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1.
Helen Eleni Zournazis Annette Marlow Carey Mather 《Collegian (Royal College of Nursing, Australia)》2018,25(4):371-375
Background
In preparation for future needs of the health workforce there has been an increase of student enrolments into health-related courses resulting in competing demands for quality professional experience placements. Consequently, additional student and preceptor support is necessary to ensure positive learning outcomes for students placed in rural areas.Aim
To evaluate a whole of community facilitator model of support for nursing students and their preceptors in rural practice settings.Methods
An evaluation approach included a needs analysis; literature review and online surveys from preceptors, facilitators and nursing students.Findings
The results of the needs analysis and surveys identified how the whole of community facilitator model contributed to supporting preceptors to build placement capability and promote workforce development. The results revealed benefits to students and preceptors. Emerging themes from responses centred on the interrelationship between the learning, teaching and healthcare environments.Conclusion
Preceptors recognised the value of the whole of community facilitator model through their contribution of clinical and educational information, resources, modelling professional development, and provision of support. It was acknowledged multiple placement opportunities within a single community, enriched student experiences. With refinement, this model has potential to contribute to workforce development in other rural placement environments. To review the effectiveness of the model of facilitation, this paper focuses on the perspective of preceptors. 相似文献2.
Melanie Birks Lea M. Budden Narelle Biedermann Tanya Park Ysanne Chapman 《Collegian (Royal College of Nursing, Australia)》2018,25(1):45-50
Background
Bullying in nursing remains an unacceptable international phenomenon and one that is widely reported in the literature. Recently, reports of bullying and harassment of nursing students have been increasing.Aim
This paper aims to describe bullying and harassment experienced by Australian nursing students while on clinical placement, as told by the participants.Methods
As part of a larger study, 884 Australian baccalaureate nursing students were surveyed to identify the nature and extent of their experiences of bullying and/or harassment during clinical placement. Almost half of the students (430) provided open-ended comments. These textual data were explored using a content analysis approach.Findings
The major themes derived from the analysis consisted of: manifestations of bullying and harassment; the perpetrators, consequences and impacts. Bullying behaviours included various forms of verbal, racial, physical and sexual abuse. Perpetrators of bullying included other nurses, medical professionals, administrative and support staff. Students reported anxiety, panic attacks, physical symptoms of distress and loss of confidence and self-esteem from their experience of bullying during clinical placement.Discussion
Bullying in nursing is a widespread yet poorly understood phenomenon that impacts negatively on the learning experience of vulnerable nursing students, effecting them physically, mentally and emotionally. The potential implications of the bullying of nursing students on patient care reinforces the need for the culture of bullying that exists amongst the nursing profession to be addressed.Conclusion
The findings of this research have implications for nursing educators and clinicians. Recommendations include ensuring adequate preparation of students, clinical instructors and registered nurses who work with students in the practice environment. 相似文献3.
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4.
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5.
Tamsin H.T. Thomas Jacqueline G. Bloomfield Christopher J. Gordon Christina Aggar 《Collegian (Royal College of Nursing, Australia)》2018,25(2):201-208
Background
In Australia, there is an increasing demand for registered nurses in primary health care. Registered nurses graduating from university typically enter the workforce via supported transition to professional practice programs in acute-care hospital settings. A prospective strategy to create a sustainable primary health care workforce is to develop comparable transition programs in primary health care settings, such as general practice. We developed, implemented, and evaluated Australia’s first transition to professional practice in primary care program.Aim
To explore the experiences and perceptions of graduate registered nurses and practice nurses participating in a novel transition to professional practice in primary care program.Methods
Thematic analysis of semi-structured interviews with graduate registered nurses (n = 4) and their preceptors (practice nurses, n = 5) on completion of the program.Findings
Three themes emerged from the graduate registered nurse interviews: opportunities for education and clinical development, job satisfaction, and career progression opportunities. Graduate registered nurses were satisfied with the available learning opportunities, indicated a career in primary health care could be potentially rewarding, and anticipated moderate career progression opportunities within general practice. Preceptor themes included program positivity and early career opportunities. The preceptors were positive about the program and believed it supported the graduate registered nurses to become confident and competent. However, both the graduate registered nurses and preceptors perceived an acute-care hospital transition to professional practice program was necessary to gain adequate nursing skills, even if they intended to have a future career in primary health care. Furthermore, they appeared to believe that a career in general practice is more appropriate for “older nurses”.Discussion
These beliefs may be a barrier for transition to professional practice in primary care programs to develop and support a sustainable primary health care workforce.Conclusions
Improved primary health care transition programs, policy, and educational strategies are required. 相似文献6.
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7.
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
Background
Simulation is potentially a means of increasing clinical education capacity. Significant investments have been made in simulation but the extent to which this has improved uptake, quality and diversity of simulation use is unclear.Aim
To describe the current use of simulation in tertiary nursing education programs leading to nurse registration Australia and New Zealand, and determine whether investments in simulation have improved uptake, quality and diversity of simulation experiences.Methods
A cross sectional electronic survey distributed to lead nursing academics in programs leading to nurse registration in Australia and New Zealand.Findings
51.6% of institutions responded and reported wide variation in allocation of program hours to clinical and simulation learning. Simulation was embedded in curricula and positively valued as an adjunct or substitute for clinical placement. While simulation environments were adequate, staff time, training and resource development were barriers to increasing the quality, amount and range of simulation experiences. Quality assurance and robust evaluation were weak.Discussion
Simulation program hours are inconsistently reported and underutilized in terms of potential contribution to clinical learning. Benefits of capital investment in simulation physical resources have been realised, but barriers persist for increasing high quality simulation in nursing programs.Conclusion
Transitioning components of clinical education from the clinical to tertiary sectors has resource implications. Establishment of sustainable, high quality simulation experiences requires staff training, shared resources, best practice and robust evaluation of simulation experiences in nursing curricula. 相似文献8.
9.
Linden Johnson Karen-Leigh Edward Jo-Ann Giandinoto 《Collegian (Royal College of Nursing, Australia)》2018,25(3):355-361
Background
Care planning is an essential part of nursing practice. Formulating nursing care plans within the framework of standardised nursing language warrants further examination.Aim
The aim of this systematic review was examine the available literature related to nursing documentation and care plans, in relation to the impacts of using standardised nursing language.Methods
The electronic databases of Medline and Cumulative Index to Nursing and Allied Health Literature were searched using predetermined search strategy. A narrative synthesis was undertaken.Findings
Of the 198 articles identified 21 articles were included in the review.Discussion
The examination of the available evidence suggests that a global and Australian difference in use of standardised nursing language in nursing care planning and documentation, including research related to nursing documentation exists.Conclusion
There are major benefits for systematically integrating nursing classification systems and standardised nursing language. Standardised nursing language is essential for the successful integration of nursing documentation into contemporary healthcare where electronic health care records will be the norm. 相似文献10.
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11.
12.
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13.
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14.
15.
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16.
17.
Lynda J. Hughes Amy N.B. Johnston Marion L. Mitchell 《Collegian (Royal College of Nursing, Australia)》2018,25(5):541-547
Background
Bachelor of Nursing programmes are designed to prepare nurses to be capable of providing safe and competent, individualised patient care. While research literature is rich with information exploring clinical competence and assessment in nursing programmes, there is a paucity of information on nursing students’ performances in clinical assessment when their capacity to provide quality care is less evident.Aim
Herein, we describe university employed assessors’ perceptions of the human influences that impact their experiences of grading students’ performances in clinical practice and other assessments within clinical courses when that performance is marginal; not a clear pass or fail.Methods
Two focus groups and 14 semi-structured one-on-one interviews were conducted with assessors at a multi-campus Australian university.Findings
Our findings indicated that assessors experience a range of challenges when grading student performances in clinical assessments when that performance is not a clear pass or fail. Thematic analysis identified ‘human influences’ significantly impact assessor experiences.Discussion
The findings provide an understanding around the human influences of assessors’ experiences. Theses influences include: the role of the assessor as gatekeeper, the impact of significant conversations; and assessor supports. Providing appropriate support through meaningful education appears to be the most needed and feasible intervention for this group of assessors. Thus, by understanding assessors’ perceptions of the impact that human influences have on their experiences, supportive measures may be able to be developed to ensure assessors can enact the role of gatekeeper appropriately.Conclusion
This study has contributed insights into assessors’ experiences in grading marginal student performance in clinical courses in an Australian context. Gaining insight into assessors’ individual experiences, enables planning and implementation of supportive measures, including clearly articulated guidelines, for assessors and potentially students. 相似文献18.
Cheryl Ross Cath Rogers Christine King 《Collegian (Royal College of Nursing, Australia)》2019,26(1):1-7
Background
Nursing workload remains an issue in current health care contexts. The use of quantitative methodologies, methods and tools to measure workload has not produced adequate data to inform workforce policy to resolve workforce concerns about workload.Objective
This study aimed to identify the influence of both culture and climate as factors in nursing workload.Methods
This research used an overall critical ethnographic methodology to investigate the real lifeworkload issues of nurses. Methods included fieldwork observations and informal discussions over a 3 year period and 11 in-depth interviews.Results
The study identifies the impact of safety mandates on nursing workload as an invisible phenomenon within current workload methodologies. Such mandates add to nursing roles and routines, and become a ‘taken-for-granted’ activity that is not always directly related to patient care, nor is a visible factor in workload measurement.Conclusion
Given that workload measurements are formulated on direct patient care activities, indirect and unrecognised activities may create additional nursing workload. 相似文献19.
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20.
The challenges in caring for morbidly obese patients in Intensive Care: A focused ethnographic study