medicine     Full-text available via subscription   (Followers: 3, SJR: 0.106, h-index: 3)
Australian J. of Adult Learning     Full-text available via subscription   (Followers: 14, SJR: 0.159, h-index: 7)
Australian J. of Advanced Nursing     Full-text available via subscription   (Followers: 11, SJR: 0.225, h-index: 26)
Australian J. of Asian Law     Full-text available via subscription   (Followers: 4)
Australian J. of Cancer Nursing     Full-text available via subscription   (Followers: 8)
Australian J. of Civil Engineering     Full-text available via subscription   (Followers: 5, SJR: 0.17, h-index: 3)
Australian J. of Dyslexia and Learning Difficulties     Full-text available via subscription   (Followers: 8)
Australian J. of Emergency Management     Full-text available via subscription   (Followers: 10, SJR: 0.401, h-index: 18)
Australian J. of French Studies     Full-text available via subscription   (Followers: 7, SJR: 0.1, h-index: 5)
Australian J. of Herbal Medicine     Full-text available via subscription   (Followers: 3, SJR: 0.109, h-index: 7)
Australian J. of Language and Literacy, The     Full-text available via subscription   (Followers: 2, SJR: 0.399, h-index: 9)
Australian J. of Legal History     Full-text available via subscription   (Followers: 14)
Australian J. of Mechanical Engineering     Full-text available via subscription   (Followers: 3, SJR: 0.129, h-index: 4)
Australian J. of Medical Science     Full-text available via subscription   (Followers: 1, SJR: 0.122, h-index: 5)
Australian J. of Multi-Disciplinary Engineering     Full-text available via subscription   (Followers: 2)
Australian J. of Music Education     Full-text available via subscription   (Followers: 3)
Australian J. of Music Therapy     Full-text available via subscription   (Followers: 8)
Australian J. of Parapsychology     Full-text available via subscription   (Followers: 2)
Australian J. of Social Issues     Full-text available via subscription   (Followers: 5, SJR: 0.178, h-index: 20)
Australian J. of Structural Engineering     Full-text available via subscription   (Followers: 6, SJR: 0.296, h-index: 8)
Australian J. of Water Resources     Full-text available via subscription   (Followers: 6, SJR: 0.226, h-index: 9)
Australian J. on Volunteering     Full-text available via subscription   (Followers: 2)
Australian J.ism Review     Full-text available via subscription   (Followers: 8)
Australian Life Scientist     Full-text available via subscription   (Followers: 2, SJR: 0.1, h-index: 2)
Australian Literary Studies     Full-text available via subscription   (Followers: 5, SJR: 0.1, h-index: 6)
Australian Mathematics Teacher, The     Full-text available via subscription   (Followers: 6)
Australian Nursing J. : ANJ     Full-text available via subscription   (Followers: 6)
Australian Orthoptic J.     Full-text available via subscription  
Australian Primary Mathematics Classroom     Full-text available via subscription   (Followers: 4)
Australian Screen Education Online     Full-text available via subscription   (Followers: 2)
Australian Senior Mathematics J.     Full-text available via subscription   (Followers: 1)
Australian Sugarcane     Full-text available via subscription  
Australian TAFE Teacher     Full-text available via subscription   (Followers: 4)
Australian Tax Forum     Full-text available via subscription   (Followers: 3)
Australian Universities' Review, The     Full-text available via subscription   (Followers: 4)
Australian Voice     Full-text available via subscription   (Followers: 6)
Bar News: The J. of the NSW Bar Association     Full-text available via subscription   (Followers: 5)
Bioethics Research Notes     Full-text available via subscription   (Followers: 13)
BOCSAR NSW Alcohol Studies Bulletins     Full-text available via subscription   (Followers: 4)
Bookseller + Publisher Magazine     Full-text available via subscription   (Followers: 5)
Breastfeeding Review     Full-text available via subscription   (Followers: 17, SJR: 0.31, h-index: 19)
British Review of New Zealand Studies     Full-text available via subscription   (Followers: 4)
Brolga: An Australian J. about Dance     Full-text available via subscription   (Followers: 1)
Cancer Forum     Full-text available via subscription   (SJR: 0.143, h-index: 10)
Cardiovascular Medicine in General Practice     Full-text available via subscription   (Followers: 7)
Chain Reaction     Full-text available via subscription  
Childrenz Issues: J. of the Children's Issues Centre     Full-text available via subscription  
Chiropractic J. of Australia     Full-text available via subscription   (SJR: 0.107, h-index: 3)
Chisholm Health Ethics Bulletin     Full-text available via subscription   (Followers: 1)
Church Heritage     Full-text available via subscription   (Followers: 4)
Commercial Law Quarterly: The J. of the Commercial Law Association of Australia     Full-text available via subscription   (Followers: 4)
Communicable Diseases Intelligence Quarterly Report     Full-text available via subscription   (Followers: 2, SJR: 0.567, h-index: 27)
Communication, Politics & Culture     Open Access   (Followers: 12)
Communities, Children and Families Australia     Full-text available via subscription   (Followers: 2)
Connect     Full-text available via subscription   (Followers: 2)
Contemporary PNG Studies     Full-text available via subscription  
Context: J. of Music Research     Full-text available via subscription   (Followers: 8)
Corporate Governance Law Review, The     Full-text available via subscription   (Followers: 7)
Creative Approaches to Research     Full-text available via subscription   (Followers: 13)
Critical Care and Resuscitation     Full-text available via subscription   (Followers: 17, SJR: 1.737, h-index: 24)
Cultural Studies Review     Full-text available via subscription   (Followers: 15)
Culture Scope     Full-text available via subscription   (Followers: 4)
Current Issues in Criminal Justice     Full-text available via subscription   (Followers: 10)
Dance Forum     Full-text available via subscription   (Followers: 2)
DANZ Quarterly: New Zealand Dance     Full-text available via subscription   (Followers: 3)
Day Surgery Australia     Full-text available via subscription   (Followers: 2)
Deakin Law Review     Full-text available via subscription   (Followers: 14)
Developing Practice : The Child, Youth and Family Work J.     Full-text available via subscription   (Followers: 19)
Early Days: J. of the Royal Western Australian Historical Society     Full-text available via subscription  
Early Education     Full-text available via subscription   (Followers: 8)
EarthSong J.: Perspectives in Ecology, Spirituality and Education     Full-text available via subscription   (Followers: 1)
East Asian Archives of Psychiatry     Full-text available via subscription   (Followers: 2, SJR: 0.331, h-index: 7)
Educare News: The National Newspaper for All Non-government Schools     Full-text available via subscription  
Educating Young Children: Learning and Teaching in the Early Childhood Years     Full-text available via subscription   (Followers: 17)
Education in Rural Australia     Full-text available via subscription   (Followers: 1)
Education, Research and Perspectives     Full-text available via subscription   (Followers: 10)
Educational Research J.     Full-text available via subscription   (Followers: 17)
Electronic J. of Radical Organisation Theory     Full-text available via subscription   (Followers: 3)
Employment Relations Record     Full-text available via subscription   (Followers: 2)
English in Aotearoa     Full-text available via subscription   (Followers: 1)
English in Australia     Full-text available via subscription   (Followers: 2, SJR: 0.19, h-index: 6)
Essays in French Literature and Culture     Full-text available via subscription   (Followers: 6)
Ethos: Official Publication of the Law Society of the Australian Capital Territory     Full-text available via subscription   (Followers: 5)
Eureka Street     Full-text available via subscription   (Followers: 5)
Extempore     Full-text available via subscription  
Family Matters     Full-text available via subscription   (Followers: 10, SJR: 0.259, h-index: 8)
Federal Law Review     Full-text available via subscription   (Followers: 21)
Fijian Studies: A J. of Contemporary Fiji     Full-text available via subscription   (Followers: 1)
Focus on Health Professional Education : A Multi-disciplinary J.     Full-text available via subscription   (Followers: 7)
Food New Zealand     Full-text available via subscription   (Followers: 4)
Fourth World J.     Full-text available via subscription   (Followers: 1)
Frontline     Full-text available via subscription   (Followers: 18)
Future Times     Full-text available via subscription   (Followers: 2)
Gambling Research: J. of the National Association for Gambling Studies (Australia)     Full-text available via subscription   (Followers: 5)
Gay and Lesbian Law J.     Full-text available via subscription   (Followers: 2)
Gender Impact Assessment     Full-text available via subscription   (Followers: 1)
Geographical Education     Full-text available via subscription   (Followers: 2)
Geriatric Medicine in General Practice     Full-text available via subscription   (Followers: 8)
Gestalt J. of Australia and New Zealand     Full-text available via subscription   (Followers: 2)
Globe, The     Full-text available via subscription   (Followers: 3)
Government News     Full-text available via subscription   (Followers: 2)
Great Circle: J. of the Australian Association for Maritime History, The     Full-text available via subscription   (Followers: 7)
Grief Matters : The Australian J. of Grief and Bereavement     Full-text available via subscription   (Followers: 11)
He Puna Korero: J. of Maori and Pacific Development     Full-text available via subscription   (Followers: 4)
Headmark     Full-text available via subscription   (Followers: 2)
Health Inform     Full-text available via subscription  
Health Issues     Full-text available via subscription   (Followers: 2)
Health Promotion J. of Australia : Official J. of Australian Association of Health Promotion Professionals     Full-text available via subscription   (Followers: 8, SJR: 0.606, h-index: 19)
Health Voices     Full-text available via subscription  
Heritage Matters : The Magazine for New Zealanders Restoring, Preserving and Enjoying Our Heritage     Full-text available via subscription   (Followers: 2)
High Court Quarterly Review, The     Full-text available via subscription   (Followers: 3)
History of Economics Review     Full-text available via subscription   (Followers: 9)
HIV Australia     Full-text available via subscription   (Followers: 3)
HLA News     Full-text available via subscription   (Followers: 3)
Hong Kong J. of Emergency Medicine     Full-text available via subscription   (Followers: 4, SJR: 0.173, h-index: 7)
Idiom     Full-text available via subscription   (Followers: 1)
Impact     Full-text available via subscription   (Followers: 1)
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Indigenous Law Bulletin     Full-text available via subscription   (Followers: 17)
InPsych : The Bulletin of the Australian Psychological Society Ltd     Full-text available via subscription   (Followers: 2)
Inside Film: If     Full-text available via subscription   (Followers: 7)
Institute of Public Affairs Review: A Quarterly Review of Politics and Public Affairs, The     Full-text available via subscription   (Followers: 11)
Instyle     Full-text available via subscription  
Intellectual Disability Australasia     Full-text available via subscription   (Followers: 7)
Interaction     Full-text available via subscription   (Followers: 3)
Intl. Employment Relations Review     Full-text available via subscription   (Followers: 2)
Intl. J. of Disability Management Research     Full-text available via subscription   (Followers: 2)

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Journal Cover Australian Journal of Advanced Nursing
  [SJR: 0.225]   [H-I: 26]   [11 followers]  Follow
    
   Full-text available via subscription Subscription journal
   ISSN (Print) 0813-0531 - ISSN (Online) 1447-4328
   Published by RMIT Publishing Homepage  [400 journals]
  • Volume 34 Issue 4 - Managing medical service delivery gaps in a socially
           disadvantaged rural community: A Nurse Practitioner led clinic
    • Abstract: Kelly, Jo; Garvey, Deb; Biro, Mary Anne; Lee, Susan
      Objective: The aim of this pilot project was to investigate how Nurse Practitioners (NP) manage medical service delivery gaps in a socio-disadvantaged rural Victorian region.

      Design: A cross-sectional study utilising data from patient consultations that took place at the Nurse Practitioner Community Clinic (NPCC) over six months in 2013 and patient satisfaction survey.

      Setting: The NPCC is a rural clinic servicing a rural population in Victoria.

      Subjects: 629 patients.

      Main outcome measures: Numbers of patients; presentations; age; gender; postcode; reason for encounter; consultation length; availability of General Practitioner (GP); consultation activities and follow up; NP Medicare Benefits Scheme (MBS) item number rebate; and equivalent GP MBS item number rebates.

      Results: Over 50% of patients were female; 60% aged over 45 years. Patients had 2.6 encounters with the NPCC; over 50% lasting between 10 and 20 minutes. Approximately half the revenue of that claimed in equivalent GP encounters. Common reasons for attendance were symptoms and complaints (37.2%) and attendance was viewed as convenient and accessible, despite having a regular GP (47.8%). Fifty six Patients responded to a satisfaction survey and indicated they were satisfied with the service would use the service again and would recommend it.

      Conclusions: The NPCC provided an accessible service that met patients' needs in a rural community. The study provides evidence that NPs can provide medical management in areas where medical service delivery gaps exist. However, there was a significant discrepancy between funding reimbursements for services provided at the NPCC and those provided by GPs.

      PubDate: Thu, 2 Nov 2017 11:47:42 GMT
       
  • Volume 34 Issue 4 - Accessibility and outcomes from a rural diabetes
           nurse-educator led self-management program
    • Abstract: Roberts, Diane Patricia; Ward, Bernadette Maree; Russell, Deborah Jane; O'Sullivan, Belinda Gabrielle
      Objective: To investigate factors associated with access to, and health outcomes of, a diabetes nurse-educator led self-management program for rural Australians with diabetes.

      Design: Retrospective cohort study

      Setting: A rural community-health service with a dispersed catchment of 10,000 population.

      Subjects: Clients diagnosed with type 2 diabetes mellitus and referred to the program between April 2008 and December 2012.

      Intervention: A diabetes self-management program comprising an initial assessment, a group education session, and 3, 6, and 12 month clinical reviews.

      Main outcome measures: Program attendance after referral; and achievement of management goals for HbA1c, BMI, total cholesterol, quality of life and psychological distress.

      Results: Ninety-four percent (n=219/232) of referred clients attended at least once. Multivariate logistic regression showed that attending at least once was significantly associated with living within 25km of the service. Non-smokers/former smokers, general practitioner-referred clients and those with diabetes management plans were significantly more likely to attend three or more sessions. At 12 months clients showed significant improvements in cholesterol, BMI, quality of life and psychological distress.

      Conclusion: This study demonstrates that diabetes nurse-educator led self-management programs which adapt to their rural contexts - including geographically dispersed catchment populations and resource constraints - provide highly accessible services meeting the needs of most. Nevertheless, some groups (cigarette smokers, those living furthest from the service) may remain marginalised and less able to access services. Improvements in health outcomes for these clients may require further adaptation of models of care to better target their health care needs.

      PubDate: Thu, 2 Nov 2017 11:47:42 GMT
       
  • Volume 34 Issue 4 - A paediatric nurses' journal club: Developing the
           critical appraisal skills to turn research into practice
    • Abstract: Purnell, Margaret; Majid, Gina; Skinner, Virginia
      Objectives: The aim of this study was to determine if implementation of a regular journal club improves critical appraisal confidence and facilitates integrating research literature into nursing practice.

      Design: A survey was distributed to all paediatric nurses across two wards who had potentially attended the journal club in the previous two years.

      Setting: This small scale study was undertaken at a northern Australian hospital.

      Sample: The surveys were distributed to 58 nurses from the two paediatric wards and 33 of them responded but only 29 of these had attended the journal club leaving 29 surveys to be analysed for this study.

      Results: The majority of responses to the survey questions were positive. When statistically analysed by Pearson's correlation, four variables showed a strong association: increased confidence with interpreting research literature, developing critical appraisal skills, the sharing of knowledge and integrating evidence-based practice into nurses' workplace.

      A number of changes in practice have occurred as a direct result of the journal club.

      Conclusion: The results from this study support the benefits of utilising nursing journal clubs to promote clinical practice that is informed by research evidence.

      PubDate: Thu, 2 Nov 2017 11:47:42 GMT
       
  • Volume 34 Issue 4 - Elements to promote a successful relationship between
           stakeholders interested in mental health promotion in schools
    • Abstract: Handley, Christine; McAllister, Margaret
      Objective: An evaluation of a mental health promotion program called iCARE which depended on collaboration between multiple partners.

      Design: A qualitative exploratory evaluation that involved purposeful sampling of a range of stakeholders in the School settings.

      Setting: Two Secondary Schools in Tasmania.

      Intervention: iCARE stands for Creating Awareness, Resilience and Enhanced Mental Health and is a structured six-week program in which trained facilitators engage Year 8 students in learning about mental health and developing resilience. The collaboration involved university researchers, child and youth mental health clinicians, and education staff. It required investment in time and resources as well as intellectual effort and good will from each of the key players.

      Results: Successful elements of collaboration were distilled from the interview data, indicating that for a mental health promotion program to succeed in schools, highly tuned negotiation and communication skills are required.

      Conclusion: Nurses are increasingly working within the community to promote the health and wellbeing of many groups. To work effectively with young people in schools, and to share the impact of that work with the professional community, requires collaboration between health, education and university stakeholders. This evaluation found that success in this interdisciplinary connection requires respect, communication, negotiation and appreciation for disciplinary differences.

      PubDate: Thu, 2 Nov 2017 11:47:42 GMT
       
  • Volume 34 Issue 4 - Rotating shift work and colorectal cancer among nurses
           and midwives: A cross-sectional study
    • Abstract: Wickremaratne, Kalana; Strand, Haakan; Zhao, Isabella
      Objective: The main aim of this study was to explore any association between colorectal cancer (CRC) and rotating shift work in nurses and midwives. The secondary aim of this study was to identify risk factors for CRC in nurses and midwives who are rotating shift workers.

      Design: Cross-sectional study.

      Setting: Electronic survey of participants from Australia, New Zealand and the United Kingdom.

      Subjects: A sample of 8,199 male and female nurses and midwives from Australia, New Zealand and the United Kingdom invited through their registration papers or newsletter advertisement.

      Main outcome measure: Prevalence of CRC in participants who have worked rotating shifts for 1-14 years or >=15 years compared to participants who have never worked rotating shifts. In addition, risk factors for CRC in the rotating shift work population were analysed in a multivariate logistic regression model in order to obtain odds ratio of CRC.

      Results: No statistically significant difference was found in the prevalence of CRC between those who have never worked rotating shift work, worked 1-14 years and worked 15 or more years.

      Among rotating shift workers, diabetes was associated with a 123-fold (95% CI 39-392; p < 0.001) increased odds of CRC, while Inflammatory Bowel Disease (IBD) was associated with a 190-fold (95%CI 68-526; p < 0.001) increased odds of CRC. Screening colonoscopy or sigmoidoscopy for CRC was associated with a 10-fold (95% CI 3-35; p < 0.001) increased odds of being diagnosed with CRC.

      Conclusion: No significant association was found between rotating shift work and colorectal cancer in nurses and midwives. In nurses and midwives who are rotating shift workers, diabetes, IBD and CRC screening significantly increased the odds of CRC.

      PubDate: Thu, 2 Nov 2017 11:47:42 GMT
       
  • Volume 34 Issue 4 - Literature review: Why do we continue to lose our
           nurses'
    • Abstract: Goodare, Pete
      Objective: To decrypt what determining factors contribute to nurses leaving the clinical facet of the profession.

      Primary argument: Nurses encompass the largest professional constituent of the health care workforce in most countries, resulting in the impact of a shortage of these professionals, as immense. A projection in the shortage of nurses is upon us, and the margin in the reduction of these health professionals is thought to be worse than any of the preceding cyclical reductions. More than half of the nursing profession feel they are underpaid and overworked, resulting in the likelihood of patient's needs not being met, significantly increasing. Lengthy hours, quality of working environments, lack of leadership and the ageing population and workforce, can all be seen as influential factors, in which have the potential to leave this profession in a situation of calamity.

      Conclusion: In light of the predicted global demand for nurses over the next decade, the departure and retirement of the existing nursing workforce will potentially result in the loss of significant and treasured experience and organisational knowledge, weakening the capacity and capability of the nursing profession.

      PubDate: Thu, 2 Nov 2017 11:47:42 GMT
       
  • Volume 34 Issue 3 - Australian undergraduate nursing students' opinions on
           mental illness
    • Abstract: Millar, Rebecca
      Objective: To determine second year Bachelor of Nursing students' opinions on mental illness and relationship with demographic data for the purpose of curriculum development.

      Design: The present study is a pilot study for a larger project which will investigate undergraduate nursing student opinions across the duration of their undergraduate degree at an Australian university. The 'Student Opinions of Mental Illness Scale', a 53 point Likert type questionnaire was used in a sample of second year nursing students to investigate their opinions of mental illness.

      Setting: Metropolitan nursing school in Victoria, Australia.

      Subjects: 133 second year undergraduate Bachelor of Nursing students'.

      Main outcome measures: Student opinions based on Likert responses.

      Results: The study revealed that student experiences, education, employment history of country of birth may impact upon student opinions of mental illness.

      Conclusion: Overall, students were found to have a generally neutral opinion about mental illness except in the sub-scale factors of benevolence, mental hygiene ideology and interpersonal aetiology where students held less positive opinions. Knowing the student populations opinions about a subject matter can assist academics to direct and focus their efforts to improve those opinions in those areas.

      PubDate: Thu, 2 Nov 2017 11:47:42 GMT
       
  • Volume 34 Issue 3 - A review for Australian nurses: Cannabis use for
           anti-emesis among terminally ill patients in Australia
    • Abstract: Chan, Alex; Molloy, Luke; Pertile, Joy; Iglesias, Miguel
      Objective: The objective of this article is to describe the potential benefits of medicinal cannabis in emesis control and the position of nurses looking after palliative patients who are on medicinal cannabis treatment in Australia.

      Setting: Palliative care

      Primary argument: Cannabis is the most commonly abused drug and its use for medical purposes was restricted throughout the world since the early 20th century. However many clinical studies show that the natural cannabinoid compounds can stimulate the cannabinoid receptors in the brain leading to attenuation of signal transmission, resulting in alleviation of the vomiting stimuli. The debate about the use of cannabis as an anti-emetic agent in patients with life-limiting conditions has renewed interest in recent years. The principle of palliative care is to improve the quality of life of patients living with life-limiting conditions based on the best evidence available. Although some evidence suggests cannabis may have therapeutic effects on some palliative patients and the Australian Commonwealth Government has recently changed the legislation, the concept of using medicinal cannabis in emesis control is very new to many Australians including the health care providers.

      Conclusion: In comparison to conventional medications, medicinal use of cannabis in palliative care is a new phenomenon and nurses as well as general public may be less prepared for the use of cannabis as a medical modality in all clinical settings. This review is intended to raise awareness of the physiological mechanism of cannabis and its medicinal use to the nurses in Australia.

      PubDate: Thu, 2 Nov 2017 11:47:42 GMT
       
  • Volume 34 Issue 3 - Can patients and their caregivers boost identification
           of HIV Associated Neurocognitive Disorder (HAND)'
    • Abstract: Cummins, Denise; Murray, Kenneth; Trotter, Gary; Batterham, Marijka; Healey, Loretta; O'Connor, Catherine C
      Objective: To ascertain whether people living with HIV and their caregivers using a self reflective tool could identify S&S of HAND.

      Design: This study was a nurse led prospective observational multi-site study using a quantitative design.

      Setting: Participants were recruited from three sites in Sydney, New South Wales (NSW), Australia: an inner metropolitan HIV clinic, an inner metropolitan sexual health clinic and a suburban hospital HIV clinic.

      Subjects: 121 patients and 44 caregivers who attended ambulatory clinics providing HIV care.

      Main Outcome Measures: Observing usual standard of care to follow patients who had formal neuropsychological testing and diagnosis of HAND.

      Results: Sixty one percent of participants and 57% of caregivers identified more than four symptoms. Sixteen had neuropsychological exams; five were diagnosed with HAND. After changes to their medication regime all of those five showed an improvement in cognition. Of the remaining 11, four results were inconclusive, with some deficits noted.

      Conclusion: Patients and caregivers stated the booklet helped them to reflect on behavior changes which they could subsequently discuss with their doctor. The booklet was considered useful to identify S and S which could indicate HAND.

      PubDate: Thu, 2 Nov 2017 11:47:42 GMT
       
  • Volume 34 Issue 3 - The impact of clinical placement model on learning in
           nursing: A descriptive exploratory study
    • Abstract: Birks, Melanie; Bagley, Tracy; Park, Tanya; Burkot, Camilla; Mills, Jane
      Background: Learning in the clinical setting is an essential component of nursing education. Two common models of clinical learning place students in facilities using either block or distributed approaches.

      Aim: The aim of this study was to examine nursing students' perceptions of the impact of block versus distributed model of clinical placement on their learning experience.

      Design: The study employed a descriptive, exploratory approach. Focus groups and an individual interview were conducted with third-year undergraduate nursing students.

      Setting: Students from four Australian universities took part in the study.

      Subjects: The average age of the 22 student participants was 37.5 years and 91% were female. More than half (55%) studied full time.

      Results: Thematic analysis of the data identified five overarching themes: We're there to learn; Taking all that knowledge out and practising it; You actually feel a part of the team; Just prepare them for us coming; and It's really individual.

      Conclusions: It is clear that both block and distributed modes of placement have inherent advantages and disadvantages that might be magnified depending on the individual student's circumstances. Sequencing, consistency and preparation must be considered when planning either mode of clinical placement to ensure the best possible experience for students. Most significantly, students need to feel as though they are part of the team while on placement to get the most out of the experience. These findings have implications for education providers planning the integration of clinical placement into the nursing curriculum.

      PubDate: Thu, 2 Nov 2017 11:47:42 GMT
       
  • Volume 34 Issue 3 - Promoting student belongingness: 'WANTED' - the
           development, implementation and evaluation of a toolkit for nurses
    • Abstract: King, Chris; Russell, Kylie; Bulsara, Caroline
      Objective: Literature suggests that the need to belong influences health and well-being, behavioural, emotional and cognitive responses. This paper describes the impending development and validation of a toolkit for nurses to create the experience of belongingness with a team approach, for student nurses undertaking a clinical placement.

      Setting and Subjects: The design of the toolkit will be developed from a selected Delphi panel process involving nursing experts' experience and opinions. The toolkit will then be distributed to nurses in selected clinical areas for use during periods of clinical placements.

      Primary Argument: Clinical placements are essential for professional socialisation in which nurses provide compelling role models for how to think, feel and act. However, students have often identified a sense of alienation through poor clinical experiences. The need to belong and be part of a team exerts a powerful influence on cognitive processes and behavioural responses. The absence of meaningful interpersonal relationships can result in failure to develop optimal clinical reasoning and critical thinking skills to manage patient care safely.

      Conclusion: More needs to be achieved than to simply justify the core attributes of a good clinical learning environment. Understanding of the key role that clinical leaders and supervisors exert to create a belongingness environment can influence positively the attitude of other staff towards students. For a valued positive clinical learning experience to become the benchmark of best practice, it requires a structured process, a toolkit to enable nurses to comprehend the concept of belongingness and to support them in embedding this model into their role of supervision.

      PubDate: Thu, 2 Nov 2017 11:47:42 GMT
       
  • Volume 34 Issue 3 - Assessing the effectiveness of clinical education to
           reduce the frequency and recurrence of workplace violence
    • Abstract: Adams, Jillian; Knowles, Alex; Irons, Garry; Roddy, Alison; Ashworth, John
      Objectives: This study assessed the effectiveness of clinical education to identify patients with a high risk for violence and to reduce the frequency of violent incidents.

      Design: A before and after design with an education intervention.

      Setting: Data were gathered from the direct care staff and from records of violent/aggressive incidents which occurred on two adult medical wards at a teaching hospital in Western Australia.

      Subjects: Nurses, Assistants in Nursing and Patient Care Assistants working on the study wards participated in the education intervention (n=65) and completed a questionnaire before and after the education. Details of 48 violent/aggressive incidents perpetrated by 21 patients were examined.

      Intervention: An education program addressed four key areas (assessment, planning, implementation [crisis], post incident). Case studies and in-patient scenarios provided context, immediacy and relevance, and 77% of the staff completed the program.

      Main outcome measure: Knowledge, confidence and capability of direct care staff to prevent/manage violent/aggressive incidents were measured. Incident data measured the frequency and recurrence of violence/aggression, and if perpetrators met the high risk criteria.

      Results: Post education, knowledge increased significantly (p=0.001, CI 0.256-0.542), the use of verbal de-escalation increased significantly (p=0.011, 1df) and the frequency and recurrence of incidents decreased. All perpetrators met criteria indicating a high risk for violence.

      Conclusions: Education and coaching provided by clinical experts resulted in increased knowledge, greater use of verbal de-escalation and less incidents. However, more time/coaching is required to improve the perceived capability of clinical staff to manage these incidents.

      PubDate: Thu, 2 Nov 2017 11:47:42 GMT
       
  • Volume 34 Issue 2 - Exploring infant deformational or positional
           plagiocephaly prevention and management by Maternal Child Health Nurses
           and Paediatric Physiotherapists
    • Abstract: Williams, Elizabeth N; Galea, Mary P
      Objectives: To explore Maternal Child Health (MCH) nurses' and Paediatric Physiotherapists' (Physiotherapists) experience with infant deformational or positional plagiocephaly (plagiocephaly).

      Design: Cross-sectional online survey.

      Setting: Community health setting in Victoria, Australia.

      Subjects: MCH nurses and Paediatric Physiotherapists in Victoria were invited to participate.

      Main outcome measures: Survey results were collated and analysed descriptively.

      Results: Surveys were completed by 183/961(19%) MCH nurses and a sample of 16 Physiotherapists, from a cross section of metropolitan (62%), regional (18%) and rural/remote (24%) Victoria. All MCH nurses and Physiotherapists reported seeing infants with plagiocephaly in the previous 12 months. Responses indicated MCH nurses saw between 11-50 infants with plagiocephaly (n=110). These were first diagnosed by MCH nurses at one to three months. Infants first presented to Physiotherapists on average at four to six months. All MCH nurses and Physiotherapists implemented prevention strategies and both groups thought it was effective subject to parents' implementing the advice. Strategies for prevention and management of plagiocephaly included early prone play (tummy-time) and counter positioning. Physiotherapists also included gross motor exercises, stretches if torticollis was present and, if appropriate, referral for helmet therapy. Referrals of infants with plagiocephaly by MCH nurses were made to Physiotherapists, General Practitioners, Chiropractors and Osteopaths.

      Conclusions: All MCH nurses and Physiotherapist respondents see infants with plagiocephaly, MCH nurses earlier than Physiotherapists. The effectiveness of plagiocephaly prevention advice can be called into question because of the high numbers of infants presenting and subsequent referrals to different health professionals. Recommendations from respondents included a review of past initiatives including extensive education for Maternal Child Health Nurses, Pamphlets in their Home visiting pack and video for demonstration at first time mothers group and the provision of clearer early prevention advice in the Government Key Ages and Stages (KAS) Framework for MCH nurses.

      PubDate: Thu, 2 Nov 2017 11:47:42 GMT
       
  • Volume 34 Issue 2 - What prompts nurses to seek help from wound care
           consultants in spinal cord injury management'
    • Abstract: Bundz, Julie; Schuurs, Sarita; Kendall, Melissa; Amsters, Delena
      Objective: This study aimed to identify clinical scenarios that might prompt nurses to seek advice from a spinal cord injury wound care nurse consultant for pressure injury management. In addition, some attributes of nurses were examined for associations with intention to seek the help of a consultant.

      Design: Exploratory quantitative survey.

      Setting: Queensland, Australia.

      Subjects: Fifty currently practising hospital and community based nurses

      Main outcome measure(s): Two part online survey - part one presented hypothetical clinical case scenarios, in which respondents indicated their likelihood of seeking help; and, part two examined participant attributes and work experience.

      Results: Each scenario presented was rated as either of little importance or utmost importance by at least one respondent. Participants identified consultant personality and proximity as more influential on help seeking than timeliness, common sense or knowledge.

      Conclusion: The study did not identify a pattern of association between the presence of certain clinical factors and intention to seek help from a spinal cord injury consultant nurse for pressure injury management. What is important and influential for one person may be of less importance for others. Consultants must market their value to nurses in order that they are front of mind during the help seeking process. Further studies are required to examine the decision making process associated with help seeking.

      PubDate: Thu, 2 Nov 2017 11:47:42 GMT
       
  • Volume 34 Issue 2 - The Cancer Nurse Coordinator Service in Western
           Australia: Perspectives of specialist cancer nurse coordinators
    • Abstract: Monterosso, Leanne; Platt, Violet; Krishnasamy, Meinir; Yates, Patsy; Bulsara, Caroline
      Objective: In Western Australia the cancer nurse coordinator (CNC) role is unique, state wide and situated in nursing. It requires the domains of clinical expert, resource consultant, educator, change agent, researcher and advocate to facilitate seamless coordination of care for patients across metropolitan, rural and remote geographical areas of Western Australia. This study examined the role, function and impact of CNCs from the perspective of coordinators themselves.

      Design: Prospective two-phase mixed method study. This paper reports data from the Self Report Activity Questionnaire in Phase one.

      Setting: The state-wide Western Australian Cancer Nurse Coordinator Service.

      Subjects: Metropolitan and rural CNCs (n=18) who had worked in the role for at least six months.

      Results: Overall, CNCs spent 70% of time in clinical consultation and 41% of CNCs reported having an educational role. Most CNCs (71%) noted that at least half of their patients had complex psychosocial needs at referral. Key role-related activities related to direct nursing care and patient education were performed most frequently on a daily basis. Tasks related to care management planning, patient advocacy and multidisciplinary clinical care were performed weekly. Strategic, team communication and professional development activities were performed less frequently.

      Conclusion: Diversity of the CNC role was demonstrated with findings showing that CNCs fulfilled the core components of the specialist cancer nurse. Given the clear need to provide consistent support to cancer patients in an increasingly individualised and integrated manner, we consider the CNC role a fundamental element of quality cancer care.

      PubDate: Thu, 2 Nov 2017 11:47:42 GMT
       
  • Volume 34 Issue 2 - Being a fellow patient to a critically ill patient
           leads to feelings of anxiety - an interview study
    • Abstract: Laursen, Jannie; Lundby, Trine Bonnevie; Danielsen, Anne Kjaergaard; Rosenberg, Jacob
      Objectives: To explore in-patients' experiences being a fellow patient to patients who become critically ill.

      Design: The study was designed as a qualitative phenomenological study.

      Setting: The study was conducted in a surgical ward of a hospital in Denmark.

      Subjects: Fifteen fellow patients to patients, who became critically ill.

      Results: Three key themes emerged from the analysis of the data: patients' interaction, anxiety, and professional support. These findings demonstrated the importance of understanding how patients experienced being a fellow patient to patients, who become critically ill, their views on interacting with such a patient, how the patients who become critically ill influenced them, and what kind of support they needed from the health professionals.

      Conclusion: The findings highlighted the different emotions and feelings experienced by fellow patients. It showed how the impact of the situation can lead to anxiety, a feeling of being forced into patient inter-action and the lack of professional support. Health professionals should have a central role in supporting the fellow patients and communicating with them about their experiences and this does not seem to be fulfilled sufficiently in daily clinical practice.

      PubDate: Thu, 2 Nov 2017 11:47:42 GMT
       
  • Volume 34 Issue 2 - The transition of overseas qualified nurses and
           midwives into the Australian healthcare workforce
    • Abstract: Ohr, Se Ok; Holm, Doreen; Brazil, Sue
      Objective: The purpose of this paper is to discuss the key elements to consider when developing and implementing strategies to enhance the transition of overseas qualified nurses and midwives (OQNMs) into the Australian healthcare clinical practice environment.

      Setting: A local health district with a major metropolitan centre and a mix of large regional centres which provide a range of public health services, to a population of approximately 850,000 people located in New South Wales, Australia.

      Subjects: Newly recruited overseas qualified nurses and midwives. Many of these nurses and midwives are from culturally and linguistically diverse backgrounds and different countries.

      Primary argument: Within the Australian nursing and midwifery practice environment the recruitment of overseas qualified nurses has gradually increased. While transitioning into the practice environment requires a range of support strategies, there is limited information on how to support them.

      Conclusion: The culturally constructed support program and its strategies assisted in minimising the impact of the challenges and difficulties faced by OQNMs in their transition into the Australian nursing workforce. The program was instrumental in improving their well-being and it provided a strategic framework to facilitate a smoother transition. Risks to patient safety were mitigated by providing opportunities for education so the provision of safe quality care was enhanced. This was also seen as a factor that enhanced the recruitment and retention of nurses in the workforce.

      PubDate: Thu, 2 Nov 2017 11:47:42 GMT
       
  • Volume 34 Issue 2 - Male or nurse what comes first': Challenges men
           face on their journey to nurse registration
    • Abstract: Juliff, Dianne; Russell, Kylie; Bulsara, Caroline
      Objective: This paper aims to provide an account of the first phase of a qualitative longitudinal study that explored the initial challenges men in nursing face to become registered. What is known is that men, a minority group within nursing, face the usual challenges of all new nurses in their quest to register as nurses. In addition, they have added pressures that hinder their quest due to being male.

      Primary Argument: An Australian nursing shortage is looming due to nurses retiring from this female-dominate profession. Hence, the retention of men in nursing is an area requiring attention in order to support a sustainable workforce.

      Subjects and Setting: Nine newly graduated male registered nurses participated. These nurses had recently commenced employment in the Western Australian metropolitan health region.

      Findings: Individual face-to-face interviews produced the theme of role misconception with a major focus on male or nurse what comes first. This theme was derived from the categories of gender stereotyping and marginalisation.

      Conclusion: This study suggests the need for a gender-neutral image when promoting nursing within and outside the professional environment. Furthermore, consideration for a professional title mutually accepted by both women and men in nursing, with the gender-neutral 'nurse' title preferred by the men in this study. Moreover to acknowledge that men in nursing will augment a technical savvy workforce that will complement emergent complex nursing practices, and enhance a more comprehensive Australian nursing workforce that will assist with meeting the health care needs of a diverse population.

      PubDate: Thu, 2 Nov 2017 11:47:42 GMT
       
  • Volume 34 Issue 1 - Stoma and shame: Engaging affect in the adaptation to
           a medical device
    • Abstract: Diebold, Lionel
      Objective: The objective is to understand difficulties some patients have with their adaptation to a medical device, specifically a stoma and an ostomy appliance, following gastro-enterologic surgery. A partial or total colectomy is typically performed in cases of digestive cancers, Crohn's disease, or anal incontinence. A psychotherapeutic application deduced from this understanding is described. The therapeutic approach is informed by Lacanian psychoanalysis.

      Setting: The setting is the digestive surgery services section of a large public teaching hospital in France. The clinical team conducting the interventions described perform their work with patients post-operatively.

      Subjects: Selected cases are chosen to provide brief illustrations of the analysis and the psychotherapeutic approach developed.

      Primary argument: This study focuses on the impact of the stoma and the ostomy appliance on the subjectivity of the patient and shows how the affect of shame can appear. It is noted that the affect of shame in the adaptation to an ostomy appliance has not been investigated to date. This affect can in turn have psychological effects on the gastroenterologic treatment itself, even to the point of the patient's abandonment of ongoing care. The analysis reported here explores the recognition of shame when it might be present, and the process of accompanying the patient therapeutically, engaging the logic of the transference.

      Conclusion: Shame cannot be treated by ignorance or by indifference. A psychotherapeutic application engaging the transference between the patient and members of the nursing and psychotherapeutic team, helps patients support shame and adapt well to the ostomy bag.

      PubDate: Thu, 2 Nov 2017 11:47:42 GMT
       
  • Volume 34 Issue 1 - Flooded with evidence: Using a 'spillway' model to
           improve research implementation in nursing practice
    • Abstract: Moloney, Clint; Taylor, Melissa; Ralph, Nicholas
      Objective: To identify barriers to implementing evidence-based practice initiatives in small to medium sub-acute facilities in Queensland.

      Design: The study uses a qualitative methodology in which field observations and convergent interviews were employed to generate data.

      Setting: Four south-east Queensland sub-acute care facilities participated in the study. Observational and interview data were collected.

      Subjects: Field observations were recorded across the sites. Five research fellows collected observational data on evidence-based practice implementation across a period of six months. Nine clinicians participated in in-depth, convergent interviews at the end of the period of observation.

      Main outcome measures: The authors analysed observational and interview data using qualitative thematic analysis.

      Results: Three themes emerged which described the needs of clinicians when evidence-based practice initiatives were being implemented: (1) valuing evidence; (2) risk prioritisation; and (3) controlling the flow of evidence. A 'Spillway Model' is proposed as a mechanism for targeting clinical priorities using integrated risk management.

      Conclusion: This study supports the use of integrated risk management as part of a Spillway Model to guide the introduction of evidence-based practice initiatives in the clinical setting.

      PubDate: Thu, 2 Nov 2017 11:47:42 GMT
       
  • Volume 34 Issue 1 - A mental health nursing transition program for
           enrolled nurses at a forensic mental health hospital
    • Abstract: Quinn, Chris; Ryan, Jo
      Objective: There are difficulties in recruiting enrolled nurses to mental health positions. A six month program was developed with the aim to bridge possible knowledge gaps for enrolled nurses, and to provide them practical support to consolidate skills and knowledge for nursing in a forensic mental health hospital.

      Setting: The setting was a 116 bed secure forensic mental health hospital in the state of Victoria, Australia.

      Subjects: Nine enrolled nurses who had completed a Diploma of Nursing, were recruited into the program.

      Primary argument: There is a national decrease in enrolled nursing supply, and a paucity of data exploring the training needs of enrolled nurses transitioning from the Diploma to a mental health nursing role. Nursing programs are required to assist enrolled nurses with the knowledge and skills, and support required to effectively make their transition into mental health nursing.

      Conclusion: The results demonstrate the importance in providing a program to assist enrolled nurses transition to mental health and that the mental health course requirements within the Diploma of Nursing and placement length may not be adequate in preparing enrolled nurses for direct entry to mental health nursing. Providing a structured transition program for a group of enrolled nurses is a useful strategy to improve knowledge, skills, and retention.

      PubDate: Thu, 2 Nov 2017 11:47:42 GMT
       
  • Volume 34 Issue 1 - Knowledge, attitudes and practices relating to
           fertility among nurses working in primary health care
    • Abstract: Hammarberg, Karin; Collison, Lisa; Nguyen, Hau; Fisher, Jane
      Objective: To explore knowledge, attitudes and practice relating to factors that affect fertility among nurses working in general practice and other primary health care settings.

      Design: Anonymous online survey.

      Setting: Primary care.

      Subjects: Members of the Australian Primary Health Care Nurses Association (APNA). Main outcome measures: Fertilityrelated knowledge, attitudes and practice.

      Results: 102 individuals completed the survey. More than half overestimated the age when male and female fertility declines and the chance of women conceiving with IVF. Most knew that smoking affects a man's sperm but only one quarter that smoking halves a woman's fertility. The majority recognised obesity and STI's as detrimental for fertility and agreed that educating patients about fertility is part of primary health care nurses' role to ask people of reproductive age about their reproductive life plan and alert them to the factors that influence fertility. The most commonly cited barrier for discussing fertility with patients was perceived lack of knowledge about the subject.

      Conclusion: This study identified opportunities and barriers for nurses working in primary health care to proactively discuss fertility and the factors that influence the chance of conceiving with their patients. Appropriate educational resources to improve knowledge and support from general practitioners (GPs) can enable nurses working in general practice and other primary health care settings to provide effective fertility related education as part of their role as health promoters.

      PubDate: Thu, 2 Nov 2017 11:47:42 GMT
       
  • Volume 34 Issue 1 - Doctoral education for nurses today: The PhD or
           professional doctorate'
    • Abstract: Walker, Kim; Campbell, Steven; Duff, Jed; Cummings, Elizabeth
      Objective: This paper seeks to stimulate discussion and debate about the future of doctoral education for nurses in Australia.

      Setting: A large Magnet recognised acute care private hospital in New South Wales and a large regional university in Australia.

      Primary argument: Healthcare today and into the future is increasingly more complex and requires ever more highly skilled healthcare professionals to meet the challenges of providing safe, quality care. Doctoral research and education based in the workplace and designed to improve healthcare while skilling up nurses and other professionals in research methods has never been more relevant and appropriate.

      Conclusion: Nurses have generally not seen the PhD as the best fit for their higher professional development. The professional doctorate offers a compelling and dynamic alternative to the more academic focus of the PhD and prepares 'inquirydriven leaders' for tomorrow's challenges.

      PubDate: Thu, 2 Nov 2017 11:47:42 GMT
       
  • Volume 34 Issue 1 - Nurse empathy and the care of people with dementia
    • Abstract: Digby, Robin; Williams, Allison; Lee, Susan
      Objective: Empathy is widely accepted as an essential nursing attribute yet the relationship between nurse empathy and the care of people with dementia in the hospital setting has rarely been explored. A number of themes have emerged from the relevant literature regarding the influences which shape a nurse's ability to deliver empathetic care to this patient cohort. These issues include a lack of hospital resources, an organisational focus on operational issues such as patient flow and risk management, and widespread stigmatisation of dementia in society.

      Setting: Acute and sub-acute facilities.

      Subjects: In-patients with dementia and nurses

      Primary argument: Although there is widespread acknowledgment that nurses require empathy to deliver quality care, the complexity of caring for people with dementia in hospital creates further challenges for both nurses and patients. This issue has been discussed previously but there is little evidence that the situation has improved.

      Conclusion: This paper details the relevant influences on the ability of nurses to care empathetically for people with dementia in hospital. The recognition that there are distinct factors related to this patient cohort is an important one and may assist nurses and health organisations to identify systemic and individual problems associated with hospitalisation and lead to the implementation of supportive strategies. Appropriate nurse-patient ratios which consider the additional workload attached to caring for people with dementia, clinical supervision and targeted nurse education must be considered to ensure health systems deliver appropriate person-centred care to people with dementia.

      PubDate: Thu, 2 Nov 2017 11:47:42 GMT
       
  • Volume 34 Issue 1 - Access to healthcare services for people living with
           HIV experiencing homelessness - a literature review
    • Abstract: Crock, Elizabeth
      Objective: People living with HIV (PLHIV) who are homeless or at risk of homelessness experience significantly worse health outcomes than those in stable housing. They are more likely to be diagnosed late, use substances, engage in high-risk sexual activities and have difficulty adhering to treatments. This review identifies strategies described and evaluated in the international social science literature which can improve access to HIV-treatment and care for PLHIV who are homeless or at risk of homelessness, to inform policy and service development in Australia.

      Setting: The principle research question addressed in this review is:

      - What strategies enhance the ability of PLHIV who are homeless to access health care services, in particular community nursing services' A literature review of social science research relating to the research question in the international and Australian contexts was conducted.

      Primary argument: No literature was identified that addressed access to community nursing services for PLHIV experiencing homelessness in Australia, and very little internationally. Community-based nursing organisations are well-placed and experienced in engaging marginalised groups in health care. Specific interventions need not always be developed: rather, better use could be made of existing services that utilise assertive outreach models of care and co-location with other services.

      Conclusion: HIV-specialist community nursing services could be better integrated with homelessness services to enhance access to care, link PLHIV into the health system and keep them engaged in care. The absence of research on engagement with HIV specialist community nursing services demands exploration.

      PubDate: Thu, 2 Nov 2017 11:47:42 GMT
       
  • Volume 33 Issue 4 - Home oxygen therapy assessment for COPD patients
           discharged from hospital: Respiratory NP Model of Care
    • Abstract: Hall, Toni
      Objectives: The research aim was to examine the impact of the introduction of the Chronic Respiratory Disease Nurse Practitioner (CRD NP) Model of Care (MOC) on the assessment for short term oxygen therapy (STOT), provision of care, and patient outcomes for patients discharged with oxygen therapy post an acute exacerbation of chronic obstructive pulmonary disease (COPD).

      Design: A retrospective uncontrolled comparative clinical audit was conducted in two six-month periods pre (2009) and post (2011) the introduction of the CRD NP MOC.

      Setting: Tertiary referral centre in central Victoria, Australia.

      Subjects: A total of 301 patient admissions with a discharge diagnosis of COPD were examined for hypoxia at rest and on exertion prior to discharge.

      Main outcome measures: The audit focused on the incidence of assessment for STOT prior to discharge, supply of STOT where indicated on discharge, and incidence of re-admission within 28 days of discharge with COPD related symptoms.

      Results: A statistically significant increase in the proportion of appropriate patients assessed with arterial blood gas analysis for eligibility of STOT from 7.7% in 2009 to 45% in 2011. Provision of STOT on discharge increased from 26.7% to 44.4%. Re-admission to hospital within 28 days of discharge for patients with STOT decreased from 25% in 2009 to 12.5% in 2011.

      Conclusion: Since the introduction of the CRD NP MOC there has been an increase in patient assessment for STOT, provision of STOT, reduction in hospital re-admissions, improved adherence to procedure protocols, improved patient outcomes and cost savings for the hospital.

      PubDate: Thu, 2 Nov 2017 11:47:42 GMT
       
  • Volume 33 Issue 4 - The art of clinical supervision: Its development and
           descriptive mixed method review
    • Abstract: Russell, Kylie; Alliex, Selma; Gluyas, Heather
      Objectives: The Health Workforce Australia Clinical Supervision Support Program Discussion Paper (2010) highlighted the education deficits of health professionals responsible for the clinical supervision of students. This research aimed to develop, implement and evaluate a new education program for nurses to assist in the development of knowledge and attitude to supervise students whilst on clinical practicum.

      Design: The impact of the ACS program was determined using a descriptive methodology involving the collection and analysis of quantitative and qualitative data using a triangulation approach. This included the use of surveys, online reflections and interviews.

      Settings: The ACS program was presented in both the metropolitan and regional areas of Western Australia.

      Subjects: Participants (n=199) were from both the public and private health care sector working in a variety of nursing specialties within both the inpatient and community setting.

      Results: Analysis of the data determined that participants improved their knowledge and attitude towards students and clinical supervision.

      Conclusions: The ACS was confirmed as a strategy for providing effective education for nurses.

      PubDate: Thu, 2 Nov 2017 11:47:42 GMT
       
  • Volume 33 Issue 4 - Key milestones in the operationalisation of
           professional nursing ethics in Australia: A brief historical overview
    • Abstract: Johnstone, Megan-Jane
      Objective: To provide a brief historical overview of the achievement of key milestones in the development of mechanisms for operationalising professional nursing ethics in Australia; examples of such milestones include: the publication of the first Australian text on nursing ethics (1989), the provision of the first Australian national distance education course on nursing ethics for registered nurses (1990), the adoption of the first code of ethics for Australian nurses (1993), and the commissioning of the first regular column on nursing ethics by the Australian Nurses Journal (2008).

      Setting: Australian nursing ethics.

      Primary argument: An historical perspective on the achievement of key milestones in the development of mechanisms for operationalising professional nursing ethics in Australia has been poorly documented. As a consequence an authentic 'Australian voice' is missing in global discourses on the history and development of nursing ethics as a field of inquiry. Compared with other countries, the achievement of key milestones pertinent to the operationalisation of nursing ethics in Australia has been relatively slow. Even so, over the past three decades an Australian perspective on nursing ethics has gained a notable voice in the international arena with Australian nursing scholars now making a significant contribution to the field.

      Conclusion: Nursing ethics in Australia remains a 'work in progress'. Although significant achievements have been made in the last three decades, the ongoing development of mechanisms for advancing nursing ethics in Australia would benefit from the development and implementation of a strategic agenda of collaborative, internationally comparative, cross disciplinary scholarship, research and critique.

      PubDate: Thu, 2 Nov 2017 11:47:42 GMT
       
  • Volume 33 Issue 4 - The role of advance care planning in end-of-life care
           for residents of aged care facilities
    • Abstract: Waird, Allyson; Crisp, Elaine
      Objective: This report will present the case of an elderly woman with rapidly declining health admitted to hospital from a nursing home. It will discuss benefits of advance care planning for residents of aged care facilities who have expressed opinions/wishes regarding their end-of-life care, and identify barriers, varying legal status, the need for documentation of discussion outcomes specifying residents' wishes, and the importance of education and expert support for nursing staff.

      Setting: Nursing home and acute tertiary referral hospital.

      Subject: Female resident of a nursing home, aged 97 years, with acute onset of abdominal pain and multiple co-morbidities.

      Primary Argument: The majority of nursing home residents do not have advance care planning initiated, nor is this routinely raised by nursing staff. While wishes may be discussed with family, they may not be fully respected if undocumented. Acutely ill residents are frequently hospitalised, especially when death is imminent, and often die alone in unfamiliar surroundings, tended by strangers. Many of these admissions could be avoided with Advance Care Planning, as could the resultant medical interventions which may cause the resident acute pain and discomfort.

      Conclusion: Advance Care Planning can lead to avoidance of non-essential hospital transfers and their inherent risks and is likely to facilitate a dignified, peaceful death in familiar surroundings for nursing home residents, averting medical interventions which may cause needless pain and prolonged suffering.

      PubDate: Thu, 2 Nov 2017 11:47:42 GMT
       
  • Volume 33 Issue 4 - A nurses' guide to mixed methods research
    • Abstract: Ingham-Broomfield, Rebecca
      Objective: This article provides a breakdown of the components of mixed methods research methodology. The intention of the article is to simplify the terminology and process of mixed methods research to enable novice readers of research to have a better understanding of the language and concepts involved. The Survey method, using both qualitative and quantitative research methods, will be used to explain the principles of mixing methods.

      Primary Argument: Australian nurses work in an environment where evidence-based practice is mandatory. Understanding the research process and terminology used may benefit nurses to implement research in their day-to-day practice. Gaining knowledge of the different approaches used in mixed methods research is paramount if nurses are to base their care on research which has utilised this style.

      Conclusion: As mixed methods are used in nursing, social and behavioural research it is essential that nurses understand the methodology. The main components of mixed methodology will, therefore, be discussed in a systematic, logical order.

      PubDate: Thu, 2 Nov 2017 11:47:42 GMT
       
  • Volume 33 Issue 3 - A prospective comparison of the AUSDRISK and HbA1c for
           persons with spinal cord injury
    • Abstract: Jannings, Wendy; Fry, Margaret; Gallagher, Robyn
      Objective: The primary object of this study was to determine the validity of the Australian Type 2 Diabetes Risk Assessment Tool (AUSDRISK) for predicting the development of type 2 diabetes in persons with spinal cord injury (SCI).

      Design and setting: The prospective comparative study (December 2013-March 2014) collected data on AUSDRISK and haemoglobin A1c (HbA1c) in participants' homes.

      Participants: Participation rate was 67% (n=79). Study criteria: over 18 years of age, a SCI for more than 12 months, living at home, wheelchair dependant and no diabetes diagnosis.

      Main outcome measures: AUSDRISK sensitivity and specificity in predicting incident type 2 diabetes in persons with SCI.

      Results: Of the 79 participants, 81% were male, mean age was 53 years (SD 14.14) with 23.2years (median 23; SD +/- 13.2yrs) since injury. There was a positive correlation between length of time since SCI and risk score (AUSDRISK) (r = .242, p = .032). Participants with high AUSDRISK scores had higher HbA1c% (5.38 versus 5.2, p = .026) level. The high risk classification explained a moderate amount of HbA1c % (area under curve = .651; 95% CI .53 - .77). The level of HbA1c which had the highest sensitivity (.59) and specificity (.73) for risk classification was 5.25%. Waist circumference and physical activity items require further powered studies to determine if appropriately weighted.

      Conclusion: Comparing the AUSDRISK with HbA1c assays, the AUSDRISK can predict type 2 diabetes risk in a person with SCI, although further powered studies are needed to be undertaken, to refine the predictive capacity of the tool.

      PubDate: Thu, 2 Nov 2017 11:47:42 GMT
       
  • Volume 33 Issue 3 - Moral distress of oncology nurses and morally
           distressing situations in oncology units
    • Abstract: Ameri, Malihe; Safavibayatneed, Zahra; Kavousi, Amir
      Objective: The purpose of this study was to evaluate the intensity and frequency of moral distress and determine clinical situations leading to moral distress in oncology units. The study also examined the relationship between moral distress scores and demographic characteristics of oncology nurses.

      Design: This descriptive study was performed between 25 January 2012 and 29 June 2013.

      Setting: The study was conducted in the oncology units of eight training hospitals in Tehran, Iran.

      Subjects: One hundred and forty eight nurses (131 females, 17 males; mean age 32.5 years; range 24 to 52 years) who had worked in oncology units of training hospitals in Tehran were included in the study.

      Main outcome measure(s): The main outcome measures included intensity and frequency of moral distress, which were assessed by the Moral Distress Scale - Revised (MDS-R).

      Results: Most of the 148 nurses had high to moderate scores. Nurses had experienced higher moral distress when receiving informed consent forms from patients and asking patients to carry out physicians' order for unnecessary tests in patients' last stages of life.

      Conclusion: Moral distress exists in oncology nurses and interventions will be developed and tested to decrease and prevent it.

      PubDate: Thu, 2 Nov 2017 11:47:42 GMT
       
  • Volume 33 Issue 3 - A nurses' guide to the hierarchy of research designs
           and evidence
    • Abstract: Ingham-Broomfield, Rebecca
      Objective: This article provides a breakdown of the components of the hierarchy, or pyramid, of research designs. Its intention is to simplify the components of the hierarchy to enable novice readers of research to better understand the differing approaches and levels of evidence.

      Primary Argument: Evidence-based Practice (EBP) is the integration of the best research evidence with clinical expertise and the patient's unique circumstances. This includes respect of patient values, and their needs, whilst delivering high-quality, cost effective health care. Understanding the differing levels of evidence, and their reliability, is paramount to making correct and appropriate health care decisions. Nurses are required to use evidence-based practice as they are responsible for a significant amount of judgments and decisions every day, and therefore, they must use research literature as part of their clinical decision-making.

      Conclusion: The content, or levels of evidence, of the hierarchy will be discussed in a systematic, logical order from the base to the apex of the pyramid. A comparative grid at the end may lead the nurse to better understand the differing components of the seven levels of evidence or, depending on the source, eight.

      PubDate: Thu, 2 Nov 2017 11:47:42 GMT
       
  • Volume 33 Issue 3 - Y doesn't Gen Y like 2 w8'
    • Abstract: Jackson, Karen; Drew, Kerry; Shaw, Jacqueline
      Objective: The aim of this small scaled research project was to identify any generational differences in expectations and satisfaction in waiting times, amongst Minor Injury patients with an ATS (Australian Triage score) four and five and how, or indeed if these relate to overall satisfaction of the Emergency Department (ED) Fast track or Treatment Stream (TS) Service. The question for this research was: In what ways do generational groups perceive waiting times for the service provided by an Emergency Department Fast track or Treatment Stream Service and with what implications for future services'

      Design: A descriptive survey design where patients entering the TS area of the ED were given a validated patient satisfaction questionnaire to complete during their stay, in order to quantify their expectations of the waiting times and their level of satisfaction. Data was descriptively analysed and discussed within the conceptual framework of generational descriptions.

      Setting: Emergency Department, within an independent Emergency Nurse Practitioner (ENP) led TS service.

      Subjects: Convenience sample, limited to a maximum of every third adult patient attending the Armadale ED TS area, was offered the opportunity to participate in the study.

      Main outcome measures: Expectations of waiting times and levels of satisfaction across generational groups.

      Results: There was no difference between the expectations of Gen Y and other generational groups (Pr Chi 0.135), however Gen Y were still significantly less satisfied with the service than the other generational groups (P=0.018).

      Conclusion: More research is required to address the expectations and satisfaction in waiting times and health services offered to different generational groups. This study offers beginning insights.

      PubDate: Thu, 2 Nov 2017 11:47:42 GMT
       
  • Volume 33 Issue 3 - Why such success': Nursing students show
           consistently high satisfaction with bioscience courses at a regional
           university
    • Abstract: Clifton, IDelma; McKillup, Stephen C
      Background: An understanding of anatomy, physiology and pathophysiology is considered essential for graduate nurses, but many nursing students find such courses difficult and anxiety-provoking. This was contrary to the authors' experiences, so student perceptions were studied at the survey institution.

      Objective: This paper examines nursing students' satisfaction with bioscience and nursing courses in the first two years of a Bachelor of Nursing at an Australian university, in order to suggest strategies for effective bioscience teaching.

      Design: Quantitative data for student satisfaction, measured on the Likert scale, were collected for three bioscience and 11 nursing courses from 2010 - 2012. Mean satisfaction was compared among courses and offerings by ANOVA, with offerings nested within courses, and correlation analysis was used to examine the relationship between student satisfaction and pass rate. Qualitative data were sourced from open questions, emails and forum posts and examined for recurrent themes.

      Results: Students rated the three bioscience courses in the top four of the 14 courses. There was no relationship between satisfaction and pass rate. Qualitative responses showed satisfaction with the course content, the learning materials, the delivery style and lecturer support.

      Conclusion: It is possible to deliver bioscience courses that are appreciated by nursing students. Four principles are suggested in this paper that may improve student satisfaction with bioscience courses and, therefore, result in more effective learning and better prepared nursing graduates.

      PubDate: Thu, 2 Nov 2017 11:47:42 GMT
       
  • Volume 33 Issue 2 - Exploring why some terminally ill people die in
           hospital when home was their preferred choice
    • Abstract: Champion, Nicola; Morrison, Paul; Medigovich, Kristina
      Objective: This small study was designed to gain a better understanding of issues that led to hospital admission of palliative care clients who had a preference for home death, but died in hospital.

      Design: A mixed method approach was chosen for the study using descriptive analysis of routinely collected client demographic and clinical data, and conventional content analysis of case note entries. Setting The study was undertaken in two community based palliative care services located in rural South Australia. Subjects: The case notes of fourteen deceased adults registered with the Northern Yorke Peninsula and Port Pirie Palliative Care Services, with a recorded preferred site of death (PSD) of home and who died in hospital were studied.

      Main outcome measure: Understanding of issues that may have led to hospital admission of palliative care clients who had a preference for home death but who died in hospital.

      Results: The findings reported here focus only on the qualitative aspect of the study. Issues that may lead to hospital admission include: unstable symptoms, deteriorating condition, client/caregiver decision making, lack of services over twenty four hours and the caregiver's ability to manage client care.

      Conclusion: Services can now consider these findings and develop local strategies to improve support for clients with a preference to die at home, and in particular, those that focus on improving caregiver training and information.

      PubDate: Thu, 2 Nov 2017 11:47:42 GMT
       
  • Volume 33 Issue 2 - Using clinical reasoning and simulation-based
           education to 'flip' the Enrolled Nurse curriculum
    • Abstract: Dalton, Lisa; Gee, Tamara; Levett-Jones, Tracy
      Objective: This paper describes the development and implementation of an innovative Diploma of Nursing curriculum for preparing Enrolled Nursing students for acute care nursing practice.

      Setting: Vocational Education and Training at the Health Education and Research Centre in Hobart, Tasmania.

      Subjects: Vocational Education and Training students enrolled in the Diploma of Nursing (Enrolled Division 2 Nursing) (HLT51612).

      Primary Argument: The increasing complexity and acuity of contemporary practice environments requires a nursing workforce that is flexible and competent. In 2013 nurse educators developed an innovative approach to offering the national standardised Diploma of Nursing course that integrates three key pedagogical approaches: the 'flipped classroom', simulation based learning and the Clinical Reasoning Cycle.

      Conclusion: By 'flipping the curriculum' students are provided with opportunities to develop and extend their clinical reasoning skills as they respond to both routine and unpredictable 'patient' scenarios in the safety of a simulation environment. These simulated clinical learning experiences are designed to challenge students to 'think like a nurse' while actively engaging in the provision of safe and effective 'patient' care.

      PubDate: Thu, 2 Nov 2017 11:47:42 GMT
       
  • Volume 33 Issue 2 - Risk stratification for obstructive sleep apnoea and
           optimal post-operative monitoring in an overnight stay ward
    • Abstract: Kadam, Vasanth Rao; Markman, Phuong; Neumann, Sally; Kingisepp, Sandi
      Objectives: Prospective data is required to clarify the role of a one night stay ward (23 hour ward, 23HW) for the post operative monitoring of surgical patients with obstructive sleep apnoea (OSA). The aim was to use a modified American Society of Anesthesiologists (ASA) screening tool to stratify the perioperative risk of OSA related complications and evaluate the role of a 23HW in the post operative management of this patient group.

      Design: Prospective cohort study.

      Setting: Tertiary referral centre.

      Subjects: Patients identified in pre-anaesthetic clinic as having a mild to moderate risk of complications from OSA were scheduled for post operative monitoring in a 23HW.

      Outcome measures: Primary end points were incidence of desaturation events (Continuous pulse oximetry measuring SpO2 90-94% mild,
      PubDate: Thu, 2 Nov 2017 11:47:42 GMT
       
  • Volume 33 Issue 2 - Can generation Y nurses supply areas of shortage':
           New graduate challenges in today's job market
    • Abstract: Christopher, Sybele Anne; Chiarella, Elizabeth Mary; Waters, Donna
      Objective: Workforce attitudes, such as intent to stay, leave temporarily, or exit permanently from nursing, develop at an early career stage. This paper explores the mismatch between the challenges faced by nursing graduates (of whom many belong to Generation Y) in obtaining a Registered Nurse (RN) position following graduation and the continuing shortages in nurse workforce in aged care and mental health areas.

      Setting: Current Australian literature reveals the discontent of university graduates seeking positions in an industry that does not make arrangements to employ graduates, but concomitantly reports workforce undersupply. Areas of nursing shortages of concern discussed in this paper are aged care and mental health nursing.

      Primary argument: A number of reasons may explain why these areas are depleted of nurses: an ageing workforce, unattractive market positions for new graduate nurses and negative perceptions of the aged care and mental health sectors. Also, numerous generational negative opinions expressed in academic literature and popular media serve to discourage newly graduating nurses from working in these areas.

      Conclusion: The paper offers potential solutions to address three main issues raised in the discussion. Firstly, addressing the shortage of new graduate positions is an effort to retain qualified but inexperienced nurses. Secondly, drawing on the pool of new graduates to supply aged care and mental health rejuvenates these specialty areas and ensures these nursing fields are well catered for. Finally, directing efforts to retain new graduate nurses is an opportunity to address the 2025 projected Australian nurse workforce shortfall.

      PubDate: Thu, 2 Nov 2017 11:47:42 GMT
       
  • Volume 33 Issue 2 - Health literacy: How nurses can make a difference
    • Abstract: Johnson, Anne
      Objective: To be a call to action to nurses and all health professionals to implement proven effective evidence based strategies that can decrease health literacy demands on health consumers, and improve health outcomes and the provision of safe person centred health care.

      Primary argument: Health professionals, specifically nurses, are important providers of health information to health consumers. They influence the health literacy demands placed on health consumers through the way they organise, present and communicate information (Australian Commission on Safety and Quality in Health Care, 2014). All health professionals need to be cognisant of the range of effective strategies they can implement to reduce the health literacy demands on health consumers through effective interpersonal communication, health materials in the written and visual formats and the creation of health literate environments to improve health outcomes and the provision of safe care.

      Population measurements of functional health literacy levels (Australian Bureau of Statistics 2008) indicate that 59 per cent of the Australian population aged 15 to 74 years did not achieve an adequate health literacy skill level to meet the complex demands of everyday life and work in a knowledge based economy.

      Conclusion: An understanding by all health professionals of the concept of health literacy, and the evidence based strategies they can implement to decrease health literacy demands on health consumers is imperative to enhancing the involvement of health consumers in their care, improving health outcomes and in the provision of safe health care.

      PubDate: Thu, 2 Nov 2017 11:47:42 GMT
       
  • Volume 33 Issue 1 - The role of specialist nurses in cardiac genetics -
           The Victorian experience: supporting partnerships in care
    • Abstract: Thompson, Tina; Morgan, Natalie; Connell, Vanessa; Zentner, Dominica; Davis, Andrew; Pflaumer, Andreas; Woodford, Noel WF; Winship, Ingrid
      Objective: In Victoria, Australia, a unique referral process exists for families who require investigation for possible inherited cardiac disease. This is spearheaded by a team of specialist nurses located at the Royal Children's Hospital Melbourne (RCH), the Royal Melbourne Hospital (RMH) and the Victorian Institute of Forensic Medicine (VIFM), who ensure that all potentially at-risk families are offered the opportunity for clinical assessment and consultation.

      Setting: In Victoria, approximately 5,500 deaths are reported to the Coroner each year. Where there is a suspicion of a causative heritable cardiac condition, the surviving relatives are offered referral to a tertiary centre for assessment and screening.

      Subjects: A specialist nurse employed by the VIFM is the focal point for forensic pathologists to flag families requiring referral. Concurrently, specialist nurses within the cardiac genetic services of RMH and RCH accept, review, triage and action these referrals. All three services work closely to create a seamless model of care, which is age appropriate and provides ease and equity of access to consistent care.

      Primary argument: The nurse specialists are a critical part of the multidisciplinary team, providing the first entry point into the hospital system. Their background experience encompasses intensive care and cardiology nursing. This is essential to the provision of professional and empathetic care in which families can approach the difficult issues surrounding post mortem consideration of a diagnosis.

      Conclusion: The Victorian nurse led system is an effective model, which could be trialled in other jurisdictions, and other disorders, where multidisciplinary care is required.

      PubDate: Thu, 2 Nov 2017 11:47:42 GMT
       
  • Volume 33 Issue 1 - Literature review: "Are you ok there'": The
           socialisation of student and graduate nurses: Do we have it right'
    • Abstract: Goodare, Pete
      Objective: To determine the effectiveness of the current socialisation processes for student and graduate nurses, into the clinical practice setting.

      Setting: The clinical nursing environment, with underlying links and reference to the academic setting of nurse education.

      Subjects: The sole focal subjects of this literature review are student/undergraduate and graduate/new nurses.

      Primary argument: Internationally, attrition rates of new graduate nurses in their first year of practice ranges between 30-60%. Undergraduate and new nurses enter the nursing profession with a beginning skill set, reflective of their education, coupled with preceded values and ideas about the profession itself. Recognition of an adjustment period undergraduate and new nurses require, is paramount to meeting the anticipated socialisation of these new professionals. Socialisation in the profession of nursing is an ongoing and complex interactive process by which the professional role, incorporating skills, knowledge, and behaviours, is learned and the individual consciously and subconsciously seeks their sense of occupational identity, and perfecting this process is crucial.

      Conclusion: Newcomers to the nursing profession have expressed that learning how to behave appropriately in the workplace is more difficult than bridging the gap between theory and practice. Intentional measures implemented by organisations, is paramount in enabling newcomers to adjust to the workplace, and it is unsafe to assume the process of socialisation is good, and underestimation of this socialisation process, would be negligent.

      PubDate: Thu, 2 Nov 2017 11:47:42 GMT
       
  • Volume 33 Issue 1 - The clinical environment - do student nurses
           belong': A review of Australian literature
    • Abstract: Gilbert, Julia; Brown, Lynne
      Objective - broad aim: This paper aims to identify some of the issues related to the nursing students' experience of belonging on clinical placements from the current Australian literature. Anecdotal and empirical evidence suggests that nursing students on clinical placements often experience problems that can adversely affect their feeling of belonging in the clinical setting and ultimately their career decisions. As nursing shortages increase, retention of student nurses in their chosen profession is often affected by their clinical experiences, both positively and negatively (HWA, 2012).

      Setting and Subjects: Health professionals' attitudes towards nursing students may affect their feelings of belonging to the environment and the health care team. These health professionals include Registered Nurses and a range of other health professionals including medical staff, physiotherapists and dieticians. The clinical settings in which student nurses' practice vary greatly and may also make a difference to the student experience and their feelings of belonging.

      Primary Argument: Student expectations should include feeling welcomed to the clinical area and respected as part of the nursing culture. Clinical placements provide the 'real world' experience to complement classroom and laboratory education. These expectations are clearly not met in some clinical environments. Complimentary research reinforces the benefit of partnering students with experienced registered nurses who have an interest in teaching nursing students.

      Conclusion: The literature has identified some examples of where students have felt a sense of belonging to the clinical environment and others where the situation has been less than encouraging. Provision of support, guidance and ensuring appropriate clinical education remain ongoing challenges for Australian universities and the health care system (Henderson et al 2011).

      PubDate: Thu, 2 Nov 2017 11:47:42 GMT
       
  • Volume 33 Issue 1 - Exploring values in nursing: Generating new
           perspectives on clinical practice
    • Abstract: Drayton, Nicola; Weston, Kathryn M
      Objective: The 'Essentials of Care' (EoC) program seeks to develop a shared vision amongst nurses within particular workplace teams. The purpose of this study was to describe the experiences of nurses during the process of exploring their values and developing these into a shared vision at both an individual level and as a team.

      Design: A qualitative, focus group design was used to provide an accurate representation of the nurses experiences in reflecting on their values and developing these into individual ward/unit vision statements. Six focus groups were conducted by independent researchers. The focus group discussions were recorded and transcribed by an independent researcher. The transcription provided the data for thematic analysis.

      Setting: This study was conducted in two tertiary hospitals from the same Local Health District in New South Wales, Australia.

      Subjects: Forty-two nurses from fourteen hospital wards or units participated in the study. Seventeen were facilitators of the program and the remainder were nursing staff who had undertaken the program.

      Main outcome measures: The authors independently interpreted the transcripts using inductive qualitative analysis, reaching consensus on emergent themes. Representative quotations were chosen for each theme.

      Results: Six themes emerged which describe the experiences of nurses during the exploration of individual and team workplace values which were then developed into shared visions. The emergent themes were: shared values and commitment to patient care; empowerment and ownership for cultural change; real and observable outcomes; the meaning of the team; different active learning approaches equalling the same outcome; and culture change results in new perspectives.

      Conclusion: This study supports the benefits of value-based programs. Exploring values led to new perspectives on clinical practice, both individually and collectively by the nursing teams.

      PubDate: Thu, 2 Nov 2017 11:47:42 GMT
       
  • Volume 33 Issue 1 - Delirium in the intensive care unit and long-term
           cognitive and psychosocial functioning: Literature review
    • Abstract: Bulic, Daniella; Bennett, Mike; Shehabi, Yahya
      Objective: This paper reviews existing literature on delirium that arises during mechanical ventilation in the Intensive Care Unit (ICU). It looks at the physiology of delirium, its subtypes and risk factors. It further considers the impact of delirium on cognitive and psychosocial function of patients after their discharge from acute care. The aim of this paper was to increase awareness of ICU delirium, accentuate the potential link between different sedation agents and the development of delirium, and inform practitioners, especially nurses, about this common neurocognitive disorder that appears in the Intensive Care Unit (ICU).

      Setting: Intensive Care Unit (of any acute hospital) where is ICU located.

      Subjects: Mechanically ventilated patients.

      Primary argument: This paper argues for the awareness of delirium in the Intensive Care Unit and examines sedation during mechanical ventilation with its potential role in promoting this disorder.

      Conclusion: Delirium is the most common neurobehavioral disorder in patients who are critically ill and mechanically ventilated in ICU. It frequently generates psychiatric and psychological outcomes such as depressed mood, anxiety and/ or Post Traumatic Stress Disorder (PTSD). Cognitive and psychological dysfunction following delirium seems to be overlooked, under recognised, and misdiagnosed in the ICU. These impairments are often incorrectly attributed to other processes, such as concurrent psychoactive medication use, substance use, or psychiatric disorders, in particular depression, rather than delirium. Although it is generally accepted that providing sedation for a patient's comfort is an essential part of bedside care for nearly every patient in ICU, an increasing number of researchers hypothesise there is a strong link between sedation practice and long-term patient centred outcomes, such as quality of life (Dimopoulou et al 2004) and cognitive and psychosocial functioning. Increasing nurses' awareness of this potential link is exceptionally important, as they are instrumental in administration and observing subsequent side effects of any medication, including sedatives.

      PubDate: Thu, 2 Nov 2017 11:47:42 GMT
       
  • Volume 33 Issue 1 - Prevention of postnatal mental health problems: A
           survey of Victorian Maternal and Child Health Nurses
    • Abstract: Wynter, Karen; Rowe, Heather; Burns, Joanna; Fisher, Jane
      Objectives: To investigate Maternal and Child Health (MCH) nurses' views on what contributes to mental health problems among new mothers, and their current practices regarding risk factors for maternal mental health problems that are potentially modifiable in primary care.

      Design: Cross-sectional, online survey.

      Setting: Universal MCH service offered free to all new parents in Victoria, Australia.

      Subjects: All MCH nurses employed in full or part-time clinical practice were invited to participate.

      Main outcome measures: MCH nurses' views on risk factors for maternal mental health problems and for unsettled infant behaviour; and their current practice regarding addressing unsettled infant behaviour and inclusion of fathers in services.

      Results: Surveys were completed by 343/1051 eligible MCH nurses (32.6%). Respondents identified social factors as major determinants of postnatal mental health problems among women, including: parents having limited knowledge about infant sleep needs and skills to manage unsettled infant behaviour; and lack of support, including from intimate partners. Respondents offered widely divergent advice to mothers about management of unsettled infant behaviour. They regarded the inclusion of fathers in routine services as valuable, but acknowledged practical barriers, including difficulties in offering services and programs outside conventional office hours.

      Conclusions: MCH nurses identified risks to maternal mental health that are potentially modifiable in primary care, but face barriers in addressing these. To facilitate more consistent advice to new parents about management of unsettled infant behaviours, evidence-based guidelines and training programs should be developed. Inclusion of men in routine services would require practical barriers to be overcome.

      PubDate: Thu, 2 Nov 2017 11:47:42 GMT
       
  • Volume 33 Issue 1 - Specialist nurses' experiences of using 'The Viewer',
           a consolidated electronic medical records system: A pre-post
           implementation survey
    • Abstract: Mills, Jane; Woods, Cindy; Hitchins, Marnie; Summers, Glynda
      Objective: Evaluate changes in specialty areas nurses' knowledge and perceptions of a consolidated electronic medical record (EMR) system before and after implementation.

      Design: A survey deployed pre-and six months post-implementation of 'The Viewer'.

      Setting: Regional Hospital and Health Service, Queensland.

      Subjects: Nurses working in specialist areas including community health, palliative care, discharge planning, wound and stoma care, diabetes education and renal dialysis satellite services (n=110) were invited to participate in the study. Response rate of the pre-implementation survey (n=42, 38%) was much higher than the post-implementation subset (n=10, 24%). A major health service restructure that included losses of nursing positions in specialist areas significantly affected post-implementation results.

      Intervention: An EMR system called 'The Viewer' to access consolidated electronic medical records of patient information produced by different parts of the organisation.

      Main Outcome Measures: Changes in participants' knowledge and perceptions of 'The Viewer', and their satisfaction with the quality, ease of use and access to patient information.

      Results: Pre-implementation, specialist nurses reported dissatisfaction with most aspects of the current patient information system but high confidence and comfort in using electronic systems. Post implementation satisfaction scores either remained the same or increased. Satisfaction with ease of access to consolidated patient data (U = 125.0, p = 0.038, r = 0.29) and usefulness of electronic systems (U = 115.0, p = 0.031, r = 0.30) increased significantly post-implementation of 'The Viewer'.

      Conclusion: Specialist nurses are positive about the possibilities EMRs offer to centralise, consolidate and improve access to patient data.

      PubDate: Thu, 2 Nov 2017 11:47:42 GMT
       
  • Volume 32 Issue 4 - A nurse communication manager reduces the number of
           non-relevant contacts
    • Abstract: Wright, Nana Keir; Nielsen, Nina Seested; Lauersen, Jannie; Rosenberg, Jacob; Danielsen, Anne Kjaergaard
      Objective: The aim of this study was to reduce interruptions in nursing practice by exploring the effects on the number of non-relevant contacts received by the nursing staff after implementation of a Nurse Communication Manager.

      Design: The study was designed as a pre/post interventional study. All contacts to the nursing staff, either by telephone or in person, were registered 14 days before intervention and 14 days after intervention.

      Setting: The study was set in a department of surgery.

      Subjects: The subjects were contacts either in person or by telephone aimed at nurses and nurse assistants in the surgical department.

      Interventions: During the daytime a Nurse Communication Manager handled all incoming contacts irrespective of whether they were in person or by telephone. When the Nurse Communication Manager was not available and during the evening, night and weekends, telephone contacts were managed by an electronic Call Centre guiding the call to the care teams. Main outcome measure(s): The main outcome measures were the number of non-relevant contacts aimed at the nursing staff.

      Results: Results showed a significant reduction in non-relevant contacts to the nursing staff from a mean of 80 contacts per day (SD 43) to a mean of 18 contacts per day (SD 7), p < 0.01.

      Conclusion: Implementation of a Nurse Communication Manager (NCM) reduced the number of non-relevant contacts. Reduction of non-relevant contacts is important for nurses in the clinical setting as non-relevant contacts may be perceived as interruptive. When nurses do not have to spend time responding to non-relevant contacts, they have more time to perform direct patient care.

      PubDate: Thu, 2 Nov 2017 11:47:42 GMT
       
  • Volume 32 Issue 4 - Registered nurses improving screening rates for non
           AIDS related comorbidities in people living with HIV
    • Abstract: Biggs, Karen; Power, Melissa
      Objective: To establish whether a nurse-led screening and brief intervention project could improve screening rates for non-AIDS comorbidities in people living with Human Immunodeficiency Virus (HIV).

      Design: A pre-post quantitative audit was used to evaluate the intervention of nurse-led comorbidities screening.

      Setting: A publicly-funded, metropolitan, outpatient sexual health service in Western Sydney, New South Wales, Australia.

      Subjects: One hundred medical records of people living with HIV were reviewed in each of the pre and post audits.

      Interventions: A standardised co-morbidities screening tool was developed; education sessions were conducted with the registered nurses (RNs) and written and electronic resources were used as an adjunct in screening and educating clients.

      Main outcome measure: To determine if interventions, including development of a structured screening tool and education with the RNs, would improve rates of nurse-led co-morbidities screening in people with HIV attending the service.

      Results: All of the co-morbidities screening done in year two was initiated by the sexual health RNs, rather than the medical officers. Improved rates of screening were noted in 20 of the 22 audited items, with 13 of these showing a statistically significant increase in the one year time period from audit one to audit two. Potential and existing co-morbidities were identified and managed according to local protocols.

      Conclusion: RN led comorbidities screening for people with HIV can improve rates of screening in this client group. The screening tool has now become part of nurse led standardised annual care for clients with HIV.

      PubDate: Thu, 2 Nov 2017 11:47:42 GMT
       
  • Volume 32 Issue 4 - Enhancing the online learning experience using virtual
           interactive classrooms
    • Abstract: Leslie, Andrew; Beverley, Ewens; Sian, Maslin-Prothero
      Objective: Enhancing online learning through the design, implementation and evaluation of a project piloting virtual interactive classrooms.

      Design: The virtual interactive classroom (classroom) design was underpinned with current best practice in higher education pedagogy. Evaluation of the project used a cross-sectional, electronic survey.

      Setting: This study was undertaken at a School of Nursing and Midwifery in a Western Australia University.

      Subjects: 144 nurse students: 130 undergraduate, 14 postgraduate.

      Interventions: Classroom options were introduced into two online units, incorporating blended learning approaches and promoting active participation in learning.

      Main outcome measures: Quantitative measures included student demographics, ease of classroom navigation, percentage participating in the classroom option in real-time and those who did so actively (questioning, discussing, etc.). Qualitative data of student learning experiences informed the findings further.

      Results: Fifty-six percent of enrolled students participated in classrooms in real-time and 9% viewed recorded sessions. The survey response rate was 56%. Non-traditional students were highly represented; with 65% of undergraduate and 100% of postgraduate students being mature-age. Seventy-one percent of undergraduate and 89% of postgraduate survey responders who participated in classrooms in real-time did so actively. The most common reason for non-participation in real-time was family and work commitments (76%). Participating students gave overwhelming positive feedback of the classroom experience, in particular around its interactive nature, blended learning approaches and user-friendliness.

      Conclusion: The classrooms supported active student participation in online learning. Students valued the interactive and blended learning features, known to be congruent with effective learning, student satisfaction and retention.

      PubDate: Thu, 2 Nov 2017 11:47:42 GMT
       
  • Volume 32 Issue 4 - Doctoral theses in nursing and midwifery: Challenging
           their contribution to nursing scholarship and the profession
    • Abstract: Wilkes, Lesley; Cummings, Joanne; Ratanapongleka, Mayryl; Carter, Bernie
      Objective: To determine the impact and outputs of research conducted as part of doctoral studies in nursing.

      Design: An online survey was conducted with 27 nursing doctoral graduates from United Kingdom and Australia who had graduated between 2001 and 2012. Textual and numerical data were collected and sorted on outcomes of research for management, education, practice and workforce. Numerical data were collected from journal article outputs regarding impact factors and citation rates; as well as demographic information on graduates. Frequencies were tallied, percentages calculated for both textual and numerical data and tables and figures formulated.

      Setting: University and health sector.

      Subjects: Doctoral nursing graduates who graduated between 2001 and 2012 from universities in Australia and the United Kingdom were recruited to complete the online survey.

      Main outcome measure: The outcomes and outputs of doctoral research are usually implied in the theses but assessment of these is often not apparent in the literature or clinical area. There is little evidence to demonstrate whether or not the nursing profession is influenced by the outcomes of and outputs from nurses' doctoral studies.

      Results: The top three topic areas covered by their theses were paediatrics, acute care and the role of nurses in practice. The key outputs from the 21 doctoral studies were 86 publications. Articles from the individual theses had verified citations ranging from 0 to 75. Outcomes from the research were evident in contributions to policy development, models of care, workplace issues at universities, and nursing curricula.

      Conclusion: The study shows the need for nursing research at the doctoral level should be directed towards professional needs which ultimately impact on patient care.

      PubDate: Thu, 2 Nov 2017 11:47:42 GMT
       
  • Volume 32 Issue 4 - Advanced skills for enrolled nurses: A developing
           classification
    • Abstract: Cusack, Lynette; Smith, Morgan; Cummins, Bernadette; Kennewell, Louise; Dennett, Lydia; Pratt, Debra
      Objective: This paper is a report of a literature review designed to identify strategies central to the implementation of the industrial classification of enrolled nurses (second level nurse) with advanced skills within Australia.

      Setting: Australian healthcare and aged care organisations that employ enrolled nurses.

      Primary Argument: Designing a clearly defined enrolled nurse with advanced skills role within an industrial classification, requires incorporation of advanced competencies, scope of practice articulation and specifically targeted organisational policies and procedures. These three areas are fundamental to successful role implementation.

      Conclusion: There is limited discussion in the literature on strategies to ensure effective implementation of the enrolled nurse with advanced skills role. In addition minimal research has been reported on the effectiveness of these roles in enhancing patient care and increasing workforce flexibility and efficiency. Further research and evaluation of the enrolled nurse with advanced skills is urgently required.

      PubDate: Thu, 2 Nov 2017 11:47:42 GMT
       
  • Volume 32 Issue 3 - Public health nurses' (PHNs) experiences of their role
           as part of a primary care team (PCT) in Ireland
    • Abstract: Giltenane, Martina; Kelly, Marcella; Dowling, Maura
      Objective: This study aimed to understand public health nurses' (PHNs) views and experiences of their role as part of a primary care team (PCT) and developments within primary care.

      Design: The study adopted a qualitative design guided by interpretative phenomenological analysis (IPA).

      Participants: Ten PHNs who were working as part of a PCT for at least two years and who also had PHN experience prior to PCT development were interviewed.

      Findings: Three super-ordinate themes representing the study participants' lived experience and meanings of PCT involvement were interpreted. 'We are a team' represents mostly positive experiences of being part of a team such as improved communication and teamwork. However, GP non-attendance at PCT meetings was also highlighted by all the PHNs. 'Pushed to the limit' revealed the PHNs' frustrations attributed to lack of resources. In addition, this theme represented PHNs' views of always having to 'take up the slack' within the team. Finally, 'PHN's role' revealed that the health promotion aspect of the PHNs' job was perceived to have been 'pushed aside', and mixed feelings around PHNs' future role were relayed.

      Conclusion: The findings contribute to the knowledge of PHNs' roles as part of PCT developments and highlight the need for more dialogue among PCTs on all roles within the team. It is clear that more resources for PHNs in Ireland are needed if they are to fulfil a vision of primary care. In addition, the study findings point to a need to investigate whether policy and practice changes introduced with the introduction of PCTs has improved patient outcomes.

      PubDate: Thu, 2 Nov 2017 11:47:42 GMT
       
  • Volume 32 Issue 3 - A nurses' guide to qualitative research
    • Abstract: Ingham-Broomfield, Rebecca
      Objective: This article provides a breakdown of the components of qualitative research methodology. Its intention is to simplify the terminology and process of qualitative research to enable novice readers of research to better understand the concepts involved (Benner 1984).

      Primary Argument: Current Competency Standards for Australian Registered Nurses and Midwives include a requirement to evaluate and implement research as part of their care (Borbasi and Jackson 2012, p.22; Nursing and Midwifery Board of Australia 2012). They are also expected to be actively involved in research studies (Borbasi and Jackson 2012, p.22). Evidence, when available, can enhance clinical judgement (Hamer and Collinson 2014, p.9). As evidence and research are threaded through professional work and study in the health sciences (Wright-St Clair et al 2014, p.5) nurses, particularly novice nurses, may benefit from a discussion that helps them understand the sequence of a research paper (Moxham 2012) using qualitative methodology.

      Conclusion: A systematic and logical approach will be used to discuss the content of a typical qualitative research paper. A comparative grid at the end of this paper comparing the qualitative research designs, may lead the nurse to better understand the differing components of several qualitative research methods (Ingham-Broomfield 2014).

      PubDate: Thu, 2 Nov 2017 11:47:42 GMT
       
  • Volume 32 Issue 3 - Radiation awareness among nurses in nuclear medicine
           departments
    • Abstract: Alotaibi, Muhammad; Al-Abdulsalam, Amal; Bakir, Yousif Y; Mohammed, Ahmed M
      Objective: The aim of this study is to explore the awareness level of radiation risks among nurses working in nuclear medicine departments (NMDs).

      Design: A cross-sectional survey was used. Data were collected between February and March 2011.The data were collected using a self-administered, structured questionnaires. One open-ended question was added at the end of the questionnaire.

      Setting: The study was conducted in NMDs representing five Kuwaiti governmental general and specialised hospitals and centres.

      Subjects: This study comprised twenty one non-Kuwaiti female nurses who worked in NMDs.

      Results: Nearly all of the nurses did not attend any radiation protection courses, they were not aware of the ALARA principle and they were not familiar with Geiger-Mueller counter. Most of these nurses were not able to read the dosimetry reports and they were not familiar with the terms RSO, RSC, and the 10 day rule concept.

      Conclusion: Nearly all nurses working in NMDs in Kuwait are not aware of radiation protection and risks. This lack of awareness has serious implications on both patients and nurses. Courses on radiation risks and protection should be provided to nurses during and after their formal nursing education.

      PubDate: Thu, 2 Nov 2017 11:47:42 GMT
       
  • Volume 32 Issue 3 - Patient satisfaction with their pain management and
           comfort level after open heart surgery
    • Abstract: Karabulut, Neziha; Aktas, Yesim Yaman; Gurcayır, Dilek; Yılmaz, Durdane; Gokmen, Volkan
      Objective: The aim of this study is to determine patient satisfaction with pain management and comfort levels after undergoing open heart surgery.

      Design: This descriptive study was performed between January 31 and April 29, 2011.

      Setting: The study was conducted in the cardiovascular surgery clinic of Region Training-Research hospital in Erzurum, Turkey.

      Subjects: Fifty two patients (32 males, 20 females; mean age 58.4 years; range 25 to 77 years) who had undergone open heart surgery were included in the study.

      Main outcome measure(s): The patient data was collected using Personal Information Form, Pain Satisfaction Surveys and General Comfort Scales at the time of discharge. The Pain Satisfaction Survey is a survey tool which was developed by the 'American Pain Society' in 1991. The General Comfort Scale was developed by Kolcaba in 1992 and its validity and reliability in a Turkish setting was tested by Kuğuoğlu and Karabacak in 2004.

      Results: In this study, 61.5% of the patients underwent coronary artery bypass graft surgery, 30.7% aorta and/or mitral valve replacement and 7.7% aneurysm repair. The mean scores of pain intensity immediately after surgery, at first post-operative ambulation, at 24 hours before discharge and at discharge were 7.07+2.6, 6.71+2.7, 6.32+2.4 and 4.57+2.3, respectively. Most subjects (88.5%) reported a wait time of 15 min as the longest time they had to wait for pain medication and patient satisfaction with pain management was found to be high. The mean score of comfort level at discharge was 3.16+0.2 and there was no statistically significant difference between the comfort level and pain rating at discharge (r=-0.225, p>0.05).

      Conclusion: It was found that pain intensity gradually decreased as patients neared hospital discharge and their overall satisfaction with the nurses' pain management was high.

      PubDate: Thu, 2 Nov 2017 11:47:42 GMT
       
  • Volume 32 Issue 3 - Development of a nurse practitioner led Carpal Tunnel
           Syndrome clinic
    • Abstract: Scanlon, Andrew; Perera, Chandrashan; Gonzalvo, Gus; Fabinyi, Gavin
      Objective: This paper aims to examine how the role of nurse practitioner was implemented within a public hospital Department of Neurosurgery carpal tunnel syndrome clinic.

      Setting: Tertiary referral centre outpatient clinic.

      Findings: The paper informs practice describing the process of developing, implementing and the requirements to become a nurse practitioner role within a public hospital's Department of Neurosurgery within Australia.

      Conclusions: The introduction of a nurse practitioner role within the Department of Neurosurgery has resulted in more timely access and cost effective care for patients referred to this specialised service. Opportunities to further expand this and similar roles in the future should be considered as demand increases.

      PubDate: Thu, 2 Nov 2017 11:47:42 GMT
       
  • Volume 32 Issue 2 - Working with refugee young people: A nurse's
           perspective
    • Abstract: Garakasha, Nyaradzai
      Objective: To improve the health outcome of young people from a refugee background through sharing nursing experiences and processes that can be used to effectively address young people's health related problems.

      Setting: Primary Health Care.

      Subjects: Newly arrived young people between the ages of 12-24 years from a refugee background.

      Primary argument: There is evidence that a young person's personal responses to history of torture and trauma, displacement, loss and interruption to family life; intertwined with adolescent uncertainty may lead to particular challenges. All young people require nurses and clinicians with the knowledge and skills to address their health problems. However this particularly vulnerable group also require health professionals that can approach these young people and their families in a manner that is culturally and professionally acceptable. This paper seeks to share some of the experiences gained while working with adolescents and youths from refugee backgrounds including common health issues raised by young people, their families and communities. In addition it will suggest some processes that are being used to address health issues. This includes setting up a health initiative that seeks to address health issues in a familiar supportive environment that is acceptable to the young people their families and communities.

      Conclusion: Refugee young people are a special group of people with different needs when compared to adults from a refugee background. It is very important for nurses to identify these needs and know how to identify the problems young people from a refugee background face. As clinicians it is very important to be aware of the issues facing refugee young people and the best way to approach young people so they feel welcome. Working with refugee young people requires patience and relationship building. It is very important to treat refugee young people as individuals and to involve the young people and their families in the treatment and problem solving as much as possible in order to get the best result.

      PubDate: Thu, 2 Nov 2017 11:47:42 GMT
       
  • Volume 32 Issue 2 - Health literacy screening instruments in adults with
           cardiovascular disease and their importance to the nursing profession
    • Abstract: Chan, Alex
      Objective: To provide context information about the currently available health literacy screening instruments that may be applicable to adults with cardiovascular disease and their importance to the nursing profession.

      Primary argument: Cardiovascular disease is a major health concern in Australia. Most cardiovascular diseases can be prevented and managed by reducing the cardiovascular risk factors. However healthcare professions, including nurses, may overestimate the health literacy skills of adults, and result in ineffective communication and misunderstanding. Adults with inadequate health literacy skills are often less compliant with their prescribed preventive treatments. As such an accurate health literacy assessment would not only promote therapeutic communication and the relationships between nurses and adults but it would also improve the compliance of secondary preventive treatment and the overall health outcomes. So this leads to the question, what health literacy screening instruments are available to measure the health literacy skills of adults with cardiovascular disease'

      Conclusion: A review of primary research dated from 2005 to 2014 indicated the derivative versions of TOFHLA and REALM are the two main instruments used to measure the health literacy skills of adults with cardiovascular disease. Accurate health literacy measures can assist nurses to develop strategies to improve the overall health outcomes of adults with complex needs and inadequate health literacy skills. As nurses comprise a substantial proportion of the healthcare workforce, they have the potential to make changes in the healthcare system and improve the quality of health education provided to this population group.

      PubDate: Thu, 2 Nov 2017 11:47:42 GMT
       
  • Volume 32 Issue 2 - Professional capability within the Australian
           hyperbaric nursing workforce
    • Abstract: Baines, Carol; Sykes, Pam
      Objective: To document and describe a contemporary profile of the Australian hyperbaric nursing workforce.

      Design: A mixed methods research methodology using a web-based survey questionnaire.

      Setting: Members of the Australian Hyperbaric Technicians and Nurses Association.

      Main outcome measures: Overview of the current Australian hyperbaric nursing workforce including demographics, education, clinical experience, employment status and workplace health and safety requirements.

      Results: A majority of the 49 respondents working in the specialty of hyperbaric medicine were female (87.7%) and aged between 45-54 years (42.9%). All have qualifications relevant to hyperbaric, wound management and/or critical care nursing. A mostly part-time and casual workforce (75.5%) participates in an on call roster between one and five times per fortnight (81.6%). Hyperbaric nurses (95.4%) have been recruited from critical and emergency care departments with many continuing to work shifts in these areas. A high level of workplace health and safety compliance includes an annual medical examination (91.8%) and associated hearing test (77.6%). Personal injuries associated with hyperbaric oxygen therapy are low.

      Conclusion: Limited data are available on the characteristics of the hyperbaric nursing workforce in Australia. Results of this survey show the recruitment and retention of female nurses' in the middle of their career ensures a high level of job suitability. Advanced clinical skills coupled with relevant post graduate tertiary qualifications are necessary. A high level of casual workforce employees ensures the mandatory 18 hour break between compression treatments is achievable. The emphasis on workplace health and safety compliance is paramount with few injuries being reported.

      PubDate: Thu, 2 Nov 2017 11:47:42 GMT
       
  • Volume 32 Issue 2 - Urinary continence care in Australian nursing homes
    • Abstract: Yu, Ping; Hailey, David; Traynor, Victoria
      Objective: Exploring urinary continence (UC) assessment and management practices in Australian nursing homes.

      Design: Mixed method using a questionnaire and interviews.

      Setting: Five nursing homes in Australian metropolitan cities.

      Subjects: Participants 121 staff: mostly female (91%) with a range of roles including personal care assistants (PCAs) (63%), enrolled nurses (ENs) (11%), registered nurses (RNs) (20%) and managers (4%).

      Main outcomes measure(s): Compliance with and perceptions about UC assessment and management.

      Results: 77% (n=71) of care staff (PCAs, ENs and RNs) were compliant with the UC management protocol of checking for wetness every 2 to 2.5 hours. Toileting time and frequency of changing continence aids varied between nursing homes. Perceptions about the accuracy of UC assessments and knowledge of an older person following UC assessment also differed between nursing homes.

      Conclusion: Areas where UC assessment and management in nursing homes could be improved include identifying the voiding times of older people, compliance with care plans in management practice, and caregiver ability to assess the capacity of continence aids to absorb urine. Training for effective continence care in nursing homes needs to be enhanced.

      PubDate: Thu, 2 Nov 2017 11:47:42 GMT
       
  • Volume 32 Issue 2 - A nurses' guide to Quantitative research
    • Abstract: Ingham-Broomfield, Rebecca
      Objective: This article provides a breakdown of the components of quantitative research methodology. Its intention is to simplify the terminology and process of quantitative research to enable novice readers of research to better understand the concepts involved (Benner 1984).

      Primary Argument: Globally, evidence-based practice (EBP) has become a major preoccupation of investigators and practitioners involved in the delivery of health care (Liamputtong 2013 pxxi). Working within the health sector requires the nurse to be familiar with research in a way that informs practice, especially if working towards a degree (**Wright-St Clair et al 2014). Nurses may benefit from a discussion that helps them understand the sequence of a research paper (Moxham 2012) that uses quantitative methodology.

      Conclusion: The content of a typical quantitative research paper will be discussed in a systematic, logical order. A quantitative grid is provided at the end of the paper. Its intention is to aid the nurse to better understand the differing components of the four main quantitative research methods.

      PubDate: Thu, 2 Nov 2017 11:47:42 GMT
       
  • Volume 32 Issue 1 - Nurses supporting life-partners conversations about
           end-of-life care wishes: A literature review for guidelines
    • Abstract: Rabbetts, Lyn
      Setting: Nurses providing end of life care.

      Objective: A literature review was conducted to establish what guidelines are available for nurses to encourage discussions between life partners about end of life care wishes.

      Subjects: Life partners and nurses

      Primary argument: This literature review located articles that addressed the impact terminal illness, culture and established communication patterns have on end of life discussions for the broad group of family members and carers. Articles generally presented the challenges doctors, nurses and other health care professionals face in speaking about end-of-life care wishes with patients, carers and family members. However, articles relating to conversations specifically between life partners about end of life care wishes were not evident. This is surprising because frequently the life partner is the primary care giver during the end of life care phase of a life limiting illness. Furthermore, literature indicates life partners who are able to speak freely about most life issues adjust better to the challenges that events such as illness, may present to them as a couple.

      Conclusion: By using the main themes identified within the literature review from discussions held by family members, nurses and health professionals it may be possible to develop guidelines for life partners. The use of a guideline may assist nurses in encouraging life partners to have conversations about end of life care wishes. This will not only acknowledge the uniqueness of the relationship between life partners, but also contribute to providing holistic patient centred care for each couple.

      PubDate: Thu, 2 Nov 2017 11:47:42 GMT
       
  • Volume 32 Issue 1 - Understanding infant feeding practices of new mothers:
           Findings from the Healthy Beginnings Trial
    • Abstract: Wardle, Karen; De Domenico, Maria; Wen, Li Ming
      Objective: This study aimed to explore the experiences of infant feeding of first-time mothers and identify the barriers and facilitators in relation to healthy infant feeding practices.

      Design: As part of the Healthy Beginnings Trial, descriptive analyses were conducted using data extracted from both baseline and six month surveys. Twenty five face-to-face in-depth interviews were conducted at 12 months postpartum by two trained research nurses with a series of semi structured questions to explore mother's infant feeding experience.

      Setting: The study was conducted in southwest Sydney, the most socially and economically disadvantaged area of metropolitan Sydney, New South Wales in 2007 2010. Main outcome measures To understand mothers' experiences of infant feeding and identify the barriers and facilitators in relation to healthy infant feeding practices.

      Results: A total of 561 mothers completed both baseline and six month surveys. Of these, 25 agreed to participate in a face-to face in depth interview at 12 months postpartum. A high proportion (96%) of mothers initiated breastfeeding, only 38% continued breastfeeding at 6 months postpartum due to numerous barriers. The main barriers for breastfeeding were milk supply and unsettled baby, latching baby to the breast and pain. The main barrier for appropriate timing of introduction of solid food was confusion about the recommended guidelines. Hospital support was regarded as the main facilitator for healthy infant feeding practices.

      Conclusions: A significant proportion of mothers did not meet the WHO recommended guidelines for breastfeeding. The first week of life was the most critical time for first time mothers to establish and consolidate breastfeeding. Education around appropriate timing of introduction of solids for both mothers and health professionals would be beneficial in ensuring consistency and adherence to the guidelines.

      PubDate: Thu, 2 Nov 2017 11:47:42 GMT
       
  • Volume 32 Issue 1 - Knowledge and practices of nurses concerning
           intravenous potassium administration in a Turkish hospital
    • Abstract: Gunes, Aysegul; Celik, Sevilay Senol
      Objective: Based on this literature review, it is clear that intravenous potassium is a potentially toxic electrolyte, which has been responsible for a large number of deaths in hospitals. In Turkey, research on intravenous potassium administration is limited in the available literature. In addition, clinical observations made by the researchers suggests there is knowledge and practice deficiencies among nurses related to potassium administration. Thus, this study aimed to determine how wide the knowledge and practice deficiencies among nurses was concerning intravenous potassium administration in a Turkish Hospital.

      Design: This was a descriptive study.

      Setting: This study was conducted in a university hospital in Turkey.

      Subjects and Method: The sample of this study consisted of a total 105 nurses working in surgery clinics or surgical intensive care units of a university hospital, who volunteered to participate in the study.The questionnaire used in this study was developed by the researchers with the help of material obtained from the literature review. Questionnaires were distributed and collected to participants by researcher. In the calculation of knowledge and practice scores, every correct answer was assigned 1 point, while incorrect answers were assigned 0. Mean, percentage, ANOVA, the kruskal wallis h test, the mann whitney u test and pearson correlation were used for data analysis.

      Results: The mean knowledge score of nurses on intravenous potassium administration was found to be 9.48+/-3.21, while the mean practice score was 10.85+/-2.04. These results suggest that the nurses' knowledge and practice scores were found to be relatively lower compared to 17 which is the highest scores of both knowledge and practice about intravenous potassium administration. It is also important to state that statistically significant and positive relationship was found (r: 0.595; p< 0.05). The majority of the nurses (61.9%) did not know all the elements of a correct potassium order. The differences in nurses' knowledge scores according to the type of hospital unit and training status on liquid electrolyte balance were found to be statistically significant (p
      PubDate: Thu, 2 Nov 2017 11:47:42 GMT
       
  • Volume 32 Issue 1 - A nurses' guide to the critical reading of research
    • Abstract: Ingham-Broomfield, Rebecca
      Objective: A sound theoretical foundation to guide practice is enhanced by the ability of nurses to evaluate and implement research. This article provides a structured route to questioning the methodology of nursing research as well as aiding the construction of nursing research.

      Primary Argument: It is common for students to wonder about the relevance of research (Wright St Clairand et al 2014). Gaining a degree in the health sector requires the nurse to be familiar with research in a way that informs practice (Wright-St Clair et al 2014). Nurses may benefit from a structured approach that helps them understand the sequence of the text and the subsequent value of a research paper (Moxham 2012).

      Conclusion: A framework is provided within this article to assist in the analysis of a research paper in a systematic, logical order. The questions presented in the framework may lead the nurse to conclusions about the strengths and weaknesses of research methods presented in a research article. The framework does not intend to separate quantitative or qualitative paradigms but to assist the nurse in making broad observations about the nature of the research.

      PubDate: Thu, 2 Nov 2017 11:47:42 GMT
       
  • Volume 32 Issue 1 - Enhancing the pre-admission process for a patient with
           breast cancer
    • Abstract: Newman, Barbara
      Objective: The purpose of this paper is to detail the development and implementation of a patient focused pre-admission process, part of which is the check list identified within this paper and comprising the main point of the paper because it is based on patient and publication evidence for women with breast cancer. Women with breast cancer together with health professionals had specific input into the designed pre-admission clinic at a tertiary care hospital. A pre admission clinic had been established some time ago however, women who attended this clinic deemed it most unsatisfactory for their needs. Results from an evaluation provided information that indicated women with breast cancer required an improved pre admission process that was aligned to their needs and those of the Breast Cancer Multidisciplinary Team (BCMT).

      Setting: A large tertiary care hospital in Sydney, New South Wales, Australia.

      Subjects: Fifty (50) women of mixed cultures. Men can be diagnosed with breast cancer however, throughout this project, women were the only patients presenting for surgery.

      Primary Argument: Even though remarkable progress has been made in breast cancer survival through medical treatment, women, newly diagnosed with breast cancer are frequently concerned, stressed and anxious as they attempt to come to terms with the news on their cancer diagnosis. Beside the initial medical consultation that informs them on their diagnosis, the women's first major interaction with the healthcare system commences when they attend the pre-admission clinic as a pre admitted person. Therefore it is appropriate to examine current nursing practices during the pre admission phase of a Tertiary Hospital so women, newly diagnosed with breast cancer are able to receive appropriate and supportive care. The goal of health professionals is to respect each patient and give voice to them by developing a specifically designed pre-admission process. It is expected any pre-admission process will utilise available evidence and include consultation with the Breast Cancer Multidisciplinary Team (BCMT). Thus the project commenced by identifying the needs of women with breast cancer in consultation with the BCMT, including nurses, physiotherapists, doctors and social workers. This evidence based approach to best practice in the pre-admission process and clinic has not been attempted previously for this cohort of patients.

      Conclusion: Improving the pre admission process of patients encourages analysis of the evidence that is appropriate for this cohort and nursing practices. In addition, it offered time to ensure applicability of the pre admission process and clinic to the lives of the women concerned. During this project opportunities arose for reflection on the journey women follow after their diagnosis and the involvement of the BCMT. Moreover, this process encouraged examination of the most appropriate allocation and use of resources within the context of the pre admission process and clinic, surgery, and discharge through to home follow up. This paper maps some of the adopted process, the collected data and briefly summarises resources utilised in relation to the pre-admission process.

      PubDate: Thu, 2 Nov 2017 11:47:42 GMT
       
  • Volume 31 Issue 4 - The effects of workplace bullying on physicians and
           nurses
    • Abstract: Ekici, Dilek; Beder, Alper
      Objective: This cross sectional and descriptive study assessed workplace bullying and its effects on work performance and depression status of physicians and nurses in a university hospital, Turkey.

      Methods: The study sample consisted of 201 physicians and 309 nurses. The variables are demographical characteristics of the participants, their perception of bullying, workload, the impact of bullying on work performance and their depression status.

      Results: A large percentage of physicians (74%) and nurses (82%) reported having experienced bullying in the workplace. No significant differences were found between the physicians and nurses in terms of experienced workplace bullying. However, there was an association between performance, depression and experienced violent behaviours.

      Conclusion: In order to solve the problem caused by workplace bullying, the rate of awareness amongst healthcare professionals needs to be raised. The researchers believe that unless organisations realise bullying's harmful effects on the employees and work performance, it is not easy to overcome the problem. Therefore, workplace bullying should be dealt with not only at an individual level, but also at organisational levels.

      PubDate: Thu, 2 Nov 2017 11:47:42 GMT
       
  • Volume 31 Issue 4 - Introduction of a novel, mobile, nurse-led prostate
           cancer education and testing service
    • Abstract: Crowe, Helen; Bugeja, Patricia; Wootten, Addie; Howard, Nicholas; Murphy, Declan; Challacombe, Ben; Costello, Anthony
      Testing for prostate cancer (PCa) remains a controversial issue with conflicting professional recommendations resulting in wide variation in general practitioner's opinions, and advice to patients. As a result some men may not receive information about their risk of developing PCa, and are therefore unable to make a decision about undergoing testing. A nurse led program was established for delivery of information about PCa, and providing convenient testing opportunities in the workplace. The program was evaluated and found to be an efficient and well-received model for delivery of this health related initiative.

      Objective: The aim of this paper is to describe the development and evaluation of a mobile, nurse led PCa education and testing service.

      Setting: PCa information and testing in work place environment.

      Primary Argument: Controversy exists regarding the risks and benefits of PCa testing. Guidelines are conflicting, with one consistent premise being that men should be provided with enough information to make an informed decision. General practitioner's uncertainty about appropriate advice, and men's reluctance to engage in health seeking behaviours, make provision of information to men regarding the risks and benefits of PCa testing a challenge. This novel nurse-led work-place service helps overcome some of the identified difficulties in men accessing information to enable them to make an informed decision regarding PCa testing and to undergo this testing.

      Conclusion: The provision of work place group education sessions and follow up individual nurse led consultation and testing sessions was well received and provided an opportunity for men to access information regarding PCa, and to undergo testing if appropriate, in a convenient, non threatening environment.

      PubDate: Thu, 2 Nov 2017 11:47:42 GMT
       
  • Volume 31 Issue 4 - Sleep quality in the elderly either living at home or
           in a nursing home
    • Abstract: Daglar, Gulseren; Pinar, Sukran Ertekin; Sabanciogullari, Selma; Kav, Sultan
      Objective: Changes in sleep duration, pattern, and quality occur with ageing. The aim of this study was to analyse the sleep quality and affecting factors in the elderly living either at home or in nursing homes.

      Design: Descriptive and cross sectional study

      Setting: Sivas, a central Anatolian city in Turkey.

      Subject: This study was carried out with 112 individuals; 52 were living in a nursing home and 60 at home.

      Main outcome measures: A personal information form and Pittsburgh Sleep Quality Index (PSQI).

      Results: There was no statistically significant difference between mean scores and sleep qualities of both groups (p > 0.05). The sleep quality of the individuals in both groups was not significantly influenced by personal variables such as age, gender, education, income, having children, and having a physical illness (p > 0.05). Individuals in both groups who reported their sleep as inadequate had sleep problems, and those who reported their sleep was affected for various reasons and who perceived their health as poor had significantly worse sleep quality (p < 0.05).

      Conclusion: The sleep quality of the elderly living either at home or in a nursing home were at similar levels and more than half of individuals in both groups had poor sleep quality.

      PubDate: Thu, 2 Nov 2017 11:47:42 GMT
       
  • Volume 31 Issue 4 - Violence against health care staff by peers and
           managers in a general hospital in Greece: A questionnaire-based study
    • Abstract: Koukia, Evmorfia; Mangoulia, Polyxeni; Papageorgiou, Dimitrios E; Gonis, Nikolaos; Katostaras, Theofanis
      Background: Many studies have investigated violence against nurses or physicians from patients and visitors especially in psychiatric settings. Few however, have focused on violence between co workers in general hospitals and various departments.

      Objectives: This study examined the types of violence experienced by physicians, nurses and nurse assistants in various departments instigated by doctors, nurses and supervisors as well as the possible causes, the effects on job performance, the handling of the incidents and the possible preventive measures.

      Design: A questionnaire based study was conducted among nurses and physicians concerning violence between co workers.

      Setting: The study was carried out in two general hospitals in Athens, Greece.

      Subjects: A total of 250 health care staff doctors, nurses, and nurses' assistants took part in the study.

      Methods: A questionnaire based study with multiple choice questions was held with doctors, nurses, and nurses' assistants. Quantitative data was analysed by SPSS. A logistic regression analysis was used in order to determine significant risk factors of violence.

      Results: A majority of respondents had experienced some form of violence (verbal, psychological, physical or sexual). Doctors and nurses were the main perpetrators followed by managers. The most frequently reported incident was psychological violence, followed by verbal violence. Associations were found between workplace violence and age, gender and wards. Violence was significantly more likely to be targeted towards less experienced, younger staff and those working in ICU, but was significantly less likely among those working in the emergency department and orthopaedics.

      Conclusion: Health care staff are at great risk of workplace violence by both co workers and managers. The reporting of these violent events needs to increase in order to develop safety policies and strategies. Future research must focus on factors influencing high levels of violence and preventive measures.

      PubDate: Thu, 2 Nov 2017 11:47:42 GMT
       
  • Volume 31 Issue 4 - Tailoring Dementia Care Mapping and reflective
           practice to empower Assistants in Nursing to provide quality care for
           residents with dementia
    • Abstract: Mansah, Martha; Coulon, Lyn; Brown, Peter; Reynolds, Heather; Kissiwaa, Sarah
      Objective: The study addressed one central aim. This was to explore the experience of Assistants in Nursing being exposed to Dementia Care Mapping coupled with reflection to improve older residents care in a residential aged care facility.

      Design and Setting: A qualitative exploratory design was employed to gain an in depth understanding of Assistants in Nursing experience of creating new care for older residents using Dementia Care Mapping and feedback. The study was conducted in a dementia specific nursing home, located in urban Sydney, New South Wales, Australia.

      Subjects: The study participants were ten Assistants in Nursing and five older residents diagnosed with mild to moderate dementia by a Physician.

      Results: For the first time, the study illuminated the Assistants in Nursing innovative care following Dementia Care Mapping feedback and reflection. Their experience was highlighted in three major themes: (i) Reflecting on Care (ii) Creating a Caring Connection and (iii) Empathetic Communication.

      Conclusion: These Assistants in Nursing valued and used findings from Dementia Care Mapping feedback coupled with reflection to improve contemporary practice. In addition, they felt empowered to create new nursing strategies for quality care. The study highlighted the usefulness of providing Assistants in Nursing with these types of educational strategies to encourage the development of creative caring for residents with dementia living in a residential aged care facility.

      PubDate: Thu, 2 Nov 2017 11:47:42 GMT
       
  • Volume 31 Issue 3 - Health literacy, does it make a difference'
    • Abstract: Johnson, Anne
      Objective: To provide contextual information about health literacy and its importance to health care, nursing, and health consumers.

      Primary argument: Health literacy is of concern to all health workers, including nurses, working in all areas of the Australian health care system. Low levels of health literacy is a significant problem in Australia. Population measurements of functional health literacy levels (ABS 2008) indicate that 59 per cent of the Australian population aged 15 to 74 years did not achieve an adequate health literacy skill level to meet the complex demands of everyday life and work in a knowledge-based economy. Nurses play a vital role in the care and education of health consumers. As such an understanding of health literacy and how it impacts on health care and health outcomes is central to providing patient-centred care, and improving health outcomes.

      Conclusion: An understanding by nurses of health literacy is central to enhancing the involvement of health consumers in their care, and improving health outcomes and the provision of safe health care.

      PubDate: Thu, 2 Nov 2017 11:47:42 GMT
       
  • Volume 31 Issue 3 - Association between CD4+ T-cell count, atypical
           squamous cells and Schiller's test in women with HIV/AIDS
    • Abstract: Silva de Brito, Daniele Mary; da Cunha, Gilmara Holanda; Gir, Elucir; Freitas, Julyana Gomes; Galvao, Marli Teresinha Gimeniz
      Objective: Infection with HIV increased risk for the development of cancer, such as Kaposi's sarcoma and invasive cancer of the cervix. Given the importance of health promotion in women, the purpose of this study was to perform cytological screening (Pap smear) and identify any association between CD4+ T-cell, atypical squamous cells and the Schiller's Test in women with HIV/AIDS in Brazil.

      Design: Descriptive and cross-sectional study.

      Setting: Gynaecology outpatient clinic in Fortaleza, Ceara, Brazil.

      Subjects: A total of 76 women with HIV/AIDS were examined and included in the study.

      Main outcome measures: For data collection a questionnaire to gather sociodemographic, clinical, epidemiological and gynaecological data and the association between CD4+ T-cell count, atypical squamous cells and Schiller's test in women with HIV/AIDS were performed.

      Results: Seventy-six women were evaluated, among which 43.5% had a positive Schiller's test and 94.8% manifested some type of inflammatory process. There was statistical significance between atypical squamous cells and the number of partners (P=0.021), age of first sexual intercourse (P=0.003) and positive Schiller's test (P=0.008). Of the patients with atypical squamous cells, eight had a low-grade, intraepithelial lesion, comprising the cytopathic effect of HPV and cervical intraepithelial neoplasia grade I (CIN I); three had intraepithelial lesion high-grade (CIN comprising II and III). There was a relationship between CD4+ T-cell counts and atypical squamous cells (P=0.028) and a positive Schiller's test (P=0.030).

      Conclusion: Increased vulnerability occurred to cervix changes with a reduction in the CD4+ T-cell counts.

      PubDate: Thu, 2 Nov 2017 11:47:42 GMT
       
  • Volume 31 Issue 3 - The effects of mindfulness training program on
           reducing stress and promoting well-being among nurses in critical care
           units
    • Abstract: Lan, Hee Kim; Subramanian, Pathmawathi; Rahmat, Norsiah; Kar, Phang Cheng
      Objective: This study was conducted to evaluate the effectiveness of a brief mindfulness-based training program in reducing stress and promoting well-being among critical care nurses.

      Design: A quasi-experimental, single-group, pre-post study design was used to evaluate the effectiveness of the program.

      Setting: This study was conducted in a tertiary referral centre in Malaysia.

      Subjects: A non-probability voluntary sample of 41 critical care nurses participated in the program. Thirty seven (90%) completed the program, with at least 80% attendance.

      Intervention: The intervention is an adapted and brief version of Mindfulness-based Cognitive Therapy (b-MBCT) using the local promotional name of 'Mindful-Gym'. b-MBCT is a group-based program, carried out for five weeks at two hours per week with practice sessions in between. It was delivered as part of the hospital's continuing nursing education program.

      Main outcome measures: Perceived Stress Scale (PSS) and Depression Anxiety Stress Scale (DASS) were used to measure the stress-related outcomes. As for the well-being outcomes, the Mindfulness Attention and Awareness Scale and Subjective Happiness Scale (SHS) were used.

      Results: fter completing the program, the participants reported significant improvement in the level of perceived stress (PSS: p < .001; r = 0.50), stress (DASS-S: p = .002; d = 0.56), anxiety (DASS-A: p < .001; r =0.38), depression (DASS-D: p < .001; r = 0.37), mindfulness (MAAS: p < .001; d = 1.002), and happiness (SHS: p = .028; d = 0.57), with a moderate to large effect size.

      Conclusion: Results support the effectiveness of b-MBCT in reducing stress and promoting well-being among critical care nurses.

      PubDate: Thu, 2 Nov 2017 11:47:42 GMT
       
  • Volume 31 Issue 3 - Overseas qualified nurses in Australia: Reflecting on
           the issue
    • Abstract: Stankiewicz, Grazyna; O'Connor, Margaret
      Objective: The migration of international nurses is a growing phenomenon and will continue in response to global nursing shortages. Historically, nursing has been depicted as a 'portable' profession, or one which enables individuals to move across inter/national borders. This 'portability' of nursing is supporting skilled nurse migration around the world. However, nursing practices learned by Overseas Qualified Nurses (OQN) in their home countries may differ to the role and expectations of the new country in relation to scope of practice, professional and legal environment, accountability, professional autonomy, health care technology and inter-professional relationships.

      Primary argument: Relatively little is known about the experiences of OQN in Australia and particularly, about those from non-English speaking backgrounds. Supported by international literature and personal experiences, this paper describes the adaptation process and challenges faced by OQN in beginning a new life in Australia.

      Conclusion: Australia, like many other developed countries, is facing an ageing population and an ageing health workforce, including nurses. The global shortage of nurses in many countries, including Australia, means that OQN will continue to be a significant part of the workforce. As the welcoming country, Australia can benefit from hosting OQN and these nurses in return contribute to the enrichment of Australian life.

      PubDate: Thu, 2 Nov 2017 11:47:42 GMT
       
  • Volume 31 Issue 3 - The predictors and outcome of psychiatric disorders
           among survivors post-earthquake: Survey from Sichuan China
    • Abstract: Liu, Dongling; Jiang, Xiaolian; Pang, Samantha; Li, Sijian
      Objective: The aims of the study were to investigate predictors and outcomes of psychiatric disorders among survivors post-earthquake.

      Design: Cross-sectional design survey.

      Setting: Government-aided communities with temporary shelters.

      Subjects: A multistage stratified and cluster sampling strategy was employed to select participants via face-to-face interviews, and a total of 1,297 survivors participated in the research.

      Main outcome measure: Psychiatric disorders were measured with self-reporting questionnaire-20 (SRQ-20), and quality of life was measured with medical outcomes study 36-item short form health survey (SF-36) and a series of problems were made to evaluate the demographic characteristics of survivors.

      Results: The findings of the present study show that psychiatric morbidity was very prevalent among survivors (76.6%). Negative correlation was found between the total score of SRQ and PCS (rs= -0.525, p 1,500 yuan, and with medical insurance were significant protection factors against psychiatric disorders.

      Conclusions: The psychiatric morbidity was very prevalent among survivors two years after the earthquake. The survivors with psychiatric disorders tend to have poor quality of life. Appropriate public health and medical interventions should put an emphasis on survivors who are female, aged 60 or older, having financial burden and having >2 chronic diseases because they are at heightened risk for psychiatric disorders.

      PubDate: Thu, 2 Nov 2017 11:47:42 GMT
       
  • Volume 31 Issue 2 - Adolescents' perceptions about their weight and
           practices to lose weight
    • Abstract: Hisar, Filiz; Toruner, Ebru
      Purpose: This descriptive study aimed to determine perceptions of adolescents about their weight and practices to lose weight. Methods: A convenience sample of adolescents (n=703) in grades 9 through 12 completed a questionnaire assessing demographic characteristics, perceptions about their weight, practices to lose weight and their information sources for losing weight. These students were then weighed and had their height measured. Body mass index (BMI) was calculated. Results: According to the measured BMIs, 11.2% of students were underweight, 74.1% were a healthy weight, 6.4% were overweight and 8.2% were obese. Of the adolescents, 13.1% perceived themselves as underweight, 65.0% perceived themselves as having a healthy weight, 19.7% perceived themselves as overweight, and 2.2 % perceived themselves as obese. There was poor agreement between measured BMI and adolescents' perceptions (p < .05). Of the adolescents, 33% had tried/were trying to lose weight. Conclusion: The study determined that there are differences between the real weights and self-perceived weights of adolescents. School training programs should include information on proper body weight and form, and healthy methods of weight loss.

      PubDate: Thu, 2 Nov 2017 11:47:42 GMT
       
  • Volume 31 Issue 2 - The effect of light therapy on the sleep quality of
           the elderly: An intervention study
    • Abstract: Akyar, Imatullah; Akdemir, Nuran
      Objective: The study was conducted to determine the effect of light therapy on the sleep quality of older adults. Design: This interventional study was conducted with a single group pre-test, post-test model. Setting: The study was conducted in a nursing home in Ankara, Turkey. Subjects: Twenty-four older adults with poor sleep quality were included in the study. Intervention: During the study procedure, a 10,000 Lux light was administered continuously for a half-hour duration in the morning over a one-month period. Main outcome measures: The main outcome measures included global and subcomponents of sleep quality, which were assessed by the Pittsburgh Sleep Quality Index, and were repeatedly measured at the baseline, pre-intervention (four weeks at baseline), post-intervention (at the end of intervention/eight weeks at baseline), and follow-up (four weeks at intervention). Results: At the end of light therapy intervention and during the four-week follow-up period, the global sleep quality scores were found to be higher compared with pre-intervention and baseline scores (p < 0.001). The 'daytime dysfunction' and 'sleep latency' sub-scores were found to be the most positively changed, whereas the change in 'duration of sleep' sub-score was less. Conclusion: Light therapy has been shown to be effective non-pharmacological therapy for improving sleep quality among healthy elders.

      PubDate: Thu, 2 Nov 2017 11:47:42 GMT
       
  • Volume 31 Issue 2 - Burnout levels in neonatal intensive care nurses and
           its effects on their quality of life
    • Abstract: Aytekin, Aynur; Yilmaz, Fatma; Kuguoglu, Sema
      Objective: The purpose of this study was to investigate burnout levels of nurses working in a neonatal intensive care unit (NICU) and the effects of burnout on their quality of life. Design: This was a descriptive and correlational study. The researchers obtained data using a questionnaire to uncover the demographic and occupational characteristics of the nurses, and conducted face-to-face interviews via the Maslach Burnout Inventory (MBI) and the World Health Organization Quality of Life -BREF (WHOQOL-BREF). Setting: The NICU of two state hospitals located in the north of Turkey. Subjects: A total of 80 nurses. Main outcome measures: Levels of burnout experienced. Results: The score means of emotional exhaustion, depersonalisation and personal accomplishment were 14.90 5.53, 3.87 2.77 and 11.43 4.63, respectively. The results showed the nurses had burnout at moderate levels with regard to emotional exhaustion and personal accomplishment, and low levels of depersonalisation. In addition, the study showed a significant negative relationship in many sub-scales of the burnout and quality of life scale. Conclusion: The nurses experienced moderate burnout in emotional exhaustion and personal accomplishment. The study found that, as burnout level increased, the quality of life of the nurses decreased. It is suggested that several measures must be taken to prevent burnout in nurses.

      PubDate: Thu, 2 Nov 2017 11:47:42 GMT
       
  • Volume 31 Issue 2 - Description, and pilot evaluation, of novel staff
           education to improve care of confused older inpatients
    • Abstract: Horner, Barbara; Watson, Natasha; Hill, Anne-Marie; Etherton-Beer, Christopher
      Objective: To determine feasibility of novel staff education aiming to optimise care for confused older people. Design: Pre/post qualitative study. Setting: Tertiary teaching hospital. Subjects: Clinical staff in two geriatric medicine wards. Interventions: Self-directed learning modules, with access to an education resource officer to reinforce learning in real time. Main outcome measures: Primary outcomes were feasibility (proportion of staff completing the education) and perceived effectiveness (measured in focus groups and individual interviews). Results: Twenty-six staff agreed to undertake the education; six confirmed completion of the entire learning package. Participants were enthusiastic about education regarding confused older people. Participants who completed the education modules reported they were satisfied with the format and content of the learning materials, but cited time constraints as a major barrier. Conclusion: Participants expressed need and enthusiasm for education but uptake of the package was less than anticipated. Organisational support (such as providing staff with protected paid time to complete education) may be required to improve adherence.

      PubDate: Thu, 2 Nov 2017 11:47:42 GMT
       
  • Volume 31 Issue 2 - Utilisation of a Native American nursing conceptual
           framework: Implications for practice and research
    • Abstract: Lowe, John; Nichols, Lee Anne
      Objective: To explore how Native American nurses and non-Native American nurses perceive how the Nursing in the Native American Culture conceptual framework can be utilised in nursing practice and research. Setting: The Eleventh Annual Indian Nursing Education Conference in Eau Claire, Wisconsin in the United States of America (USA). Participants: A total of 50 female and six male participants who were Native American nursing students, Native American nurses, and non-Native American nurses who were nursing educators and/or delivered health care to Native American populations. Main outcome measures: Participants were placed into 14 small groups and were asked "What is the usefulness of the Native American Nursing conceptual framework in guiding nursing practice and research'" The small groups were allotted 45 minutes to dialogue and answer the research question. Each group recorded field notes of their discussion. Results: Overall themes emerged from the data that relate to the usefulness of the conceptual framework for nursing practice and research which include: (a) serves as a cultural foundation in practice, (b) supports and guides the value for personal and professional growth, (c) guides research when investigating and exploring Native American phenomenon that are health related, and (d) guides the development of cultural appropriate nursing and health care resources. Conclusions: The Nursing in the Native American Culture conceptual framework should be used as a guide when planning and implementing health care and research with Native American populations. Health care providers and researchers should utilise the conceptual framework to establish trust and commitment to deliver care and conduct research in a culturally respectful manner.

      PubDate: Thu, 2 Nov 2017 11:47:42 GMT
       
  • Volume 31 Issue 1 - Changing philosophies: A paradigmatic nursing shift
           from Nightingale
    • Abstract: Warelow, Philip J
      Objective: To consider the changing philosophical and theoretical construction of nursing which has moved from an initial focus on positivism and science, and undergone a paradigmatic shift so that it is now being interpreted by some nursing theorists in alternative ways. Primary Argument: A theoretical review of some nursing theorists and a critical consideration of the wider concepts which have been influential in theoretical constructions gradually moving from the received (positivistic) to the perceived view. The perceived view encompasses the emergence and influence of non-positivist philosophies, which shift the theoretical focus away from causation to a more interpretive, unscientific standpoint, with foundations in phenomenology, humanism, holistic care and qualitative research. The paper demonstrates that many of the theories offered are esoteric, complicated and constructed in an academic way that tends to escape the everyday nurse practitioner. Conclusion: That multiple options which capture the philosophies and ideologies of both paradigms should/could be considered.

      PubDate: Thu, 2 Nov 2017 11:47:42 GMT
       
  • Volume 31 Issue 1 - Adolescents and youth in adult hospitals: Psychosocial
           assessment on admission - an evaluation of the youth care plan
    • Abstract: Sturrock, Tegan; Steinbeck, Kate
      Objective: The study was undertaken to evaluate the effectiveness of our previously published Youth Care Plan (YCP) as a tool for the psychosocial assessment of adolescents and young adults admitted to hospital. Design: A comparative study of a quasi-convenient sample of two pre-defined groups. Setting: Young people aged 12-24 years admitted to a university teaching hospital in Sydney, New South Wales (NSW),Australia. Subjects: Group 1 had a completed YCP on admission and a HEADSS assessment during their admission. Group 2 had no completed YCP and had a HEADSS assessment during their admission. Group 1 n = 20 (15F) with a mean age of 18.8 yrs; Group 2 (7F) with a mean age of 20.1yrs. Main outcome measure: Group 1 tests the hypothesis that the YCP is capable of identifying most psychosocial issues in a brief assessment, compared to the formal HEADSS interview. Group 2 tests the hypothesis that a significant proportion of young people admitted to hospital have some psychosocial issues that may impact on management. Results: The psychosocial risks detected with the YCP are 72.5%, of those identified by HEADSS interview. Young people with a standard care plan have the same number of risks identified as those with the YCP. Risk issues that YCP was less likely to identify were drug use and depression. Conclusions: The YCP provides an opportunistic screen for lifestyle risks in adolescents on admission to an acute adult care facility that can be undertaken by nurses in their routine care. Training may be necessary to provide confidence to ask about more sensitive risk issues.

      PubDate: Thu, 2 Nov 2017 11:47:42 GMT
       
  • Volume 31 Issue 1 - Understanding compliance with protective eyewear
           amongst peri-operative nurses: A phenomenological inquiry
    • Abstract: Neo, Felicia; Edward, Karen-Leigh; Mills, Cally
      Objective: The objective of this study is to obtain an in-depth understanding of the phenomenon of peri-operative nurses' use of protective eyewear in the operating room (OR), and to understand nurses' attitudes and beliefs towards protective eyewear. Design: Data was collected via one-on-one interviews with eight peri-operative nurses working in a private hospital in Melbourne. The data collected underwent rigorous thematic analysis using an extended version of Colaizzi's method of phenomenological inquiry. Setting: The participating site is a large, private, metropolitan hospital that has 420 beds and employs 1,100 nurses and midwives, of which 31% are peri-operative nurses. Subjects: Eight registered nurses were recruited. They were all female, aged between early 20s to early 60s, ranging in experience in the peri-operative setting from more than six months to approximately twenty years. Main outcome measure: The investigation of the phenomenon of peri-operative nurses' use of protective eyewear in the OR with information to help further understand peri-operative nurses' attitudes and beliefs towards protective eyewear. Results: For nurses, being compliant with protective eyewear is a combination of intrapersonal, environmental and professional factors, including protecting self, risk appraisal, beliefs, previous experiences, fear, comfort and functionality, professionalism, leadership, forgetting versus routine, time pressure and accessibility, alternatives and patient-centred care. Conclusion: Individual nurse's beliefs towards protective eyewear and its impact on work, life and patient care influence their decision to use protective eyewear. Peri-operative nurses are more compliant when they are well informed and are in a supportive work environment.

      PubDate: Thu, 2 Nov 2017 11:47:42 GMT
       
  • Volume 31 Issue 1 - Nurse satisfaction with working in a nurse led primary
           care walk-in centre: An Australian experience
    • Abstract: Desborough, Jane; Forrest, Laura; Parker, Rhian
      Objective: The aim of this study was to gain insight into the nursing staff's experiences and satisfaction with working at the ACT nurse led Walk-in Centre. Design and Setting: Interviews with nursing staff working at the ACT Walk-in Centre were informed by a phenomenological approach. Questions were developed within inter, extra and intra-personal variables of satisfaction, underpinned by the principles of role theory. Subjects: Twelve nurses were interviewed; three nurse practitioners and nine advanced practice nurses. Their ages ranged from 31 to 63 years and they had a minimum of 15 years of nursing experience. Interviews ranged from 30 minutes to two hours duration. Results: Walk-in Centre nurses' satisfaction with a number of inter and extra-personal factors was associated with their previous education and experience (intra-personal factors). Role stressors included adapting to autonomy, role incongruity and lack of access to appropriate education, training and sources of collaboration and mentorship. Sources of satisfaction were the autonomous role, relationships with the team and the capacity to deliver quality nursing care. Conclusion: Whilst autonomy is valued by nurses, this does not translate to isolation or independence. Autonomy is only a source of satisfaction when coupled with supportive and cohesive professional relationships with both nursing and medical colleagues. Organisations implementing advanced nursing roles must have a comprehensive understanding of the requirements of nursing autonomy to ensure effective role implementation and associated job satisfaction. These findings add impetus to the need for the development of nursing education programs tailored specifically to primary health care.

      PubDate: Thu, 2 Nov 2017 11:47:42 GMT
       
  • Volume 31 Issue 1 - Nurses' perceptions of spirituality and spiritual care
    • Abstract: Cetinkaya, Bengu; Azak, Arife; Dundar, Sebahat Altundag
      Objective: The study was conducted to determine the perceptions of nurses regarding spirituality and spiritual care. Design: This descriptive-type study was carried out in three hospitals in a province in the west of Turkey. The study's population was made up of 733 nurses working in these hospitals and the sample consisted of 289 nurses who agreed to take part in the study. The data were collected using the nurses' defining characteristics data form and the Spirituality and Spiritual Care Rating Scale. Results: It was established that 96.9% of the nurses included in the study had not received any training regarding spirituality and spiritual healing. The Spirituality and Spiritual Care Rating Scale point average for nurses in the study was determined to be 62.43+/-7.54. Conclusions: It was established that nurses do not receive sufficient training on the subject of spiritual care, both before and after graduation; but also that their perception of the topic is quite high.

      PubDate: Thu, 2 Nov 2017 11:47:42 GMT
       
  • Volume 30 Issue 4 - The effect of overactive bladder syndrome on the
           sexual life in asymptomatic continent women
    • Abstract: Alatas, Erkan; Ozkan, Sevgi; Ogce, Filiz
      Objective: Overactive bladder syndrome (OAB) is a very common problem, particularly in women, and has an effect on their daily lifestyle and sexual activity. The purpose of this study was to evaluate the effect of overactive bladder syndrome on sexual life in asymptomatic continent women who are considered to be sexually active. Design: Descriptive and cross-sectional study. Setting: Gynaecology and obstetrics outpatient clinic, Pamukkale University Medical Faculty, Turkey. Subject: A total of 1,504 patients as research population were examined and 117 patients without gynaecological symptoms presenting to the Obstetric and Gynaecology Clinic were included in the study. Main outcome measures: For data collection a questionnaire to gather socio-demographic and medical information, an assessment tool (OAB-at) and the Female Sexual Function Index (FSFI) for evaluating sexual dysfunction were utilised. Results: Patients were determined as 28 continent women with OAB, 89 women without OAB. In line with this information we found the mean score of OAB positive continent women was 13.00+/-5.06 and the mean score of OAB negative women was 3.57+/-2.15. Patients with OAB had negatively impacted sexual function in the areas of arousal, lubrication, orgasm and pain. Conclusion: OAB syndrome adversely affects sexual life even in continent women.

      PubDate: Thu, 2 Nov 2017 11:47:42 GMT
       
  • Volume 30 Issue 4 - Clinical placement in Jordan: Qualitative views of
           final year nursing students
    • Abstract: Shoqirat, Noordeen; Abu-Qamar, Ma'en Zaid
      Objective: This study explored the nurse student's experience of the final year placement, and uncovered contributing factors to a positive clinical experience in Jordan. Design: A qualitative explorative approach was used. Two focus group discussions were conducted in Arabic language with a total of 12 participants selected randomly from the list of students who completed the period of pre-‑graduation intensive clinical placement. The focus discussions were digitally recorded. Setting: The setting for this study was a public faculty of nursing located in the southern province, Jordan. Subjects: Twelve final year nursing students including seven males and five females took part in the study. Main outcomes measures: The recorded discussions were translated independently into English text and were uploaded into Nvivo 9 for thematic analysis. Results: Three themes emerged from the data. The first theme related to the environment of clinical placement and included two sub-‑themes: 'from orientation-to-team work' and 'from tiredness-to-ignorance'. The second theme is about the faculty and preceptors as reflected by the lack of coordination between the clinical settings and the faculty, plus inconsistency in students' evaluation. The third theme concerned patient preferences that included a lack of interest in receiving care from students. Conclusion: Creating a supportive learning environment guided by issues identified and implications put forward by this research is a prerequisite for successfully executed nursing programs. Failure to do so could lead to a stressful transitional journey and detachment from the classroom and the real world of clinical work.

      PubDate: Thu, 2 Nov 2017 11:47:42 GMT
       
  • Volume 30 Issue 4 - Diabetes- a significant contributor to complications
           in cardiac surgery: How and when to optimise glycaemic control
    • Abstract: Penrose, Melissa; Lee, Geraldine A
      Objective: The aim is to present the literature on the association between pre-‑operative hyperglycaemia and post-‑operative complications and to review the current interventions (pre surgery, peri /intra-‑ and post-‑operatively) in those with diabetes undergoing cardiac surgery. Design: A literature review was undertaken to examine complications and interventions in those with diabetes undergoing cardiac surgery. Setting: Acute care. Subjects: Those with diabetes undergoing cardiac surgery. Main outcome measures: Mortality and morbidity and improved glycaemic control. Results: Pre-operative hyperglycaemia is associated with wound infections and prolonged length of hospital stay. Studies on intra- and post-operative medical interventions to control glycaemia in cardiac surgical patients demonstrate improved short-term medical outcomes, including decreased mortality and improved glycaemic control, reduction in infection rates and reduced length of stay. Some studies examined the roles of pre-operative glucose management (using glycosylated haemoglobin, HbA1c) prior to surgery and demonstrated that HbA1c can be decreased in short term post-educational interventions. Improvements in physical functioning and quality of life post-educational interventions have been reported. Although the primary outcome is often HbA1c, patient focused outcomes (such as empowerment and education) are equally as important in this chronic condition. Conclusion: Diabetes is a chronic condition and patients need to be educated about the association between coronary artery disease and diabetes and the importance of glycaemic control. Interventions can improve glycaemic control in the short-term as well increasing patients' empowerment and self-mastery. There is evidence supporting the benefits of educational interventions in those with diabetes undergoing cardiac surgery.

      PubDate: Thu, 2 Nov 2017 11:47:42 GMT
       
  • Volume 30 Issue 4 - Career choices and destinations of rural nursing
           students undertaking single and double degrees in nursing
    • Abstract: Hickey, Noelene; Harrison, Linda
      Objectives: To identify and compare the location and career preferences of students enrolled in single and transdisciplinary double degrees in a Bachelor of Nursing program at a rural university. To understand what influences and motivates students to enrol in a double degree program that includes nursing. Design: A cross-sectional cohort study using a semi structured survey. Setting: Charles Sturt University, Bathurst, New South Wales, Australia. Subjects: 209 undergraduate students in all years of the Bachelor of Nursing (BN), Bachelor of Nursing/Bachelor of Clinical Practice (Paramedic) (BN/BCP), and Bachelor of Nursing/Bachelor of Early Childhood Teaching (BN/BECT).programs. Main outcome measures: Demographics of participants; reasons double degree students enrolled in a nursing program; career location and career discipline preferences. Results: In 2008 the majority (70%) of students in all three groups were from rural areas, but double degree students came from a higher socio-economic background, were younger and were more likely to be male than single degree nursing students. They also had different motivating factors for enrolling and many did not prefer nursing as a career. 40% of BN, 45% of BN/BECT students and 28% of BN/BCP students preferred to work in a rural location for their graduate year. Conclusions: Students undertaking this rural based double degree nursing program are different to single degree nursing students in a number of important areas. The lack of interest in a nursing career and a rural location by over half of these students is concerning. Targeted strategies are needed to reverse this loss of potential nursing graduates.

      PubDate: Thu, 2 Nov 2017 11:47:42 GMT
       
  • Volume 30 Issue 4 - Career progression - the views of Queensland's nurses
    • Abstract: Eley, Robert; Francis, Karen; Hegney, Desley
      Objectives: To inform policy through determination of the views of Queensland nurses on career progression. Design: A quantitative cross-‑sectional cohort design with mailed survey. Setting: Financial members of the Queensland Nurses' Union. Main outcome measures: Extent of the relationship between opportunity for career progression in nursing with turnover and retention. Results: A majority (54.4%) of the 1365 respondents were satisfied with their career progression. Only 11.6% were dissatisfied. Satisfaction was not related to length of time in nursing, but did increase among nurses enrolled in further education programs. Dissatisfaction was related to four themes: lack of support to advance knowledge; lack of opportunities for promotion; number of career options; and costs associated with advancement. A quarter of the nurses were contemplating a move within nursing in the next year and most of these nurses (62%) indicated that the move was for the purpose of career advancement. One in six nurses were contemplating leaving nursing altogether; however only 12.8% of those cited lack of career as the factor for intended departure. Results continued the trend seen in previous surveys over the last decade of a small but significant reduction in the perception that career prospects in nursing were limited. Conclusion: Although the perception that there are limitations to career advancement in nursing has reduced in the last decade, there is still room for improvement. Lack of career progression remains a concern of nurses; however this is not generally manifested in an intention to leave nursing. Rather, nurses are prepared to consider moves within nursing to further their careers.

      PubDate: Thu, 2 Nov 2017 11:47:42 GMT
       
  • Volume 30 Issue 4 - Getting the message out - disseminating research
           findings to employees in large rural mining organisations
    • Abstract: Drury, Vicki; Hart, Kristy
      Objective: To identify that effective dissemination of research results in large organisations is possible through novel approaches. Setting: Two mine sites in Western Australia. Subjects: All employees working in two large mining organisations in rural Australia. Primary argument: To encourage employees to participate in research it is essential to disseminate findings. Currently utilised dissemination methods include conference presentations, journal articles and company reports. However these methods of dissemination do not reach all employees and often neglect to inform employees below middle management levels of the outcomes of projects. It is imperative that researchers develop strategies through a consultative process with industry to inform people of research findings. This paper argues that despite ongoing rhetoric concerning the need to disseminate research there is little evidence in the literature that describes effective methods of dissemination in large organisations. Conclusion: Discussion during each focus group highlighted the dissatisfaction staff had regarding involvement in research projects as they rarely received any feedback or perceived any improvement. By organising a research steering group including membership by all key stakeholder groups from senior management to junior staff and identifying dissemination of results as a priority the research team developed a climate of trust. Dissemination of results through posters was a decision made by the team in response to staff dissatisfaction. This 'bottom up' approach created a climate of ownership catalysing behaviour change.

      PubDate: Thu, 2 Nov 2017 11:47:42 GMT
       
  • Volume 30 Issue 4 - A view from the outside: Nurses' clinical decision
           making in the twenty first century
    • Abstract: Deegan, Joan
      Objective: The purpose of this paper is to highlight some observations of clinical decision making processes made by culturally and linguistically diverse nurses (CALD), in relation to elderly patients in particular. It will explore some of the potentially serious professional and legal implications for nurses when there is an over reliance on experiential knowledge and routine tasks without mindful application of evidence and consideration of the ethico legal imperatives. Setting: The CALD nurses in the study were enrolled in competency based assessment programs (CBAP) in two universities in Melbourne, Victoria between 2005 and 2006 in preparation for their professional registration in Australia. Participants: Following ethical approval from the relevant universities and participating hospitals, a purposive sample was chosen followed by theoretical sampling. Fourteen CALD nurses and three teachers, who were directly involved in the clinical supervision of the nurses during their placement took part. Primary Argument: Using some in vivo quotes to highlight what appear to be less than optimal decision making process by nurses, it will be argued that sound decision making in clinical practice is ideally based on a combination of factors; amongst them professional judgement and a sound knowledge base, supported by principles of physical/psychological assessment and ethical principlism. Conclusion: The views of nurses who are new to the system can foster reflection on practices that have become routine, potentially lacking in application of scientific knowledge, and therefore a potential threat to patient safety with associated legal implications for the nurse.

      PubDate: Thu, 2 Nov 2017 11:47:42 GMT
       
  • Volume 30 Issue 4 - Open access to nursing journals: An audit of the 2010
           ERA journal list
    • Abstract: Bail, Kasia; Ranse, Jamie; Clarke, Roger; Rattray, Ben
      Objective: To determine the proportion of nursing journals that are fully open access or have some elements of openness, and hence are readily accessible by nurses in clinical settings. Design: A descriptive study, with interpretive analysis of existing data sources. Setting: Access to online journals from the perspective of a nurse as a consumer. Subjects: Nursing specific journals from the 2010 Excellence in Research for Australia (ERA) list of publications. Main outcome measure: The proportion of nursing journals with unrestricted online open access as of October 2011. Results: Of the 224 journals included in this research, 12% (27/224) had unrestricted open access to all published manuscripts, 39% (88/224) had partial or conditional access and 49% (109/224) had no elements of open access, and required the consumer to have access to a paid subscription. Conclusion: Approximately half (51%) of nursing journals surveyed have all or some articles that are open access. This is higher than other studies of open access research articles globally. However, barriers at an institutional level may need to be addressed to ensure nurses can be informed in their care of patients.

      PubDate: Thu, 2 Nov 2017 11:47:42 GMT
       
  • Volume 30 Issue 3 - Practice-based simulation model: A curriculum
           innovation to enhance the critical thinking skills of nursing students
    • Abstract: Park, Mee Young; McMillan, Margaret Anna; Conway, Jane Frances; Cleary, Sonja R; Murphy, Leonie; Griffiths, Sharee Kathleen
      Objective: The purpose of this paper is to describe the Practice Based Simulation Model (PBSM) as a pedagogical framework that enables the integration of simulation in a way that ensures critical thinking skills are explicitly taught as part of the processes and outcomes of students' learning. Setting: The PBSM is an innovative pedagogical strategy that offers greater flexibility; one that can be applied to various types of educational contexts and delivery modes, while simultaneously ensuring desired learning outcomes. Primary argument: The use of simulation has been gaining popularity because of its capacity to provide effective experiential learning as a method of enhancing learners' critical thinking skills. Despite ample literature that highlights the need for the integration of simulation into nursing curricula, there are few papers demonstrating simulated learning experiences that are underpinned by sound pedagogy. This paper asserts that simulated learning experiences need to be integrated into a curriculum underpinned by sound pedagogy, such as the PBSM, in order to ensure that learning facilitates the development of the critical thinking abilities deemed essential for nursing. Conclusion: The PBSM demonstrates an example of effective integration of simulation into a curriculum, and highlights the importance of the integral relationship of simulation as a key component of curriculum.

      PubDate: Thu, 2 Nov 2017 11:47:42 GMT
       
  • Volume 30 Issue 3 - To investigate the concerns and benefits of job
           sharing a community based Clinical Nurse Consultant role
    • Abstract: Woodhouse, Gay; Finn, Tracey; Johnson-De Wit, Karen
      Objective: The purpose of this study was to identify concerns and benefits of job sharing the Clinical Nurse Consultant (CNC) Youth Health team role and how these impact on job sharing a nursing leadership role. Design: A qualitative descriptive method was used in this study. Setting: Primary care. Subjects: The sample comprised of key stakeholders of the Youth Health care team including members of the multidisciplinary team and health care referrers to the Clinical Nurse Consultants as well as the Clinical Nurse Consultants whom share the role. Main outcome measures: Identification of needs required to assist in developing recommendations for nursing leadership job share models for a changing workforce in healthcare. Results: The study identified several themes needed to ensure successful job sharing of a leadership role: effective communication, compatibility, support, teamwork, mentoring and flexibility in care provision. Implementing systems that support and encourage these are necessary. Conclusion: Results suggest that concerns do exist for organisations when staff job share a leadership role. However, several key points can aid in successful job sharing for organisations and nurses as well as improved patient outcomes. These results should help nurses to develop and facilitate increased success for job sharing of leadership roles and contribute to the current need to be flexible in workforce models of nursing.

      PubDate: Thu, 2 Nov 2017 11:47:42 GMT
       
  • Volume 30 Issue 3 - The challenges for families managing an adolescent
           with an intellectual disability and type 1 diabetes
    • Abstract: Hillege, Sharon; Gallagher, Susan; Evans, Jennifer
      Objective: This paper describes the experiences of two families caring for their adolescent sons who have type 1 diabetes (T1D) and an intellectual disability. Design: This paper arises from a larger study and reports on the findings from four parents, (two couples), who have adolescent sons with both type 1 diabetes and intellectual disability. Case study analysis of these interviews gave a more in depth understanding of management of these dual conditions from the perspective of the parents. Setting: The interviews occurred in the parents homes. Subjects: Family one consisted of a mother, father, and three children aged 16 to 20 years. Family two comprised both parents and four children attending secondary school. At the time of the study all siblings were living at home. The two adolescent men with intellectual disability and T1D were 19 year old, still living at home and attending sheltered employment. Main Outcome Measures: This paper describes the experiences of two families caring for their adolescent sons who have T1D and an intellectual disability. Results: Independence was the major issue. Obtaining independence was hindered on several fronts: having an intellectual disability and having to manage T1D concurrently, and the short and long term effects this management has on the family now and in the future. Conclusion: The complex management of T1D coupled with intellectual disability makes independence more difficult to attain for these adolescents. The parents in this study accepted that full independence may not be possible for their sons and voiced concern for their future wellbeing.

      PubDate: Thu, 2 Nov 2017 11:47:42 GMT
       
  • Volume 30 Issue 3 - The influence of personal characteristics on
           perioperative nurses' perceived competence: Implications for workforce
           planning
    • Abstract: Gillespie, Brigid M; Polit, Denise F; Chaboyer, Wendy
      Objective: To examine the influence of personal characteristics on perioperative nurses' perceived competence. Design: A cross sectional survey design was used. Setting: A census of 3,209 operating room nurses who were members of the Australian College of Operating Room Nurses across all Australian states and territories was invited to participate. Primary Outcome Measure: The Perceived Perioperative Competence Scale Revised, a 40 item survey consisting of six subscales measuring the dimensions of perioperative competence was used. Results: A total of 1,044 usable surveys were analysed representing 32.5% of the accessible population. Across the six subscales, demographic predictors accounted for 5% to 33% of the variance in nurses' perceived perioperative competence. Conclusions: These results may inform workforce planning initiatives designed to address the needs of this diverse specialty group. Efforts to retain older nurses need to be centred on redesigning workplaces, increased remuneration and professional recognition, and integrating technology to promote efficiency and safety. Workforce planning should include strategies such as creating academic partnerships with universities, to provide perioperative nurses access to specialty education and advanced skills programs.

      PubDate: Thu, 2 Nov 2017 11:47:42 GMT
       
  • Volume 30 Issue 3 - The development and evaluation of a preceptorship
           program using a practice development approach
    • Abstract: Ford, Karen; Courtney-Pratt, Helen; Fitzgerald, Mary
      Objective: The aim of the research was to evaluate a Preceptorship Workshop for nurses and midwives structured using a Practice Development framework. The workshop was underpinned by an exploration of nurses and midwives attitudes, perceptions and concerns about being a preceptor. Design: Emancipatory Practice Development guided this study. Setting: The study was conducted in a 400 bed tertiary referral hospital in an Australian state. Subjects: Ninety three nurses and midwives participated in the study. Main outcome measures: Data collection was undertaken from July - December 2009. Participants' completed a self assessment of six identified learning outcomes on a five point Likert scale pre and post workshop. Findings were further informed by qualitative data collected during and following the workshops. Results: A paired samples t test was used to compare pre and post workshop participant self ratings of knowledge, understanding and ability to apply preceptor skills. Statement four: 'My knowledge of the requirements of my role as a preceptor in relation to the structure of a range of nursing programs' demonstrates the highest shift in self assessment. There was a significant difference in the scores pre test (M= 3.04, SD=.751) and post test (M=3.99, SD=.617). Statistically significant changes occurred across all six learning outcomes, confirmed by qualitative findings from participant input on the day. Conclusion: Findings support the use of a Practice Development approach in the provision of a preceptor workshop, with clinicians indicating high acceptability that resulted in achievement of key learning outcomes.

      PubDate: Thu, 2 Nov 2017 11:47:42 GMT
       
 
 
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