Chinese mental health professionals’ perceptions of shared decision-making regarding people diagnosed with schizophrenia : a qualitative study
- Authors: Huang, Chongmei , Lam, Louisa , Zhong, Yaping , Plummer, Virginia , Cross, Wendy
- Date: 2021
- Type: Text , Journal article
- Relation: International Journal of Mental Health Nursing Vol. 30, no. 1 (2021), p. 189-199
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- Description: The implementation of shared decision-making regarding people diagnosed with schizophrenia is limited, although it is reported to have a positive impact on improving treatment adherence, therapeutic relationships and saving medical costs. The successful implementation of it is mainly dependent on the active engagement of mental health professionals. This study aims to identify mental health professionals’ perceptions of shared decision-making regarding people diagnosed with schizophrenia in collectivist cultures such as Chinese culture. A qualitative descriptive approach was used, involving ten individual interviews with psychiatrists and four focus groups with twenty-three mental health nurses from the psychiatry department of a tertiary hospital in mainland China. An inductive thematic approach was used to analyze the data. Two main themes with five subthemes generated: willingness to engage in shared decision-making and perceiving shared decision-making as unachievable. The last theme included five subthemes: (i) deference to authority, (ii) tension between family decision-making and patient autonomy, (iii) uncertainty of trusting therapeutic relationships, (iv) implicit persuasion and (v) insufficient consultation time. Patients often lack opportunity and support to engage in decision-making. Mental health nurses in other countries need to be aware that Chinese patients and patients with a similar background are not knowledgeable about or value shared decision-making to the extent that other countries might. They need to evaluate and support them, including encouraging them to engage in decision-making as well as providing appropriate information. Mental health nurses need to collaborate with patients and their families to achieve patient-centred care when family involvement is expected. © 2020 Australian College of Mental Health Nurses Inc.
The impact of COVID-19 on the service of emergency department
- Authors: Alharthi, Shaia , Al-Moteri, Modi , Plummer, Virginia , Thobiaty, Abdulellah
- Date: 2021
- Type: Text , Journal article
- Relation: Healthcare (Switzerland) Vol. 9, no. 10 (2021), p.
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- Description: (1) Introduction: the COVID-19 pandemic significantly impacted the number and acuity of emergency departments (ED) patients, specifically those with non-COVID-19-related health problems. However, the exact impact of the COVID-19 pandemic on ED services is the subject of comprehensive debate. (2) Aim: to gain insight into the consequences of the first wave of the COVID-19 pandemic based on non-COVID-19 presentations and patient acuity using the Canadian Triage and Acuity Scale (CTAS). (3) Method: in Phase 1, the ED records of one of the main regional non-COVID-19 hospitals in Saudi Arabia were retrospectively audited from August 2020 to February 2021—after the first wave of COVID-19—then compared to information collected for the same period in previous year. Phase 2 included calculating the waiting time to identify delays and issues that may impact the triage effectiveness. (4) Results: a change across all CTAS levels was observed post the 1st wave of COVID-19 pandemic. Specifically, there was an increase in the number of patients presenting as higher acuity (CTAS 1 and 2) and a decrease in patients presenting as lower acuity (CTAS 4 and 5). Longer waiting times for patients presenting to ED were also reported. Specifically, 83% of patients presenting as higher acuity experienced a delay. (5) Conclusion: further studies are required to investigate association between the 1st wave of COVID-19 and patient presentations and/or acuity or patient demand and ED capacity. © 2021 by the authors. Licensee MDPI, Basel, Switzerland.
Falls risk score removal does not impact inpatient falls : a stepped-wedge, cluster-randomised trial
- Authors: Jellett, Joanna , Williams, Cylie , Clayton, Diana , Plummer, Virginia , Haines, Terry
- Date: 2020
- Type: Text , Journal article
- Relation: Journal of Clinical Nursing Vol. 29, no. 23-24 (2020), p. 4505-4513
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- Description: Aims and objectives: To investigate the impact of removing a falls risk screening tool from an overall falls risk assessment programme on the rate of falls, injurious falls and completion of falls prevention activities by staff. Background: Falls in older patients are common adverse events in hospital settings. Screening and assessing individual patients for risk of falls are a common, but controversial element of falls prevention strategies in hospitals. Design: A stepped-wedge, cluster-randomised controlled trial using a disinvestment approach. Methods: This trial was carried out according to the Consolidated Standards of Reporting Trials (CONSORT). All patients were admitted to 20 health service wards (9 units) over the 10-month study period. The control condition contained a falls risk screening tool element, a full falls risk factor assessment and intervention provision section. In the intervention condition, only the full falls risk factor assessment and intervention provision section was applied, and the falls risk screening tool element was removed. Fall rates were extracted from hospital level data, files were audited for tool completion, and nurses surveyed about tool use. Results: There did not appear to be an impact on the falls rate per month when the risk screening tool component was removed (incidence rate ratio (IRR) = 0.84—favours intervention, 95%CI = 0.67 to 1.05, p =.14) nor on the falls rate with serious injury (IRR = 0.90, 95%CI = 0.26 to 3.09, p =.87). There was a thirty-six second reduction of time per patient reported by staff to complete paperwork (p <.001). There was no difference in the proportion of patients for whom the tool was completed, nor the number of falls prevention interventions identified for implementation. Conclusion: Removing the falls risk screening tool section did not negatively impact falls and reduced time spent completing falls prevention paperwork. Relevance to clinical practice: Falls prevention is an important issue in health services. Removal of a screening risk tool is unlikely to impact falls. This has the potential to reduce nursing administration time that may be otherwise redirected to individual approaches to falls prevention. © 2020 John Wiley & Sons Ltd
I am the person who knows myself best : perception on shared decision-making among hospitalized people diagnosed with schizophrenia in China
- Authors: Huang, Chongmei , 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
Nurse expertise : a critical resource in the covid-19 pandemic response
- Authors: Schwerdtl, Patricia , Connell, Clifford , Lee, Susan , Plummer, Virginia , Russo, Philip , Endacott, Ruth , Kuhn, Lisa
- Date: 2020
- Type: Text , Journal article
- Relation: Annals of Global Health Vol. 86, no. 1 (2020), p.
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Practice priorities for acute care nursing : a Delphi study
- 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 effects of resilience and turnover intention on nurses’ burnout : Findings from a comparative cross-sectional study
- 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.
The risk factors of antenatal depression : A cross-sectional survey
- Authors: Chen, Jiarui , Cross, Wendy , Plummer, Virginia , Lam, Louisa , Sun, Mei , Qin, Chunxiang , Tang, Siyuan
- Date: 2019
- Type: Text , Journal article
- Relation: Journal of Clinical Nursing Vol. 28, no. 19-20 (2019), p. 3599-3609
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- Description: Aims and objectives To investigate the prevalence of depression in the third trimester of pregnancy and identify the related demographic risk factors. Background Antenatal depression as a disabling and treatable disease has a wide-ranging impact on perinatal women and has received extensive attention from researchers. Design A cross-sectional survey was conducted at three public hospitals. Methods Demographic questionnaire was developed from the literature review, and depression was assessed using the Edinburgh Postnatal Depression Scale. A binary logistic regression model was used to assess the association between depression and demographic predictors. STROBE checklist for cross-sectional studies was applied in this paper (see Appendix S1). Result A total of 773 pregnant women participated in the study. 29.6% of participants scored more than 9 points on Edinburgh Postnatal Depression Scale. In the final logistic model, living in rural area, marital satisfaction, assisted reproductive technology, lacking of prenatal health knowledge and life events were strongly significantly associated with antenatal depression. Moreover, living in an extended family, without Medicare insurance, unemployed, working as civil servants or healthcare workers, and lower household income also predicted antenatal depression. However, education level, smoking or drinking before pregnancy was found not to be associated with antenatal depression. Conclusion Our findings suggest that the prevalence of antenatal depression was high. Satisfied with the current marital status, pregnancy without assisted reproductive technology, knowledge of perinatal care and no life events recently were considered as the protective factors for antenatal depression. Relevance to clinical practice Antenatal psychological interventions should focus on how to improve the marital satisfaction and the relationship with their family members. More attentions should be paid to the women who have had some life events recently or received assisted reproductive technology for pregnancy.
A new scale for disaster nursing core competencies : Development and psychometric testing
- Authors: Al Thobaity, Abdulellah , Williams, Brett , Plummer, Virginia
- Date: 2016
- Type: Text , Journal article
- Relation: Australasian Emergency Nursing Journal Vol. 19, no. 1 (2016), p. 11-19
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- Description: Background: All nurses must have core competencies in preparing for, responding to and recovering from a disaster. In the Kingdom of Saudi Arabia (KSA), as in many other countries, disaster nursing core competencies are not fully understood and lack reliable, validated tools. Thus, it is imperative to develop a scale for exploring disaster nursing core competencies, roles and barriers in the KSA. Objectives: This study's objective is to develop a valid, reliable scale that identifies and explores core competencies of disaster nursing, nurses' roles in disaster management and barriers to developing disaster nursing in the KSA. Methods: This study developed a new scale testing its validity and reliability. A principal component analysis (PCA) was used to develop and test psychometric properties of the new scale. The PCA used a purposive sample of nurses from emergency departments in two hospitals in the KSA. Participants rated 93 paper-based, self-report questionnaire items from 1 to 10 on a Likert scale. PCA using Varimax rotation was conducted to explore factors emerging from responses. Findings: The study's participants were 132 nurses (66% response rate). PCA of the 93 questionnaire items revealed 49 redundant items (which were deleted) and 3 factors with eigenvalues of >1. The remaining 44 items accounted for 77.3% of the total variance. The overall Cronbach's alpha was 0.96 for all factors: 0.98 for Factor 1, 0.92 for Factor 2 and 0.86 for Factor 3. Conclusions: This study provided a validated, reliable scale for exploring nurses' core competencies, nurses' roles and barriers to developing disaster nursing in the KSA. The new scale has many implications, such as for improving education, planning and curricula. © 2015.
Collaboration between nurses and physicians in an Indonesian Emergency Department
- Authors: Suryanto , Plummer, Virginia , Copnell, Beverley
- Date: 2016
- Type: Text , Journal article
- Relation: Australasian Emergency Nursing Journal Vol. 19, no. 2 (2016), p. 82-89
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- Description: Background: Positive collaboration between nurses and physicians is essential in emergency practice because it has a significant relationship with the quality, safety, accountability, and responsibility of care. The aim of this study was to examine nurses' and physicians' attitudes towards collaboration in the Emergency Department in the Indonesian context. Methods: The study was a comparative study using a modified Jefferson Scale of Attitude towards Physician-Nurse Collaboration. Data were collected from 47 nurses and 24 physicians of one of 25 general hospitals in Malang, Indonesia, by anonymous survey. Results: Emergency nurses had significantly more positive attitudes towards collaboration than emergency physicians (P < 0.001). Emergency nurses had significantly higher scores in three of four domains of the instrument, "physician dominance", "nurse autonomy", and "caring as opposed to curing". The effects of gender, age, and education on nurses' and physicians' attitude towards collaboration were not statistically significant. However, experience in the Emergency Department of the general hospital was significantly related to participants' attitudes towards collaboration (P = 0.023). Conclusions: The findings of this study indicate that attitudes towards collaboration among the two professions should be enhanced. Inter-professional education and promotion of teamwork may be solutions to improve the relationship, not only between nurses and physicians, but also other healthcare providers. © 2016 College of Emergency Nursing Australasia.
Perceptions of knowledge of disaster management among military and civilian nurses in Saudi Arabia
- Authors: Al Thobaity, Abdulellah , Plummer, Virginia , Innes, Kelli , Copnell, Beverley
- Date: 2015
- Type: Text , Journal article
- Relation: Australasian Emergency Nursing Journal Vol. 18, no. 3 (2015), p. 156-164
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- Description: Summary Background It is generally accepted that nurses have insufficient knowledge about disaster preparedness due to a lack of acceptance of core competencies and the absence of disaster preparedness in nursing curricula.1 This study explored nurses’ knowledge and sources of knowledge, and skills as they relate to disaster management in Saudi Arabia, where more than 4660 people have died, 32,000 people have been affected, and US$4.65 billion in damage has been caused by disaster since 1980.2 Methods A quantitative, non-experimental, descriptive research design. Results Nurses in Saudi Arabia have moderate knowledge concerning disaster preparedness. However, nurses in military hospitals possess more knowledge than those who work in government hospitals. The majority of nurses gained their knowledge and skills from disaster drills. Conclusions Nurses need more education in all areas of disaster management, most importantly in their roles during response to disasters. Nurses perceive themselves as not well-prepared but they are willing to improve their skills in disaster preparedness if educational opportunities are provided.
At the crossroads of violence and aggression in the emergency department : Perspectives of Australian emergency nurses
- Authors: Morphet, Julia , Griffiths, Debra , Plummer, Virginia , Innes, Kelli , Fairhall, Robyn , Beattie, Jill
- Date: 2014
- Type: Text , Journal article , Review
- Relation: Australian Health Review Vol. 38, no. 2 (2014), p. 194-201
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- Description: Objective Violence is widespread in Australian emergency departments (ED) and most prevalent at triage. The aim of the present study was to identify the causes and common acts of violence in the ED perceived by three distinct groups of nurses. Methods The Delphi technique is a method for consensus-building. In the present study a three-phase Delphi technique was used to identify and compare what nurse unit managers, triage and non-triage nurses believe is the prevalence and nature of violence and aggression in the ED. Results Long waiting times, drugs and alcohol all contributed to ED violence. Triage nurses also indicated that ED staff, including security staff and the triage nurses themselves, can contribute to violence. Improved communication at triage and support from management to follow up episodes of violence were suggested as strategies to reduce violence in the ED Conclusion There is no single solution for the management of ED violence. Needs and strategies vary because people in the waiting room have differing needs to those inside the ED. Participants agreed that the introduction and enforcement of a zero tolerance policy, including support from managers to follow up reports of violence, would reduce violence and improve safety for staff. Education of the public regarding ED processes, and the ED staff in relation to patient needs, may contribute to reducing ED violence. What is known about the topic? Violence is prevalent in Australian healthcare, and particularly in emergency departments (ED). Several organisations and government bodies have made recommendations aimed at reducing the prevalence of violence in healthcare but, to date, these have not been implemented consistently, and violence continues. What does this paper add? This study examined ED violence from the perspective of triage nurses, nurse unit managers and non-triage nurses, and revealed that violence is experienced differently by emergency nurses, depending on their area of work. Triage nurses have identified that they themselves contribute to violence in the ED by their style of communication. Nurse unit managers and non-triage nurses perceive that violence is the result of drugs and alcohol, as well as long waiting times. What are the implications for practitioners? Strategies to reduce violence must address the needs of patients and staff both within the ED and in the waiting room. Such strategies should be multifaceted and include education of ED consumers and staff, as well as support from management to respond to reports of violence. © AHHA 2014.
Attitudes of healthcare providers towards family involvement and presence in adult critical care units in Saudi Arabia : A quantitative study
- Authors: Al Mutair, Abbas , Plummer, Virginia , O'Brien, Anthony , Clerehan, Rosemary
- Date: 2014
- Type: Text , Journal article
- Relation: Journal of Clinical Nursing Vol. 23, no. 5-6 (2014), p. 744-755
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- Description: Aims and objectives: To describe healthcare providers' attitudes to family involvement during routine care and family presence during resuscitation or other invasive procedures in adult intensive care units in Saudi Arabia. Background: Previous research has shown that healthcare professionals have revealed a diversity of opinions on family involvement during routine care and family presence during resuscitation or other invasive procedures. Attitude assessment can provide an indication of staff acceptance or rejection of the practice and also help identify key potential barriers that will need to be addressed. It has also been evident that participation in the care has potential benefits for patients and families as well as healthcare providers. Design: A quantitative descriptive design. Methods: A questionnaire was used with a convenience sample of 468 healthcare providers who were recruited from eight intensive care units. Results: The analysis found that healthcare providers had positive attitudes towards family involvement during routine care, but negative attitudes towards family presence during resuscitation or other invasive procedures. Physicians expressed more opposition to the practice than did nurses and respiratory therapists. Staff indicated a need to develop written guidelines and policies, as well as educational programmes, to address this sensitive issue in clinical practice. Conclusion: Family is an important resource in patient care in the context of the critical care environment. Clinical barriers including resources, hospital policies and guidelines, staff and public education should be taken into account to facilitate family integration to the care model. Relevance to clinical practice: The findings can help to develop policies and guidelines for safe implementation of the practice. They can also encourage those who design nursing and other medical curricula to place more emphasis on the role of the family especially in critical care settings. © 2013 John Wiley & Sons Ltd.
Family needs and involvement in the intensive care unit : A literature review
- Authors: Al Mutair, Abbas , Plummer, Virginia , O'Brien, Anthony , Clerehan, Rosemary
- Date: 2013
- Type: Text , Journal article , Review
- Relation: Journal of Clinical Nursing Vol. 22, no. 13-14 (2013), p. 1805-1817
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- Description: Aims and objectives: To understand the needs of critically ill patient families', seeking to meet those needs and explore the process and patterns of involving family members during routine care and resuscitation and other invasive procedures. Methods: A structured literature review using Cumulative Index to Nursing and Allied Health Literature, Pubmed, Proquest, Google scholar, Meditext database and a hand search of critical care journals via identified search terms for relevant articles published between 2000 and 2010. Results: Thirty studies were included in the review either undertaken in the Intensive Care Unit or conducted with critical care staff using different methods of inquiry. The studies were related to family needs; family involvement in routine care; and family involvement during resuscitation and other invasive procedures. The studies revealed that family members ranked both the need for assurance and the need for information as the most important. They also perceived their important needs as being unmet, and identified the nurses as the best staff to meet these needs, followed by the doctors. The studies demonstrate that both family members and healthcare providers have positive attitudes towards family involvement in routine care. However, family members and healthcare providers had significantly different views of family involvement during resuscitation and other invasive procedures. Conclusion: Meeting Intensive Care Unit family needs can be achieved by supporting and involving families in the care of the critically ill family member. More emphasis should be placed on identifying the family needs in relation to the influence of cultural values and religion held by the family members and the organisational climate and culture of the working area in the Intensive Care Unit. © 2013 Blackwell Publishing Ltd.