Australian nursing students’ clinical experiences in residential aged care: Reports from nurse academics

BackgroundNurses are the largest group of registered healthcare professionals and are fundamental to delivering health and aged care in Australia.AimTo explore how nursing students report clinical experiences when caring for older people as part of a larger study investigating how care of the older person content is included in Australian undergraduate nursing curricula.MethodsA population sample of all Australian nursing schools that offered a Bachelor of Nursing degree (n = 35) in 2019. Nurse academics involved in curriculum development or delivery were recruited. A telephone-assisted survey was used, and qualitative content analysis undertaken.ResultsAll schools of nursing participated in the survey, representing a response rate of 100%. The acute care focus of nursing curricula meant clinical experiences for nursing students related to older person's care commonly occurred in residential aged care facilities in the first year of the degree. Student reports of these experiences varied, with a majority of respondents reporting mixed or negative feedback associated with a lack of preparation and inadequate supervision.ConclusionsThis study highlights the: significance of the timing of nursing students’ clinical placements in residential aged care; the selection of appropriate care homes; and the need for the right clinical teaching staff who can supervise high quality learning experiences for students.     

Nurses’ perception of missed nursing care in a Western Australian teaching hospital: A cross-sectional study

BackgroundMissed nursing care (MNC) has gained increasing emphasis in nursing literature because of its association with nurse and patient outcomes in healthcare settings. While missed care has been widely studied, little evidence is available on the types and frequency of missed care, reasons for its occurrence, and predictors of missed care in Western Australia.AimsTo determine nurses’ perceptions of the types of MNC, reasons for missed care and to identify factors predicting missed care occurrence in Western Australian acute care settings.MethodsA cross-sectional study in medical and surgical wards was performed. The nurse MISSCARE survey tool was used to capture self-reported types and reasons for missed care and level of nurse job satisfaction from a sample of 204 nurses working in 16 acute care wards. Data analyses were carried out in International Business Machines Corperation located in Armonk, New York United States (IBM SPSS Statistics) (v 29).FindingsThe most common perceived missed activities included ambulation (87%), patient teaching (79%), interdisciplinary conference attendance (78%), mouth care (78%), intake and output (77%), and patient turning (75%). Labour resources ranked highest for reasons for missed care followed by material resources and communication. Significant relationships were observed between missed care and job satisfaction, role satisfaction, and teamwork.DiscussionWorking overtime, job dissatisfaction, inadequate staffing, and heavy admissions and discharges were related to increased likelihood for missed care occurrence.ConclusionAlthough further studies examining the link between MNC and staffing methodologies are needed, this study provides evidence on nurse-reported missed care and the impact of missed care in Western Australia.     

Who cares for older people with mental illness? A survey of residential aged care facilities in the Australian Capital Territory: Implications for mental health nursing

Residential aged care facilities are increasingly becoming locations wherein the most frail and older people with mental illness live out the remainder of their lives, yet it has become apparent in recent years that these institutions are fraught with a variety of social and clinical problems. One issue of concern has been the exodus of registered nurses (both general and psychiatric), who have been increasingly replaced by carers with little or no expertise in psychiatric illness or disorders of cognitive decline. This 'de-professionalizing' of aged care has important implications for the well-being of clients, particularity those with complex mental health problems. In this survey we sought to discover demographic information concerning those who provide front-line care to this population of aged Australians, and we sought also to ascertain how much education in caring for residents who suffer specifically from neurodegenerative disorders (the dementias) and mental illness was provided by the facilities to those who care for such older people. The lack of training in the areas of mental health and cognitive impairment raises a variety of issues that mental health nurses need to address. These issues cover clinical, professional, and social justice dimensions. We believe that mental health nurses are strategically and professionally placed to take a leadership role in raising the profile of aged care in this country and they need to act proactively to secure the well-being of this particularly vulnerable client group.     

Impact of the nurse-related information through social media use on undergraduate nursing students’ professional identity in nursing: A mixed-methods study

AimTo understand the impact of nurse-related information, through social media usage on undergraduate nursing students’ professional identity.BackgroundPrevious research has addressed professional knowledge and practice that affect the development of undergraduate nursing students’ professional identities. As an increasingly crucial factor in the internet age, social media needs to be explored in-depth for its influence on the professional identity in nursing.DesignSequential explanatory mixed method was used in this study.MethodsIn this quantitative study, participants (N = 698) completed an e-questionnaire survey between June and July of 2020. The relationship between main variables was analyzed by linear regression using SPSS 20.0. Then, face-to-face semi-structured and audio-recorded interviews were carried out among participants (N = 16) between January and March of 2021.ResultsThe quantitative findings indicated that the mean score of professional identity was 93.07 ± 11.96 in participants. The results of the linear regression showed that the year in school, whether nursing was the first choice, online time per day, frequency of reading official accounts related nursing on WeChat and appraisal of the online nurse-related information and so on explained 49.0 % of the variance in professional identity. Four major themes emerged from the qualitative study: 1) increased concern; 2) few and non-professional information; 3) encouraged by positive information; 4) limited impact of negative information.ConclusionsNurse-related information on social media has the potential to have an impact on undergraduate nursing students’ professional identity. Nursing educators should guide undergraduate nursing students to use social media appropriately and assist them in developing their professional identity with it.     

Universal design and the challenge of diversity: reflections on the principles of UD,based on empirical research of people’s mobility

Abstract

Purpose: The author analyses some theoretical presuppositions of the Universal Design approach. She shows that it is based on two paradoxes: (1) it reduces diversity to the “universal”, (2) it depends on an asymmetrical view of abilities and disabilities. The author suggests a way of changing this concept in order to take into account uniqueness and diversity, in order to allow the shaping of abilities. Methods: The data are taken from an ethnographical survey carried out between 2007 and 2009 made up of in-depth interviews with wheelchair users and their families. The interviews were analysed inductively using the Nvivo© programme. Results: The mobility of people in wheelchairs, and their capacity to act, are linked to their particular experience and are the result of a process of adjustment and arrangement. This process involves specific and varied resources and leads to changes in the individuals, in their dis/abilites, but also in their perceptions. Conclusions: This analysis leads to a change in the question of policy. This question is no longer “how to include diversity using the definition of ‘universal’”, but “how to bring out and articulate this diversity, so as to vary the qualities of persons and the world in which they live”.

• Implications for Rehabilitation

• “Inaccessibility” is analysed in terms of a discrepancy between the user and her/his environment and in terms of experience.

• Accessibility is analysed as a process of adjustment and practical arrangements between the person and her/his environment.

• The universalism of Universal Design is criticized in the way it tries to force the variety of users into the uniqueness of one materiality.

• Emphasis is put on diversity and the necessity of articulating this diversity in a plural world offering various resources that individuals can call upon to act, depending on what they are and on what they want to become.

     

Liverpool “lunatic asylum”: A forgotten chapter in the history of Australian health care

Background

Historical accounts of Australia’s early colonial lunatic asylums often neglect to mention the asylum that operated in Liverpool, NSW between 1826 and 1839.

“From the classroom to Dr. YouTube”: nursing students' experiences of learning and teaching styles in Jordan

Students' experiences and preferences of learning styles have not been explored using qualitative research. This study uncovered nursing students' experiences and preferences of learning and teaching styles in Jordan. A qualitative approach using focus group discussions (n = 6) was used in this study. A purposive sample consisting of 48 participants was recruited from second-, third-, and fourth-year nursing students at a public nursing school. The findings indicated that receiving information in a methodical, structured, and one-dimensional manner was the predominant learning style experienced by students. Although some learning experiences were negative, guided by the fear of record of absenteeism and limited teaching resources, students displayed increased attention to simulation and education facilitated using YouTube.com. Integrating the students’ perspective in educational reform maximizes the students' willingness to learn. Increased engagement in academics enhances the educational experience.     

‘I don't want to impose on anybody’: Older people and their families discuss their perceptions of risk,cause and care in the context of falls

Background

Falls in hospitalised patients remain an ongoing challenge for healthcare systems internationally. Limited research exists on the perspectives of older people on falls risk, cause and care.

Objectives

This study explored the experiences of patients and their families after a fall in a healthcare facility.

Methods

Semi-structured interviews were conducted with patients and families to explore the experience of having a fall. Data were analysed thematically.

Results

The themes that emerged from the 14 interviews included the following: explanations; physical environment; communication; experiences of care; perceptions of risk; ageism; feelings towards the fall; and independence and dignity.

Conclusions

This research emphasises the diversity in older people's experiences after experiencing a fall. Falls prevention should be incorporated as one part of healthy, dignified ageing.

Implications for practice

Falls prevention and management strategies should be multifactorial, including enhanced communication with the patient and their families. When engaging in education and awareness, falls prevention should be positioned as one component of independent and dignified healthy ageing.     

Australian nurses in general practice,enabling the provision of cervical screening and well women’s health care services: a qualitative study

Background

The role of Australian general practice nurses (PNs) has developed exponentially since the introduction of service based funding in 2005. In particular, their role has expanded to include cervical screening and well women’s health care services provided under the supervision of a general practitioner (GP). While previous research identifies barriers to the provision of these services, this study sought to investigate enablers for nurse led care in this area.

Methods

A number of grounded theory methods including constantly comparing data, concurrent data collection and analysis and theoretical sampling are utilised in this qualitative, exploratory study. A purposive sample of PNs who completed the required program of education in order to provide cervical screening and well women’s health care services was recruited to the study. Data is presented in categories, however a limitation of the study is that a fully integrated grounded theory was unable to be produced due to sampling constraints.

Results

Four enablers for the implementation of a change in the PN role to include cervical screening and well women’s health checks are identified in this study. These enablers are: GPs being willing to relinquish the role of cervical screener and well women’s health service provider; PNs being willing to expand their role to include cervical screening and well women’s health services; clients preferring a female practice nurse to meet their cervical screening and well women’s health needs; and the presence of a culture that fosters interprofessional teamwork. Seven strategies for successfully implementing change from the perspective of PNs are also constructed from the data. This study additionally highlights the lack of feedback on smear quality provided to PNs cervical screeners and well women’s health service providers.

Conclusions

The influence of consumers on the landscape of primary care service delivery in Australia is of particular note in this study. Developing interprofessional teams that maximise each health care provider’s role will be fundamental to comprehensive service delivery in the future.

     

“Integrity is integrity. IT doesn't matter the context”: A qualitative exploratory study of academic integrity in an undergraduate nursing program

Academic integrity is integral to the development of knowledge, clinical skills, and the professional development of nursing students, and provides an inextricable link to the standards for professional nursing practice. A semi-structured interview of 11 nursing academics was undertaken to explore academic integrity in an undergraduate nursing program in a large, Australian metropolitan university. An inductive approach to thematic analysis was used to identify the following themes (1) Graduate attributes: the participants believed academic integrity was important in equipping nurses with the knowledge, skills, critical thinking, and moral integrity necessary to support decision making in clinical practice. They expressed concerns that dishonest behavior may be transferred into clinical practice and threaten patient safety. (2) Gatekeepers: participants viewed themselves as gatekeepers, with vested interest to protect patients and the professional reputation of nursing. (3) Role models: participants instilled integrity in students nurses through dialog and role modeling of discipline-specific values. (4) Curriculum: participants believed that assessment design, course content and the physical environment influenced a student's ability to maintain integrity. Based on these findings, the participants identified a greater focus on the importance of academic integrity in the development of graduate attributes should be made more explicit to nursing students throughout their studies. A focus to learning with integrity will create notable learning opportunities and better prepare students for future professional practice.