Adult deterioration detection system (ADDS) : An evaluation of the impact on met and code blue activations in a regional healthcare service
- Authors: Missen, Karen , Porter, Joanne , Raymond, Anita , de Vent, Kerry , Larkins, Jo-Ann
- Date: 2018
- Type: Text , Journal article
- Relation: Collegian Vol. 25, no. 2 (2018), p. 157-161
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- Description: Aims: To evaluate the impact of Acute Deterioration Detection System (ADDS) charts introduced to a regional healthcare service. Background: To assist health professionals in identifying essential elements for recognizing patient clinical deterioration, a national initiative introduced track and trigger observation charts, to hospitals in Australia. This study investigated whether the introduction of ADDS charts had an impact on the number of Medical Emergency Team (MET) and Code Blue activations at one regional healthcare service, according to their incident recording database. Method: A retrospective study of all Code Blue and MET activations was undertaken at a regional hospital, pre and post the introduction of ADDS charts in a two year period, June 2012 to June 2014. Results: There was a significant increase in MET activations from 5.91 to 11.27 per 1000 admissions (p < 0.01) after the implementation of ADDS charts. There was also an unexplained non-significant increase from 0.50 to 0.88 per 1000 admissions in the activations of Code Blue during this period (p = 0.05). It was also found that ADDS charts did not overly influence the activation criteria for calling a MET/Code Blue, except for an increase in reports of high heart rate and a decrease in the use of the criteria ‘worried’. Conclusion: The introduction of ADDS charts has provided health professionals with a clear track and trigger set of criteria, improving the detection of early signs of deterioration in patients. This study demonstrated an increase in activations as a result of the introduction of ADDS charts in one regional healthcare service.
The meaning of ‘worried’ in MET call activations : A regional hospital examination of the clinical indicator
- Authors: Raymond, Anita , Porter, Joanne , Missen, Karen , Larkins, Jo-Ann , de Vent, Kerry , Redpath, Simone
- Date: 2019
- Type: Text , Journal article
- Relation: Collegian Vol. 26, no. 3 (2019), p. 378-382
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- Description: Little is known about why nurses escalate a Medical Emergency Team (MET) response based on ‘worried’ criteria or what clinical findings define a ‘worried’ MET call. Limited clarity exists in nursing literature regarding the clinical definition of ‘worried’ in medical emergencies. Commonly ‘worried’ terminology is associated with nursing intuition about a patient's condition before signs of decline in clinical condition. This research has identified the exact clinical cause of ‘worried’ escalations, with evidence to support that clinical reasoning and patient deterioration are the main cause of ‘worried’ activation. This research has also highlighted areas for further professional development to enhance levels of patient safety and quality care within a regional hospital setting.
Influence of perceptions and stereotypes of the nursing role on career choice in secondary students : A regional perspective
- Authors: Raymond, Anita , James, Ainsley , Jacob, Elisabeth , Lyons, Judith
- Date: 2018
- Type: Text , Journal article
- Relation: Nurse Education Today Vol. 62, no. (2018), p. 150-157
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- Description: Background: This study examined the influence that perceptions and stereotypes of the nursing role had on future career choice of rural secondary students. Objective: The study was undertaken to identify a method of attracting final year secondary school students to an undergraduate nursing degree at a rural University. Design: A mixed method study using a pre–post-interventional design. Setting: The rural campus of an Australian university. Participants: 71 secondary students attending a secondary school career development program at a rural Australian university. Method: Semi structured questionnaires were used for data collection. The surveys were analysed using descriptive statistics and content analysis of open-ended survey questions. Results: The research supports the importance of being aware of young people's impressions about nurses and nursing as a career, to ensure the successful implementation of targeted recruitment. Conclusion: Targeted recruitment strategies can increase students’ awareness of the wide variety of pathways within nursing, rather than leaving awareness to what family, friends or career advisers tell them, or how nurses are portrayed on television, movies and the media. © 2018 Elsevier Ltd
Understanding the bereavement care roles of nurses within acute care : A systematic review
- Authors: Raymond, Anita , Lee, Susan , Bloomer, Melissa
- Date: 2017
- Type: Text , Journal article , Review
- Relation: Journal of Clinical Nursing Vol. 26, no. 13-14 (2017), p. 1787-1800
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- Description: Aims and objectives: To investigate nurses’ roles and responsibilities in providing bereavement care during the care of dying patients within acute care hospitals. Background: Bereavement within acute care hospitals is often sudden, unexpected and managed by nurses who may have limited access to experts. Nurses’ roles and experience in the provision of bereavement care can have a significant influence on the subsequent bereavement process for families. Identifying the roles and responsibilities, nurses have in bereavement care will enhance bereavement supports within acute care environments. Design: Mixed-methods systematic review. Methods: The review was conducted using the databases Cumulative Index Nursing and Allied Health Literature Plus, Embase, Ovid MEDLINE, PsychINFO, CareSearch and Google Scholar. Included studies published between 2006–2015, identified nurse participants, and the studies were conducted in acute care hospitals. Seven studies met the inclusion criteria, and the research results were extracted and subjected to thematic synthesis. Results: Nurses’ role in bereavement care included patient-centred care, family-centred care, advocacy and professional development. Concerns about bereavement roles included competing clinical workload demands, limitations of physical environments in acute care hospitals and the need for further education in bereavement care. Conclusions: Further research is needed to enable more detailed clarification of the roles nurse undertake in bereavement care in acute care hospitals. There is also a need to evaluate the effectiveness of these nursing roles and how these provisions impact on the bereavement process of patients and families. Relevance to clinical practice: The care provided by acute care nurses to patients and families during end-of-life care is crucial to bereavement. The bereavement roles nurses undertake are not well understood with limited evidence of how these roles are measured. Further education in bereavement care is needed for acute care nurses. © 2016 John Wiley & Sons Ltd
Physical deterioration in an acute mental health unit : A quantitative retrospective analysis of medical emergencies
- Authors: Porter, Joanne , Cant, Robyn , Missen, Karen , Raymond, Anita , Churchill, Anne
- Date: 2018
- Type: Text , Journal article
- Relation: International Journal of Mental Health Nursing Vol. 27, no. 5 (2018), p. 1364-1370
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- Description: Nursing management of physical deterioration of patients within acute mental health settings is observed, recorded, and actively managed with the use of standardized Adult Deterioration Detection System (ADDS) charts. Patient deterioration may require the urgent assistance of a hospital rapid response or Medical Emergency Team. A five-and-a-half-year (2011–2016) audit of hospital-wide Medical Emergency Team attendances was conducted in an acute mental health unit of a single large 250 bed regional hospital in Victoria, Australia. Data were extracted from the hospitals’ quality and patient safety program, RISKMan, and entered into a statistical data program for analysis. A total of 140 patient records were analysed, and the ‘Worried’ category (34%, n = 47) was the principle reason for a Medical Emergency Team call in a mental health ward, followed by hypotension (23%, n = 31) and a low Glasgow Coma Score (16%, n = 22). Upon further investigation of the ‘Worried’ category, the most common conditions recorded were an altered conscious state (22%, n = 9), low oxygen saturation (20%, n = 8), or chest pain (17%, n = 7). Activation of Medical Emergency Team calls predominantly occurred in the daylight morning hours (6am–12md). When data were compared to the general hospital patients, the context of the physiological deterioration of the mental health patients was strikingly similar. Further research is recommended to ascertain the extent and frequency with which staff working in mental health units are performing vital signs monitoring as an essential component of detection of early signs of physiological deterioration.
Cultural desire need not improve with cultural knowledge : A cross-sectional study of student nurses
- Authors: Isaacs, Anton , Raymond, Anita , Jacob, Elisabeth , Jones, Janet , McGrail, Matthew , Drysdale, Marlene
- Date: 2016
- Type: Text , Journal article
- Relation: Nurse Education in Practice Vol. 19, no. (2016), p. 91-96
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- Description: Cultural desire is considered to be a prerequisite for developing cultural competence. This study explored cultural desire among student nurses towards Aboriginal peoples and its association with participation in a one-semester unit on Aboriginal health through a cross-sectional survey. Our main outcome, cultural desire, was measured using two items level of agreement with Aboriginal health being an integral component of the nursing curriculum and an expressed interest in Aboriginal health. 220 (74.58%) student nurses completed the survey. Completing the Aboriginal Health and wellbeing unit did not influence students' opinions on inclusion of the unit as part of the nursing curriculum (odds ratio OR 0.73, 95% CI 0.43-1.29) or their overall cultural desire (mean difference = -0.69, 95% CI -1.29 to -0.08, p = 0.026). Students who completed the unit reported a higher understanding of Aboriginal health (OR = 2.35, 95% CI = 1.35-4.08) but lower interest levels in the subject (OR = 0.45, 95% CI: 0.24-0.84). Further research is necessary to explore how and when cultural desire might develop in nurses who are trained in cultural competence particularly in the contexts of post-colonial disparities and political conflict. © 2016 Elsevier Ltd.
Exploration of nursing degree students’ content expectations of a dedicated Indigenous health unit
- Authors: Jacob, Elisabeth , Raymond, Anita , Jones, Janet , Jacob, Alycia , Drysdale, Marlene , Isaacs, Anton
- Date: 2016
- Type: Text , Journal article
- Relation: Collegian Vol. 23, no. 3 (2016), p. 313-319
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- Description: Mandatory Aboriginal and Torres Strait Islander health units are included in all nursing education programmes in Australia to improve students’ knowledge, skills and attitudes towards Indigenous people in order to help address health inequities. This research explores content expectations of nursing students required to undertake Aboriginal and Torres Strait Islander health studies as part of a Bachelor of Nursing Degree at a rural university campus. A cross-sectional survey was undertaken to examine students’ opinions of course content of an Aboriginal health and wellbeing unit. Two hundred and ninety-four students across the three years of the degree were asked to complete the anonymous survey. Two hundred and forty-six students (83.6%) completed the survey. One hundred and thirty-nine students had completed, and 107 students were yet to undertake the unit. Qualitative content analysis of an open-ended survey question was used to interrogate the data. Four themes emerged from the data: cultural competence, disease implications and management, nursing care and other issues. Content expectations were consistent for students who were yet to undertake (pre) or had completed (post) the unit. Content expectations included Aboriginal and Torres Strait Islander culture (pre 30.4%–post 29.8%), Aboriginal and Torres Strait Islander health issues (pre 20.0%–post 23.7%) and understanding nursing care related issues (pre 15.7%–post 17.1%). Data findings were significant for enhancing the current unit. Students express the need for a safe learning environment in which to challenge beliefs and opinions. Course facilitators need to be sensitive to student populations and include content relevant to the programme being studied. Cultural immersion experiences may improve confidence in nursing Aboriginal and Torres Strait Islander people. © 2015 Australian College of Nursing Ltd