Description:
Background: Family-witnessed resuscitation remains controversial among clinicians from implementation to practice and there are a number of countries, such as Iran, where that is considered a low priority. Objective: To explore the lived experience of resuscitation team members with the presence of the patient's family during resuscitation. Settings: The emergency departments and critical care units of 6 tertiary hospitals in Tabriz, Iran. Participants: There were potentially 380 nurses and physicians working in the emergency departments and acute care settings of 6 tertiary hospitals in Tabriz. A purposive sample of these nurses and physicians was used to recruit participants who had at least 2 years of experience, had experienced an actual family witnessed resuscitation event, and wanted to participate. The sample size was determined according to data saturation. Data collection ended when the data were considered rich and varied enough to illuminate the phenomenon, and no new themes emerged following the interview of 12 nurses and 8 physicians. Methods: Semi-structured, face-to-face interviews were held with the participants over a period of 6 months (April 2015 to September 2015), and Van Manen's method of data analysis was adopted. Results: Three main themes emerged from the data analysis, including 'Futile resuscitation', 'Family support liaison', and 'Influence on team's performance'. A further 9 sub-themes emerged under the 3 main themes, which included 'futile resuscitation in end-stage cancer patients', 'when a patient dies', 'young patients', 'care of the elderly', 'accountable person', 'family supporter', 'no influence', 'positive influence', and 'negative influence'. Conclusions: Participants noted both positive and negative experiences of having family members present during cardiopulmonary resuscitation. Welltrained and expert resuscitation team members are less likely to be stressed in the presence of family. A family support liaison would act to decrease family anxiety levels and to de-escalate any potentially aggressive person during the resuscitation. It is recommended that an experienced health care professional be designated to be responsible for explaining the process of resuscitation to the patient's family.
Description:
Bacicgrottral: Family-witnessed resuscitation remains controversial among clinicians from implementation to practice and there are a number of countries, such as Iran, where that is considered a low priority. Objective: To explore the lived experience of resuscitation team members with the presence of the patient's family during resuscitation. Settings: The emergency departments and critical care units of 6 tertiary hospitals in Tabriz, Iran. Participants: There were potentially 380 nurses and physicians working in the emergency departments and acute care settings of 6 tertiary hospitals in Tabriz. A purposive sample of these nurses and physicians was used to recruit participants who had at least 2 years of experience, had experienced an actual family witnessed resuscitation event, and wanted to participate. The sample size was determined according to data saturation. Data collection ended when the data were considered rich and varied enough to illuminate the phenomenon, and no new themes emerged following the interview of 12 nurses and 8 physicians. Methods: Semi-structured, face-to-face interviews were held with the participants over a period of 6 months (April 2015 to September 2015), and Van Manen's method of data analysis was adopted. Results: Three main themes emerged from the data analysis, including 'Futile resuscitation', 'Family support liaison', and 'Influence on team's performance'. A further 9 sub-themes emerged under the 3 main themes, which included 'futile resuscitation in end-stage cancer patients', 'when a patient dies', 'young patients', 'care of the elderly', 'accountable person', 'family supporter', 'no influence', 'positive influence', and 'negative influence'. Conclusions: Participants noted both positive and negative experiences of having family members present during cardiopulmonary resuscitation. Welltrained and expert resuscitation team members are less likely to be stressed in the presence of family. A family support liaison would act to decrease family anxiety levels and to de-escalate any potentially aggressive person during the resuscitation. It is recommended that an experienced health care professional be designated to be responsible for explaining the process of resuscitation to the patient's family.
Description:
Background: While Australia has high breastfeeding initiation, there is a sharp decline in the first weeks postpartum and this continues throughout the first year. Supporting breastfeeding In Local Communities (SILC) was a three-arm cluster randomised controlled trial to determine whether early home-based breastfeeding support by a maternal and child health nurse (SILC-MCHN), with or without access to a community-based breastfeeding drop-in centre, increased the proportion of infants receiving any breast milk at three, four and six months. The trial was conducted in ten Local Government Areas (LGAs) in Victoria, Australia. The primary aim of this paper is to describe the three drop-in centres established during the trial; and the profile of women who accessed them. The secondary aim is to explore the views and experiences of the drop-in centre staff, and the challenges faced in establishing and maintaining a breastfeeding drop-in centre in the community. Methods: Evaluation of the three LGAs with drop-in centres was multifaceted and included observational visits and field notes; data collected from attendance log books from each drop-in centre; a written survey and focus groups with maternal and child health (MCH) nurses who ran the drop-in centres; and semi-structured interviews with MCH coordinators of the participating LGAs. Results: The three LGAs developed and ran different models of breastfeeding drop-in centres. They reported challenges in finding convenient, accessible locations. Overall, attendance was lower than expected, with an average of only one attendee per session. Two global themes were identified regarding staff views: implementation challenges, encompassing finding accessible, available space, recruiting volunteers to provide peer support, and frustration when women did not attend; and the work of SILC-MCHNs, including themes of satisfying and rewarding work, juggling roles, and benefits to women, babies and the community. Conclusion: Providing community-based breastfeeding support was satisfying for the drop-in centre staff but proved difficult to implement, reflected by the lower than anticipated attendances at all of the drop-in centres. Interventions to increase breastfeeding in complex community settings require sufficient time to build partnerships with the existing services and the target population; to understand when and how to offer interventions for optimum benefit. Trial registration: Australian New Zealand Clinical Trials Registry ACTRN12611000898954.
Description:
Background: While Australia has high breastfeeding initiation, there is a sharp decline in the first weeks postpartum and this continues throughout the first year. Supporting breastfeeding In Local Communities (SILC) was a three-arm cluster randomised controlled trial to determine whether early home-based breastfeeding support by a maternal and child health nurse (SILC-MCHN), with or without access to a community-based breastfeeding drop-in centre, increased the proportion of infants receiving any breast milk at three, four and six months. The trial was conducted in ten Local Government Areas (LGAs) in Victoria, Australia. The primary aim of this paper is to describe the three drop-in centres established during the trial; and the profile of women who accessed them. The secondary aim is to explore the views and experiences of the drop-in centre staff, and the challenges faced in establishing and maintaining a breastfeeding drop-in centre in the community. Methods: Evaluation of the three LGAs with drop-in centres was multifaceted and included observational visits and field notes; data collected from attendance log books from each drop-in centre; a written survey and focus groups with maternal and child health (MCH) nurses who ran the drop-in centres; and semi-structured interviews with MCH coordinators of the participating LGAs. Results: The three LGAs developed and ran different models of breastfeeding drop-in centres. They reported challenges in finding convenient, accessible locations. Overall, attendance was lower than expected, with an average of only one attendee per session. Two global themes were identified regarding staff views: implementation challenges, encompassing finding accessible, available space, recruiting volunteers to provide peer support, and frustration when women did not attend; and the work of SILC-MCHNs, including themes of satisfying and rewarding work, juggling roles, and benefits to women, babies and the community. Conclusion: Providing community-based breastfeeding support was satisfying for the drop-in centre staff but proved difficult to implement, reflected by the lower than anticipated attendances at all of the drop-in centres. Interventions to increase breastfeeding in complex community settings require sufficient time to build partnerships with the existing services and the target population; to understand when and how to offer interventions for optimum benefit. Trial registration: Australian New Zealand Clinical Trials Registry ACTRN12611000898954.
Description:
Purpose: To date, the Nursing Community Apgar Questionnaire (NCAQ) has been effectively utilized to quantify resources and capabilities of a rural Idaho communities to recruit and retain nurses. As such, the NCAQ was used in a rural Australian context to examine its efficacy as an evidence-based tool to better inform nursing recruitment and retention. Sample: The sample included nursing administrators, senior nurses and other nurses from six health facilities who were familiar with the community and knowledgeable with health facility recruitment and retention history. Participants were registered nurses and/or directly involved in nursing recruitment. Method: The 50 factor NCAQ was administered online. Data were cleaned, checked, and analyzed by assigning quantitative values to the four-point scale of community advantages or challenges for each factor and then weighted according to the participant's perceived importance to create a community asset and capability measure. Higher scores represented more developed community assets and capabilities relating to nursing recruitment and retention. Findings: The findings demonstrate that lifestyle, emphasis on patient safety and high quality care, availability of necessary materials and equipment, perception of quality were among the highest scoring factors and considered to have the most impact on recruiting and retaining nurses. The lowest factors impacting recruitment and retention included spousal satisfaction, access to larger communities, and opportunities for social networking within communities. Conclusions: The implementation of the NCAQ has the capacity to offer health facilities and managers to examine what is appealing about the health service and community, while highlighting key challenges impacting recruitment and retention. The NCAQ assists health services to develop strategic plans tailored specifically to enhance recruitment and retention of nursing staff. Its use has the capacity to provide health services with greater evidence as they seek to address site specific or regional recruitment and retention issues. Keywords: Rural, nursing, Workforce, Recruitment, Retention, Community apgar
Description:
Purpose: To date, the Nursing Community Apgar Questionnaire (NCAQ) has been effectively utilized to quantify resources and capabilities of a rural Idaho communities to recruit and retain nurses. As such, the NCAQ was used in a rural Australian context to examine its efficacy as an evidence-based tool to better inform nursing recruitment and retention. Sample: The sample included nursing administrators, senior nurses and other nurses from six health facilities who were familiar with the community and knowledgeable with health facility recruitment and retention history. Participants were registered nurses and/or directly involved in nursing recruitment. Method: The 50 factor NCAQ was administered online. Data were cleaned, checked, and analyzed by assigning quantitative values to the four-point scale of community advantages or challenges for each factor and then weighted according to the participant's perceived importance to create a community asset and capability measure. Higher scores represented more developed community assets and capabilities relating to nursing recruitment and retention. Findings: The findings demonstrate that lifestyle, emphasis on patient safety and high quality care, availability of necessary materials and equipment, perception of quality were among the highest scoring factors and considered to have the most impact on recruiting and retaining nurses. The lowest factors impacting recruitment and retention included spousal satisfaction, access to larger communities, and opportunities for social networking within communities. Conclusions: The implementation of the NCAQ has the capacity to offer health facilities and managers to examine what is appealing about the health service and community, while highlighting key challenges impacting recruitment and retention. The NCAQ assists health services to develop strategic plans tailored specifically to enhance recruitment and retention of nursing staff. Its use has the capacity to provide health services with greater evidence as they seek to address site specific or regional recruitment and retention issues. Keywords: Rural, nursing, Workforce, Recruitment, Retention, Community apgar
Description:
Simulation modalities are numerous in nursing education, with a need to reveal their range and impact. We reviewed current evidence for effectiveness of medium to high fidelity simulation as an education mode in pre-licensure/pre-registration nurse education. A state-of-the-art review and meta-analyses was conducted based on a systematic search of publications in English between 2010 and 2015. Of 72 included studies, 43 were quantitative primary studies (mainly quasi-experimental designs), 13 were qualitative studies and 16 were reviews of literature. Forty of 43 primary studies reported benefits to student learning, and student satisfaction was high. Simulation programs provided multi-modal ways of learning. A meta-analysis (8 studies, n = 652 participants) identified that simulation programs significantly improved clinical knowledge from baseline. The weighted mean increase was 5.0 points (CI: 3.25–6.82) on a knowledge measure. Other objectively rated measures (eg, trained observers with checklists) were few. Reported subjective measures such as confidence and satisfaction when used alone have a strong potential for results bias. Studies presented valid empirical evidence, but larger studies are required. Simulation programs in pre-licensure nursing curricula demonstrate innovation and excellence. The programs should be shared across the discipline to facilitate development of multimodal learning for both pre-licensure and postgraduate nurses.
Description:
Simulation modalities are numerous in nursing education, with a need to reveal their range and impact. We reviewed current evidence for effectiveness of medium to high fidelity simulation as an education mode in pre-licensure/pre-registration nurse education. A state-of-the-art review and meta-analyses was conducted based on a systematic search of publications in English between 2010 and 2015. Of 72 included studies, 43 were quantitative primary studies (mainly quasi-experimental designs), 13 were qualitative studies and 16 were reviews of literature. Forty of 43 primary studies reported benefits to student learning, and student satisfaction was high. Simulation programs provided multi-modal ways of learning. A meta-analysis (8 studies, n = 652 participants) identified that simulation programs significantly improved clinical knowledge from baseline. The weighted mean increase was 5.0 points (CI: 3.25–6.82) on a knowledge measure. Other objectively rated measures (eg, trained observers with checklists) were few. Reported subjective measures such as confidence and satisfaction when used alone have a strong potential for results bias. Studies presented valid empirical evidence, but larger studies are required. Simulation programs in pre-licensure nursing curricula demonstrate innovation and excellence. The programs should be shared across the discipline to facilitate development of multimodal learning for both pre-licensure and postgraduate nurses.
Barriers and enablers to the delivery of psychological care in the management of patients with type 2 diabetes mellitus in China : a qualitative study using the theoretical domains framework