List of Titles

A cross-sectional survey of nursing students' patient safety knowledge

- Levett-Jones, Tracy, Andersen, Patrea, Bogossian, Fiona, Cooper, Simon, Guinea, Stephen, Hopmans, Ruben, McKenna, Lisa, Pich, Jacqui, Reid-Searl, Kerry, Seaton, Philippa

Authors: Levett-Jones, Tracy , Andersen, Patrea , Bogossian, Fiona , Cooper, Simon , Guinea, Stephen , Hopmans, Ruben , McKenna, Lisa , Pich, Jacqui , Reid-Searl, Kerry , Seaton, Philippa
Date: 2020
Type: Text , Journal article
Relation: Nurse Education Today Vol. 88, no. (2020), p.
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Description: Background: Knowledge provides a foundation for safe and effective nursing practice. However, most previous studies have focused on exploring nursing students' self-reported perceptions of, or confidence in, their level of patient safety knowledge, rather than examining their actual levels of knowledge. Objective: The overarching objective of this study was to examine final year nursing students' levels of knowledge about key patient safety concepts. Design: A cross-sectional design was used for this study. Data collection was undertaken during 2018 using a web-based patient safety quiz with 45 multiple choice questions informed by the Patient Safety Competency Framework for Nursing Students. A Modified Angoff approach was used to establish a pass mark or ‘cut score’ for the quiz. Setting and participants: Nursing students enrolled in the final year of a pre-registration nursing program in Australia or New Zealand were invited to participate in the study. Results: In total, 2011 final year nursing students from 23 educational institutions completed the quiz. Mean quiz scores were 29.35/45 or 65.23% (SD 5.63). Participants achieved highest scores in the domains of person-centred care and therapeutic communication, and lowest scores for infection prevention and control and medication safety. Based on the pass mark of 67.3% determined by the Modified Angoff procedure, 44.7% of students (n = 899) demonstrated passing performance on the quiz. For eight of the institutions, less than half of their students achieved a passing mark. Conclusions: Given the pivotal role that nurses play in maintaining patient safety, the results from this quiz raise important questions about the preparation of nursing students for safe and effective clinical practice. The institutional results also suggest the need for increased curricula attention to patient safety. © 2020 Elsevier Ltd

A review of code blue activations in a single regional Australian healthcare service : a retrospective descriptive study of RISKMAN data

- Porter, Joanne, Peck, Blake, McNabb, Tiffinee, Missen, Karen

Authors: Porter, Joanne , Peck, Blake , McNabb, Tiffinee , Missen, Karen
Date: 2020
Type: Text , Journal article
Relation: Journal of Clinical Nursing Vol. 29, no. 1-2 (2020), p. 221-227
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Description: Background: In the case of life-threatening conditions such as respiratory or cardiac arrest, or the clinical deterioration of the patient, a Code Blue activation may be instigated. A Code Blue activation involves a team of advanced trained clinicians attending the emergency needs of the patient. Aims and objectives: The aim of the study was to explore the number of cases of Code Blue activations, looking at the timing, clinical ward, diagnosis and activation criteria while noting cases where escalation from a Medical Emergency Team (MET) call occurs in one Regional Healthcare Service in Victoria, Australia, over a six-year period. Methods: A quantitative retrospective descriptive study of Code Blue emergencies over a six-year period from June 2010 to June 2016 was conducted. Data collected from the RISKMAN program operating at a single site was imported into SPSS (V 22) for descriptive statistical analysis. A STROBE EQUATOR checklist was used for this study (see File S1). Findings: The majority of Code Blue activations were male (59%, n = 127) and aged between 70 and 89 years of age (43%, n = 93). A Code Blue activation was more likely to occur at 08:00 hr, 14:00 hr or 22:00 hr, corresponding to the nurses’ change in shift, with the majority of Code Blues (27.8%, n = 60) occurring in the emergency department. Cardiac arrest was the main activation criterion with 54.6% (n = 118) cases followed by respiratory arrest (14%, n = 32). Interestingly, 20% (n = 45) of the Code Blue activations were upgraded from a Medical Emergency Team (MET) call. Conclusion: This project has produced several interesting findings surrounding Code Blue activations at one regional healthcare service which are not present in existing literature and is worthwhile for further investigation. Relevance to clinical practice: Understanding Code Blue activation criteria, common timings (month, time of day) and patient demographics ensures clinicians can remain vigilant in watching for the signs of patient deterioration and improve staff preparedness Code Blue events. © 2019 John Wiley & Sons Ltd

Academic and clinical performance among nursing students : what's grit go to do with it?

- Terry, Daniel, Peck, Blake

Authors: Terry, Daniel , Peck, Blake
Date: 2020
Type: Text , Journal article
Relation: Nurse Education Today Vol. 88, no. (2020), p.
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Description: Background: Nursing is both a science and an art and requires students to develop sound scientific foundations for artful application. The at times binary nature of how the way in which the knowledge and skills of nursing are delivered in higher education can be difficult for students to comprehend initially and synchronise for practice and can lead to feelings of being overwhelmed, withdrawal or failure. Understanding what influences student performance in bachelor level nursing studies is imperative so educators can develop programs that straddle the art and science conundrum and lead to graduate success. Grit is a non-cognitive trait, a drive that keeps an individual on task through difficult circumstances for sustained periods of time. Grit might well represent a key factor in our understanding of why one student succeeds while another withdraws. Objectives: To examine measures of grit in the context of demographic characteristics of nursing students and their impact on student self-perceived academic and clinical performance. Design: A cross-sectional design. Setting: A single School of Nursing at a multi-campus, regional, peri-urban Australian University. Participants: All nursing students (n = 2349) studying a three-year bachelor of nursing degree were invited to participate. Methods: Data were collected using a questionnaire that included several demographic items, questions relating to the student's perceived level of academic and clinical performance, and the eight-item Short Grit Scale (Grit-S) used to measure trait-level perseverance and passion for long-term goals. Results: Students, regardless of their year of study or any other demographic factor, showed grit was the only significant predictor of clinical and academic performance. Conclusions: The strength between grit and perceived performance both academically and clinically, makes grit a valuable factor for development in students as a vehicle for success in nursing programs of study. This paper culminates in suggestions for creative approaches to grit development. © 2020 Elsevier Ltd

Body-worn versus bell-and-pad alarm device for the management of monosymptomatic nocturnal enuresis in children : a randomized controlled trial

- Peck, Blake, Peck, Bronwyn, Harvey, Jack, Green, Andrea, Svedas, Kerrie, Whitaker, Shirley, Nethercote, Mark, Shea, Rosemarie

Authors: Peck, Blake , Peck, Bronwyn , Harvey, Jack , Green, Andrea , Svedas, Kerrie , Whitaker, Shirley , Nethercote, Mark , Shea, Rosemarie
Date: 2020
Type: Text , Journal article
Relation: Journal of wound, ostomy, and continence nursing : official publication of The Wound, Ostomy and Continence Nurses Society Vol. 47, no. 5 (2020), p. 507-512
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Description: PURPOSE: The purpose of this study was to compare the effectiveness of bell-and-pad alarm therapy to body-worn alarm therapy for the management of monosymptomatic enuresis in children 6 to 16 years of age. DESIGN: A prospective, randomized, adaptive clinical control trial. SUBJECTS AND SETTING: The sample comprised 86 children who attended a continence clinic for treatment of monosymptomatic enuresis and met the criteria for enuresis alarm therapy as per International Children's Continence Society (ICCS) guidelines. Subjects were randomly allocated to an experimental group (body-worn alarm, n = 41) or a control group (bell-and-pad alarm, n = 45). The study setting was a single-site specialist continence service in regional Victoria, Australia. Treatment was administered in the child's home. METHODS: Alarm therapy was administered by the child and/or parent for an initial period of 8 weeks at which time the child underwent a review with the continence nurse specialist. If the child had achieved 14 consecutive dry nights, the therapy was deemed successful and ceased. Children who had not become dry continued therapy for a further 8 weeks up to a maximum of 16 weeks, with a final review was instituted. Each child kept a diary for the duration of alarm therapy to report on frequency of wet/dry nights, times of alarm, response to alarm, and response to sensation to void (without alarm). The 2 types of alarm devices were compared with respect to categorical variables using dichotomous cross-tabulations and χ tests of independence based on the most positive outcome versus the other outcomes. RESULTS: Dryness in accordance with the criteria outlined by the ICCS guidelines was achieved in 18 children (43.9%) in the body-worn alarm group versus 29 children (64.4%) in the routine (bell-and-pad) group (P = .056). The bell-and-pad alarm performed better on 7 out of the 9 indicators, including the primary outcome measure of the child attained dryness for 14 nights or more, nightly alarm use, alarm woke child, alarm woke parent (P = .022), false (positive) alarms (P = .039), child turned alarm off and went back to sleep (P = .003), and child was compliant with alarm use. The body-worn device produced higher proportions of the most positive outcomes for 2 of the 9 indicators: relapse (P = .076) and false (negative) nonalarms (P = .066). CONCLUSIONS: Study findings suggests that the bell-and-pad alarm is preferable to the body-worn alarm. Additional research is recommended using other body-worn alarm devices across a larger population in order to establish the more definitive findings needed for clinical decision-making.

Communities of practice : a systematic review and meta-synthesis of what it means and how it really works among nursing students and novices

- Terry, Daniel, Nguyen, Hoang, Peck, Blake, Smith, Andrew, Phan, Hoang

Authors: Terry, Daniel , Nguyen, Hoang , Peck, Blake , Smith, Andrew , Phan, Hoang
Date: 2020
Type: Text , Journal article , Review
Relation: Journal of Clinical Nursing Vol. 29, no. 3-4 (2020), p. 370-380
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Description: Aims and objectives: To evaluate the enablers, barriers and impact that communities of practice have on novice nurses and students learning to become registered nurses. Background: Communities of practice have formed the basis for conceptualising the process of learning that occurs among groups of people within a place of work—a mainstay of healthcare practice. There is a dearth of literature that focuses specifically on the outcomes from student and novice engagement with existing communities of practice. Design: Systematic review and Meta-synthesis. Methods: MEDLINE, PubMed, EMBASE, CINAHL, ProQuest, Scopus and PsycINFO databases were accessed between 1997–2019. The screening and selection of studies were based on eligibility criteria and methodological quality assessment using the Critical Appraisal Skills Programme tool for qualitative research. Meta-synthesis was grounded in the original experiences and collectively synthesised into meaningful themes. The review follows the PRISMA reporting guidelines and PRISMA checklist. Results: The findings highlight three major themes and included enablers for successful communities of practice, barriers to successful communities of practice, and success in action as described by students and novice nurses. Discussion: We suggest successful communities of practice occur when safe and supported spaces ensure students and novices feel comfortable to experiment with their learning, and we emphasise the benefits of having more novice nurses situated within close proximity and under the direct influence of the established practices of more experienced or core group of peers. Relevance to clinical practice: Communities of practice that function successfully create an environment that prioritises the embedding of novices into the broader group. In so doing, students and novice nurses feel supported, welcomed, empowered, and able to make the transition from student to colleague and novice nurse to more experienced nurse. It allows them to experiment with ever new ways of fulfilling the role, while aiding better clinical outcomes. © 2019 John Wiley & Sons Ltd

Compassion satisfaction and compassion fatigue in Australian emergency nurses : a descriptive cross-sectional study

- O'Callaghan, Erin, Lam, Louisa, Cant, Robyn, Moss, Cheryle

Authors: O'Callaghan, Erin , Lam, Louisa , Cant, Robyn , Moss, Cheryle
Date: 2020
Type: Text , Journal article
Relation: International Emergency Nursing Vol. 48, no. (Jan 2020), p. 8
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Description: Introduction: Emergency nurses are at risk of compassion fatigue. Compassion fatigue caused by exposure to suffering may compromise the individual's personal wellbeing and reduce work efficiency. Methods: A quantitative cross-sectional survey with open responses was conducted using the Professional Quality of Life: Compassion Satisfaction and Compassion Fatigue (ProQOL) scale and open-ended questions. Responses from a convenience sample of 86 nurses from two hospital emergency departments in Victoria, Australia, were analysed. Results: The median score for Compassion Satisfaction was 78% with all nurses reporting average to high scores. Most had average levels of Compassion Fatigue: Burnout median score was 53% and Secondary Traumatic Stress median score 49%. No statistically significant correlation was found between scales nor with influencing demographic characteristics. A qualification in emergency nursing was predictive of Compassion Satisfaction. Six descriptive job-associated factors contributed to nurses' stress: human resources, the organisation, job-specific components, patient mix and professional and personal components. Conclusion/s: Average to high levels of Compassion Satisfaction and low to average levels of Compassion Fatigue were found in emergency nurses. Issues contributing to stress were work and role related. An understanding of these stressors may help nurses and nurse managers to ameliorate emergency nurses' levels of stress and help limit staff burnout.

Coronavirus disease (COVID-19) prevention : virtual classroom education for hand hygiene

- Ng, Yuet, Or, Pui

Authors: Ng, Yuet , Or, Pui
Date: 2020
Type: Text , Journal article , Editorial
Relation: Nurse Education in Practice Vol. 45, no. (2020), p.
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Description: Coronavirus disease (COVID-19), has spread rapidly in Asia, Europe, the Middle East and the Americas. Considering the recent outbreak of COVID-19, some precautionary measures have been announced, including campus class suspensions. Nursing campus courses have also been suspended, and there may be a learning gap between hand hygiene theory and clinical training for nursing students. A virtual classroom education approach may help address the learning gap by providing ongoing theoretical strengthening of hand hygiene during clinical nursing training. This editorial proposes a 3-step virtual classroom education approach to support nursing educators in online theoretical hand hygiene enhancement. © 2020 Elsevier Ltd

Factors influencing hand hygiene practice of nursing students : a descriptive, mixed-methods study

- Zimmerman, Peta-Anne, Sladdin, Ishtar, Shaban, Ramon, Gilbert, Julia, Brown, Lynne

Authors: Zimmerman, Peta-Anne , Sladdin, Ishtar , Shaban, Ramon , Gilbert, Julia , Brown, Lynne
Date: 2020
Type: Text , Journal article
Relation: Nurse Education in Practice Vol. 44, no. (2020), p.
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Description: Developing nursing students' knowledge and practice of infection prevention and control (IPC) is fundamental to safe healthcare. A two-phase descriptive, mixed-method study conducted within a Bachelor of Nursing program at an Australian university aimed to explore: (i) theoretical knowledge of IPC, highlighting hand hygiene, of nursing students and; (ii) nursing students' and clinical facilitators' perceptions of factors influencing these practices during clinical placement. Phase One utilised an anonymous validated questionnaire assessing students' knowledge; identifying variables influencing students' IPC practices, subjected to descriptive and inferential analysis. Phase Two were semi-structured interviews exploring clinical facilitators' experiences/perceptions of students during clinical placement, analysed thematically. Students' demonstrated satisfactory knowledge of IPC in their second and third year, but clinical facilitators perceived that. students lacked awareness of the importance of these practices. Five themes arose from the interviews: (i) understanding workplace culture; (ii) students' modelling local behaviour; (iii) enhancing and consolidating knowledge for practice; (iv) adjusting to practice reality and; (v) accessing additional hand hygiene resources. Factors specific to workplace setting and culture were perceived to influence nursing students' socialisation. Future practice/education strategies could address these factors by ensuring students receive adequate supervision during clinical placement, and having strong advocates/role models present in the workplace. © 2020 Elsevier Ltd

High-intensity interval training improves cardiorespiratory fitness in cancer patients and survivors : a meta-analysis

- Wallen, Matthew, Hennessy, Declan, Brown, Stephen, Evans, Luke, Rawstorn, Jonathan, Wong Shee, Anna, Hall, Adrian

Authors: Wallen, Matthew , Hennessy, Declan , Brown, Stephen , Evans, Luke , Rawstorn, Jonathan , Wong Shee, Anna , Hall, Adrian
Date: 2020
Type: Text , Journal article , Review
Relation: European Journal of Cancer Care Vol. 29, no. 4 (2020), p.
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Description: Objective: The primary objective of this systematic review and meta-analysis was to compare the effects of high-intensity interval training (HIIT) versus moderate-intensity continuous training (MICT) and usual care (UC) on cardiorespiratory fitness (peak V̇O2) in cancer patients and survivors. Secondary objectives were to compare the effects of HIIT versus MICT and UC on other cardiopulmonary exercise testing (CPET) indices. Safety and adherence to HIIT were also evaluated. Methods: A systematic review and meta-analysis of controlled trials were undertaken using eligible studies from electronic database searching (inception—December 2019). Mean differences (MD) with 95% confidence intervals (CI) were compared and heterogeneity assessed using Cochran's Q and I2 statistic. Results: Twelve eligible studies included 516 participants with post-intervention CPET data. No serious adverse events occurred. Adherence to HIIT ranged between 71.2% and 95.6%. HIIT had significantly higher peak V̇O2 compared with UC (MD = 2.11 ml kg−1 min−1, 95% CI 0.75–3.47, p =.002). No significant difference was found between HIIT and MICT (MD = 2.03 ml kg−1 min−1, 95%CI −0.75–4.83, p =.15). HIIT was more effective than UC to improve peak oxygen pulse (MD = 1.59 ml/beat, 95%CI 0.06–3.12, p =.04). Conclusions: Quantitative assessment of HIIT studies indicates good compliance, with a significant effect on peak V̇O2 and peak oxygen pulse compared with UC in cancer patients and survivors. HIIT demonstrates a comparable effect with MICT to improve peak V̇O2. © 2020 John Wiley & Sons Ltd
Description: Western Alliance Academic Health Science Centre , WA-739501

Home-based care for people with disabilities : role of registered nurses within the district health system in Thailand

- Wanaratwichit, Civilaiz, Hills, Danny, Cruickshank, Mary

Authors: Wanaratwichit, Civilaiz , Hills, Danny , Cruickshank, Mary
Date: 2020
Type: Text , Journal article
Relation: Collegian Vol. 27, no. 1 (2020), p. 18-22
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Description: Background: In Thailand, the number of people with physical disabilities (PwD) has been increasing. Following sweeping health care reforms in 2002, efforts were made to improve accessibility to health care by greatly increasing the number of Registered Nurses (RNs) working in local community health centres. Little is known, however, about the role of RNs in improving accessibility to home-based care and the outcomes of care for PwD in Thailand. Aim: To explore the role of RNs in providing high quality home-based services for PwD who have severe limitations in movement. Methods: A case study design was used to explore and describe the role of RNs in home-based care for PwD in one rural and one urban area in lower north Thailand. There were 73 participants, including PwD and their family members, community health volunteers, primary care providers, local government officers and members of the District Health management team. Data were collected from in-depth interviews and focus groups, which were analysed using thematic analysis. Results: The roles of RNs in home-based care for PwD were found in four domains, as case manager, rehabilitation care provider, manager of the community health volunteers and broader care coordinator. Conclusion: The full scope of the RN role in the provision of home-based care for PwD, in the district health system of Thailand, not only involves direct nursing care. The role also encompasses planning and co-ordination of the broad range of professional and non-professional services to meet the needs of PwDs in rural and urban settings. © 2019 Australian College of Nursing Ltd

I am the person who knows myself best : perception on shared decision-making among hospitalized people diagnosed with schizophrenia in China

- Huang, C.hongmei, Plummer, Virginia, Wang, Yun, Lam, Louisa, Cross, Wendy

Authors: Huang, C.hongmei , Plummer, Virginia , Wang, Yun , Lam, Louisa , Cross, Wendy
Date: 2020
Type: Text , Journal article
Relation: International Journal of Mental Health Nursing Vol. 29, no. 5 (2020), p. 846-855
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Description: Shared decision-making is related to better health outcomes in serious mental illness. It is not well addressed in non-Western cultures, for example Chinese culture. Chinese could be influenced by both paternalism and familism when making treatment decisions. However, this is unexplored. The study purpose is to explore shared decision-making from perspectives of inpatients diagnosed with schizophrenia in China. This study adopted qualitative descriptive approach. Through semi-structured interviews, twelve participants from the psychiatry department of a tertiary hospital shared their perceptions of shared decision-making. An inductive thematic approach was used to analyse the transcripts. Primary results included three main themes with nine subthemes: (1) Having a positive attitude: i) wanting my voice to be heard, ii) needing my family to be involved, and iii) preferring the psychiatrist to decide; (2) Feeling excluded: i) having limited financial capacity, ii) lacking interactive communication, iii) too few psychiatrists, and iv) being unsatisfied with informed consent process; and (3) Self-motivation in decision-making by: i) easing the burden on the family and ii) actively collecting health information. In this context, patients have fewer treatment options and a limited role in SDM. Yet, they have preference for SDM, actively seeking health information from mental health professionals particularly nurses. © 2020 Australian College of Mental Health Nurses Inc.
Description: China Scholarship Council, CSC, [2017] 3109

Nurses' cognitive and perceptual bias in the identification of clinical deterioration cues

- Al-Moteri, Modi, Cooper, Simon, Symmons, Mark, Plummer, Virginia

Authors: Al-Moteri, Modi , Cooper, Simon , Symmons, Mark , Plummer, Virginia
Date: 2020
Type: Text , Journal article
Relation: Australian Critical Care Vol. 33, no. 4 (2020), p. 333-342
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Description: Background: Perception and processing of clinical cues have rarely been investigated in the nursing literature despite their relevance to the early identification and management of clinical deterioration. Aim: This study used a hypovolemic shock scenario from the Feedback Incorporating Review and Simulation Techniques to Act on Clinical Trends (FIRST2ACT) virtual simulation program, equipped with an eye tracker, to investigate cue processing during the management of patient deterioration. Result: The study revealed that attention deviation distorted interpretation of subsequent cues, causing 63% of participants to exhibit a cognitive bias (heightened sensitivity to specific but noncritical cues) and 65% to exhibit at least one episode of nonfixation on clinically relevant cues. Attention deviation and distorted interpretations of clinical cues will have an impact on patient safety. Conclusion: The findings are likely to have important implications for understanding error and associated training implications. © 2019 Australian College of Critical Care Nurses Ltd

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Organophosphate exposure and the chronic effects on farmers : a narrative review

- Perry, Jessica, Cotton, Jacqueline, Rahman, Muhammad, Brumby, Susan

Authors: Perry, Jessica , Cotton, Jacqueline , Rahman, Muhammad , Brumby, Susan
Date: 2020
Type: Text , Journal article , Review
Relation: Rural and Remote Health Vol. 20, no. 1 (2020), p. 17
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Description: Introduction: Organophosphates are a class of insecticides used globally by the agricultural industry for insect control. Acute consequences of organophosphate exposures are well known, while there has been limited research on their long-term effects. The objective of this review was to discuss the health effects of chronic organophosphate exposure in farmers. Methods: Medline, Scopus and Web of Science were searched to find the relevant articles. Articles published only in English and until December 2018 were reviewed. The selected articles were then categorised as neurological (neurobehaviour, neurodevelopmental, neurological signs and symptoms) or non-neurological subheadings. Results: A total of 53 articles for neurological effects and 17 articles for non-neurological effects were identified. Chronic organophosphates exposure was associated with deficits in the neurobehaviour subsets of attention and short-term memory, increased incidence of neurodegenerative diseases and effects on peripheral nerves and neurodevelopment. However, research to support non-neurological effects such as respiratory symptoms, increased cancer risk, endocrine disruption, cardiac issues, chronic fatigue and infertility was limited. Conclusion: Chronic organophosphate exposure was found to affect four of the five areas of described neurological effects in the literature. A large proportion of the research in this area was not methodologically strong, therefore few recommendations can be conclusively made. Future research is warranted to investigate the non-neurological effects of chronic exposure to ensure the occupational risks of low-level chronic exposure are clearly communicated to farmers and farm workers.

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Organophosphate exposure and the chronic effects on farmers: a narrative review

- Perry, Jessica, Cotton, Jacqueline, Rahman, Muhammad, Brumby, Susan

Authors: Perry, Jessica , Cotton, Jacqueline , Rahman, Muhammad , Brumby, Susan
Date: 2020
Type: Text , Journal article
Relation: Rural and remote health Vol. 20, no. 1 (2020), p. 4508
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Description: INTRODUCTION: Organophosphates are a class of insecticides used globally by the agricultural industry for insect control. Acute consequences of organophosphate exposures are well known, while there has been limited research on their long-term effects. The objective of this review was to discuss the health effects of chronic organophosphate exposure in farmers. METHODS: Medline, Scopus and Web of Science were searched to find the relevant articles. Articles published only in English and until December 2018 were reviewed. The selected articles were then categorised as neurological (neurobehaviour, neurodevelopmental, neurological signs and symptoms) or non-neurological subheadings. RESULTS: A total of 53 articles for neurological effects and 17 articles for non-neurological effects were identified. Chronic organophosphates exposure was associated with deficits in the neurobehaviour subsets of attention and short-term memory, increased incidence of neurodegenerative diseases and effects on peripheral nerves and neurodevelopment. However, research to support non-neurological effects such as respiratory symptoms, increased cancer risk, endocrine disruption, cardiac issues, chronic fatigue and infertility was limited. CONCLUSION: Chronic organophosphate exposure was found to affect four of the five areas of described neurological effects in the literature. A large proportion of the research in this area was not methodologically strong, therefore few recommendations can be conclusively made. Future research is warranted to investigate the non-neurological effects of chronic exposure to ensure the occupational risks of low-level chronic exposure are clearly communicated to farmers and farm workers.

Patients’ experiences of acute deterioration : A scoping review

- Chung, Catherine, McKenna, Lisa, Cooper, Simon

Authors: Chung, Catherine , McKenna, Lisa , Cooper, Simon
Date: 2020
Type: Text , Journal article
Relation: International Journal of Nursing Studies Vol. 101, no. (2020), p.
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Description: Background: Patient experience is recognised as a means of assessing healthcare delivery with organisations in many countries now gathering patient experience or satisfaction data. It is well documented that the benefits of improving a patients' experience include increased satisfaction, reduced length of stay, improved patient outcomes and reduction of costs. The experience of acute clinical deterioration is unique, extensive and complex as well as being a difficult experience for all involved. However, little is known about this experience from the patient's perspective. Aim: To explore what is known about the experiences of acute deterioration from the perspective of the patient. Design: A scoping review of international, peer-reviewed research studies and grey literature published between the years of 2000 and 2018. This review was guided by the three-step search strategy recommended by the Joanna Briggs Institute (JBI). Data sources: A range of databases were searched, including CINAHL, Medline, Health Source, Joanna Briggs Institute, PsycINFO, Embase via Ovid, Cochrane library, Ovid Emcare, Scopus as well as grey literature, reference lists and the search engine Google Scholar. Review methods: Joanna Briggs Institute (JBI) scoping review framework was utilised to identify patients' experiences of acute deterioration. Ten databases were searched, and 249 articles were retrieved. After screening the titles and abstracts, 102 articles were assessed in full text for eligibility, and finally 23 articles were further analysed and synthesised using inductive thematic analysis. Results: 19 qualitative studies, three quantitative and one mixed methods study met the inclusion criteria. Seven key themes emerged related to patients' experience of acute deterioration: (1) transformation of perception: memories of factual events; (2) psychological transformation: emotional distress and well-being; (3) physiological transformation: physical distress; (4) facing death; (5) the severity of acute deterioration: from the perspective of the patient; (6) relationship with healthcare professionals and the clinical environment; and (7) the value of relationships: the support of family and friends. Conclusions: Participants had considerable recall of their experiences and hospital admissions. The themes highlight the important issues patients face during their own acute physiological deterioration. This review has highlighted that further research is needed to specifically explore the patients' experience of acute deterioration and the emergency management they receive, for example from a hospital's rapid response team (RRT) or medical emergency team (MET). © 2019

Practice priorities for acute care nursing : a Delphi study

- Connell, Clifford, Plummer, Virginia, Crawford, Kimberley, Endacott, Ruth, Foley, Pieternella, Griffiths, Debra, Innes, Kelli, Schwerdtle, Patricia, Walker, Lorraine, Morphet, Julia

Authors: Connell, Clifford , Plummer, Virginia , Crawford, Kimberley , Endacott, Ruth , Foley, Pieternella , Griffiths, Debra , Innes, Kelli , Schwerdtle, Patricia , Walker, Lorraine , Morphet, Julia
Date: 2020
Type: Text , Journal article
Relation: Journal of Clinical Nursing Vol. 29, no. 13-14 (2020), p. 2615-2625
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Description: Aims and objectives: To describe the risk and frequency of challenges in acute care nursing, and the practice priorities in Australian hospital wards based upon expert consensus. Background: Health care is facing increasing demands that are negatively impacting upon the safety and quality of nursing care. Design: Delphi Method. Method: A three-round electronic Delphi method was used to collect and synthesise expert consensus opinion of 30 participants in Rounds One and Two of the survey, and 12 participants in Round Three. The study was carried out from July to December 2016. This study complied with the STROBE checklist. Results: High patient acuity or complexity, as well as inadequate bed space on wards, are “very high” risks that occur “often” and “very often,” respectively. The pressure to admit patients, delayed medical review and patient boarding are all “high” risks that occur “often.” Though only occurring “sometimes,” inadequate numbers and skill mix of staff, suboptimal communication and early or inappropriate discharge all pose a “very high” risk to patient care. Conclusion: The key practice priorities for nurse managers should include the design, implementation and evaluation of sustainable system-wide frameworks, processes and models of care that address patient boarding, communication and discharge processes, job satisfaction, staffing numbers and expertise. Relevance to clinical practice: This study provides a description of the challenges that face acute care nursing in the provision of safe and high-quality care. © 2020 John Wiley & Sons Ltd

The academic experiences of transitioning to blended online and digital nursing curriculum

- Porter, Joanne, Barbagallo, Michael, Peck, Blake, Allen, Louise, Tanti, Erin, Churchill, Anne

Authors: Porter, Joanne , Barbagallo, Michael , Peck, Blake , Allen, Louise , Tanti, Erin , Churchill, Anne
Date: 2020
Type: Text , Journal article
Relation: Nurse Education Today Vol. 87, no. (2020), p.
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Description: Background: The blended online digital (BOLD) approach to teaching is popular within many universities. However, much of the research conducted in this area focusses on the student perspective. Aim The aim of this study is to explore the experiences and perspectives of academics involved in the development and implementation of an inaugural BOLD Bachelor of Nursing curriculum at a regional multi-campus institution in Victoria, Australia. Methods: Eleven academics across two regional campuses participated in one of five focus groups. Creswell's (2003) six step approach to thematic analysis was used to analyse the semi-structured interview data in order to capture the meaning of the transition experience. Findings: Three significant themes emerged from the focus group data: ‘Get Ready’, ‘Get Set’, and ‘Go’. Discussion: Three significant themes emerged, ‘Get Ready’, embodies insight from academic staff preparing to make the transition to a BOLD delivery model acknowledging the need for staff to be genuinely prepared, educated, guided and supported to understand the pedagogy of BOLD. Secondly, ‘Get Set’, acknowledges the period immediately after the preparatory phase and preparedness of academic staff to manage content and delivery for both face-to-face and online student cohorts within the learning platform. Thirdly, the theme ‘Go’ recognises the culmination of the previous two phases and is a recognition of the need for ongoing evaluation across the implementation phase. Conclusion: This qualitative exploration of nursing academics' experience contributes to contemporary pedagogical insights in relation to the blended approaches to teaching and learning. © 2020

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The data deficit for asthma emergency presentations might surprise you : how RAHDaR addresses the data chasm

- Terry, Daniel, Peck, Blake, Kloot, Kate

Authors: Terry, Daniel , Peck, Blake , Kloot, Kate
Date: 2020
Type: Text , Journal article
Relation: Rural and remote health Vol. 20, no. 2 (2020), p. 5776
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Description: INTRODUCTION: National and state-based minimum data sets remain inadequate in providing a complete representation of emergency presentations, especially among paediatric asthma presentations. Thus, the aim of the study was to identify if a deficit exists in current emergency paediatric asthma hospital presentation datasets and how this may inform an understanding of childhood asthma in Victoria Methods: This retrospective cross-sectional study examined emergency hospital presentation data between 1 February 2017 and 31 January 2019. All paediatric (0-14 years) emergency asthma presentation data were collected from nine hospitals in south-western Victoria, Australia, using the Rural Acute Hospital Data Register (RAHDaR), which gathers both Victorian Emergency Minimum Dataset (VEMD) data from larger government hospitals, and non-VEMD data from smaller, more rural institutions. RESULTS: Of the 854 emergency presentations identified for children with asthma aged 0-14 years, 540 (63.2%) were managed initially at larger government-reporting hospitals. A total of 314 (36.8%) emergency presentations were initially managed at emergency facilities, such as urgent care centres. Overall, it was found that a total 278 (32.5%) of all emergency presentations did not appear in current government datasets. CONCLUSION: The RAHDaR database, a complete register of data, captures all emergency presentations in south-western Victoria and highlights as much as a 33% deficit in the data currently available to inform asthma resource initiatives including policy development, funding allocation, prevention and management initiatives in Victoria. More accurate data from sources such as RAHDaR are essential to fill the now-evident data chasm.

The impact of emerging simulation-based technologies on the management of deteriorating patients : aiming for a gold standard educational evaluation

- Cooper, Simon, Cant, Robyn, Chung, Catherine, First Act Impact Team

Authors: Cooper, Simon , Cant, Robyn , Chung, Catherine , First Act Impact Team
Date: 2020
Type: Text , Journal article
Relation: Clinical Simulation in Nursing Vol. 45, no. (2020), p. 50-59
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Description: Background: Measuring the impact of patient safety interventions is challenging. This article aims to illustrate a “gold standard” model of program evaluation incorporating examples from two patient deterioration programs. Methods: Australian nurses were trained in primary responses to emergencies in four hospitals using either face-to-face (F2F) or screen-based simulation versions of a simulation program. Evaluation outcomes were measured using Kirkpatrick's evaluation hierarchy covering participant ‘reaction’, ‘learning’, ‘behaviour’ change and ‘results’—based on 1,564 pre–post intervention vital signs chart reviews. Results: Seventy-four nurses participated. Reaction—participant confidence/competence ratings and Learning improved significantly in both modalities (p <.001). Behaviour—oxygen delivery systems were used more appropriately after training in the F2F group (p =.037). Applicable recording of oxygen saturation (SpO2) improved significantly (p ≤.008) in both modalities. Results—at least a two-fold increase in the overall initiation of a clinical review after training, in both modalities (p <.001; effect: d = 0.41 F2F and d = 0.35 screen-based simulation). Conclusions: Kirkpatrick's evaluation model enables a suitable template for gold standard education evaluations. © 2020 International Nursing Association for Clinical Simulation and Learning
Description: Funding details: State Government of Victoria, 31362

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