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1.
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2.
The challenges in caring for morbidly obese patients in Intensive Care: A focused ethnographic study
Background
Critically ill morbidly obese patients pose considerable healthcare delivery and resource utilisation challenges. However little is known about the care of these patients in intensive care.Objective
To explore medical and nursing practices and attitudes in intensive care when caring for critically ill morbidly obese patients.Methods
A focused ethnographic approach was adopted. Participant observation of care practices and interviews with intensive care doctors and nurses were undertaken over a four month period. Qualitative analysis was conducted using constant comparison.Setting
An 18 bedded tertiary intensive care unit in New Zealand.Participants
Sixty-seven intensive care nurses and 13 intensive care doctors involved with the care and management of seven critically ill patients with a body mass index ≥40 kg/m2.Findings
Morbidly obese patients present significant physical and language challenges for intensive care practice. The physical shape of morbidly obese patients did not appropriately fit the different equipment used. Staff used specific knowledge of the patient’s body size and shape to adapt care practices and keep patients safe and comfortable. There were also specific language challenges where staff expressed concern about what words were most appropriate to use to describe body mass when in the presence of morbidly obese patients.Conclusions
Bariatric care pathways need to be developed that use more suitable body measurements to inform the use of bariatric equipment. Intensive care staff need to engage in debate about what is acceptable, respectful, and appropriate language in the delivery of bariatric patient care. 相似文献3.
Louise Newton Leeanne M. Pront Tracey M. Giles 《Collegian (Royal College of Nursing, Australia)》2018,25(5):533-540
Background
Clinical experience exposes nursing students to the realities of professional practice and opportunities to integrate theory with practice. Increasing multiculturalism in Australia means that approximately 27% of students studying in Australian universities originate from overseas. Yet there is a paucity of literature examining the experiences of Registered Nurses charged with their clinical supervision.Aim
To examine the experiences of Registered Nurses who supervise undergraduate international nursing students in the clinical setting.Design and methods
A qualitative holistic case study approach was employed to achieve the study aims. Semi-structured, in-depth interviews were undertaken with six Registered Nurses.Findings
Thematic analysis elicited four main themes representative of Registered Nurses’ experiences supervising international students: (1) communication, (2) the role of supervision of international nursing students, (3) language and culture, and (4) supervisors’ perceptions of responsibility.Conclusions
Participants provided valuable insight into the role of supervision of international students in the clinical environment. Suggestions for improved communication between healthcare and educational organisations and increased support for supervising Registered Nurses were made. Specifically, training regarding different linguistic and cultural issues was suggested. 相似文献4.
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Carina Anderson Lorna Moxham Marc Broadbent 《Collegian (Royal College of Nursing, Australia)》2018,25(2):231-235
Problem
Pre registration nursing students do not always feel supported by Registered Nurses during their clinical placements. To help develop and refine clinical skills, in order to deliver safe, competent nursing care, nursing students rely on Registered Nurses to teach and support them in their clinical learning.Background
Pre-registration nursing students in Australia must undertake a minimum of 800 clinical placement hours as part of their undergraduate nursing education. Registered Nurses are required to provide professional development and to teach and support students during these clinical placements. Little is known about Registered Nurses’ understanding of this nursing standard requirement.Aim
To explore Registered Nurses’ understanding of the nursing standard requirement to provide professional development to pre-registration nursing students during their clinical placements.Methods
A Grounded Theory study was used involving in-depth semi-structured individual interviews to gather data from fifteen Registered Nurse participants. Constant comparative analysis was used to analyse the data and it was from this data analysis that the substantive theory emerged.Findings
The substantive theory developed as a result of this research is titled, Doing the Right Thing. The core category, the right thing to do, is informed by four elements; sense of responsibility, an added extra, choice, and nursing standard.Conclusion
Registered Nurses are motivated to teach and support nursing students on clinical placements because they believe it is the right thing to do. 相似文献7.
Tasneem Islam Alison M. Hutchinson Tracey K. Bucknall 《Collegian (Royal College of Nursing, Australia)》2018,25(4):401-407
Background
Nurse managers enact changes to practice based on information collected from the local ward environment with the aid of electronic risk management and incident reporting systems. Despite being key users of electronic risk management and incident reporting systems, little knowledge exists on nurse managers’ use and communication of information derived from these systems.Aim
This qualitative study aimed to explore nurse manager information requirements, risk management practices, and influences on decision-making when interacting with an electronic risk management and incident reporting system.Methods
Focus groups with eight nurse managers were conducted at a teaching hospital in Melbourne, Australia.Findings
Decision-making and information management approaches varied depending on whether the nurse manager investigated a single incident report or viewed summarised incident reports. Thematic and content analysis produced three themes: navigating the system, relying on data, and communication and feedback.Discussion
Nurse managers faced individual and organisational barriers preventing them from using the risk management and incident reporting system to its full potential.Conclusion
The findings from this study will assist nursing and health care administrators in identifying ineffective practice and meeting nurse manager information requirements. 相似文献8.
Melanie Birks Nicholas Ralph Robyn Cant Ylona Chun Tie Elspeth Hillman 《Collegian (Royal College of Nursing, Australia)》2018,25(2):209-215
Background
Nursing practice is underpinned by science knowledge. While the literature is consistent in identifying limitations in teaching science content to nurses, there is a lack of consensus regarding what should be taught and to what level of detail. No studies to date have systematically surveyed registered nurses (RNs) for their perspectives about the science knowledge that should underpin nursing practice.Aim
To establish the relative importance RNs place on science content taught to nurses.Method
Practicing RNs across Australia were invited to participate in a cross-sectional survey administered online. The survey asked participants to prioritize 179 science topics according to the relative importance of each item to nursing practice.Findings
A total of 1583 RNs completed the survey. Participants indicated strong support for the inclusion of foundational science knowledge in undergraduate pre-registration nursing programs. The majority of topics (88%) were rated as a ‘high priority’ (a rating of 4 or 5), particularly anatomy, physiology and pathophysiology. No topic received a rating of less than 3 (of a possible 5).Discussion
RNs expressed different views about the prioritization of science content areas for nursing practice compared with the views of academics who teach science to nursing students. Identification of the science content areas that RNs regard as high priority for nursing practice can be used to guide improvements in nursing curriculum development.Conclusion
The results of this study demonstrate that practising RNs place high value on various science topics and the teaching of biological sciences generally. This study suggests the need for greater inclusion of key stakeholders, including practicing RNs, when integrating bioscience within nursing curricula. 相似文献9.
Toby Raeburn Carol Liston Jarrad Hickmott Michelle Cleary 《Collegian (Royal College of Nursing, Australia)》2018,25(3):347-353
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.Aim
To find and explore the earliest available evidence of the mental health care provided within Liverpool lunatic asylum.Methods
A literature search was followed by manual searches of primary sources held by the State Records Authority of New South Wales, the State Library of NSW, Liverpool Library and Liverpool Regional Museum. International records available through Ancestry.com were also accessed.Findings
Contrary to previous historical accounts, Liverpool lunatic asylum was located within the parsonage of St Luke’s Church in Liverpool. This building was better suited to mental health care than the disused military barracks previously home to the patients of Australia’s first asylum at Castle Hill.Discussion
Despite the substantial challenges of delivering mental health care in the early colony of NSW, the lunatic asylum at Liverpool retained long term staff who worked there throughout the 13 years of its operation. Payment of wages to a nurse within the Liverpool lunatic asylum indicates a shift in approach to nursing in colonial mental health care that makes an important contribution to the historical identity of nursing in Australia.Conclusion
Clarifying historical information using primary sources that illuminate care within Liverpool lunatic asylum is important because history has the potential to inform and contextualise modern approaches to health care. 相似文献10.
Evdokia Kalaitzidis Ann Harrington 《Collegian (Royal College of Nursing, Australia)》2018,25(5):509-515
Background
Worldwide research confirms that older people value autonomy, want to remain independent and want control over their lives for as long as possible. Accordingly, the aged care system in Australia is undergoing major government-initiated reforms and is moving towards consumer directed care.Aim
To explore the views of residents and care staff of resident decision-making, choice and control in the residential aged care context.Methods
Residents from across four residential aged care facilities in Adelaide were interviewed and staff focus groups were held. A thematic analysis of the data was conducted.Findings
Residents valued opportunities for privacy, communal engagement, productivity, negotiation with staff, and for opportunities to engage with systems of governance. How staff prioritise resident decision-making is influenced by the carer’s judgement of the resident’s characteristics and of the organisation’s rules and polices.Discussion
Older people living in residential care are no longer living in their own home but instead are dealing with organisational rules and routines framed by others upon whom they are dependent.Conclusion
The day-to-day decision-making process for residents is likely to remain complex due to residents having to take into account rules, regulations and policies operationalized through organisational channels. 相似文献11.
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Background
The intensive care nursing workforce plays an essential role in the achievement of positive healthcare outcomes. A growing body of evidence indicates that inadequate nurse staffing and poor skill mix are associated with negative outcomes for patients, and potentially compromises nurses’ ability to maintain the safety of those in their care. In Australia, the Australian College of Critical Care Nurses (ACCCN) has previously published a position statement on intensive care staffing. There was a need for a stronger more evidence based document to support the intensive nursing workforce.Objectives
To undertake a systematic and evidence review of the evidence related to intensive care nurse staffing and quality of care, and determine evidence-based professional standards for the intensive care nursing workforce in Australia.Methods
The National Health and Medical Research Council standard for clinical practice guidelines methodology was employed. The English language literature, for the years 2000-2015 was searched. Draft standards were developed and then peer- and consumer-reviewed.Results
A total of 553 articles was retrieved from the initial searches. Following evaluation, 231 articles met the inclusion criteria and were assessed for quality using established criteria. This evidence was used as the basis for the development of ten workforce standards, and to establish the overall level of evidence in support of each standard. All draft standards and their subsections were supported multi-professionally (median score >6) and by consumers (85–100% agreement). Following minor revisions, independent appraisal using the AGREE II tool indicated that the standards were developed with a high degree of rigour.Conclusion
The ACCCN intensive care nursing nurse workforce standards are the first to be developed using a robust, evidence-based process. The standards represent the optimal nurse workforce to achieve the best patient outcomes and to maintain a sustainable intensive care nursing workforce for Australia. 相似文献13.
M.A. van Egmond M. van der Schaaf T. Vredeveld M.M.R. Vollenbroek-Hutten M.I. van Berge Henegouwen J.H.G. Klinkenbijl R.H.H. Engelbert 《Physiotherapy》2018,104(3):277-298
Background
Over the last few years, telerehabilitation services have developed rapidly, and patients value benefits such as reduced travelling barriers, flexible exercise hours, and the possibility to better integrate skills into daily life. However, the effects of physiotherapy with telerehabilitation on postoperative functional outcomes compared with usual care in surgical populations are still inconclusive.Objectives
To study the effectiveness of physiotherapy with telerehabilitation on postoperative functional outcomes and quality of life in surgical patients.Data sources
Relevant studies were obtained from MEDLINE, EMBASE, CINAHL, the Cochrane Library, PEDro, Google Scholar and the World Health Organization International Clinical Trials Registry Platform.Study selection
Randomised controlled trials, controlled clinical trials, quasi-randomised studies and quasi-experimental studies with comparative controls were included with no restrictions in terms of language or date of publication.Data extraction and synthesis
Methodological quality was assessed using the Cochrane risk of bias tool. Twenty-three records were included for qualitative synthesis. Seven studies were eligible for quantitative synthesis on quality of life, and the overall pooled standardised mean difference was 1.01 (95% confidence interval 0.18 to 1.84), indicating an increase in favour of telerehabilitation in surgical patients.Limitations
The variety in contents of intervention and outcome measures restricted the performance of a meta-analysis on all clinical outcome measures.Conclusions
Physiotherapy with telerehabilitation has the potential to increase quality of life, is feasible, and is at least equally effective as usual care in surgical populations. This may be sufficient reason to choose physiotherapy with telerehabilitation for surgical populations, although the overall effectiveness on physical outcomes remains unclear.PROSPERO registration number: CRD42015017744. 相似文献
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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16.
Objective
Nursing students are prone to needle stick injuries (NSIs) during their practice in the hospitals. This study aimed to identify the effective NSI prevention strategies for nursing students in the clinical settings.Method
Literature review was performed using the databases of ScienceDirect, ProQuest, MEDLINE, PsycINFO, Scopus, CINAHL, SpringerLink, JSTOR, and PubMed. The search terms of “nursing students”, “NSI incidents”, “prevention”, and “clinical settings” were entered, generating 103 articles published between 1991 and 2015.Results
Our study demonstrated the high rates of NSIs in low- and middle (India, 91.85%). and high-income countries (Taiwan, 56.00%). Most injuries especially occurred when students opening the ampules (53.15%) and performing intravenous cannulation (44.50%). Our review identified four main strategies to prevent NSIs; education, trainings, safe needle use, and effective communication. Our study suggested the development of education and trainings curriculum and self- report system and culture, the provision of financial, material and manpower resources to support the prevention of NSIs.Conclusions
four main strategies to prevent NSIs were education, trainings, safe needle use and effective communication.Implications for practice
collaboration of hospitals and educational institutions is essential to develop effective NSI prevention programs. 相似文献17.
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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19.
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20.
Fiona Bogossian Simon Cooper Michelle Kelly Tracy Levett-Jones Lisa McKenna Julia Slark Philippa Seaton 《Collegian (Royal College of Nursing, Australia)》2018,25(3):327-334