Nursing informatics and undergraduate nursing curricula: A scoping review protocol

AimThis scoping review aims to review contemporary published literature on Nursing Informatics education in undergraduate nursing education.IntroductionNursing is the largest workforce in health care and nurses are increasingly required to work with digital information systems. The need for nurses to understand and embrace information technology is closely linked with the ability to function in the contemporary healthcare workplace. However, despite the early adoption of Nursing Informatics in Australia in the 1980 s, there remain barriers to Nursing Informatics engagement and proficiency, including poor computer literacy, limited professional development and a lack of undergraduate informatics education.DesignThis scoping review will be developed in adherence with the JBI Manual for Evidence Synthesis: Scoping Reviews and the PRISMA-ScR Checklist.MethodsTo be included in this scoping review, papers need to include Nursing Informatics education for undergraduate nursing students in a Bachelor of Nursing program. Undergraduate nursing students are defined as individuals enrolled in a recognised nursing program leading to registration as a Nurse. To meet the requirements for registration as a Registered Nurse, in Australia, individuals are required to complete a Bachelor of Nursing program at a university (Australian Qualifications Framework Level 7) For the purpose of this scoping review, undergraduate nursing students are defined as those individuals undertaking a three year Bachelor of Nursing program at a university. Equivalent international definitions will be also used in the scoping review procedure. Sources of information will be included if they were published between 2015 and 2022 and describe curriculum recommendations (including barriers to implementing Nursing Informatics education). The purpose of the identified timespan is to reflect the rapidly evolving nature of health informatics and digital technologies. The requirement for curriculum recommendations is to reflect the purpose of the scoping review as the basis for a Delphi study, where Nursing Informatics and its integration into Bachelor of Nursing curricula will be explored and described in collaboration with domain experts.Ethics and disseminationEthics approval has been obtained for this scoping review (Project ID: 2156) from the Flinders University’s Human Research Ethics Committee and has been determined to be low risk.     

Implementation of a Registered Undergraduate Student of Nursing (RUSON) program: The nurses’ perspective

ProblemUndergraduate nursing students remain an underutilised workforce within healthcare. This paper explores the establishment of a Registered Undergraduate Students of Nursing (RUSON) model through a university and healthcare partnership.BackgroundNursing continues to adapt to increasingly complex patient populations. Initiatives are needed to enable nurses to focus on patients’ care needs amidst increasing healthcare costs. This study identifies opportunities and strategies for engaging undergraduate nursing students as part of the healthcare workforce through the RUSON model, from the perspective of nurse leaders.AimThis project aimed to explore nurse leaders’ perspectives surrounding implementation of a RUSON model.MethodA qualitative exploratory design was employed for this study. Thematic analysis from a focus group with the nurse leaders was undertaken.FindingsTwo key themes were identified from the analysis, i) Establishing the RUSON; with sub-themes: “Who are RUSONs?”, “You are not on clinical placement” and “The importance of inclusivity” and ii) Benefits of the RUSONs; with sub-themes: “Addressing patient care needs”, “Value to the nursing team” and “Creating future ready employees”. Participants identified barriers that were overcome, subsequently leading to the model being considered advantageous to the clinical environment.DiscussionThe establishment of a RUSON workforce in acute care settings brings with it benefits to the nursing staff and the RUSONs themselves. In order to successfully embed a RUSON model in an organisation, it is important to collaborate with the nursing leadership team in the implementation process.ConclusionA RUSON workforce is an appropriate human resource strategy, both at the immediate point of implementation and longitudinally, as a recruitment strategy for future employment. Successful implementation of a RUSON model requires engagement and collaboration with nursing leaders.     

Full-time work for nurses: employers’ perspectives

Aim To examine an employer response to a government employment policy, the Nursing Graduate Guarantee (NGG), over a 2-year period (2008–2009 and 2009–2010). Background Healthcare organizations rely on a stable supply of nurses to meet their staffing needs. However, employment trends have indicated a propensity for part-time employment. The NGG was created to stimulate full-time employment of new graduate nurses in Ontario, Canada. Methods A mixed methods design was used, which included online surveys and focus groups. All healthcare providers (n = 1198) were surveyed in 2008–2009 and 2009–2010. Each year, a sample of NGG employers participated in sector-specific focus groups. Results Approximately 20% of potential healthcare employers participated in the NGG. Reasons for non-participation included lack of awareness of the initiative and lack of full-time jobs. Barriers to offering full-time employment to new graduates included lack of full-time vacancies and budget constraints. Conclusions Employers perceive flexible staffing practices as a way to contain personnel costs but often at the expense of a stable full-time nursing workforce. Implications for Nursing Management This research contributes to an understanding of employers’ perspectives on full-time hiring and participation in a government employment policy.     

Confidence,interest and intentions of final-year nursing students regarding employment in general practice

BackgroundRising health care burden has increased demand for general practice nurses. Exploring final-year nursing students’ perceived levels of confidence, interest and intention to work in this area can inform preparation and recruitment of new graduates into this workforce.AimTo explore final-year nursing students’ confidence, interest and intention to work in general practice.MethodsFinal-year nursing students from five universities situated in New South Wales, Australia were surveyed between March and June 2019. The survey comprised investigator-developed questions and validated tools adapted for use in general practice.FindingsOf the 355 included responses, 34.1% respondents had a clinical placement in general practice. Work experience was a significant predictor of confidence in working as a Registered or General Practice Nurse. Being enrolled as an international student, general practice placement experience and high confidence to work in general practice were significant predictors of interest and intention to work in this setting. Analysis showed a strong positive relationship between interest and intention to work in general practice, and a small but positive relationship between confidence and intention to work in general practice.DiscussionDespite generally positive views around their confidence, interest and intention to work in general practice, some respondents indicated uncertainties around these, and the usefulness of their undergraduate preparation towards PHC employment. This may be attributable to the inconsistent exposure to general practice nursing within Australian undergraduate nursing programs.ConclusionIncreasing students’ theoretical and clinical exposure to general practice enhances confidence and interest to pursue a career in this setting.     

Intensive care nurse practitioners in Australia: A description of a service model in an adult tertiary intensive care unit

BackgroundAlthough well-established internationally, nurse practitioners (NPs) in Australian adult intensive care units (ICUs) are rare. Australian literature clearly highlights the importance of creating ICU NP roles to meet emerging demands. An ICU NP model of care at a metropolitan hospital in Sydney provides care in four core practice areas: complex case management, vascular access, tracheostomy management, and intrahospital transport of critically ill patients. The ICU NPs also provide training and assessment for ICU nurses and medical officers in these same core practice areas and can efficiently meet service gaps in crisis such as the most recent COVID-19 pandemic.ResultsThe ICU NP program described is an innovative model of care that has demonstrated potential benefits to patients and their families. Potential benefits to the healthcare system including supporting advanced practice nursing development in regional and rural Australia and in addressing future ICU workforce issues are also identified. This model of care provides a clear role and structure for the integration of NPs in the adult ICU. Research to evaluate the impact of the role is required and is underway.ConclusionsThis model is being used to develop a national adult ICU NP fellowship training program for ICU transitional NPs preparing for endorsement or endorsed NPs who require additional ICU-specific training. This immersive clinical training program combined with didactic learning modules offers a framework to support the implementation of the adult ICU NP role as well as a framework for NP fellowship programs in other specialties.     

The demographic profile of alcohol and other drug (AOD) nurses in Australia: Experienced,highly qualified… and endangered?

BackgroundLittle is known about the demographic profile of Australian alcohol and other drug nurses, a key part of the workforce that provides care to healthcare consumers who seek treatment for problematic alcohol and other drug use.AimTo explore the demographics of the alcohol and other drug nursing workforce in Australia.MethodElectronic survey, comprising quantitative demographic questions and qualitative responses. Statistical analysis was conducted to explore workforce demographics, and thematic analysis used to explore free-text responses.FindingsIn total, we surveyed 337 nurses working in alcohol and other drug nursing positions. Most (81.3%) were female, and postgraduate qualified (67%). Approximately 60% of participants were aged 45 and over, and 9% 31 or under. Participants were highly experienced in the specialty (mean 13.72 years, SD 10.10), and in nursing overall (mean 26.29 years, SD 13.38). When compared with the total nursing workforce, alcohol and other drug nurses are older, with proportionally fewer nurses under the age of 35. Qualitative themes indicate workforce sustainability and attracting new entrants as key issues.DiscussionThese findings indicate that the Australian alcohol and other drug nursing workforce is older, with many participants nearing retirement. There are fewer younger entrants to the specialty, lending support to the argument that alcohol and other drug nurses are endangered.ConclusionThere is an urgent need to develop strategies to encourage nurses to take up alcohol and other drug nursing; especially considering the number of highly experienced and qualified nurses likely to leave the specialty soon.     

Fostering graduate nurse practice readiness in context

BackgroundThe healthcare environment is highly pressured, dynamic and demanding of staff. Existing research indicates that when graduate nurses begin work, they are not practice ready and struggle to adapt and manage their responsibilities as registered nurses.AimAs part of a larger study, this paper examines the impact of the healthcare environment on graduate nurses’ practice readiness and the factors that assist them to become practice ready.MethodMultiple case study design with 67 participants from four different professional groups employed in four healthcare institutions in one state in Australia. Grounded theory methods of data analysis, document review, and cross case analysis were utilised in this study.FindingsThe healthcare system, workplace environment and quality of workplace interactions impact on actual and perceived graduate nurse performance. Graduate nurses develop practice readiness progressively along a transition continuum and attaining practice readiness is reliant on factors present in both the education and workplace environments.DiscussionEducation and workplace factors collectively create the right environment for graduate nurses to flourish. Education and practice sectors need to work together to ensure graduate readiness over a four-year timeline from the commencement of nursing studies through to the end of the graduate year to ensure practice readiness.ConclusionCreating positive workplace environments that support nursing students and graduate nurses to develop practice readiness can enhance the quality of care they provide, promote their retention in the health workforce and contribute to improved healthcare practice and outcomes.     

Towards nursing leadership for professional and career outcomes of Bachelor of Nursing (Honours) students: A case study

BackgroundWithin Australia and internationally, there is increasing and widespread recognition of the importance of developing nurses’ capabilities in research and evidence-based practice to advance the discipline. Literature is sparse on the contribution of nursing Honours degrees to academic, professional, and industry outcomes in nursing.Aims and objectivesTo critically evaluate the contribution of a Bachelor of Nursing (Honours) degree to individual career development and nursing leadership, the profession, higher education, and the health industry to inform future directions.MethodsThis case study of a longstanding Bachelor of Nursing (Honours) degree uses data collected from multiple sources. The data included university and public records, as well as an anonymous online survey in 2018-19 of all students who had enrolled in the programme since 2004. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) Cross-Sectional Studies checklist was followed.FindingsOf the 95 Honours programme graduates, 22.1% (n = 21) progressed to PhD studies, and 33.7% (n = 32) produced one or more publications. Of the 42 participants who accessed the survey, 78.6% (n = 33) had completed the nursing Honours programme, and 21.4% (n = 9) had commenced but did not complete the degree. Insufficient time was the main reason for not completing the nursing Honours degree, and qualitative responses indicated the nursing Honours degree developed student confidence and skills relevant to research and professional practice.DiscussionFindings highlight opportunities for nursing Honours degrees to contribute to individual achievement, best practices in healthcare, development of future leaders in nursing, and discipline-specific research outcomes.ConclusionNursing Honours degrees can offer important benefits to the individual, as well as the profession and the healthcare industry.     

Undergraduate nurse students' perspectives of spiritual care education in an Australian context

BackgroundThe Australian Nursing and Midwifery Accreditation Council competency standards highlight the need to provide holistic care that is inclusive of spiritual care. Literature shows that internationally many nurses feel unsure of how to provide spiritual care which has been attributed to a lack of spiritual care education during undergraduate nursing programs.AimThis study explores the impact of a spiritual care subject in an undergraduate nursing program in an Australian tertiary institution.MethodQualitative research design using in-depth semi-structured interviews.SettingA tertiary institution with a Christian orientation in Sydney, Australia.ParticipantsSix undergraduate nursing students who had completed the spiritual care subject.Data ResultsTwo themes emerged from the data: Seeing the person as a whole and Being with the person.ConclusionsThe spiritual care subject had a positive impact on the perceptions of undergraduate nursing students. In particular students perceived themselves more prepared to provide holistic care that was inclusive of spiritual care.     

Spotlight on equality of employment opportunities: A qualitative study of job seeking experiences of graduating nurses and physiotherapists from black and minority ethnic backgrounds

BackgroundThere is growing attention in the UK and internationally to the representation of black and minority ethnic groups in healthcare education and the workplace. Although the NHS workforce is very diverse, ethnic minorities are unevenly spread across occupations, and considerably underrepresented in senior positions. Previous research has highlighted that this inequality also exists at junior levels with newly qualified nurses from non-White/British ethnic groups being less likely to get a job at graduation than their White/British colleagues. Although there is better national data on the scale of inequalities in the healthcare workforce, there is a gap in our understanding about the experience of job seeking, and the factors that influence disadvantage in nursing and other professions such as physiotherapy.AimThis qualitative study seeks to fill that gap and explores the experience of student nurses (n = 12) and physiotherapists (n = 6) throughout their education and during the first 6-months post qualification to identify key experiences and milestones relating to successful employment particularly focusing on the perspectives from different ethnic groups.ParticipantsParticipants were purposively sampled from one university to ensure diversity in ethnic group, age and gender.MethodsUsing a phenomenological approach, in-depth semi-structured interviews were conducted at course completion and 6 months later.ResultsTwo main themes were identified. The ‘proactive self’ (‘It’s up to me’) theme included perceptions of employment success being due to student proactivity and resilience; qualities valued by employers. The second theme described the need to ‘fit in’ with organisational culture. Graduates described accommodating strategies where they modified aspects of their identity (clothing, cultural markers) to fit in. At one extreme, rather than fitting in, participants from minority ethnic backgrounds avoided applying to certain hospitals due to perceptions of discriminatory cultures, ‘I wouldn’t apply there ‘cos you know, it’s not really an ethnic hospital’. In contrast, some participants recognised that other graduates (usually white) did not need to change and aspects of their identity brought unsolicited rewards ‘if your face fits then the barriers are reduced'.ConclusionsThe findings indicate that success in getting work is perceived as determined by individual factors, and fitting in is enabled by strategies adopted by the individual rather than the workplace. Demands for change are more acute for graduates from black and minority ethnic backgrounds. This is an issue for healthcare organisations seeking to be inclusive and challenges employers and educators to acknowledge inequalities and take action to address them.     

Double degree destinations: Nursing or midwifery

BackgroundDouble degrees in nursing and midwifery have evolved in Australia as a proposed solution to possible impending shortages of qualified midwives in the healthcare workforce. The double degree is seen as a more acceptable option in non-metropolitan areas in particular. Concern has been expressed however, about dilution of midwifery philosophy and graduates’ opportunities in respect of future clinical practice.AimThis study aimed to provide a better understanding of motivations and intentions of students who undertake the Bachelor of Nursing Science/Bachelor of Midwifery double degree.MethodsA cross-sectional survey design was employed at four universities that offered double degrees in nursing and midwifery in three states of Australia. Students enrolled in first and fourth year of a double degree and graduates of a double degree were invited to complete an online survey comprised of Likert scales and items requiring free text responses. Quantitative data was analysed using SPSS and thematic analysis was used to analyse the qualitative data.FindingsParticipants indicated a clear preference for midwifery as a career with this preference increasing for each cohort at each stage of study.DiscussionPrimary reasons for selecting a double degree were perceived increased opportunity for employment and use of nursing skills to enhance midwifery practice in a population with growing co-morbidities. A strong identification with midwifery philosophy and identity was also demonstrated.ConclusionAn understanding of motivations and career intentions of students undertaking double degree studies can inform future program development and workforce planning.     

A Dedicated Education Unit and a Novel Resident Nurse Transition-to-Practice Program in an Ambulatory Oncology Setting

ObjectiveTo summarize an innovative initiative in oncology nurse workforce development that addresses critical current and future gaps and encompasses use of dedicated education units for student nurse rotation and a transition-to-practice residency program.Data SourcesReview of institutional data including original pilot analysis and ongoing programmatic metrics (N=8 years), consensus, professional guidelines, and published literature.ConclusionThe dedicated education unit serves as a conduit for recruitment into institutional oncology nurse residency positions, and retention rates in the residency program continue to exceed national averages. Subsequent mentoring of these nurses in transition to practice has manifested high rates of promotion into nurse leadership roles year over year.Implications for Nursing PracticeOncology nurse practice incorporates state-of-the-science approved therapies, early phase clinical trial implementation, and evidence-based complex oncology patient care management. A new model of student clinical nurse rotations in ambulatory settings, nurse resident transition to practice, and ongoing leadership mentoring is essential in creating a sustainable, highly skilled, and robust oncology nurse work force.     

Review of Aboriginal and Torres Strait Islander content within a Bachelor of Nursing

BackgroundThere have been significant improvements in the past decade in the health of Aboriginal and Torres Strait Islander peoples however, the target to close the gap in life expectancy by 2031 is not on track to be met. The Aboriginal and Torres Strait Islander Health Curriculum Framework (The Framework) provides a guide for developing health professional’s cultural capabilities to enhance the service delivery to Aboriginal and Torres Strait Islander peoples (Australian Government, 2016).AimThe purpose of this study is to review Aboriginal and Torres Strait Islander content included in the Bachelor of Nursing Program at an Australian university, assessing alignment with The Framework.MethodsThis research utilises mixed methods to confirm the presence of Aboriginal and Torres Strait Islander curriculum in the Bachelor of Nursing program and to further explain these findings.FindingsThis study provides evidence that the Bachelor of Nursing program meets the Australian Nursing and Midwifery Council accreditation requirements, yet Aboriginal and Torres Strait Islander health content within the program is fragmented and inconsistent.DiscussionEnablers with the potential to align tertiary undergraduate Nursing programs with The Framework have been identified to facilitate embedding of appropriate content.ConclusionThe outcome of this study is a clear picture and the true nature of the content related to Aboriginal and Torres Strait Islander health within the Bachelor of Nursing curriculum and alignment with the expectations of The Framework, with a process that can be applied elsewhere.     

Human resource management strategies for the retention of nurses in acute care settings in hospitals in Australia

It is paramount that there is an adequate nursing workforce supply for now and in the future, to achieve equitable and quality health outcomes and consumer access to healthcare, regardless of geographic location. Nursing forms the largest body of employees in the health care system, spanning all segments of care. A shortage of nurses, particularly in the acute care settings in hospitals, jeopardizes the provision of quality health care to consumers. This article provides a literature review of Australian State and Federal Government reports into nurse retention. All reports discuss staff turnover rates; the average age of nurses; enrolment numbers in nursing courses; workloads; nursing workforce shortfalls and the effect on the work environment; leadership and management styles; organizational culture; change management; the mobility of nursing qualifications both locally and internationally and the critical need to value nurses. Then why has the situation of nurse retention not improved? Possible reasons for the continued nurse shortage and the promise of strategic HRM in addressing nurse retention are discussed.     

Undergraduate registered nursing students working as assistants in nursing within the acute care environment: Program development and discussion

BackgroundMost pre-registration nursing students require employment during their studies which may entail undertaking another qualification.This paper describes how one university developed a program whereby undergraduate nursing students complete the national vocational education – HLT33115 Assistant in Nursing qualification through recognition of prior learning, a self-directed education package and completion of an objective structured clinical examination.ObjectiveTo discuss the development of an ‘Assistant in Nursing’ in the acute care environment program for pre-registration undergraduate nursing degree students using the national vocational education framework.DesignThis program maps the national ‘Assistant in Nursing- Acute Care’ vocational qualification to the pre-registration registered nurse degree. Upon successful completion of this program students can work as Assistants in Nursing within the acute care environment.ConclusionsThis program enables student nurses to work as Assistants in Nursing within the acute care environment. This provides employment in a health facility and opportunities for students to immerse themselves in the clinical environment whilst continuing their studies. This may assist students to gain a deeper insight into their future role as a nurse, build networks within the nursing community and assimilate into the clinical environment. This program design may prove useful as a template for other nursing faculties wishing to implement a similar program.     

Bridging the theory practice gap: a review of Graduate Nurse Program (GNP) in Dubai, United Arab Emirates

NEMATOLLAHI R. & ISAAC J.P. (2012) Bridging the theory practice gap: a review of Graduate Nurse Program (GNP) in Dubai, United Arab Emirates. International Nursing Review 59 , 194–199 Background: One of the prime concerns of government is the investment in people and resources for the education and health care of its nation. The United Arab Emirates has invested in improving Arab nurse education to reflect the latest emerging standards in international nurse education as part of this ongoing investment: a need to bridge the theory practice divide was identified. Introduction: The Dubai Health Authority (DHA), which is the main government healthcare provider in Dubai, granted full scholarship for Arab nationals to enrol in the first baccalaureate nursing degree program offered by a local university in the country. Problem: Since its conception, 56 students have graduated from the program, of which eight graduates have resigned or did not join the nursing workforce. Current new graduates expressed lack of confidence and not feeling work ready to join the workforce; in addition, the nurses in service also voiced the opinion that the new Arab nursing graduates were inadequately prepared for service provision at the time of graduation. Conclusion: A graduate nurse program to bridge the gap between theory and practice and to ease the transition of new graduate nurses into the nursing workforce was developed by the DHA. Discussion: This paper offers a positional discussion on the development of this program in Dubai, its findings, action planning and works in progress to resolve identified issues.