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Feasibility and acceptability of a volunteer-mediated diversional therapy program for older patients with cognitive impairment

  • Authors: Shee, Anna Wong , Phillips, Bev , Hill, Keith , Dodd, Karen
  • Date: 2014
  • Type: Text , Journal article
  • Relation: Geriatric Nursing Vol. 35, no. 4 (2014), p. 300-305
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  • Description: Understanding the perceptions of stakeholders is critical for determining acceptability and feasibility of volunteer-mediated programs. This study evaluated the feasibility and acceptability for staff, volunteers, patients and their carers, of a volunteer diversional therapy program for patients with cognitive impairment undergoing inpatient rehabilitation. Post-program structured interviews were conducted with the volunteers (n = 10), patients (n = 30) and their carers (n = 3); and nursing staff (n = 6) participated in a focus group. Thematic analysis identified five themes (values, attitudes, knowledge, purpose, support) in two dimensions (personal, team culture). Overall, patients, carers, staff and volunteers were satisfied with the volunteer program and perceived benefits for quality of care. Recommendations for improvements to the program related to staff engagement with the program and the volunteers' education and training. The volunteer diversional therapy pilot program for patients with cognitive impairment on a sub-acute ward was acceptable and feasible for patients, carers, staff and volunteers. (C) 2014 Mosby, Inc. All rights reserved.

Graduate nurse program coordinators’ perceptions of role adaptation experienced by new nursing graduates : A descriptive qualitative approach

  • Authors: Missen, Karen , McKenna, Lisa , Beauchamp, Alison
  • Date: 2014
  • Type: Text , Journal article
  • Relation: Journal of Nursing Education and Practice Vol. 4, no. 12 (2014), p. 134-141
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  • Description: Aims: This research explores the challenges that new nursing graduates experience whilst adapting to their new role in their first year of practice. These challenges are presented from the perspectives of Graduate Nurse Program Coordinators in the state of Victoria, Australia, previously not described in the literature. Background: Each year, thousands of new nursing graduates join the workforce in Australia, with many suffering major stressors and dissatisfaction in their first year of practice. Much has been written about challenges faced by this group from their own perspectives, yet nothing has been heard from the perspectives of those who support them; that is, the coordinators of year-long graduate nurse transition programs. Methods: This descriptive qualitative study used individual, semi-structured interviews to access information and perceptions from sixteen Graduate Nurse Program Coordinators about the challenges experienced by nursing graduates in their first year of practice. Transcripts were thematically analysed to reveal reoccurring themes and sub-themes. Results: The interviews provided an insight into various challenges that nursing graduates experience in relation to role adaptation in their first year of practice. Nursing graduates found difficulties with reality shock, work-life balancing and having unrealistic assumptions in their capacity to work, assuming they should be at a higher level despite being a beginner practitioner. Conclusions: This study reinforces the need for education providers to maintain currency in their undergraduate nursing programs and to work closely with health care services in providing a quality clinical experience to all nursing students. It also provides evidence that graduate transition programs are essential, with Graduate Nurse Program Coordinators performing a crucial role in providing appropriately planned strategies to support graduates through this vulnerable time.

Here they come, ready or not

Historical imagination, narrative learning and nursing practice : Graduate nursing students' reader-responses to a nurse's storytelling from the past

  • Authors: Wood, Pamela
  • Date: 2014
  • Type: Text , Journal article
  • Relation: Nurse Education in Practice Vol. 14, no. 5 (2014), p. 473-478
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  • Description: Storytelling and narrative are widely used in nurse education and the value of narrative-based curricula, such as those governed by narrative pedagogy, is well recognised. Storytelling stimulates students' imagination, a central feature of narrative learning. One form of story and imagination yet to be fully considered by educators is the historical story and historical imagination. The use of historical storytelling creates a temporal dissonance between the story and reader that stimulates readers' imagination and response, and enables them to gain rich insights which can be applied to the present. Reader-response theory can support educators when using narrative and storytelling. This article presents an analysis of graduate nursing students' reader-responses to a nurse's story from the past. This narrative learning group used their historical imagination in responding to the story and prompted and challenged each other in their interpretation and in translating their responses to their current nursing practice. The article discusses this analysis within the context of reader-response theory and its potential application to narrative-based learning in nurse education. Historical stories stimulate historical imagination and offer a different frame of reference for students' development of textual competence and for applying insights to the present. © 2014 Elsevier Ltd.

Management of Maternal and Child Health Services in Victoria Australia : Education or Health Portfolio

  • Authors: Breach, Rayleen , Jones, Linda , Sheeran, Leanne
  • Date: 2014
  • Type: Text , Journal article
  • Relation: International Journal of Nursing Vol. 1, no. 2 (2014), p. 103-114
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  • Description: In Victoria, Maternal and Child Health (MCH) service is currently located within the State Government’s Department of Education and EarlyChildhood Development (DEECD) portfolio. This department is accountable for the planning and provision of early childhood services in partnership with local government. The MCH service has experienced many changes in State Government departmental portfolios over the years.It was therefore considered relevant to explore the knowledge, attitudes and beliefs held by the MCH workforce in regards to the portfolio that they considered should manage the MCH service.A qualitative exploratory descriptive approach was used to explore the Knowledge, attitudes and beliefs of the Victorian MCH nurses regarding the positioning portfolio for the service. The involved interviewing 12 key stakeholders and 36 MCH nurses until data saturation was reached. Presented are the findings that indicated that the majority of the participants believed that the service did not belong well currently in either Victorian Government Education or Health portfolio. The strength of this opinion, however, highlights the need for some collaborative discussion with all concerned parties in order to appropriately position the MCH service in order to achieve optimum outcomes for children in Victoria.

Measuring students perceptions of interprofessional clinical placements: Development of the interprofessional clinical placement learning environment inventory

  • Authors: Anderson, Amanda , Cant, Robyn , Hood, Kerry
  • Date: 2014
  • Type: Text , Journal article
  • Relation: Nurse Education in Practice Vol. 14, no. 5 (2014), p. 518-524
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  • Description: Pre-professional healthcare courses, including nursing, are increasingly focused on interprofessional learning and experimentation with clinical education in ‘training wards’. This involves students from at least two disciplines who, under supervision, are responsible for patients' care. There is no consensus on how students' clinical learning experiences in this context are evaluated. We report the development and testing of the Interprofessional Clinical Placement Learning Environment Inventory (ICPLEI) in the Australian context. A question set was developed to measure student's perceptions of key variables in an interprofessional clinical learning environment: orientation, supervision, roles, learning and autonomy. An expert nursing panel rated items for a Content Validity Index of .93. Reliability was tested with 38 students. After a 2-week interprofessional ward placement nursing, medical and allied health students (n = 38) rated their learning environment highly, with median responses 4 or 5 of five (mean total 83%). The scale was reliable with a Cronbach alpha of .80 and moderate item-to-total correlations for 22/26 items. The Interprofessional Clinical Placement Learning Environment Inventory is a reliable, feasible, fast to complete tool, suitable for use with pre-registration healthcare students in this setting. Further testing of the tool's psychometric properties is recommended.

Perceptions from the front line : Professional identity in mental health nursing

  • Authors: Hercelinskyj, Gylo , Cruickshank, Mary , Brown, Peter , Phillips, Brian
  • Date: 2014
  • Type: Text , Journal article
  • Relation: International Journal of Mental Health Nursing Vol. 23, no. 1 (2014), p. 24-32
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  • Description: In the context of a growing population of people experiencing mental illness worldwide, mental health nurses are a crucial workforce. Their recruitment and retention, however, is in decline. Drawing on qualitative data obtained from interviews with mental health nurses () in ictoria, Australia, the paper employs a range of concepts from role theory to explore professional identity within mental health nursing. The data highlight three key issues in relation to the future recruitment and retention of : (i) the ambiguity of the role; (ii) the weak definition and lack of understanding of the scope of the role by nursing students; and (iii) a lack of communication about as a profession to a wider audience. These findings indicate three avenues through which recruitment and retention in mental health nursing could be improved: (i) public communication; (ii) training and educating of the next generation of ; and (iii) more accurately defining the role of the MHN.

Problematising autonomy and advocacy in nursing

  • Authors: Cole, Clare , Wellard, Sally , Mummery, Jane
  • Date: 2014
  • Type: Text , Journal article
  • Relation: Nursing Ethics Vol. 21, no. 5 (2014), p. 576-582
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  • Description: Customarily patient advocacy is argued to be an essential part of nursing, and this is reinforced in contemporary nursing codes of conduct, as well as codes of ethics and competency standards governing practice. However, the role of the nurse as an advocate is not clearly understood. Autonomy is a key concept in understanding advocacy, but traditional views of individual autonomy can be argued as being outdated and misguided in nursing. Instead, the feminist perspective of relational autonomy is arguably more relevant within the context of advocacy and nurses' work in clinical healthcare settings. This article serves to highlight and problematise some of the assumptions and influences around the perceived role of the nurse as an advocate for patients in contemporary Western healthcare systems by focusing on key assumptions concerning autonomy inherent in the role of the advocate. © The Author(s) 2014.

Reviewing tribunal cases and nurse behaviour : Putting empathy back into nurse education with Bloom's taxonomy

  • Authors: Doyle, Kerrie , Hungerford, Catherine , Cruickshank, Mary
  • Date: 2014
  • Type: Text , Journal article
  • Relation: Nurse Education Today Vol. 34, no. 7 (2014), p. 1069-1073
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  • Description: Recent events in the UK and Australia have shown howpoor patient outcomes are achievedwhen the behaviour of nurses lacks empathy. The UK's Francis Inquiry and the Keogh Report both call for an increase in the ‘caring and compassion’ of health careworkers. A reviewof cases presented to the nurses’ disciplinary tribunal in NewSouth Wales' (Australia) also suggests that the majority of complaints against nurses in this jurisdiction is the result of callousness or lack of empathy. Such events reinforce the need for nurse educators to support nursing students to develop the affective attributes of caring and empathy. This paper considers howto raise the awareness of undergraduate students as a first step to developing empathy by using Bloom's Taxonomy of Educational Objectives; and includes a description of how to facilitate interactions with undergraduate nursing students about caring with empathy. Enculturating empathy is an evidence-based method of increasing compassionate care in health organisations generally.

Satisfaction of newly graduated nurses enrolled in transition-to-practice programmes in their first year of employment: a systematic review

  • Authors: Missen, Karen , McKenna, Lisa , Beauchamp, Alison
  • Date: 2014
  • Type: Text , Journal article
  • Relation: Journal of Advanced Nursing Vol. 70, no. 11 (2014), p. 2419-2433
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  • Description: AIMS: To investigate job satisfaction and confidence levels of graduate nurses during their first year of employment and the impact various training programmes have on these factors. BACKGROUND: The transition from nursing student to practising nurse can be a challenging and stressful time for new nurses. Healthcare organizations provide transition programmes to support nurses through this vulnerable time and to assist in increasing graduates' job satisfaction and retention rates. However, no systematic review of transition programme outcomes has been undertaken to determine the impact of these programmes on improving satisfaction levels and on easing the challenges faced by nursing graduates in their new roles as Registered Nurses. DESIGN: Systematic review of effect using narrative synthesis. DATA SOURCES: Quantitative studies published between 2000-December 2012 were identified using electronic databases and reference lists and by searching 'grey literature'. Primary search terms were 'new graduate nurse' and 'transitional programmes'. REVIEW METHODS: The three authors, guided by standardized procedures, performed independent, blinded data extraction and quality assessment. RESULTS: From 338 studies initially identified, eleven studies were included in this review. These studies used a variety of study designs including quasi-experimental and pre- and posttesting. CONCLUSION: Evidence suggests that transition programmes are necessary in creating working environments that support new nurses in the clinical environment and this is demonstrated by increased job satisfaction and retention rates. However, optimum programme length and structure are unclear.

Simulation in the Internet age: The place of Web-based simulation in nursing education. An integrative review

  • Authors: Cant, Robyn , Cooper, Simon J.
  • Date: 2014
  • Type: Text , Journal article
  • Relation: Nurse Education Today Vol. 34, no. 12 (2014), p. 1435-1442
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  • Description: Objective The objective of this article was to review the literature on utilisation and place of Web-based simulation within nursing education. Web-based simulation combines electronic multimedia options with a central video or virtual world to produce interactive learning activities mediated by the learner. Design An integrative review. Data sources A search was conducted of healthcare databases between 2000 and 2014 and of Internet sources for hosted simulation programs in nursing. Eighteen primary programs were identified for inclusion. Review methods A strategy for integrative review was adopted in which studies were identified, filtered, classified, analysed and compared. Results and discussion Of 18 programs, two game-based programs were identified which represented a ‘virtual world’ in which students could simultaneously or individually immerse themselves in a character role-play. However, most programs (n = 10) taught an aspect of procedural patient care using multimedia (e.g. video, audio, graphics, quiz, text, memo). Time-limited sequences, feedback and reflective activities were often incorporated. Other studies (n = 8) taught interpersonal communication skills or technical skills for equipment use. Descriptive study outcomes indicated ease of program use, strong satisfaction with learning and appreciation of program accessibility. Additionally, four studies reported significant improvements in knowledge post-intervention. Conclusion Web-based simulation is highly acceptable to students and appears to provide learning benefits that align with other simulation approaches and it augments face-to-face teaching. Web-based simulation is likely to have a major place in nursing curricula in the next decade, yet further research is necessary to objectively evaluate learner outcomes and to justify its use.

Situation awareness in undergraduate nursing students managing simulated patient deterioration

  • Authors: McKenna, Lisa , Missen, Karen , Cooper, Simon J. , Bogossian, Fiona , Bucknall, Tracey , Cant, Robyn
  • Date: 2014
  • Type: Text , Journal article
  • Relation: Nurse Education Today Vol. 34, no. 6 (June 2014), p. e27-e31
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  • Description: Background: Nursing work often occurs in complex and potentially hazardous settings. Awareness of patient and practice environments is an imperative for nurses in practice. Objectives: To explore nursing students' situation awareness while engaging in simulated patient deterioration scenarios. Design: The educational process of FIRST2ACT was the model for the nurse intervention. Situation awareness was measured quantitatively using the Situation Awareness Global Assessment tool. Four domains were measured: physiological perception (patient parameters), global perception (surroundings), comprehension (interpretation of information), and projection (forecasting outcomes). Settings: Clinical laboratories at each of three participating universities. Participants: Ninety-seven nursing students from three Australian universities. Methods: Between March and July 2012, students participated in three video-recorded simulation events, in which a trained actor played patient roles and groups of three students worked as teams. To measure situation awareness, following the simulation each team leader was taken to a separate room and asked to report on a question set regarding the patient's vital signs, bedside setting and medical diagnosis. Results and Conclusions: Overall, situation awareness was low (41%). Of the four domains, physiological perceptions scored the lowest (26%) and projection the highest (59%).Final year nursing students may not have well developed situation awareness skills, especially when dealing with these types of scenarios. Education providers need to consider ways to assist students to fully develop this attribute. Findings suggest that this is an aspect of undergraduate nursing education that requires significant consideration by curriculum developers.

Stethoscope hygiene: A best practice review of the literature

The effect of an e-health intervention designed to reduce prolonged occupational sitting on mean arterial pressure

  • Authors: Mainsbridge, Casey , Cooley, Dean , Fraser, Sharon , Pedersen, Scott
  • Date: 2014
  • Type: Text , Journal article
  • Relation: Journal of Occupational and Environmental Medicine Vol. 56, no. 11 (2014), p. 1189-1194
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  • Description: Objective: To evaluate the effect of a workplace health intervention designed to reduce prolonged occupational sitting on the mean arterial pressure (MAP) of desk-based employees. Methods: This randomized controlled trial involved an experimental group who received an e-health intervention and a control group who did not. The 13-week intervention passively prompted participants to stand and engage in short bouts of office-based physical activity by interrupting prolonged occupational sitting time periodically throughout the workday. Mean arterial pressure was measured at pretest and posttest. Results: Between pretest and posttest the experimental group significantly reduced their MAP, whereas MAP in the control group did not. Conclusions: A workplace e-health intervention designed to reduce prolonged occupational sitting was effective in decreasing MAP in desk-based employees.

The implementation of Mask-Ed: reflections of academic participants

  • Authors: Reid-Searl, Kerry , Cooper, Simon J. , Levett-Jones, Tracy , Happell, Brenda
  • Date: 2014
  • Type: Text , Journal article
  • Relation: Nurse Education in Practice Vol. 14, no. 5 (2014), p. 485-90
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  • Description: This paper profiles the findings from a study that explored the perspectives and experiences of nurse educators who implemented a novel simulation approach termed Mask-Ed. The technique involves the educator wearing a silicone mask and or body parts and transforming into a character. The premise of this approach is that the masked educator has domain specific knowledge related to the simulation scenario and can transmit this to learners in a way that is engaging, realistic, spontaneous and humanistic. Nurse educators charged with the responsibility of implementing Mask-Ed in three universities were invited to participate in the study by attending an introductory workshop, implementing the technique and then journaling their experiences, insights and perspectives over a 12 month period. The journal entries were then thematically analysed. Key themes were categorised under the headings of Preparation, Implementation and Impact; Reflexivity and Responsiveness; Student Engagement and Ownership; and Teaching and Learning. Mask-Ed is a simulation approach which allows students to interact with the 'characters' in humanistic ways that promote person-centred care and therapeutic communication. This simulation approach holds previously untapped potential for a range of learning experiences, however, to be effective, adequate resourcing, training, preparation and practice is required. Copyright © 2014 Elsevier Ltd. All rights reserved.

Undergraduate nursing students' peformance in recognising and responding to sudden patient deterioration in high psychological fidelity simulated environments: Quantitative results from an Australian multi-centre study

  • Authors: Bogossian, Fiona , Cooper, Simon J. , Cant, Robyn , Beauchamp, Alison , Porter, Joanne , Kain, Victoria , Bucknall, Tracey , Phillips, Nicole
  • Date: 2014
  • Type: Text , Journal article
  • Relation: Nurse Education Today Vol. 34, no. 5 (2014), p. 691-696
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  • Description: Objectives This paper reports the quantitative findings of the first phase of a larger program of ongoing research: Feedback Incorporating Review and Simulation Techniques to Act on Clinical Trends (FIRST2ACTTM). It specifically aims to identify the characteristics that may predict primary outcome measures of clinical performance, teamwork and situation awareness in the management of deteriorating patients. Design Mixed-method multi-centre study. Setting High fidelity simulated acute clinical environment in three Australian universities. Participants A convenience sample of 97 final year nursing students enrolled in an undergraduate Bachelor of Nursing or combined Bachelor of Nursing degree were included in the study. Method In groups of three, participants proceeded through three phases: (i) pre-briefing and completion of a multi-choice question test, (ii) three video-recorded simulated clinical scenarios where actors substituted real patients with deteriorating conditions, and (iii) post-scenario debriefing. Clinical performance, teamwork and situation awareness were evaluated, using a validated standard checklist (OSCE), Team Emergency Assessment Measure (TEAM) score sheet and Situation Awareness Global Assessment Technique (SAGAT). A Modified Angoff technique was used to establish cut points for clinical performance. Results Student teams engaged in 97 simulation experiences across the three scenarios and achieved a level of clinical performance consistent with the experts' identified pass level point in only 9 (1%) of the simulation experiences. Knowledge was significantly associated with overall teamwork (p = .034), overall situation awareness (p = .05) and clinical performance in two of the three scenarios (p = .032 cardiac and p = .006 shock). Situation awareness scores of scenario team leaders were low overall, with an average total score of 41%. Conclusions Final year undergraduate nursing students may have difficulty recognising and responding appropriately to patient deterioration. Improving pre-requisite knowledge, rehearsal of first response and team management strategies need to be a key component of undergraduate nursing students' education and ought to specifically address clinical performance, teamwork and situation awareness.

Who speaks for whom? Can nurses be patient advocates in renal settings?

  • Authors: Wellard, Sally
  • Date: 2014
  • Type: Text , Journal article
  • Relation: Renal Society of Australasia Journal Vol. 10, no. 2 (2014), p. 81-83
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  • Description: Nursing texts laud the role of nurses as advocates for patients. With increased acknowledgement of patient-centred care, is it appropriate or desired for nurses to presume this as their role? An examination of concepts of advocacy and autonomy highlight potential conflicts between the nurses' adoption of the roles of advocate and surveyor in renal care. There is no clear and definitive answer to 'who can speak for whom' when considering advocacy for people involved in renal replacement therapies. It is evident that what is required is clearer articulation of how renal nurses can act as advocates for patients within the context of their multiple roles and with a goal of partnerships in care.

'Diabetes is nothing': the experience of older Singaporean women living and coping with type 2 diabetes

  • Authors: Li, Jiemin , Drury, Vicki , Taylor, Beverley
  • Date: 2013
  • Type: Text , Journal article
  • Relation: Contemporary Nurse Vol. 45, no. 2 (2013), p. 188-196
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  • Description: Purpose: The purpose of this study was to describe, through qualitative methods, the experiences and ways of coping of older Singaporean Chinese women with type 2 diabetes. Methods: Using a qualitative approach, 10 Singaporean Chinese women between the ages of 60–69 described their experiences of living and coping with type 2 diabetes. Data were collected via semi-structured interviews and analysed using thematic analysis. Results: Three themes were identified in the analysis: (i) Living with diabetes; (ii) Coping with diabetes; and (iii) Caring for the self in diabetes. Conclusions: Findings indicate that women living and coping with diabetes confront numerous issues. In order to help these patients initiate and sustain lifestyle modifications, healthcare providers are encouraged to be empathetic and supportive and an understanding of the coping strategies used will ensure that effective coping strategies are utilised. Furthermore, diabetes education for family members will assist them to provide essential, ongoing support for the patient.

Assessing preregistration nursing students' clinical competence : A systematic review of objective measures

  • Authors: Cant, Robyn , McKenna, Lisa , Cooper, Simon J.
  • Date: 2013
  • Type: Text , Journal article
  • Relation: International Journal of Nursing Practice Vol. 19, no. 2 (2013), p. 163-176
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  • Description: Nursing students are required to develop clinical knowledge, skills and attitudes for professional practice. However, objectivity and parity of students' clinical assessments has been questioned. In the last decade, more objective techniques have been developed, with increased use of Objective Structured Clinical Examinations. We reviewed objective clinical assessment measures used in preregistration nursing courses to determine utilization and the validity and reliability of assessment techniques. A systematic search was made of quantitative research publications between 2000 and May 2011, identifying 16 studies that were subsequently reviewed. The validity and reliability of studies varied, with six studies judged as high quality, using various methodologies. This paper describes methods of instrument development and reports on their application in preregistration nursing programs. © 2013 Wiley Publishing Asia Pty Ltd.

Assessment of clinical competence of pre-registration nursing students: a systematic review of objective measures

  • Authors: Cant, Robyn , McKenna, Lisa , Cooper, Simon J.
  • Date: 2013
  • Type: Text , Journal article
  • Relation: International Journal of Nursing Practice Vol. 19, no. 2 (2013), p. 163-76
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  • Description: Nursing students are required to develop clinical knowledge, skills and attitudes for professional practice. However, objectivity and parity of students' clinical assessments has been questioned. In the last decade, more objective techniques have been developed, with increased use of Objective Structured Clinical Examinations. We reviewed objective clinical assessment measures used in preregistration nursing courses to determine utilization and the validity and reliability of assessment techniques. A systematic search was made of quantitative research publications between 2000 and May 2011, identifying 16 studies that were subsequently reviewed. The validity and reliability of studies varied, with six studies judged as high quality, using various methodologies. This paper describes methods of instrument development and reports on their application in preregistration nursing programs.