Development and validation of the human activity profile into Chinese language : Lessons in determining equivalence
- Bonner, Ann, Wellard, Sally, Kenrick, Marita
- Authors: Bonner, Ann , Wellard, Sally , Kenrick, Marita
- Date: 2006
- Type: Text , Journal article
- Relation: Nursing and Health Sciences Vol. 8, no. 1 (2006), p. 36-43
- Full Text:
- Reviewed:
- Description: The Human Activity Profile (HAP), and associated Dyspnea Scale, is a self-report instrument for assessing levels of human activity. Although it has been used in studies examining the levels of activity in people, it is limited to people who are only able to understand English. However, many countries are multicultural with significant numbers of people whose native language is not English. This study sought to demonstrate the equivalence between the Chinese and English versions of the HAP and Dyspnea scales.Thirty-five bilingual university students completed both the Chinese and English versions of each questionnaire. There was 89% and 85% agreement between items across the HAP and Dyspnea Scale questionnaires, respectively. Although the psychometric evaluations suggested there was equivalence between the Chinese and English versions of both the HAP and Dyspnea Scale, lessons have been learnt regarding the different written forms of Chinese. © 2006 The Authors Journal Compilation © 2006 Blackwell Publishing Asia Pty Ltd.
- Description: C1
- Description: 2003001972
- Authors: Bonner, Ann , Wellard, Sally , Kenrick, Marita
- Date: 2006
- Type: Text , Journal article
- Relation: Nursing and Health Sciences Vol. 8, no. 1 (2006), p. 36-43
- Full Text:
- Reviewed:
- Description: The Human Activity Profile (HAP), and associated Dyspnea Scale, is a self-report instrument for assessing levels of human activity. Although it has been used in studies examining the levels of activity in people, it is limited to people who are only able to understand English. However, many countries are multicultural with significant numbers of people whose native language is not English. This study sought to demonstrate the equivalence between the Chinese and English versions of the HAP and Dyspnea scales.Thirty-five bilingual university students completed both the Chinese and English versions of each questionnaire. There was 89% and 85% agreement between items across the HAP and Dyspnea Scale questionnaires, respectively. Although the psychometric evaluations suggested there was equivalence between the Chinese and English versions of both the HAP and Dyspnea Scale, lessons have been learnt regarding the different written forms of Chinese. © 2006 The Authors Journal Compilation © 2006 Blackwell Publishing Asia Pty Ltd.
- Description: C1
- Description: 2003001972
Exploring the use of clinical laboratories in undergraduate nursing programs in regional Australia
- Wellard, Sally, Woolf, Rhonda, Gleeson, Lynne
- Authors: Wellard, Sally , Woolf, Rhonda , Gleeson, Lynne
- Date: 2007
- Type: Text , Journal article
- Relation: International Journal of Nursing Education Scholarship Vol. 4, no. 1 (2007), p.
- Full Text:
- Reviewed:
- Description: Preparation for clinical practice is arguably a vital component of undergraduate nursing education with clinical laboratories widely adopted as a strategy to support student development of clinical skills. However, there is little empirical evidence about the role laboratories play in students' learning or how they assist in linking theory to practice. This study aimed to explore the current clinical laboratory practices in Schools of Nursing in regional Victoria, Australia through site visits, interviews and review of curricula. Findings revealed that approaches to laboratory learning are based on traditions rather than evidence, and have evolved in response to fiscal and environmental challenges. The predominance of teacher talk in the laboratory, has lead to acute care over other areas of practice. This study indicates a need for rigorous investigation of pedagogies that can support nursing students in preparation for clinical practice. It remains unclear if laboratory learning experiences assist students in the translation of theoretical knowledge to practice. Copyright ©2007 The Berkeley Electronic Press. All rights reserved.
- Description: C1
- Description: 2003005867
- Authors: Wellard, Sally , Woolf, Rhonda , Gleeson, Lynne
- Date: 2007
- Type: Text , Journal article
- Relation: International Journal of Nursing Education Scholarship Vol. 4, no. 1 (2007), p.
- Full Text:
- Reviewed:
- Description: Preparation for clinical practice is arguably a vital component of undergraduate nursing education with clinical laboratories widely adopted as a strategy to support student development of clinical skills. However, there is little empirical evidence about the role laboratories play in students' learning or how they assist in linking theory to practice. This study aimed to explore the current clinical laboratory practices in Schools of Nursing in regional Victoria, Australia through site visits, interviews and review of curricula. Findings revealed that approaches to laboratory learning are based on traditions rather than evidence, and have evolved in response to fiscal and environmental challenges. The predominance of teacher talk in the laboratory, has lead to acute care over other areas of practice. This study indicates a need for rigorous investigation of pedagogies that can support nursing students in preparation for clinical practice. It remains unclear if laboratory learning experiences assist students in the translation of theoretical knowledge to practice. Copyright ©2007 The Berkeley Electronic Press. All rights reserved.
- Description: C1
- Description: 2003005867
- Wellard, Sally, Bethune, Elizabeth, Heggen, Kristin
- Authors: Wellard, Sally , Bethune, Elizabeth , Heggen, Kristin
- Date: 2007
- Type: Text , Journal article
- Relation: Nurse Education Today Vol. 27, no. 1 (2007), p. 68-72
- Full Text:
- Reviewed:
- Description: In Australia and Norway final examinations to determine eligibility for registration as a nurse were discontinued during the period when nurse education moved into the higher education sector. In response to recent calls for the reintroduction of final examinations we explore the range of knowledge needs for the practice of nursing. These various forms of knowledge demand different forms of mediation and acquisition as well as assessment. There are numerous problems identified in the literature about the shortcomings of examinations as the foundation of assessing clinically based professions. There is a need to develop systems of appropriate assessment to ensure that graduates of nursing demonstrate adequate knowledge and competence to enter their profession. © 2006 Elsevier Ltd. All rights reserved.
- Description: C1
- Description: 2003002546
Increased unintended patient harm in nursing practise as a consequence of the dominance of economic discourses
- Heggen, Kristin, Wellard, Sally
- Authors: Heggen, Kristin , Wellard, Sally
- Date: 2004
- Type: Text , Journal article
- Relation: International Journal of Nursing Studies Vol. 41, no. 3 (2004), p. 293-298
- Full Text:
- Reviewed:
- Description: Caring is characterized by close and fragile relations between nurses and patients. At times, even with good intentions, nurses cause unintended harm of patients. We argue that the dominance of economic discourses in health care and their subsequent influence on service delivery and health care practices has the potential to increase unintended patient harm. Similar techniques and practices can result in either desired outcomes or harmful outcomes. We explore the notion of unintended harm and some of the ways it arises in nursing practice. We argue there is a clear link between the dominance of economic discourses and an increased risk of unintended harm. As a consequence of the dominance of economic rationalist discourses and the subsequent systems of control introduced, the practice of nursing has been significantly influenced. The challenge for nurses and the nursing profession is to develop strategies to refuse to give in to the dominance of economic interests over the need to prevent harm.
- Description: C1
- Description: 2003000837
- Authors: Heggen, Kristin , Wellard, Sally
- Date: 2004
- Type: Text , Journal article
- Relation: International Journal of Nursing Studies Vol. 41, no. 3 (2004), p. 293-298
- Full Text:
- Reviewed:
- Description: Caring is characterized by close and fragile relations between nurses and patients. At times, even with good intentions, nurses cause unintended harm of patients. We argue that the dominance of economic discourses in health care and their subsequent influence on service delivery and health care practices has the potential to increase unintended patient harm. Similar techniques and practices can result in either desired outcomes or harmful outcomes. We explore the notion of unintended harm and some of the ways it arises in nursing practice. We argue there is a clear link between the dominance of economic discourses and an increased risk of unintended harm. As a consequence of the dominance of economic rationalist discourses and the subsequent systems of control introduced, the practice of nursing has been significantly influenced. The challenge for nurses and the nursing profession is to develop strategies to refuse to give in to the dominance of economic interests over the need to prevent harm.
- Description: C1
- Description: 2003000837
Issues in the provision of nursing care to people undergoing cardiac surgery who also have type 2 diabetes
- Wellard, Sally, Cox, Helen, Bhujoharry, Claire
- Authors: Wellard, Sally , Cox, Helen , Bhujoharry, Claire
- Date: 2007
- Type: Text , Journal article
- Relation: International journal of nursing practice Vol. 13, no. 4 (2007), p. 222-228
- Full Text:
- Reviewed:
- Description: There has been little investigation of the issues associated with caring for patients presenting for cardiac surgery with a comorbid diagnosis of diabetes although there is some evidence that the diabetes management is suboptimal. This study aimed to identify issues that patients and cardiac specialist nurses experience with the provision of inpatient services for people undergoing cardiac surgery who also have type 2 diabetes. A qualitative interpretive design, using individual interviews with patients and nurses, provided data about some of these issues. The study found that nurses had high levels of confidence in their cardiac care but little confidence in diabetes management. Patients described concerns about their diabetes care and treatment regimens. A 'typical journey' for a person with diabetes undergoing cardiac surgery was identified. The findings support the need to build increased capacity in specialist nurses to support diabetes care as a secondary diagnosis.
- Description: C1
- Description: 2003005865
- Authors: Wellard, Sally , Cox, Helen , Bhujoharry, Claire
- Date: 2007
- Type: Text , Journal article
- Relation: International journal of nursing practice Vol. 13, no. 4 (2007), p. 222-228
- Full Text:
- Reviewed:
- Description: There has been little investigation of the issues associated with caring for patients presenting for cardiac surgery with a comorbid diagnosis of diabetes although there is some evidence that the diabetes management is suboptimal. This study aimed to identify issues that patients and cardiac specialist nurses experience with the provision of inpatient services for people undergoing cardiac surgery who also have type 2 diabetes. A qualitative interpretive design, using individual interviews with patients and nurses, provided data about some of these issues. The study found that nurses had high levels of confidence in their cardiac care but little confidence in diabetes management. Patients described concerns about their diabetes care and treatment regimens. A 'typical journey' for a person with diabetes undergoing cardiac surgery was identified. The findings support the need to build increased capacity in specialist nurses to support diabetes care as a secondary diagnosis.
- Description: C1
- Description: 2003005865
Discursive influences on clinical teaching in Australian undergraduate nursing programs
- McKenna, Lisa, Wellard, Sally
- Authors: McKenna, Lisa , Wellard, Sally
- Date: 2004
- Type: Text , Journal article
- Relation: Nurse Education Today Vol. 24, no. 3 (2004), p. 229-235
- Full Text:
- Reviewed:
- Description: Clinical teaching is a vital, yet multidimensional component of Australian undergraduate nursing courses. Unlike other parts of curricula, clinical teaching relies on the both higher education and health care sectors to meet prescribed goals and for effective student learning to occur. As such it is influenced by discourses from within both education and health. Whilst there is considerable literature related to undergraduate nursing clinical teaching; it mainly deals with practical aspects such as effectiveness of clinical teaching or discussions of models employed. Only a small pool of literature exists that discusses the construction of clinical teaching including the factors that have influenced the development of practices both in the past and present. Using the work of Foucault, this paper examines dominant and competing discourses influencing clinical teaching through their constructions within the literature. These are discourses of academia, nursing, and economics. The discussion situates these discourses and discusses how some of the resultant issues surrounding clinical education remain largely unresolved. Crown Copyright © 2004 Published by Elsevier Ltd. All rights reserved.
- Description: C1
- Description: 2003000838
- Authors: McKenna, Lisa , Wellard, Sally
- Date: 2004
- Type: Text , Journal article
- Relation: Nurse Education Today Vol. 24, no. 3 (2004), p. 229-235
- Full Text:
- Reviewed:
- Description: Clinical teaching is a vital, yet multidimensional component of Australian undergraduate nursing courses. Unlike other parts of curricula, clinical teaching relies on the both higher education and health care sectors to meet prescribed goals and for effective student learning to occur. As such it is influenced by discourses from within both education and health. Whilst there is considerable literature related to undergraduate nursing clinical teaching; it mainly deals with practical aspects such as effectiveness of clinical teaching or discussions of models employed. Only a small pool of literature exists that discusses the construction of clinical teaching including the factors that have influenced the development of practices both in the past and present. Using the work of Foucault, this paper examines dominant and competing discourses influencing clinical teaching through their constructions within the literature. These are discourses of academia, nursing, and economics. The discussion situates these discourses and discusses how some of the resultant issues surrounding clinical education remain largely unresolved. Crown Copyright © 2004 Published by Elsevier Ltd. All rights reserved.
- Description: C1
- Description: 2003000838
Medication errors and professional practice of registered nurses
- Authors: Deans, Cecil
- Date: 2005
- Type: Text , Journal article
- Relation: Collegian Vol. 12, no. 1 (2005), p. 29-33
- Full Text:
- Reviewed:
- Description: This Australian study identified and described the incidence of medication errors among registered nurses, the type and causes of these errors and the impact that administration of medications has on the professional practice of registered nurses. Mostly, medication errors were attributed to documentation issues, including: illegible handwriting, misunderstanding abbreviations, misplaced decimal point, misreading and misinterpreting written orders. Several human factors were attributed to potential causes of medication errors, including: stress, fatigue, knowledge and skill deficits. Environmental factors, namely, interruptions and distractions during the administration of medications, were also attributed to potential errors. The study found professional nursing practice involving administration of medications had a strong education, patient and ethical focus. Over a quarter of the respondents indicated that further training in medication administration would positively impact on their nursing practice. The registered nurses also highlighted they would appreciate more time to spend with patients when administering medications. Medication errors are not the sole responsibility of any single professional group, therefore, collaboration with other health professionals is central to establishing processes, policies, strategies and systems that will reduce their occurrence. The organisation and those nurses employed within it share an accountability to ensure safe administration of medications to patients. Based on study results, several recommendations are directed towards preventing or reducing medication errors and supporting nurses in providing best practice.
- Description: C1
- Description: 2003001207
- Authors: Deans, Cecil
- Date: 2005
- Type: Text , Journal article
- Relation: Collegian Vol. 12, no. 1 (2005), p. 29-33
- Full Text:
- Reviewed:
- Description: This Australian study identified and described the incidence of medication errors among registered nurses, the type and causes of these errors and the impact that administration of medications has on the professional practice of registered nurses. Mostly, medication errors were attributed to documentation issues, including: illegible handwriting, misunderstanding abbreviations, misplaced decimal point, misreading and misinterpreting written orders. Several human factors were attributed to potential causes of medication errors, including: stress, fatigue, knowledge and skill deficits. Environmental factors, namely, interruptions and distractions during the administration of medications, were also attributed to potential errors. The study found professional nursing practice involving administration of medications had a strong education, patient and ethical focus. Over a quarter of the respondents indicated that further training in medication administration would positively impact on their nursing practice. The registered nurses also highlighted they would appreciate more time to spend with patients when administering medications. Medication errors are not the sole responsibility of any single professional group, therefore, collaboration with other health professionals is central to establishing processes, policies, strategies and systems that will reduce their occurrence. The organisation and those nurses employed within it share an accountability to ensure safe administration of medications to patients. Based on study results, several recommendations are directed towards preventing or reducing medication errors and supporting nurses in providing best practice.
- Description: C1
- Description: 2003001207
Editorial: Challenges for health professionals in working with consumers in partnership
- Authors: Wellard, Sally
- Date: 2007
- Type: Text , Journal article
- Relation: Journal of Clinical Nursing Vol. 16, no. 11C (2007), p. 245-246
- Full Text:
- Reviewed:
- Description: C1
- Description: 2003002996
- Authors: Wellard, Sally
- Date: 2007
- Type: Text , Journal article
- Relation: Journal of Clinical Nursing Vol. 16, no. 11C (2007), p. 245-246
- Full Text:
- Reviewed:
- Description: C1
- Description: 2003002996
Being active supports client control over health care
- Authors: Fiveash, Barbara , Nay, R.
- Date: 2004
- Type: Text , Journal article
- Relation: Contemporary Nurse Vol. 17, no. 3 (2004), p. 192-203
- Full Text:
- Reviewed:
- Description: The purpose of this study was to identify how healthcare clients achieve and maintain a sense of control over their health. The literature review conducted refers to: (i) key definitions of control, (ii) locus of control, and (iii) control and wellbeing. Participants with a range of acute and chronic health conditions and who had been hospitalised at some point were selected for the study. Symbolic interactionism (Blumer, 1969) and modified grounded theory of Strauss & Corbin (1998) provided the frameworks for this study. During the six month study period, data were collected from sixty participants and included interviews, participant observation, reviewing participants' records (nursing care plans, nursing notes and case histories), the nursing units' philosophy, organisational charts, policies and procedures, annual reports, consumer brochures and any other relevant information sources. Findings from the study indicated that participants moved from feeling vulnerable to having a sense of control through to being purposefully active. Vulnerability was associated with: (i) having limited choices in respect to their health, (ii) lacking adequate health information to make choices, (iii) being ignored by health providers with respect to their needs, and (iv) lacking friend/family supports. Purposefully activating was associated with three major categories: (i) reflecting, (ii) being self-determiningly involved and (iii) normalising. Findings from this study could be used by health care clients who want a sense of control over their health care, and also by health care providers who wish to support clients in the healthcare process.
- Description: C1
- Description: 2003000836
- Authors: Fiveash, Barbara , Nay, R.
- Date: 2004
- Type: Text , Journal article
- Relation: Contemporary Nurse Vol. 17, no. 3 (2004), p. 192-203
- Full Text:
- Reviewed:
- Description: The purpose of this study was to identify how healthcare clients achieve and maintain a sense of control over their health. The literature review conducted refers to: (i) key definitions of control, (ii) locus of control, and (iii) control and wellbeing. Participants with a range of acute and chronic health conditions and who had been hospitalised at some point were selected for the study. Symbolic interactionism (Blumer, 1969) and modified grounded theory of Strauss & Corbin (1998) provided the frameworks for this study. During the six month study period, data were collected from sixty participants and included interviews, participant observation, reviewing participants' records (nursing care plans, nursing notes and case histories), the nursing units' philosophy, organisational charts, policies and procedures, annual reports, consumer brochures and any other relevant information sources. Findings from the study indicated that participants moved from feeling vulnerable to having a sense of control through to being purposefully active. Vulnerability was associated with: (i) having limited choices in respect to their health, (ii) lacking adequate health information to make choices, (iii) being ignored by health providers with respect to their needs, and (iv) lacking friend/family supports. Purposefully activating was associated with three major categories: (i) reflecting, (ii) being self-determiningly involved and (iii) normalising. Findings from this study could be used by health care clients who want a sense of control over their health care, and also by health care providers who wish to support clients in the healthcare process.
- Description: C1
- Description: 2003000836
Attitudes of registered psychiatric nurses towards patients diagnosed with borderline personality disorder
- Authors: Deans, Cecil , Meocevic, E.
- Date: 2006
- Type: Text , Journal article
- Relation: Contemporary Nurse Vol. 21, no. 1 (2006), p. 43-49
- Full Text:
- Reviewed:
- Description: Caring for patients with a diagnosis of Borderline Personality Disorder (BPD) has been identified as a problem area for mental health professionals with some studies suggesting that a diagnosis of BPD will influence the level and quality of interaction staff have with patients. It is inherent to psychiatric nursing that practitioners are able to establish rapport, develop trust and demonstrate empathy with consumers of mental health services. Despite the importance of this issue for psychiatric nurses and for consumers, the perceptions and attitudes of psychiatric nurses towards patients diagnosed with BPD have received almost no research attention. This paper describes findings from a study of attitudes held by 65 registered nurses employed in a psychiatric inpatient unit and psychiatric community service where individuals with a DSM-IV diagnosis of BPD received treatment. In particular, findings relating to Clinical Description, Emotional Reactions, Concerns and Management of patients with BPD are reported. Results show that a proportion of psychiatric nurses experience negative emotional reactions and attitudes toward people with BPD with the majority of nurses perceiving people with BPD as manipulative, almost one third reporting that patients with BPD made them angry and over one third either 'strongly disagreed' or 'disagreed' that they know how to care for people with BPD. Although psychiatric nurses face many challenges in providing care for patients with BPD, it is also of concern to the profession that one of the problems confronting people with BPD is the negative attitudes of those staff that care for them. Further research is necessary to identify appropriate service frameworks and clinical interventions that assist in more effective clinical management of clients of BPD.
- Description: C1
- Description: 2003002006
- Authors: Deans, Cecil , Meocevic, E.
- Date: 2006
- Type: Text , Journal article
- Relation: Contemporary Nurse Vol. 21, no. 1 (2006), p. 43-49
- Full Text:
- Reviewed:
- Description: Caring for patients with a diagnosis of Borderline Personality Disorder (BPD) has been identified as a problem area for mental health professionals with some studies suggesting that a diagnosis of BPD will influence the level and quality of interaction staff have with patients. It is inherent to psychiatric nursing that practitioners are able to establish rapport, develop trust and demonstrate empathy with consumers of mental health services. Despite the importance of this issue for psychiatric nurses and for consumers, the perceptions and attitudes of psychiatric nurses towards patients diagnosed with BPD have received almost no research attention. This paper describes findings from a study of attitudes held by 65 registered nurses employed in a psychiatric inpatient unit and psychiatric community service where individuals with a DSM-IV diagnosis of BPD received treatment. In particular, findings relating to Clinical Description, Emotional Reactions, Concerns and Management of patients with BPD are reported. Results show that a proportion of psychiatric nurses experience negative emotional reactions and attitudes toward people with BPD with the majority of nurses perceiving people with BPD as manipulative, almost one third reporting that patients with BPD made them angry and over one third either 'strongly disagreed' or 'disagreed' that they know how to care for people with BPD. Although psychiatric nurses face many challenges in providing care for patients with BPD, it is also of concern to the profession that one of the problems confronting people with BPD is the negative attitudes of those staff that care for them. Further research is necessary to identify appropriate service frameworks and clinical interventions that assist in more effective clinical management of clients of BPD.
- Description: C1
- Description: 2003002006
Hearing what older consumers say about participation in their care
- Penney, Wendy, Wellard, Sally
- Authors: Penney, Wendy , Wellard, Sally
- Date: 2007
- Type: Text , Journal article
- Relation: International Journal of Nursing Practice Vol. 13, no. (2007), p. 61-68
- Full Text:
- Reviewed:
- Description: A study exploring older people's participation in their care in acute hospital settings reveals both consumers' and nurses' views of participation. Using a critical ethnographic design, data were collected through participant observation and interviews from consumers in acute care settings who were over 70 years old and nurses who were caring from them. Thematic analysis identified that older people equated participation with being independent. Importantly, consumers highlighted the complexity of the notion of participation when describing situations where they were unable to participate in their own care. The difficulties in communicating with health professionals and an inability to administer their own medications in inpatient settings were identified as barriers to participation. Understanding what consumers believe participation means provides a starting point for developing meaningful partnerships between health professionals and people receiving care.
- Description: C1
- Description: 2003002538
- Authors: Penney, Wendy , Wellard, Sally
- Date: 2007
- Type: Text , Journal article
- Relation: International Journal of Nursing Practice Vol. 13, no. (2007), p. 61-68
- Full Text:
- Reviewed:
- Description: A study exploring older people's participation in their care in acute hospital settings reveals both consumers' and nurses' views of participation. Using a critical ethnographic design, data were collected through participant observation and interviews from consumers in acute care settings who were over 70 years old and nurses who were caring from them. Thematic analysis identified that older people equated participation with being independent. Importantly, consumers highlighted the complexity of the notion of participation when describing situations where they were unable to participate in their own care. The difficulties in communicating with health professionals and an inability to administer their own medications in inpatient settings were identified as barriers to participation. Understanding what consumers believe participation means provides a starting point for developing meaningful partnerships between health professionals and people receiving care.
- Description: C1
- Description: 2003002538
Managing patient deterioration: A protocol for enhancing student nurses' competence through web-based simulation and feedback techniques
- Cooper, Simon J., Beauchamp, Alison, Bogossian, Fiona, Bucknall, Tracey, Cant, Robyn, Devries, Brett, Endacott, Ruth, Forbes, Helen, Hill, Robyn, Kinsman, Leigh, Kain, Victoria, McKenna, Lisa, Porter, Joanne, Phillips, Nicole, Young, Susan
- Authors: Cooper, Simon J. , Beauchamp, Alison , Bogossian, Fiona , Bucknall, Tracey , Cant, Robyn , Devries, Brett , Endacott, Ruth , Forbes, Helen , Hill, Robyn , Kinsman, Leigh , Kain, Victoria , McKenna, Lisa , Porter, Joanne , Phillips, Nicole , Young, Susan
- Date: 2012
- Type: Text , Journal article
- Relation: BMC Nursing Vol. 11, no. 18 (2012), p.1-7
- Full Text:
- Reviewed:
- Description: Aims To describe a funded proposal for the development of an on-line evidence based educational program for the management of deteriorating patients. Background There are international concerns regarding the management of deteriorating patients with issues around the ‘failure to rescue’. The primary response to these issues has been the development of medical emergency teams with little focus on the education of primary first responders. Design/Methods A mixed methods triangulated convergent design. In this four phase proposal we plan to 1. examine nursing student team ability to manage deteriorating patients and based upon these findings 2. develop web based educational material, including interactive scenarios. This educational material will be tested and refined in the third Phase 3, prior to evaluation and dissemination in the final phase. Conclusion This project aims to enhance knowledge development for the management of deteriorating patients through rigorous assessment of team performance and to produce a contemporary evidence-based online training program.
- Authors: Cooper, Simon J. , Beauchamp, Alison , Bogossian, Fiona , Bucknall, Tracey , Cant, Robyn , Devries, Brett , Endacott, Ruth , Forbes, Helen , Hill, Robyn , Kinsman, Leigh , Kain, Victoria , McKenna, Lisa , Porter, Joanne , Phillips, Nicole , Young, Susan
- Date: 2012
- Type: Text , Journal article
- Relation: BMC Nursing Vol. 11, no. 18 (2012), p.1-7
- Full Text:
- Reviewed:
- Description: Aims To describe a funded proposal for the development of an on-line evidence based educational program for the management of deteriorating patients. Background There are international concerns regarding the management of deteriorating patients with issues around the ‘failure to rescue’. The primary response to these issues has been the development of medical emergency teams with little focus on the education of primary first responders. Design/Methods A mixed methods triangulated convergent design. In this four phase proposal we plan to 1. examine nursing student team ability to manage deteriorating patients and based upon these findings 2. develop web based educational material, including interactive scenarios. This educational material will be tested and refined in the third Phase 3, prior to evaluation and dissemination in the final phase. Conclusion This project aims to enhance knowledge development for the management of deteriorating patients through rigorous assessment of team performance and to produce a contemporary evidence-based online training program.
Managing deteriorating patients: Registered nurses' performance in a simulated setting
- Cooper, Simon J., McConnell-Henry, Tracy, Cant, Robyn, Porter, Joanne, Missen, Karen, Kinsman, Leigh, Endacott, Ruth, Scholes, Julie
- Authors: Cooper, Simon J. , McConnell-Henry, Tracy , Cant, Robyn , Porter, Joanne , Missen, Karen , Kinsman, Leigh , Endacott, Ruth , Scholes, Julie
- Date: 2011
- Type: Text , Journal article
- Relation: The Open Nursing Journal Vol. 5, no. (2011), p. 120-126
- Full Text:
- Reviewed:
- Description: Aim: To examine, in a simulated environment, rural nurses’ ability to assess and manage patient deterioration using measures of knowledge, situation awareness and skill performance. Background: Nurses’ ability to manage deterioration and ‘failure to rescue’ are of significant concern with questions over knowledge and clinical skills. Simulated emergencies may help to identify and develop core skills. Methods: An exploratory quantitative performance review. Thirty five nurses from a single ward completed a knowledge questionnaire and two video recorded simulated scenarios in a rural hospital setting. Patient actors simulated deteriorating patients with an Acute Myocardial Infarction (AMI) and Chronic Obstructive Pulmonary Disease (COPD) as the primary diagnosis. How aware individuals were of the situation (levels of situation awareness) were measured at the end of each scenario. Results: Knowledge of deterioration management varied considerably (range: 27%-91%) with a mean score of 67%. Average situation awareness scores and skill scores across the two scenarios (AMI and COPD) were low (50%) with many important observations and actions missed. Participants did identify that ‘patients’ were deteriorating but as each patient deteriorated staff performance declined with a reduction in all observational records and actions. In many cases, performance decrements appeared to be related to high anxiety levels. Participants tended to focus on single signs and symptoms and failed to use a systematic approach to patient assessment. Conclusion: Knowledge and skills were generally low in this rural hospital sample with notable performance decrements as patients acutely declined. Educational models that incorporate high fidelity simulation and feedback techniques are likely to have a significant positive impact on performance.
- Authors: Cooper, Simon J. , McConnell-Henry, Tracy , Cant, Robyn , Porter, Joanne , Missen, Karen , Kinsman, Leigh , Endacott, Ruth , Scholes, Julie
- Date: 2011
- Type: Text , Journal article
- Relation: The Open Nursing Journal Vol. 5, no. (2011), p. 120-126
- Full Text:
- Reviewed:
- Description: Aim: To examine, in a simulated environment, rural nurses’ ability to assess and manage patient deterioration using measures of knowledge, situation awareness and skill performance. Background: Nurses’ ability to manage deterioration and ‘failure to rescue’ are of significant concern with questions over knowledge and clinical skills. Simulated emergencies may help to identify and develop core skills. Methods: An exploratory quantitative performance review. Thirty five nurses from a single ward completed a knowledge questionnaire and two video recorded simulated scenarios in a rural hospital setting. Patient actors simulated deteriorating patients with an Acute Myocardial Infarction (AMI) and Chronic Obstructive Pulmonary Disease (COPD) as the primary diagnosis. How aware individuals were of the situation (levels of situation awareness) were measured at the end of each scenario. Results: Knowledge of deterioration management varied considerably (range: 27%-91%) with a mean score of 67%. Average situation awareness scores and skill scores across the two scenarios (AMI and COPD) were low (50%) with many important observations and actions missed. Participants did identify that ‘patients’ were deteriorating but as each patient deteriorated staff performance declined with a reduction in all observational records and actions. In many cases, performance decrements appeared to be related to high anxiety levels. Participants tended to focus on single signs and symptoms and failed to use a systematic approach to patient assessment. Conclusion: Knowledge and skills were generally low in this rural hospital sample with notable performance decrements as patients acutely declined. Educational models that incorporate high fidelity simulation and feedback techniques are likely to have a significant positive impact on performance.
Australian clinician's views on interprofessional education for students in the rural clinical setting
- Jacob, Elisabeth, Barnett, Tony, Missen, Karen, Cross, Dorothy, Walker, Lorraine
- Authors: Jacob, Elisabeth , Barnett, Tony , Missen, Karen , Cross, Dorothy , Walker, Lorraine
- Date: 2012
- Type: Text , Journal article
- Relation: Journal of Research in Interprofessional Practice and Education Vol. 2, no. 2 (2012 2012), p. 219-229
- Full Text:
- Reviewed:
- Description: Background: Collaboration between education providers and clinical agencies to develop models that facilitate cross-disciplinary clinical education for students is essential to produce work-ready graduates. Methods and Findings: This exploratory study investigated the perceptions of and opportunities for interprofessional education (IPE) from the perspectives of 57 clinical staff from three regional/rural health services across Victoria, Australia. Data were collected through a semi-structured questionnaire, interviews, and focus group discussions with staff from 15 disciplinary groups who were responsible for clinical education. Although different views emerged on what IPE entailed, it was perceived by most clinicians to be valuable for students in enhancing teamwork, improving the understanding of roles and functions of team members, and facilitating common goals for patient care. While benefits of IPE could be articulated by clinicians, student engagement with IPE in clinical areas appeared to be limited, largely ad hoc, and opportunistic. Barriers to IPE included: timing of students’ placements, planning and coordination of activities, resource availability, and current regulatory and education provider requirements. Conclusions: Without the necessary resources and careful planning and coordination, the integration of IPE as a part of students’ clinical placement experience will remain a largely untapped resource.
- Authors: Jacob, Elisabeth , Barnett, Tony , Missen, Karen , Cross, Dorothy , Walker, Lorraine
- Date: 2012
- Type: Text , Journal article
- Relation: Journal of Research in Interprofessional Practice and Education Vol. 2, no. 2 (2012 2012), p. 219-229
- Full Text:
- Reviewed:
- Description: Background: Collaboration between education providers and clinical agencies to develop models that facilitate cross-disciplinary clinical education for students is essential to produce work-ready graduates. Methods and Findings: This exploratory study investigated the perceptions of and opportunities for interprofessional education (IPE) from the perspectives of 57 clinical staff from three regional/rural health services across Victoria, Australia. Data were collected through a semi-structured questionnaire, interviews, and focus group discussions with staff from 15 disciplinary groups who were responsible for clinical education. Although different views emerged on what IPE entailed, it was perceived by most clinicians to be valuable for students in enhancing teamwork, improving the understanding of roles and functions of team members, and facilitating common goals for patient care. While benefits of IPE could be articulated by clinicians, student engagement with IPE in clinical areas appeared to be limited, largely ad hoc, and opportunistic. Barriers to IPE included: timing of students’ placements, planning and coordination of activities, resource availability, and current regulatory and education provider requirements. Conclusions: Without the necessary resources and careful planning and coordination, the integration of IPE as a part of students’ clinical placement experience will remain a largely untapped resource.
The value of peer learning in undergraduate nursing education: A systematic review
- Stone, Robyn, Cooper, Simon J., Cant, Robyn
- Authors: Stone, Robyn , Cooper, Simon J. , Cant, Robyn
- Date: 2013
- Type: Text , Journal article
- Relation: ISRN Nursing Vol. 2013 (Art. ID: 930901), no. (2013), p. 1-10
- Full Text:
- Reviewed:
- Description: The study examined various methods of peer learning and their effectiveness in undergraduate nursing education. Using a specifically developed search strategy, healthcare databases were systematically searched for peer-reviewed articles, with studies involving peer learning and students in undergraduate general nursing courses (in both clinical and theoretical settings) being included. The studies were published in English between 2001 and 2010. Both study selection and quality analysis were undertaken independently by two researchers using published guidelines and data was thematically analyzed to answer the research questions. Eighteen studies comprising various research methods were included. The variety of terms used for peer learning and variations between study designs and assessment measures affected the reliability of the study. The outcome measures showing improvement in either an objective effect or subjective assessment were considered a positive result with sixteen studies demonstrating positive aspects to peer learning including increased confidence, competence, and a decrease in anxiety. We conclude that peer learning is a rapidly developing aspect of nursing education which has been shown to develop students’ skills in communication, critical thinking, and self-confidence. Peer learning was shown to be as effective as the conventional classroom lecture method in teaching undergraduate nursing students.
- Authors: Stone, Robyn , Cooper, Simon J. , Cant, Robyn
- Date: 2013
- Type: Text , Journal article
- Relation: ISRN Nursing Vol. 2013 (Art. ID: 930901), no. (2013), p. 1-10
- Full Text:
- Reviewed:
- Description: The study examined various methods of peer learning and their effectiveness in undergraduate nursing education. Using a specifically developed search strategy, healthcare databases were systematically searched for peer-reviewed articles, with studies involving peer learning and students in undergraduate general nursing courses (in both clinical and theoretical settings) being included. The studies were published in English between 2001 and 2010. Both study selection and quality analysis were undertaken independently by two researchers using published guidelines and data was thematically analyzed to answer the research questions. Eighteen studies comprising various research methods were included. The variety of terms used for peer learning and variations between study designs and assessment measures affected the reliability of the study. The outcome measures showing improvement in either an objective effect or subjective assessment were considered a positive result with sixteen studies demonstrating positive aspects to peer learning including increased confidence, competence, and a decrease in anxiety. We conclude that peer learning is a rapidly developing aspect of nursing education which has been shown to develop students’ skills in communication, critical thinking, and self-confidence. Peer learning was shown to be as effective as the conventional classroom lecture method in teaching undergraduate nursing students.
Implied consent and nursing practice : Ethical or convenient?
- Authors: Cole, Clare
- Date: 2012
- Type: Text , Journal article
- Relation: Nursing Ethics Vol. 19, no. 4 (2012), p. 550-557
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- Reviewed:
- Description: Nursing professionals in a variety of practice settings routinely use implied consent. This form of consent is used in place of or in conjunction with informed or explicit consent. This article looks at one aspect of a qualitative exploratory study conducted in a Day of Surgery Admission unit. This article focuses on the examination of nurses' understandings of implied consent and its use in patient care in nursing practice. Data were collected through one-on-one interviews and analysed using a thematic analysis. Nurses participating in this study revealed that they routinely used implied consent in their nursing practice. This article will look at whether implied consent supports or impedes a patient's autonomy. © The Author(s) 2012.
- Authors: Cole, Clare
- Date: 2012
- Type: Text , Journal article
- Relation: Nursing Ethics Vol. 19, no. 4 (2012), p. 550-557
- Full Text:
- Reviewed:
- Description: Nursing professionals in a variety of practice settings routinely use implied consent. This form of consent is used in place of or in conjunction with informed or explicit consent. This article looks at one aspect of a qualitative exploratory study conducted in a Day of Surgery Admission unit. This article focuses on the examination of nurses' understandings of implied consent and its use in patient care in nursing practice. Data were collected through one-on-one interviews and analysed using a thematic analysis. Nurses participating in this study revealed that they routinely used implied consent in their nursing practice. This article will look at whether implied consent supports or impedes a patient's autonomy. © The Author(s) 2012.
Investigation of adaptation after liver transplantation using Roy's Adaptation Model
- Ordin, Yaprak, Karayurt, Özgül, Wellard, Sally
- Authors: Ordin, Yaprak , Karayurt, Özgül , Wellard, Sally
- Date: 2013
- Type: Text , Journal article
- Relation: Nursing and Health Sciences Vol. 15, no. 1 (2013), p. 31-38
- Full Text:
- Reviewed:
- Description: In this study we explored the adaptation of transplant recipients in Turkey using the Roy Adaptation Model. A descriptive qualitative design was used with data collected from liver transplant recipients in either individual or group interviews between May 2009 and February 2010. Using deductive content analysis, four themes were identified in the data: physiological mode, self-concept mode, role function mode, and interdependence mode. Each theme included both adaptive and ineffective behaviors of liver transplant recipients. The findings of this study indicate that liver transplant recipients need information and support about their ineffective behaviors in all modes of the Roy Adaptation Model. The findings also support the use of a nursing model in the delivery of nursing care for liver transplantation recipients. © 2012 Wiley Publishing Asia Pty Ltd.
- Description: 2003010860
- Authors: Ordin, Yaprak , Karayurt, Özgül , Wellard, Sally
- Date: 2013
- Type: Text , Journal article
- Relation: Nursing and Health Sciences Vol. 15, no. 1 (2013), p. 31-38
- Full Text:
- Reviewed:
- Description: In this study we explored the adaptation of transplant recipients in Turkey using the Roy Adaptation Model. A descriptive qualitative design was used with data collected from liver transplant recipients in either individual or group interviews between May 2009 and February 2010. Using deductive content analysis, four themes were identified in the data: physiological mode, self-concept mode, role function mode, and interdependence mode. Each theme included both adaptive and ineffective behaviors of liver transplant recipients. The findings of this study indicate that liver transplant recipients need information and support about their ineffective behaviors in all modes of the Roy Adaptation Model. The findings also support the use of a nursing model in the delivery of nursing care for liver transplantation recipients. © 2012 Wiley Publishing Asia Pty Ltd.
- Description: 2003010860
What factors influence midwives to provide obstetric high dependency care on the delivery suite or request care be escalated away from the obstetric unit? Findings of a focus group study
- James, Alison, Cooper, Simon J., Stenhouse, Elizabeth, Endacott, Ruth
- Authors: James, Alison , Cooper, Simon J. , Stenhouse, Elizabeth , Endacott, Ruth
- Date: 2019
- Type: Text , Journal article
- Relation: Bmc Pregnancy and Childbirth Vol. 19, no. 1 (2019), p. 1-15
- Full Text:
- Reviewed:
- Description: Background In the United Kingdom, midwives will engage in discussions with the multidisciplinary team as to whether they can provide Obstetric High Dependency Care (OHDC) on the Delivery Suite or whether a woman's care should be escalated to the critical care team. This study aimed to explore the question: What factors influence midwives to provide OHDC or request care be escalated away from the obstetric unit in hospitals remote from tertiary referral centres? Methods Focus groups were undertaken with midwives (n = 34) across three obstetric units in England, with annual birth rates ranging from 1500 to 5000 per annum, in District General Hospitals. Three scenarios in the form of video vignettes of handover were used as triggers for the focus groups. Scenario 1; severe pre-eclampsia, physiologically unstable 2; major postpartum haemorrhage requiring invasive monitoring 3; recent admission of woman with chest pain receiving facial oxygen and requiring continuous electrocardiogram (ECG) monitoring. Two focus groups were conducted in each of the obstetric units with experienced midwives. Data were analysed using a qualitative framework approach. Results Factors influencing midwives' care escalation decisions included the care environment, a woman's diagnosis and fetal or neonatal factors. The overall plan of care including the need for ECG and invasive monitoring were also influential factors. Midwives in the smallest obstetric unit did not have access to the facilities for OHDC provision. Midwives in the larger obstetric units provided OHDC but identified varying degrees of skill and sometimes used 'workarounds' to facilitate care provision. Midwifery staffing levels, skill mix and workload were also influential. Some differences of opinion were evident between midwives working in the same obstetric units as to whether OHDC could be provided and the support they would enlist to help them provide it. Reliance on clinical guidelines appeared variable. Conclusions Findings indicate that there may be inequitable OHDC provision at a local level. Organisationally robust systems are required to promote safe, equitable OHDC care including skills development for midwives and precise escalation guidelines to minimise workarounds. Training for midwives must include strategies that prevent skills fade.
- Authors: James, Alison , Cooper, Simon J. , Stenhouse, Elizabeth , Endacott, Ruth
- Date: 2019
- Type: Text , Journal article
- Relation: Bmc Pregnancy and Childbirth Vol. 19, no. 1 (2019), p. 1-15
- Full Text:
- Reviewed:
- Description: Background In the United Kingdom, midwives will engage in discussions with the multidisciplinary team as to whether they can provide Obstetric High Dependency Care (OHDC) on the Delivery Suite or whether a woman's care should be escalated to the critical care team. This study aimed to explore the question: What factors influence midwives to provide OHDC or request care be escalated away from the obstetric unit in hospitals remote from tertiary referral centres? Methods Focus groups were undertaken with midwives (n = 34) across three obstetric units in England, with annual birth rates ranging from 1500 to 5000 per annum, in District General Hospitals. Three scenarios in the form of video vignettes of handover were used as triggers for the focus groups. Scenario 1; severe pre-eclampsia, physiologically unstable 2; major postpartum haemorrhage requiring invasive monitoring 3; recent admission of woman with chest pain receiving facial oxygen and requiring continuous electrocardiogram (ECG) monitoring. Two focus groups were conducted in each of the obstetric units with experienced midwives. Data were analysed using a qualitative framework approach. Results Factors influencing midwives' care escalation decisions included the care environment, a woman's diagnosis and fetal or neonatal factors. The overall plan of care including the need for ECG and invasive monitoring were also influential factors. Midwives in the smallest obstetric unit did not have access to the facilities for OHDC provision. Midwives in the larger obstetric units provided OHDC but identified varying degrees of skill and sometimes used 'workarounds' to facilitate care provision. Midwifery staffing levels, skill mix and workload were also influential. Some differences of opinion were evident between midwives working in the same obstetric units as to whether OHDC could be provided and the support they would enlist to help them provide it. Reliance on clinical guidelines appeared variable. Conclusions Findings indicate that there may be inequitable OHDC provision at a local level. Organisationally robust systems are required to promote safe, equitable OHDC care including skills development for midwives and precise escalation guidelines to minimise workarounds. Training for midwives must include strategies that prevent skills fade.
Clinical decision-making: midwifery students' recognition of, and response to, postpartum haemorrhage in the simulation environment
- Scholes, Julie, Endacott, Ruth, Biro, Mary Anne, Bulle, Bree, Cooper, Simon J., Miles, Maureen, Gilmour, Carole, Buykx, Penny, Kinsman, Leigh, Boland, Rosemarie, Jones, Janet, Zaidi, Fawzia
- Authors: Scholes, Julie , Endacott, Ruth , Biro, Mary Anne , Bulle, Bree , Cooper, Simon J. , Miles, Maureen , Gilmour, Carole , Buykx, Penny , Kinsman, Leigh , Boland, Rosemarie , Jones, Janet , Zaidi, Fawzia
- Date: 2012
- Type: Text , Journal article
- Relation: BMC Pregnancy and Childbirth Vol. 12, no. 19 (2012), p. 1-12
- Full Text:
- Reviewed:
- Description: Background This paper reports the findings of a study of how midwifery students responded to a simulated post partum haemorrhage (PPH). Internationally, 25% of maternal deaths are attributed to severe haemorrhage. Although this figure is far higher in developing countries, the risk to maternal wellbeing and child health problem means that all midwives need to remain vigilant and respond appropriately to early signs of maternal deterioration. Methods Simulation using a patient actress enabled the research team to investigate the way in which 35 midwifery students made decisions in a dynamic high fidelity PPH scenario. The actress wore a birthing suit that simulated blood loss and a flaccid uterus on palpation. The scenario provided low levels of uncertainty and high levels of relevant information. The student's response to the scenario was videoed. Immediately after, they were invited to review the video, reflect on their performance and give a commentary as to what affected their decisions. The data were analysed using Dimensional Analysis. Results The students' clinical management of the situation varied considerably. Students struggled to prioritise their actions where more than one response was required to a clinical cue and did not necessarily use mnemonics as heuristic devices to guide their actions. Driven by a response to single cues they also showed a reluctance to formulate a diagnosis based on inductive and deductive reasoning cycles. This meant they did not necessarily introduce new hypothetical ideas against which they might refute or confirm a diagnosis and thereby eliminate fixation error. Conclusions The students response demonstrated that a number of clinical skills require updating on a regular basis including: fundal massage technique, the use of emergency standing order drugs, communication and delegation of tasks to others in an emergency and working independently until help arrives. Heuristic devices helped the students to evaluate their interventions to illuminate what else could be done whilst they awaited the emergency team. They did not necessarily serve to prompt the students' or help them plan care prospectively. The limitations of the study are critically explored along with the pedagogic implications for initial training and continuing professional development.
- Authors: Scholes, Julie , Endacott, Ruth , Biro, Mary Anne , Bulle, Bree , Cooper, Simon J. , Miles, Maureen , Gilmour, Carole , Buykx, Penny , Kinsman, Leigh , Boland, Rosemarie , Jones, Janet , Zaidi, Fawzia
- Date: 2012
- Type: Text , Journal article
- Relation: BMC Pregnancy and Childbirth Vol. 12, no. 19 (2012), p. 1-12
- Full Text:
- Reviewed:
- Description: Background This paper reports the findings of a study of how midwifery students responded to a simulated post partum haemorrhage (PPH). Internationally, 25% of maternal deaths are attributed to severe haemorrhage. Although this figure is far higher in developing countries, the risk to maternal wellbeing and child health problem means that all midwives need to remain vigilant and respond appropriately to early signs of maternal deterioration. Methods Simulation using a patient actress enabled the research team to investigate the way in which 35 midwifery students made decisions in a dynamic high fidelity PPH scenario. The actress wore a birthing suit that simulated blood loss and a flaccid uterus on palpation. The scenario provided low levels of uncertainty and high levels of relevant information. The student's response to the scenario was videoed. Immediately after, they were invited to review the video, reflect on their performance and give a commentary as to what affected their decisions. The data were analysed using Dimensional Analysis. Results The students' clinical management of the situation varied considerably. Students struggled to prioritise their actions where more than one response was required to a clinical cue and did not necessarily use mnemonics as heuristic devices to guide their actions. Driven by a response to single cues they also showed a reluctance to formulate a diagnosis based on inductive and deductive reasoning cycles. This meant they did not necessarily introduce new hypothetical ideas against which they might refute or confirm a diagnosis and thereby eliminate fixation error. Conclusions The students response demonstrated that a number of clinical skills require updating on a regular basis including: fundal massage technique, the use of emergency standing order drugs, communication and delegation of tasks to others in an emergency and working independently until help arrives. Heuristic devices helped the students to evaluate their interventions to illuminate what else could be done whilst they awaited the emergency team. They did not necessarily serve to prompt the students' or help them plan care prospectively. The limitations of the study are critically explored along with the pedagogic implications for initial training and continuing professional development.
Exploring staff diabetes medication knowledge and practices in regional residential care : Triangulation study
- Wellard, Sally, Rasmussen, Bodil, Savage, Sally, Dunning, Trisha
- Authors: Wellard, Sally , Rasmussen, Bodil , Savage, Sally , Dunning, Trisha
- Date: 2013
- Type: Text , Journal article
- Relation: Journal of Clinical Nursing Vol. 22, no. 13-14 (2013), p. 1933-1940
- Full Text:
- Reviewed:
- Description: Aims and objectives: This study is drawn from a larger project that aimed to identify the staffing and organisational factors influencing the quality of diabetes care for older people living in residential care in regional Victoria, Australia. The focus of the current study is on medication management for residents with diabetes. Background: With a continuous rise in diabetes in the population, there is an associated increase in the prevalence of diabetes in aged care residential settings. However, there is little specific guidance on how to manage diabetes in older people living in institutional settings who experience multiple concurrent chronic conditions. Design: A triangulation strategy consisting of three phases. Methods: A one-shot cross-sectional survey (n = 68) focus group interviews and a case file audit (n = 20). Data were collected between May 2009-January 2010. Findings: Staff knowledge of diabetes and its contemporary medication management was found to be suboptimal. Challenges to managing residents with diabetes included limited time, resident characteristics and communication systems. Additionally, the variability in medical support available to residents and a high level of polypharmacy added to the complexity of medication management of resident. Conclusions: The current study suggests administering medicine to residents in aged care settings is difficult and has potentially serious medical, professional and economic consequences. Limitations to staff knowledge of contemporary diabetes care and medications potentially place residents with diabetes at risk of receiving less than optimal diabetes care. Relevance to clinical practice: Providing evidence-based guidelines about diabetes care in residential care settings is essential to achieve acceptable outcomes and increase the quality of life for residents in public aged care. Continuing education programs in diabetes care specifically related to medication must be provided to all health professionals and encompass scope of practice. © 2013 John Wiley & Sons Ltd.
- Description: 2003011093
- Authors: Wellard, Sally , Rasmussen, Bodil , Savage, Sally , Dunning, Trisha
- Date: 2013
- Type: Text , Journal article
- Relation: Journal of Clinical Nursing Vol. 22, no. 13-14 (2013), p. 1933-1940
- Full Text:
- Reviewed:
- Description: Aims and objectives: This study is drawn from a larger project that aimed to identify the staffing and organisational factors influencing the quality of diabetes care for older people living in residential care in regional Victoria, Australia. The focus of the current study is on medication management for residents with diabetes. Background: With a continuous rise in diabetes in the population, there is an associated increase in the prevalence of diabetes in aged care residential settings. However, there is little specific guidance on how to manage diabetes in older people living in institutional settings who experience multiple concurrent chronic conditions. Design: A triangulation strategy consisting of three phases. Methods: A one-shot cross-sectional survey (n = 68) focus group interviews and a case file audit (n = 20). Data were collected between May 2009-January 2010. Findings: Staff knowledge of diabetes and its contemporary medication management was found to be suboptimal. Challenges to managing residents with diabetes included limited time, resident characteristics and communication systems. Additionally, the variability in medical support available to residents and a high level of polypharmacy added to the complexity of medication management of resident. Conclusions: The current study suggests administering medicine to residents in aged care settings is difficult and has potentially serious medical, professional and economic consequences. Limitations to staff knowledge of contemporary diabetes care and medications potentially place residents with diabetes at risk of receiving less than optimal diabetes care. Relevance to clinical practice: Providing evidence-based guidelines about diabetes care in residential care settings is essential to achieve acceptable outcomes and increase the quality of life for residents in public aged care. Continuing education programs in diabetes care specifically related to medication must be provided to all health professionals and encompass scope of practice. © 2013 John Wiley & Sons Ltd.
- Description: 2003011093