List of Titles

Assessing preregistration nursing students' clinical competence : A systematic review of objective measures

- Cant, Robyn, McKenna, Lisa, Cooper, Simon J.

Authors: Cant, Robyn , McKenna, Lisa , Cooper, Simon J.
Date: 2013
Type: Text , Journal article
Relation: International Journal of Nursing Practice Vol. 19, no. 2 (2013), p. 163-176
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Description: Nursing students are required to develop clinical knowledge, skills and attitudes for professional practice. However, objectivity and parity of students' clinical assessments has been questioned. In the last decade, more objective techniques have been developed, with increased use of Objective Structured Clinical Examinations. We reviewed objective clinical assessment measures used in preregistration nursing courses to determine utilization and the validity and reliability of assessment techniques. A systematic search was made of quantitative research publications between 2000 and May 2011, identifying 16 studies that were subsequently reviewed. The validity and reliability of studies varied, with six studies judged as high quality, using various methodologies. This paper describes methods of instrument development and reports on their application in preregistration nursing programs. © 2013 Wiley Publishing Asia Pty Ltd.

“I don’t want to become a scientist” : undergraduate nursing students’ perceived value of course content

- Birks, Melanie, Cant, Robyn, Al-Motlaq, Mohammad, Jones, Jan

Authors: Birks, Melanie , Cant, Robyn , Al-Motlaq, Mohammad , Jones, Jan
Date: 2011
Type: Text , Journal article
Relation: Australian Journal Of Advanced Nursing Vol. 28, no. 4 (2011), p. 20-27
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Description: Background: In the development and delivery of pre‑registration baccalaureate nursing programs, universities must address both the needs of industry and the registering authorities that regulate health professional practice. Balanced with this, providers of education at this level also wish to deliver an experience to students that they both value and enjoy. Objective: This paper describes the findings of a study examining these factors in the first year of four pre‑registration programs at a rural campus and outreach centre of one Australian university. Design: A descriptive, exploratory survey was employed in this research, which is drawn from a larger study into entry pathway, success and academic experience. Results: Results indicate that students found units such as fundamental nursing subjects and law most enjoyable and valuable. Units with a sociological foundation were considered less enjoyable and valuable. Overall, students recognised the value of the bioscience units while contrarily not expressing enjoyment of this aspect of their studies. Conclusions: These findings have implications for nurse educators in respect of the content and delivery of pre‑registration nursing programs. As first year students, the participants may have been focused on learning fundamental nursing tasks, lacking an understanding of the breadth of knowledge required for their professional role. Future research into aspects of nursing studies found to be most valuable may provide a different perspective if conducted in the period post graduation.

Addressing information needs of vulnerable communities about incontinence: a survey of ten CALD communities

- Cross, Wendy, Cant, Robyn, Manning, Deborah, McCarthy, Susan

Authors: Cross, Wendy , Cant, Robyn , Manning, Deborah , McCarthy, Susan
Date: 2014
Type: Text , Journal article
Relation: Collegian (Royal College of Nursing, Australia) Vol. 21, no. 3 (2014), p. 209-216
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Description: Urinary incontinence is a common and distressing condition. Using focus groups, we explored the views of ten ethnic language groups in Melbourne about knowledge and awareness of incontinence. The 218 participants (with or without incontinence) spoke with trained interpreters. Twenty focus group discussions of single and mixed sex groups were audio-recorded and transcribed into English. Narratives were analyzed using thematic analysis with open coding and also incorporated themes from literature. Participants' knowledge of incontinence was low and incontinence was thought to be an inevitable consequence of ageing. There was little understanding of treatments or assistance available under government-funded programmes. No group was aware of the national continence programme or phone helpline. Sensitivities of the topic plus language barriers in immigrant culturally and linguistically diverse communities may impose barriers to accessing help. Several groups thought they would cope with incontinence by themselves, while all groups suggested they would be able to discuss the condition with a doctor. Various preferences voiced about social limitations and permissible communications with others are described. Nurses should be aware of the needs and communication preferences of ethnic language groups regarding continence information and continence service delivery.

Decade of Medicare : The contribution of private practice dietitians to chronic disease management and diabetes group services

- Cant, Robyn, Ball, Lauren

Authors: Cant, Robyn , Ball, Lauren
Date: 2015
Type: Text , Journal article
Relation: Nutrition and Dietetics Vol. 72, no. 3 (2015), p. 284-290
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Description: Aim: To review changes in utilisation of dietetics services through the Medicare Chronic Disease Management program over the last decade and describe patient uptake in 2013. Methods: Dietetics service data were extracted from published Medicare statistics for the periods (i) January 2004 to December 2013 and (ii) January to December 2013. Data comprised individual dietetics services by state and patient demography, and group services data for provider professions regarding type 2 diabetes: dietitians, diabetes educators and exercise physiologists. t-test was used to investigate the association of dietetics' individual service utilisation and workforce statistics. Results: Individual dietetics Chronic Disease Management consultations in private practice have increased annually since 2004. Dietetics has remained the third largest provider. In 2013, a total of 302910 individual consultations were conducted; 7% of allied health consultations. Likewise, individual services for Indigenous Australians increased since 2008. Utilisation of group services for type 2 diabetes comprised <2% of dietetics services. Dietitians provided more group services than diabetes educators but considerably fewer than exercise physiologists. Middle-aged and older patients were common, with highest uptake by those aged 55-74 years. Overall, total and per capita utilisation rates were considerably higher in NSW, Victoria and Queensland compared to less populous states, although this disparity has reduced since 2010. Conclusions: As 10 years has elapsed since the program's inception, further evaluation of the policy is needed to examine large variations in dietetics' Chronic Disease Management uptake by state and territory in both individual and group services. © 2015 Dietitians Association of Australia.

An Australian mixed methods pilot study exploring students performing patient risk screening

- Gibson, Simone, Golder, Janet, Cant, Robyn, Davidson, Zoe

Authors: Gibson, Simone , Golder, Janet , Cant, Robyn , Davidson, Zoe
Date: 2016
Type: Text , Journal article
Relation: Nursing and Health Sciences Vol. 18, no. 2 (2016), p. 203-209
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Description: Clinical placement shortages and rising costs have created demand to provide low-resource, high value student learning opportunities. Malnutrition screening provides a vehicle for achieving this. A mixed methods explanatory sequential intervention study investigated time costs, and students' perceptions of preparedness after performing routine patient screening tasks, as well as students' overall views on their feelings of confidence and preparedness when commencing their first clinical placements. Pre-clinical student dietitians commencing initial placements participated (n=58), with 16 of these forming a subgroup who performed malnutrition screening tasks while the others attended usual placement orientation. The time saved when students undertook screening tasks usually assigned to nurses was substantial. Questionnaires revealed that student perceived confidence increased in the screening group when compared with controls. Focus group themes included "anxiety and confidence," "learning in the clinical learning environment," "communication skill development," and "the pre-placement screening experience." Students performing routine patient-screening tasks prior to initial clinical placement has potential cost savings for healthcare organizations and was perceived to be valuable for learning. © 2016 John Wiley & Sons Australia, Ltd.

The FIRST2ACT simulation program improves nursing practice in a rural Australian hospital

- Kinsman, Leigh, Buykx, Penny, Cant, Robyn, Champion, Robert, Cooper, Simon J., Endacott, Ruth, McConnell-Henry, Tracy, Missen, Karen, Porter, Joanne, Scholes, Julie

Authors: Kinsman, Leigh , Buykx, Penny , Cant, Robyn , Champion, Robert , Cooper, Simon J. , Endacott, Ruth , McConnell-Henry, Tracy , Missen, Karen , Porter, Joanne , Scholes, Julie
Date: 2012
Type: Text , Journal article
Relation: Australian Journal of Rural Health Vol. 20, no. 5 (2012), p. 270-274
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Description: Objective: To measure the impact of the Feedback Incorporating Review and Simulation Techniques to Act on Clinical Trends (FIRST2ACT) simulation program on nursing observations and practice relevant to patient deterioration in a rural Australian hospital. Design: Interrupted time series analysis. Setting: A rural Australian hospital. Participants: All registered nurses (Division 1) employed on an acute medical/surgical ward. Intervention: The FIRST2ACT simulation program. Outcome measures: Appropriate frequency of a range of observations and administration of oxygen therapy. Results: Thirty-four nurses participated (83% of eligible nurses) in the FIRST2ACT program, and 258 records were audited before the program and 242 records after. There were statistically significant reductions in less than satisfactory frequency of observations (P = 0.009) and pain score charting (P = 0.003). There was no measurable improvement in the administration of oxygen therapy (P = 0.143), while the incidence of inappropriate nursing practice for other measures both before and after the intervention was too low to warrant analysis. Conclusion: FIRST2ACT was associated with measurable improvements in nursing practice.

FIRST2ACT: Educating nurses to identify patient deterioration - a theory-based model for best practice simulation education

- Buykx, Penny, Kinsman, Leigh, Cooper, Simon J., McConnell-Henry, Tracy, Cant, Robyn, Endacott, Ruth

Authors: Buykx, Penny , Kinsman, Leigh , Cooper, Simon J. , McConnell-Henry, Tracy , Cant, Robyn , Endacott, Ruth
Date: 2011
Type: Text , Journal article
Relation: Nurse Education Today Vol. 31, no. 7 (2011), p. 687-693
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Description: Delayed assessment and mismanagement of patient deterioration is a substantial problem for which educational preparation can have an impact. This paper describes the development of the FIRST2ACT simulation model based on well-established theory and contemporary empirical evidence. The model combines evidence-based elements of assessment, simulation, self-review and expert feedback, and has been tested in undergraduate nurses, student midwives and post-registration nurses. Participant evaluations indicated a high degree of satisfaction and substantial self-rated increases in knowledge, confidence and competence. This evidence-based model should be considered for both undergraduate and post-registration education programs.

Factors affecting evidence translation for general practice nurses

- Mills, Jane, Field, John, Cant, Robyn

Authors: Mills, Jane , Field, John , Cant, Robyn
Date: 2011
Type: Text , Journal article
Relation: International Journal of Nursing Practice Vol. 17, no. 5 (2011), p. 455-463
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Description: This paper explores the domains of influence affecting practice nurses' ability to find, evaluate and use clinical evidence. A cross-sectional survey of general practice nurses (n=590) in Victoria, Australia in 2008 provided data for a principal components analysis. The research replicates a study undertaken in the UK using the Developing Evidence-Based Practice Questionnaire. Five domains of influence on nurses' translation of evidence were identified: skills in finding/reviewing evidence; barriers to finding/reviewing evidence; knowledge from published sources; knowledge from other sources; and barriers or facilitators to change. Each domain was interpreted as underlying the relationship of nurses with evidence-based practice and was comparable to the original study's findings when subjected to factor analysis. Findings from this study show that the Developing Evidence-Based Practice Questionnaire-Au is a valid and useful instrument in determining the influences on practice nurses' ability to effect knowledge translation and conduct practice based on evidence. Given these findings, a new model is proposed that explains the influence of a number of domains on Australian general practice nurses' translation of knowledge into practice. © 2011 Blackwell Publishing Asia Pty Ltd.

Emergency training boosts confidence

- Buykx, Penny, Missen, Karen, Cooper, Simon J., Porter, Joanne, McConnell-Henry, Tracy, Cant, Robyn, Kinsman, Leigh, Endacott, Ruth, Scholes, Julie

Authors: Buykx, Penny , Missen, Karen , Cooper, Simon J. , Porter, Joanne , McConnell-Henry, Tracy , Cant, Robyn , Kinsman, Leigh , Endacott, Ruth , Scholes, Julie
Date: 2012
Type: Text , Journal article
Relation: Australian Nursing Journal Vol. 19, no. 7 (2012), p. 43
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Simulation in the Internet age: The place of Web-based simulation in nursing education. An integrative review

- Cant, Robyn, Cooper, Simon J.

Authors: Cant, Robyn , Cooper, Simon J.
Date: 2014
Type: Text , Journal article
Relation: Nurse Education Today Vol. 34, no. 12 (2014), p. 1435-1442
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Description: Objective The objective of this article was to review the literature on utilisation and place of Web-based simulation within nursing education. Web-based simulation combines electronic multimedia options with a central video or virtual world to produce interactive learning activities mediated by the learner. Design An integrative review. Data sources A search was conducted of healthcare databases between 2000 and 2014 and of Internet sources for hosted simulation programs in nursing. Eighteen primary programs were identified for inclusion. Review methods A strategy for integrative review was adopted in which studies were identified, filtered, classified, analysed and compared. Results and discussion Of 18 programs, two game-based programs were identified which represented a ‘virtual world’ in which students could simultaneously or individually immerse themselves in a character role-play. However, most programs (n = 10) taught an aspect of procedural patient care using multimedia (e.g. video, audio, graphics, quiz, text, memo). Time-limited sequences, feedback and reflective activities were often incorporated. Other studies (n = 8) taught interpersonal communication skills or technical skills for equipment use. Descriptive study outcomes indicated ease of program use, strong satisfaction with learning and appreciation of program accessibility. Additionally, four studies reported significant improvements in knowledge post-intervention. Conclusion Web-based simulation is highly acceptable to students and appears to provide learning benefits that align with other simulation approaches and it augments face-to-face teaching. Web-based simulation is likely to have a major place in nursing curricula in the next decade, yet further research is necessary to objectively evaluate learner outcomes and to justify its use.

Rating medical emergency teamwork performance: development of the Team Emergency Assessment Measure (TEAM)

- Cooper, Simon J., Cant, Robyn, Sellick, Kenneth, Porter, Joanne, Somers, George, Kinsman, Leigh, Nestel, Debra

Authors: Cooper, Simon J. , Cant, Robyn , Sellick, Kenneth , Porter, Joanne , Somers, George , Kinsman, Leigh , Nestel, Debra
Date: 2010
Type: Text , Journal article
Relation: Resuscitation Vol. 81, no. 4 (2010), p. 446-452
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Description: Aim To develop a valid, reliable and feasible teamwork assessment measure for emergency resuscitation team performance. Background Generic and profession specific team performance assessment measures are available (e.g. anaesthetics) but there are no specific measures for the assessment of emergency resuscitation team performance. Methods (1) An extensive review of the literature for teamwork instruments, and (2) development of a draft instrument with an expert clinical team. (3) Review by an international team of seven independent experts for face and content validity. (4) Instrument testing on 56 video-recorded hospital and simulated resuscitation events for construct, consistency, concurrent validity and reliability and (5) a final set of ratings for feasibility on fifteen simulated ‘real time’ events. Results Following expert review, selected items were found to have a high total content validity index of 0.96. A single ‘teamwork’ construct was identified with an internal consistency of 0.89. Correlation between the total item score and global rating (rho 0.95; p < 0.01) indicated concurrent validity. Inter-rater (k 0.55) and retest reliability (k 0.53) were ‘fair’, with positive feasibility ratings following ‘real time’ testing. The final 12 item (11 specific and 1 global rating) are rated using a five-point scale and cover three categories leadership, teamwork and task management. Conclusion In this primary study TEAM was found to be a valid and reliable instrument and should be a useful addition to clinicians’ tool set for the measurement of teamwork during medical emergencies. Further evaluation of the instrument is warranted to fully determine its psychometric properties.

E-simulation:pre-registration nursing students' evaluation of an on-line patient deterioration program

- Cant, Robyn, Young, Susan, Cooper, Simon J., Porter, Joanne

Authors: Cant, Robyn , Young, Susan , Cooper, Simon J. , Porter, Joanne
Date: 2015
Type: Text , Journal article
Relation: CIN: Computers, Informatics, Nursing Vol. 33, no. 3 (2015), p. 108-114
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Description: This study explores preregistration nursing students’ views of a Web-based simulation program: FIRST2 ACTWeb (Feedback Incorporating Review and Simulation Techniques to Act on Clinical Trends-Web). The multimedia program incorporating three videoed scenarios portrayed by a standardized patient (human actor) aims to improve students’ recognition and management of hospital patient deterioration. Participants were 367 final-year nursing students from three universities who completed an online evaluation survey and 19 students from two universities who attended one of five focus groups. Two researchers conducted a thematic analysis of the transcribed narratives. Three core themes identified were as follows: “ease of program use,” “experience of e-Simulation,” and “satisfaction with the learning experience.” The Web-based clinical learning environment was endorsed as functional, feasible, and easy to use and was reported to have high fidelity and realism. Feedback in both focus groups and surveys showed high satisfaction with the learning experience. Overall, evaluation suggested that the Web-based simulation program successfully integrated elements essential for blended learning. Although Web-based educational applications are resource intensive to develop, positive appraisal of program quality, plus program accessibility and repeatability, appears to provide important educational benefits. Further research is needed to determine the transferability of these learning experiences into real-world practice.

Facilitating patients' dietary change : A review of dietitians' correspondence practices with general practitioners

- Cant, Robyn, Pomeroy, Sylvia

Authors: Cant, Robyn , Pomeroy, Sylvia
Date: 2011
Type: Text , Journal article , Review
Relation: Nutrition and Dietetics Vol. 68, no. 2 (2011), p. 140-148
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Description: Aim: Dietitian and general practitioner collaboration in the nutrition care of a patient is important to assist patients to achieve their nutrition goals. This paper aims to review the published literature on dietitians' correspondence practices with recipient general practitioners regarding nutrition interventions recommended to patients. Methods: A literature search was conducted of publications from 1995 to December 2009. Key words were used to search the electronic databases Medline, CINAHL Plus, ProQuest, PsycINFO and Google Scholar. Twenty papers that addressed this topic were selected by two authors for inclusion in the review. Results: There is evidence that dietitians often fail to provide general practitioners with formalised correspondence that describes dietitians' nutrition interventions with patients. Doctors report they lack patient information via dietitians' correspondence. Information about nutrition care of hospital patients often remains within hospital records. Doctors prefer standardised letter formats with content presented succinctly. The letter should include a nutrition diagnosis, agreed goals, a plan for ongoing dietetic visits and instructions for a general practitioner's supportive actions. Conclusion: Dietitians need skill in drafting reports or letters useful for general practitioners by selecting content of value to doctors and using a suitable style. Implementation of shared electronic records in Australia will facilitate information transfer to help realise collaborative patient care. Further investigations of dietitian-general practitioner correspondence are warranted to determine best practice. © 2011 The Authors. Nutrition & Dietetics © 2011 Dietitians Association of Australia.

Patient deterioration education: Evaluation of face-to-face simulation and e-simulation approaches

- Cooper, Simon J., Cant, Robyn, Bogossian, Fiona, Kinsman, Leigh, Bucknall, Tracey

Authors: Cooper, Simon J. , Cant, Robyn , Bogossian, Fiona , Kinsman, Leigh , Bucknall, Tracey
Date: 2015
Type: Text , Journal article
Relation: Clinical Simulation in Nursing Vol. 11, no. 2 (2015), p. 97-105
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Description: Background Simulation-based education is one strategy that may be used to teach nursing students to recognize and manage patient deterioration. Method Final-year preregistration nursing students (n = 97) completed three face-to-face laboratory-based team simulations with a simulated patient (actor) and 330 students individually completed a three-scenario Web-based simulation program: FIRST2ACTWeb™. Results Both groups achieved moderate performance scores (means: face to face, 49%; e-simulation, 69%). Course evaluations were positive, skill gain showing a greater effect size in the face-to-face program than for e-simulation, and higher satisfaction and more positive appraisal. Conclusion Face-to-face simulation and e-simulation are effective educational strategies with e-simulation offering greater feasibility. Either strategy is likely to add value to the learning experience.

Improving the non-technical skills of hospital medical emergency teams : The Team Emergency Assessment Measure (TEAM™)

- Cant, Robyn, Porter, Joanne, Cooper, Simon J., Roberts, Kate, Wilson, Ian, Gartside, Christopher

Authors: Cant, Robyn , Porter, Joanne , Cooper, Simon J. , Roberts, Kate , Wilson, Ian , Gartside, Christopher
Date: 2016
Type: Text , Journal article
Relation: EMA - Emergency Medicine Australasia Vol. 28, no. 6 (2016), p. 641-646
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Description: Objectives: This prospective descriptive study aimed to test the validity and feasibility of the Team Emergency Assessment Measure (TEAM™) for assessing real-world medical emergency teams' non-technical skills. Second, the present study aimed to explore the instrument's contribution to practice regarding teamwork and learning outcomes. Methods: Registered nurses (RNs) and medical staff (n = 104) in two hospital EDs in rural Victoria, Australia, participated. Over a 10 month period, the (TEAM™) instrument was completed by multiple clinicians at medical emergency episodes. Results: In 80 real-world medical emergency team resuscitation episodes (283 clinician assessments), non-technical skills ratings averaged 89% per episode (39 of a possible 44 points). Twenty-one episodes were rated in the lowest quartile (i.e. ≤37 points out of 44). Ratings differed by discipline, with significantly higher scores given by medical raters (mean: 41.1 ± 4.4) than RNs (38.7 ± 5.4) (P = 0.001). This difference occurred in the Leadership domain. The tool was reliable with Cronbach's alpha 0.78, high uni-dimensional validity and mean inter-item correlation of 0.45. Concurrent validity was confirmed by strong correlation between TEAM™ score and the awarded Global Rating (P < 0.001), with 38.4% of shared variance. RNs praised the instrument as it initiated staff reflection and debriefing discussions around performance improvement. Conclusion: Non-technical skills of medical emergency teams are known to often be suboptimal; however, average ratings of 89% were achieved in this real-world study. TEAM™ is a valid, reliable and easy to use tool, for both training and clinical settings, with benefits for team performance when used as an assessment and/or debriefing tool. © 2016 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine

Preparing nursing students for the future: development and implementation of an Australian Bachelor of Nursing program with a community health focus

- Cooper, Simon J., Cant, Robyn, Browning, Mark, Robinson, Eddie

Authors: Cooper, Simon J. , Cant, Robyn , Browning, Mark , Robinson, Eddie
Date: 2015
Type: Text , Journal article
Relation: Contemporary Nurse: A Journal for the Australian Nursing Profession Vol. 49, no. (2015), p. 68-74
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Description: This paper focuses on changes in the educational preparation of undergraduate nurses in line with contemporary primary and preventative healthcare models. We evaluated a new Australian nursing and community care degree programme using focus groups with 38 students in their first years of study, and quantitative performance data (regarding entry, performance and course attrition). Four main themes were identified related to students’ course experience: ‘I think community health should be an elective’; ‘Focus on relevance to practice’; ‘Teaching by non-nursing academics’ and ‘Access to support during transition to university.’ Overall pass rates were 94% (first year) and 97% (second year) with a low 11% attrition rate. We conclude that based on prior experiences and stereotypical views, students may be ambivalent about the inclusion of primary and preventative care models which nevertheless are essential to enhance practice and to prepare the future nursing workforce

Australian nursing students’ experience of bullying and/or harassment during clinical placement

- Budden, Lea, Birks, Melanie, Cant, Robyn, Bagley, Tracy, Park, Tanya

Authors: Budden, Lea , Birks, Melanie , Cant, Robyn , Bagley, Tracy , Park, Tanya
Date: 2017
Type: Text , Journal article
Relation: Collegian Vol. 24, no. 2 (2017), p. 125-133
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Description: Bullying and harassment in nursing are unacceptable behaviours in the workplace. There is a large body of evidence relating this problem, however little of it focuses on the experiences of nursing students. This prospective cross-sectional survey investigated Australian undergraduate nursing students’ (N = 888) experiences of bullying and/or harassment during clinical placement. Half (50.1%) of the students indicated they had experienced this behaviour in the previous 12 months. Younger students were more likely to be bullied/harassed than older students (p = 0.05). Participants identified perpetrators of bullying/harassment as registered nurses (56.6%), patients (37.4%), enrolled nurse's (36.4%), clinical facilitators (25.9%), preceptors (24.6%), nurse managers (22.8%) and other student nurses (11.8%). The majority of students reported that the experience of being bullied/harassed made them feel anxious (71.5%) and depressed (53.6%). Almost a third of students (32.8%) indicated that these experiences negatively affected the standard of care they provided to patients with many (46.9%) reconsidering nursing as their intended career. In the face of workforce attrition in nursing, the findings of this study have implications for education providers, clinical institutions and the profession at large. © 2015 Australian College of Nursing Ltd

The divided self: Near death experiences of resuscitated patients: a literature review

- Cant, Robyn, Cooper, Simon J., Chung, Catherine, O'Connor, Margaret

Authors: Cant, Robyn , Cooper, Simon J. , Chung, Catherine , O'Connor, Margaret
Date: 2012
Type: Text , Journal article
Relation: International Emergency Nursing Vol. 20, no. 2 (2012), p. 88-93
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Description: This paper explores the prevalence of ‘near death experience’ phenomena associated with a resuscitation event and examines the current state of evidence for causation. Patients’ reports of unusual recollections associated with a period of unconsciousness (perceived as approaching death) have fascinated individuals and the medical fraternity. Near death experiences (NDE) are reported in 4–9% of general community members and up to 23% of critical illness patients, although they can occur in healthy individuals who may think they are in peril. One explanation is that paranormal visions that include seeing bright lights, a tunnel and having feelings of peace may be a stage of enlightenment as death approaches. More objective explanations point to neuro-chemical changes in a stressed or dying brain as explanation for nearly all the elements of near death experience. However if this is so, NDE should occur in all patients who are critically ill and near death. In general, patients report positive psychological outcomes after a near death experience. Nurses can support patients during a time of crisis by assisting them and their families to comprehend the experiential event using effective communication and listening skill.

The impact of walk-in centres and GP co-operatives on emergency department presentations : A systematic review of the literature

- Crawford, Jessica, Cooper, Simon J., Cant, Robyn, DeSouza, Ruth

Authors: Crawford, Jessica , Cooper, Simon J. , Cant, Robyn , DeSouza, Ruth
Date: 2017
Type: Text , Journal article , Review
Relation: International Emergency Nursing Vol. 34, no. (2017), p. 36-42
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Description: Background Internationally, non-urgent presentations are increasing the pressure on Emergency Department (ED) staff and resources. This systematic review aims to identify the impact of alternative emergency care pathways on ED presentations – specifically GP cooperatives and walk-in clinics. Methods Based on a structured PICO enquiry with either walk-in clinic or GP cooperative as the intervention, a search was made for peer-reviewed publications in English, between 2000 and 2014. Medline plus, OVID, PubMed, and Google Scholar were searched. The Critical Appraisal Skills Program (CASP) guidelines were used to assess study quality and data was extracted using an adapted JBI Qualitative Assessment and Review Instrument (QARI). Subsequent reporting followed the PRISMA guideline. Results Eleven high quality quantitative studies met the inclusion criteria. Walk-in clinics do have the potential to reduce non-urgent emergency department presentations, however evidence of this effect is low. GP cooperatives offer an alternative care stream for patients presenting to the ED and do significantly reduce local ED attendances. Community members need to be made aware of these options in order to make informed treatment choices. Conclusion GP cooperatives in particular do have the potential to reduce ED workload. Further research is required to uncover recent trends and patient outcomes for walk-in clinics and GP cooperatives. © 2017 Elsevier Ltd

Measuring the non-technical skills of medical emergency teams: an update on validity and reliability of Team Emergency Assessment Measure (Team).

- Cant, Robyn, Cooper, Simon J.

Authors: Cant, Robyn , Cooper, Simon J.
Date: 2014
Type: Text , Journal article
Relation: Resuscitation Vol. 85, no. (2014), p. 31-33
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Description: Medical emergency team performance including non-technical skills, is receiving increased attention due to the influences on patient safety. The Team Emergency Assessment Measure View the MathML source was developed to enable standardized performance assessment and structured team debriefing. From several studies, the View the MathML source has demonstrated a substantial body of normative data confirming its validity and reliability. This includes high uni-dimensional validity, significant subscale relationships between Teamwork and Leadership and between Teamwork and Task Management (p < 0.001), a Cronbach alpha of 0.92 and adequate construct validity. The tool has potential for team training to improve team's non-technical performance. Further testing is required in ‘real’ clinical settings.

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