An exploration into suicide prevention initiatives for mental health nurses : a systematic literature review
- Authors: Dabkowski, Elissa , Porter, Joanne
- Date: 2021
- Type: Text , Journal article , Review
- Relation: International Journal of Mental Health Nursing Vol. 30, no. 3 (2021), p. 610-623
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- Description: Mental health and suicide prevention are national health priorities in Australia, with research currently focussed towards the ZERO Suicide (ZS) initiative. The aim of this review was to evaluate the impact of suicide prevention programmes, in particular the ZS prevention initiative. A systematic review using the PRISMA guidelines was conducted using six EBSCO Host databases; Academic Search Complete, Australian/New Zealand Reference Centre, CINAHL Complete, MEDLINE, APA PsycINFO, and APA Psyc Articles. The data extracted from the eligible papers were analysed using a thematic approach. The final data set consisted of fourteen (n = 14) peer-reviewed articles meeting the eligibility criteria, which included quantitative (n = 10), mixed methods (n = 2), and qualitative studies (n = 2). Results indicated variances between suicide prevention programmes with some papers examining single workshops and others assessing multimodal, organizational interventions. Five major themes were produced from this review including measuring the success of suicide prevention programmes, improvements to the delivery of suicide prevention programmes, barriers to implementing changes, cultural considerations, and further research required for suicide prevention programmes. This review concludes that further long-term research is required to evaluate the implementation and efficacy of suicide prevention programmes in health care. Cultural awareness in suicide prevention training is another area that may benefit from further research. A growing body of evidence establishes the need for multimodal and organizational approaches for suicide prevention initiatives. © 2021 John Wiley & Sons Australia, Ltd
Learning needs of Iranian patients with coronary heart disease : a cross-sectional, comparative study
- Authors: Hassankhani, Hadi , Haririan, Hamidreza , Jafari, Arezoo , Porter, Joanne , O’Brien, Frances , Feizollahzadeh, Hossein
- Date: 2021
- Type: Text , Journal article
- Relation: Clinical Nursing Research Vol. 30, no. 2 (2021), p. 193-199
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- Description: Background: Patient education requires modification as it is either nonexistent or implemented irregularly or inadequately. Study’s purpose: To examine the learning needs of patients with coronary heart disease from the perspective of the patients, their relatives, and health care providers. Methodology: The cross-sectional, comparative study conducted at two cardiac hospitals of Tabriz and Ardebil, Iran from May 2016 to September 2016.Through convenience sampling perceptions of 137 patients, 137 relatives, 33 cardiologists, and 108 nurses were compared using the Cardiac Learning Need Inventory questionnaire. Major results: The most important learning needs of patients from the perspective of physicians, nurses, and patients’ relatives was information about risk factors. In contrast, patient’s perceived information about medication to be their most important learning need. Clinical implications: Patients’ perceptions of their educational needs was different from the perceptions of physicians, nurses, and relatives of the patients. Therefore, when planning patient education a comprehensive review of the patients’ learning needs is required in order to develop a suitable education plan by prioritizing patients’ educational needs. © The Author(s) 2020.
Palliative and end-of-life care in the home in regional/rural Victoria, Australia : the role and lived experience of primary carers
- Authors: Miller, Elizabeth , Porter, Joanne , Peel, Rebecca
- Date: 2021
- Type: Text , Journal article
- Relation: SAGE Open Nursing Vol. 7, no. (2021), p.
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- Description: Introduction: Palliative support services (generalist or specialist) can provide much-needed assistance to carers who are providing palliative and end-of-life care in their homes, but access to such services in regional and rural areas of Australia is poorly understood. Objectives: This study aimed to explore the role and lived experience of primary carers who are providing palliative and end-of-life care in the home in regional/rural Victoria, Australia. Methods: Nine female participants, of whom six were bereaved between 7 and 20 months were interviewed using a semistructured interview technique. Each interview was audio-recorded, transcribed verbatim, and analyzed thematically. Results: Two themes emerged: “Negotiating healthcare systems” which described the needs for multidisciplinary supports and “The caring experience” which discussed daily tasks, relationships, mental and physical exhaustion, respite, isolation, medication management, and grief and loss. Findings show that regional/rural carers have an added burden of travel stress as well as feeling overwhelmed, isolated, and physically and emotionally exhausted. Carers would benefit from greater flexibility for short-term respite care. The engagement of specialist palliative care services assisted the participants to navigate the health care system. Some participants did not understand the value of palliative care, highlighting the need for general practitioners to conduct early conversations about this with their patients. Education is needed to build capacity within the primary palliative care workforce, confirming the importance of timely referrals to a specialist palliative care practitioner if pain or symptom control is not effectively managed. Conclusion: Providing palliative and end-of-life care in the home is an exhausting and emotionally draining role for unpaid, primary carers. Multiple supports are needed to sustain primary carers, as they play an essential role in the primary health care system. © The Author(s) 2021.
A review of code blue activations in a single regional Australian healthcare service : a retrospective descriptive study of RISKMAN data
- Authors: Porter, Joanne , Peck, Blake , McNabb, Tiffinee , Missen, Karen
- Date: 2020
- Type: Text , Journal article
- Relation: Journal of Clinical Nursing Vol. 29, no. 1-2 (2020), p. 221-227
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- Description: Background: In the case of life-threatening conditions such as respiratory or cardiac arrest, or the clinical deterioration of the patient, a Code Blue activation may be instigated. A Code Blue activation involves a team of advanced trained clinicians attending the emergency needs of the patient. Aims and objectives: The aim of the study was to explore the number of cases of Code Blue activations, looking at the timing, clinical ward, diagnosis and activation criteria while noting cases where escalation from a Medical Emergency Team (MET) call occurs in one Regional Healthcare Service in Victoria, Australia, over a six-year period. Methods: A quantitative retrospective descriptive study of Code Blue emergencies over a six-year period from June 2010 to June 2016 was conducted. Data collected from the RISKMAN program operating at a single site was imported into SPSS (V 22) for descriptive statistical analysis. A STROBE EQUATOR checklist was used for this study (see File S1). Findings: The majority of Code Blue activations were male (59%, n = 127) and aged between 70 and 89 years of age (43%, n = 93). A Code Blue activation was more likely to occur at 08:00 hr, 14:00 hr or 22:00 hr, corresponding to the nurses’ change in shift, with the majority of Code Blues (27.8%, n = 60) occurring in the emergency department. Cardiac arrest was the main activation criterion with 54.6% (n = 118) cases followed by respiratory arrest (14%, n = 32). Interestingly, 20% (n = 45) of the Code Blue activations were upgraded from a Medical Emergency Team (MET) call. Conclusion: This project has produced several interesting findings surrounding Code Blue activations at one regional healthcare service which are not present in existing literature and is worthwhile for further investigation. Relevance to clinical practice: Understanding Code Blue activation criteria, common timings (month, time of day) and patient demographics ensures clinicians can remain vigilant in watching for the signs of patient deterioration and improve staff preparedness Code Blue events. © 2019 John Wiley & Sons Ltd
The academic experiences of transitioning to blended online and digital nursing curriculum
- Authors: Porter, Joanne , Barbagallo, Michael , Peck, Blake , Allen, Louise , Tanti, Erin , Churchill, Anne
- Date: 2020
- Type: Text , Journal article
- Relation: Nurse Education Today Vol. 87, no. (2020), p.
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- Description: Background: The blended online digital (BOLD) approach to teaching is popular within many universities. However, much of the research conducted in this area focusses on the student perspective. Aim The aim of this study is to explore the experiences and perspectives of academics involved in the development and implementation of an inaugural BOLD Bachelor of Nursing curriculum at a regional multi-campus institution in Victoria, Australia. Methods: Eleven academics across two regional campuses participated in one of five focus groups. Creswell's (2003) six step approach to thematic analysis was used to analyse the semi-structured interview data in order to capture the meaning of the transition experience. Findings: Three significant themes emerged from the focus group data: ‘Get Ready’, ‘Get Set’, and ‘Go’. Discussion: Three significant themes emerged, ‘Get Ready’, embodies insight from academic staff preparing to make the transition to a BOLD delivery model acknowledging the need for staff to be genuinely prepared, educated, guided and supported to understand the pedagogy of BOLD. Secondly, ‘Get Set’, acknowledges the period immediately after the preparatory phase and preparedness of academic staff to manage content and delivery for both face-to-face and online student cohorts within the learning platform. Thirdly, the theme ‘Go’ recognises the culmination of the previous two phases and is a recognition of the need for ongoing evaluation across the implementation phase. Conclusion: This qualitative exploration of nursing academics' experience contributes to contemporary pedagogical insights in relation to the blended approaches to teaching and learning. © 2020
The meaning of ‘worried’ in MET call activations : A regional hospital examination of the clinical indicator
- Authors: Raymond, Anita , Porter, Joanne , Missen, Karen , Larkins, Jo-Ann , de Vent, Kerry , Redpath, Simone
- Date: 2019
- Type: Text , Journal article
- Relation: Collegian Vol. 26, no. 3 (2019), p. 378-382
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- Description: Little is known about why nurses escalate a Medical Emergency Team (MET) response based on ‘worried’ criteria or what clinical findings define a ‘worried’ MET call. Limited clarity exists in nursing literature regarding the clinical definition of ‘worried’ in medical emergencies. Commonly ‘worried’ terminology is associated with nursing intuition about a patient's condition before signs of decline in clinical condition. This research has identified the exact clinical cause of ‘worried’ escalations, with evidence to support that clinical reasoning and patient deterioration are the main cause of ‘worried’ activation. This research has also highlighted areas for further professional development to enhance levels of patient safety and quality care within a regional hospital setting.
Adult deterioration detection system (ADDS) : An evaluation of the impact on met and code blue activations in a regional healthcare service
- Authors: Missen, Karen , Porter, Joanne , Raymond, Anita , de Vent, Kerry , Larkins, Jo-Ann
- Date: 2018
- Type: Text , Journal article
- Relation: Collegian Vol. 25, no. 2 (2018), p. 157-161
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- Description: Aims: To evaluate the impact of Acute Deterioration Detection System (ADDS) charts introduced to a regional healthcare service. Background: To assist health professionals in identifying essential elements for recognizing patient clinical deterioration, a national initiative introduced track and trigger observation charts, to hospitals in Australia. This study investigated whether the introduction of ADDS charts had an impact on the number of Medical Emergency Team (MET) and Code Blue activations at one regional healthcare service, according to their incident recording database. Method: A retrospective study of all Code Blue and MET activations was undertaken at a regional hospital, pre and post the introduction of ADDS charts in a two year period, June 2012 to June 2014. Results: There was a significant increase in MET activations from 5.91 to 11.27 per 1000 admissions (p < 0.01) after the implementation of ADDS charts. There was also an unexplained non-significant increase from 0.50 to 0.88 per 1000 admissions in the activations of Code Blue during this period (p = 0.05). It was also found that ADDS charts did not overly influence the activation criteria for calling a MET/Code Blue, except for an increase in reports of high heart rate and a decrease in the use of the criteria ‘worried’. Conclusion: The introduction of ADDS charts has provided health professionals with a clear track and trigger set of criteria, improving the detection of early signs of deterioration in patients. This study demonstrated an increase in activations as a result of the introduction of ADDS charts in one regional healthcare service.
Cultural aspects of death notification following cardiopulmonary resuscitation
- Authors: Hassankhani, Hadi , Haririan, Hamidreza , Porter, Joanne , Heaston, Sondra
- Date: 2018
- Type: Text , Journal article
- Relation: Journal of Advanced Nursing Vol. 74, no. 7 (2018), p. 1564-1572
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- Description: Aims: To explore the lived experience of resuscitation team members involved in notifying family members when a patient dies following a resuscitation event in an Iranian cultural context. Background: Death notification to the family is indeed a difficult and an important issue for resuscitation team members. The way health professionals deliver news to family members should incorporate elements of sensitivity, timing and adequate clinical explanations with emphasis on the efforts made by the professionals during the resuscitation. Design: A phenomenological study. Method: Over a period of 5 months (June 2016–November 2016) eleven nurses and six physicians were interviewed using an in-depth interview process applying Van Manen's hermeneutic phenomenological approach for data collection and analysis. The participants were recruited from six tertiary hospitals in Tabriz, Iran. Findings: There were two main themes that emerged from the data analysis including: “contributing factors on the impact of notification” and “notification strategies”. A further 13 subthemes emerged under the main themes. Several culturally related issues emerged with the participants feeling more comfortable informing male rather than female relatives about the death of the patient following a resuscitation. Conclusions: Notifying family members of a patient's death is a stressful and culturally sensitive task for the resuscitation team members. The nature of the patient's presenting condition, together with the various resuscitation interventions can result in relatives responding unpredictably. Providing health professionals with the appropriate training and skills to effectively communicate with family members will ensure that the families’ level of preparedness, understanding and cultural beliefs are taken into consideration. © 2018 John Wiley & Sons Ltd
Evaluating a blended online learning model among undergraduate nursing students : A quantitative study
- Authors: Ota, Marianne , Peck, Blake , Porter, Joanne
- Date: 2018
- Type: Text , Journal article
- Relation: CIN - Computers Informatics Nursing Vol. 36, no. 10 (2018), p. 507-512
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- Description: In Australia, the emerging use of technology in higher education has brought about significant change in the delivery of undergraduate nursing programs. Universities are now tasked with delivering a blend of online and face-to-face education, while students face new and sometimes challenging online learning environments with little technical support. This article explores the attitudes held by Bachelor of Nursing students toward the blended educational mode at a rural university in Victoria, Australia. A total of 109 participants constituted a convenience sample from a Bachelor of Nursing program across all 3-year levels. Responses provided by participants who completed an online self-report questionnaire were analyzed via descriptive and inferential statistics. The results indicated that participants struggled with inaccurate expectations of workload and the technical difficulties presented by online modules. Although this area requires further research, to an extent autonomy and flexibility were identified as two prominent traits exhibited by students who flourished in the blended modes. All in all, the results of this study strongly reflect the challenges faced by undergraduate nursing students navigating newly introduced online systems in a blended mode of study.
Physical deterioration in an acute mental health unit : A quantitative retrospective analysis of medical emergencies
- Authors: Porter, Joanne , Cant, Robyn , Missen, Karen , Raymond, Anita , Churchill, Anne
- Date: 2018
- Type: Text , Journal article
- Relation: International Journal of Mental Health Nursing Vol. 27, no. 5 (2018), p. 1364-1370
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- Description: Nursing management of physical deterioration of patients within acute mental health settings is observed, recorded, and actively managed with the use of standardized Adult Deterioration Detection System (ADDS) charts. Patient deterioration may require the urgent assistance of a hospital rapid response or Medical Emergency Team. A five-and-a-half-year (2011–2016) audit of hospital-wide Medical Emergency Team attendances was conducted in an acute mental health unit of a single large 250 bed regional hospital in Victoria, Australia. Data were extracted from the hospitals’ quality and patient safety program, RISKMan, and entered into a statistical data program for analysis. A total of 140 patient records were analysed, and the ‘Worried’ category (34%, n = 47) was the principle reason for a Medical Emergency Team call in a mental health ward, followed by hypotension (23%, n = 31) and a low Glasgow Coma Score (16%, n = 22). Upon further investigation of the ‘Worried’ category, the most common conditions recorded were an altered conscious state (22%, n = 9), low oxygen saturation (20%, n = 8), or chest pain (17%, n = 7). Activation of Medical Emergency Team calls predominantly occurred in the daylight morning hours (6am–12md). When data were compared to the general hospital patients, the context of the physiological deterioration of the mental health patients was strikingly similar. Further research is recommended to ascertain the extent and frequency with which staff working in mental health units are performing vital signs monitoring as an essential component of detection of early signs of physiological deterioration.
Rating teams’ non-technical skills in the emergency department : A qualitative study of nurses’ experience
- Authors: Porter, Joanne , Cant, Robyn , Cooper, Simon J.
- Date: 2018
- Type: Text , Journal article
- Relation: International Emergency Nursing Vol. 38, no. (2018), p. 15-20
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- Description: Introduction: Non-technical skills (NTS) teamwork training can enhance clinicians’ understanding of roles and improve communication. We evaluated a quality improvement project rating teams’ NTS performance to determine the value of formal rating and debriefing processes. Methods: In two Australian emergency departments the NTS of resuscitation teams were rated by senior nurses and medical staff. Key measures were leadership, teamwork, and task management using a valid instrument: Team Emergency Assessment Measure (TEAM™). Emergency nurses were asked to attend a focus group from which key themes around the quality improvement process were identified. Results: Main themes were: ‘Team composition’ (allocation of resuscitation team roles), ‘Resuscitation leadership’ (including both nursing and medical leadership roles) and ‘TEAM™ ratings promote reflective practice’ (providing staff a platform to discuss team effectiveness). Objective ratings were seen as enabling staff to provide feedback to other team members. Reflection on practice and debriefing were thought to improve communication, help define roles and responsibilities, and clarify leadership roles. Conclusion: Use of a non-technical skills rating scheme such as TEAM™ after team-based clinical resuscitation events was seen by emergency department nurses as feasible and a useful process for examining and improving multi-disciplinary practice, while improving team performance. © 2018 Elsevier Ltd
An exploration of emergency nurses’ perceptions, attitudes and experience of teamwork in the emergency department
- Authors: Grover, Elise , Porter, Joanne , Morphet, Julia
- Date: 2017
- Type: Text , Journal article
- Relation: Australasian Emergency Nursing Journal Vol. 20, no. 2 (2017), p. 92-97
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- Description: Background Teamwork may assist with increased levels of efficiency and safety of patient care in the emergency department (ED), with emergency nurses playing an indispensable role in this process. Method A descriptive, exploratory approach was used, drawing on principles from phenomenology and symbolic interactionism. Convenience, purposive sampling was used in a major metropolitan ED. Semi structured interviews were conducted, audio recorded, and transcribed verbatim. Transcripts were analysed using thematic analysis. Results Three major themes emerged from the data. The first theme ‘when teamwork works’ supported the notion that emergency nurses perceived teamwork as a positive and effective construct in four key areas; resuscitation, simulation training, patient outcomes and staff satisfaction. The second theme ‘team support’ revealed that back up behaviour and leadership were critical elements of team effectiveness within the study setting. The third theme ‘no time for teamwork’ centred around periods when teamwork practices failed due to various contributing factors including inadequate resources and skill mix. Discussion Outcomes of effective teamwork were valued by emergency nurses. Teamwork is about performance, and requires a certain skill set not necessarily naturally possessed among emergency nurses. Building a resilient team inclusive of strong leadership and communication skills is essential to being able to withstand the challenging demands of the ED. © 2017 College of Emergency Nursing Australasia
Family Presence During Resuscitation (FPDR) : Observational case studies of emergency personnel in Victoria, Australia
- Authors: Porter, Joanne , Miller, Nareeda , Giannis, Anita , Coombs, Nicole
- Date: 2017
- Type: Text , Journal article
- Relation: International Emergency Nursing Vol. 33, no. (2017), p. 37-42
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- Description: Introduction Family Presence During Resuscitation (FPDR), although not a new concept, remains inconsistently implemented by emergency personnel. Many larger metropolitan emergency departments (ED) have instigated a care coordinator role, however these personnel are often from a non-nursing background and have therefore limited knowledge about the clinical aspects of the resuscitation. In rural emergency departments there are simply not enough staff to allocate an independent role. A separate care coordinator role, who is assigned to care for the family and not take part in the resuscitation has been well documented as essential to the successful implementation of FPDR. Methods One rural and one metropolitan emergency department in the state of Victoria, Australia were observed and data was collected on FPDR events. The participants consisted of resuscitation team members, including; emergency trained nurses, senior medical officers, general nurses and doctors. The participants were not told that the data would be recorded around interactions with family members or team discussions regarding family involvement in the resuscitation, following ethical approval involving limited disclosure of the aims of the study. Results Seventeen adult presentations (Metro n = 9, Rural n = 8) were included in this study and will be presented as resuscitation case studies. The key themes identified included ambiguity around resuscitation status, keeping the family informed, family isolation and inter-professional communication. Conclusion During 17 adult resuscitation cases, staff were witnessed communicating with family, which was often limited and isolation resulted. Family were often uninformed or separated from their family member, however when a family liaison person was available it was found to be beneficial. This research indicated that staff could benefit from a designated family liaison role, formal policy and further education. © 2016 Elsevier Ltd
Family support liaison in the witnessed resuscitation : A phenomenology study
- Authors: Hassankhani, Hadi , Zamanzade, Vahid , Rahmani, Azad , Haririan, Hamidreza , Porter, Joanne
- Date: 2017
- Type: Text , Journal article
- Relation: International Journal of Nursing Studies Vol. 74, no. (2017), p. 95-100
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- 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.
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
A trial of e-simulation of sudden patient deterioration (FIRST2ACT WEB
- Authors: Bogossian, Fiona , Cooper, Simon J. , Cant, Robyn , Porter, Joanne , Forbes, Helen , McKenna, Lisa , Kinsman, Leigh , Endacott, Ruth , Devries, Brett , Philips, Nicole , Bucknall, Tracey , Young, Susan , Kain, Victoria
- Date: 2015
- Type: Text , Journal article
- Relation: Nurse Education Today Vol. 35, no. 10 (2015), p. e36-e42
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- Description: Background: High-fidelity simulation pedagogy is of increasing importance in health professional education; however, face-to-face simulation programs are resource intensive and impractical to implement across large numbers of students. Objectives: To investigate undergraduate nursing students' theoretical and applied learning in response to the e-simulation program-FIRST2ACT WEBTM, and explore predictors of virtual clinical performance. Design and setting: Multi-center trial of FIRST2ACT WEBTM accessible to students in five Australian universities and colleges, across 8 campuses. Participants: A population of 489 final-year nursing students in programs of study leading to license to practice. Methods: Participants proceeded through three phases: (i) pre-simulation-briefing and assessment of clinical knowledge and experience; (ii) e-simulation-three interactive e-simulation clinical scenarios which included video recordings of patients with deteriorating conditions, interactive clinical tasks, pop up responses to tasks, and timed performance; and (iii) post-simulation feedback and evaluation.Descriptive statistics were followed by bivariate analysis to detect any associations, which were further tested using standard regression analysis. Results: Of 409 students who commenced the program (83% response rate), 367 undergraduate nursing students completed the web-based program in its entirety, yielding a completion rate of 89.7%; 38.1% of students achieved passing clinical performance across three scenarios, and the proportion achieving passing clinical knowledge increased from 78.15% pre-simulation to 91.6% post-simulation.Knowledge was the main independent predictor of clinical performance in responding to a virtual deteriorating patient R2=0.090, F(7, 352)=4.962, p<0.001. Discussion: The use of web-based technology allows simulation activities to be accessible to a large number of participants and completion rates indicate that 'Net Generation' nursing students were highly engaged with this mode of learning. Conclusion: The web-based e-simulation program FIRST2ACTTM effectively enhanced knowledge, virtual clinical performance, and self-assessed knowledge, skills, confidence, and competence in final-year nursing students. © 2015 Elsevier Ltd.
Designing a medical records review tool: An instructional guide
- Authors: McConnell-Henry, Tracy , Cooper, Simon J. , Endacott, Ruth , Porter, Joanne , Missen, Karen , Sparkes, Louise
- Date: 2015
- Type: Text , Journal article
- Relation: Contemporary Nurse Vol. 50, no. 1 (2015), p. 72-79
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- Description: Background: Medical Records Reviews (MRR) are commonly used in research and quality activities in health care, however, there is a paucity of literature offering a step by step guide to devising a reliable, user-friendly tool. Aim: This instructional paper focuses on the stages used to design and implement successful MRR using examples from two reviews in Australian rural hospitals investigating the responses of Registered Nurses to patient deterioration, and guided by time series principals. Methods: The MRR were conducted in two rural hospitals in conjunction with a simulation learning intervention where nurses rehearsed clinical management of a deteriorating patient. A six-step template is presented to guide practitioners on how to design and use a MRR tool. Conclusion: When well-planned and appropriately used, MRR provides an excellent means for examining patient outcomes in addition to safety and quality of care.
E-simulation:pre-registration nursing students' evaluation of an on-line patient deterioration program
- Authors: Cant, Robyn , Young, Susan , Cooper, Simon J. , Porter, Joanne
- Date: 2015
- Type: Text , Journal article
- Relation: CIN: Computers, Informatics, Nursing Vol. 33, no. 3 (2015), p. 108-114
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- Description: This study explores preregistration nursing students’ views of a Web-based simulation program: FIRST2 ACTWeb (Feedback Incorporating Review and Simulation Techniques to Act on Clinical Trends-Web). The multimedia program incorporating three videoed scenarios portrayed by a standardized patient (human actor) aims to improve students’ recognition and management of hospital patient deterioration. Participants were 367 final-year nursing students from three universities who completed an online evaluation survey and 19 students from two universities who attended one of five focus groups. Two researchers conducted a thematic analysis of the transcribed narratives. Three core themes identified were as follows: “ease of program use,” “experience of e-Simulation,” and “satisfaction with the learning experience.” The Web-based clinical learning environment was endorsed as functional, feasible, and easy to use and was reported to have high fidelity and realism. Feedback in both focus groups and surveys showed high satisfaction with the learning experience. Overall, evaluation suggested that the Web-based simulation program successfully integrated elements essential for blended learning. Although Web-based educational applications are resource intensive to develop, positive appraisal of program quality, plus program accessibility and repeatability, appears to provide important educational benefits. Further research is needed to determine the transferability of these learning experiences into real-world practice.
Family presence during resuscitation (FPDR) : A survey of emergency personnel in Victoria, Australia
- Authors: Porter, Joanne , Cooper, Simon J. , Taylor, Beverley
- Date: 2015
- Type: Text , Journal article
- Relation: Australasian Emergency Nursing Journal Vol. 18, no. 2 (2015), p. 98-105
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- Description: Background: Family presence during resuscitation (FPDR) has been endorsed internationally by resuscitation councils since the year 2000; however, the extent to which FPDR is practiced in emergency settings requires further investigation. Methods: Emergency personnel ( n= 347) from 18 participating emergency departments across the state of Victoria, Australia completed a 10-page questionnaire, which was designed to develop an understanding of the current practice and implementation of FPDR and to ascertain the differences in practice between adult and paediatric resuscitations. Results: Emergency personnel update their adult and paediatric advanced life support qualifications annually with 87% of nurses and 65% of doctors completing adult life support and 72% of nurses and 49% of doctors completing paediatric advanced life support training. The majority of nursing staff reported support for FPDR (83%) with over 70% indicating that it is apart of their current practice. There was strong agreement from both nurses (79%) and doctors (77%) that the family have the right to be present. A family support person was deemed as essential by nurses (92%) and doctors (89%) when allowing family to be present. A factor analysis was conducted on participant statements, revealing four codes; impact on professional practice and performance, personnel beliefs about FPDR, professional satisfaction and the importance of a support person and saying goodbye. Conclusion: A family support person was highlighted as essential to the successful implementation of FPDR, together with the development of a comprehensive training the education program for emergency personnel. FPDR continues to be a significant issue and further investigation into FPDR practice and implementation in the ED is warranted. © 2014 College of Emergency Nursing Australasia Ltd.
Leadership and teamwork in medical emergencies: Performance of nursing students and registered nurses in simulated patient scenarios
- Authors: Endacott, Ruth , Bogossian, Fiona , Cooper, Simon J. , Forbes, Helen , Kain, Victoria , Young, Susan , Porter, Joanne , First2Act Team
- Date: 2015
- Type: Text , Journal article
- Relation: Journal of Clinical Nursing Vol. 24, no. 1-2 (2015), p. 90-100
- Full Text: false
- Reviewed:
- Description: Aims and objectivesTo examine nursing students' and registered nurses' teamwork skills whilst managing simulated deteriorating patients.Background Studies continue to show the lack of timely recognition of patient deterioration. Management of deteriorating patients can be influenced by education and experience.DesignMixed methods study conducted in two universities and a rural hospital in Victoria, and one university in Queensland, Australia.Methods Three simulation scenarios (chest pain, hypovolaemic shock and respiratory distress) were completed in teams of three by 97 nursing students and 44 registered nurses, equating to a total of 32 student and 15 registered nurse teams. Data were obtained from (1) Objective Structured Clinical Examination rating to assess performance; (2) Team Emergency Assessment Measure scores to assess teamwork; (3) simulation video footage; (4) reflective interview during participants' review of video footage. Qualitative thematic analysis of video and interview data was undertaken.ResultsObjective structured clinical examination performance was similar across registered nurses and students (mean 54% and 49%); however, Team Emergency Assessment Measure scores differed significantly between the two groups (57% vs 38%, t = 6·841, p < 0·01). In both groups, there was a correlation between technical (Objective Structured Clinical Examination) and nontechnical (Team Emergency Assessment Measure) scores for the respiratory distress scenario (student teams: r = 0·530, p = 0·004, registered nurse teams r = 0·903, p < 0·01) and hypovolaemia scenario (student teams: r = 0·534, p = 0·02, registered nurse teams: r = 0·535, p = 0·049). Themes generated from the analysis of the combined quantitative and qualitative data were as follows: (1) leadership and followership behaviours; (2) help-seeking behaviours; (3) reliance on previous experience; (4) fixation on a single detail; and (5) team support.Conclusions There is scope to improve leadership, team work and task management skills for registered nurses and nursing students. Simulation appears to be beneficial in enabling less experienced staff to assess their teamwork skills.Relevance to clinical practiceThere is a need to encourage less experienced staff to become leaders and for all staff to develop improved teamwork skills for medical emergencies.