A model of home-based care for people with disabilities : Better practice in rural Thailand
- Wanaratwichit, Civilaiz, Hills, Danny, Cruickshank, Mary, Newman, Barbara
- Authors: Wanaratwichit, Civilaiz , Hills, Danny , Cruickshank, Mary , Newman, Barbara
- Date: 2015
- Type: Text , Journal article
- Relation: Asia Pacific Journal of Health Management Vol. 10, no. 2 (2015), p. 44-51
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Background and objective: People with disabilities living in rural areas often require considerable support to meet their complex needs. This study investigated a best practice model in home-based care for people with disabilities in rural Thailand.
Design and Setting: A case study method was adopted to investigate a best practice model of home-based care for people with disabilities in Nakhonthai District, Phitsanulok Province, Thailand. Data were collected from 30 participants through in-depth interviews, focus groups, direct observation and document analysis. Content and thematic analyses were conducted for qualitative data. The Wilcoxon Signed-Rank test was used for the outcome measurement of activities of daily living (ADL) scores.
Results: This model of home-based care for people with disabilities, as an integrated network model, brings together the community, health professionals and other organisations. The role of trained community health volunteers was mainly to deliver home-based personal care for people with disabilities, while health professionals focused mainly on controlling the quality of care, managing the knowledge and skills of volunteers, and co-ordinating the network. The difference between ADL scores before and after the implementation of the model (n=20) was statistically significant (p<0.01). Conclusion: This best practice model of home-based care for people with disabilities in rural Thailand shifts responsibility in the main service decisions from professionals to the community and other stakeholders and engages and empowered all stakeholders in the provision, co-ordination and management of care.
- Authors: Wanaratwichit, Civilaiz , Hills, Danny , Cruickshank, Mary , Newman, Barbara
- Date: 2015
- Type: Text , Journal article
- Relation: Asia Pacific Journal of Health Management Vol. 10, no. 2 (2015), p. 44-51
- Full Text:
- Reviewed:
- Description:
Background and objective: People with disabilities living in rural areas often require considerable support to meet their complex needs. This study investigated a best practice model in home-based care for people with disabilities in rural Thailand.
Design and Setting: A case study method was adopted to investigate a best practice model of home-based care for people with disabilities in Nakhonthai District, Phitsanulok Province, Thailand. Data were collected from 30 participants through in-depth interviews, focus groups, direct observation and document analysis. Content and thematic analyses were conducted for qualitative data. The Wilcoxon Signed-Rank test was used for the outcome measurement of activities of daily living (ADL) scores.
Results: This model of home-based care for people with disabilities, as an integrated network model, brings together the community, health professionals and other organisations. The role of trained community health volunteers was mainly to deliver home-based personal care for people with disabilities, while health professionals focused mainly on controlling the quality of care, managing the knowledge and skills of volunteers, and co-ordinating the network. The difference between ADL scores before and after the implementation of the model (n=20) was statistically significant (p<0.01). Conclusion: This best practice model of home-based care for people with disabilities in rural Thailand shifts responsibility in the main service decisions from professionals to the community and other stakeholders and engages and empowered all stakeholders in the provision, co-ordination and management of care.
- Hills, Danny, Tan, Khoon, Heng, Doreen
- Authors: Hills, Danny , Tan, Khoon , Heng, Doreen
- Date: 2021
- Type: Text , Book chapter
- Relation: Cross-Cultural Design for Healthy Ageing Chapter 4 p. 63-72
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Conclusions, Overview, and Recommendations
- Scharoun, Lisa, Peng, Fanke, Hills, Danny, Liu, Jie, Montana-Hoyos, Carlos, Sung, Vivien
- Authors: Scharoun, Lisa , Peng, Fanke , Hills, Danny , Liu, Jie , Montana-Hoyos, Carlos , Sung, Vivien
- Date: 2021
- Type: Text , Book chapter
- Relation: Cross-Cultural Design for Healthy Ageing p. 160-168
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Cross-cultural design for healthy ageing
- Scharoun, Lisa, Hills, Danny, Montana-Hoyos, Carlos, Peng, Fanke, Sung, Vivien
- Authors: Scharoun, Lisa , Hills, Danny , Montana-Hoyos, Carlos , Peng, Fanke , Sung, Vivien
- Date: 2020
- Type: Text , Book
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- Description: We wrote this book as a compilation of many years of research and pedagogical experiences around cross-cultural and multidisciplinary design for healthy ageing. In it, we combine different voices and perspectives, including descriptions of several cross-cultural design for healthy ageing workshops conducted with students from design and nursing disciplines in different Australasian locations. These experiences are described in detail, offering a roadmap and many ideas for readers to build upon. Literature reviews and background research inform these practical experiences, which were then used to develop new theory and insights around the topics, mainly from academic and pedagogic points of view. The multiplicity of voices of student participants in the workshops provides a more personalised account of these experiences, while our reflections highlight the pedagogic and life-changing value of these experiences. We are a multidisciplinary team of researchers based mainly in Australia. Initially, a majority of the team members met while working at the University of Canberra (UC), with specialties in nursing, graphic design, industrial design, and fashion design, all from different cultural backgrounds and with interests in health and healthy ageing. Building on research undertaken with several study tours of Australian students from design and nursing to various Asian countries, mainly China and Singapore, and through collaborations with numerous partners including higher education institutions in Singapore, China, Hong Kong, and Taiwan, the research team explored the multi-layered relationships between design and healthy ageing. "From Introduction"
Defining and classifying aggression and violence in health care work
- Authors: Hills, Danny
- Date: 2018
- Type: Text , Journal article
- Relation: Collegian Vol. 25, no. 6 (2018), p. 607-612
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- Description: Background: There is considerable contention in defining workplace aggression, especially in health care. This can lead to challenges in effectively researching workplace aggression, and ensuring a sound basis for developing strategies to prevent and minimise its likelihood and consequences. Aim: The aim of this discussion paper is to provide a pragmatic definition of workplace aggression, based on a contemporary conceptualisation of human aggression, followed by a discussion on key classifications of workplace aggression. Methods: The argument presented draws on theoretical and applied literature to develop a case for adopting a pragmatic definition of aggression, with key classification components. Findings and Discussion: A highly practical conceptualisation of workplace aggression differentiates two main forms – verbal or written and physical aggression – and two main source groups – internal (co-workers) and external (patients, their relatives or carers and others external to the workplace). Conclusion: Clarity and consensus on defining and classifying workplace aggression, should provide a sound and coherent basis for researchers, policy makers, clinicians and health care organisations to successfully prevent and minimise this challenging and serious work health and safety concern. © 2018 Australian College of Nursing Ltd
- Authors: Hills, Danny
- Date: 2018
- Type: Text , Journal article
- Relation: Collegian Vol. 25, no. 6 (2018), p. 607-612
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- Description: Background: There is considerable contention in defining workplace aggression, especially in health care. This can lead to challenges in effectively researching workplace aggression, and ensuring a sound basis for developing strategies to prevent and minimise its likelihood and consequences. Aim: The aim of this discussion paper is to provide a pragmatic definition of workplace aggression, based on a contemporary conceptualisation of human aggression, followed by a discussion on key classifications of workplace aggression. Methods: The argument presented draws on theoretical and applied literature to develop a case for adopting a pragmatic definition of aggression, with key classification components. Findings and Discussion: A highly practical conceptualisation of workplace aggression differentiates two main forms – verbal or written and physical aggression – and two main source groups – internal (co-workers) and external (patients, their relatives or carers and others external to the workplace). Conclusion: Clarity and consensus on defining and classifying workplace aggression, should provide a sound and coherent basis for researchers, policy makers, clinicians and health care organisations to successfully prevent and minimise this challenging and serious work health and safety concern. © 2018 Australian College of Nursing Ltd
- Hungerford, Catherine, Hills, Sharon, Richards, Catelyn, Robinson, Tracy, Hills, Danny
- Authors: Hungerford, Catherine , Hills, Sharon , Richards, Catelyn , Robinson, Tracy , Hills, Danny
- Date: 2022
- Type: Text , Journal article , Review
- Relation: Issues in Mental Health Nursing Vol. 43, no. 11 (2022), p. 1014-1021
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- Description: The origins of mindfulness go back some 25 centuries to Eastern teachings, including Buddhism and Hinduism. Mindfulness-based interventions gained credence in Western mental health settings in the late 1970s through the work of medical researcher Kabat-Zinn, whose interest in Eastern meditation led him to develop a program for stress reduction. Since then, mindfulness-based interventions have been utilized for various populations, including older people with anxiety. Group mindfulness-based interventions have demonstrated benefits for older people with anxiety living in residential aged care and the community. In primary care settings, innovative delivery models for group mindfulness-based interventions could be facilitated by nurses to support older people with anxiety to age in place with dignity. The benefits of mindfulness-based interventions suggest the value of integrating ancient Eastern techniques with modern Western strategies to achieve better health outcomes for older people with mental health concerns. © 2022 Taylor & Francis Group, LLC.
Factors contributing to the recruitment and retention of rural pharmacist workforce: a systematic review
- Terry, Daniel, Peck, Blake, Hills, Danny, Baker, Ed, Schmitz, David
- Authors: Terry, Daniel , Peck, Blake , Hills, Danny , Baker, Ed , Schmitz, David
- Date: 2021
- Type: Text , Journal article
- Relation: BMC Health Services Research Vol. 21, no. 1 (2021), p.
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- Description: Background: Recruiting and retaining medical, nursing, and allied health professionals in rural and remote areas is a worldwide challenge, compromising continuity of care and population health outcomes in these locations. Specifically, pharmacists play an essential and accessible frontline healthcare role, and are often the first point of contact for health concerns. Despite several incentives, there remains a maldistribution and undersupply of pharmacists in rural and remote areas across many parts of the world. Although current systematic reviews have focussed on factors affecting pharmacists’ retention generally, literature specifically focused on rural pharmacist workforce in a global context remains limited. The aim of this systematic review is to identify factors associated with recruitment and retention of the pharmacist workforce in rural and remote settings. Better understanding of these contributors will inform more effective interventional strategies to resolve pharmacist workforce shortages. Methods: A systematic search of primary studies was conducted in online databases, including Medline, Embase, CINAHL, Scopus, Web of Science and PsycINFO, and by hand-searching of reference lists. Eligible studies were identified based on predefined inclusion/exclusion criteria and methodological quality criteria, utilising the Critical Appraisal Skills Programme (CASP) and Good Reporting of A Mixed Methods Study (GRAMMS) checklists. Results: The final review included 13 studies, with quantitative, qualitative, or mixed methods research design. Study-specific factors associated with recruitment and retention of pharmacists in rural practice were identified and grouped into five main themes: geographic and family-related, economic and resources, scope of practice or skills development, the practice environment, and community and practice support factors. Conclusions: The results provide critical insights into the complexities of rural recruitment and retention of pharmacists and confirms the need for flexible yet multifaceted responses to overcoming rural pharmacist workforce challenges. Overall, the results provide an opportunity for rural communities and health services to better identify key strengths and challenges unique to the rural and remote pharmacist workforce that may be augmented to guide more focussed recruitment and retention endeavours. © 2021, The Author(s). **Please note that there are multiple authors for this article therefore only the name of the Federation University Australia affiliates “Daniel Terry, Blake Peck, Danny Hills, Ed Baker and David Schmitz” are provided in this record** Correction to: Factors contributing to the recruitment and retention of rural pharmacist workforce: a systematic review (BMC Health Services Research, (2021), 21, 1, (1052), 10.1186/s12913-021-07072-1)
- Authors: Terry, Daniel , Peck, Blake , Hills, Danny , Baker, Ed , Schmitz, David
- Date: 2021
- Type: Text , Journal article
- Relation: BMC Health Services Research Vol. 21, no. 1 (2021), p.
- Full Text:
- Reviewed:
- Description: Background: Recruiting and retaining medical, nursing, and allied health professionals in rural and remote areas is a worldwide challenge, compromising continuity of care and population health outcomes in these locations. Specifically, pharmacists play an essential and accessible frontline healthcare role, and are often the first point of contact for health concerns. Despite several incentives, there remains a maldistribution and undersupply of pharmacists in rural and remote areas across many parts of the world. Although current systematic reviews have focussed on factors affecting pharmacists’ retention generally, literature specifically focused on rural pharmacist workforce in a global context remains limited. The aim of this systematic review is to identify factors associated with recruitment and retention of the pharmacist workforce in rural and remote settings. Better understanding of these contributors will inform more effective interventional strategies to resolve pharmacist workforce shortages. Methods: A systematic search of primary studies was conducted in online databases, including Medline, Embase, CINAHL, Scopus, Web of Science and PsycINFO, and by hand-searching of reference lists. Eligible studies were identified based on predefined inclusion/exclusion criteria and methodological quality criteria, utilising the Critical Appraisal Skills Programme (CASP) and Good Reporting of A Mixed Methods Study (GRAMMS) checklists. Results: The final review included 13 studies, with quantitative, qualitative, or mixed methods research design. Study-specific factors associated with recruitment and retention of pharmacists in rural practice were identified and grouped into five main themes: geographic and family-related, economic and resources, scope of practice or skills development, the practice environment, and community and practice support factors. Conclusions: The results provide critical insights into the complexities of rural recruitment and retention of pharmacists and confirms the need for flexible yet multifaceted responses to overcoming rural pharmacist workforce challenges. Overall, the results provide an opportunity for rural communities and health services to better identify key strengths and challenges unique to the rural and remote pharmacist workforce that may be augmented to guide more focussed recruitment and retention endeavours. © 2021, The Author(s). **Please note that there are multiple authors for this article therefore only the name of the Federation University Australia affiliates “Daniel Terry, Blake Peck, Danny Hills, Ed Baker and David Schmitz” are provided in this record** Correction to: Factors contributing to the recruitment and retention of rural pharmacist workforce: a systematic review (BMC Health Services Research, (2021), 21, 1, (1052), 10.1186/s12913-021-07072-1)
- Wanaratwichit, Civilaiz, Hills, Danny, Cruickshank, Mary
- Authors: Wanaratwichit, Civilaiz , Hills, Danny , Cruickshank, Mary
- Date: 2020
- Type: Text , Journal article
- Relation: Collegian Vol. 27, no. 1 (2020), p. 18-22
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- Description: Background: In Thailand, the number of people with physical disabilities (PwD) has been increasing. Following sweeping health care reforms in 2002, efforts were made to improve accessibility to health care by greatly increasing the number of Registered Nurses (RNs) working in local community health centres. Little is known, however, about the role of RNs in improving accessibility to home-based care and the outcomes of care for PwD in Thailand. Aim: To explore the role of RNs in providing high quality home-based services for PwD who have severe limitations in movement. Methods: A case study design was used to explore and describe the role of RNs in home-based care for PwD in one rural and one urban area in lower north Thailand. There were 73 participants, including PwD and their family members, community health volunteers, primary care providers, local government officers and members of the District Health management team. Data were collected from in-depth interviews and focus groups, which were analysed using thematic analysis. Results: The roles of RNs in home-based care for PwD were found in four domains, as case manager, rehabilitation care provider, manager of the community health volunteers and broader care coordinator. Conclusion: The full scope of the RN role in the provision of home-based care for PwD, in the district health system of Thailand, not only involves direct nursing care. The role also encompasses planning and co-ordination of the broad range of professional and non-professional services to meet the needs of PwDs in rural and urban settings. © 2019 Australian College of Nursing Ltd
Interdisciplinary and cross-cultural approaches to design for healthy ageing
- Scharoun, Lisa, Hills, Danny, Montana-Hoyos, Carlos Alberto
- Authors: Scharoun, Lisa , Hills, Danny , Montana-Hoyos, Carlos Alberto
- Date: 2017
- Type: Text , Conference proceedings
- Relation: Proceedings of the Fourth International Conference on Design4Health 2017; Centre for Design Innovation, Swinburne University of Technology, Australia; p. 103-105
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Mentors supporting nurses transitioning to primary healthcare roles : a practice improvement initiative
- Rossiter, Rachel, Robinson, Tracy, Cox, Rebekah, Collison, Lisa, Hills, Danny
- Authors: Rossiter, Rachel , Robinson, Tracy , Cox, Rebekah , Collison, Lisa , Hills, Danny
- Date: 2024
- Type: Text , Journal article
- Relation: SAGE Open Nursing Vol. 10, no. (2024), p.
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- Description: Introduction: Effective primary healthcare services have been identified by the World Health Organization as the most equitable approach to enhancing universal healthcare. Robust models of mentoring for registered nurses (RNs) transitioning to primary healthcare roles have yet to be described in the Australian context. A robust mentoring model can support RNs to fulfill their potential, bridging the gap between theory and practice. In 2015, the peak body for nurses in primary health care (PHC) began developing a transition to practice program, including embedded mentoring to support newly graduated and more experienced registered and enrolled nurses. This quality improvement study reports the experiences and perspectives of nurses participating as mentors in two separate offerings of the program delivered between 2019 and 2021. Method: A two-phase concurrent mixed methods evaluation utilized data from pre- and post online surveys and post program meetings. Quantitative items underwent descriptive analyses. Thematic analysis of free-text responses and comments was conducted independently by two researchers. Mentors voluntarily provided self-report data and were informed that data is routinely collected to support continuous quality improvement processes for all programs. An Information Sheet informed mentors of data usage, confidentiality, and options to withdraw without penalty from the program at any time. Results: Seventy-nine mentors were recruited to support two groups of nurses (N = 111). Mentor self-rated overall satisfaction with program participation was 86.67% (very or extremely satisfied). Mentors described being “witness to mentee growth,” “having facilitated access to learning” and receiving “unexpected benefits” including personal and professional growth and enhanced enthusiasm for their role in PHC. Conclusion: The embedded mentoring reported in this article combined a focus on skills acquisition and professional identity with the provision of a range of resources and support activities. Sustainable mentoring programs will be an important mechanism for supporting the expanding roles required of nurses working in primary health. © The Author(s) 2024.
- Authors: Rossiter, Rachel , Robinson, Tracy , Cox, Rebekah , Collison, Lisa , Hills, Danny
- Date: 2024
- Type: Text , Journal article
- Relation: SAGE Open Nursing Vol. 10, no. (2024), p.
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- Description: Introduction: Effective primary healthcare services have been identified by the World Health Organization as the most equitable approach to enhancing universal healthcare. Robust models of mentoring for registered nurses (RNs) transitioning to primary healthcare roles have yet to be described in the Australian context. A robust mentoring model can support RNs to fulfill their potential, bridging the gap between theory and practice. In 2015, the peak body for nurses in primary health care (PHC) began developing a transition to practice program, including embedded mentoring to support newly graduated and more experienced registered and enrolled nurses. This quality improvement study reports the experiences and perspectives of nurses participating as mentors in two separate offerings of the program delivered between 2019 and 2021. Method: A two-phase concurrent mixed methods evaluation utilized data from pre- and post online surveys and post program meetings. Quantitative items underwent descriptive analyses. Thematic analysis of free-text responses and comments was conducted independently by two researchers. Mentors voluntarily provided self-report data and were informed that data is routinely collected to support continuous quality improvement processes for all programs. An Information Sheet informed mentors of data usage, confidentiality, and options to withdraw without penalty from the program at any time. Results: Seventy-nine mentors were recruited to support two groups of nurses (N = 111). Mentor self-rated overall satisfaction with program participation was 86.67% (very or extremely satisfied). Mentors described being “witness to mentee growth,” “having facilitated access to learning” and receiving “unexpected benefits” including personal and professional growth and enhanced enthusiasm for their role in PHC. Conclusion: The embedded mentoring reported in this article combined a focus on skills acquisition and professional identity with the provision of a range of resources and support activities. Sustainable mentoring programs will be an important mechanism for supporting the expanding roles required of nurses working in primary health. © The Author(s) 2024.
Models and interventions to promote and support engagement of first nations women with maternal and child health services : an integrative literature review
- Austin, Catherine, Hills, Danny, Cruickshank, Mary
- Authors: Austin, Catherine , Hills, Danny , Cruickshank, Mary
- Date: 2022
- Type: Text , Journal article
- Relation: Children Vol. 9, no. 5 (2022), p.
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- Description: Background: Studies show that participation in maternal and child health (MCH) services improves health outcomes for First Nations families. However, accessing MCH services can be associated with fear, anxiety, and low attendance at subsequent appointments. Objective: To identify the existing knowledge of models/interventions that support engagement of First Nations women with MCH services in the child’s first five years. Methods: An integrative review was undertaken of full-text, peer-reviewed journal articles and grey literature, which were analysed to identify barriers and enabling factors that influenced the engagement of First Nations families with MCH services. Results: Enabling factors that influenced the engagement with MCH services included service models/interventions that are timely and appropriate, and effective integrated community-based services that are flexible, holistic, culturally strong, and encourage earlier identification of risk and further assessment, intervention, referral, and support from the antenatal period to the child’s fifth birthday. Barriers to engagement included inefficient communication, lack of understanding, cultural differences between the client and the provider, poor continuity of care, limited flexibility of service delivery to meet individual needs, and a health care model that does not recognise the importance of the social determinants of health and wellbeing. Discussion: Timely, effective, holistic engagement with First Nations women during their child’s first 2000 days, which respects their culture and facilitates genuine partnerships built on co-design and shared decision making with the indigenous community, needs to be an essential part of the MCH service model if health care providers seek to practise within First Nations communities. Conclusion: Improving engagement with MCH services is important for First Nations families, the nursing practice, and public health. © 2022 by the authors. Licensee MDPI, Basel, Switzerland.
- Authors: Austin, Catherine , Hills, Danny , Cruickshank, Mary
- Date: 2022
- Type: Text , Journal article
- Relation: Children Vol. 9, no. 5 (2022), p.
- Full Text:
- Reviewed:
- Description: Background: Studies show that participation in maternal and child health (MCH) services improves health outcomes for First Nations families. However, accessing MCH services can be associated with fear, anxiety, and low attendance at subsequent appointments. Objective: To identify the existing knowledge of models/interventions that support engagement of First Nations women with MCH services in the child’s first five years. Methods: An integrative review was undertaken of full-text, peer-reviewed journal articles and grey literature, which were analysed to identify barriers and enabling factors that influenced the engagement of First Nations families with MCH services. Results: Enabling factors that influenced the engagement with MCH services included service models/interventions that are timely and appropriate, and effective integrated community-based services that are flexible, holistic, culturally strong, and encourage earlier identification of risk and further assessment, intervention, referral, and support from the antenatal period to the child’s fifth birthday. Barriers to engagement included inefficient communication, lack of understanding, cultural differences between the client and the provider, poor continuity of care, limited flexibility of service delivery to meet individual needs, and a health care model that does not recognise the importance of the social determinants of health and wellbeing. Discussion: Timely, effective, holistic engagement with First Nations women during their child’s first 2000 days, which respects their culture and facilitates genuine partnerships built on co-design and shared decision making with the indigenous community, needs to be an essential part of the MCH service model if health care providers seek to practise within First Nations communities. Conclusion: Improving engagement with MCH services is important for First Nations families, the nursing practice, and public health. © 2022 by the authors. Licensee MDPI, Basel, Switzerland.
Newly qualified graduate nurses’ experiences of workplace incivility in Australian hospital settings
- Mammen, Bindu, Hills, Danny, Lam, Louisa
- Authors: Mammen, Bindu , Hills, Danny , Lam, Louisa
- Date: 2018
- Type: Text , Journal article
- Relation: Collegian Vol. 25, no. 6 (2018), p. 591-599
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- Description: Background: Workplace incivility is a well-documented issue of concern known to negatively impact on new graduate nurses’ confidence, which in turn may affect the quality of patient care. However, there is lack of qualitative research that solely focuses on workplace incivility experiences of new graduate registered nurses enrolled in graduate nurse programs. Aim: This paper aims to explore new graduate nurses’ experiences of workplace incivility while enrolled in graduate nurse programs Method: A descriptive-qualitative method was used to discover the ‘who, what, and where’ of events and experiences, and assist in understanding the perceptions of newly qualified nurses, through face-to-face, in-depth interviews. After transcription, the interviews were analysed by thematic analysis. Findings: Four major themes emerged: ‘realising vulnerability’ ‘sensing self actualisation’ ‘changing expectations’ and ‘yearning for respect, support & information’. Discussion: Our interpretations of what participants said suggest that workplace incivility is an extant issue in nurses’ supportive graduate year, with the temporary employment status offered by the graduate nurse program being identified as a major contributing factor. Paradoxically, the relatively short duration of clinical rotation was also found to be a morale booster, as the new graduate nurses knew that any conflict experienced would cease, which therefore acted as a decisive factor for their continuation in nursing. Conclusion: This study has provided more depth and insight into the experiences of incivility experienced by new graduate nurses, highlighting that the role of temporary employment as a major causative element for exposure to workplace incivility. Graduate nurse programs could be strengthened, with additional support provided for each rotation and throughout the graduate year.
Newly qualified graduate nurses’ experiences of workplace incivility in Australian hospital settings
- Authors: Mammen, Bindu , Hills, Danny , Lam, Louisa
- Date: 2018
- Type: Text , Journal article
- Relation: Collegian Vol. 25, no. 6 (2018), p. 591-599
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- Description: Background: Workplace incivility is a well-documented issue of concern known to negatively impact on new graduate nurses’ confidence, which in turn may affect the quality of patient care. However, there is lack of qualitative research that solely focuses on workplace incivility experiences of new graduate registered nurses enrolled in graduate nurse programs. Aim: This paper aims to explore new graduate nurses’ experiences of workplace incivility while enrolled in graduate nurse programs Method: A descriptive-qualitative method was used to discover the ‘who, what, and where’ of events and experiences, and assist in understanding the perceptions of newly qualified nurses, through face-to-face, in-depth interviews. After transcription, the interviews were analysed by thematic analysis. Findings: Four major themes emerged: ‘realising vulnerability’ ‘sensing self actualisation’ ‘changing expectations’ and ‘yearning for respect, support & information’. Discussion: Our interpretations of what participants said suggest that workplace incivility is an extant issue in nurses’ supportive graduate year, with the temporary employment status offered by the graduate nurse program being identified as a major contributing factor. Paradoxically, the relatively short duration of clinical rotation was also found to be a morale booster, as the new graduate nurses knew that any conflict experienced would cease, which therefore acted as a decisive factor for their continuation in nursing. Conclusion: This study has provided more depth and insight into the experiences of incivility experienced by new graduate nurses, highlighting that the role of temporary employment as a major causative element for exposure to workplace incivility. Graduate nurse programs could be strengthened, with additional support provided for each rotation and throughout the graduate year.
- Mammen, Bindu, Lam, Louisa, Hills, Danny
- Authors: Mammen, Bindu , Lam, Louisa , Hills, Danny
- Date: 2023
- Type: Text , Journal article , Review
- Relation: Nurse Education in Practice Vol. 69, no. (2023), p.
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- Description: Aim: To explore, identify and integrate the existing knowledge to categorise the characteristics, likelihood, and consequences of workplace incivility among newly qualified graduate registered nurses. A particular focus of this review is on the experiences of new nurses related to these negative workplace behaviours and the strategies employed by these nurses and their organisations to manage workplace incivility. Background: Workplace incivility has been widely recognised as a global problem in healthcare settings and is known to affect nurses in all facets of their professional and personal life. This might be particularly harmful for newly qualified graduate nurses, as they are unprepared to deal with this uncivil culture. Design: An integrative review of the global literature, conducted according to the Whittemore and Knafl framework. Methods: Database searches (CINAHL, OVID Medline, PubMed, Scopus, Ovid Emcare and PsycINFO), and manual searching generated an aggregate of 1904 articles, which were further screened based on inclusion criteria and eligibility using the Mixed Methods Appraisal Tool (MMAT). Peer-reviewed empirical studies that explored the workplace incivility experiences of new graduate nurses were included in this review. Extracted data were grouped to develop themes and sub-themes. Results: This review included 14 studies in total with seven quantitative and seven qualitative studies. The data collected from these studies were categorised according to the research questions into a) expectations of civility, b) experiences and exposure to workplace incivility, c) forms and characteristics of incivility, d) sources of incivility, e) consequences of incivility, and f) managing and coping with incivility. Across studies, graduate nurses' views about the prestige and power of the nursing profession are conflicted due to experiences of incivility in clinical practice. New graduate nurses experienced a high but variable prevalence of incivility from their co-workers (25.6–87 %), with manifestations of incivility varying greatly, including eye rolling, yelling, exclusion and sexual harassment. Included studies primarily focused on professional and organisational effects and their outcomes relative to the physical and psychological effects on new nurses. Conclusion: Findings from the literature demonstrate that incivility directed toward newly qualified graduate nurses is prevalent and can have significant negative impact on their self-esteem and confidence, which may ultimately impact on their workforce participation decisions and the quality of patient care. Supportive and empowering work environments are vital not only for improved nurse health and well-being, but also to retain new graduate nurses. The current nursing shortage emphasises the need for such conditions. © 2023 Elsevier Ltd
Nurse leadership in promoting and supporting civility in health care settings : a scoping review
- Ota, Marianne, Lam, Louisa, Gilbert, Julia, Hills, Danny
- Authors: Ota, Marianne , Lam, Louisa , Gilbert, Julia , Hills, Danny
- Date: 2022
- Type: Text , Journal article , Review
- Relation: Journal of Nursing Management Vol. 30, no. 8 (2022), p. 4221-4233
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- Description: Aim: This scoping review aimed to identify the existing evidence on how nurse leaders promote and maintain civility amongst nurses in health care settings. Background: Research on managing workplace incivility in nursing, a prevalent and concerning issue worldwide, recommends nurse leaders to command cultural change through strong leadership and civility interventions. However, there is very little empirical evidence summarizing and analysing how nurse leaders pragmatically achieve civility, and combat workplace incivility, in the health care setting. Evaluation: A scoping review was undertaken using the electronic databases CINAHL, Emerald Insight, MEDLINE, PsychINFO, PubMed and Scopus. Google Scholar was used to search for grey literature. Key issues: The eight studies included in this review describe how nurse leaders promote and maintain civility under four key themes: (1) creating a shared vision, (2) educating self and others, (3) fostering accountability and (4) providing support. Conclusion: The review provides an overview of commonly used strategies and actions that pragmatically promote and maintain civility in the health care setting by nurse leaders, while also highlighting areas of future research needed to strengthen the evidence base. Implications for Nursing Management: It is important for nurse leaders to gain an understanding of evidence-based practices when addressing workplace incivility in order to address this prevailing problem for the future and safety of nurses moving forward. © 2022 The Authors. Journal of Nursing Management published by John Wiley & Sons Ltd.
- Authors: Ota, Marianne , Lam, Louisa , Gilbert, Julia , Hills, Danny
- Date: 2022
- Type: Text , Journal article , Review
- Relation: Journal of Nursing Management Vol. 30, no. 8 (2022), p. 4221-4233
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- Description: Aim: This scoping review aimed to identify the existing evidence on how nurse leaders promote and maintain civility amongst nurses in health care settings. Background: Research on managing workplace incivility in nursing, a prevalent and concerning issue worldwide, recommends nurse leaders to command cultural change through strong leadership and civility interventions. However, there is very little empirical evidence summarizing and analysing how nurse leaders pragmatically achieve civility, and combat workplace incivility, in the health care setting. Evaluation: A scoping review was undertaken using the electronic databases CINAHL, Emerald Insight, MEDLINE, PsychINFO, PubMed and Scopus. Google Scholar was used to search for grey literature. Key issues: The eight studies included in this review describe how nurse leaders promote and maintain civility under four key themes: (1) creating a shared vision, (2) educating self and others, (3) fostering accountability and (4) providing support. Conclusion: The review provides an overview of commonly used strategies and actions that pragmatically promote and maintain civility in the health care setting by nurse leaders, while also highlighting areas of future research needed to strengthen the evidence base. Implications for Nursing Management: It is important for nurse leaders to gain an understanding of evidence-based practices when addressing workplace incivility in order to address this prevailing problem for the future and safety of nurses moving forward. © 2022 The Authors. Journal of Nursing Management published by John Wiley & Sons Ltd.
Nurses transitioning to primary health care in Australia : a practice improvement initiative
- Cox, Rebekah, Robinson, Tracy, Rossiter, Rachel, Collison, Lisa, Hills, Danny
- Authors: Cox, Rebekah , Robinson, Tracy , Rossiter, Rachel , Collison, Lisa , Hills, Danny
- Date: 2023
- Type: Text , Journal article
- Relation: SAGE Open Nursing Vol. 9, no. (2023), p.
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- Description: Introduction: Current nursing programs provide little pre-registration information and clinical exposure to primary health care nursing practice. Newly graduated nurses and those transitioning to primary health care report disorientation and confusion. Limited knowledge about the ideal elements of a program to support transitioning nurses is an imperative to understand how best to support nurses during this period. The peak body for nurses in primary health care was funded to develop and implement a 1-year transition to practice improvement initiative for nurses in Australia about to be employed in or who are new to primary health care. This quality improvement evaluation study aimed to determine the impact of the transition program on participants’ nursing knowledge, skills, and confidence, and their overall satisfaction with the program. Methods: A mixed methods evaluation of the project utilized data from online pre- and post-participation surveys, mentor meetings, and field notes. Descriptive statistics and paired t-tests were employed for quantitative items. Free text and field notes were subject to broad thematic analysis. Findings from qualitative and quantitative data were triangulated. Results: Ninety-three nurse participants and 62 mentors were recruited. There were statistically significant differences between mean summed post-completion and pre-completion self-assessment rating scores for knowledge, skills, and confidence. Program elements were well received. The orientation workshop, mentoring, and education activities were identified as most influential in supporting transition. The self-assessment framework was identified as least influential. Conclusion: A 12-month transition program was effective in building the knowledge, skills, and confidence of participants to deliver comprehensive and effective nursing services. © The Author(s) 2023.
- Authors: Cox, Rebekah , Robinson, Tracy , Rossiter, Rachel , Collison, Lisa , Hills, Danny
- Date: 2023
- Type: Text , Journal article
- Relation: SAGE Open Nursing Vol. 9, no. (2023), p.
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- Description: Introduction: Current nursing programs provide little pre-registration information and clinical exposure to primary health care nursing practice. Newly graduated nurses and those transitioning to primary health care report disorientation and confusion. Limited knowledge about the ideal elements of a program to support transitioning nurses is an imperative to understand how best to support nurses during this period. The peak body for nurses in primary health care was funded to develop and implement a 1-year transition to practice improvement initiative for nurses in Australia about to be employed in or who are new to primary health care. This quality improvement evaluation study aimed to determine the impact of the transition program on participants’ nursing knowledge, skills, and confidence, and their overall satisfaction with the program. Methods: A mixed methods evaluation of the project utilized data from online pre- and post-participation surveys, mentor meetings, and field notes. Descriptive statistics and paired t-tests were employed for quantitative items. Free text and field notes were subject to broad thematic analysis. Findings from qualitative and quantitative data were triangulated. Results: Ninety-three nurse participants and 62 mentors were recruited. There were statistically significant differences between mean summed post-completion and pre-completion self-assessment rating scores for knowledge, skills, and confidence. Program elements were well received. The orientation workshop, mentoring, and education activities were identified as most influential in supporting transition. The self-assessment framework was identified as least influential. Conclusion: A 12-month transition program was effective in building the knowledge, skills, and confidence of participants to deliver comprehensive and effective nursing services. © The Author(s) 2023.
Nursing perspectives on reducing sedentary behaviour in sub-acute hospital settings : a mixed methods study
- Hills, Danny, Ekegren, Christina, Plummer, Virginia, Freene, Nicole, Kunstler, Breanne, Robinson, Tracy, Healy, Ellen, Vo, Jennifer, Gasevic, Danijela, Crabtree, Amelia
- Authors: Hills, Danny , Ekegren, Christina , Plummer, Virginia , Freene, Nicole , Kunstler, Breanne , Robinson, Tracy , Healy, Ellen , Vo, Jennifer , Gasevic, Danijela , Crabtree, Amelia
- Date: 2022
- Type: Text , Journal article
- Relation: Journal of Clinical Nursing Vol. 31, no. 9-10 (2022), p. 1348-1361
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- Description: Aim and objectives: To determine the factors influencing nurses’ decisions and capacity to reduce sedentary behaviour in hospital inpatients in sub-acute hospital settings. Background: Sedentary behaviour in hospital inpatients is a complex issue that can be resistant to resolution. There is little research investigating factors influencing nurses’ promotion of reduced levels of sedentary behaviour in sub-acute hospital settings. Design: An explanatory sequential design was employed, comprising quantitative and qualitative phases. Methods: An online survey was conducted with a convenience sample of 138 nurses from five Australian states. Logistic regression modelling identified demographic and behavioural characteristics of nurses who often encouraged patients to reduce their sedentary behaviour. In-depth interviews were conducted with 11 ward nurses and nurse managers, with the content subjected to thematic analysis. STROBE and GRAMMS checklists were employed. Results: Nurses recognised their role in promoting reduced sedentary behaviour but faced a range of personal and organisational barriers in achieving this outcome for patients. Few nurses were aware of national physical activity and sedentary behaviour guidelines. Five themes emerged from interviews (nursing role, care challenges, expectations of advocates, teamwork and improving the experience). Overall, many nurses experienced a lack of agency in promoting reduced sedentary behaviour and cognitive dissonance in feeling unable to undertake this role. Conclusions: The results of this study are significant in confirming that reducing sedentary behaviour in hospital inpatients is influenced by a range of complex and multi-level factors. There is a fundamental need for organisational and clinical leadership in building a culture and climate in which staff feel empowered to promote reduced sedentary behaviour in their patients. Relevance to clinical practice: The results of this study highlight the importance of taking action to reduce sedentary behaviour in sub-acute hospital settings. A co-design approach to developing interventions in local health services is warranted. © 2021 John Wiley & Sons Ltd.
- Authors: Hills, Danny , Ekegren, Christina , Plummer, Virginia , Freene, Nicole , Kunstler, Breanne , Robinson, Tracy , Healy, Ellen , Vo, Jennifer , Gasevic, Danijela , Crabtree, Amelia
- Date: 2022
- Type: Text , Journal article
- Relation: Journal of Clinical Nursing Vol. 31, no. 9-10 (2022), p. 1348-1361
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- Description: Aim and objectives: To determine the factors influencing nurses’ decisions and capacity to reduce sedentary behaviour in hospital inpatients in sub-acute hospital settings. Background: Sedentary behaviour in hospital inpatients is a complex issue that can be resistant to resolution. There is little research investigating factors influencing nurses’ promotion of reduced levels of sedentary behaviour in sub-acute hospital settings. Design: An explanatory sequential design was employed, comprising quantitative and qualitative phases. Methods: An online survey was conducted with a convenience sample of 138 nurses from five Australian states. Logistic regression modelling identified demographic and behavioural characteristics of nurses who often encouraged patients to reduce their sedentary behaviour. In-depth interviews were conducted with 11 ward nurses and nurse managers, with the content subjected to thematic analysis. STROBE and GRAMMS checklists were employed. Results: Nurses recognised their role in promoting reduced sedentary behaviour but faced a range of personal and organisational barriers in achieving this outcome for patients. Few nurses were aware of national physical activity and sedentary behaviour guidelines. Five themes emerged from interviews (nursing role, care challenges, expectations of advocates, teamwork and improving the experience). Overall, many nurses experienced a lack of agency in promoting reduced sedentary behaviour and cognitive dissonance in feeling unable to undertake this role. Conclusions: The results of this study are significant in confirming that reducing sedentary behaviour in hospital inpatients is influenced by a range of complex and multi-level factors. There is a fundamental need for organisational and clinical leadership in building a culture and climate in which staff feel empowered to promote reduced sedentary behaviour in their patients. Relevance to clinical practice: The results of this study highlight the importance of taking action to reduce sedentary behaviour in sub-acute hospital settings. A co-design approach to developing interventions in local health services is warranted. © 2021 John Wiley & Sons Ltd.
- Engel, Lidia, Brijnath, Bianca, Chong, Terence, Hills, Danny, Hjorth, Larissa, Loi, Samantha, Majmudar, Ishani, Mihalopoulos, Cathrine, Gerber, Katrin
- Authors: Engel, Lidia , Brijnath, Bianca , Chong, Terence , Hills, Danny , Hjorth, Larissa , Loi, Samantha , Majmudar, Ishani , Mihalopoulos, Cathrine , Gerber, Katrin
- Date: 2023
- Type: Text , Journal article
- Relation: Death Studies Vol. 47, no. 9 (2023), p. 994-1005
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- Description: Older people experience bereavements more often than any other age group. National survey data collected across Australia from 633 bereaved adults aged 65+ years showed that 21% met the criteria for prolonged grief. Their quality of life was significantly lower and loneliness significantly higher compared to older people in the general population. Risk factors for the low quality of life and high loneliness post-bereavement included being female, experiencing the death of a partner, and being the full-time carer of the deceased. Time since bereavement, expectedness, and cause of death were not significantly associated with quality of life and loneliness. © 2022 Taylor & Francis Group, LLC.
- Hills, Danny, Tribe, Ruby, Weng, Cheng-Wei, Chong, Grace, Ng, Tracy, Koh, Jo-Lynn, Chen, Shao-Ming, An, Sharon, Jhaung, Debbie, Gardner, Paul, Ilami, Hariz, Seow, Emmaline, Ting-Yu, Lin, Qi, Tan, Hao, Li, Carey, Dayna
- Authors: Hills, Danny , Tribe, Ruby , Weng, Cheng-Wei , Chong, Grace , Ng, Tracy , Koh, Jo-Lynn , Chen, Shao-Ming , An, Sharon , Jhaung, Debbie , Gardner, Paul , Ilami, Hariz , Seow, Emmaline , Ting-Yu, Lin , Qi, Tan , Hao, Li , Carey, Dayna
- Date: 2021
- Type: Text , Book chapter
- Relation: Cross-Cultural Design for Healthy Ageing p. 133-159
- Full Text: false
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Sustaining rural pharmacy workforce understanding key attributes for enhanced retention and recruitment
- Terry, Daniel, Peck, Blake, Hills, Danny, Bishop, Jaclyn, Kirschbaum, Mark, Obamiro, Kehinde, Phan, Hoang, Baker, Ed, Schmitz, David
- Authors: Terry, Daniel , Peck, Blake , Hills, Danny , Bishop, Jaclyn , Kirschbaum, Mark , Obamiro, Kehinde , Phan, Hoang , Baker, Ed , Schmitz, David
- Date: 2023
- Type: Text , Journal article
- Relation: Australian Journal of Rural Health Vol. 31, no. 2 (2023), p. 218-229
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- Description: Objective: To pilot the Pharmacist Community Apgar Questionnaire (PharmCAQ) and evaluate its usability and capacity to develop a greater understanding of the unique factors that impact the rural recruitment and retention of pharmacists. Design: Cross-sectional design involving face-to-face, telephone or video conferencing interviews. Setting: Twelve rural communities across Tasmania and Western Victoria, Australia. Participants: Participants (n = 24) included pharmacists, a Director of Clinical Services, pharmacy practice managers and senior pharmacy assistants. Main Outcome Measures: Interviews enabled the completion of the PharmCAQ, which assigns quantitative values to 50 key factors to ascertain a community's strengths and challenges associated with recruitment and retention and their relative importance to the pharmacist workforce. Results: The cumulative PharmCAQ scores indicated the tool was sensitive enough to differentiate high- and low-performing communities. Overall, the highest-rated factors considered most vital to pharmacist recruitment and retention were the reputation of the pharmacy, the ability of the pharmacist to be independent and autonomous, the loyalty of the community to the pharmacy, the level and stability of monetary compensation and the breadth of tasks available to a pharmacist. Conclusions: This study identified the strengths and challenges of participating communities and provided an insight into the shared factors to consider in recruiting and retaining pharmacists. Further, each community has unique strengths that can further be promoted in recruitment, flagging where limited resources are best used to address site specific challenges. This is more likely to ensure the matching of the right candidate with the right community. © 2022 The Authors. Australian Journal of Rural Health published by John Wiley & Sons Australia, Ltd on behalf of National Rural Health Alliance Ltd.
- Authors: Terry, Daniel , Peck, Blake , Hills, Danny , Bishop, Jaclyn , Kirschbaum, Mark , Obamiro, Kehinde , Phan, Hoang , Baker, Ed , Schmitz, David
- Date: 2023
- Type: Text , Journal article
- Relation: Australian Journal of Rural Health Vol. 31, no. 2 (2023), p. 218-229
- Full Text:
- Reviewed:
- Description: Objective: To pilot the Pharmacist Community Apgar Questionnaire (PharmCAQ) and evaluate its usability and capacity to develop a greater understanding of the unique factors that impact the rural recruitment and retention of pharmacists. Design: Cross-sectional design involving face-to-face, telephone or video conferencing interviews. Setting: Twelve rural communities across Tasmania and Western Victoria, Australia. Participants: Participants (n = 24) included pharmacists, a Director of Clinical Services, pharmacy practice managers and senior pharmacy assistants. Main Outcome Measures: Interviews enabled the completion of the PharmCAQ, which assigns quantitative values to 50 key factors to ascertain a community's strengths and challenges associated with recruitment and retention and their relative importance to the pharmacist workforce. Results: The cumulative PharmCAQ scores indicated the tool was sensitive enough to differentiate high- and low-performing communities. Overall, the highest-rated factors considered most vital to pharmacist recruitment and retention were the reputation of the pharmacy, the ability of the pharmacist to be independent and autonomous, the loyalty of the community to the pharmacy, the level and stability of monetary compensation and the breadth of tasks available to a pharmacist. Conclusions: This study identified the strengths and challenges of participating communities and provided an insight into the shared factors to consider in recruiting and retaining pharmacists. Further, each community has unique strengths that can further be promoted in recruitment, flagging where limited resources are best used to address site specific challenges. This is more likely to ensure the matching of the right candidate with the right community. © 2022 The Authors. Australian Journal of Rural Health published by John Wiley & Sons Australia, Ltd on behalf of National Rural Health Alliance Ltd.
The pharmacy community apgar questionnaire : a modified Delphi technique to develop a rural pharmacist recruitment and retention tool
- Terry, Daniel, Peck, Blake, Hills, Danny, Bishop, Jaclyn, Kirschbaum, Mark, Obamiro, Kehinde, Phan, Hoang, Baker, Ed, Schmitz, David
- Authors: Terry, Daniel , Peck, Blake , Hills, Danny , Bishop, Jaclyn , Kirschbaum, Mark , Obamiro, Kehinde , Phan, Hoang , Baker, Ed , Schmitz, David
- Date: 2022
- Type: Text , Journal article
- Relation: Rural and remote health Vol. 22, no. 4 (2022), p. 7347
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- Description: INTRODUCTION: An adequate healthcare workforce remains essential for the health of rural communities. Strategies to address rural health workforce challenges have often centred on the medical and nursing workforce; however, addressing the rural pharmacist workforce also remains critical as they are often the first point of contact for health advice. Initiatives have increased pharmacist supply; however, key issues such as poor attraction, recruitment, and retention to rural areas remain. The aim of this study was to support the recruitment and retention of pharmacists in rural areas of Australia through the development of the Pharmacy Community Apgar Questionnaire (PharmCAQ). METHODS: A modified Delphi technique was employed to develop the PharmCAQ. A panel of experts were purposively selected. Eight representatives were from organisations with rural experience relevant to the study including the Society of Hospital Pharmacists of Australia, the Pharmaceutical Society of Australia, the Pharmacy Guild of Australia, the Pharmacy Board of Australia, and a representative of a government health agency, who also leads a hospital pharmacy. Three additional participants included local and international academics with health policy and rural health workforce expertise. All participants participated in three separate focus groups of 45-60 minutes duration, where the review and refinement of factors that drive recruitment and retention of pharmacist were discussed. Face and content validity was achieved through the representatives, while internal consistency was achieved when the tool was piloted among 10 rural pharmacists in rural Victoria. RESULTS: Fifty key factors that impact the recruitment and retention of pharmacists were identified, developed and succinctly described. All factors were grouped into five classifications: (1) geographic, (2) economic and resources, (3) practice and scope of practice, (4) practice environment and (5) community practice support. After final consensus, the factors and their definitions formed the final questionnaire. Lastly, the reliability of PharmCAQ was determined, with a Cronbach's alpha coefficient of 0.852. CONCLUSION: While the development and use of the Apgar questionnaire for the recruitment and retention of health professionals is not a novel idea, seeking to specifically focus on pharmacists is unique. However, 10 factors were similar to factors associated with rural recruitment and retention of both physicians and nurses; they encompassed geographic, community support, and economic and resource factors. Regardless of similarities or differences between health professions in terms of recruitment and retention, as a mechanism for addressing the worsening health professional shortage currently experienced in rural areas, the PharmCAQ was developed to support the recruitment and retention of the pharmacist workforce in rural areas.
- Authors: Terry, Daniel , Peck, Blake , Hills, Danny , Bishop, Jaclyn , Kirschbaum, Mark , Obamiro, Kehinde , Phan, Hoang , Baker, Ed , Schmitz, David
- Date: 2022
- Type: Text , Journal article
- Relation: Rural and remote health Vol. 22, no. 4 (2022), p. 7347
- Full Text:
- Reviewed:
- Description: INTRODUCTION: An adequate healthcare workforce remains essential for the health of rural communities. Strategies to address rural health workforce challenges have often centred on the medical and nursing workforce; however, addressing the rural pharmacist workforce also remains critical as they are often the first point of contact for health advice. Initiatives have increased pharmacist supply; however, key issues such as poor attraction, recruitment, and retention to rural areas remain. The aim of this study was to support the recruitment and retention of pharmacists in rural areas of Australia through the development of the Pharmacy Community Apgar Questionnaire (PharmCAQ). METHODS: A modified Delphi technique was employed to develop the PharmCAQ. A panel of experts were purposively selected. Eight representatives were from organisations with rural experience relevant to the study including the Society of Hospital Pharmacists of Australia, the Pharmaceutical Society of Australia, the Pharmacy Guild of Australia, the Pharmacy Board of Australia, and a representative of a government health agency, who also leads a hospital pharmacy. Three additional participants included local and international academics with health policy and rural health workforce expertise. All participants participated in three separate focus groups of 45-60 minutes duration, where the review and refinement of factors that drive recruitment and retention of pharmacist were discussed. Face and content validity was achieved through the representatives, while internal consistency was achieved when the tool was piloted among 10 rural pharmacists in rural Victoria. RESULTS: Fifty key factors that impact the recruitment and retention of pharmacists were identified, developed and succinctly described. All factors were grouped into five classifications: (1) geographic, (2) economic and resources, (3) practice and scope of practice, (4) practice environment and (5) community practice support. After final consensus, the factors and their definitions formed the final questionnaire. Lastly, the reliability of PharmCAQ was determined, with a Cronbach's alpha coefficient of 0.852. CONCLUSION: While the development and use of the Apgar questionnaire for the recruitment and retention of health professionals is not a novel idea, seeking to specifically focus on pharmacists is unique. However, 10 factors were similar to factors associated with rural recruitment and retention of both physicians and nurses; they encompassed geographic, community support, and economic and resource factors. Regardless of similarities or differences between health professions in terms of recruitment and retention, as a mechanism for addressing the worsening health professional shortage currently experienced in rural areas, the PharmCAQ was developed to support the recruitment and retention of the pharmacist workforce in rural areas.