The impact of a Web-based educational program on the recognition and management of deteriorating patients
- Authors: Liaw, Sok , Chng, Devon , Wong, Lai , Ho, Jasmine , Mordiffi, Siti , Cooper, Simon J. , Chua, Wei , Ang, Emily
- Date: 2017
- Type: Text , Journal article
- Relation: Journal of Clinical Nursing Vol. 26, no. 23-24 (2017), p. 4848-4856
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- Description: Aims and objectives: To evaluate the effectiveness of a Web-based educational program to enhance enrolled nurses’ knowledge and skills in the recognition and management of deteriorating patients. Background: Ward nurses of different skill levels play a pivotal role in detecting and responding to deteriorating patients. A skill mix of registered nurses, enrolled nurses, licensed practical nurses or healthcare assistants is often employed for the provision of nursing care in acute settings. Non-registered nurses frequently perform bedside care and are in the best position to detect deteriorating patients and initiate immediate actions, including commanding the attention of registered nurses. Education is needed to improve the knowledge and skills of these nurses. Design: A randomised controlled trial with a pretest–post-test design. Methods: The sample included enrolled nurses from an acute care tertiary hospital. Following a baseline evaluation, the experimental group received a Web-based educational intervention. Pre–post assessment of skills and knowledge was performed with a simulated scenario and a knowledge questionnaire. Sixty-four nurses completed the entire study. Results: Following the intervention, participants from the experimental group were significantly more likely than those in the control group to monitor the patient's respiratory and pulse rates. In addition, they had significantly higher post-test mean scores for knowledge and skills in assessing and managing clinical deterioration and reporting deterioration. Conclusion: The Web-based educational intervention significantly improved enrolled nurses’ knowledge and skills in the recognition and management of a deteriorating patient in a simulated setting. Relevance to clinical practice: Ease of access to the Web-based platform contributed to the feasibility and acceptability of this study, which has the potential to positively impact patient safety. © 2017 John Wiley & Sons Ltd
The impact of walk-in centres and GP co-operatives on emergency department presentations : A systematic review of the literature
- Authors: Crawford, Jessica , Cooper, Simon J. , Cant, Robyn , DeSouza, Ruth
- Date: 2017
- Type: Text , Journal article , Review
- Relation: International Emergency Nursing Vol. 34, no. (2017), p. 36-42
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- Description: Background Internationally, non-urgent presentations are increasing the pressure on Emergency Department (ED) staff and resources. This systematic review aims to identify the impact of alternative emergency care pathways on ED presentations – specifically GP cooperatives and walk-in clinics. Methods Based on a structured PICO enquiry with either walk-in clinic or GP cooperative as the intervention, a search was made for peer-reviewed publications in English, between 2000 and 2014. Medline plus, OVID, PubMed, and Google Scholar were searched. The Critical Appraisal Skills Program (CASP) guidelines were used to assess study quality and data was extracted using an adapted JBI Qualitative Assessment and Review Instrument (QARI). Subsequent reporting followed the PRISMA guideline. Results Eleven high quality quantitative studies met the inclusion criteria. Walk-in clinics do have the potential to reduce non-urgent emergency department presentations, however evidence of this effect is low. GP cooperatives offer an alternative care stream for patients presenting to the ED and do significantly reduce local ED attendances. Community members need to be made aware of these options in order to make informed treatment choices. Conclusion GP cooperatives in particular do have the potential to reduce ED workload. Further research is required to uncover recent trends and patient outcomes for walk-in clinics and GP cooperatives. © 2017 Elsevier Ltd
The need to know : the information needs of parents of infants with an intellectual disability-a qualitative study
- Authors: Douglas, Tracy , Redley, Bernice , Ottmann, Goetz
- Date: 2017
- Type: Text , Journal article
- Relation: Journal of Advanced Nursing Vol. 73, no. 11 (Nov 2017), p. 2600-2608
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- Description: Aim: The aim of this study was to explore the information needs of parents of infants with an intellectual disability in the first year of life. Background: Parents whose infant has an intellectual disability need access to information if they are to facilitate optimal care for their child. A lack of timely, accurate information provision by health professionals, particularly nurses and midwives, can increase parental stress and hinder access to the supports they and their infant require. Design: A qualitative descriptive methodology was used for the study. Methods: Qualitative interviews were undertaken with parents of 11 children with intellectual disabilities in Victoria, Australia in 2014. Data were analysed using descriptive thematic analysis. Findings: Parents experienced challenges accessing quality information during the first year of their child's life. Parents required incremental information provision to build a strong knowledge base to facilitate optimal care for their infants. Three types of knowledge were identified as crucial for parents: knowledge about (1) the infant's condition; (2) the infant's specific needs and (3) available supports and services. Health professionals were the key resource to access this information. Conclusion: Health professionals’ responsibilities include providing relevant, timely information to parents of infants with intellectual disabilities. This study conceptualises three types of information parents need to develop a strong knowledge base to guide their infant's care and provides guidance concerning the optimal timing for the delivery of information. © 2017 John Wiley & Sons Ltd
The nursing community apgar questionnaire in rural Australia : an evidence based approach to recruiting and retaining nurses
- Authors: Prengaman, Molly , Terry, Daniel , Schmitz, David , Baker, Ed
- Date: 2017
- Type: Text , Journal article
- Relation: Online Journal of Rural Nursing & Health Care Vol. 17, no. 2 (2017), p. 148
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- 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
The value of simulation-based learning in pre-licensure nurse education : A state-of-the-art review and meta-analysis
- Authors: Cant, Robyn , Cooper, Simon J.
- Date: 2017
- Type: Text , Journal article , Review
- Relation: Nurse Education in Practice Vol. 27, no. (2017), p. 45-62
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- 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. © 2017 Elsevier Ltd
Understanding the bereavement care roles of nurses within acute care : A systematic review
- Authors: Raymond, Anita , Lee, Susan , Bloomer, Melissa
- Date: 2017
- Type: Text , Journal article , Review
- Relation: Journal of Clinical Nursing Vol. 26, no. 13-14 (2017), p. 1787-1800
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- Description: Aims and objectives: To investigate nurses’ roles and responsibilities in providing bereavement care during the care of dying patients within acute care hospitals. Background: Bereavement within acute care hospitals is often sudden, unexpected and managed by nurses who may have limited access to experts. Nurses’ roles and experience in the provision of bereavement care can have a significant influence on the subsequent bereavement process for families. Identifying the roles and responsibilities, nurses have in bereavement care will enhance bereavement supports within acute care environments. Design: Mixed-methods systematic review. Methods: The review was conducted using the databases Cumulative Index Nursing and Allied Health Literature Plus, Embase, Ovid MEDLINE, PsychINFO, CareSearch and Google Scholar. Included studies published between 2006–2015, identified nurse participants, and the studies were conducted in acute care hospitals. Seven studies met the inclusion criteria, and the research results were extracted and subjected to thematic synthesis. Results: Nurses’ role in bereavement care included patient-centred care, family-centred care, advocacy and professional development. Concerns about bereavement roles included competing clinical workload demands, limitations of physical environments in acute care hospitals and the need for further education in bereavement care. Conclusions: Further research is needed to enable more detailed clarification of the roles nurse undertake in bereavement care in acute care hospitals. There is also a need to evaluate the effectiveness of these nursing roles and how these provisions impact on the bereavement process of patients and families. Relevance to clinical practice: The care provided by acute care nurses to patients and families during end-of-life care is crucial to bereavement. The bereavement roles nurses undertake are not well understood with limited evidence of how these roles are measured. Further education in bereavement care is needed for acute care nurses. © 2016 John Wiley & Sons Ltd
Use of simulation-based learning in undergraduate nurse education : An umbrella systematic review
- Authors: Cant, Robyn , Cooper, Simon J.
- Date: 2017
- Type: Text , Journal article , Review
- Relation: Nurse Education Today Vol. 49, no. (2017), p. 63-71
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- Description: Objective To conduct a systematic review to appraise and review evidence on the impact of simulation-based education for undergraduate/pre-licensure nursing students, using existing reviews of literature. Design An umbrella review (review of reviews). Data Sources Cumulative Index of Nursing and Allied Health Literature (CINAHLPlus), PubMed, and Google Scholar. Study Selection Reviews of literature conducted between 2010 and 2015 regarding simulation-based education for pre-licensure nursing students. Data Extraction The Joanna Briggs Institute methodology for conduct of an umbrella review was used to inform the review process. Results of Data Synthesis Twenty-five systematic reviews of literature were included, of which 14 were recent (2013–2015). Most described the level of evidence of component studies as a mix of experimental and quasi-experimental designs. The reviews measured around 14 different main outcome variables, thus limiting the number of primary studies that each individual review could pool to appraise. Many reviews agreed on the key learning outcome of knowledge acquisition, although no overall quantitative effect was derived. Three of four high-quality reviews found that simulation supported psychomotor development; a fourth found too few high quality studies to make a statistical comparison. Simulation statistically improved self-efficacy in pretest-posttest studies, and in experimental designs self-efficacy was superior to that of other teaching methods; lower level research designs limiting further comparison. The reviews commonly reported strong student satisfaction with simulation education and some reported improved confidence and/or critical thinking. Conclusion This umbrella review took a global view of 25 reviews of simulation research in nursing education, comprising over 700 primary studies. To discern overall outcomes across reviews, statistical comparison of quantitative results (effect size) must be the key comparator. Simulation-based education contributes to students’ learning in a number of ways when integrated into pre-licensure nursing curricula. Overall, use of a constellation of instruments and a lack of high quality study designs mean that there are still some gaps in evidence of effects that need to be addressed. © 2016 Elsevier Ltd
Viewing nurse practitioners' perceptions of patient care through the lens of enablement
- Authors: Frost, Jane , Currie, Marian , Cruickshank, Mary , Northam, Holly
- Date: 2017
- Type: Text , Journal article
- Relation: Journal for Nurse Practitioners Vol. 13, no. 8 (2017), p. 570-576
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- Description: Research conducted in primary health care (PHC) shows the value of patient enablement. Although nurse practitioners (NPs) are increasingly playing a role in PHC, limited research exploring their contribution to enabling patients exists. This article describes a qualitative descriptive study in which enablement was used to explore PHC NPs' perceptions of the care they provide to patients. Analysis of the focus group data identified 3 primary themes: patient centeredness and bespoke care; reciprocity, trust, and acceptance; and knowledge transference. Relating these themes to the constructs of the Patient Enablement Instrument demonstrated a clear link between NP care and patient enablement. © 2017 Elsevier Inc.
A new scale for disaster nursing core competencies : Development and psychometric testing
- Authors: Al Thobaity, Abdulellah , Williams, Brett , Plummer, Virginia
- Date: 2016
- Type: Text , Journal article
- Relation: Australasian Emergency Nursing Journal Vol. 19, no. 1 (2016), p. 11-19
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- Description: Background: All nurses must have core competencies in preparing for, responding to and recovering from a disaster. In the Kingdom of Saudi Arabia (KSA), as in many other countries, disaster nursing core competencies are not fully understood and lack reliable, validated tools. Thus, it is imperative to develop a scale for exploring disaster nursing core competencies, roles and barriers in the KSA. Objectives: This study's objective is to develop a valid, reliable scale that identifies and explores core competencies of disaster nursing, nurses' roles in disaster management and barriers to developing disaster nursing in the KSA. Methods: This study developed a new scale testing its validity and reliability. A principal component analysis (PCA) was used to develop and test psychometric properties of the new scale. The PCA used a purposive sample of nurses from emergency departments in two hospitals in the KSA. Participants rated 93 paper-based, self-report questionnaire items from 1 to 10 on a Likert scale. PCA using Varimax rotation was conducted to explore factors emerging from responses. Findings: The study's participants were 132 nurses (66% response rate). PCA of the 93 questionnaire items revealed 49 redundant items (which were deleted) and 3 factors with eigenvalues of >1. The remaining 44 items accounted for 77.3% of the total variance. The overall Cronbach's alpha was 0.96 for all factors: 0.98 for Factor 1, 0.92 for Factor 2 and 0.86 for Factor 3. Conclusions: This study provided a validated, reliable scale for exploring nurses' core competencies, nurses' roles and barriers to developing disaster nursing in the KSA. The new scale has many implications, such as for improving education, planning and curricula. © 2015.
A registered nurse in 20 weeks?
- Authors: Miller, Elizabeth , Cooper, Simon J.
- Date: 2016
- Type: Text , Journal article
- Relation: Australian Nursing and Midwifery Journal Vol. 24, no. 1 (2016), p. 34
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- Description: This paper raises concerns and issues related to the adequacy of nursing students' clinical placement hours.
A systematic review and meta-analysis of factors that relate to aggression perpetrated against nurses by patients/relatives or staff
- Authors: Edward, Karen-Leigh , Stephenson, John , Ousey, Karen , Lui, Steve , Warelow, Philip , Giandinoto, Jo-Anne
- Date: 2016
- Type: Text , Journal article
- Relation: Journal of Clinical Nursing Vol. 25, no. 3-4 (2016), p. 289-299
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- Description: Aims and objectives: The aim of this meta-analysis was to identify the factors that related to aggression (verbal abuse or physical abuse/assault) perpetrated against the nurse or other health professionals by patients/relatives or staff. In the light of the paucity of systematic reviews on this common issue in nursing, the objective was to present a comprehensive systematic review and meta-analysis of these papers. Background: Aggression towards nurses is common around the world and can be the impetus for nurses leaving the profession or developing anxiety when working in particular settings. Design: Systematic review with meta-analysis. Methods: Meta-analyses were conducted to assess the effect of the factors of gender and context (dichotomised as mental health/psychiatric or nonmental health/psychiatric). The databases of Medline (1966-2015), CINAHL (1982-2015) and PsychInfo (1920-2015). Results: A total of 1571 papers were screened by two reviewers. At the final decision 14 were selected for analysis. A higher proportion of female nurses than male nurses were reported to be the victims of verbal abuse, with the difference in proportions being statistically significant. A statistically significant higher proportion of male nurses than female nurses were reported to be the victims of physical abuse. There was a significantly higher proportion of mental health nurses reported experiencing physical abuse as compared to nonmental health nurses. Conclusions: The analysis reveal female nurses have greater odds of verbal abuse than male nurses and male nurses have greater odds of physical abuse than female nurses. Overall mental health nurses had three times higher odds of physical assault than other nurses. © 2016 John Wiley & Sons Ltd.
Access to, interest in and attitude toward e-learning for continuous education among Malaysian nurses
- Authors: Chong, Meichan , Francis, Karen , Cooper, Simon J. , Abdullah, Khatijah Lim , Hmwe, Nant , Sohod, Salina
- Date: 2016
- Type: Text , Journal article
- Relation: Nurse Education Today Vol. 36, no. (2016), p. 370-374
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- Description: Background: Continuous nursing education (CNE) courses delivered through e-learning is believed to be an effective mode of learning for nurses. Implementation of e-learning modules requires pre-assessment of infrastructure and learners' characteristics. Understanding the learners' needs and their perspectives would facilitate effective e-learning delivery by addressing the underlying issues and providing necessary support to learners. Objective: The aim of this study was to examine access to computer and Internet facilities, interest in and preferences regarding e-learning, and attitudes toward e-learning among nurses in Peninsular Malaysia. Design: The study utilized a cross-sectional descriptive survey. Setting: Government hospitals and community clinics in four main regions of Peninsular Malaysia. Participants: A total of 300 registered nurses. Method: Data were collected using questionnaires, which consisted of demographic and background items and questions on access to computer and Internet facilities, interest and preferences in e-learning, and attitudes toward e-learning. Descriptive analysis and a chi-squared test were used to identify associations between variables. Results: Most Malaysian nurses had access to a personal or home computer (85.3%, n=256) and computer access at work (85.3%, n=256). The majority had Internet access at home (84%, n=252) and at work (71.8%, n=215); however, average hours of weekly computer use were low. Most nurses (83%, n=249) did not have an e-learning experience but were interested in e-learning activities. Most nurses displayed positive attitudes toward e-learning. Average weekly computer use and interest in e-learning were positively associated with attitudes toward e-learning. Conclusion: Study findings suggest that organizational support is needed to promote accessibility of information and communications technology (ICT) facilities for Malaysian nurses to motivate their involvement in e-learning. © 2015 Elsevier Ltd.
An analysis of nursing students’ decision-making in teams during simulations of acute patient deterioration
- Authors: Bucknall, Tracey , Forbes, Helen , Phillips, Nicole , Hewitt, Nicky , Cooper, Simon J. , Bogossian, Fiona , FIRST2ACT Investigators
- Date: 2016
- Type: Text , Journal article
- Relation: Journal of Advanced Nursing Vol. 72, no. 10 (2016), p. 2482-2494
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- Description: Aim: The aim of this study was to examine the decision-making of nursing students during team based simulations on patient deterioration to determine the sources of information, the types of decisions made and the influences underpinning their decisions. Background: Missed, misinterpreted or mismanaged physiological signs of deterioration in hospitalized patients lead to costly serious adverse events. Not surprisingly, an increased focus on clinical education and graduate nurse work readiness has resulted. Design: A descriptive exploratory design. Methods: Clinical simulation laboratories in three Australian universities were used to run team based simulations with a patient actor. A convenience sample of 97 final-year nursing students completed simulations, with three students forming a team. Four teams from each university were randomly selected for detailed analysis. Cued recall during video review of team based simulation exercises to elicit descriptions of individual and team based decision-making and reflections on performance were audio-recorded post simulation (2012) and transcribed. Results: Students recalled 11 types of decisions, including: information seeking; patient assessment; diagnostic; intervention/treatment; evaluation; escalation; prediction; planning; collaboration; communication and reflective. Patient distress, uncertainty and a lack of knowledge were frequently recalled influences on decisions. Conclusions: Incomplete information, premature diagnosis and a failure to consider alternatives when caring for patients is likely to lead to poor quality decisions. All health professionals have a responsibility in recognizing and responding to clinical deterioration within their scope of practice. A typology of nursing students’ decision-making in teams, in this context, highlights the importance of individual knowledge, leadership and communication. © 2016 John Wiley & Sons Ltd
An Australian mixed methods pilot study exploring students performing patient risk screening
- Authors: Gibson, Simone , Golder, Janet , Cant, Robyn , Davidson, Zoe
- Date: 2016
- Type: Text , Journal article
- Relation: Nursing and Health Sciences Vol. 18, no. 2 (2016), p. 203-209
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- Description: Clinical placement shortages and rising costs have created demand to provide low-resource, high value student learning opportunities. Malnutrition screening provides a vehicle for achieving this. A mixed methods explanatory sequential intervention study investigated time costs, and students' perceptions of preparedness after performing routine patient screening tasks, as well as students' overall views on their feelings of confidence and preparedness when commencing their first clinical placements. Pre-clinical student dietitians commencing initial placements participated (n=58), with 16 of these forming a subgroup who performed malnutrition screening tasks while the others attended usual placement orientation. The time saved when students undertook screening tasks usually assigned to nurses was substantial. Questionnaires revealed that student perceived confidence increased in the screening group when compared with controls. Focus group themes included "anxiety and confidence," "learning in the clinical learning environment," "communication skill development," and "the pre-placement screening experience." Students performing routine patient-screening tasks prior to initial clinical placement has potential cost savings for healthcare organizations and was perceived to be valuable for learning. © 2016 John Wiley & Sons Australia, Ltd.
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
- Authors: Chapman, Anna , Yang, Hui , Thomas, Shane , Searle, Kendall , Browning, Colette
- Date: 2016
- Type: Text , Journal article
- Relation: BMC Health Services Research Vol. 16, no. 1 (2016), p.
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- Description: Background: China has the largest number of type 2 diabetes mellitus (T2DM) cases globally and individuals with T2DM have an increased risk of developing mental health disorders and functional problems. Despite guidelines recommending that psychological care be delivered in conjunction with standard T2DM care; psychological care is not routinely delivered in China. Community Health Centre (CHC) doctors play a key role in the management of patients with T2DM in China. Understanding the behavioural determinants of CHC doctors in the implementation of psychological care recommendations allows for the design of targeted and culturally appropriate interventions. As such, this study aimed to examine barriers and enablers to the delivery of psychological care to patients with T2DM from the perspective of CHC doctors in China. Methods: Two focus groups were conducted with 23 CHC doctors from Shenzhen, China. The discussion guide applied the Theoretical Domains Framework (TDF) that examines current practice and identifies key barriers and enablers perceived to influence practice. Focus groups were conducted with an interpreter, and were digitally recorded and transcribed. Two researchers independently coded transcripts into pre-defined themes using deductive thematic analysis. Results: Barriers and enablers perceived by doctors as being relevant to the delivery of psychological care for patients with T2DM were primarily categorised within eight TDF domains. Key barriers included: CHC doctors' knowledge and skills; time constraints; and absence of financial incentives. Other barriers included: societal perception that treating psychological aspects of health is less important than physical health; lack of opinion leaders; doctors' intentional disregard of psychological care; and doubts regarding the efficacy of psychological care. In contrast, perceived enablers included: Training of CHC doctors in psychological skills; identification of afternoon/evening clinic times when recommendations could be implemented; introduction of financial incentives; and the creation of a professional role (e.g. diabetes educator), that could implement psychological care recommendations to patients with T2DM. © 2016 Chapman et al..
Collaboration between nurses and physicians in an Indonesian Emergency Department
- Authors: Suryanto , Plummer, Virginia , Copnell, Beverley
- Date: 2016
- Type: Text , Journal article
- Relation: Australasian Emergency Nursing Journal Vol. 19, no. 2 (2016), p. 82-89
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- Description: Background: Positive collaboration between nurses and physicians is essential in emergency practice because it has a significant relationship with the quality, safety, accountability, and responsibility of care. The aim of this study was to examine nurses' and physicians' attitudes towards collaboration in the Emergency Department in the Indonesian context. Methods: The study was a comparative study using a modified Jefferson Scale of Attitude towards Physician-Nurse Collaboration. Data were collected from 47 nurses and 24 physicians of one of 25 general hospitals in Malang, Indonesia, by anonymous survey. Results: Emergency nurses had significantly more positive attitudes towards collaboration than emergency physicians (P < 0.001). Emergency nurses had significantly higher scores in three of four domains of the instrument, "physician dominance", "nurse autonomy", and "caring as opposed to curing". The effects of gender, age, and education on nurses' and physicians' attitude towards collaboration were not statistically significant. However, experience in the Emergency Department of the general hospital was significantly related to participants' attitudes towards collaboration (P = 0.023). Conclusions: The findings of this study indicate that attitudes towards collaboration among the two professions should be enhanced. Inter-professional education and promotion of teamwork may be solutions to improve the relationship, not only between nurses and physicians, but also other healthcare providers. © 2016 College of Emergency Nursing Australasia.
Community assets and capabilities to recruit and retain GPs : the community apgar questionnaire in rural Victoria
- Authors: Terry, Daniel , Baker, Ed , Schmitz, David
- Date: 2016
- Type: Text , Journal article
- Relation: Rural and Remote Health Vol. 16, no. 4 (2016), p.
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- Description: Introduction: Rural communities continue to experience significant challenges recruiting and retaining physicians. The Community Apgar Questionnaire (CAQ) was developed in Idaho in the USA to comprehensively assess the characteristics associated with successful recruitment and retention of rural physicians. The CAQ has been utilised and validated across the USA; however, its value in rural Australia has not been examined. The objective of this study was to use the CAQ in rural Australia to examine its utility and develop a greater understanding of the community factors that impact general practitioner (GP) recruitment and retention. Method: The project conducted structured face-to-face interviews with hospital chief executive officers (CEOs) and directors of clinical services (DCSs) from 14 of the 21 (76%) health services that agreed to participate in rural north-eastern Victoria, Australia. The interviews were undertaken to complete the CAQ, which contains 50 questions centred on factors that influence physician recruitment and retention. Once completed, CAQs were scored by assigning quantitative values to a community's strengths and challenges including the level of importance placed on each factor. As such, the most important factors in physician recruitment, whether they are advantages or challenges for that community, were then weighed for their relative importance. Scores were then combined to create a CAQ score. To ensure reliability and validity of the results, three additional CAQs were purposefully administered to key general practices within the region. Results: The 14 rural communities exhibited cumulative CAQ scores ranging from a high of 387 to a low score of 61. This suggests the tool was sensitive enough to differentiate between communities that were high and low performers in terms of physician recruitment. The groups of factors that had the greatest impact on recruitment and retention were ranked highest to lowest and included medical support, hospital/community support, economic, scope of practice and geographic factors. Overall, the highest individual factors to impact recruitment and retention were perception of quality, hospital leadership, nursing workforce and transfer arrangements. Conversely, the lowest factors and challenges to recruitment and retention were family related, specifically spousal satisfaction and access to schools. Conclusions: Hume, in rural Victoria, was the first international site to implement the CAQ to differentially diagnose a community's relative strengths and challenges in recruiting and retaining GPs, while supporting health facilities to prioritise achievable goals to improve long-term retention strategies. It provided each community with a tailored gap analysis, while confidentially sharing best practices of other health facilities. Within Hume, open communication and trust between GPs and health facility leadership and nursing staff ensures that GPs can feel valued and supported. Possible solutions for GP recruitment and retention must consider the social, employment and educational opportunities that are available for spouses and children. Participation in the program was useful as it helped health facilities ascertain how they were performing while highlighting areas for improvement. © James Cook University 2016.
Cultural desire need not improve with cultural knowledge : A cross-sectional study of student nurses
- Authors: Isaacs, Anton , Raymond, Anita , Jacob, Elisabeth , Jones, Janet , McGrail, Matthew , Drysdale, Marlene
- Date: 2016
- Type: Text , Journal article
- Relation: Nurse Education in Practice Vol. 19, no. (2016), p. 91-96
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- Description: Cultural desire is considered to be a prerequisite for developing cultural competence. This study explored cultural desire among student nurses towards Aboriginal peoples and its association with participation in a one-semester unit on Aboriginal health through a cross-sectional survey. Our main outcome, cultural desire, was measured using two items level of agreement with Aboriginal health being an integral component of the nursing curriculum and an expressed interest in Aboriginal health. 220 (74.58%) student nurses completed the survey. Completing the Aboriginal Health and wellbeing unit did not influence students' opinions on inclusion of the unit as part of the nursing curriculum (odds ratio OR 0.73, 95% CI 0.43-1.29) or their overall cultural desire (mean difference = -0.69, 95% CI -1.29 to -0.08, p = 0.026). Students who completed the unit reported a higher understanding of Aboriginal health (OR = 2.35, 95% CI = 1.35-4.08) but lower interest levels in the subject (OR = 0.45, 95% CI: 0.24-0.84). Further research is necessary to explore how and when cultural desire might develop in nurses who are trained in cultural competence particularly in the contexts of post-colonial disparities and political conflict. © 2016 Elsevier Ltd.
Do dummies make good teachers? A paradigm shift for clinical educators
- Authors: Griffin, Kristina , McLeod, Margaret , Francis, Karen , Brown, Ann-Marie
- Date: 2016
- Type: Text , Journal article
- Relation: Collegian Vol. 23, no. 3 (2016), p. 321-326
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- Description: This discussion paper will explore contemporary clinical nursing in Australia and simulation technologies used in universities to educate Bachelor of Nursing (BN) students. Informed by auto-ethnographic principles the authors reflect on their teaching experiences in both clinical and tertiary sectors with specific reference to challenges encountered through the use of simulation technologies. Further, increased reliance on simulation as a teaching tool in nursing education is discussed and techniques for embracing this explored. The authors’ pedagogical goal is to ensure students develop the capacity to competently process patient information, enabling them to safely plan, implement and evaluate interventions and outcomes. © 2015 Australian College of Nursing Ltd
ED-HOME : Improving educator confidence and patient education in the Emergency Department
- Authors: Coombs, Nicole , Porter, Joanne , Beauchamp, Alison
- Date: 2016
- Type: Text , Journal article
- Relation: Australasian Emergency Nursing Journal Vol. 19, no. 3 (2016), p. 133-137
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- Description: Background Barriers to effective patient communication in the emergency department (ED) are well recognised; time, resources and staff and consumer expectations. This project aimed to improve the quality of health education provided in the ED by increasing nurses’ confidence as educators. Method By providing a staff information package including the introduction of a new structured education tool; ED-HOME, and by assessing the confidence and self-efficacy of the nurses in the process, we hoped to determine if an improvement in practice and confidence was achieved. A quantitative, pre and post-test questionnaire comparison study was undertaken before and after a four week implementation period. The project examined the attitudes and practices of registered emergency nurses and was conducted in one metropolitan emergency department. Results Results indicated that nurse confidence and self-efficacy improved by using the new structured ED-HOME format and both staff satisfaction and education competence increased. Participants positively responded to the new tool and recommended future use in the ED. Conclusion This project demonstrates that if emergency nurses feel more confident with their educating practices and by using a structured format, patients will benefit from better quality patient education provided in the ED. © 2016 College of Emergency Nursing Australasia