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Publisher: RMIT Publishing   (Total: 403 journals)

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Showing 1 - 200 of 403 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: 11)
Aboriginal Child at School     Full-text available via subscription   (Followers: 4)
About Performance     Full-text available via subscription   (Followers: 9)
Access     Full-text available via subscription   (Followers: 25)
ACCESS: Critical Perspectives on Communication, Cultural & Policy Studies     Full-text available via subscription   (Followers: 10)
Accounting, Accountability & Performance     Full-text available via subscription   (Followers: 13)
ACORN : The J. of Perioperative Nursing in Australia     Full-text available via subscription   (Followers: 16, 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: 2)
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: 5)
AIMA Bulletin     Full-text available via subscription   (Followers: 4)
AJP : The Australian J. of Pharmacy     Full-text available via subscription   (Followers: 8, SJR: 0.102, h-index: 5)
AlterNative: An Intl. J. of Indigenous Peoples     Full-text available via subscription   (Followers: 7)
Analysis     Full-text available via subscription   (Followers: 4)
Ancient History : Resources for Teachers     Full-text available via subscription   (Followers: 1)
Anglican Historical Society J.     Full-text available via subscription   (Followers: 2)
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: 4)
Appita J.: J. of the Technical Association of the Australian and New Zealand Pulp and Paper Industry     Full-text available via subscription   (Followers: 8, SJR: 0.18, h-index: 27)
AQ - Australian Quarterly     Full-text available via subscription   (Followers: 1)
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: 11)
Art Monthly Australia     Full-text available via subscription   (Followers: 8)
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: 8, SJR: 0.672, h-index: 51)
Asia Pacific J. of Health Management     Full-text available via subscription   (Followers: 2)
Aurora J.     Full-text available via subscription  
Australasian Biotechnology     Full-text available via subscription   (SJR: 0.1, h-index: 8)
Australasian Catholic Record, The     Full-text available via subscription   (Followers: 7)
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: 4, SJR: 0.115, h-index: 3)
Australasian J. of Human Security, The     Full-text available via subscription   (Followers: 3)
Australasian J. of Irish Studies, The     Full-text available via subscription   (Followers: 9)
Australasian J. of Regional Studies, The     Full-text available via subscription   (Followers: 2)
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: 2)
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: 38)
Australasian Review of African Studies, The     Full-text available via subscription   (Followers: 2)
Australian Aboriginal Studies     Full-text available via subscription   (Followers: 9, 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: 4)
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 Archaeology     Full-text available via subscription   (Followers: 12, SJR: 0.491, h-index: 15)
Australian Art Education     Full-text available via subscription   (Followers: 6)
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: 2)
Australian Cottongrower, The     Full-text available via subscription   (Followers: 1)
Australian Educational and Developmental Psychologist, The     Full-text available via subscription   (Followers: 6, SJR: 0.143, h-index: 4)
Australian Family Physician     Full-text available via subscription   (Followers: 2, SJR: 0.364, h-index: 31)
Australian Field Ornithology     Full-text available via subscription   (Followers: 3, SJR: 0.141, h-index: 6)
Australian Forest Grower     Full-text available via subscription   (Followers: 3)
Australian Forestry     Full-text available via subscription   (Followers: 2, SJR: 0.252, h-index: 24)
Australian Grain     Full-text available via subscription   (Followers: 3)
Australian Holstein J.     Full-text available via subscription  
Australian Humanist, The     Full-text available via subscription   (Followers: 5)
Australian Indigenous Law Review     Full-text available via subscription   (Followers: 16)
Australian Intl. Law J.     Full-text available via subscription   (Followers: 25)
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: 12, SJR: 0.159, h-index: 7)
Australian J. of Advanced Nursing     Full-text available via subscription   (Followers: 9, SJR: 0.225, h-index: 26)
Australian J. of Asian Law     Full-text available via subscription   (Followers: 5)
Australian J. of Cancer Nursing     Full-text available via subscription   (Followers: 10)
Australian J. of Civil Engineering     Full-text available via subscription   (Followers: 3, 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: 5, SJR: 0.401, h-index: 18)
Australian J. of French Studies     Full-text available via subscription   (Followers: 6, 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: 3, SJR: 0.399, h-index: 9)
Australian J. of Legal History     Full-text available via subscription   (Followers: 19)
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: 5)
Australian J. of Parapsychology     Full-text available via subscription   (Followers: 1)
Australian J. of Social Issues     Full-text available via subscription   (Followers: 6, 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: 1)
Australian J.ism Review     Full-text available via subscription   (Followers: 7)
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: 7)
Australian Nursing J. : ANJ     Full-text available via subscription   (Followers: 4)
Australian Orthoptic J.     Full-text available via subscription  
Australian Primary Mathematics Classroom     Full-text available via subscription   (Followers: 2)
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: 2)
Australian Tax Forum     Full-text available via subscription   (Followers: 2)
Australian Universities' Review, The     Full-text available via subscription   (Followers: 3)
Australian Voice     Full-text available via subscription   (Followers: 3)
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: 14)
BOCSAR NSW Alcohol Studies Bulletins     Full-text available via subscription   (Followers: 5)
Bookseller + Publisher Magazine     Full-text available via subscription   (Followers: 5)
Breastfeeding Review     Full-text available via subscription   (Followers: 14, SJR: 0.31, h-index: 19)
British Review of New Zealand Studies     Full-text available via subscription   (Followers: 2)
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: 6)
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: 7)
Commercial Law Quarterly: The J. of the Commercial Law Association of Australia     Full-text available via subscription   (Followers: 5)
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: 1)
Connect     Full-text available via subscription  
Contemporary PNG Studies     Full-text available via subscription  
Context: J. of Music Research     Full-text available via subscription   (Followers: 6)
Corporate Governance Law Review, The     Full-text available via subscription   (Followers: 7)
Creative Approaches to Research     Full-text available via subscription   (Followers: 11)
Critical Care and Resuscitation     Full-text available via subscription   (Followers: 13, SJR: 1.737, h-index: 24)
Cultural Studies Review     Full-text available via subscription   (Followers: 14)
Culture Scope     Full-text available via subscription   (Followers: 2)
Current Issues in Criminal Justice     Full-text available via subscription   (Followers: 9)
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: 9)
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: 14)
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: 15)
Electronic J. of Radical Organisation Theory     Full-text available via subscription   (Followers: 2)
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: 4)
Eureka Street     Full-text available via subscription   (Followers: 4)
Extempore     Full-text available via subscription  
Family Matters     Full-text available via subscription   (Followers: 13, SJR: 0.259, h-index: 8)
Federal Law Review     Full-text available via subscription   (Followers: 20)
Fijian Studies: A J. of Contemporary Fiji     Full-text available via subscription  
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  
Frontline     Full-text available via subscription   (Followers: 17)
Future Times     Full-text available via subscription   (Followers: 1)
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  
Geographical Education     Full-text available via subscription   (Followers: 3)
Geriatric Medicine in General Practice     Full-text available via subscription   (Followers: 7)
Gestalt J. of Australia and New Zealand     Full-text available via subscription   (Followers: 2)
Globe, The     Full-text available via subscription   (Followers: 4)
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: 8)
Grief Matters : The Australian J. of Grief and Bereavement     Full-text available via subscription   (Followers: 10)
He Puna Korero: J. of Maori and Pacific Development     Full-text available via subscription  
Headmark     Full-text available via subscription   (Followers: 1)
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Health Issues     Full-text available via subscription   (Followers: 1)
Health Promotion J. of Australia : Official J. of Australian Association of Health Promotion Professionals     Full-text available via subscription   (Followers: 10, 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: 3)
High Court Quarterly Review, The     Full-text available via subscription   (Followers: 3)
History of Economics Review     Full-text available via subscription   (Followers: 10)
HIV Australia     Full-text available via subscription   (Followers: 3)
HLA News     Full-text available via subscription   (Followers: 7)
Hong Kong J. of Emergency Medicine     Full-text available via subscription   (Followers: 1, 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: 13)
InPsych : The Bulletin of the Australian Psychological Society Ltd     Full-text available via subscription   (Followers: 3)
Inside Film: If     Full-text available via subscription   (Followers: 8)
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Instyle     Full-text available via subscription   (Followers: 1)
Intellectual Disability Australasia     Full-text available via subscription   (Followers: 7)
Interaction     Full-text available via subscription   (Followers: 3)

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Journal Cover Australian Journal of Advanced Nursing
  [SJR: 0.225]   [H-I: 26]   [9 followers]  Follow
    
   Full-text available via subscription Subscription journal
   ISSN (Print) 0813-0531 - ISSN (Online) 1447-4328
   Published by RMIT Publishing Homepage  [403 journals]
  • 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: Fri, 20 Jan 2017 22:52:06 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: Fri, 20 Jan 2017 22:52:06 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: Fri, 20 Jan 2017 22:52:06 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: Fri, 20 Jan 2017 22:52:06 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: Fri, 20 Jan 2017 22:52:06 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: Fri, 20 Jan 2017 22:52:06 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: Fri, 20 Jan 2017 20:56:49 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 evidencebased 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: Fri, 20 Jan 2017 20:56:49 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: Fri, 20 Jan 2017 20:56:49 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: Fri, 20 Jan 2017 20:56:49 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: Fri, 20 Jan 2017 20:56:49 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: Fri, 20 Jan 2017 20:56:49 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: Fri, 20 Jan 2017 20:56:49 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, 18 Aug 2016 22:49:35 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, 18 Aug 2016 22:49:35 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, 18 Aug 2016 22:49:35 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, 18 Aug 2016 22:49:35 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, 18 Aug 2016 22:49:35 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: Tue, 16 Aug 2016 22:00:11 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: Tue, 16 Aug 2016 22:00:11 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: Tue, 16 Aug 2016 22:00:11 GMT
       
  • Volume 33 Issue 3 - Y doesn't Gen Y2 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: Tue, 16 Aug 2016 22:00:11 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: Tue, 16 Aug 2016 22:00:11 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: Fri, 29 Apr 2016 22:10:50 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: Fri, 29 Apr 2016 22:10:50 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: Fri, 29 Apr 2016 22:10:50 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: Fri, 29 Apr 2016 22:10:50 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: Fri, 29 Apr 2016 22:10:50 GMT
       
  • Volume 30 Issue 1 - Lifestyle risk factor modification in midlife women
           with type 2 diabetes: Theoretical modelling of perceived barriers
    • Abstract: McGuire, Amanda M; Anderson, Debra J
      Objective: The aim of this paper is to highlight the importance of the concept of perceived barriers in health promotion for risk factor reduction, and to describe a 'Perceived barriers and lifestyle risk factor modification model' which could potentially be incorporated into existing frameworks for diabetes education to enhance lifestyle risk factor education in women with type 2 diabetes. Setting: Diabetes education, community health. Primary argument: 'Perceived barriers' is a health promotion concept that has been found to be a significant predictor of health promotion behaviour. There is evidence that women face a range of perceived barriers that prevent them from engaging in healthy lifestyle activities. Despite this evidence, current Australian and international evidence based frameworks for diabetes education do not explicitly incorporate the concept of perceived barriers to action. Building on existing frameworks for diabetes education and elements of Pender's Health Promotion Model (1982, 2006, 2010), a model of risk factor reduction which incorporates 'perceived barriers' is described. Conclusion: Although further research is required, it is argued that current approaches to risk factor reduction in type 2 diabetes could be enhanced by assessment and goal setting to reduce an individual's perceived barriers to lifestyle behaviour change. A 'Lifestyle risk factor modification and perceived barriers model' could potentially provide an innovative approach to support this.

      PubDate: Mon, 15 Oct 2012 15:03:17 GMT
       
  • Volume 30 Issue 1 - Clinical assessment and the benefit of the doubt: What
           is the doubt'
    • Abstract: Deegan, Joan; Burton, Trish; Rebeiro, Geraldine
      Clinical education and associated assessment is an important component of nurse education. A range of factors contribute to a culture that makes the assessment of clinical competence difficult. These factors are environmental, educational, cultural and linguistic diversity amongst students, student expectation, a diverse range of clinical education models. All of which contribute to the variable quality of the clinical education experience and the outcome of clinical assessment. Aim: The term 'benefit of the doubt' is frequently heard in relation to the assessment process; and, despite the utilisation of a seemingly comprehensive competency framework to assess clinical learning for close to two decades, it seems that a concerning level of doubt persists. The aim of this paper is to examine the complex factors that impact on the quality of decisions around competence the decision by an assessor to assign a judgement of competent or not, and to explore the reasons that lead to doubt on the part of the assessor and to suggest some possible solutions. Conclusion: It is suggested that what is needed going forward is a continued commitment on the part of government, the health sector, the tertiary education sector and the National Regulatory Authority to implement, value and extend the initiatives that are currently being developed to insure a viable and sustainable education and training culture for clinical supervisors in the future.

      PubDate: Mon, 15 Oct 2012 15:03:17 GMT
       
  • Volume 30 Issue 1 - Conditions in which nurses are exposed to the
           hepatitis viruses and precautions taken for prevention
    • Abstract: Ozdelikara, Afitap; Tan, Mehtap
      Objective: The aim of this study is to evaluate the exposure status of nurses to hepatitis B and C, and to determine the precautionary measures taken for protection from these infections. Design: This descriptive study was performed between February and May 2008 among nurses working in surgery and internal medicine wards. Setting: A total of 300 nurses working in the Aziziye Research Hospital and Yakutiye Research Hospital. Subject: The nurses included in the study comprised those who had three different levels of education, namely undergraduate, associate degree and high school. The data were collected via a questionnaire composed of 34 questions. The questionnaire consisted of questions on socio demographic characteristics, questions for estimating the frequency of exposure to blood and bodily fluids, questions about precautions, and questions for estimating HBV, HCV and the vaccination status of the nurses. Main outcome measure(s): A questionnaire developed by the researchers and data collected through a review of literature. Result: The results of completed questionnaires were collated, and Chi square test and percentage tests was used for analysis. 94.9% of the nurses participating in the study stated they had contact with blood and bodily fluids, and 75.8% of them had taken precautions during contact. The mostly commonly used preventive methods were hand washing before and after the invasive procedures on the patients (85.6%), hand washing between the invasive procedures on different patients (69%), and use of gloves (67.9%), respectively. The least used method was wearing protective glasses (0.2%). Among the distribution, injuries whilst replacing the cap of the syringe were leading (87.7%), and the least frequent were injuries sustained during the disposal of medical waste (54.6%). It was seen that 20.5% of the nurses in the study had undergone vaccination for hepatitis B. Majority of the nurses who had not had the vaccination (12.6%) stated they had not yet had the opportunity. Conclusions: As a result of the study, it was found almost all of the nurses had been in contact with blood and bodily fluids. Above all healthcare workers should receive periodic training on universal precautions, with a view on improving the overall safety of patients and healthcare workers.

      PubDate: Mon, 15 Oct 2012 15:03:17 GMT
       
  • Volume 30 Issue 1 - Handover: Faster and safer'
    • Abstract: Bradley, Stacey; Mott, Sarah
      Objective: This study aimed to introduce bedside handover to three rural South Australian hospitals. Design: A mixed method, pre test post test evaluative approach involving quantitative (quasi experimental) and qualitative (ethnographic) elements was used. Setting: This study was set in three acute hospital wards. Subjects: The sample comprised forty eight self selected enrolled/registered nursing staff; forty seven females and one male. Main outcome measure(s): A 7 point Likert scale (19 items) and ethnographic interview questions covered themes relating to nurses satisfaction of pre and post handover processes, frequency of incidents and estimations of time taken to conduct handover processes. Pre and post handover processes were digitally timed. Documentation review of pre and post incident frequencies and journaling were also undertaken. Results: With regard to handover duration, the average total time taken to conduct handover had decreased between 13% and 70% depending on the site. From a practical aspect, this can be regarded as significant. With regard to incident comparison, there is a clear trend from pre to post; the total number of incidents dropping from eighteen to seven. Conclusions: The results of this study indicate that bedside handover approach is significantly less time consuming than the closed door approach previously adopted. The findings indicate a trend in the reduction of frequency of incidents under the bedside handover process. Literature suggests that incident reduction is directly correlated with increased information accuracy, however, this was not found to be the case in this study. Further research is warranted into factors, other than information accuracy, that may increase safety in clinical settings.

      PubDate: Mon, 15 Oct 2012 15:03:17 GMT
       
 
 
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