Description:
Background: Trade agreements in the 21st century have evolved to include provisions that affect domestic public policy and public health in signatory countries. There are growing calls for health professionals and public health advocates to pursue an active advisory role in trade negotiations in order to anticipate and prevent negative outcomes for health services and public health. Aim: This scoping review explored current literature to identify existing knowledge of the implications of trade agreements for the nursing workforce, nursing practice and public health using as an example the 2018 'Comprehensive and Progressive Agreement for Trans-Pacific Partnership'. Design: Scoping review Data sources: Emerald Insight, Informit, Ovid MEDLINE, PubMed, ProQuest, Scopus, and a number of specialist Economics, International Trade and Business, and International Relations databases. Grey literature included national and international policy documents. Review method: Literature was selected according to extraction field criteria, supplemented by hand searching of relevant grey literature and snowballing references from the selected literature reference lists. Analysis was undertaken to identify key themes emerging from the literature. Review results: Six key themes relevant to nursing workforce, nursing practice or public health were 1. Lack of consultation with public health and health professionals in trade negotiations; 2. Implications of strengthened intellectual property provisions for equitable access to medicines (including biologics) and medical devices; 3. Threats to government capacity to regulate domestic policy for public health and health services through 'Investor State Dispute Settlement' provisions 4. Threats to government capacity to regulate domestic policy for public health and health services through 'Regulatory Coherence' 5. Potential limited benefits to communities and increased health inequities 6. Potential implications of increased temporary migration. Gaps were identified in the literature for implications for nursing practice and the nursing workforce from regulatory and labour provisions of trade agreements. Conclusions: The analysis of the literature reviewed is of international importance for the nursing workforce, nursing practice and public health. Policymakers must anticipate and respond to how the inclusion of labour or regulatory provisions in trade agreements will affect nursing practice and the nursing workforce, and how this may subsequently impact on the health of communities globally. (C) 2020 Elsevier Ltd. All rights reserved.
Description:
Electroconvulsive therapy (ECT) is a highly technical procedure requiring a team that consists of an anesthetist, a psychiatrist, a clinical nurse specialist, and recovery nurses. Traditionally, nursing education and training in the context of providing a safe and high standard of care has not been addressed. Ninety-two nurses from 42 different health agencies participated in a training program focusing on defibrillation, electrocardiogram (ECG) and electroencephalogram (EEG) monitoring, intubation, stimulus dosing, setting up the ECT equipment, and caring for the patient. A non-experimental, one-group, pretest-posttest research design was used in this study to evaluate the effectiveness of the training program for nurses working with ECT. Effective training for nurses was hypothesized to make a difference in the standards of practice and clinical effectiveness for patients undergoing ECT. Findings from this study indicated a major knowledge deficit in key components of ECT among nurses who have responsibilities in this area of nursing care. With effective training, nurses’ confidence levels increased related to setting up the equipment, administering a double dose, helping with intubation, and using a defibrillator. If nurses are to effectively function as team members in the ECT procedure, they must receive the training necessary to prepare them for this important role. The results of this study support the recommendation of the Royal Australian and New Zealand College of Psychiatrists that ECT nurses should be appropriately trained in anaesthetic and resuscitation techniques and modern ECT practice.
Description:
Australia is a large country with 60% of land used for agricultural production. Its interior is sparsely populated, with higher morbidity and mortality recorded in rural areas, particularly farmers, farm families, and agricultural workers. Rural health professionals in addressing health education gaps of farming groups have reported using behavioralist approaches. These approaches in isolation have been criticized as disempowering for participants who are identified as passive learners or 'empty vessels.' A major challenge in rural health practice is to develop more inclusive and innovative models in building improved health outcomes. The Sustainable Farm Families Train the Trainer (SFFTTT) model is a 5-day program developed by Western District Health Service designed to enhance practice among health professionals working with farm families in Australia. This innovative model of addressing farmer health asks health professionals to understand the context of the farm family and encourages them to value the experience and existing knowledge of the farmer, the family and the farm business. The SFFTTT program has engaged with health agencies, community, government, and industry groups across Australia and over 120 rural nurses have been trained since 2005. These trainers have successfully delivered programs to 1000 farm families, with high participant completion, positive evaluation, and improved health indicators. Rural professionals report changes in how they approach health education, clinical practice, and promotion with farm families and agricultural industries. This paper highlights the success of SFFTTT as an effective tool in enhancing primary health practice in rural and remote settings. The program is benefiting not only drought ravaged farmers but assisting rural nurses, health agencies, and health boards to engage with farm families at a level not identified previously. Furthermore, nurses and health professionals are now embracing a more 'farmer-centered model of care.'
Description:
Aims. Levels of fatigue as experienced by people with end stage renal disease (ESRD), were assessed using the Fatigue Severity Scale (FSS). Background. Fatigue, a common symptom reported by people with ESRD, is a multifaceted, subjective experience, which is readily understood by individuals but difficult to measure. There is limited understanding of the level of fatigue experienced by people with ESRD, with research currently limited to people treated with haemodialysis. Method. The FSS was completed by 92 people with ESRD who were patients of a renal service in far North Queensland, Australia. Demographic and renal health history data were also collected with the self-report survey. Results. Comparisons were preformed between overall fatigue levels and different renal disorders, genders, ethnicity and renal replacement therapy (RRT). Participants in this study were more fatigued than the general population; there was no difference in levels of fatigue between gender and ethnicity. Participants with diabetic nephropathy and those who were predialysis were the most fatigued. A significant difference between mean fatigue scores was found for type of RRT [F(3,88) = 2.4, p < 0.05], with participants using peritoneal dialysis reporting the most fatigue. Additionally, participants categorized according to type of RRT, erythropoietin replacement therapy and current haemoglobin levels revealed significant mean differences on fatigue levels [F(3,88) = 2.74, p < 0.05]. Relevance to clinical practice. People with ESRD experience considerable fatigue; it is particularly important for nurses to understand this level of fatigue impacts on the daily life of patients. These findings provide the preliminary evidence to support the development of renal nursing practice guidelines related to symptom recognition and management of fatigue.
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"The major criticism by hospital trained clinical nurses is that university graduates are perceived as not being competent practioners as a result of limited time spent in clinical areas. This lack of clinical experience is thought to contribute to new graduates' sense of occupational stress."--leaf xii.
Description:
"The major criticism by hospital trained clinical nurses is that university graduates are perceived as not being competent practioners as a result of limited time spent in clinical areas. This lack of clinical experience is thought to contribute to new graduates' sense of occupational stress."--leaf xii.
Description:
Nursing, as a new discipline in the academic world, has to combine scientific traditions with its identity as a clinical profession. Joint clinical professorial appointments have been established in order to combine these two worlds.
Description:
Aims and objectives: To examine the impact of fatigue on the daily activity levels of people with chronic kidney disease, compare whether being predialysis or receiving different renal replacement therapies had any effect on fatigue and activity and identify whether any items in the fatigue severity scale were more predictive of daily activity levels. Background: Chronic kidney disease is a complex and long-term disease where people commonly experience fatigue and reduced levels of fitness; both of which impact on an individual's ability to carry out routine activities of daily life. Design: A descriptive cross-sectional design. Methods: A convenience sample of 112 people completed the fatigue severity scale and Human Activity Profile. Participants differed in their renal history and were either predialysis or receiving renal replacement therapy. Results: Women or older participants were significantly more fatigued and less active than men or younger participants. A significant difference between mean fatigue and activity scores was found for type of renal replacement therapy, with participants receiving peritoneal dialysis being the most fatigued and the least active. Additionally, lower levels of albumin were significantly correlated with greater levels of fatigue and the ability to engage in fewer activities. Conclusion: People with chronic kidney disease regardless of whether they are predialysis or receiving either peritoneal or haemodialysis experience high levels of fatigue and are able to engage in fewer daily activities. The fatigue severity scale and the Human Activity Profile are useful indicators of fatigue and physical activities which can be used in routine assessment practices. Relevance to clinical practice: Renal nurses are ideally positioned to engage in early identification and regular monitoring of both fatigue and activity levels in people with chronic kidney disease. Individual care plans can be developed to incorporate supportive rehabilitative strategies which aim to reduce fatigue and maximise activity levels.
Description:
Narrative or story telling has long been used to structure and organise human experience. In contrast to logical models of reasoning, narrative models enable complex situations to be understood and recalled by humans readily. In this work a narrative model is integrated into a logical reasoning model for the purpose of advancing a learning environment that promises to be engaging and effective. The narrative model includes a representation of the point of a story and a simple story grammar. The logical reasoning model is based on an argumentation model. The learning environment is designed to enable the automated generation of plausible scenarios that involves an intensive care unit nurse responding to a low oxygen level alarm.
Description:
Nursing practice underpinned by humanistic values may promote presence experiences within nurse-patient interactions. These interactions are powerful and beneficial both to nurse and patient. However, the phenomenon of presence is surrounded by competing and confused definitions. Whilst presence is arguably a core aspect of nursing practice, current health care environments significantly influence nurses' opportunities to experience presence.
Description:
Aim. This Norwegian-based study investigates how and to what extent the idea of the nursing home as a home has been realized. Background. For the last two decades, Norway, as other Western Country has had an explicit national policy that nursing homes should become more like homes. The research literature indicates that residents in nursing home seem to lack the opportunities to maintain a private sphere. Design. A field study design was conducted. Methods. Data were collected in 1999 in two long-term units in a traditional nursing home by using participant observation and interviewing the residents. A phenomenological hermeneutic analysis strategy was used to get an impression of the residents' everyday life. Results. The residents spend most of their time in the common living room. The common living room has an ambiguous boundary between the public and private spheres, unlike the clear boundaries characterizing a home. The relationship among the residents is fragile, and the residents who can, withdraw from the common living room. Conclusions. Despite having single rooms and more home-like interior decoration, the residents in nursing home still have reduced opportunity to develop a private everyday lifestyle. The long-term unit examined in this research had a forced relationship between the residents, and the residents with best health resources systematically withdraw from the common area to control both where and with whom they wish to spend their time. Relevance to clinical practice. This study lays the foundation for rethinking daily routines in long-term units in nursing homes. One way to realize the idea of the nursing home as a home could be to define the living room as a clear public area and to give the residents a chance to develop a more private lifestyle by alternating between their private rooms and a public common living room.
Description:
It is crucial to the development and credibility of the nursing profession that its knowledge base be recognised as legitimate scholarly endeavour by established members of academia. For that reason, this report concerns examination of the attitudes and values of a group of non-nurse academics employed in universities in Melbourne, Victoria, Australia and the degree to which they view nursing as an epistemic entity. Perceptions are considered within the dual contexts of recent major changes in nursing education and in academia. Naturalistic Inquiry, informed by a hermeneutic attitude, is employed as a heuristic to examine the sub-culture of nursing within the broad culture of academia. Analysis of extensive interview data provided by the contemplation of study participants provides emergent themes. Several metaphors are chosen to explicate the findings that nursing is largely perceived to be nebulous, atheoretical, and subservient to the medical profession, Implications are discussed and recommendations are made with the view to encourage modernisation of the university through improving internal communication and challenging traditional models of operations within the tertiary sector.
Description:
In Australia, anti-discrimination legislation and government policies have been introduced which aim to facilitate the inclusion of people with disabilities in employment and education. However in the area of nursing, attitudinal barriers persist that effectively hinder the full participation of people with disabilities in nurse education programs. These attitudinal barriers prevail despite such legislative and policy changes, and run counter to changing community views about disability. Normative assumptions about the ideal attributes of nurses appear to influence these attitudes, especially in the area of admission of students with disabilities to nurse education programs per se, and to their participation in the practicum component of nurse education programs. This paper reports on research conducted in Victoria, Australia, by nurse academics and equity practitioners at three Victorian universities, into the barriers facing such students. The research examined the views of undergraduate student nurses, their lecturers and their clinical educators, nurse clinicians, and university disability practitioners about the participation of people with disabilities in nurse education programs. The research also sought to document their responses to a framework, developed through the research that aims to facilitate the inclusion of students with disabilities in undergraduate nursing programs. It did this against a pluralistic and technological milieu that in the researchers' view requires a more diverse mix within the nursing profession.
Description:
Aim To identify factors that have an impact on nurses’ performance of patients’ conscious level assessment. Background There is a need for nurses to accurately assess a patient’s conscious level to detect neurological changes and initiate prompt action. Methods Nine databases were systematically searched (1990–February 2010) to review experimental, cohort, case control, cross-sectional and descriptive studies that addressed factors which affected nurses’ performance of patient conscious level assessment. Participants in the studies reviewed were nursing staff. The Joanna Briggs Institute Meta Analysis of Statistics Assessment and Review Instrument was used for quality assessment. Results Eleven studies were analysed in this review. Knowledge and experience were found to be the most significant factors in determining nurses’ performance of patient conscious level assessment. Formal training was found to be effective in improving assessment skills and experience greatly affected the accuracy of assessment. Conclusion Knowledge and experience are the most significant factors on nurses’ performance of consciousness level assessment. Implications for nursing management Formal training is needed on a continual basis to maintain skills in consciousness level assessment, and nurses who are more experienced in the use of assessment should mentor those that are less experienced