A labour of love : reward and satisfaction for nurses : findings from a grounded theory study in dementia care
- Authors: Gilbert, Julia , Ward, Louise , Walter, Ruby
- Date: 2021
- Type: Text , Journal article
- Relation: Dementia Vol. 20, no. 5 (2021), p. 1697-1710
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- Description: Aim: To understand nurses’ perceptions of quality nursing care in the dementia-specific care unit. As the world’s population ages, the incidence of dementia is projected to rise in tandem. The requirement for skilled, dementia-trained registered nurses who can provide quality nursing care will need to increase accordingly to meet the needs of these individuals. Extensive research has been completed on dementia nursing care in a variety of settings; however, little research has been undertaken into nurses’ perceptions of quality nursing care in the dementia-specific care unit. Understanding how registered nurses perceive quality nursing care in the dementia-specific care unit is important and provides valuable information about nursing practice in this environment for nurses and decision-makers. Gaining a better understanding of quality nursing care in this care unit may result in better nurse education and an improved patient experience. It may also assist nursing organisations, residential aged-care facilities, government bodies and nongovernment agencies that support, manage, and oversee dementia-specific care units. Method: A grounded theory study was conducted to understand nurses’ perceptions of quality nursing care in dementia-specific care units. The study involved interviewing nine registered nurses working in two dementia-specific care units on the Gold Coast, Queensland. Data were collected during semi-structured interviews and analysed using both constant comparison and thematic analysis. Findings: Three themes emerged from this study—Caring at the Coalface, Labour of love and the Business of Dementia Healthcare. The largest theme, Labour of love, represents the personal reward and feeling of satisfaction six nurses said they experienced when interacting with individuals living in the dementia-specific care unit. They identified and repeatedly discussed the joy and fulfilment they experienced when caring for them, and considered this to be an essential element of quality nursing care. It was evident from the data that the nurses cared very deeply about these individuals, and despite increased risks to personal safety at work, they did not want to work anywhere else. This article reports on the largest and key theme identified in the study Labour of Love. © The Author(s) 2020.
An evidence-based checklist for improving scoping review quality
- Authors: Cooper, Simon J. , Cant, Robyn , Kelly, Michelle , Levett-Jones, Tracy , McKenna, Lisa
- Date: 2021
- Type: Text , Journal article
- Relation: Clinical Nursing Research Vol. 30, no. 3 (2021), p. 230-240
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- Description: A scoping review aims to systematically explore and map the research available from a wide range of sources. The objective of this study was to produce a scoping review checklist to guide future scoping studies to enable rigorous review and critique of phenomena of interest. The methods used included a review of literature, expert consensus group meetings, a modified Delphi survey and, finally, verification against recent scoping study examples. Results showed that the checklist was able to identify key elements of scoping reviews. The 22-item Scoping Review Checklist (SRC), which includes two optional stakeholder consultation items, has been developed using rigorous recommended approaches. The checklist can be used to guide the conduct and critique of scoping studies. **Please note that there are multiple authors for this article therefore only the name of the first 5 including Federation University Australia affiliate “Simon Cooper and Robyn Cant” is provided in this record**
Association between psychological capital and spiritual care competencies of clinical nurses : a multicentre cross-sectional study
- Authors: Guo, Yu-Fang , Cross, Wendy , Lam, Louisa , Plummer, Virginia , Wang, Xin-Xin , Wang, Shuang-Shuang
- Date: 2021
- Type: Text , Journal article
- Relation: Journal of Nursing Management Vol. 29, no. 6 (2021), p. 1713-1722
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- Description: Aims: To investigate the status of spiritual care competencies among clinical nurses and their relationships with psychological capital. Background: Limited knowledge is about the influence of positive personal characteristics on nurses’ spiritual care competencies. Methods: A multicentre cross-sectional study. A total of 1717 nurses were recruited from nine separate Chinese hospitals. Online questionnaires were delivered through a local nursing association to assess socio-demographics, spiritual care competencies and psychological capital of nurses. Results: Nurses had mild-to-moderate levels of spiritual care competencies and moderate levels of psychological capital. Psychological capital and its two metrics (self-efficacy and hope), spiritual care education, professional qualification and shift work were the main predictors of spiritual care competencies (each p <.05). Conclusion: The findings of the study show a positive relationship between psychological capital and spiritual care competencies of clinical nurses. Strengthening nurses’ psychological capital could improve their spiritual care competencies. Implications for nursing managers: Nurse managers and hospital administrators should better understand the value of psychological capital for nurses’ capacity development. Effective interventions need to be implemented separately or combined with spiritual care education programmes to improve nurses’ psychological capital and spiritual care competencies. © 2021 John Wiley & Sons Ltd
Beyond crisis : enacted sense-making among ethnic minority carers of people with dementia in Australia
- Authors: Brijnath, Bianca , Gilbert, Andrew , Kent, Mike , Ellis, Katie , Browning, Colette
- Date: 2021
- Type: Text , Journal article
- Relation: Dementia Vol. 20, no. 6 (2021), p. 1910-1924
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- Description: The ‘family crisis’ narrative is frequently used in dementia studies to explain ethnic minority families’ pathways to health and aged care and why there is delayed dementia diagnoses in ethnic minority communities. Such narratives may obscure the family carers’ agency in negotiating services and managing personal, social and structural burdens in the lead up to diagnosis. To illuminate agency, this article describes ethnic minority families’ pathways to a dementia diagnosis using the concept of sense-making. Three case studies were drawn from 56 video interviews with family carers of older adults with dementia from Chinese, Arab and Indian backgrounds. Interviews were conducted across Australia from February to August 2018, then translated, transcribed and thematically analysed. Findings suggest families did not enter into formal care because of a crisis, instead navigating fragmented systems and conflicting advice to obtain a dementia diagnosis and access to relevant care. This experience was driven by sense-making (a search for plausible explanations) that involved family carers interpreting discrepant cues in changes to the behaviour of the person with dementia over time, managing conflicting (medical) advice about these discrepancies and reinterpreting their relationships with hindsight. The sense-making concept offers a more constructive hermeneutic than the ‘family crisis’ narrative as it illuminates the agency of carers’ in understanding changed behaviours, negotiating services and managing personal, social and structural barriers pre-diagnosis. The concept also demonstrates the need for a multimodal approach to promoting timely diagnosis of dementia in ethnic minority communities through dementia awareness and literacy campaigns as well as initiatives that address structural inequities. © The Author(s) 2020. **Please note that there are multiple authors for this article therefore only the name of the first 5 including Federation University Australia affiliate “Colette Browning” is provided in this record**
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.
Exploration and model development for emergency department waiting room nurse role : synthesis of a three-phase sequential mixed methods study
- Authors: Innes, Kelli , Jackson, Debra , Plummer, Virginia , Elliott, Doug
- Date: 2021
- Type: Text , Journal article
- Relation: International Emergency Nursing Vol. 59, no. (2021), p.
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- Description: Background: To improve flow and care in waiting rooms, some emergency departments introduced a specific nursing role to care for this patient cohort with the aim of commencing interventions early, improving patient safety by reassessing and enhancing communication. The objective of the research was to explore to what extent does qualitative interviews and quantitative survey contribute to describing emergency department waiting room nurses, through integration and synthesis of findings from a multiphase mixed methods study. Methods: Multiphase mixed methods exploratory sequential design with integration of findings. Data integration occurred during the phases and when assimilating all findings. Findings: Experienced emergency nurses, preferably with graduate qualifications, who are autonomous practitioners with highly developed communication skills, clinical decision making and proficiency in assessment and monitoring are required to perform the role. The waiting room nurse provides patient-centered care and ensures safe, timely care is delivered to those in the waiting room. A standardised approach and high risk of exposure to occupational stressors need to be considered. Conclusions: This mixed methods sequential design explored the waiting room nurse role from the perspective of emergency nurses generating new knowledge into the role. This advanced practice nursing role contributes to patient safety and delivery of patient centred care in the emergency department waiting room. © 2021 Elsevier Ltd
Learning needs of Iranian patients with coronary heart disease : a cross-sectional, comparative study
- Authors: Hassankhani, Hadi , Haririan, Hamidreza , Jafari, Arezoo , Porter, Joanne , O’Brien, Frances , Feizollahzadeh, Hossein
- Date: 2021
- Type: Text , Journal article
- Relation: Clinical Nursing Research Vol. 30, no. 2 (2021), p. 193-199
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- Description: Background: Patient education requires modification as it is either nonexistent or implemented irregularly or inadequately. Study’s purpose: To examine the learning needs of patients with coronary heart disease from the perspective of the patients, their relatives, and health care providers. Methodology: The cross-sectional, comparative study conducted at two cardiac hospitals of Tabriz and Ardebil, Iran from May 2016 to September 2016.Through convenience sampling perceptions of 137 patients, 137 relatives, 33 cardiologists, and 108 nurses were compared using the Cardiac Learning Need Inventory questionnaire. Major results: The most important learning needs of patients from the perspective of physicians, nurses, and patients’ relatives was information about risk factors. In contrast, patient’s perceived information about medication to be their most important learning need. Clinical implications: Patients’ perceptions of their educational needs was different from the perceptions of physicians, nurses, and relatives of the patients. Therefore, when planning patient education a comprehensive review of the patients’ learning needs is required in order to develop a suitable education plan by prioritizing patients’ educational needs. © The Author(s) 2020.
Measuring the safety climate in an Australian emergency department
- Authors: Connell, Clifford , Cooper, Simon J. , Endacott, Ruth
- Date: 2021
- Type: Text , Journal article
- Relation: International Emergency Nursing Vol. 58, no. (2021), p.
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- Description: Background: There are numerous intricate human, system and cultural factors that can impact upon the safe and effective implementation of patient safety systems (e.g. rapid response systems). Safety climate is one of these factors and is a measure of frontline healthcare workers’ shared perceptions, behaviours, beliefs and attitudes towards the organisation's culture of safety. Safety climate scores are also associated with the frequency of errors and adverse events in the healthcare setting. However, there is little evidence regarding the relationships between attitudes to patient safety and staff characteristics such as emergency care expertise and experience. The aims of this study were to measure perceptions of the safety climate in an Australian metropolitan Emergency Department and examine relationships between safety climate perceptions and staff characteristics. Methods: The Victorian Managed Insurance Authority Safety Climate Survey was administered to all doctors (n = 44) and nurses (n = 119) at an Australian emergency department. Results: Completed surveys were received from 127 (78%) respondents, 25 (52%) doctors and 100 (84%) nurses. Reliability analysis showed very good internal consistency of all 43-items of the survey (α = 0.94). With the exception of stress recognition, nurses rated the organisation's commitment to patient safety higher than doctors in all remaining attitudinal domains (p < 0.05). Both groups acknowledge that fatigue, increased workload and stress recognition negatively impacts upon patient safety. There was a significant trend for declining safety climate ratings related to participants’ clinical competence level and experience across all domains except stress recognition (p < 0.05). Conclusions: The Safety Climate Survey appears to be a reliable measure of patient safety climate for use in Emergency Departments. Emergency doctors and nurses did not perceive there to be a strong organisational commitment to patient safety in an Australian Emergency Department. Emergency Departments can provide a safer environment through genuine commitment to safety culture improvement which capitalises on the insights, intrinsic strengths and behaviours characteristic of the ED team's expertise and experience. This kind of commitment can positively influence the effectiveness of actions taken to minimise risk to patient safety and improve ED staff job satisfaction and effectiveness. © 2021 Elsevier Ltd
Nurse educator knowledge, attitude and skills towards using high-fidelity simulation : a study in the vocational education sector
- Authors: Akhter, Zainab , Malik, Gulzar , Plummer, Virginia
- Date: 2021
- Type: Text , Journal article
- Relation: Nurse Education in Practice Vol. 53, no. (2021), p.
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- Description: High-fidelity simulation has become an essential educational approach in nurse education globally. Several studies have explored the experience of undergraduate nursing students and educators with high-fidelity simulation; however, none have explored the experience of students in the vocational educational sector. The aim of the study was to explore nurse educators’ knowledge, attitude and skills toward using high-fidelity simulation in the setting of vocational education. An anonymous on-line survey design was conducted at three campuses of a major Australian Technical and Further Education vocational education setting. Forty-eight nurse educators teaching into Diploma of Nursing program for at least six months were invited to participate, 29 participated in the study, a response rate of 60%. Participants expressed lack of knowledge in managing technological issues, simulation facilitation procedures and conducting scenarios. Most participants had positive attitude towards high-fidelity simulation and rated their skills as ‘novice’. An urgent need for nurse educator training was identified to enhance knowledge and skills in technical and scenario management of high-fidelity simulation. A program of supportive mentoring by nurse educator mentors experienced in high-fidelity simulation, engaging with existing simulation associations, will enhance and sustain nurse educator knowledge, attitude and skills in a protected environment further, so that they can optimise training they provide to students for safe quality care of patients in the future. © 2021 Elsevier Ltd
Rapid visual search games and accuracy of students' clinical observation skills : a comparative study
- Authors: Al-Moteri, Modi , Alrehaili, Amani , Plummer, Virginia , Yaseen, Ruba , Alhakami, Reem
- Date: 2021
- Type: Text , Journal article
- Relation: Clinical Simulation in Nursing Vol. 55, no. (2021), p. 19-26
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- Description: Background: Rapid visual search (RVS) games require a player to search for a target against a distracting background. Playing RVS is known to improve observation and related skills for those professions that require ultimate observation skills. Aim: To examine whether using RVS games improves clinical observation of nursing students. Method: Post intervention assessment design was used in which participants were assigned to either RVS group or non-RVS group and their performance was compared to assess the impact of RVS games on students’ observational skills. Finding: Study findings revealed that RVS improved identification of cues that are highly visual in nature and related to liver cirrhosis. This may indicate that the RVS groups were more focused on the clinical markers than were the non-RVS group. © 2021. **Please note that there are multiple authors for this article therefore only the name of the first 5 including Federation University Australia affiliate “Virginia Plummer” is provided in this record**
Resident-to-resident elder mistreatment in residential aged care services : a systematic review of event frequency, type, resident characteristics, and history
- Authors: Woolford, Marta , Stacpoole, Susan , Clinnick, Lisa
- Date: 2021
- Type: Text , Journal article , Review
- Relation: Journal of the American Medical Directors Association Vol. 22, no. 8 (2021), p. 1678-1691.e6
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- Description: Objectives: Resident-to-resident elder mistreatment (R-REM) between residents living in residential aged care (RAC) services is a challenging issue in relation to the care of older people. Evidence suggests that R-REM, such as verbal, physical, and sexual conflict between residents, is a common and pervasive issue. This review examines the frequency with which R-REM occurs in RAC services; identifies the types of R-REM that occur; and provides an overview of the reported characteristics of both the victim and perpetrator involved in the R-REM event. Design: A systematic review was conducted. We searched MEDLINE, EMBASE, CINAHL, PsycINFO, Ageline, and Cochrane Library to identify qualitative and quantitative studies published in the English language. Setting and Participants: Residents living in RAC services. Measures: Data on frequency and characteristics were collated, and aggregate proportions were calculated where possible. Results: Twenty-six studies were identified; most (n = 20) were published in the United States. The overall proportion of residents engaged in R-REM was provided by 7 quantitative studies with the estimated frequency reported to be 12% to 23%. For qualitative studies, the number of care staff reporting to have observed R-REM ranged from 18.7% to 98.0%. Physical and verbal abuse were the most commonly reported types of mistreatment. Characteristics of the perpetrator of R-REM were reported in 12 (46.2%) studies. Overall, the mean age of perpetrators was 80.93 years, most were men (83.2%), and 64.4% had dementia and/or Alzheimer diagnosis. Characteristics of the victim and the history of R-REM were largely omitted from the published studies. Conclusion and Implications: The findings from the review broaden understanding on the extent of R-REM; the individual and event characteristics and ultimately support care planning, policy, and direction for future research. To improve understanding, quality of care, and RAC residents’ well-being, further studies are recommended to address the identified gaps in knowledge. © 2021 AMDA – The Society for Post-Acute and Long-Term Care Medicine
Severity of illness and distress in caregivers of patients with schizophrenia : do internalized stigma and caregiving burden mediate the relationship?
- Authors: Guan, Ziyao , Wang, Yuwei , Lam, Louisa , Cross, Wendy , Wiley, James
- Date: 2021
- Type: Text , Journal article
- Relation: Journal of Advanced Nursing Vol. 77, no. 3 (2021), p. 1258-1270
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- Description: Aims: To test a multiple mediation model of internalized stigma and caregiving burden in the relationship between severity of illness and distress among family caregivers of persons living with schizophrenia. Design: This is a cross-sectional study. Methods: Data were collected from a consecutive sample of 344 Chinese family caregivers of persons living with schizophrenia between April-August 2018. Instruments used in this research included the Clinical Global Impression-Severity of Illness, the Internalized Stigma of Mental Illness Scale, the Caregiver Burden Inventory, and the Distress Thermometer. Data analysis was conducted using descriptive statistics, the Spearman correlation, and regression analysis to estimate direct and indirect effects using bootstrap analysis. Results: This research found that internalized stigma and caregiving burden can separately and sequentially mediate the relationship between severity of illness and distress. Moreover the mediation of internalized stigma plays the largest role among the multiple mediations. Conclusion: The severity of illness, internalized stigma, and caregiving burden are significant factors of distress among family caregivers of persons living with schizophrenia. The future intervention studies which be designed aiming at the three factors may be beneficial for family caregivers of persons living with schizophrenia. Impact: This research examined the psychosocial development of distress and indicated that interventions improving patients’ symptoms and decreasing internalized stigma and caregiving burden can help to prevent or reduce distress among family caregivers. © 2020 John Wiley & Sons Ltd. *Please note that there are multiple authors for this article therefore only the name of the first 5 including Federation University Australia affiliates “Louisa Lam, Wendy Cross” is provided in this record**
The impact of web-based and face-to-face simulation education programs on nurses' response to patient deterioration : a multi-site interrupted time series study
- Authors: Kinsman, Leigh , Cooper, Simon J. , Cant, Robyn , Kim, Jeong-Ah , Chung, Catherine
- Date: 2021
- Type: Text , Journal article
- Relation: Nurse Education Today Vol. 102, no. (2021), p.
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- Description: Background: Nurses' response to patient deterioration in acute hospital wards is a priority issue. Simulation education programs improve nurses' knowledge and confidence, but the translation into better care is largely unknown for both web based (WB) and face to face (F2F) simulation programs. Aim: To measure the impact of simulation education on nurses' response to patient deterioration in acute medical ward settings, and to compare the impact of WB and F2F versions. Design: An interrupted time series, non-randomised trial across four medical wards in Victoria, Australia. Wards were allocated to either web-based or face-to-face versions of the same simulation program, FIRST2ACT. Interrupted time series measurement for six fortnights both before and after the intervention were used to measure and compare responses to deterioration. Responses to patient deterioration were extracted from medical records and grouped into outcomes for escalation (e.g. initiation of clinical review), assessment and observation (e.g. increased recording of vital signs, conscious state and pain scores) and clinical interventions (e.g. oxygen administration). Results: 126 nurses (89%) participated across the four wards. 946 patient records (506 in the F2F; 440 in the WB group) were included in analyses. There were significant and sustained improvements between pre and post samples in outcomes for escalation (13.0% to 28.8%; p = 0.000) and assessment and observation (conscious state recorded increased from 91.1% to 100%; p = 0.000, and pain score recorded increased from 97.8% to 99.8%; p = 0.000). There were no differences between the web-based and face-to-face groups except in appropriate oxygen application which increased by 7.7% in the F2F group and decreased by 11.8% in the WB group (p = 0.046). Conclusions: There was a significant improvement in nurses' response to patient deterioration following both versions of simulation, indicating that both have a role to play in supporting nurses' response to patient deterioration. © 2021. *Please note that there are multiple authors for this article therefore only the name of the first 5 including Federation University Australia affiliate “Simon Cooper, Robyn Cant, Jeong-Ah Kim, Catherine Chung” is provided in this record**
- Description: Background: Nurses' response to patient deterioration in acute hospital wards is a priority issue. Simulation education programs improve nurses' knowledge and confidence, but the translation into better care is largely unknown for both web based (WB) and face to face (F2F) simulation programs. Aim: To measure the impact of simulation education on nurses' response to patient deterioration in acute medical ward settings, and to compare the impact of WB and F2F versions. Design: An interrupted time series, non-randomised trial across four medical wards in Victoria, Australia. Wards were allocated to either web-based or face-to-face versions of the same simulation program, FIRST2ACT. Interrupted time series measurement for six fortnights both before and after the intervention were used to measure and compare responses to deterioration. Responses to patient deterioration were extracted from medical records and grouped into outcomes for escalation (e.g. initiation of clinical review), assessment and observation (e.g. increased recording of vital signs, conscious state and pain scores) and clinical interventions (e.g. oxygen administration). Results: 126 nurses (89%) participated across the four wards. 946 patient records (506 in the F2F; 440 in the WB group) were included in analyses. There were significant and sustained improvements between pre and post samples in outcomes for escalation (13.0% to 28.8%; p = 0.000) and assessment and observation (conscious state recorded increased from 91.1% to 100%; p = 0.000, and pain score recorded increased from 97.8% to 99.8%; p = 0.000). There were no differences between the web-based and face-to-face groups except in appropriate oxygen application which increased by 7.7% in the F2F group and decreased by 11.8% in the WB group (p = 0.046). Conclusions: There was a significant improvement in nurses' response to patient deterioration following both versions of simulation, indicating that both have a role to play in supporting nurses' response to patient deterioration. © 2021. *Please note that there are multiple authors for this article therefore only the name of the first 5 including Federation University Australia affiliate “Simon Cooper” is provided in this record**
The way we do things around here. A qualitative study of the workplace aggression experiences of Victorian nurses, midwives and care personnel
- Authors: Hills, Sharon , Crawford, Kimberley , Lam, Louisa , Hills, Danny
- Date: 2021
- Type: Text , Journal article
- Relation: Collegian Vol. 28, no. 1 (2021), p. 18-26
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- Description: Background: Workplace aggression in the health and care sectors is a major work health and safety and public health concern, worldwide. In Australia, rates of exposure to workplace aggression are consistent with those experienced by nurses internationally, and have not decreased over the past 35 years. Objectives: To explore the experiences and perspectives of nurses, midwives and care personnel relating to experiences of verbal or written and physical aggression from external sources (patients, patients’ relatives or carers and others external to the workplace) and internal sources (co-workers). Design: A pragmatic, descriptive, qualitative study, integrating themes emerging from online survey comments and follow-up, in depth interviews. Settings: Health and aged care services in the Australian State of Victoria. Participants: Nurses, midwives and care personnel who were members of the Australian Nursing and Midwifery Federation – Victorian Branch in May and June 2017. Method: Thematic analysis was undertaken on the combined comments provided in up to seven free-form text fields of an online survey questionnaire and the content of follow-up interviews of selected survey participants. Results: From the online survey data, comments from 623 participants were able to be included in analyses. Of the 293 respondents initially indicating a willingness to be contacted by researchers, a sample of 29 participated in in-depth interviews. Eight thematic categories emerged from the data, relating to patient aggression, contextual categories (three sub-categories – care of older people, mental health care and emergency department settings), co-worker aggression (two sub-categories – aggression from managers/supervisors, aggression from colleagues/peers), reporting behaviours, trade union involvement, security personnel and police involvement, legal action and the impacts of workplace aggression. Conclusions: Over the past 35 years, little progress has been made in mitigating the likelihood and consequences of this serious work health and safety, and public health issue. There appears to be have been a sustained failure to implement co-ordinated, multi-sectorial, system-wide and targeted interventions to reduce what seem to be growing levels of harmful exposure to incivility and aggression in care settings in Victoria. There is an urgent need to strengthen and enforce existing legislation, introduce new laws and develop more effective systems and practices to adequately protect the health and safety of nurses, midwives and other care personnel in their daily work. Stronger evidence for system and service level interventions to prevent and minimise workplace aggression in care settings is also required. © 2020 Australian College of Nursing Ltd
Twice-daily moisturizer application for skin tear prevention among older adults in acute care
- Authors: Mornane, Carolyn , Peck, Blake , Terry, Daniel , Ryan, Michael
- Date: 2021
- Type: Text , Journal article
- Relation: Advances in skin & wound care Vol. 34, no. 2 (2021), p. 1-4
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- Description: OBJECTIVE: To examine the effectiveness of twice-daily moisturizer application for patients admitted to an acute care setting on reducing the incidence of skin tear (ST) injuries. DESIGN, SETTING, AND PARTICIPANTS: This prospective, nonrandomized, case-control study identified an experimental and control ward equivalent in demography and patient acuity in a large hospital in regional Victoria, Australia. Patients 70 years or older admitted to the wards were invited to participate. INTERVENTION: Twice-daily application of a commercially available skin and body lotion to the arms and legs of participants. MAIN OUTCOME MEASURES: The incidence of ST in the experimental and control settings in the pre-, intra-, and posttrial periods. MAIN RESULTS: Although a decrease in ST incidence was observed over the study period (n = 128), this decrease was not significant pre- (median = 2.16, n = 73), intra- (median = 2.16, n = 73), or postintervention (median = 2.16, n = 69; χ[2, 152] = 0.502, P = .778). Similarly, there was no significant difference between wards (median = 9.86 [n = 152] vs median = 13.14 [n = 177]; U = 42.50, z = -1.198, r = 0.358, P = .231). CONCLUSIONS: The moisturizer in this study did not have a direct influence on the frequency of STs in the study population, although the data would suggest an intermittent reduction in ST incidence. The authors postulate that this was correlated with behavior change effects from the study. Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.
A cross-sectional survey of nursing students' patient safety knowledge
- Authors: Levett-Jones, Tracy , Andersen, Patrea , Bogossian, Fiona , Cooper, Simon J. , Guinea, Stephen , Hopmans, Ruben , McKenna, Lisa , Pich, Jacqui , Reid-Searl, Kerry , Seaton, Philippa
- Date: 2020
- Type: Text , Journal article
- Relation: Nurse Education Today Vol. 88, no. (2020), p.
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- Description: Background: Knowledge provides a foundation for safe and effective nursing practice. However, most previous studies have focused on exploring nursing students' self-reported perceptions of, or confidence in, their level of patient safety knowledge, rather than examining their actual levels of knowledge. Objective: The overarching objective of this study was to examine final year nursing students' levels of knowledge about key patient safety concepts. Design: A cross-sectional design was used for this study. Data collection was undertaken during 2018 using a web-based patient safety quiz with 45 multiple choice questions informed by the Patient Safety Competency Framework for Nursing Students. A Modified Angoff approach was used to establish a pass mark or ‘cut score’ for the quiz. Setting and participants: Nursing students enrolled in the final year of a pre-registration nursing program in Australia or New Zealand were invited to participate in the study. Results: In total, 2011 final year nursing students from 23 educational institutions completed the quiz. Mean quiz scores were 29.35/45 or 65.23% (SD 5.63). Participants achieved highest scores in the domains of person-centred care and therapeutic communication, and lowest scores for infection prevention and control and medication safety. Based on the pass mark of 67.3% determined by the Modified Angoff procedure, 44.7% of students (n = 899) demonstrated passing performance on the quiz. For eight of the institutions, less than half of their students achieved a passing mark. Conclusions: Given the pivotal role that nurses play in maintaining patient safety, the results from this quiz raise important questions about the preparation of nursing students for safe and effective clinical practice. The institutional results also suggest the need for increased curricula attention to patient safety. © 2020 Elsevier Ltd
A review of code blue activations in a single regional Australian healthcare service : a retrospective descriptive study of RISKMAN data
- Authors: Porter, Joanne , Peck, Blake , McNabb, Tiffinee , Missen, Karen
- Date: 2020
- Type: Text , Journal article
- Relation: Journal of Clinical Nursing Vol. 29, no. 1-2 (2020), p. 221-227
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- Description: Background: In the case of life-threatening conditions such as respiratory or cardiac arrest, or the clinical deterioration of the patient, a Code Blue activation may be instigated. A Code Blue activation involves a team of advanced trained clinicians attending the emergency needs of the patient. Aims and objectives: The aim of the study was to explore the number of cases of Code Blue activations, looking at the timing, clinical ward, diagnosis and activation criteria while noting cases where escalation from a Medical Emergency Team (MET) call occurs in one Regional Healthcare Service in Victoria, Australia, over a six-year period. Methods: A quantitative retrospective descriptive study of Code Blue emergencies over a six-year period from June 2010 to June 2016 was conducted. Data collected from the RISKMAN program operating at a single site was imported into SPSS (V 22) for descriptive statistical analysis. A STROBE EQUATOR checklist was used for this study (see File S1). Findings: The majority of Code Blue activations were male (59%, n = 127) and aged between 70 and 89 years of age (43%, n = 93). A Code Blue activation was more likely to occur at 08:00 hr, 14:00 hr or 22:00 hr, corresponding to the nurses’ change in shift, with the majority of Code Blues (27.8%, n = 60) occurring in the emergency department. Cardiac arrest was the main activation criterion with 54.6% (n = 118) cases followed by respiratory arrest (14%, n = 32). Interestingly, 20% (n = 45) of the Code Blue activations were upgraded from a Medical Emergency Team (MET) call. Conclusion: This project has produced several interesting findings surrounding Code Blue activations at one regional healthcare service which are not present in existing literature and is worthwhile for further investigation. Relevance to clinical practice: Understanding Code Blue activation criteria, common timings (month, time of day) and patient demographics ensures clinicians can remain vigilant in watching for the signs of patient deterioration and improve staff preparedness Code Blue events. © 2019 John Wiley & Sons Ltd
A scoping review of intravenous opioid pain protocols and their dose-time intervals in the management of acute postoperative pain in the postanesthesia care unit
- Authors: Stephens, Sarah , Malik, Gulzar , Rahman, Muhammad Aziz
- Date: 2020
- Type: Text , Journal article
- Relation: Journal of Perianesthesia Nursing Vol. 35, no. 4 (2020), p. 374-381
- Full Text: false
- Reviewed:
- Description: Purpose: This review aims to explore intravenous opioid pain protocols and their dose-time intervals in managing acute postoperative pain in adults in the postanesthesia care unit (PACU). Design: A scoping review using a systematic search strategy. Methods: Sixteen articles were identified from MEDLINE, CINAHL, PubMed, Embase, and Cochrane specific to the aims. Findings: The literature demonstrated several variations on dose-time intervals used for opioid pain protocol administration globally. Furthermore, opioid analgesic pain protocols in the PACU appear to be effective in postoperative pain management. However, the literature did not identify optimal time intervals related to dose administration within these protocols. Conclusions: Literature gaps were identified regarding the significance of dose-time intervals when using opioid analgesic pain protocols in the PACU. © 2019 American Society of PeriAnesthesia Nurses
A wechat-based “three good things” positive psychotherapy for the improvement of job performance and self-efficacy in nurses with burnout symptoms : a randomized controlled trial
- Authors: Guo, Yu-Fang , Lam, Louisa , Plummer, Virginia , Cross, Wendy , Zhang, Jing-Ping
- Date: 2020
- Type: Text , Journal article
- Relation: Journal of Nursing Management Vol. 28, no. 3 (2020), p. 480-487
- Full Text: false
- Reviewed:
- Description: Aim: To evaluate the effects of a WeChat-based “Three Good Things” on job performance and self-efficacy of clinical nurses with burnout symptoms. Background: Few studies have valued the impact of nurses' personal strengths and positive work environment on job performance, particularly in developing countries. Methods: A randomized controlled trial. The intervention group (n = 33) participated in WeChat-based Three Good Things, while the control group (n = 40) did not. Data were collected prior to and immediately after the intervention. WeChat, a popular social software, provides several communicating and recording functions. Results: The main intervention effects and interactions between time and intervention on job performance and self-efficacy were significant (each p < .05). The main time effects on self-efficacy were also significant (p < .05). The post-intervention scores for job performance and self-efficacy between the two groups were statistically different (each p < .05). The scores for job performance and self-efficacy of the intervention group were statistically different before and after the intervention (each p < .05). Conclusion: Three Good Things could significantly improve job performance and self-efficacy of nurses with burnout. Implications for Nursing Management: Nurse managers are recommended to include Three Good Things into their management systems to improve nurses' physical and mental health and work outcomes over the long term. © 2019 John Wiley & Sons Ltd.
Body-worn versus bell-and-pad alarm device for the management of monosymptomatic nocturnal enuresis in children : a randomized controlled trial
- Authors: Peck, Blake , Peck, Bronwyn , Harvey, Jack , Green, Andrea , Svedas, Kerrie , Whitaker, Shirley , Nethercote, Mark , Shea, Rosemarie
- Date: 2020
- Type: Text , Journal article
- Relation: Journal of wound, ostomy, and continence nursing : official publication of The Wound, Ostomy and Continence Nurses Society Vol. 47, no. 5 (2020), p. 507-512
- Full Text: false
- Reviewed:
- Description: PURPOSE: The purpose of this study was to compare the effectiveness of bell-and-pad alarm therapy to body-worn alarm therapy for the management of monosymptomatic enuresis in children 6 to 16 years of age. DESIGN: A prospective, randomized, adaptive clinical control trial. SUBJECTS AND SETTING: The sample comprised 86 children who attended a continence clinic for treatment of monosymptomatic enuresis and met the criteria for enuresis alarm therapy as per International Children's Continence Society (ICCS) guidelines. Subjects were randomly allocated to an experimental group (body-worn alarm, n = 41) or a control group (bell-and-pad alarm, n = 45). The study setting was a single-site specialist continence service in regional Victoria, Australia. Treatment was administered in the child's home. METHODS: Alarm therapy was administered by the child and/or parent for an initial period of 8 weeks at which time the child underwent a review with the continence nurse specialist. If the child had achieved 14 consecutive dry nights, the therapy was deemed successful and ceased. Children who had not become dry continued therapy for a further 8 weeks up to a maximum of 16 weeks, with a final review was instituted. Each child kept a diary for the duration of alarm therapy to report on frequency of wet/dry nights, times of alarm, response to alarm, and response to sensation to void (without alarm). The 2 types of alarm devices were compared with respect to categorical variables using dichotomous cross-tabulations and χ tests of independence based on the most positive outcome versus the other outcomes. RESULTS: Dryness in accordance with the criteria outlined by the ICCS guidelines was achieved in 18 children (43.9%) in the body-worn alarm group versus 29 children (64.4%) in the routine (bell-and-pad) group (P = .056). The bell-and-pad alarm performed better on 7 out of the 9 indicators, including the primary outcome measure of the child attained dryness for 14 nights or more, nightly alarm use, alarm woke child, alarm woke parent (P = .022), false (positive) alarms (P = .039), child turned alarm off and went back to sleep (P = .003), and child was compliant with alarm use. The body-worn device produced higher proportions of the most positive outcomes for 2 of the 9 indicators: relapse (P = .076) and false (negative) nonalarms (P = .066). CONCLUSIONS: Study findings suggests that the bell-and-pad alarm is preferable to the body-worn alarm. Additional research is recommended using other body-worn alarm devices across a larger population in order to establish the more definitive findings needed for clinical decision-making.