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1.
Susan Edwards Melanie Birks Ysanne Chapman Karen Yates 《Collegian (Royal College of Nursing, Australia)》2018,25(3):293-301
Background
Pregnancy is a significant event in a woman’s life, a time of great expectation and attachment to the possibilities and dreams placed onto the new life growing inside her. Complications in pregnancy are physically and psychologically traumatic experiences that can generate high levels of anxiety. Vaginal bleeding, pain, or both in the first trimester of pregnancy are common causes for presentation in any Australian emergency department. These emergency departments play an important role in the provision of healthcare in regional, rural and remote areas. When experiencing possible miscarriage, the care that is provided to women and their partners presenting to their regional, rural and remote emergency departments can have significant impact on their approach to current and future pregnancies.Aim
The aim of this research was to explore the experiences of women and male partners who presented to non-metropolitan emergency departments with possible miscarriage, along with the experiences of nursing staff who provided care in these settings.Methods
Using a grounded theory methodology, three participant groups were included in this study: women who presented to an emergency department, their partners, and the nursing staff who provided care in these settings.Findings
The developed theory ‘Threads of Care’ incorporated five stages of their journey through a non-metropolitan emergency department with possible pregnancy loss: presenting as one; wanting recognition and inclusion; seeking support and understanding; leaving as one; and moving on.Discussion
The theory enhances the understanding of what constitutes optimal and effective care for women and their partners when presenting to non-metropolitan emergency departments with possible miscarriage.Conclusion
The recommendations from this grounded theory will inform approaches to care that aim to meet the needs of women, their partners and nursing staff who care for them. 相似文献2.
Nerolie Bost Amy Johnston Marc Broadbent Julia Crilly 《Collegian (Royal College of Nursing, Australia)》2018,25(4):415-420
Background
The increasing number of presentations to hospital emergency departments has seen the implementation of a variety of strategies in an effort to enhance care delivery and care continuity. One such strategy was designed and implemented to improve the transition of mental health consumers presenting to an Australian emergency department and admitted to a hospital mental health ward.Aim
The aim of this paper is to present the findings of a study that explored clinician perceptions regarding the implementation of a mental health consumer flow strategy.Methods
This was a qualitative study. Semi structured interviews were conducted with four emergency and four mental health clinicians employed at the hospital.Findings
Three key themes emerged regarding the consumer flow strategy. ‘Bridging the care provision gap’ revealed a lack of shared understanding between departments, insufficient education and lack of process consistency that impacted on care provision. ‘Ownership of and responsibility for consumers’ revealed misunderstandings about ownership of the person with a mental illness in the emergency department. ‘Dissonance in expectations of quality and timely care’ revealed that the quality and timeliness of care was impacted by physical, organisational and communication barriers.Discussion
Findings suggest that the implementation of the consumer flow strategy was supported in principal by clinicians. However, to improve the process and foster a shared understanding between departments, the provision of recurring education and adequate resources was required.Conclusion
This paper identifies the complexities of introducing a new process to two hospital departments. 相似文献3.
Helen Hall Caragh Brosnan Jane Frawley Jon Wardle Melissa Collins Matthew Leach 《Collegian (Royal College of Nursing, Australia)》2018,25(3):285-291
Background
: Many people integrate complementary and alternative medicine (CAM) into their health care. Nurses potentially play a significant role in communicating with patients about their CAM utilisation.Aim
: The study aimed to explore whether, how and why nurses working in Australia communicate about patients’ CAM use.Methods
: This paper reports on phase one of a mixed methods study. Qualitative data was obtained, via interviews, with nineteen registered nurses who work in a wide variety of clinical environments across all states of Australia.Findings
: Four themes related to nurses’ communication with patients about CAM, were developed from the qualitative data; engaging with patients about CAM, communication with doctors about patients’ use of CAM, connecting with CAM practitioners and barriers to CAM communication.Discussion
: Despite their positive attitudes, nurses are often not comfortable discussing or documenting patients’ CAM use. Furthermore, nurses perceive that patients may be apprehensive about disclosing their use. CAM communication with colleagues is moderated by the workplace culture and the perceived attitude of co-workers. There is very little evidence of nurses referring or collaborating with CAM practitioners. Professional expectation, time restraints and the nurses’ lack of relevant CAM knowledge all have a powerful effect on limiting CAM communication.Conclusion
: Communication about patients’ use of CAM is imperative to support safe therapeutic decisions. Currently, this is limited in the Australian healthcare workplace. The nursing professional needs to consider introducing basic CAM education and flexible guidelines to enable nurses’ to respond appropriately to the patient driven demand for CAM. 相似文献4.
Carol Reid Lee Jones Cameron Hurst Debra Anderson 《Collegian (Royal College of Nursing, Australia)》2018,25(1):57-63
Background
Self-efficacy in nursing is the nurses’ perception of their abilities to show caring orientations, attitudes, and behaviours and to develop caring relationships with patients. Self-efficacy is associated with years of experience, higher levels of job satisfaction and changes to nursing practices that conform with best practice. There is currently a paucity of evidence and no Australian studies were found examining the relationships between socio-demographic variables and self-efficacy in Australian nurses.Aim
The aim of this study was to examine if relationships existed between the socio-demographic variables, years of experience, age, gender, marital status, level of education, years employed in the same workplace, employment status, geographical location, specialty area, health sector and Australian state and the perceived self-efficacy of Australian registered nurses.Research
Design Cross-sectional survey of Australian registered nurses.Methods
A stratified random sample of registered nurses was drawn from the database of a national industrial and professional organisation. The Caring Efficacy Scale (CES) was categorised into quartiles, and bivariate and multivariable relationships were examined using ordinal logistic regression.Results
The proportion of nurses reporting low caring efficacy scores tended to decrease with years of experience and was lower in nurses who have been married. After adjustment in the final multivariable model, marital status and years of experience remained significantly related to caring efficacy (p < 0.05).Conclusion
A relationship exists between years of nursing experience, marital status and perceived self-efficacy among Australian registered nurses who belonged to an industrial and professional organisation. Targeted professional development programmes that support the improvement of perceived self-efficacy of all levels of nurses, might improve nurses’ confidences and abilities to develop caring relationships with patients. 相似文献5.
Objective
To identify the correlation between nurse's perception of the continuing professional development (CPD) and the satisfaction of nursing career ladder system (NCLS) implementation.Method
A non-experimental survey design was used for this study. The respondents were selected using proportional random sampling technique with the total sample size of 149 nurses. Data were measured using proportion, central tendency and Pearson product-moment correlation.Results
There was a moderate, positive correlation between the CPD and the NCLS satisfaction (R: 0.42, p= 0.0001).Conclusions
The results of this research should be used as recommendation for improving CPD at the hospitals in Indonesia. 相似文献6.
Serpil Türkleş Mualla Yılmaz Pınar Soylu 《Collegian (Royal College of Nursing, Australia)》2018,25(4):441-446
Background
It is of the utmost importance to determine the views of nurses about patients with suicidal behavior and who attempt suicide so that they can help such individuals.Aim
The aim of this study was to investigate the feelings, thoughts and experiences of nurses working in a mental health clinic regarding individuals with suicidal behaviors and suicide attempts.Methods
A qualitative study design was employed. Data in this research study were collected through individual in-depth interviews. The study population included 121 nurses working at a Mental Health and Diseases Hospital in Turkey. The study sample consisted of 33 nurses who had been working at the hospital for at least one year, had experience working with patients who attempted suicide, and agreed to participate in the study.Results
The nurses understood the patients; they experienced sadness, worry, anxiety, stress, unrest and fear; they were blamed by the hospital administration when a patient committed suicide; they blamed themselves and doctors for patient suicides; and they had developed proposals to prevent suicide among hospitalized or discharged patients. The nurses also stated that patients committed suicide in the evening or in the early hours of the morning by strangling or hanging themselves or by shocking and unforeseen methods, although the nurses performed the necessary emergency intervention procedures.Conclusion
It is recommended that planned group meetings for nurses be arranged and that follow-up guidelines/protocols for patients with suicidal tendencies who are residing in mental health clinics be prepared by a committee of healthcare professionals. 相似文献7.
Background
A remuneration system greatly influences the quality of nursing care and services.Objective
The goal of this study was to identify the effects of a remuneration system on nurses’ performance.Design
This research used a literature review design and involved the analysis of 25 articles published in the Cumulative Index to Nursing and Allied Health Literature (CINAHL), MEDLINE, EMBASE, PsycINFO, and Global Health databases. The literature was limited to articles published in English between August 2006 and August 2015.Results
The results of this study indicate that the improvement of remuneration systems has positive consequences in terms of nurses’ performance and subsequent quality of healthcare services. A well-managed remuneration system has the potential to increase nurses’ motivation, productivity, satisfaction, and even improve retention. In contrast, poorly managed and low remuneration contributes to a shortage of nurses due to high turnover rates.Conclusions
Adequate remuneration has been shown to improve nurses’ performance and, consequently, improve the quality of healthcare. This literature review provides scientific evidence for decision-makers to consider the implementation of remuneration systems that include credentialing, re-credentialing, and career ladders. Future studies are suggested to investigate the development of well-managed remuneration systems for nurses. 相似文献8.
Angela Christiansen Elisabeth Jacob Di Twigg 《Collegian (Royal College of Nursing, Australia)》2018,25(5):567-571
Background
The need for new graduate nurses to have the capabilities to function effectively in increasingly complex, dynamic and diverse health care settings has energised debate about the need for four year nursing degrees.Questions
What types of four year bachelor degrees are evident globally and what are the key arguments and evidence suggesting a need for four year nursing degrees in Australia?Methods
A scoping of contemporary literature is conducted to identify and discuss the key trends, concerns and evidence that informs the current debate on the appropriate duration of nursing degrees.Findings
A unique combination of emerging health care challenges and shifting health care priorities are fuelling the call to reconsider the duration of nursing degrees in Australia.Discussion
Future nurses will need the capabilities to work effectively across organisational and geographical boundaries, work as partners with a well-informed public, engage with advancing technologies and work autonomously and collaboratively as equals in inter-professional teams.Conclusion
The need for nurse education to produce nurse graduates with key capability for the future, gives credence to a call for a four year nursing degree in Australia. 相似文献9.
10.
Objective
This study aimed to identify the association between stereotyping and professional intercollaborative practice.Method
This study used a cross-sectional analytical study involving physicians, nurses, pharmacists, and dietitians in a hospital in Jakarta, Indonesia, who were selected using the stratified random sampling method. Data was collected using the Student Stereotypes Rating Questionnaire (SSRQ) and the Assessment of Interprofessional Team Collaboration Scale (AITCS). The stereotyping level was analyzed based on a nine-point SSRQ, while interprofessional collaborative practice was scored based on partnership/shared decision-making, cooperation, and coordination.Results
Stereotyping was shown to significantly correlate with interprofessional collaborative practice as measured by the SSRQ and AITCS.Conclusions
Poor interprofessional collaborative practice in subscale partnership/decision-making was dominant. Also, low-rating stereotyping was shown to be dominant with poor interprofessional collaborative practice.Recommendation
The research recommends that health care providers improve partnership/ decision-making skills for better interprofessional collaboration. For further research, it's recommended to explore another barrier of interprofessional collaborative practice. 相似文献11.
Sandra Sharp Margaret Mcallister Mark Broadbent 《Collegian (Royal College of Nursing, Australia)》2018,25(1):11-17
Problem
Person centred care is a key indicator of quality care and a policy direction in many hospitals yet some patients experience care that falls short of this standard.Background
Health services worldwide are prioritising the delivery of person centred in order to address historical concerns over patient safety and quality care and to improve workplace morale. Workplace culture is known to affect nurses’ care giving.Question
This research aimed to uncover the cultural factors that hindered or facilitated the delivery of person centred care in an acute setting and answer the question: How does workplace culture influence nurses’ delivery of person centred care?Methods
Critical ethnography provided the philosophical and methodological framework. Data were collected through participant observation, individual and focus group interviews, examination of care planning documents. Data were analysed hermeneutically and critically to make tacit cultural knowledge explicit and to suggest ways to reconstruct the culture of this specific nursing unit.Findings
Nurses organised their work in response to the urgency of the task at hand and nursing routines. People who received that care were rarely included in planning care.Discussion
Task focused ways of working can predominate in workplace cultures where an emphasis is placed on efficiency. Efficiency is part of the neoliberalist health care agenda and it stands in contrast to ideals of person-centred effectiveness because the latter may actually slow down procedures and require holistic approaches, rather than segmented care. Efficiency in this study appeared to be reinforced by an embedded and naturalised cultural practice amongst the nurses, which was to value fast-paced and completed tasks, because of the recognition it would receive from peers. Yet it also constituted a tension and bind for the nurses because the failure to be person-centred meant their professional values were unmet, and this led to moral distress and workplace dissatisfaction. If nurses were assisted to develop recognition of competing discourses in their work, and rationales to support a values-based practice, it is likely that they could be empowered to resist the status-quo and actually achieve the aspirations outlined in person-centred care rhetoric.Conclusion
Organisations and individuals striving for person-centred care need to develop awareness of the social and political forces that shape and constrain practice, in order to approach their work more consciously and critically. 相似文献12.
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Clint Douglas Diana Schmalkuche Debra Nizette Patsy Yates Ann Bonner 《Collegian (Royal College of Nursing, Australia)》2018,25(4):363-370
Background
Nurse-led services are expanding in Australia, yet current information about the scope and nature of these services is lacking. The need for more coordinated service planning and systematic evaluation prompted a scoping study to inform future development.Aim
To provide a comprehensive profile of nurse-led services in the Queensland public health system.Methods
A scoping study of 257 nurse-led services was conducted using an online survey distributed through each Hospital and Health Service in Queensland. Service level data were collected on structure, process and outcome evaluation, as well as enablers and barriers to sustainability of care delivery models.Findings
There is a diverse and growing range of nurse-led services across the state that have evolved to meet the dynamic needs of their communities. Increasingly, registered nurses are rising to the challenge of providing equitable and accessible healthcare in ways that transcend traditional professional or care setting boundaries. The major challenges for sustainability were funding and resource limitations, particularly for developing service capacity to meet growing demands. There were also tensions around the need for ongoing negotiation and review of nurse-led services with medical and administrative stakeholders.Discussion
Findings underscore the need for a modernised regulatory and policy framework to support sustainable nurse-led services and allow nurses to work to their full potential to optimise outcomes for the community.Conclusion
Nurse-led services are the sleeping giant of healthcare reform in Australia. Now is the time for policy and practice changes that will realise the transformative potential of nurse-led care. 相似文献16.
Anna Maria Bosco Natalie Williams Jacqueline Marie Graham Dianne Lorraine Malagas Yvonne Hauck 《Collegian (Royal College of Nursing, Australia)》2018,25(1):73-80
Background
Nurses working in clinical settings are instrumental to translating research into practice. The Delphi approach has been used by clinicians worldwide to set research agendas relevant to their clinical work.Aim
To identify nursing research priorities at the tertiary women's hospital in Western Australia and to develop an agenda for gynaecological nursing research.Methods
A three-round Delphi study was used. Round one incorporated an open-ended questionnaire to generate ideas or issues important to gynaecology nurses. During round two, the 32 topics generated from the first round were prioritised into 12 topics with a final ranking performed in round three.Findings
Fifty-four nurses who work in gynaecology clinical areas at the study hospital were invited to participate with 18 (33.3%) participating in round one, 41 (75.9%) in round two and 40 nurses (74.1%) in the final round. The highest ranked research priorities were: managing trial of void; providing compassionate care to women who experience pregnancy loss – the role of the gynaecological nurse; and understanding a woman's journey of treatment following a diagnosis of gynaecological cancer.Discussion
We explore potential factors from the literature around the identified gynaecology research topics plus challenges around the generation and translation of evidence into clinical practice.Conclusion
Establishing a partnership between researchers and gynaecology nurses has contributed to the development of a nursing research agenda. We anticipate that using the Delphi approach may facilitate future collaboration in implementing this research agenda and translating the findings into clinical practice. 相似文献17.
Objectives
To explore the disclosure decisions made in the workplace by physiotherapy staff with a specific learning difficulty (SpLD).Design & setting
An exploratory qualitative design was used, which was informed by the social model of disability. The research was undertaken in North West England. It is presented according to the Consolidated Criteria for Reporting Qualitative Research.Participants
A purposive sample of eight physiotherapists recognised as having a SpLD were recruited. All participants had studied on one of two programmes at a university in England between 2004–2012. Their NHS workplace experience was from across the UK.Data generation
In-depth, semi-structured interviews were undertaken within the university setting or via telephone. Interviews lasted 40 to 70 minutes and were digitally recorded. An interview guide was used to direct the interview.Data analysis
Interview data were transcribed verbatim and analysed using thematic analysis.Findings
Four participants were female. The mean number of years qualified as a physiotherapist was 4.5 years (SD = 2.27). Three themes were identified: ‘Disclosing during the workplace application’; ‘Positive about disabled people scheme’; ‘Disclosing in the workplace’.Conclusions
Disclosure of dyslexia is a selective process and is a central dilemma in the lives of individuals who have a concealable stigmatised identity. As a consequence, physiotherapy staff with dyslexia may choose to conceal their disability and not disclose to their employer. In order for staff with dyslexia to get the support they need in the workplace, disclosure is recommended. A number of recommendations have been made to facilitate the disclosure process. 相似文献18.
19.
Tonia Crawford Peter Roger Sally Candlin 《Collegian (Royal College of Nursing, Australia)》2018,25(5):501-507
Background
While patient education has long been an important part of nurses’ roles in patient care, research has found difficulties with providing patient education. Sound subject matter knowledge is not enough to give effective and meaningful instruction; pedagogical knowledge is also needed, with an understanding of different aspects of learning processes to inform our teaching methods Despite the importance of patient education, many nurses do not necessarily have pedagogical knowledge regarding how to teach, how to support patient’s learning and how to consciously implement strategies into patient education.Aim
By understanding theories that explain how people learn better, and awareness of the consequences of different approaches to giving patient education, nurses can be better informed about how to structure their information-giving in ways that will support patient learning.Methods
Discourse analysis from an interactional sociolinguistic perspective is used to examine authentic nurse-patient health information encounters, mapped against cognitive learning theories, schema theory in particular.Findings
The interactional consequences, when elements drawn from learning theories are implemented, are observable in the data.Discussion
Strategies that support patients’ learning include linking information to the patients’ prior experience/knowledge, providing information that is relevant to them, and chunking information into unified themes while encouraging patients’ active involvement through questioning and clarification of information.Conclusion
Awareness of learning theories and strategies outlined in this paper can strengthen communication skills and assist health professionals to structure patient education in ways that support patients’ learning, thereby enhancing patient safety. 相似文献20.