Developing team based acute care scenarios: a rural hospital experience
- Authors: Missen, Karen , Sparkes, Louise , Porter, Joanne , Cooper, Simon J. , McConnell-Henry, Tracy
- Date: 2013
- Type: Text , Journal article
- Relation: International Emergency Nursing Vol. 21, no. 3 (2013), p. 186-189
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- Description: Background Health professionals work in teams in a variety of health care settings especially in medical emergency teams at times of crisis. However, Registered Nurses (RNs) rarely have the chance to partake in educational programs designed for teams of nurses to practice working together in life-threatening situations. Further RN’s employed in rural setting have less opportunities for professional development than their city based counterparts. Simulated scenarios with a patient actor in a rural hospital have been utilised in this study to provide nurses with the opportunity to work as a team in the early recognition and management of patients with acute medical conditions. Aim This discussion paper focuses on one aspect of a larger research project with the aim of describing the development of team based scenarios for a rural hospital setting, focusing on the detection and management of a deteriorating patient. Methods Three team based scenarios, the related assessments and feedback techniques are all described. Conclusion Team based simulation provides a unique opportunity to assist registered nurses in rural settings in re-skilling or maintaining their emergency management skills.
Here they come, ready or not
- Authors: Missen, Karen
- Date: 2014
- Type: Text , Journal article
- Relation: Nursing standard (Royal College of Nursing (Great Britain) : 1987) Vol. 29, no. 6 (2014), p. 66
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- Description: As many students begin to undertake their third year of study, the prospect of registration becomes imminent. Most students will be wondering how they will cope when they don their staff nurse uniforms for the first time.
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.
Registered nurses' perceptions of new nursing graduates' clinical competence : A systematic integrative review
- Authors: Missen, Karen , McKenna, Lisa , Beauchamp, Alison
- Date: 2016
- Type: Text , Journal article
- Relation: Nursing and Health Sciences Vol. 18, no. 2 (2016), p. 143-153
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- Description: Over the past decade, many questions have been raised about graduates' clinical competence and fitness for practice upon completion of their undergraduate education. Despite the significance of this issue, the perspectives of registered nurses have rarely been examined. This systematic review explores the perceptions of experienced registered nurses regarding the clinical competence of new nursing graduates. Original research studies published between 2004-2014 were identified using electronic databases, reference lists, and by searching "grey literature." Papers were critically reviewed and relevant data extracted and synthesized using an approach based on Preferred Reporting Items for Systematic Reviews and Meta-Analysis. From 153 studies initially identified, 15 original research papers were included. Four main research themes were identified: clinical/technical skills, critical thinking, interaction/communication, and overall readiness for practice. Areas of concern in relation to the clinical competence of new nursing graduates specifically related to two themes: critical thinking and clinical/technical skills. Further research is required on strategies identified within the literature with the ultimate aim of ensuring new nursing graduates are safe and competent practitioners.
Work readiness of nursing graduates : Current perspectives of graduate nurse program coordinators
- Authors: Missen, Karen , McKenna, Lisa , Beauchamp, Alison
- Date: 2015
- Type: Text , Journal article
- Relation: Contemporary Nurse Vol. 51, no. 1 (2015), p. 27-38
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- Description: Background: The transition from nursing student to graduate remains problematic internationally with issues arising concerning graduates’ work readiness upon commencing employment. Aim: This exploratory study specifically investigated perceptions of graduate nurse program coordinators on the work readiness of nursing graduates, with the aims of identifying strengths, weaknesses and challenges that exist. Design: Qualitative descriptive design. Methods: Sixteen graduate nurse program coordinators were interviewed from various healthcare services in the state of Victoria, Australia. Interviews were audio-recorded and transcribed verbatim and thematic analysis was used to disclose reoccurring themes and sub-themes. Findings: This paper reports on one theme, preparation readiness, and three sub-themes associated with this theme; clinical skills deficits, communication issues and transitioning as an enrolled nurse to a registered nurse. Conclusions: There are several areas of weaknesses and challenges for nursing graduates in their preparation for practice. As a poorly understood area, evidence from this study will inform curriculum development and transition programs, not only in Australia, but also internationally.
Qualified nurses' rate new nursing graduates as lacking skills in key clinical areas
- Authors: Missen, Karen , McKenna, Lisa , Beauchamp, Alison , Larkins, Jo-Ann
- Date: 2016
- Type: Text , Journal article
- Relation: Journal of Clinical Nursing Vol. 25, no. 15-16 (2016), p. 2134-2143
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- Description: Aims and objectives: The aim of this study was to explore perceptions of qualified nurses on the abilities of newly registered nursing graduates to perform a variety of clinical skills. Background: Evidence from the literature suggests that undergraduate nursing programmes do not adequately prepare nursing students to be practice-ready on completion of their nursing courses. Design: A descriptive quantitative design was used. Methods: Participants were recruited through the Australian Nursing and Midwifery Federation, Victorian branch. A brief explanation of the study and a link to the survey were promoted in their monthly e-newsletter. A total of 245 qualified nurses in the state of Victoria, Australia participated in this study. A survey tool of 51 clinical skills and open-ended questions was used, whereby participants were asked to rate new nursing graduates' abilities using a 5-point Likert scale. Results: Overall participants rated new nursing graduates' abilities for undertaking clinical skills as good or very good in 35·3% of skills, 33·3% were rated as adequate and 31·4% rated as being performed poorly or very poorly. Of concern, essential clinical skills, such as critical thinking and problem solving, working independently and assessment procedures, were found to be poorly executed and affecting new registered nurses graduates' competence. Conclusion: The findings from this study can further serve as a reference for nursing education providers to enhance nursing curricula and work collaboratively with healthcare settings in preparing nurses to be competent, safe practitioners on completion of their studies. Relevance to clinical practice: Identifying key areas in which new nursing graduates are not yet competent means that educational providers and educators from healthcare settings can focus on these skills in better preparing our nurses to be work ready.
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.
Graduate nurse program coordinators' perspectives on graduate nurse programs in Victoria, Australia : A descriptive qualitative approach
- Authors: Missen, Karen , McKenna, Lisa , Beauchamp, Alison
- Date: 2016
- Type: Text , Journal article
- Relation: Collegian Vol. 23, no. 2 (2016), p. 201-208
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- Description: Aims: The purpose of this study was to describe the formal preparation nursing graduates are given throughout their first year of nursing in terms of educational structure and content of work-based year-long graduate nurse programs, from the perspectives of Graduate Nurse Program Coordinators. Background: In Australia, graduate nurse programs aim to provide a supportive learning environment, assisting nursing graduates in applying their theory to practice and supporting them in becoming safe, competent and responsible professionals. Internationally, research has demonstrated an increase in the job satisfaction and more importantly retention rates of newly qualified nurses who are supported in their first year of employment in some type of transition program. Method: Using a descriptive qualitative approach, individual semi-structured interviews were used. These interviews were audio recorded, transcribed verbatim and thematically analysed to reveal themes and sub-themes. Results: The interviews provided an insight into the various aspects of preparation that nursing graduates are given in their first year of practice with the main theme to emerge from analysis, nature of transition programs. The three subthemes associated with nature of transition programs consisted of composition of rotations and study days and supernumerary strategies. Findings indicate variation in pedagogical models underpinning graduate nurse programs across Victoria. Clinical rotations varied between three to twelve months, the number of study days offered were between four and thirteen days and there was variation in supernumerary time and strategies within the programs investigated. © 2015 Australian College of Nursing Ltd.
Are we there yet? Graduate readiness for practice, assessment and final examinations
- Authors: Missen, Karen , McKenna, Lisa , Beauchamp, Alison
- Date: 2018
- Type: Text , Journal article
- Relation: Collegian Vol. 25, no. 2 (2018), p. 227-230
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- Description: Background This paper reports on one aspect of a larger doctoral project which investigated the perceptions of qualified nurses on the abilities of newly registered nursing graduates. Aims To explore qualified nurses’ perceptions on national examinations for registration in Australia.
Qualified nurses' perceptions of nursing graduates' abilities vary according to specific demographic and clinical characteristics. A descriptive quantitative study
- Authors: Missen, Karen , McKenna, Lisa , Beauchamp, Alison , Larkins, Jo-Ann
- Date: 2016
- Type: Text , Journal article
- Relation: Nurse Education Today Vol. 45, no. (2016), p. 108-113
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- Description: Background: Evidence from the literature and anecdotally from clinical settings suggests that newly graduated nurses are not fully prepared to be independent practitioners in healthcare settings. Aims and Objectives: The aim of this studywas to explore perceptions of qualified nurses in relation to the practice readiness of newly registered nursing graduates and determine whether these views differ according to specific demographic characteristics, clinical settings, and geographical locations. Design: A descriptive quantitative design was used. Methods: An online survey tool was used to assess how qualified nurses (n = 201) in Victoria, Australia, rated newly graduated nurses' abilities on 51 individual clinical skills/competencies in eight key skill areas. A composite score was calculated for each skill area and a comparative analysis was undertaken on the various cohorts of participants according to their demographic and clinical characteristics using one-way ANOVA and post hoc tests. Results: Newly graduated nurses were found to be lacking competence in two key skill areas and were rated as performing adequately in the remaining six skill areas assessed. Significant differences (p ≤ 0.05) in performance were found according to the age of the nurse, number of years registered, the educational setting in which they undertook their nurse education, their role, and the clinical area inwhich theyworked. There were no significant differences according to whether the nurse worked in the private or public healthcare sector. Few differences were found between nurses working in a metropolitan vs. regional/rural healthcare setting. Conclusion: This is the first study to quantify the scale of this problem. Our findings serve as a reference for both nurse education providers and healthcare settings in better preparing nursing graduates to be competent, safe practitioners in all clinical areas.
Effective interprofessional collaboration in rural contexts : A research protocol
- Authors: Mitchell, Rebecca , Paliadelis, Penny , McNeil, Karen , Parker, Vicki , Giles, Michelle , Higgins, Isabel , Parmenter, Glenda , Ahrens, Yvonne
- Date: 2013
- Type: Text , Journal article
- Relation: Journal of Advanced Nursing Vol. 69, no. 10 (2013), p. 2317-2326
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- Description: Abstract AIM: To describe the research protocol that will be used to investigate factors contributing to effective interprofessional practice in a rural context in Australia. BACKGROUND: Interprofessional practice is a key strategy for overcoming rural health challenges; however, our knowledge of interprofessional initiatives and consequences in rural areas is limited. DESIGN: A modified realistic evaluation approach will be used to explore the structures, systems, and social processes contributing to effective interprofessional outcomes. This 'context-mechanism-outcome' approach provides a useful framework for identifying why and how interprofessional practice works in rural contexts. METHOD: Initial propositions regarding the factors that explain effective collaborative practice will be generated through interviews with lead clinicians, policy-makers, and clinician managers. Clinician interviews, document analysis, and multi-participant focus groups will be used as evidence to support, refine, or redevelop the initial propositions. This will allow the development of a model of rural interprofessional practice that will explain how and why collaborative approaches work in rural environments. This study is funded by an Institute of Rural Clinical Services and Teaching grant (January 2010). DISCUSSION: Rural healthcare challenges are well documented; however, studies investigating the nature of interprofessional practice in rural contexts are not common. Rural contexts also present research design, particularly data collection, challenges. This proposed research is one of the first to identify the factors that facilitate or constrain effective interprofessional work in rural settings. This is particularly important, given the continuing workforce shortages and maldistribution and poorer health outcomes in rural communities globally.
Issues post-stroke for Muslim people in maintaining the practice of salat (prayer) : A qualitative study
- Authors: Mohamed, Che Rabiaah , Nelson, Katherine , Wood, Pamela , Moss, Cheryle
- Date: 2015
- Type: Text , Journal article
- Relation: Collegian Vol. 22, no. 3 (2015), p. 243-249
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- Description: Background: Muslims throughout the world perform salat (prayer) five times a day; salat involves a person reciting the Holy Qur'an while being in several positions. There are several steps that should be carried out before prayer, including wudhu (ablution) and covering one's awrah (body). Objectives: To identify educational needs for stroke patients and their caregivers in Malaysia. Another purpose is to report on the needs identified by stroke patients and their families related to salat. Methods: Descriptive qualitative study. Phase 1 involved semi-structured interviews with stroke patients (. n=. 5), family caregivers (. n=. 5) and health professionals (. n=. 12) in Kelantan Malaysia. Phase 2 involved presenting the findings from Phase 1 to the health professionals with the aim of establishing priorities and processes to develop education strategies for stroke patients and their families. Results: Preparing for and performing salat was challenging for both patient and family carers to do following a stroke. Themes identified were prayer and the meaning of the stroke events for participants, difficulties praying post-stroke, prayer as part of rehabilitation therapy. Conclusion: Providing culturally safe care should include how nurses assess and support patients and their caregivers post stroke to meet their prayer needs. Nurses have a role in discussing with stroke patients and their families how in addition to its spiritual and customary benefits, prayer and for Muslims reciting the Holy Qur'an can have cognitive and rehabilitation benefits, as well as being a source of psychological support for stroke patients. © 2014 Australian College of Nursing Ltd.
Twice-daily moisturizer application for skin tear prevention among older adults in acute care
- Authors: Mornane, Carolyn , Peck, Blake , Terry, Daniel , Ryan, Michael
- Date: 2021
- Type: Text , Journal article
- Relation: Advances in skin & wound care Vol. 34, no. 2 (2021), p. 1-4
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- Description: OBJECTIVE: To examine the effectiveness of twice-daily moisturizer application for patients admitted to an acute care setting on reducing the incidence of skin tear (ST) injuries. DESIGN, SETTING, AND PARTICIPANTS: This prospective, nonrandomized, case-control study identified an experimental and control ward equivalent in demography and patient acuity in a large hospital in regional Victoria, Australia. Patients 70 years or older admitted to the wards were invited to participate. INTERVENTION: Twice-daily application of a commercially available skin and body lotion to the arms and legs of participants. MAIN OUTCOME MEASURES: The incidence of ST in the experimental and control settings in the pre-, intra-, and posttrial periods. MAIN RESULTS: Although a decrease in ST incidence was observed over the study period (n = 128), this decrease was not significant pre- (median = 2.16, n = 73), intra- (median = 2.16, n = 73), or postintervention (median = 2.16, n = 69; χ[2, 152] = 0.502, P = .778). Similarly, there was no significant difference between wards (median = 9.86 [n = 152] vs median = 13.14 [n = 177]; U = 42.50, z = -1.198, r = 0.358, P = .231). CONCLUSIONS: The moisturizer in this study did not have a direct influence on the frequency of STs in the study population, although the data would suggest an intermittent reduction in ST incidence. The authors postulate that this was correlated with behavior change effects from the study. Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.
The effect of transition to specialty practice programs on Australian emergency nurses’ professional development, recruitment and retention
- Authors: Morphet, Julia , Kent, Bridie , Plummer, Virginia , Considine, Julie
- Date: 2015
- Type: Text , Journal article
- Relation: Australasian Emergency Nursing Journal Vol. 18, no. 4 (2015/11/01/ 2015), p. 204-211
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- Description: Summary Background To date, emergency nursing Transition to Specialty Practice Program (TSPP) evaluations have been single-site observational studies. The aim of this paper was to examine the professional development, recruitment and retention outcomes of Australian emergency nursing TSPPs. Methods An explanatory sequential design was used. Data were collected via online surveys and interviews of emergency Nurse Unit Managers and Nurse Educators. Survey data from EDs with TSPPs and EDs without TSPPs were compared. Qualitative data were analysed using content analysis. Results Data were collected from 118 EDs, and 13 interviews. TSPPs were offered in 72.1% of EDs. EDs with TSPPs had higher proportions of nurses with postgraduate qualifications (Mdn 28.3% vs. 22.1%, p=0.45) and Clinical Specialists (Mdn 16.4% vs. 6.3%, p=0.04). The median proportion of currently rostered nurses with TSPP completion was 34.2% in EDs with TSPPs introduced in 2000–2005 indicating ED high levels of retention. Conclusion Emergency nursing TSPPs have had a positive effect on nursing professional development, recruitment and retention. To ensure consistency in outcomes and optimise reliability of emergency nursing skills and knowledge, a national emergency nursing TSPP framework is needed.
At the crossroads of violence and aggression in the emergency department : Perspectives of Australian emergency nurses
- Authors: Morphet, Julia , Griffiths, Debra , Plummer, Virginia , Innes, Kelli , Fairhall, Robyn , Beattie, Jill
- Date: 2014
- Type: Text , Journal article , Review
- Relation: Australian Health Review Vol. 38, no. 2 (2014), p. 194-201
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- Description: Objective Violence is widespread in Australian emergency departments (ED) and most prevalent at triage. The aim of the present study was to identify the causes and common acts of violence in the ED perceived by three distinct groups of nurses. Methods The Delphi technique is a method for consensus-building. In the present study a three-phase Delphi technique was used to identify and compare what nurse unit managers, triage and non-triage nurses believe is the prevalence and nature of violence and aggression in the ED. Results Long waiting times, drugs and alcohol all contributed to ED violence. Triage nurses also indicated that ED staff, including security staff and the triage nurses themselves, can contribute to violence. Improved communication at triage and support from management to follow up episodes of violence were suggested as strategies to reduce violence in the ED Conclusion There is no single solution for the management of ED violence. Needs and strategies vary because people in the waiting room have differing needs to those inside the ED. Participants agreed that the introduction and enforcement of a zero tolerance policy, including support from managers to follow up reports of violence, would reduce violence and improve safety for staff. Education of the public regarding ED processes, and the ED staff in relation to patient needs, may contribute to reducing ED violence. What is known about the topic? Violence is prevalent in Australian healthcare, and particularly in emergency departments (ED). Several organisations and government bodies have made recommendations aimed at reducing the prevalence of violence in healthcare but, to date, these have not been implemented consistently, and violence continues. What does this paper add? This study examined ED violence from the perspective of triage nurses, nurse unit managers and non-triage nurses, and revealed that violence is experienced differently by emergency nurses, depending on their area of work. Triage nurses have identified that they themselves contribute to violence in the ED by their style of communication. Nurse unit managers and non-triage nurses perceive that violence is the result of drugs and alcohol, as well as long waiting times. What are the implications for practitioners? Strategies to reduce violence must address the needs of patients and staff both within the ED and in the waiting room. Such strategies should be multifaceted and include education of ED consumers and staff, as well as support from management to respond to reports of violence. © AHHA 2014.
Informing the development midwifery standards for practice : A literature review for policy development
- Authors: Nagle, Cate , McDonald, Susan , Morrow, Jane , Kruger, Gina , Cramer, Rhian , Couch, Sara , Hartney, Nicole , Bryce, Julianne , Birks, Melanie , Heartfield, Marie
- Date: 2019
- Type: Text , Journal article , Review
- Relation: Midwifery Vol. 76, no. (2019), p. 8-20
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- Description: Aim: To critically appraise and synthesise the literature regarding the role and scope of midwifery practice, specifically to inform the evidence based development of standards for practice for all midwives in Australia. Design: A structured scoping review of the literature Data sources: CINAHL Complete, MEDLINE Complete and Cochrane Libraries databases, online and grey literature databases Review methods: Comprehensive searches of databases used key words and controlled vocabulary for each database to search for publications 2006-2016. Studies were not restricted by research method. Findings: There is no substantive body of literature on midwifery competency standards or standards for practice. From 1648 papers screened, twenty-eight papers were identified to inform this review. Eight studies including systematic reviews were annotated with three research papers further assessed as having direct application to this review. To inform the development of Midwife standards for practice, the comprehensive role of the midwife across multiple settings was seen to include: woman centred and primary health care; safe supportive and collaborative practice; clinical knowledge and skills with interpersonal and cultural competence. Key conclusions: Midwifery practice is not restricted to the provision of direct clinical care and extends to any role where the midwife uses midwifery skills and knowledge. This practice includes working in clinical and non-clinical relationships with the woman and other clients as well as working in management, administration, education, research, advisory, regulatory, and policy development roles. Implications for practice: This review articulates the definition, role and scope of midwifery practice to inform the development of contemporary standards for practice for the Australian midwife. (C) 2019 Elsevier Ltd. All rights reserved.
Developing situation awareness amongst nursing and paramedicine students utilising eye tracking technology and video debriefing techniques: a proof of concept paper.
- Authors: O'Meara, Peter , Munro, Graham , Williams, Brett , Cooper, Simon J. , Bogossian, Fiona , Ross, Linda , Sparkes, Louise , Browning, Mark , McCounan, Mariah
- Date: 2015
- Type: Text , Journal article
- Relation: International Emergency Nursing Vol. 23, no. 2 (2015), p. 94-99
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- Description: Objective The aims of this quasi-experimental before-and-after study were to first determine whether the use of eye tracking technology combined with video debriefing techniques has the potential to improve the quality of feedback and enhance situation awareness (SA) in simulated settings and second to determine students' satisfaction towards simulated learning. Methods Nursing and paramedicine students from three universities participated in three 8-minute simulation scenarios of acutely deteriorating patients. Eye tracking glasses video recorded the scenarios and tracked right eye movement. On completion, participants were questioned using the Situation Awareness Global Assessment Technique, completed the Satisfaction with Simulation Experience Scale (SSES), and provided textual feedback and received video-based verbal feedback. Results Participants lacked awareness of presenting medical conditions and patient environments and had poor recall of patient vital signs. Significant improvements in SA scores were demonstrated between the first and third scenarios (P = 0.04). Participants reported greater insight into their performance and were satisfied with simulated learning. Conclusions Use of visual field review techniques appears to enhance the use of realistic simulated practice as a means of addressing significant performance deficits. Eye tracking and point of view recording techniques are feasible and with applicable debriefing techniques could enhance clinical and situated performance.
No one said he was dying : Families’ experiences of end-of-life care in an acute setting
- Authors: Odgers, Jade , Fitzpatrick, Denise , Penney, Wendy , Shee, Anna Wong
- Date: 2018
- Type: Text , Journal article
- Relation: Australian Journal of Advanced Nursing Vol. 35, no. 3 (2018), p. 21-31
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- Description: Objective To explore the family’s experience of end-of-life care for their dying family member during the last few days of life in an acute rural hospital. Design Interpretive design using qualitative methods, including 1: 1 semi- structured interviews. Setting The study was undertaken in a large regional health service in Victoria. Subjects Twelve relatives who were next of kin of people who died between 1 January 2012 and 30 June 2013 in an acute ward at the health service agreed to participate in the study. Main outcome measure Families’ perceptions of end-of-life care for their dying family member. Results Data analysis identified five themes that were grouped into two general dimensions - communication (guidance for family member’s role in end of life care, the family’s preparation for death, the dying experience) and care and support (the hospital care experience, follow-up after death). Conclusion A lack of open and candid communication hindered family members’ engagement in decision-making and involvement in their loved ones’ last days of life. The absence of formal processes for end of life (EOL) care planning resulted in families being unprepared for what they perceived as their family member’s ‘sudden death’.
Health justice partnerships: Initial insights into the delivery of an integrated health and legal service for youth in regional Victoria
- Authors: Ollerenshaw, Alison , Camilleri, Marg
- Date: 2017
- Type: Text , Journal article
- Relation: Rural and Remote Health Vol. 17, no. 2 (2017), p. 1-6
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- Description: Introduction: This article presents interim findings from research examining the implementation of a health justice partnership (HJP) focusing on the legal and health needs of regional young people. HJPs provide an innovative service model offering an integrated health and legal service for the community. HJPs are a relatively new service model for Australia, yet the program is well suited to meet the needs of particular population cohorts, including young people and those in regional locations experiencing complex legal issues. Methods: Funded by the Victorian Legal Services Board and Commissioner, an HJP in partnership with three organisations was established in a large regional area in Victoria, Australia. Research is being conducted alongside the program to examine its impact on young people, and the implications on practice for staff in the partner organisations. Results: Findings provide preliminary support for the HJP model with a number of young people - from predominantly disadvantaged backgrounds and with varying legal issues - having been referred to the program in the first 6 months. Referrals were received from both partner agencies and external agencies. Initial client and staff survey responses indicate that the legal problem of the young people was affecting how they feel. Conclusions: While these findings provide preliminary support for the HJP further research will offer longer term insights about HJPs within the Australian context, particularly rural and regional settings. © A Ollerenshaw, M Camilleri, 2017.
Quality of life in recipients before and after liver transplantation in Turkey
- Authors: Ordin, Yaprak , Dicle, Aklime , Wellard, Sally
- Date: 2011
- Type: Text , Journal article
- Relation: Progress in Transplantation Vol. 21, no. 3 (September 2011 2011), p. 260-267
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- Description: Context: Liver transplantation has become the treatment of choice for patients with end-stage liver disease. Most studies show a positive effect on quality of life after liver transplantation, but most studies are based on data from Western countries and little is known about quality of life in liver transplant recipients in Turkey or other developing countries. Objective: To investigate liver transplant recipients' quality of life and factors affecting it, before and 3 months after transplantation in western Turkey. Design: Descriptive and comparative, with data collected prospectively. Setting: Two medical centers in Western Turkey. Patients: Sixty-five adult recipients of a liver transplant between May 15 and December 31,2007. Instruments: Quality of life was measured by using the Nottingham Health Profile Turkish version, and sociodemographic and clinical data were collected from patients' records. Results: Scores on all subscales of the Nottingham Health Profile differed significantly from before to after liver transplantation. The differences between the mean scores for quality of life before and after transplantation varied significantly with the patients' sex and disease severity.