List of Titles

A mixed method exploration of student perceptions of assessment in nursing and biomedicine

- Garvey, Loretta, Hodgson, Yvonne, Tighe, Josephine

Authors: Garvey, Loretta , Hodgson, Yvonne , Tighe, Josephine
Date: 2022
Type: Text , Journal article
Relation: Journal of Further and Higher Education Vol. 46, no. 1 (2022), p. 128-141
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Description: Assessment in higher education requires a high level of accountability and responsibility and is a major influence on student learning but can be a source of stress for staff and students. This project aimed to evaluate first-year students’ conceptions of assessment in biomedical science and nursing to determine positive or negative trends and how these can be facilitated or mitigated. This mixed-methods study compared the conceptions of assessment between students in nursing and biomedical science students at one university, using the Conceptions of Assessment questionnaire. The results revealed that overall students in the two different areas of study had similar perceptions of assessment. Students were found to have positive conceptions of assessment which were identified as relating to their secondary education. Thematic analysis of students’ responses identified eight themes associated with their perception of what assessment is, and the associated limitations of assessment and the multi-faceted personal factors that affected students’ position towards assessment. This study recommends a shift in focus from assessment relating to accountability, towards assessment for learning to maintain students’ initial perceptions of assessment to ensure their experience aligns with their expectations. Transparent communication about assessment requirements and support for students to undertake assessment may mitigate students’ negative perceptions held towards assessment. © 2021 UCU.

A multi-layered approach to developing academic written communication skills for nursing students

- Garvey, Loretta, Willetts, Georgina, Herrmann, Antje, Verezub, Elena, Sinchenko, Elena

Authors: Garvey, Loretta , Willetts, Georgina , Herrmann, Antje , Verezub, Elena , Sinchenko, Elena
Date: 2023
Type: Text , Journal article
Relation: International Journal of Nursing Education Scholarship Vol. 20, no. 1 (2023), p.
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Description: Objectives: Academic literacy in nursing students has historically been poor this research therefore aimed to investigate the effectiveness of an embedded multidisciplinary approach to academic written communication skills for first year Bachelor of Nursing students in Australia. Methods: This initiative consisted of (1) collaboratively embedding academic skills with nursing staff and Learning and Academic Skills Advisors using scaffolded tasks, curriculum/material development, workshops/tutorials on writing skills; and (2) individual support sessions. Data was obtained via questionnaire. Results: Responses were received from 92 (74% local and 26% international) students. Key findings showed the collaborative approach to embedding skills with added follow up, was beneficial for students' skills development, including improved academic writing, increased confidence, and recognition of the importance of academic writing. Conclusions: It is important to equip student to develop academic literacy and an embedded academic literacy program has been determined to assist and may contribute to future professionalisation in nursing. © 2023 Walter de Gruyter GmbH, Berlin/Boston.

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A qualitative study on undergraduate student nurses’ experience of mental health simulation preclinical placement

- Olasoji, Michael, Garvey, Loretta, Sadoughi, Navideh, Willetts, Georgina

Authors: Olasoji, Michael , Garvey, Loretta , Sadoughi, Navideh , Willetts, Georgina
Date: 2023
Type: Text , Journal article
Relation: Clinical Simulation in Nursing Vol. 84, no. (2023), p.
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Description: Background: Simulations allow students to be challenged and supported while gaining both technical and non-technical skills within a clinical learning environment. Working in a mental health setting can be quite challenging and confronting at times for undergraduate nursing students in clinical placement. The study aims to explore nursing students’ perceptions of a mental health simulation workshop's impact before clinical placement, which provides a supportive environment to gain technical and non-technical skills while being challenged and supported. Sample: Participants were a second-year cohort (n = 89) of undergraduate nursing students enrolled in a mental health unit. Methods: Descriptive survey design. The researchers thematically analysed narrative responses of a pre- and post-simulation survey from an immersive simulation using a descriptive survey design. Results: The researchers identified six key themes: two from the pre-simulation survey – communication with and assessment of mental health patients, and the opportunity for placement preparation; and four from the post-simulation survey – the opportunity for debriefing, the realism of the simulation, increased confidence levels, and the perception of a safe learning environment. Conclusion: Effective skill acquisition is essential to advance recruitment and retention into mental health environments. The use of mental health simulation that comprises of realism and immersion working with simulated patients provided opportunity to advance this. © 2023

Anxiety, flipped approach and self-efficacy : exploring nursing student outcomes

- Croy, Glen, Garvey, Loretta, Willetts, Georgina, Wheelahan, Jamie, Hood, Kerry

Authors: Croy, Glen , Garvey, Loretta , Willetts, Georgina , Wheelahan, Jamie , Hood, Kerry
Date: 2020
Type: Text , Journal article
Relation: Nurse Education Today Vol. 93, no. (2020), p.
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Description: Background: Self-efficacy is crucial for student success. Studies have demonstrated a positive relationship between flipped learning approach and self-efficacy. Anxiety, however, can reduce self-efficacy. Objective: Testing the relationship between the flipped approach and self-efficacy by flipping a nursing module within an externally-imposed and once-off anxiety-inducing context. Method: Students completed a self-efficacy survey before (n = 71) and after (n = 91) a compressed semester, which provided the anxiety-inducing context. Results: Pre-semester self-efficacy was 2.93/4, and post-semester was 2.98/4. The results demonstrated no significant change in students' self-efficacy. Conclusion: We argue the flipped approach counters anxiety-inducing effects to maintain self-efficacy. In less anxiety-inducing contexts, we argue the flipped approach would develop students' confidence, capability, persistence and strength beliefs, collectively enhancing self-efficacy perceptions. © 2020 Elsevier Ltd

Conceptions of assessment in students and staff teaching biomedical sciences: a pilot study

- Hodgson, Yvonne, Garvey, Loretta

Authors: Hodgson, Yvonne , Garvey, Loretta
Date: 2020
Type: Text , Journal article
Relation: Journal of Further and Higher Education Vol. 44, no. 6 (2020), p. 818-828
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Description: Higher education assessment policies aim to please all, creating confusion for staff and students. This study reports on staff and student conceptions of assessment and the students’ experience of the assessment regime over their Biomedical Science degree. There was a general alignment of staff and students views of assessment for 19 of 27 items on the ‘Conceptions of Assessment’ questionnaire (CoA). Areas of discrepancy were identified in: (i) the use of assessment as institutional quality, students identified this as more important than staff, and (ii) assessment is used for modifying teaching practices, students did not recognise this as an important role. Students experience of the assessment regime over their degree revealed : (i) the excessive quantity of assessment without a clear delineation between formative and summative assessment, (ii) the importance of exams in learning, (iii) dissatisfaction with feedback timing, quality and quantity and (iv) self-reported high use of feedback received. This retrospective study highlights the need for an assessment dialogue between staff and students to reduce student mistrust over assessment and to improve staff–student relationships. Identifying the gap in assessment conceptions may assist staff in understanding student’s behaviour towards their grades, feed- back and the competitive student environment. © 2019, © 2019 UCU.

Constructing nurses' professional identity through group performance

- Willetts, Georgina, Garvey, Loretta

Authors: Willetts, Georgina , Garvey, Loretta
Date: 2020
Type: Text , Journal article
Relation: International Journal of Nursing Practice Vol. 26, no. 6 (2020), p.
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Description: Aims: The aim of this study was to examine professional identity through the group performances of nurses within a specific work environment. Background: Professional identity and social identity are closely linked. Nurses undertake clinical practice usually within a social group environment. The literature is limited on the development of professional identity within the context of nurses' daily work. Design: An integrated ethnographic case context design was adopted, consisting of two clinical wards in one acute health-care facility in Australia. The application of the social identity theory (SIT) was used to study two specific professional activities to describe the group performance of nurses within this organizational cultural context and how this influenced nurses' professional identity. Method: The research was undertaken between 2012 and 2014. Data collection included observation, interviews and fieldnotes of a convenience sample of nurses and allied health-care professionals who undertook two professional activities in their normal work environment. Findings: The development of group efficacy contributed to the development of the professional identity in the homogenous handover activity. Self-efficacy was demonstrated in the heterogenous multidisciplinary activity. Conclusion: The results indicated the importance of recognizing core identity-building activities and understanding the value of these activities to professional identity development. © 2020 John Wiley & Sons Australia, Ltd

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Developing entrustable professional activities to enhance application of an aggression prevention protocol

- Maguire, Tessa, Willetts, Georgina, McKenna, Brian, Daffern, Michael, Garvey, Loretta

Authors: Maguire, Tessa , Willetts, Georgina , McKenna, Brian , Daffern, Michael , Garvey, Loretta
Date: 2023
Type: Text , Journal article
Relation: Nurse Education in Practice Vol. 73, no. (2023), p.
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Description: Aim: The research aim of this study was to seek feedback from prevention of aggression training experts about the suitability of Entrustable Professional Activities (EPAs) as an assessment tool for an Aggression Prevention Protocol. The protocol was designed to structure intervention to prevent aggression and reduce the use of restrictive practices following risk assessment using a validated instrument (the Dynamic Appraisal of Situational Aggression). Background: Preventing aggression and limiting the use of restrictive practices are key priorities for inpatient mental health services. Assessing clinical activities using a competence framework has limitations, particularly when determining complex interventions. EPAs could provide a suitable method for assessing complex clinical activities like de-escalation and limit setting, which comprise some of the interventions in the Aggression Prevention Protocol. EPAs are new to forensic mental health nursing; therefore, feedback was sought regarding the utility of EPAs to assess aggression prevention interventions. Methods: Data were collected via focus groups including 11 aggression prevention experts from Australia and New Zealand. A thematic analysis, comparative analysis and a Strength, Weakness, Opportunity and Threats analysis was conducted. Results: Three themes were interpreted from the data: 1) Frameworks such as the APP are needed to work towards elimination of restrictive practices; 2) APP-EPAs afford an opportunity to set the standard for practice; and 3) ‘who watches the watchers’, were identified by the experts as well as areas to enhance EPAs prior to introduction into practice. Conclusions: EPAs address a practice-gap and offer a framework to assist movement towards elimination of restrictive practices, while prompting best-practice, self-reflection and practice improvement guidance. © 2023

Enhancing cultural capabilities amongst health professions students : a pilot study of interprofessional tag team simulation

- Garvey, Loretta, Mackelprang, Jessica, Bhowmik, Jahar, Cassar, Nicole, Delbridge, Robyn, El-Ansary, Doa, Willetts, Georgina, Williams, Anne

Authors: Garvey, Loretta , Mackelprang, Jessica , Bhowmik, Jahar , Cassar, Nicole , Delbridge, Robyn , El-Ansary, Doa , Willetts, Georgina , Williams, Anne
Date: 2022
Type: Text , Journal article
Relation: Clinical Simulation in Nursing Vol. 62, no. (2022), p. 83-91
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Description: Background: To facilitate inclusive healthcare and increase cultural capabilities, health professions students require authentic interprofessional learning experiences that challenge their social, professional, and historical positioning. Tag Team Simulation (TTS) is an innovative approach to develop students’ interprofessional collaboration and cultural competency for working with Aboriginal people. Method: Co-designed and delivered by Aboriginal people and an interdisciplinary team of health professions academics, this pilot aimed to: (a) evaluate the effect of TTS on students’ self-rated cultural capabilities (Cultural Capabilities Measurement Tool) and interprofessional attitudes (Interprofessional Attitude Scale), and (b) explore students’ simulation learning experience. Results: Students’ respect, communication, and safety and quality scores on the Cultural Capabilities Measurement Tool were significantly higher post simulation, as were their Interprofessional Attitude Scale scores. Students experienced the simulation as authentic and effective in advancing their communication skills and cultural understanding. Conclusions: This co-designed interprofessional simulation improved health professions students’ self-rated cultural capabilities and interprofessional attitudes. Coupled with positive student feedback, results indicate that TTS is an innovative simulation method for building cultural competence in health professions students across disciplines. © 2021

Exploration of the utility of the nursing process and the clinical reasoning cycle as a framework for forensic mental health nurses : a qualitative study

- Maguire, Tessa, Garvey, Loretta, Ryan, Jo, Willetts, Georgina, Olasoji, Michael

Authors: Maguire, Tessa , Garvey, Loretta , Ryan, Jo , Willetts, Georgina , Olasoji, Michael
Date: 2022
Type: Text , Journal article
Relation: International Journal of Mental Health Nursing Vol. 31, no. 2 (2022), p. 358-368
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Description: Forensic mental health nursing (FMHN) is a specialized field, designed to meet the needs of people who have a serious mental illness across the criminal justice system, inpatient services and community. Frameworks can assist assessment, planning, intervention, documentation and evaluation of nursing care. However, there is no prior research investigating frameworks in FMHN. This study aimed to explore the Nursing Process (NP) and the Clinical Reasoning Cycle (CRC), with nurses, to determine a suitable framework for use service-wide. A Nominal Group Technique was used to facilitate exploration of the two frameworks, where open-ended verbal and written responses collected from a Nominal Group were thematically analysed, and the participants voted on their preferred framework. Seventeen nurses from a state-wide forensic mental health (FMH) service participated. The four main themes were as follows: challenges to current practice, limitations of the NP, perceived benefits of the CRC and addressing implementation. Consensus was reached with the nurses selecting the CRC as the framework of choice. This is the first study to explore frameworks to guide practice in FMHN. Nurses in this study considered the CRC to be a suitable framework for novice through to expert, offering a contemporary framework to guide nursing care in complex FMH settings. Some adjustments to the existing cycle were suggested to emphasize recovery-oriented practice, and inclusion of family and carers. Any changes to the cycle warrant exploration with the interdisciplinary team and consumer carer workforce. © 2021 John Wiley & Sons Australia, Ltd.

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Exploring adaptations to the clinical reasoning cycle for forensic mental health nursing : a qualitative enquiry

- Maguire, Tessa, Garvey, Loretta, Ryan, Jo, Levett-Jones, Tracy, Olasoji, Michael, Willetts, Georgina

Authors: Maguire, Tessa , Garvey, Loretta , Ryan, Jo , Levett-Jones, Tracy , Olasoji, Michael , Willetts, Georgina
Date: 2023
Type: Text , Journal article
Relation: International Journal of Mental Health Nursing Vol. 32, no. 2 (2023), p. 544-555
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Description: Forensic mental health nurses (FMHN) provide care to address the needs of people who have mental illnesses across a range of diverse settings. The Clinical Reasoning Cycle (CRC) has been identified as a potential framework to assist FMHNs; however, adaptations were required to reflect the unique nature of the clinical setting. This study aimed to explore adaptations made to determine suitability prior to implementation in practice. Nominal Group Technique was used to explore suggested adaptations determined from a previous study and reach a consensus on the changes. Fourteen senior nurses from a state-wide Forensic mental Health (FMH) service participated. A consensus was reached for two proposed changes. Data were analysed using thematic analysis. Three main themes were interpreted from the data; FMH adaptations are warranted, the focus of the CRC, and who owns the cycle? Nurses in this study considered the need to include offence and risk issues due to the impact these factors have on the therapeutic relationship and cognitive bias; however, they also identified the need to focus on recovery-oriented care while engaging in clinical reasoning. Nurses in this study also expressed some reluctance for nursing to ‘own' the model, due to concern that ownership may cause division among the team or result in inconsistency in care. However, some participant's suggested the CRC with adaptations assisted FMH nurses to articulate their specialist skills and knowledge to others and highlight the nursing contribution to care. Further work is needed to finalize adaptations with a focus on engaging the consumer carer workforce and interdisciplinary team. © 2022 The Authors. International Journal of Mental Health Nursing published by John Wiley & Sons Australia, Ltd.

Implementation of a Registered Undergraduate Student of Nursing (RUSON) program : the nurses’ perspective

- Willetts, Georgina, Nieuwoudt, Laurina, Olasoji, Michael, Sadoughi, Navideh, Garvey, Loretta

Authors: Willetts, Georgina , Nieuwoudt, Laurina , Olasoji, Michael , Sadoughi, Navideh , Garvey, Loretta
Date: 2022
Type: Text , Journal article
Relation: Collegian Vol. 29, no. 1 (2022), p. 70-77
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Description: Problem: Undergraduate nursing students remain an underutilised workforce within healthcare. This paper explores the establishment of a Registered Undergraduate Students of Nursing (RUSON) model through a university and healthcare partnership. Background: Nursing continues to adapt to increasingly complex patient populations. Initiatives are needed to enable nurses to focus on patients’ care needs amidst increasing healthcare costs. This study identifies opportunities and strategies for engaging undergraduate nursing students as part of the healthcare workforce through the RUSON model, from the perspective of nurse leaders. Aim: This project aimed to explore nurse leaders’ perspectives surrounding implementation of a RUSON model. Method: A qualitative exploratory design was employed for this study. Thematic analysis from a focus group with the nurse leaders was undertaken. Findings: Two key themes were identified from the analysis, i) Establishing the RUSON; with sub-themes: “Who are RUSONs?”, “You are not on clinical placement” and “The importance of inclusivity” and ii) Benefits of the RUSONs; with sub-themes: “Addressing patient care needs”, “Value to the nursing team” and “Creating future ready employees”. Participants identified barriers that were overcome, subsequently leading to the model being considered advantageous to the clinical environment. Discussion: The establishment of a RUSON workforce in acute care settings brings with it benefits to the nursing staff and the RUSONs themselves. In order to successfully embed a RUSON model in an organisation, it is important to collaborate with the nursing leadership team in the implementation process. Conclusion: A RUSON workforce is an appropriate human resource strategy, both at the immediate point of implementation and longitudinally, as a recruitment strategy for future employment. Successful implementation of a RUSON model requires engagement and collaboration with nursing leaders. © 2021

Improving the physical health of young people with early psychosis with lifestyle interventions : scoping review

- Hui, Ting, Garvey, Loretta, Olasoji, Michael

Authors: Hui, Ting , Garvey, Loretta , Olasoji, Michael
Date: 2021
Type: Text , Journal article , Review
Relation: International Journal of Mental Health Nursing Vol. 30, no. 6 (2021), p. 1498-1524
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Description: People with mental illness experience a shorter life expectancy compared to the general population. Poor physical health trajectory emerges following the onset of psychosis and is further compounded by the initiation of antipsychotic treatment. Young people are particularly at risk as the onset of mental illness mostly occurs between the age of 12 and 25 years. This represents a crucial period for early intervention to prevent a physical ill health trajectory. Furthermore, those who are at ultra-high risk for psychosis should also be targeted for early intervention. Lifestyle interventions have been identified as the first-line physical health promotion practice for improving the physical health of people with severe mental illness. The aim of this study was to conduct a scoping review following the JBI methodological guidance on scoping reviews to explore the current literature on lifestyle intervention trialled for early psychosis, including first-episode psychosis and those who are at ultra-high risk for psychosis. This review also explores the extent of literature examining physical health literacy in this specific population. The literature search was conducted on Medline, Embase, PsycINFO and Scopus. Twenty-two studies were included for the purpose of this scoping review, 21 of which examined the effects of lifestyle interventions and one of which reported on physical health literacy. This scoping review indicates the need for co-designed lifestyle interventions with the involvement of service users, families and carers and a focus on promoting physical health literacy, social support, and an incorporation of a health behaviour change model focus on promoting autonomous motivation. The findings of this study can inform future development of a novel co-designed lifestyle intervention for the targeted population. © 2021 John Wiley & Sons Australia, Ltd

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Modifying the clinical reasoning cycle to enhance forensic mental health nursing utility

- Maguire, Tessa, Ryan, Jo, Levett-Jones, Tracy, Olasoji, Michael, Garvey, Loretta

Authors: Maguire, Tessa , Ryan, Jo , Levett-Jones, Tracy , Olasoji, Michael , Garvey, Loretta
Date: 2024
Type: Text , Journal article
Relation: International Journal of Mental Health Nursing Vol. 33, no. 3 (2024), p. 636-648
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Description: Forensic mental health nursing is a specialty area of practice requiring specific knowledge and skills to work collaboratively with consumers. The Clinical Reasoning Cycle has been recognised as a potential framework to support nursing practice; however, it has been identified that adaptations are required to enhance utility in a forensic mental health services. The aim of this study was to explore and finalise a version of the cycle for forensic mental health nursing practice. Focus groups and interviews were used to explore adaptations with staff from a state-wide forensic service and forensic mental health nursing academics. Data were thematically analysed. Four main themes were interpreted: (1) allegiance to the Nursing Process, (2) moving the cycle from page to practice, (3) working as a team, or not, and (4) implementation will be a marathon and not a sprint. While nursing academics were more in favour of updating the Nursing Process to ensure contemporary practice is captured, staff from the service were supportive of the adapted cycle but emphasised the need to ensure collaboration with the consumer and their supporters. The adapted cycle was seen to articulate the contribution of forensic mental health nursing care, and support for a nursing-specific cycle was embraced by other disciplines, despite some hesitation from nurses. Prior to implementation there is a need to ensure the merits of the cycle are clearly articulated, along with a range of resources and specific contextual information to ensure the cycle can be successfully applied to enhance nursing practice and consumer care. © 2023 The Authors. International Journal of Mental Health Nursing published by John Wiley & Sons Australia, Ltd.

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Nurses' perspectives on medication errors and prevention strategies in residential aged care facilities through a national survey

- Kuppadakkath, Subhash, Bhowmik, Jahar, Olasoji, Michael, Garvey, Loretta

Authors: Kuppadakkath, Subhash , Bhowmik, Jahar , Olasoji, Michael , Garvey, Loretta
Date: 2023
Type: Text , Journal article
Relation: International Journal of Older People Nursing Vol. 18, no. 6 (2023), p.
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Description: Background: Medication errors are common in residential aged care facilities (RACFs) due to several factors. Effective medication management is essential to prevent medication errors among older people particularly due to the complexity of co-morbidities they can experience. Objectives: This study aimed to examine and quantify the contributing factors of medication errors from nurses' perspectives and the prevention strategies to reduce medication errors among older adults living in RACFs. Methods: A survey with 140 completed responses from registered nurses (RNs) and endorsed enrolled nurses (EENs) working in RACFs across Australia were included in the study. The survey had 24 items, related to contributing factors of medication errors, and the prevention strategies. Descriptive statistics and exploratory factor analysis were used in the data analysis process. Results: The study identified medication errors are caused by contributing factors such as use of agency staffing (70.4%) and delays in receipt of laboratory results (94.3%). However, it also identified suggestions to reduce medication errors in RACFs, for example use of electronic alerts (88.3%), and efficient laboratory communication (91.8%). Our results revealed three key factors for causes (workload, interprofessional involvement and interruptions) and suggestions (medication safety alerts, medication process improvement and effective reporting). Conclusion: Medication errors in RACFs are a global problem being one of the leading causes of morbidity and mortality. The knowledge and awareness of the factors associated with medication errors and the prevention strategies can guide potential quality improvement plans and contribute to minimisation of risk associated with medication safety in RACFs. Implications for practice: The study recommends strategies for best practices in medication management such as interprofessional collaboration, implementing standardised policies and electronic alerts to reduce medication errors in RACFs. © 2023 The Authors. International Journal of Older People Nursing published by John Wiley & Sons Ltd.

Nurses’ experience of medication errors in residential aged care facilities : an exploratory descriptive study

- Kuppadakkath, Subhash, Olasoji, Michael, Garvey, Loretta

Authors: Kuppadakkath, Subhash , Olasoji, Michael , Garvey, Loretta
Date: 2022
Type: Text , Journal article
Relation: Collegian Vol. 29, no. 6 (2022), p. 880-886
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Description: Background: The incidence of medication errors is of great concern in residential aged care facilities. However, registered nurses’ perceptions on medication errors and the strategies to reduce medication errors have not been previously explored. Aim: The aim of this study was to explore nurses’ experiences of medication errors and their suggestions to reduce these in residential aged care facilities. Methods: An exploratory descriptive design was employed; 12 registered nurses working in residential aged care facilities across Victoria participated in the study. Semi-structured interviews were used for data collection, and the data were thematically analysed. Findings: Four themes emerged from the interviews: (i) work environment, with sub themes of inadequate staffing and unmanageable workload; (ii) external constraints, with sub themes of involvement of a multi-disciplinary team and work interruptions; (iii) psychological impact; and (iv) medication error prevention strategies. Discussion: This study identified that medication errors occur because of inadequate staffing, work interruptions, and varying factors of multi-disciplinary team involvement. Medication errors negatively impact staff, residents, and family members causing additional stress and frustration surrounding follow-up and management. However, practical suggestions provided by registered nurses could be implemented in future to reduce the occurrence of such medication errors. Conclusion: This study described the contributing factors to medication errors; their impact on the staff, residents, and family members; and practical strategies to reduce medication errors, based on the experience of registered nurses in residential aged care facilities. This study makes a novel contribution to knowledge and practice in medication management process in RACF. © 2022

Nursing educators’ professional identity : challenges and consequences when adopting the flipped approach

- Garvey, Loretta, Hood, Kerry, Willetts, Georgina, Weller-Newton, Jennifer, Wheelahan, Jamie, Croy, Glen

Authors: Garvey, Loretta , Hood, Kerry , Willetts, Georgina , Weller-Newton, Jennifer , Wheelahan, Jamie , Croy, Glen
Date: 2023
Type: Text , Journal article
Relation: Teaching and Learning in Nursing Vol. 18, no. 2 (2023), p. 257-262
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Description: To discover how adopting the flipped approach impacts nursing educators’ professional identity we used an autoethnographic qualitative design, underpinned by appreciative inquiry. The flipped approach was first implemented in a second-year intensive clinical module with 154 pre-registration nursing students. Four nursing educators recorded their experiences (using journals), followed by an appreciative-inquiry-guided focus group drawing on their journal entries. Four themes associated with adopting the flipped approach were: (i) challenged existing and developed new professional identity; (ii) developing practice in the flipped approach; (iii) triumphs in students’ achievements and renewed motivations as educators; and (iv) challenges in developing new expertise, access to appropriate resources, and unaligned assessment program. Despite the direct challenge to their identity, participants welcomed the new approach. The challenges forced participants’ reflexive attention to core elements of the nursing academic educator prototype, from which participants felt more aligned with the newly adopted approach and subsequent outcomes. © 2022

Pain assessment of the adult sedated and ventilated patients in the intensive care setting : a scoping review

- Kerbage, Samira, Garvey, Loretta, Lambert, Gavin, Willetts, Georgina

Authors: Kerbage, Samira , Garvey, Loretta , Lambert, Gavin , Willetts, Georgina
Date: 2021
Type: Text , Journal article , Review
Relation: International Journal of Nursing Studies Vol. 122, no. (2021), p.
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Description: Background: Pain is frequently encountered in the intensive care setting. Given the impact of pain assessment on patient outcomes and length of hospital stay, studies have been conducted to validate tools, establish guidelines and cast light on practices relating to pain assessment. Objective: To examine the extent, range and nature of the evidence around pain assessment practices in adult patients who cannot self-report pain in the intensive care setting and summarise the findings from a heterogenous body of evidence to aid in the planning and the conduct of future research and management of patient care. The specific patient cohort studied was the sedated/ ventilated patient within the intensive care setting. Design: A scoping review protocol utilised the Preferred Reporting Items for Systematic Reviews and Meta-Analysis extension for Scoping review checklist (PRISMA-ScR). Methods: The review comprised of five phases: identifying the research question, identifying relevant studies, study selection, charting the data and collating, summarizing, and reporting the results. Databases were systematically searched from January to April 2020. Databases included were Scopus, Web of Science, Medline via Ovid, CINAHL COMPLETE via EBSCO host, Health Source and PUBMED. Limits were applied on dates (2000 to current), language (English), subject (human) and age (adult). Key words used were “pain”, “assessment”, “measurement”, “tools”, “instruments”, “practices”, “sedated”, “ventilated”, “adult”. A hand search technique was used to search citations within articles. Database alerts were set to apprise the availability of research articles pertaining to pain assessment practices in the intensive care setting. Results: The review uncovered literature categorised under five general themes: behaviour pain assessment tools, pain assessment guidelines, position statements and quality improvement projects, enablers and barriers to pain assessment, and evidence appertaining to actual practices. Behaviour pain assessment tools are the benchmark for pain assessment of sedated and ventilated patients. The reliability and validity of physiologic parameters to assess pain is yet to be determined. Issues of compliance with pain assessment guidelines and tools exist and impact on practices. In some countries like Australia, there is a dearth of information regarding the prevalence and characteristics of patients receiving analgesia, type of analgesia used, pain assessment practices and the process of recording pain management. In general, pain assessment varies across different intensive care settings and lacks consistency. Conclusion: Research on pain assessment practices requires further investigation to explore the causative mechanisms that contribute to poor compliance with established pain management guidelines. The protocol of this review was registered with Open Science Framework (https://osf.io/25a6) Tweetable abstract: Pain assessment in intensive care settings lacks consistency. New information is needed to understand the causative mechanisms underpinning poor compliance with guidelines. © 2021

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Pain management interventions of the non-communicating patient in intensive care : what works for whom and why? A rapid realist review

- Hamadeh, Samira, Willetts, Georgina, Garvey, Loretta

Authors: Hamadeh, Samira , Willetts, Georgina , Garvey, Loretta
Date: 2024
Type: Text , Journal article , Review
Relation: Journal of Clinical Nursing Vol. 33, no. 6 (2024), p. 2050-2068
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Description: Aim: The utility and uptake of pain management interventions across intensive care settings is inconsistent. A rapid realist review was conducted to synthesise the evidence for the purpose of theory building and refinement. Design: A five-step iterative process was employed to develop project scope/ research questions, collate evidence, appraise literature, synthesise evidence and interpret information from data sources. Methods: Realist synthesis method was employed to systematically review literature for developing a programme theory. Data Sources: Initial searches were undertaken in three electronic databases: MEDLINE, CINHAL and OVID. The review was supplemented with key articles from bibliographic search of identified articles. The first 200 hits from Google Scholar were screened. Results: Three action-oriented themes emerged as integral to successful implementation of pain management interventions. These included health facility actions, unit/team leader actions and individual nurses' actions. Conclusion: Pain assessment interventions are influenced by a constellation of factors which trigger mechanisms yielding effective implementation outcomes. Implications: The results have implications on policy makers, health organisations, nursing teams and nurses concerned with optimising the successful implementation of pain management interventions. Impact: The review enabled formation of a programme theory concerned with explaining how to effectively implement pain management interventions in intensive care. Reporting Method: This review was informed by RAMESES publication standards for realist synthesis. Public Contribution: No patient or public contribution. The study protocol was registered in Open Science Framework. 10.17605/OSF.IO/J7AEZ. © 2024 The Authors. Journal of Clinical Nursing published by John Wiley & Sons Ltd.

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Pain management of adult sedated and ventilated patients in the intensive care units : a survey with free text responses

- Hamadeh, Samira, Lambert, Gavin, Willetts, Georgina, Garvey, Loretta

Authors: Hamadeh, Samira , Lambert, Gavin , Willetts, Georgina , Garvey, Loretta
Date: 2024
Type: Text , Journal article
Relation: Intensive and Critical Care Nursing Vol. 84, no. (2024), p.
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Description: Background: Pain management of sedated and ventilated patients in intensive care units lacks consistency. Objectives: To investigate nurses’ training, governance, practices, knowledge and attitudes relating to pain management in consideration of published guidelines and explore nurses’ perspectives. Methods: A survey design, using an online questionnaire with free text responses, was employed. Quantitative and qualitative data from nurses working across different hospitals were collated and saved on Qualtrics platform. Quantitative data were analysed non-parametrically and narrative responses thematically. CROSS and SRQR reporting guidelines were adhered to. Outcome measures: Demographics, training, governance, clinical practice, knowledge, and attitudes. Results/findings: 108 nurses participated with ninety-two completed surveys analysed. Analgesia was used to complete nursing tasks regardless of comfort needs (n = 49, 53.3 %). Changes in vital signs prompted opioid administration (n = 48, 52.1 %). Choice of analgesia depended on doctor's preference (n = 63, 68.5 %). Non-opioid therapy was administered before opioids (n = 42, 45.7 %). Sedatives were used to alleviate agitation(n = 50,54.3 %). No statistically significant difference in nurses’ knowledge existed between hospitals. Weak positive relationship: r = [0.081], p = [0.441] between “knowledge scores” and “years of ICU experience” and weak negative relationship r = [-0.119], p = [0.260] between “knowledge scores” and “hours of clinical practice” was detected. Lack of training, resources, policies, high patient acuity and casual employment were acknowledged barriers to pain management. Two overarching themes emerged from narrative responses: “Pain assessment, where is it?” And “Priorities of critical illness.” Conclusion: The study uncovered pain management situation and examined nurses’ demographics, training, governance, practices, knowledge and attitudes. Narrative responses highlighted barriers to pain management. Implications for clinical practice: Health organisations should provide education, institute governance and develop policies to inform pain management. Nurses’ role encompasses updating knowledge, adhering to interventions and overcoming biases. This subsequently manifests as improvement in patient outcomes. © 2024 The Author(s)

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Perspectives of mental health clinicians on physical health of young people with early psychosis

- Hui, Ting, Garvey, Loretta, Olasoji, Michael

Authors: Hui, Ting , Garvey, Loretta , Olasoji, Michael
Date: 2024
Type: Text , Journal article
Relation: International Journal of Mental Health Nursing Vol. 33, no. 3 (2024), p. 649-659
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Description: The aim of this study is to explore the views and understanding of youth mental health clinicians with regard to the physical health of young people with early psychosis and their perspectives on lifestyle interventions improving the health and well-being of young people with early psychosis. Physical health disparities leading to premature mortality among people with mental illness are well evident in the literature. Mental health and physical health are directly correlated. The risk of poor physical health often begins before the onset of mental ill health. Young people with early psychosis are highly susceptible to poor physical health. A co-designed integrated approach focusing on early prevention and intervention in overall well-being and health is imminent for this targeted population to prevent poor physical health trajectory across the lifespan. Ten clinicians were recruited and participated in this study through semi-structured interviews. Five themes were identified: (i) Impact of early psychosis, (ii) Focus of care, (iii) Conversations around physical health, (iv) Co-location of specialist roles and (v) Health literacy. The findings of this study confirm the dimensional impact of early psychosis on the well-being and health of young people through the vicious cycle of early psychosis. Promotion of health literacy along with social connectedness and elements of self-determination, as well as having a prime focus on the individuals' experience in the journey of health promotion through participation in lifestyle interventions, has been identified as critically prominent. © 2023 The Authors. International Journal of Mental Health Nursing published by John Wiley & Sons Australia, Ltd.

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