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Introduction. In Australia, the rural health care environment is characterized by increasing disadvantage in relation to access to services and resources. Within this context, health professionals are challenged to provide what they feel is good-quality health care in a community of which they are a part. This paper presents the results of a study which aimed to • identify challenges confronting health care professionals in rural acute care settings and • facilitate interprofessional collaboration in working toward improved patient outcomes and staff participation. Method. A mixed method approach involved a consultative, participatory process. An initial survey was followed by focus groups and workshops. The target population was health care professionals across disciplines, in rural acute care facilities within one large Area Health Service in NSW, Australia. Workshops facilitated interdisciplinary collaboration to identify strategies for addressing concerns with the aim of developing priorities for practice change projects. Results. Results highlighted issues to do with staffing, isolation and communication as most significantly impacting on staff and patient outcomes. Access to resources and support services was the most frequently cited challenge. Results were consistent across professions and sites within the Area Health service. Focus groups identified a range of issues related to geographic and professional isolation, working with and apart from larger centers, generalist practice, and insufficient services and staff. Conclusion. Findings point to the urgent need to support clinicians through the mobilization of strategies that are context specific, locally based and led, but at the same time transferrable across sites.
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The Asia Pacific region is a vast geographical area in the Southern Hemisphere comprising 48 countries, with sharp contrasts in economics and social conditions. Due to longer life expectancies, ageing populations and smaller families, ageing persons will require much health and social care in the future. "From abstract"
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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.
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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.
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Health care in most contexts depends on teams of professionals with diverse skills working together synergistically to achieve optimal outcomes for patients and their families. The way is which interprofessional practice occurs in rural healthcare varies from that which occurs in metropolitan areas. This variation reflects the social, economic and geographic characteristics of rural communities. Further, rural workforce challenges and lack of access to resources and services are compounded by the difficulties associated with the intersection of speciality driven metropolitan models and the generalist models of care that are a feature of rural health care. This study’s aim was to examine how IPP happens in rural contexts, and to identify barriers, enablers and existing and potential models of IPP. Interviews were conducted with health professionals (nurses, doctors and allied health) in a range of rural healthcare contexts (Hospitals, GP practices, Multi-Purpose Services and Community centres) in NSW, Australia. Interview data were supplemented with document review and review of communication systems. Findings suggest that the nature of IPP in rural contexts is diverse and determined by a number of critical factors including rurality, connection to community, availability of staff, funding programs and specific interests and skills of staff. Rural IPP is characterised by a small numbers of professionals across few professions, focus on generalist practice and informal communication systems. IPP is growing in response to changes in government funding models and policy and through the establishment or strengthening of pivotal co-ordinating roles, with a clear mandate to involve other professionals and patients in decision making.
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Aims The aim of the literature review was to identify new and emerging out of hospital emergency care roles and to describe their activity and impact. Background Demographic changes, increased demands for health services, altered working practices, and health system economic pressures have led to the development of a disparate set of new health care roles. Data sources MEDLINE, EMBASE and CINAHL databases, and the two search engines Google and Google Scholar were searched for contemporary studies in the identified study area. Review methods All publications identified through the search were assessed for relevance. Those that discussed new roles were included (n = 34) and empirical studies (n = 14) analysed in detail. Results Emergency care and paramedic practitioner roles (ECP & PP) are having an impact on patient care, including an average 25% reduction in the conveyance rate to hospital, improved inter-professional working, immediacy of treatment and referral, and high patient satisfaction. Limited economic data suggests savings of between £31 (USD 55) and £37 (USD 65) per case when ECPs replace standard ambulance responders. Concerns have been expressed about patient safety, recruitment and training levels, regulatory and role implementation issues. Conclusion Further work is required to fully understand the patient safety, clinical practice, professional role and financial implications of these new roles.
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Aims: This research explores the challenges that new nursing graduates experience whilst adapting to their new role in their first year of practice. These challenges are presented from the perspectives of Graduate Nurse Program Coordinators in the state of Victoria, Australia, previously not described in the literature. Background: Each year, thousands of new nursing graduates join the workforce in Australia, with many suffering major stressors and dissatisfaction in their first year of practice. Much has been written about challenges faced by this group from their own perspectives, yet nothing has been heard from the perspectives of those who support them; that is, the coordinators of year-long graduate nurse transition programs. Methods: This descriptive qualitative study used individual, semi-structured interviews to access information and perceptions from sixteen Graduate Nurse Program Coordinators about the challenges experienced by nursing graduates in their first year of practice. Transcripts were thematically analysed to reveal reoccurring themes and sub-themes. Results: The interviews provided an insight into various challenges that nursing graduates experience in relation to role adaptation in their first year of practice. Nursing graduates found difficulties with reality shock, work-life balancing and having unrealistic assumptions in their capacity to work, assuming they should be at a higher level despite being a beginner practitioner. Conclusions: This study reinforces the need for education providers to maintain currency in their undergraduate nursing programs and to work closely with health care services in providing a quality clinical experience to all nursing students. It also provides evidence that graduate transition programs are essential, with Graduate Nurse Program Coordinators performing a crucial role in providing appropriately planned strategies to support graduates through this vulnerable time.
Description:
Aims: This research explores the challenges that new nursing graduates experience whilst adapting to their new role in their first year of practice. These challenges are presented from the perspectives of Graduate Nurse Program Coordinators in the state of Victoria, Australia, previously not described in the literature. Background: Each year, thousands of new nursing graduates join the workforce in Australia, with many suffering major stressors and dissatisfaction in their first year of practice. Much has been written about challenges faced by this group from their own perspectives, yet nothing has been heard from the perspectives of those who support them; that is, the coordinators of year-long graduate nurse transition programs. Methods: This descriptive qualitative study used individual, semi-structured interviews to access information and perceptions from sixteen Graduate Nurse Program Coordinators about the challenges experienced by nursing graduates in their first year of practice. Transcripts were thematically analysed to reveal reoccurring themes and sub-themes. Results: The interviews provided an insight into various challenges that nursing graduates experience in relation to role adaptation in their first year of practice. Nursing graduates found difficulties with reality shock, work-life balancing and having unrealistic assumptions in their capacity to work, assuming they should be at a higher level despite being a beginner practitioner. Conclusions: This study reinforces the need for education providers to maintain currency in their undergraduate nursing programs and to work closely with health care services in providing a quality clinical experience to all nursing students. It also provides evidence that graduate transition programs are essential, with Graduate Nurse Program Coordinators performing a crucial role in providing appropriately planned strategies to support graduates through this vulnerable time.
Description:
Children are their parents’ pride and joy. Parents have hopes, dreams and expectations for their children to grow and develop in a holistic healthy manner physically, emotionally, and socially. It is an extremely vulnerable situation when the life and health of children are threatened; hence, when a child is diagnosed with a chronic condition, parents grieve for the loss of their child’s health, their expectations and dreams can be challenged, and their sense of protection, feeling of invulnerability are severely shaken. Objectives: This study focuses on Saudi parents and in particular the mothers who have children with chronic illnesses. It aimed to describe and explore the coping patterns of Saudi mothers who have chronically ill children. Method: A survey questionnaire was administered to 122 Saudi parents with chronically ill children in peadiatric wards at three public hospitals in the Jeddah region in Saudi Arabia. Demographic data, Quality of Life Scale (QOL), The General Self-efficacy scale (GSE) and Social Support Questionnaire (SSQ) were distributed to the Saudi parents with identified chronically ill children. Results: The results of the descriptive statistical analyses provided significant correlations between QOL score and GSE, between QOL and SSQ, between QOL and stress and adversity, between GES and SSQ, between stress and adversity and duration of child’s illness, and between stress and adversity and family time spent in caring activities. In addition, a nearly significant result was found between GES and stress and adversity. Conclusion: The results of the study emphasise the importance of a thorough and holistic assessment of families, their social environments and the level of support they require to assist them to cope with the chronic illness of their children.
Description:
Children are their parents’ pride and joy. Parents have hopes, dreams and expectations for their children to grow and develop in a holistic healthy manner physically, emotionally, and socially. It is an extremely vulnerable situation when the life and health of children are threatened; hence, when a child is diagnosed with a chronic condition, parents grieve for the loss of their child’s health, their expectations and dreams can be challenged, and their sense of protection, feeling of invulnerability are severely shaken. Objectives: This study focuses on Saudi parents and in particular the mothers who have children with chronic illnesses. It aimed to describe and explore the coping patterns of Saudi mothers who have chronically ill children. Method: A survey questionnaire was administered to 122 Saudi parents with chronically ill children in peadiatric wards at three public hospitals in the Jeddah region in Saudi Arabia. Demographic data, Quality of Life Scale (QOL), The General Self-efficacy scale (GSE) and Social Support Questionnaire (SSQ) were distributed to the Saudi parents with identified chronically ill children. Results: The results of the descriptive statistical analyses provided significant correlations between QOL score and GSE, between QOL and SSQ, between QOL and stress and adversity, between GES and SSQ, between stress and adversity and duration of child’s illness, and between stress and adversity and family time spent in caring activities. In addition, a nearly significant result was found between GES and stress and adversity. Conclusion: The results of the study emphasise the importance of a thorough and holistic assessment of families, their social environments and the level of support they require to assist them to cope with the chronic illness of their children.
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The purpose of this study was to evaluate the effectiveness of the Home Fall Hazards Assessment (HFHA) tool adjusted for Chinese homes to raise awareness of the dangers of falling among Chinese older adults. This descriptive study of 415 Chinese adults age 60 and older was completed in the older adults’ homes in the community. The study was an assessment by nurses of hazards in the home setting using the HFHA. The hazards identified by nurses were compared with those reported by the elderly individuals. The study identified the most frequently found hazards in the homes and showed that a large discrepancy existed between the actual hazards assessed by trained nurses using the HFHA and the perceived hazards reported by the participants (p < .001). The study suggests that the HFHA can be an effective health education method and that the involvement of older adults in the assessment process will effectively raise their awareness of existing risk factors for falls in their everyday life.
Description:
The aim of this study is to evaluate the effect of a mental health clinical placement on student nurses attitudes towards mental illness and mental health nursing. Health holds different definitions for different people. The term health can mean wellness or a state of being. Mental health in our society still is wrought with stigma. It is the use of negative labels to identify someone living with a mental illness. Stigma can be a barrier and may discourage families and individuals from seeking help. In the health care system, these barriers need to be broken, from the first contact with the health profession, these being the nurses. Nurse’s attitudes can develop for many different reasons, these being, and lack of knowledge, stigma, and prior experience with mental illness. As a health care profession, we need to start at the beginning, with assessing and encouraging more understanding and tolerance of mental illness with our student nurses. This study used a longitudinal descriptive pre-post survey design to determine the degree to which a clinical placement with a psychiatric/mental health agency changed student nurses’ attitudes towards mental illness and mental health/psychiatric nursing. Bachelor of nursing students are required to complete a mental health unit of study within the Bachelor of Nursing Degree. This unit of study required student nurses to complete a 4 week clinical placement in a mental health facility. Students were invited to complete a survey before the clinical placement and at the completion of the clinical placement. Of the (n=184) nurses invited to participate in this study, 65 completed the pre and post clinical placement surveys, giving a response rate of 35%.The results show that there is a statistical significance of .001 in the mean attitude scores towards mental illness for pre and post placement. The attitudes towards psychiatric nursing show a statistical significance of .01.Results from this study support recent literature towards a positive change in student nurses attitudes towards mental illness and mental health nursing on the completion of a clinical placement in a mental health facility.
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Context: Liver transplantation has become the treatment of choice for patients with end-stage liver disease. Most studies show a positive effect on quality of life after liver transplantation, but most studies are based on data from Western countries and little is known about quality of life in liver transplant recipients in Turkey or other developing countries. Objective: To investigate liver transplant recipients' quality of life and factors affecting it, before and 3 months after transplantation in western Turkey. Design: Descriptive and comparative, with data collected prospectively. Setting: Two medical centers in Western Turkey. Patients: Sixty-five adult recipients of a liver transplant between May 15 and December 31,2007. Instruments: Quality of life was measured by using the Nottingham Health Profile Turkish version, and sociodemographic and clinical data were collected from patients' records. Results: Scores on all subscales of the Nottingham Health Profile differed significantly from before to after liver transplantation. The differences between the mean scores for quality of life before and after transplantation varied significantly with the patients' sex and disease severity.
Description:
Background: Evidence from the literature and anecdotally from clinical settings suggests that newly graduated nurses are not fully prepared to be independent practitioners in healthcare settings. Aims and Objectives: The aim of this studywas to explore perceptions of qualified nurses in relation to the practice readiness of newly registered nursing graduates and determine whether these views differ according to specific demographic characteristics, clinical settings, and geographical locations. Design: A descriptive quantitative design was used. Methods: An online survey tool was used to assess how qualified nurses (n = 201) in Victoria, Australia, rated newly graduated nurses' abilities on 51 individual clinical skills/competencies in eight key skill areas. A composite score was calculated for each skill area and a comparative analysis was undertaken on the various cohorts of participants according to their demographic and clinical characteristics using one-way ANOVA and post hoc tests. Results: Newly graduated nurses were found to be lacking competence in two key skill areas and were rated as performing adequately in the remaining six skill areas assessed. Significant differences (p ≤ 0.05) in performance were found according to the age of the nurse, number of years registered, the educational setting in which they undertook their nurse education, their role, and the clinical area inwhich theyworked. There were no significant differences according to whether the nurse worked in the private or public healthcare sector. Few differences were found between nurses working in a metropolitan vs. regional/rural healthcare setting. Conclusion: This is the first study to quantify the scale of this problem. Our findings serve as a reference for both nurse education providers and healthcare settings in better preparing nursing graduates to be competent, safe practitioners in all clinical areas.