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1.
Amy J. Spooner Natasha Booth Tai-Rae Downer Louisa Gordon Adrienne P. Hudson Natalie K. Bradford Chris O’Donnell Alanna Geary Robyn Henderson Cherie Franks Aaron Conway Patsy Yates Raymond J. Chan 《Collegian (Royal College of Nursing, Australia)》2019,26(1):103-109
Background
Effective coordination and integration of care between health care providers is critical to manage complex, chronic medical conditions.Aim
Describe the advanced practice profile and activities of nurse navigators who provide a service for patients with chronic health conditions.Design
An observational study was conducted in four health services, in Queensland, Australia.Methods
In part one, nurse navigators completed a survey incorporating the Advanced Practice Role Delineation tool. In part two, nurse navigators completed a work activity diary, capturing the time spent performing daily activities, modes of communication and referral sources.Findings
Twenty-three and 18 nurse navigators participated in the survey and diary, respectively. Participants were experienced nurses, working full-time. Participants reported spending a great extent of time performing direct comprehensive care, support of systems and education in surveys. The diaries captured a mean of 20 working days per participant, a total of 5,748 work activities. including care of 615 patients. The majority of nurse navigator activities were performed within the direct comprehensive care domain. Communication predominantly occurred with patients, families, hospital health professionals either in person, at a healthcare facility or via phone.Discussion
Our research identified three focus areas of nurse navigator activities: direct comprehensive care, support of systems and education. Further work is required to extend the nurse navigators’ unique contribution to research and publication and professional leadership.Conclusions
This study established baseline knowledge regarding advanced practice profiles and work activities of nurse navigators, which can be utilised to improve current processes and future enhancement of the role. 相似文献2.
Philippa Seaton Tracy Levett-Jones Robyn Cant Simon Cooper Michelle A. Kelly Lisa McKenna Linda Ng Fiona Bogossian 《Collegian (Royal College of Nursing, Australia)》2019,26(1):194-203
Background
There is unprecedented increase in use of simulation-based education in healthcare settings. The key driver is improving quality and safety in healthcare. To date, there is limited understanding of the degree to which this goal has been achieved.Aim
This scoping review aimed to explore the extent to which simulation-based education in healthcare has addressed and impacted contemporary patient safety priorities.Methods
Systematic searches of literature (2007–2016) were based on each of 10 patient safety priorities articulated in Australia’s National Safety and Quality Health Service Standards and New Zealand’s Health, Quality and Safety Indicators and markers. Included primary studies evaluated transferability to practice and/or behavioural change and improved patient outcomes, based on Kirkpatrick’s training evaluation model Level 3 and Level 4.Findings
Fifteen papers met inclusion criteria. Studies aligned with four of ten National Safety and Quality Health Service Standards: (3). Preventing and controlling healthcare associated infections; (4). Medication safety; (6). Clinical handover; (9). Recognising and responding to clinical deterioration. The studies were indicative of potential for simulation-based education to have a significant impact on patient safety.Discussion
Studies that qualify as translational science, demonstrating changes in clinician behaviours and improved patient outcomes, are emerging. Little evidence from Australian and New Zealand contexts suggests that outcomes of simulation-based education in this region are not commensurate with the significant government investments.Conclusion
Translational studies, despite being difficult to design and conduct, should form part of a thematic, sustained and cumulative program of simulation-based research to identify translational science. 相似文献3.
Nicholas Ralph Coralie Graham Lisa Beccaria Cath Rogers 《Collegian (Royal College of Nursing, Australia)》2019,26(1):140-145
Background
Entrance requirements for undergraduate nursing programs have been under government scrutiny in recent times. To date, no Australia studies have reported nurse academics’ perspectives of entry requirements for Bachelor of Nursing programs.Study aim
The aim of this study is to examine nursing academics’ perceptions of entry requirements for Australian Bachelor of Nursing Programs.Methods
A total of 223 nurse academics responded to questions in an online national survey on pre-requisite subject areas, minimum tertiary entrance scores, English proficiency, and inherent requirements for clinical practice.Findings
English, Maths and Science were seen as important pre-requisite subject areas for students commencing a Bachelor of Nursing Program. Nurse academics believed that increasing the tertiary entrance score and English proficiency, was necessary to increase entrance standards and that a minimum score be consistently applied across universities. There were mixed views as to the disclosure of inherent requirements by students.Conclusion
Nationally, dialogue needs to occur about how universities can apply a consistent approach to ensure that the necessary foundation skills, knowledge and abilities are in place prior to admission into programs. 相似文献4.
Carole Elledge Ayoade Avworo Josefina Cochetti Clarissa Carvalho Patti Grota 《Collegian (Royal College of Nursing, Australia)》2019,26(1):171-182
Background
Quality healthcare is increasingly measured through the integration of research findings into clinical practice. Individuals recognized as facilitators are essential to bridging the chasm between knowledge generation and translation.Aim
This integrative review synthesizes evidence describing attributes of effective facilitators involved in knowledge translation.Methods
Multiple databases were explored to identify publications issued between January 2000 and July 2016 describing facilitator characteristics. A rigorous methodology, applied by two assessors using quality assessment tools determined inclusion. Eighteen publications were identified.Findings
Facilitator characteristics were extracted and assigned into one of the six domains of the facilitation competency framework: self-awareness, self-management, social awareness, relationship management, skills, and knowledge translation and understanding.Discussion
This review highlighted the lack of research exploring characteristics of successful facilitators. Recognizing that contextual elements within an organization may be “fixed”, facilitator characteristics may be key influencers in the success of knowledge translation into the clinical setting and therefore, merit attention.Conclusion
This integrative review provides an important listing of facilitator attributes attendant with successful knowledge translation in healthcare. Future research should focus on exploring the influence of these unique facilitator characteristics in supporting the uptake of evidence into the clinical setting. 相似文献5.
6.
M. González-Rincón P. Díaz de Herrera-Marchal M.L. Martínez-Martín 《Enfermería intensiva / Sociedad Espa?ola de Enfermería Intensiva y Unidades Coronarias》2019,30(2):78-91
Objective
Analyze the role of the nurse at the end of the life of a critically ill patient.Method
Bibliographic review from a search of the health science databases such as PubMed, CINAHL, Cuiden, Scopus, Cochrane, as well as specialized platforms, general and thematic browsers. The limits were language (English or Spanish) and publication date (2005-2015).Results
180 articles met the inclusion criteria, and 16 of them were selected for analysis. The main results were grouped into three categories of analysis: direct patient care, family-focussed care and the nurse's role within the team.Conclusions
the described roles place the nurse as a key element in humanising death in the ICU and so nurses can and must lead change, playing an active role in creating strategies that really promote the integration of a palliative care approach in ICU. 相似文献7.
8.
Philip Crispin Benjamin Stephens Evelyn McArthur Farah Sethna 《Transfusion and apheresis science》2019,58(1):50-57
Objectives
To determine the optimum approach and timing to screen for iron deficiency in pregnancy.Background
There is a lack of consensus on identifying and treating iron deficiency during pregnancy. Patient blood management programs may be refined by evaluating outcomes.Methods
Retrospective data collection on women delivering prior to and following implementation of patient blood management interventions. Ferritin, transferrin saturation and haemoglobin levels were evaluated in first and second trimesters as predictors of pre-delivery anaemia. The optimum time to screen was determined. Comparison with results following a quality improvement intervention was undertaken. A separate retrospective study was performed to validate the predictive value of ferritin using data extracted from the laboratory information system.Results
Ferritin and transferrin saturation in first trimester detected women who subsequently had anaemia pre-delivery, with ferritin being most discriminatory. Both were superior to haemoglobin concentration. Iron studies in second trimester did not predict pre-delivery anaemia and haemoglobin remained poorly discriminatory. Iron studies lost predictive value when a systematic program ensured treatment of iron depletion during pregnancy. The ability of ferritin to predict pre-delivery anaemia in the first, but not the second, trimester was confirmed on the validation cohort.Conclusion
First trimester serum ferritin may identify candidates for iron therapy during pregnancy. This strategy may be preferable to haemoglobin screening alone or universal replacement in centres at low risk of anaemia. 相似文献9.
10.
Problem
Throughout the world people who are homeless experience high rates of hospitalisation. Nurses who work in hospitals have the potential to improve outcomes for this group. To date, a review of qualitative literature pertaining to hospital-based nursing for people who are homeless has been lacking.Aim
To synthesize findings of contemporary qualitative studies related to hospital-based nursing care for people who are homeless in Organisation for Economic Cooperation and Development (OECD) nations.Design
A systematic database search was conducted in mid-2017 using search terms: homeless*, hospital* and nurs*, combined by the Boolean operator ‘AND’. Inclusion and exclusion criteria that mandated publication year, language, method, quality, participants, and setting were applied. 341 abstracts were screened for relevancy resulting in the final inclusion of 8 qualitative and 2 mixed method studies.Findings
Three overarching themes emerged; (1) Homelessness challenges rigid approaches to hospital-based care (2) Stigma impedes healthcare for people who are homeless (3) Hospitals can provide a platform to address homelessness.Discussion
Delivering flexible, non-stigmatising nursing in a way that empowers people experiencing homelessness challenges hospitals around the globe. Research is needed to explore local approaches and subgroups within the homeless population.Conclusion
Experiences of homelessness vary across nations and between cities necessitating local solutions. Within hospitals, if nurses can provide flexible, non-stigmatising care, they have potential to make a huge difference both the lives of individuals who are homeless and in the wellbeing of society as a whole. 相似文献11.
Rebecca J. Leon Jaimie H. Tredoux Suzanne M. Foster 《Collegian (Royal College of Nursing, Australia)》2019,26(1):158-164
Background
Despite the investment in education and training, a Health Service in Australia continues to experience a shortage of enrolled nurses.Aim
The aim of this study was to understand the investment education and training have on the retention of enrolled nurses in the Health Service.Methods
An explanatory sequential mixed methods design was used. The study was divided into three phases: 1. Separate surveys to enrolled nurses and stakeholders (nursing managers and educators); 2. Focus groups for enrolled nurses and stakeholders; 3. Analysis of recruitment and retention data from the graduating Diploma of Nursing cohorts.Results
Phase 1 and 2 identified that enrolled nurses participated in education and training for self-satisfaction and personal interest. A professional development pathway was identified as something that would retain enrolled nurses. Inconsistent standards and confusion in their scope of practice, together with a lack of respect for the enrolled nurse, contributed to them leaving. Phase 3 identified poor recruitment processes for the graduating Diploma of Nursing cohorts negatively impacted on their retention.Discussion
Retention of enrolled nurses was influenced by inconsistent standards of practice, confusion in their scope of practice, and a lack of career progression. Phase 3 demonstrated that changes made to the recruitment process resulted in improved retention.Conclusion
Limited opportunities for professional development, confusion in their scope of practice and feelings of being undervalued influenced the retention of enrolled nurses. The results also indicated a well-structured recruitment program favourably impacted on retention. 相似文献12.
Introduction
The Ratu's Model is a nursing model to prevent postpartum depression, is a product of Ratu's dissertation. Depression is one of the common psychological problem experienced by postpartum women. The number is estimated to reach 20% in Indonesia, 15–20% in the Riau Province, and must to be pressed to 1%.Objectives
This study aims to identify the effectiveness of Ratu's Model to prevent postpartum depression.Method
Quasi-experiment research alongside with pre–post test analysis of the control group, number of the respondents was undergone among 54 women pregnant and the spouses in each intervention and control group. Educational intervention was given toward intervention group for 3 times, with 3 times monitoring, and 3 times measurement.Result
A significant correlation between Ratu's Model with lowered postpartum depression incidence.Conclusion
The Ratu's Model is effective lowering the incidence of postpartum depression. 相似文献13.
K. Innes-Walker C.N. Parker K.J. Finlayson M. Brooks L. Young N. Morley D. Maresco-Pennisi H.E. Edwards 《Collegian (Royal College of Nursing, Australia)》2019,26(1):62-68
Background
Wound management is frequently performed in the community and forms a large part of daily activities of General Practice health professionals. However, previous research has acknowledged a need for further education and training on evidence based wound management for these health professionals.Aim
The aim of this project was to develop and trial a Cooperative Wound Clinic model of care in General Practices, using a nurse led, interdisciplinary, holistic approach; including training and coaching to increase the wound management expertise and capacity of health professionals working in the primary healthcare environment.Methods
A longitudinal, pre-post design was used. Four Cooperative Wound Clinic pilot sites and nine wound clinics were established in General Practices across three Australian states with the intervention of the study being the model care and incorporating a local wound expert employed to provide the training and coaching. Pre and post survey data were collected on wound management practices, health professional confidence in evidence based wound management, patient health, wellbeing and healing outcomes. Longitudinal patient data were collected for 24 weeks.Findings
Results included an increase in the confidence of health professionals to manage wounds. Utilisation of a repetitive coaching model over a six month period empowered the decision making process and assessment knowledge for a variety of wound types. A positive impact on patient outcomes for a variety of wound types was also observed.Conclusion
The potential for expanding this model will bring many benefits including: empowerment of nurses’ confidence in managing wounds, promoting the role of nurse led clinics; improved wound related capability and confidence of health professionals; improved wound management, patient knowledge and better patient satisfaction and outcomes. 相似文献14.
15.
Michelle Barakat-Johnson Michelle Lai Timothy Wand Kathryn White 《Collegian (Royal College of Nursing, Australia)》2019,26(1):95-102
Background
Hospital-acquired pressure injuries are a quality indicator in healthcare, including nursing care. Successful implementation of interventions to prevent pressure injuries can be impeded by factors beyond the control of nursing staff. Limited research exists on nurses’ experiences of providing pressure injury prevention and management in a hospital setting.Aim
To gain an in-depth understanding of nurses’ experiences concerning pressure injury prevention and management in a hospital setting.Methods
A qualitative study design was employed. The purposive sample consisted of twenty nurses working in units with a high incidence of pressure injuries across a local health district in Sydney, Australia. Participants were interviewed between May and September 2016, either individually or as a group using semi-structured interviews.Findings
Four themes were identified that captured the experiences of nurses providing pressure injury prevention and management in a hospital setting: “managing competing demands in complex clinical settings”; “the importance of knowledge and skill”; “clarifying organisational expectations, purpose and successes”; and “feeling ethically challenged when unable to provide quality patient care”.Discussion
Participants were aware of the importance of pressure injury prevention and management but found it difficult to provide quality care due to competing priorities and challenges faced at both an organisational and patient level.Conclusion
Pressure injury prevention and management is just one aspect of patient care and should not be considered on its own to change existing practice. Participants wanted to implement preventative strategies and provide optimal pressure injury care, however, complexities associated with a hospital setting hindered this process. Hospitals need to put measures in place that support and enable nurses to deliver the quality care required to prevent and manage pressure injuries. 相似文献16.
17.
Karen M. Davies Ian D. Coombes Samantha Keogh Karen M. Whitfield 《Collegian (Royal College of Nursing, Australia)》2019,26(1):118-124
Background
Tools currently available to evaluate nurse medication administration practices have limitations and are either not validated or have poor reliability.Aim
To identify criteria and content for inclusion in a tool to evaluate medication administration by nurses in the clinical setting, using an expert panel.Methods
A peer review process using an expert multidisciplinary panel rated the relevance of the content on three tools; Medication Administration Safety Assessment Tool, Medication with Respect Tool and Clinical Skills Assessment Tool, using a four-point rating scale. Expert opinion was provided on relevance of content, rating scales and frequency of nurse evaluation. The level of agreement was analysed by item content validity index, mean item content validity index, mean expert proportion, scale content validity index with universal agreement, probability of chance agreement and a modified kappa rating. Qualitative themes were also reviewed.Findings
The item and scale content validity index and the kappa index both rated the Medication Administration Safety Assessment Tool and Clinical Skills Assessment Tool as excellent. For the Medication with Respect Tool less than half of the item content validity index ratings rated as good and the kappa index rated as excellent, therefore the scale content validity did not achieve a good rating.Conclusions
The expert panel review identified items of high level of agreement for relevance and determined that content needed to be clear, concise, observable, generic and practical to be useful for all nurses. Self-evaluation, feedback and a developmental plan were also key criteria. 相似文献18.
Objective
The present study aimed to identify e-leader preferences among nurses based on several attributes namely: style, trait, and characteristics.Method
Conjoint analysis via card sort was employed to capture the responses of 174 purposively selected nurses in the Philippines with prior interaction with a virtual nursing leader. Ten (10) orthogonal combination cards grounded from literature reviews were used as study tools. Data was collected online for about two months and was analyzed using SPSS version 21.Results
The study surfaces that transformational leadership (0.237), authentic and artistic leadership (0.167) and physique (0.201) attributes were the most preferred style, trait and characteristics, respectively.Conclusion
The study promotes prior notions that leaders, even at virtual spaces, are being acknowledged as an essential figure in leader-subordinate interaction. 相似文献19.
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20.
Kirsteen Fleming Yan Cheng Jessica Botfield Mariana Sousa Deborah Bateson 《Collegian (Royal College of Nursing, Australia)》2019,26(1):28-32