List of Titles

The effects of resilience and turnover intention on nurses’ burnout : Findings from a comparative cross-sectional study

- Guo, Yu-fang, Plummer, Virginia, Lam, Louisa, Wang, Yan, Cross, Wendy, Zhang, Jing-ping

Authors: Guo, Yu-fang , Plummer, Virginia , Lam, Louisa , Wang, Yan , Cross, Wendy , Zhang, Jing-ping
Date: 2019
Type: Text , Journal article
Relation: Journal of Clinical Nursing Vol. 28, no. 3-4 (2019), p. 499-508
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Description: Aims and objectives: To investigate burnout among nurses from Australia and China and explore the effects of resilience and turnover intention on nurse burnout between the two countries. Background: Nursing shortages and burnout have become serious problems worldwide in recent years. In both developed and developing countries, such as Australia and China, nurse burnout levels are high and therefore attract concern from nurse managers, hospital administrators, nurse educators and researchers. However, few studies have been conducted exploring the differences in burnout and its predictors between Australian and Chinese nurses, particularly investigating the differences in the effect sizes of the predictors. Design: A comparative cross-sectional design was employed. Methods: A total of 100 Australian nurses and 197 Chinese nurses participated in the study. Australian participants completed an online questionnaire, while Chinese participants completed a hardcopy questionnaire. Burnout, resilience and turnover intention were measured. Results: Burnout was worse for Australian participants than Chinese participants. Only having turnover intention significantly predicted burnout in Australian participants, while low resilience, having turnover intention and low level of regular exercise strongly predicted burnout in Chinese participants. The effect size of turnover intention on burnout in the Australian group was almost twice that of the Chinese group. Conclusion: The findings of this study show that there are differences in burnout between Australian and Chinese nurses. The effects of resilience and turnover intention on burnout between the two groups are also identified. Relevance to clinical practice: The differences in nurse burnout and the effects of resilience and turnover intention on burnout should be better understood by nurse managers from Australia and China. Moreover, developing effective strategies relevant to their own country to reduce nurse burnout is recommended.

Why articles continue to be cited after they have been retracted : An audit of retraction notices

- Gray, Richard, Al-Ghareeb, Amal, McKenna, Lisa

Authors: Gray, Richard , Al-Ghareeb, Amal , McKenna, Lisa
Date: 2019
Type: Text , Journal article
Relation: International Journal of Nursing Studies Vol. 90, no. (2019), p. 11-12
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Description: Background: Papers continue to be cited by authors even after they have been retracted. Retraction notices provide readers with information about retracted papers and may help minimise post-retraction citation. To date, a review of the quality of retraction notices in nursing science has not been reported. Design: An audit of retraction notices associated with 29 retracted manuscripts published in nursing science journals. Methods: Retraction notices were reviewed again using the Committee on Publication Ethics (COPE) guidelines. Results: In total, 28 retraction notices were retrieved and reviewed (one retracted paper did not have a retraction notice). Details of the retracted manuscripts were included in all reviewed notices and, in all but two, author names were reported. Details of the time between a paper being published and retracted were not reported and generally there was a little information in notices about how the retraction decisions were made. All retraction notices were freely available. Seven notices stated who had made the decision to retract. Twenty-two (77%) notices stated the reason for retraction. Notices were brief and contained factual information. The webpages of three retracted articles did not clearly indicate that the paper had been retracted. Conclusion: More detailed and informative retraction notices will inform readers and may help reduce post- retraction citation.

Adult deterioration detection system (ADDS) : An evaluation of the impact on met and code blue activations in a regional healthcare service

- Missen, Karen, Porter, Joanne, Raymond, Anita, de Vent, Kerry, Larkins, Jo-Ann

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.

Are we there yet? Graduate readiness for practice, assessment and final examinations

- Missen, Karen, McKenna, Lisa, Beauchamp, Alison

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.

Best practice in clinical simulation education − are we there yet? A cross-sectional survey of simulation in Australian and New Zealand pre-registration nursing education

- Bogossian, Fiona, Cooper, Simon J., Kelly, Michelle, Levett-Jones, Tracy, McKenna, Lisa, Slark, Julia, Seaton, Philippa

Authors: Bogossian, Fiona , Cooper, Simon J. , Kelly, Michelle , Levett-Jones, Tracy , McKenna, Lisa , Slark, Julia , Seaton, Philippa
Date: 2018
Type: Text , Journal article
Relation: Collegian Vol. 25, no. 3 (2018), p. 327-334
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Description: Background: Simulation is potentially a means of increasing clinical education capacity. Significant investments have been made in simulation but the extent to which this has improved uptake, quality and diversity of simulation use is unclear. Aim: To describe the current use of simulation in tertiary nursing education programs leading to nurse registration Australia and New Zealand, and determine whether investments in simulation have improved uptake, quality and diversity of simulation experiences. Methods: A cross sectional electronic survey distributed to lead nursing academics in programs leading to nurse registration in Australia and New Zealand. Findings: 51.6% of institutions responded and reported wide variation in allocation of program hours to clinical and simulation learning. Simulation was embedded in curricula and positively valued as an adjunct or substitute for clinical placement. While simulation environments were adequate, staff time, training and resource development were barriers to increasing the quality, amount and range of simulation experiences. Quality assurance and robust evaluation were weak. Discussion: Simulation program hours are inconsistently reported and underutilized in terms of potential contribution to clinical learning. Benefits of capital investment in simulation physical resources have been realised, but barriers persist for increasing high quality simulation in nursing programs. Conclusion: Transitioning components of clinical education from the clinical to tertiary sectors has resource implications. Establishment of sustainable, high quality simulation experiences requires staff training, shared resources, best practice and robust evaluation of simulation experiences in nursing curricula. © 2017 Australian College of Nursing Ltd

Cultural aspects of death notification following cardiopulmonary resuscitation

- Hassankhani, Hadi, Haririan, Hamidreza, Porter, Joanne, Heaston, Sondra

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

Defining and classifying aggression and violence in health care work

- Hills, Danny

Authors: Hills, Danny
Date: 2018
Type: Text , Journal article
Relation: Collegian Vol. 25, no. 6 (2018), p. 607-612
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Description: Background: There is considerable contention in defining workplace aggression, especially in health care. This can lead to challenges in effectively researching workplace aggression, and ensuring a sound basis for developing strategies to prevent and minimise its likelihood and consequences. Aim: The aim of this discussion paper is to provide a pragmatic definition of workplace aggression, based on a contemporary conceptualisation of human aggression, followed by a discussion on key classifications of workplace aggression. Methods: The argument presented draws on theoretical and applied literature to develop a case for adopting a pragmatic definition of aggression, with key classification components. Findings and Discussion: A highly practical conceptualisation of workplace aggression differentiates two main forms – verbal or written and physical aggression – and two main source groups – internal (co-workers) and external (patients, their relatives or carers and others external to the workplace). Conclusion: Clarity and consensus on defining and classifying workplace aggression, should provide a sound and coherent basis for researchers, policy makers, clinicians and health care organisations to successfully prevent and minimise this challenging and serious work health and safety concern. © 2018 Australian College of Nursing Ltd

Development and psychometric testing of a Clinical Reasoning Evaluation Simulation Tool (CREST) for assessing nursing students' abilities to recognize and respond to clinical deterioration

- Liaw, Sok, Rashasegaran, Ahtherai, Wong, Lai, Deneen, Christopher, Cooper, Simon J., Levett-Jones, Tracy, Goh, Hongli, Ignacio, Jeanette

Authors: Liaw, Sok , Rashasegaran, Ahtherai , Wong, Lai , Deneen, Christopher , Cooper, Simon J. , Levett-Jones, Tracy , Goh, Hongli , Ignacio, Jeanette
Date: 2018
Type: Text , Journal article
Relation: Nurse Education Today Vol. 62, no. (2018), p. 74-79
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Description: Background The development of clinical reasoning skills in recognising and responding to clinical deterioration is essential in pre-registration nursing education. Simulation has been increasingly used by educators to develop this skill. Objective To develop and evaluate the psychometric properties of a Clinical Reasoning Evaluation Simulation Tool (CREST) for measuring clinical reasoning skills in recognising and responding to clinical deterioration in a simulated environment. Design A scale development with psychometric testing and mixed methods study. Participants/Settings Nursing students and academic staff were recruited at a university. Method A three-phase prospective study was conducted. Phase 1 involved the development and content validation of the CREST; Phase 2 included the psychometric testing of the tool with 15 second-year and 15 third-year nursing students who undertook the simulation-based assessment; Phase 3 involved the usability testing of the tool with nine academic staff through a survey questionnaire and focus group discussion. Results A 10-item CREST was developed based on a model of clinical reasoning. A content validity of 0.93 was obtained from the validation of 15 international experts. The construct validity was supported as the third-year students demonstrated significantly higher (p < 0.001) clinical reasoning scores than the second-year students. The concurrent validity was also supported with significant positive correlations between global rating scores and almost all subscale scores, and the total scores. The predictive validity was supported with an existing tool. The internal consistency was high with a Cronbach's alpha of 0.92. A high inter-rater reliability was demonstrated with an intraclass correlation coefficient of 0.88. The usability of the tool was rated positively by the nurse educators but the need to ease the scoring process was highlighted. Conclusions A valid and reliable tool was developed to measure the effectiveness of simulation in developing clinical reasoning skills for recognising and responding to clinical deterioration. © 2017

Do simulation studies measure up? A simulation study quality review

- Cant, Robyn, Levett-Jones, Tracy, James, Ainsley

Authors: Cant, Robyn , Levett-Jones, Tracy , James, Ainsley
Date: 2018
Type: Text , Journal article , Review
Relation: Clinical Simulation in Nursing Vol. 21, no. (2018), p. 23-39
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Description: Simulation-based education has become a ubiquitous teaching approach in nursing. However, ensuring the quality of simulation research is critical. We reviewed the methodological quality of 26 quantitative studies published in Clinical Simulation in Nursing, 2017. The Medical Education Research Study Quality Instrument and Simulation Research Evaluation Rubric showed that nearly all studies were of moderate to high quality (rated ≥50%). Correlation coefficients showed that interrater agreement was high overall (≥0.94). In conclusion, this was a valid approach for examining simulation study quality. Although most included studies were of high quality, some elements of study reporting can be improved upon.

Evaluating a blended online learning model among undergraduate nursing students : A quantitative study

- Ota, Marianne, Peck, Blake, Porter, Joanne

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.

Health service planning and sustainable development: considering what, where and how care is delivered through a pro-environmental lens

- Desmond, Sharon

Authors: Desmond, Sharon
Date: 2018
Type: Text , Journal article , Review
Relation: Australian Health Review Vol. 42, no. 2 (2018), p. 140-145
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Description: The aim of the present paper was to review the opportunities currently available to health service planners to advance sustainable development in their future-facing roles within health service organisation. Critical challenges and enablers to facilitate health services planners in adopting a pro-environmental lens are discussed. What is known about the topic? Despite its harmful effect on the environment, health has been slower than other industries to embrace the sustainable development agenda. The attitudes and knowledge base of health service planners with regard to environmental sustainability has not been widely studied. For health service planners, embracing pro-environmental considerations in sustainable model of care development is a powerful opportunity to review care paradigms and prepare for the implementation of meaningful, improved health and system efficiency. What does this paper add? This paper advances the case for health service planners to embrace a pro-environmental stance and guides health service leaders in the preparation and implementation of sustainable and improved health and system efficiency. What are the implications for practitioners? Health service planers are in an ideal position to champion the sustainable development agenda as they explore what care is delivered, how care is delivered and where care is delivered. External policy, health service leadership and carbon literacy are advanced as critical contextual factors to facilitate the key role that health service planners can play in building sustainable healthcare organisations.

Influence of perceptions and stereotypes of the nursing role on career choice in secondary students : A regional perspective

- Raymond, Anita, James, Ainsley, Jacob, Elisabeth, Lyons, Judith

Authors: Raymond, Anita , James, Ainsley , Jacob, Elisabeth , Lyons, Judith
Date: 2018
Type: Text , Journal article
Relation: Nurse Education Today Vol. 62, no. (2018), p. 150-157
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Description: Background: This study examined the influence that perceptions and stereotypes of the nursing role had on future career choice of rural secondary students. Objective: The study was undertaken to identify a method of attracting final year secondary school students to an undergraduate nursing degree at a rural University. Design: A mixed method study using a pre–post-interventional design. Setting: The rural campus of an Australian university. Participants: 71 secondary students attending a secondary school career development program at a rural Australian university. Method: Semi structured questionnaires were used for data collection. The surveys were analysed using descriptive statistics and content analysis of open-ended survey questions. Results: The research supports the importance of being aware of young people's impressions about nurses and nursing as a career, to ensure the successful implementation of targeted recruitment. Conclusion: Targeted recruitment strategies can increase students’ awareness of the wide variety of pathways within nursing, rather than leaving awareness to what family, friends or career advisers tell them, or how nurses are portrayed on television, movies and the media. © 2018 Elsevier Ltd

Lived experiences and insights into the advantages important to rural recruitment and retention of general practitioners

- Terry, Daniel, Nguyen, Hoang, Schmitz, David, Baker, Ed

Authors: Terry, Daniel , Nguyen, Hoang , Schmitz, David , Baker, Ed
Date: 2018
Type: Text , Journal article
Relation: Rural and remote health Vol. 18, no. 3 (2018), p. 1-16
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Description: INTRODUCTION: Despite existing studies in this field, community factors behind recruiting and retaining rural general practitioners (GPs) are not fully understood. To address this issue, the Community Apgar Questionnaire (CAQ) was developed to extend the understanding of communities' assets and capabilities that impact GP recruitment and retention. However, more in-depth insights are vital to develop a comprehensive approach. METHODS: This mixed methods study was administered using face-to-face structured interviews with a total of 40 health service representatives. All interviews lasted 35-40 minutes and were audio-taped. Qualitative data were generated from the extended responses to the structured questions of the CAQ and later transcribed. Thematic analysis was conducted in relation to explanations, elaborations, and relevant strategic approaches to improving workforce retention. RESULTS: The qualitative findings illuminated the most important advantages of recruiting and retaining GPs were linked to medical support, hospital and community support, and economic factors, while the challenges were related to geographic factors. The underlying reasons for and nature of those advantages and challenges reinforce that health professionals' decisions to stay or leave are complex and multifactorial. CONCLUSION: The originality of the study rests on the administration of the CAQ accompanied by the opportunity for participants to provide extended responses, which gives critical insights into the complexities of rural recruitment and retention. As such, the results confirm the need for a flexible multifaceted response to improving rural GP workforce and informs decision-making in terms of addressing workforce issues within the scope of available resources and capacity.

Newly qualified graduate nurses’ experiences of workplace incivility in Australian hospital settings

- Mammen, Bindu, Hills, Danny, Lam, Louisa

Authors: Mammen, Bindu , Hills, Danny , Lam, Louisa
Date: 2018
Type: Text , Journal article
Relation: Collegian Vol. 25, no. 6 (2018), p. 591-599
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Description: Background: Workplace incivility is a well-documented issue of concern known to negatively impact on new graduate nurses’ confidence, which in turn may affect the quality of patient care. However, there is lack of qualitative research that solely focuses on workplace incivility experiences of new graduate registered nurses enrolled in graduate nurse programs. Aim: This paper aims to explore new graduate nurses’ experiences of workplace incivility while enrolled in graduate nurse programs Method: A descriptive-qualitative method was used to discover the ‘who, what, and where’ of events and experiences, and assist in understanding the perceptions of newly qualified nurses, through face-to-face, in-depth interviews. After transcription, the interviews were analysed by thematic analysis. Findings: Four major themes emerged: ‘realising vulnerability’ ‘sensing self actualisation’ ‘changing expectations’ and ‘yearning for respect, support & information’. Discussion: Our interpretations of what participants said suggest that workplace incivility is an extant issue in nurses’ supportive graduate year, with the temporary employment status offered by the graduate nurse program being identified as a major contributing factor. Paradoxically, the relatively short duration of clinical rotation was also found to be a morale booster, as the new graduate nurses knew that any conflict experienced would cease, which therefore acted as a decisive factor for their continuation in nursing. Conclusion: This study has provided more depth and insight into the experiences of incivility experienced by new graduate nurses, highlighting that the role of temporary employment as a major causative element for exposure to workplace incivility. Graduate nurse programs could be strengthened, with additional support provided for each rotation and throughout the graduate year.

No one said he was dying : Families’ experiences of end-of-life care in an acute setting

- Odgers, Jade, Fitzpatrick, Denise, Penney, Wendy, Shee, Anna Wong

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’.

Nonstandard advance health care directives in emergency departments : Ethical and legal dilemma or reality : A narrative review

- Gilbert, Julia, Boag, Jane

Authors: Gilbert, Julia , Boag, Jane
Date: 2018
Type: Text , Journal article
Relation: Advanced Emergency Nursing Journal Vol. 40, no. 4 (2018), p. 324-327
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Description: People have tattooed themselves for thousands of years, and it remains popular with various groups across mainstream society. Although many people choose tattoos that express their life philosophy, epic events in their life, or their personal mantra, the use of tattooing in medicine such as a "do not resuscitate" tattoo is increasingly becoming more common (Drew, 2017; Islam et al., 2016). As these tattoos do not meet the legal requirements for an advance health directive, they are at best a guide to the person's wishes and at worst a useless, painful exercise. New technology such as "talking tattoos" or implantable microchips could conceivably be used to record either an audible advance health directive or directions for emergency responders to access an individual's advance health directive. This article discusses the ethical and legal implications of nonstandard advance health directive tattoos in emergency treatment situations.

Participant characteristics of users of holistic movement practices in Australia

- Vergeer, Ineke, Bennie, Jason, Charity, Melanie, van Uffelen, Jannique, Harvey, Jack, Biddle, Stuart, Eime, Rochelle

Authors: Vergeer, Ineke , Bennie, Jason , Charity, Melanie , van Uffelen, Jannique , Harvey, Jack , Biddle, Stuart , Eime, Rochelle
Date: 2018
Type: Text , Journal article
Relation: Complementary Therapies in Clinical Practice Vol. 31, no. (2018), p. 181-187
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Description: Objectives: The aim of this study was to compare the characteristics of users of holistic movement practices in Australia to people who were physically active but not using holistic movement practices. A second aim was to compare characteristics of users of specific holistic movement practices (yoga/Pilates and t'ai chi/qigong). Design: We performed a secondary data analysis on pooled data of a nationally-representative physical activity survey conducted yearly 2001–2010 (n = 195,926). Setting: Australia-wide Exercise, Recreation, and Sport Survey (ERASS). Main outcome measures: A range of socio-demographic and participation characteristics were documented and compared between users and non-users of holistic movement practices and between yoga/Pilates and t'ai chi/qigong users, employing descriptive statistics, chi square, and multiple logistic regression analyses. Results: Users of holistic movement practices (n = 6826) were significantly more likely than non-users to be female, older, have fewer children at home, and have higher levels of education, socio-economic background, and physical activity involvement (p < 0.001). Yoga/Pilates (n = 5733) and t'ai chi/qigong (n = 947) users were also found to differ on a number of characteristics, including age, sex, socioeconomic background, and marital status. Conclusion: As a group, Australian users of holistic movement practices differ on a range of characteristics from those Australians active in other types of physical activities. However, differences between yoga/Pilates and t'ai chi/qigong users suggest these practices attract somewhat different sub-populations. To what extent these differences are due to characteristics inherent to the practices themselves or to differences in delivery-related parameters needs to be examined in future research.

Physical deterioration in an acute mental health unit : A quantitative retrospective analysis of medical emergencies

- Porter, Joanne, Cant, Robyn, Missen, Karen, Raymond, Anita, Churchill, Anne

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

- Porter, Joanne, Cant, Robyn, Cooper, Simon J.

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

The educational impact of web-based and face-to-face patient deterioration simulation programs : An interventional trial

- Chung, Catherine, Cooper, Simon J., Cant, Robyn, Connell, Cliff, McKay, Angela, Kinsman, Leigh, Gazula, Swapnali, Boyle, Jayne, Cameron, Amanda, Cash, Penny, Evans, Lisa, Kim, Jeong-Ah, Masud, Rana, McInnes, Denise, Norman, Lisa, Penz, Erika, Rotter, Thomas, Tanti, Erin, Breakspear, Tom

Authors: Chung, Catherine , Cooper, Simon J. , Cant, Robyn , Connell, Cliff , McKay, Angela , Kinsman, Leigh , Gazula, Swapnali , Boyle, Jayne , Cameron, Amanda , Cash, Penny , Evans, Lisa , Kim, Jeong-Ah , Masud, Rana , McInnes, Denise , Norman, Lisa , Penz, Erika , Rotter, Thomas , Tanti, Erin , Breakspear, Tom
Date: 2018
Type: Text , Journal article
Relation: Nurse Education Today Vol. 64, no. (2018), p. 93-98
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Description: Background: There are international concerns relating to the management of patient deterioration. The “failure to rescue” literature identifies that nursing staff miss cues of deterioration and often fail to call for assistance. Simulation-based educational approaches may improve nurses’ recognition and management of patient deterioration. Objectives: To investigate the educational impact of the First2Act web-based (WB) and face-to-face (F2F) simulation programs. Design & Setting: A mixed methods interventional cohort trial with nursing staff from four Australian hospitals. Participants: Nursing staff working in four public and private hospital medical wards in the State of Victoria. Methods: In 2016, ward nursing staff (n = 74) from a public and private hospital completed three F2F laboratory-based team simulations with a patient actor in teams of three. 56 nursing staff from another public and private hospital individually completed a three-scenario WB simulation program (First2ActWeb) [A 91% participation rate]. Validated tools were used to measure knowledge (multi-choice questionnaire), competence (check-list of actions) and confidence (self-rated) before and after the intervention. Results: Both WB and F2F participants’ knowledge, competence and confidence increased significantly after training (p ≤0.001). Skill performance for the WB group increased significantly from 61% to 74% (p ≤ 0.05) and correlated significantly with post-test knowledge (p = 0.014). No change was seen in the F2F groups’ performance scores. Course evaluations were positive with median ratings of 4/5 (WB) and 5/5 (F2F). The F2F program received significantly more positive evaluations than the WB program (p < 0.05), particularly with regard to quality of feedback. Conclusion: WB and F2F simulation are effective education strategies with both programs demonstrating positive learning outcomes. WB programs increase ease of access to training whilst F2F enable the development of tactile hands on skills and teamwork. A combined blended learning education strategy is recommended to enhance competence and patient safety. © 2018 Elsevier Ltd

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