bluuebunny/crossref_metadata_2025 huggingface dataset:
Challenges for midwives: pregnant women and illicit drug use
Authors: Miles Maureen , Francis Karen , Chapman Ysanne
Published: June 2024

Objective: The purpose of the paper is to introduce illicit drug use as a societal problem and describes the response of the Australian Government. Specifically the paper examines the use of illicit drugs by pregnant women and the role of midwives in supporting these women throughout pregnancy and birth.
Setting: Maternity services, specifically antenatal care clinics.
Conclusion: In Australia the rate of pregnant women who use illicit drugs is escalating. These pregnancies are high obstetric risk with potential for harm to both the mother and the baby. Pregnancy however is seen as ‘window of opportunity’; a time to provide education, choices and support. The literature describes that for health professionals working with pregnant women who are illicit drug users is challenging and for some health professionals their interaction can be negative. Australia advocates harm minimisation and encourages harm reduction strategies. Midwives are in a position to implement these strategies within the maternity setting. Further research is recommended as well as professional development programs for midwives to upgrade knowledge and cultivate engagement skills to enable appropriate and positive interaction with pregnant women who use illicit drugs.
End of life clinician‑family communication in ICU: a retrospective observational study ‑ implications for nursing
Authors: Bloomer Melissa , Lee Susan , O'Connor Margaret
Published: June 2024

Objective: The objective of this study was to identify practice issues that influence end of life communication and care of patients and families in the intensive care unit (ICU).
Design: This study used a retrospective observational approach utilising a medical record review.
Setting: An Australian metropolitan mixed medical/surgical ICU.
Subjects: There are two parts to this study. The first part related to all of the patients who died in the ICU in one calendar year, a total of 97. The second part of this study related to a random selection of 25% of these patients, a total of 24.
Results: This study showed that death in the ICU was often anticipated, and that whilst communication between family and medical personnel was evident in the medical record, the involvement or occurrence of communication between the nurse and the family was not recorded, and that nurses were included in only 25% of formal family meetings.
Conclusion: Whilst this study confirmed that death is often predicted for critically ill patients, and opportunities for communication with the family or next of kin assists to achieve consensus on end of life decisions, the involvement of nurses, as primary care‑givers is not well represented in the medical record, thus undermining the importance of the nurses role in direct patient care that extends to the family in the ICU.
Behind barriers: patients’ perceptions of source isolation for Methicillin‑resistant Staphylococcus aureus (MRSA)
Authors: Barratt Ruth , Shaban Ramon , Moyle Wendy
Published: June 2024

Objective: To explore the lived experience of patients in MRSA isolation in an acute care hospital in New Zealand.
Design: Interpretive phenomenology.
Setting: Acute care hospital in New Zealand.
Participants: A purposive sample of ten adult patients with MRSA infection and under isolation precautions for more than three days.
Results: The majority of participants found some positive aspect of being accommodated in a single room; however, the overall experience of MRSA isolation was viewed as a negative one. ‘Being MRSA positive’, ‘Being with others’; and ‘Living within four walls’ were the major themes associated with participants’ experience. The central characterisation of their experience, ‘Behind barriers’, suggested that for these patients MRSA isolation imposes barriers to the expression of own identity and normal interpersonal relationships, and impacts on the delivery of quality care.
Conclusion: Source isolation for MRSA influences the quality of care and in particular the opportunity for emotional support. Consideration must be given to the design of the isolation environs and staff must be equipped with adequate infection control knowledge to ameliorate and inform patients and their families of the effects of isolation.
Investing in patients’ nutrition: nutrition risk screening in hospital
Authors: Cant Robyn
Published: June 2024

Objective: This paper explores the current state of knowledge and evidence for investing in the nutrition screening of patients in hospital.
Setting: Hospitals.
Subjects: Hospital patients; nursing care. 
Primary argument: Nutrition screening of hospital patients is widely supported in evidence‑based guidelines because poor nutritional status has a negative impact, increasing patients’ morbidity, mortality and length of hospital stay. Screening is often undertaken by nurses as part of the patient admission process and in conjunction with other health risk screening tools, although the extent of routine nutrition screening in Australian hospitals is unclear. Once a patient is screened and subsequently assessed and diagnosed with malnutrition and treatment is commenced, there is a lack of high quality evidence about the effect of this treatment on longer term patient outcomes. This has most likely restrained nursing decisions about investing nursing resources in routine nutrition screening of all targeted patients.
Conclusion: Routine screening of hospital patients for nutrition risk early in their admission is obligatory according to best evidence, though not universal in Australian hospitals. Further high quality research (eg., randomised trial) is warranted to determine the consequences of screening which appear to include positive impact of nutritional interventions upon undernourished/malnourished patients. If this data were available, administrators may recognise both economic and patient‑centred benefits of investing in systematic nutrition screening.
The Team Leader Model: an alternative to preceptorship
Authors: Russell Kylie , Hobson Ann , Watts Robin
Published: June 2024

Objective: To improve the clinical practice environment for student nurses through an increased understanding of the relationships and of the situations in which that practice occurs.
Setting: Fremantle Hospital and Health Service (FHHS) in partnership with Curtin University of Technology.
Subjects: This project sought to assess a new model of supervision and support based on a team approach, the team being a Registered Nurse, Graduate Nurse and a Student Nurse, that supported students, graduates and staff.
Main outcome measures: To determine if the students clinical placement provided a reality of practice, where the student became the leader of the shift, supervised by the supervisor. To understand the relationships of support between graduate and student nurses, and to determine if the allocation of students via the Team Leader method reduced preceptor burnout.
Results: The Team Leader Model demonstrated that it provided an improved allocation model of student supervisors, students felt a greater sense of reality of practice, and graduates appreciated the support of the Team Leader.
Conclusion: The model has been perceived by staff and students as a practice that can provide for a better clinical practice placement for the student.
Preferred models of cardiac rehabilitation in rural South Australia from a health consumer’s perspective
Authors: Wachtel Tracey
Published: June 2024

Objective: To investigate preferred models of cardiac rehabilitation (CR) in rural South Australia from a health consumer’s perspective.
Design: Cross‑sectional, descriptive pilot study.
Setting: Rural community setting.
Subjects: Convenience sample of 40 (17 male) health consumers from the Riverland.
Main outcome measure: Self‑reported preferred models of CR.
Results: A previous heart condition was reported by 57.5% of participants and 7.5% had previously been referred to CR. More than half (52%) considered their condition ‘not serious at all’ or ‘slightly serious’ despite reporting a significant cardiac history. Transport, convenience, and flexible programs were raised as major considerations for planning future services. Most participants (69%) listed their local hospital as a preferred program location, with 55% stating they would not use an internet‑based program. Overall a group program was preferred to an individual program (46% vs. 36%), with a higher proportion of men preferring an individual program.
Conclusions: The main aim of cardiac rehabilitation is to maximise health and quality of life. However it is vital to consider other characteristics of CR, such as convenience, accessibility, flexibility, and personal beliefs and preferences. Health consumer preferences are therefore an important consideration when designing future programs, to ensure interventions are individualised, and designed to increase access and attendance while minimising barriers. This pilot study provides valuable insight into health consumer preferences for health care professionals and decision makers involved in planning further needs analysis and future cardiac rehabilitation services for rural South Australia. Further research is needed to ensure findings are both rigorous and valid and to ensure the development and implementation of future programs is based on the best available evidence.
Content validity of the ResCareQA: An Australian residential care quality assessment based on resident outcomes
Authors: Courtney Mary , O'Reilly Maria , Edwards Helen , Hassall Stacey
Published: June 2024

Objective: To determine the face and content validity of the Residential Care Quality Assessment (ResCareQA) developed to fill the current gap in quality assessment tools within the Australian residential aged care system. The ResCareQA contains 24 questions across four domains: Resident Health (seven questions), Personal Care (five questions), Resident Lifestyle (five questions) and Care Environment (seven questions), and allows the easy calculation of 36 clinical indicators for an overall assessment of quality in the residential care setting.
Design: Face and content validity were assessed by using modified Delphi process to consult an expert panel of experienced aged care professionals and a consumer representative.
Setting: The Delphi questionnaire was distributed via email and all panellists completed it online in their own home or place of work.
Subjects: The expert panel constituted six members, all of whom were experienced residential aged care professionals.
Main outcome measures: The Delphi survey aimed to reach agreement about the face and content validity of the assessment tool.
Results: All agreed the ResCareQA had good face and content validity, although some minor changes were suggested to improve content validity.
Conclusion: The ResCareQA provides a comprehensive but easy to administer means of monitoring quality in residential aged care facilities, with the tool usually completed in less than 30 minutes. Example questions are included with this article.
Senior clinical nurses effectively contribute to the pandemic influenza public health response
Authors: Hope Kirsty , Massey Peter , Osbourn Maggi , Durrheim David , Kewley Christopher , Turner Catherine
Published: June 2024

Objective: To describe the experience of engaging senior clinical nurses as surge staff in a pandemic public health response and determine the effect of an on‑line training package and exercise participation on these individuals’ perceptions and confidence of being deployed during an influenza pandemic.
Design: After action reviews, end of exercise surveys, and pre‑ and post‑training risk perceptions questionnaire completion.
Setting: The study was conducted within the operational aspects of a public health exercise response to an influenza pandemic.
Subjects: Clinical nurse consultants, nurse educators and nurse managers sourced from areas defined as not clinically critical during the early containment phase of an influenza pandemic response.
Interventions: Four hour on‑line training package and a four day influenza pandemic exercise.
Main outcome measures: Expert observation and self‑perceived appropriateness of surge staff and measured changes in risk perception.
Results: Observers’ comments and after action reviews indicated that by the end of the deployment, day surge staff were able to perform public health surveillance functions competently. The end of day survey showed that the on‑line training package served as a useful reference document but alone was an inadequate means of equipping staff for deployment. Exercise pre‑ and post‑perceptions surveys found that self‑perceived knowledge and confidence in performing duties increased following the exercise from 46% to 93% (p<0.01) and from 46% to 90% (p<0.01), respectively.
Conclusion: Clinical nurse consultants, nurse educators and nurse managers working within a health authority are an appropriate surge workforce during public health emergencies if provided with appropriate training and support.
Nurses make a difference in immunisation service delivery
Authors: Desmond Natalie , Grant Cameron , Goodyear‑Smith Felicity , Turner Nikki , Petousis‑Harris Helen
Published: June 2024

Objective: The study aimed to determine nurse characteristics associated with childhood immunisation coverage and timeliness in the New Zealand primary care setting.
Design: In 2005‑2006 a survey of randomly selected practices and health providers was conducted, with multiple regression analysis to establish significant determinants of coverage and timeliness. The multivariate analysis adjusted for social deprivation, region, practice governance and the age of the children registered at each enrolled practice.
Setting: The study was conducted in family practices in two regions in New Zealand, where approximately 66% of the national population reside.
Subjects: One hundred and fifteen practice nurses employed in the primary care setting.
Main Outcome Measures: Nurse characteristics, knowledge and attitudes associated with immunisation.
Results: Immunisations were delivered by 95% of practice nurses. Factors associated with higher practice immunisation coverage and less delay were a lower ratio of nurses to children ‑ in the practice (1:1 to 1:74 (85)1:75 to 1:1290 (30) coverage P=0.04, timeliness P=0.03), nurse comfort with their own immunisation knowledge (Yes (105), No (4) coverage P<0.001, timeliness P=0.01) and their perception of parental apathy (Yes (56) No (53) coverage P=0.01, timeliness P=0.02), or fear (Yes (66) No (43) coverage P=0.01), as a barrier to immunisation.
Conclusion: Higher coverage and more timely immunisation delivery is achieved at practices where the nurse to child ratio is lower, where nurses are confident in their immunisation knowledge and are perceptive of parental attitudes which can be barriers to immunisation.
Nurses’ experience establishing a nurse‑led bladder cancer surveillance flexible cystoscopy service
Authors: Chatterton Kathryn , Bugeja Pat , Challacombe Benjamin , Anderson Paul , Costello Anthony
Published: June 2024

Objective: The aim of this article is to describe and evaluate the processes involved in setting up a nurse‑led bladder cancer surveillance flexible cystoscopy service.
Setting: Day Surgery Unit, Royal Melbourne Hospital, Melbourne, Australia.
Subjects: Registered nurses, follow‑up bladder cancer patients and the urological team.
Primary argument: As a result of inefficiencies in current practice including, waiting times, utilisation of doctors’ time, poor documentation and communication and patients being lost to follow‑up the existing system for bladder cancer surveillance was questioned.
Conclusion: This experience has resulted in the creation of a training‑tool with competencies, patient pathways, guidelines and protocols. In turn there was a noticeable reduction in waiting times and improved communication and documentation resulting in a robust nurse‑ led bladder cancer surveillance service.
Medication calculation competencies for registered nurses: a literature review
Authors: Sherriff Karen , Wallis Marianne , Burston Sarah
Published: June 2024

Objective: To describe the literature that focuses on safe administration of medications, medication calculation skills development and maintenance of ongoing competence in nurses.
Setting: University and hospital nurse education departments.
Subjects: Theoretical and empirical literature focusing on nurse mediated medication administration errors
Primary argument: Nurse education departments devote a high proportion of time to medication calculation skill development and testing. Annual testing is time consuming for both nurse educators and nurses, and the validity, frequency, acceptable pass mark, self‑efficacy and maintenance of skills related to medication calculation testing is largely unclear.
Conclusion: The theoretical literature focuses on drug administration errors, development of tools and techniques to improve nurses’ medication calculation skills and guidelines. There is considerable debate as to nurses’ self‑perception of their arithmetical skills, their educational needs in this area and the relationship between skill level and patient outcomes. Empirical literature focuses on the incidence of errors, evaluation of medication calculation skills; the relationship between test results and errors, effectiveness of strategies to improve medication calculation skills and medication calculation testing and policy. Course content and delivery are thought to influence safe medication administration; however, there has been a lack of rigorous research demonstrating the efficacy of educational models. Several studies report low levels of calculation proficiency in nurses; however, it is unclear whether medication calculation testing affects medication administration error rates. Further research is required to determine the robustness of the current processes to assess nurses’ medication calculation competence and ensure optimal patient safety.
Implementation of the nurse practitioner role within a Victorian healthcare network: an organisational perspective
Authors: Wintle Marie , Newsome Penny , Livingston Patricia
Published: June 2024

Objective: This paper presents a discussion of the development of a framework to implement and sustain the nurse practitioner (NP) role within one health service designed to strengthen the capacity of the health system and which could be readily transferable to other health services.
Setting: Eastern Health (EH) is a multi‑campus tertiary health care organisation servicing a population of approximately 800,000 people in the east and outer eastern suburbs of Melbourne, Australia. EH is committed to advancing the nursing profession and exploring innovative, research based models of practice that are responsive to the needs of the community it serves.
Primary argument: The Framework documents the processes of providing a new career pathway for advanced practice nurses that incorporates education and training, and utilises current evidenced‑based practice guidelines to define and promote the scope of practice.
Conclusion: Strong organisational support to facilitate interdisciplinary and multidisciplinary learning opportunities assists integration of the NP role into the healthcare team. Role clarity will assist interprofessional teams to understand and value the role NPs provide.
Interaction between primary health care professionals and people who are overweight or obese: A critical review
Authors: Walsh Matthew , Fahy Kathleen
Published: June 2024

Objective: To identify through a review of the literature how primary health care professionals interact with people who are overweight or obese.
Setting: Primary health care practices.
Primary Argument: Interactions between primary health care professionals and overweight or obese patients are influenced by complex factors that impact on effective management of overweight and obesity.
Conclusions: The practice skills and knowledge of primary health care professionals, lack of resources, and inconsistent overweight and obesity management guidelines impact on the interaction with patients. The emotive and personal nature of overweight and obesity, and the attitudes and beliefs of primary health care professionals also impact on the interaction. Education of primary health care professionals must address attitudes and beliefs about overweight and obesity. Education in the diagnosis of overweight and obesity and the acquisition of effective weight loss counselling skills is essential to improving interactions and the overall management of overweight and obesity.
OVoiD delirium and improved outcomes in acute care. Introducing a model of care
Authors: Hoolahan Anne
Published: June 2024

Objective: In this article three aspects of prevention/management will be available at a glance to nursing staff – the key personnel who manage this difficult area in aged care.
Setting: The acute hospital environment.
Primary argument: Delirium is a syndrome characterised by a sudden onset, over hours or days, impaired attention that fluctuates, together with altered consciousness and impaired cognition (ASGM 2005). Delirium is well reported to be already present for older people (10% ‑ 24%) (Inouye 1998) on admission to hospital and develops in many more (up to 61%) (Gustafson; Berggren; Brannstrom et al 1998). Research has reported a multifaceted approach to reduce and manage the incidence of delirium in acute care, but do acute care staff have access to a brief overview of the information they can refer to, to prevent a crisis? Upon review, many of the non‑pharmacological strategies to manage delirium are similar to those which prevent delirium.
Conclusion: Delirium is under recognised and often poorly managed. This paper suggests preventing and managing delirium is achievable through a consistent, systematic, multifaceted team approach.
Graduate entry to practice in nursing: exploring demographic characteristics of commencing students
Authors: McKenna Lisa , Vanderheide Rebecca
Published: June 2024

Objective: Graduate entry to nursing programs are new to Australia. This paper reports on an analysis of students enrolled in an accelerated, pre‑registration, masters‑level nursing course in Melbourne, Australia.
Design: Quantitative surveys were used to gather data on a range of demographic characteristics and factors relating to students’ choice to undertake nursing.
Setting: The study was conducted at one campus of an Australian university.
Subjects: Seventy‑nine students from the first two cohorts of the Master of Nursing Practice participated in the study.
Main outcome measure(s): Descriptive statistics were used to examine age and gender distributions, previous education and employment history, along with reasons surrounding students’ application for entry to the course.
Results: Findings revealed higher male participation than traditional undergraduate nursing programs and students originated from a wide range of cultural and disciplinary backgrounds. Students’ previous education ranged from bachelor degree to doctoral levels. A wide range of reasons were given for moving to a nursing career. Predominant reasons were career stability, being part of a caring profession and previous personal or family experience with the health care setting.
Conclusion: Accelerated programs such as this have the potential to add to the nursing workforce in a way other programs do not, build diverse expertise and professional knowledge. Understanding the characteristics of people attracted to these courses will assist with appropriate tailoring of programs, as well as assisting with marketing the nursing profession.
Patient views of over 75 years health assessments in general practice
Authors: Spillman Margaret , Kimber Debbie , Cheffins Tracy
Published: June 2024

Objective: To gain an understanding of the value and timeframe of health assessments (HA) from the perspective of the patient.
Design: A self‑completed questionnaire for patients who had undergone an over 75 years HA in a 12 month period excluding patients in residential or hospital care.
Setting: General practice patient group in a regional Queensland town.
Subjects: 65 general practice patients with a response rate of 45.1% (65/144). The respondents were 67.7% (44/65) female and 30.8% (20/65) male with one gender (1.5%) not recorded.
Main outcome measure: Whether patients found the over 75 HAs beneficial, and whether they considered the annual timeframe for HAs appropriate.
Results: The majority of respondents 77% (47/61) indicated that their most recent HA was beneficial even though few respondents had a new health concern identified at this HA. A majority (82.5%, 52/63) also supported the current time frame of annual HAs, although 12.7% (8/63) thought once every 2 years was acceptable.
Conclusion: The findings confirm the benefits of health assessments in providing timely treatment for new health concerns and allaying anxiety in the elderly patients of this practice.
Job satisfaction of Australian nurses and midwives:A descriptive research study
Authors: Skinner Virginia , Madison Jeanne , Harris Humphries Judy
Published: June 2024

Objective: To assess factors linked with job satisfaction of Australian nurses and midwives.
Design: Descriptive survey.
Setting: Public hospital, aged care facility and community health centres.
Subjects: A total of 562 enrolled and registered nurses and midwives were selected by convenience sampling when they attended professional conferences. The return rate was 41.4 per cent. A sample size of 550 was used to calculate overall results for job satisfaction.
Main outcome measure: Factors contributing to nurses’ and midwives’ job satisfaction.
Results: The majority (96%) of this sample of nurses and midwives were  moderately or highly satisfied with their work and this was not diminished by experiencing moderate amounts of work‑related stress. Factors positively related to high levels of job satisfaction were 1) enjoying their current area of practice; 2) feeling well‑suited to the particular type ofwork; 3) wanting to stay in their current area of practice; and 4) having no intention of leaving the profession.
Conclusion: For this group of professionally engaged nurses and midwives, enjoying their work and perceiving themselves as well‑suited to it were the major contributory factors for job satisfaction. The finding that nurses and midwives are dealing with moderate effects of stress does not reflect as job dissatisfaction. This finding is important because it challenges existing belief that stress may be a cause of job dissatisfaction.
Causes, reporting, and prevention of medication errors from a pediatric nurse perspective
Authors: Kilicarslan Toruner Ebru , Uysal Gulzade
Published: June 2024

Objective: The aim of this study was to determine the perspective of pediatric nurses regarding the causes, reporting, and prevention of medication errors.
Design: A descriptive, cross‑sectional study.
Setting: Nurses were selected from inpatient pediatric wards of 4 hospitals in Turkey.
Subjects: 119 pediatric nurses agreed to participate in the research and completed semi‑structured questionnaires. These data were collected and analyzed. The average age of the nurses was 24.7 ± 3.58 years; the majority was women (96.6%).
Results: Pediatric nurses stated that the most common causes of medication errors were long work hours (68.1%) and a high patient/nurse ratio (58.8%). Although the majority of nurses (88%) made use of a medication error notification system, many errors were not reported and nurses cited potential blaming of nurses in case of adverse outcome for the patient (52.95%), loss of trust (50.45%), and fear of disciplinary proceedings (42%) among the causes of lack of notification. With regard to avoidance, nurses most commonly cited the need for adequate information regarding the safe use of medications (45.4%).
Conclusions: This is the first study in Turkey to address the pediatric nurse perspective regarding medication errors. The results argue that there is a need for ongoing training of pediatric nurses concerning safe medication administration and that the causes and underreporting of medication errors warrant further investigation.
A view from the outside: nurses’ clinical decision making in the twenty first century
Authors: Deegan Joan
Published: June 2024

Objective: The purpose of this paper is to highlight some observations of clinical decision making processes made by culturally and linguistically diverse nurses (CALD), in relation to elderly patients in particular. It will explore some of the potentially serious professional and legal implications for nurses when there is an over reliance on experiential knowledge and routine tasks without mindful application of evidence and consideration of the ethico-legal imperatives.
Setting: The CALD nurses in the study were enrolled in competency based assessment programs (CBAP) in two universities in Melbourne, Victoria between 2005 and 2006 in preparation for their professional registration in Australia.
Participants: Following ethical approval from the relevant universities and participating hospitals, a purposive sample was chosen followed by theoretical sampling. Fourteen CALD nurses and three teachers, who were directly involved in the clinical supervision of the nurses during their placement took part.
Primary Argument: Using some in vivo quotes to highlight what appear to be less than optimal decision making process by nurses, it will be argued that sound decision making in clinical practice is ideally based on a combination of factors; amongst them professional judgement and a sound knowledge base, supported by principles of physical/psychological assessment and ethical principles.
Conclusion: The views of nurses who are new to the system can foster reflection on practices that have become routine, potentially lacking in application of scientific knowledge, and therefore a potential threat to patient safety with associated legal implications for the nurse.
Nurse satisfaction with working in a nurse led primary care walk-in centre: an Australian experience
Authors: Desborough Jane , Forrest Laura , Parker Rhian
Published: June 2024

Objective: The aim of this study was to gain insight into the nursing staff’s experiences and satisfaction with working at the ACT nurse led Walk-in Centre.
Design and Setting: Interviews with nursing staff working at the ACT Walk-in Centre were informed by a phenomenological approach. Questions were developed within inter, extra and intra-personal variables of satisfaction, underpinned by theprinciples of role theory.
Subjects: Twelve nurses were interviewed; three nurse practitioners and nine advanced practice nurses. Their ages ranged from 31 to 63 years and they had a minimum of 15 years of nursing experience. Interviews ranged from 30 minutes to two hours duration.
Results: Walk-in Centre nurses’ satisfaction with a number of inter and extra-personal factors was associated with their previous education and experience (intra-personal factors). Role stressors included adapting to autonomy, role incongruity and lack of access to appropriate education, training and sources of collaboration and mentorship. Sources of satisfaction were the autonomous role, relationships with the team and the capacity to deliver quality nursing care.
Conclusion: Whilst autonomy is valued by nurses, this does not translate to isolation or independence. Autonomy is only a source of satisfaction when coupled with supportive and cohesive professional relationships with both nursing and medical colleagues. Organisations implementing advanced nursing roles must have a comprehensive understanding of the requirements of nursing autonomy to ensure effective role implementation and associated job satisfaction. These findings add impetus to the need for the development of nursing education programs tailored specifically to primary health care.
Description, and pilot evaluation, of novel staff education to improve care of confused older inpatients
Authors: Horner Barbara , Watson Natasha , Hill Anne-Marie , Etherton-Beer Christopher
Published: June 2024

Objective: To determine feasibility of novel staff education aiming to optimise care for confused older people.
Design: Pre/post qualitative study.
Setting: Tertiary teaching hospital.
Subjects: Clinical staff in two geriatric medicine wards.
Interventions: Self-directed learning modules, with access to an education resource officer to reinforce learning in real time.
Main outcome measures: Primary outcomes were feasibility (proportion of staff completing the education) and perceived effectiveness (measured in focus groups and individual interviews).
Results: Twenty-six staff agreed to undertake the education; six confirmed completion of the entire learning package. Participants were enthusiastic about education regarding confused older people. Participants who completed the education modules reported they were satisfied with the format and content of the learning materials, but cited time constraints as a major barrier.
Conclusion: Participants expressed need and enthusiasm for education but uptake of the package was less than anticipated. Organisational support (such as providing staff with protected paid time to complete education) may be required to improve adherence.
Association between CD4+ T-cell count, atypical squamous cells and Schiller’s test in women with HIV/AIDS
Authors: Silva de Brito Daniele , Da Cunha Gilmara , Gir Elucir , Freitas Julyana , Galvao Marli
Published: June 2024

Objective: Infection with HIV increased risk for the development of cancer, such as Kaposi’s sarcoma and invasive cancer of the cervix. Given the importance of health promotion in women, the purpose of this study was to perform cytological screening (Pap smear) and identify any association between CD4+ T-cell, atypical squamous cells and the Schiller’s Test in women with HIV/AIDS in Brazil.
Design: Descriptive and cross-sectional study.
Setting: Gynaecology outpatient clinic in Fortaleza, Ceará, Brazil.
Subjects: A total of 76 women with HIV/AIDS were examined and included in the study.
Main outcome measures: For data collection a questionnaire to gather sociodemographic, clinical, epidemiological and  gynaecological data and the association between CD4+ T-cell count, atypical squamous cells and Schiller’s test in women with HIV/AIDS were performed.
Results: Seventy-six women were evaluated, among which 43.5% had a positive Schiller’s test and 94.8% manifested some type of inflammatory process. There was statistical significance between atypical squamous cells and the number of partners (P=0.021), age of first sexual intercourse (P=0.003) and positive Schiller’s test (P=0.008). Of the patients with atypical squamous cells, eight had a low-grade, intraepithelial lesion, comprising the cytopathic effect of HPV and cervical intraepithelial neoplasia grade I (CIN I); three had intraepithelial lesion high-grade (CIN comprising II and III). There was a relationship between CD4+ T-cell counts and atypical squamous cells (P=0.028) and a positive Schiller’s test (P=0.030).
Conclusion: Increased vulnerability occurred to cervix changes with a reduction in the CD4+ T-cell counts.
Overseas qualified nurses in Australia: reflecting on the issue
Authors: Stankiewicz Grazyna , O'Connor Maragaret
Published: June 2024

Objective: The migration of international nurses is a growing phenomenon and will continue in response to global nursing shortages. Historically, nursing has been depicted as a ‘portable’ profession, or one which enables individuals to move across inter/national borders. This ‘portability’ of nursing is supporting skilled nurse migration around the world. However, nursing practices learned by Overseas Qualified Nurses (OQN) in their home countries may differ to the role and expectations of the new country in relation to scope of practice, professional and legal environment, accountability, professional autonomy, health care technology and inter-professional relationships.
Primary argument: Relatively little is known about the experiences of OQN in Australia and particularly, about those from non-English speaking backgrounds. Supported by international literature and personal experiences, this paper describes the adaptation process and challenges faced by OQN in beginning a new life in Australia.
Conclusion: Australia, like many other developed countries, is facing an ageing population and an ageing health workforce, including nurses. The global shortage of nurses in many countries, including Australia, means that OQN will continue to be a significant part of the workforce. As the welcoming country, Australia can benefit from hosting OQN and these nurses in return contribute to the enrichment of Australian life.
Violence against health care staff by peers and managers in a general hospital in Greece: a questionnaire-based study
Authors: Koukia Evmorfia , Mangoulia Polyxeni , Papageorgiou Dimitrios , Gonis Nikolaos , Katostaras Theofanis
Published: June 2024

Background: Many studies have investigated violence against nurses or physicians from patients and visitors especially in psychiatric settings. Few however, have focused on violence between co-workers in general hospitals and various departments.
Objectives: This study examined the types of violence experienced by physicians, nurses and nurse assistants in various departments instigated by doctors, nurses and supervisors as well as the possible causes, the effects on job performance, the handling of the incidents and the possible preventive measures.
Design: A questionnaire based study was conducted among nurses and physicians concerning violence between co-workers.
Setting: The study was carried out in two general hospitals in Athens, Greece.
Subjects: A total of 250 health care staff - doctors, nurses, and nurses’ assistants took part in the study.
Methods: A questionnaire based study with multiple choice questions was held with doctors, nurses, and nurses’ assistants. Quantitative data was analysed by SPSS. A logistic regression analysis was used in order to determine significant risk factors of violence.
Results: A majority of respondents had experienced some form of violence (verbal, psychological, physical or sexual). Doctors and nurses were the main perpetrators followed by managers. The most frequently reported incident was psychological violence, followed by verbal violence. Associations were found between workplace violence and age, gender and wards. Violence was significantly more likely to be targeted towards less experienced, younger staff and those working in ICU, but was significantly less likely among those working in the emergency department and orthopaedics.
Conclusion: Health care staff are at great risk of workplace violence by both co-workers and managers. The reporting of these violent events needs to increase in order to develop safety policies and strategies. Future research must focus on factors influencing high levels of violence and preventive measures.
Understanding infant feeding practices of new mothers: findings from the Healthy Beginnings Trial
Authors: Wardle Karen , De Domenico Maria , Ming Wen Li
Published: June 2024

Objective: This study aimed to explore the experiences of infant feeding of first-time mothers and identify the barriers and facilitators in relation to healthy infant feeding practices.
Design: As part of the Healthy Beginnings Trial, descriptive analyses were conducted using data extracted from both baseline and six month surveys. Twenty five face-to-face in-depth interviews were conducted at 12 months postpartum by two trained research nurses with a series of semi structured questions to explore mother’s infant feeding experience.
Setting: The study was conducted in southwest Sydney, the most socially and economically disadvantaged area of metropolitan Sydney, New South Wales in 2007-2010.
Main outcome measures: To understand mothers’ experiences of infant feeding and identify the barriers and facilitators in relation to healthy infant feeding practices.
Results: A total of 561 mothers completed both baseline and six month surveys. Of these, 25 agreed to participate in a faceto-face in-depth interview at 12 months postpartum. A high proportion (96%) of mothers initiated breastfeeding, only 38% continued breastfeeding at 6 months postpartum due to numerous barriers. The main barriers for breastfeeding were milk supply and unsettled baby, latching baby to the breast and pain. The main barrier for appropriate timing of introduction of solid food was confusion about the recommended guidelines. Hospital support was regarded as the main facilitator for healthy infant feeding practices.
Conclusions: A significant proportion of mothers did not meet the WHO recommended guidelines for breastfeeding. The first week of life was the most critical time for first time mothers to establish and consolidate breastfeeding. Education around appropriate timing of introduction of solids for both mothers and health professionals would be beneficial in ensuring consistency and adherence to the guidelines.
Nurses supporting life-partners conversations about end-of-life care wishes: a literature review for guidelines
Authors: Rabbetts Lyn
Published: June 2024

Setting: Nurses providing end-of-life care.
Objective: A literature review was conducted to establish what guidelines are available for nurses to encourage discussions between life-partners about end-of-life care wishes.
Subjects: Life-partners and nurses.
Primary argument: This literature review located articles that addressed the impact terminal illness, culture and established communication patterns have on end-of-life discussions for the broad group of family members and carers. Articles generally presented the challenges doctors, nurses and other health care professionals face in speaking about end-of-life care wishes with patients, carers and family members. However, articles relating to conversations specifically between life-partners about end-of-life care wishes were not evident. This is surprising because frequently the life-partner is the primary care giver during the end-of-life care phase of a life limiting illness. Furthermore, literature indicates life-partners who are able to speak freely about most life issues adjust better to the challenges that events such as illness, may present to them as a couple.
Conclusion: By using the main themes identified within the literature review from discussions held by family members, nurses and health professionals it may be possible to develop guidelines for life-partners. The use of a guideline may assist nurses in encouraging life-partners to have conversations about end-of-life care wishes. This will not only acknowledge the uniqueness of the relationship between life-partners, but also contribute to providing holistic patient centred care for each couple.
Public health nurses’ (PHNs) experiences of their role as part of a primary care team (PCT) in Ireland
Authors: Giltenane Martina , Kelly Marcella , Dowling Maura
Published: June 2024

Objective: This study aimed to understand public health nurses’ (PHNs) views and experiences of their role as part of a primary care team (PCT) and developments within primary care.
Design: The study adopted a qualitative design guided by interpretative phenomenological analysis (IPA).
Participants: Ten PHNs who were working as part of a PCT for at least two years and who also had PHN experience prior to PCT development were interviewed.
Findings: Three super-ordinate themes representing the study participants’ lived experience and meanings of PCT involvement were interpreted. ‘We are a team’ represents mostly positive experiences of being part of a team such as improved communication and teamwork. However, GP non-attendance at PCT meetings was also highlighted by all the PHNs. ‘Pushed to the limit’ revealed the PHNs’ frustrations attributed to lack of resources. In addition, this theme represented PHNs’ views of always having to ‘take up the slack’ within the team. Finally, ‘PHN’s role’ revealed that the health promotion aspect of the PHNs’ job was perceived to have been ‘pushed aside’, and mixed feelings around PHNs’ future role were relayed.
Conclusion: The findings contribute to the knowledge of PHNs’ roles as part of PCT developments and highlight the need for more dialogue among PCTs on all roles within the team. It is clear that more resources for PHNs in Ireland are needed if they are to fulfil a vision of primary care. In addition, the study findings point to a need to investigate whether policy and practice changes introduced with the introduction of PCTs has improved patient outcomes.
A nurses’ guide to Qualitative Research
Authors: Ingham-Broomfield Rebecca
Published: June 2024

Objective: This article provides a breakdown of the components of qualitative research methodology. Its intention is to simplify the terminology and process of qualitative research to enable novice readers of research to better understand the concepts involved (Benner 1984).
Primary Argument: Current Competency Standards for Australian Registered Nurses and Midwives include a requirement to evaluate and implement research as part of their care (Borbasi and Jackson 2012, p.22; Nursing and Midwifery Board of Australia 2012). They are also expected to be actively involved in research studies (Borbasi and Jackson 2012, p.22). Evidence, when available, can enhance clinical judgement (Hamer and Collinson 2014, p.9). As evidence and research are threaded through professional work and study in the health sciences (Wright-St Clair et al 2014, p.5) nurses, particularly novice nurses, may benefit from a discussion that helps them understand the sequence of a research paper (Moxham 2012) using qualitative methodology.
Conclusion: A systematic and logical approach will be used to discuss the content of a typical qualitative research paper. A comparative grid at the end of this paper (appendix 1) comparing the qualitative research designs, may lead the nurse to better understand the differing components of several qualitative research methods (Ingham-Broomfield 2014).
Doctoral theses in nursing and midwifery: challenging their contribution to nursing scholarship and the profession
Authors: Wilkes Lesley , Cummings Joanne , Ratanapongleka Mayryl , Carter Bernie
Published: June 2024

Objective: To determine the impact and outputs of research conducted as part of doctoral studies in nursing.
Design: An online survey was conducted with 27 nursing doctoral graduates from United Kingdom and Australia who had graduated between 2001 and 2012. Textual and numerical data were collected and sorted on outcomes of research for management, education, practice and workforce. Numerical data were collected from journal article outputs regarding impact factors and citation rates; as well as demographic information on graduates. Frequencies were tallied, percentages calculated for both textual and numerical data and tables and figures formulated.
Setting: University and health sector.
Subjects: Doctoral nursing graduates who graduated between 2001 and 2012 from universities in Australia and the United Kingdom were recruited to complete the online survey.
Main outcome measure: The outcomes and outputs of doctoral research are usually implied in the theses but assessment of these is often not apparent in the literature or clinical area. There is little evidence to demonstrate whether or not the nursing profession is influenced by the outcomes of and outputs from nurses’ doctoral studies.
Results: The top three topic areas covered by their theses were paediatrics, acute care and the role of nurses in practice. The key outputs from the 21 doctoral studies were 86 publications. Articles from the individual theses had verified citations ranging from 0 to 75. Outcomes from the research were evident in contributions to policy development, models of care, workplace issues at universities, and nursing curricula.
Conclusion: The study shows the need for nursing research at the doctoral level should be directed towards professional needs which ultimately impact on patient care.