bluuebunny/crossref_metadata_2025 huggingface dataset:
NURSING AND THE DEVELOPMENT OF NURSING EDUCATION IN FIJI
Authors: Usher Kim , Rabuka Iloi , Nadakuitavuki Rigi , Tollefson Joanne , Luck Lauretta
Published: June 2024

Fiji is one of Australia’s Pacific neighbours. Nursing and nurse education in that country is at an exciting stage of development. The Ministry of Health in Fiji has recently introduced new nursing initiatives and is about to introduce a new pre-registered nurse curriculum in 2004. The introduction of the new curriculum will pave the way for the Fiji School of Nursing to merge with the Fiji School of Medicine, part of a more inclusive goal for healthcare education in Fiji. Other initiatives such as the introduction of the nurse practitioner role and nursing competencies have assisted nursing in Fiji to move towards this goal. This paper will explore these new developments in nursing as well as provide an historical account of the development of nursing education in Fiji.
THE EFFECTIVENESS OF A TRAINING PROGRAM FOR EMERGENCY DEPARTMENT NURSES IN MANAGING VIOLENT SITUATIONS
Authors: Deans Cecil
Published: June 2024

An Australian Institute of Criminology report (1999) highlighted the health industry as the most violent industry in Australia with registered nurses recording the second highest number of violence related workers compensation claims, ranking higher than prison and police officers. Workplace violence has become such a common phenomenon that many nurses accept it as a part of nursing. Nurses employed in emergency departments (EDs) are considered to be especially vulnerable to workplace violence.
Although there have been a number of studies reporting on the incidence of workplace violence and its consequences upon nurses, to date there have been no empirical studies that have evaluated interventions which are thought to reduce its occurrence and impact.
This study investigated the effectiveness of a oneday training program in which ED nurses participated. In particular, their knowledge, skills and attitudes relating to management of workplace violence were examined.
Results show that a training program has many positive outcomes which enhance nurses’ ability to manage aggressive behaviours. With some basic training, ED nurses can be more prepared to manage violent and potentially violent situations, and by doing so may in fact reduce the incidence of aggression in their workplace by 50%. This has largely been achieved by raising the awareness of ED nurses to the nature of the problem, developing their knowledge and skills in managing aggressive behaviour, and improving their attitudes toward potentially violent patients.
REGISTERED AND ENROLLED NURSES’ EXPERIENCES OF ETHICAL ISSUES IN NURSING PRACTICE
Authors: Johnstone Megan-Jane , D Costa Cliff , Turale Sue
Published: June 2024

Research aims: To explore and describe registered and enrolled nurses’ experiences of ethics and human rights issues in nursing practice in the Australian State of Victoria.
Method: Descriptive survey of 398 Victorian nurses using the Ethical Issues Scale (EIS) survey questionnaire.
Major findings: The most frequent and most disturbing ethical issues reported by the nurses surveyed included: protecting patients’ rights and human dignity, providing care with possible risk to their own health, informed consent, staffing patterns that limited patient access to nursing care, the use of physical/chemical restraints, prolonging the dying process with inappropriate measures, working with unethical/impaired colleagues, caring for patients/families who are misinformed, not considering a patient’s quality of life, poor working conditions.
Conclusions: Nurses in Victoria frequently experience disturbing ethical issues in nursing practice that warrant focussed attention by health service managers, educators and policy makers.
AGEING IN PLACE – DYING IN PLACE: COMPETING DISCOURSES FOR CARE OF THE DYING IN AGED CARE POLICY
Authors: O'Connor Margaret , Pearson Alan
Published: June 2024

Australian Government aged care policy documents emphasise healthy ageing. Even though death in the aged care setting is a common occurrence, minimal policy exists to underpin activities that surround dying in this setting. Issues and practices about caring well for the dying remain a hidden discourse in aged care policy, the literature and therefore in practice.
A discourse analysis of aged care and palliative care policy documents for the period 2000-mid 2001 was undertaken. The analysis highlighted competing discourses about care of the dying in residential aged care. This paper describes the main discourses, explores competing and hidden discourses, and raises questions about the disparities found.
The conclusion is that care received by the dying person in Australia is dependent upon the setting in which this care is delivered. ‘Dying in place’ should be attached to the Government’s policy slogan - ‘Ageing in place’.
SHROUDS OF SILENCE: THREE WOMEN’S STORIES OF PRENATAL LOSS
Authors: St John Annette , Cooke Marie , Goopy Suzanne
Published: June 2024

Objective: To give voice to the experiences of women who have suffered a prenatal loss prior to a full term pregnancy.
Design: A descriptive, exploratory qualitative study using mini-biographies was used. In-depth interviews were conducted with women to record their experiences and stories. Interviews were transcribed and the patterns that emerged from the data were identified and themes generated.
Subjects: The mini-biographical stories of three women were gathered. Interviews occurred in the women’s homes. The women were recruited through an advertisement in the Stillbirth and Neonatal Death Support (SANDS) newsletter.
Results: The stories revealed the tragedy, pain and silence endured by these women, as they live with loss and grief. Common themes emerged from their stories highlighting grief, isolation, anger and self-blame in the face of their loss and subsequent full term pregnancy.
Conclusions and Implications for Practice: The emergent theme suggests that further research needs to explore how society and the health care community may compound women’s grief and isolation and in-turn perpetuate their feelings of anger. In telling their stories, these women give voice to their experiences and offer a number of insights into how current health care practices may be modified to better support the needs of women who have suffered a prenatal loss and also points to the need for further research. Specifically, the study identifies a need for nurses and midwives to offer sensitive care, acknowledgment of previous loss and supportive counseling strategies for women following prenatal loss and during antenatal care for subsequent pregnancies.
THE ATTITUDES AND PRACTICES OF NEONATAL NURSES IN THE USE OF KANGAROO CARE
Authors: Chia Pauline , Sellick Ken , Gan Sharon
Published: June 2024

Objectives: To survey the attitudes and practices of Australian neonatal nurses in the use of kangaroo care (KC) and identify possible concerns with promoting KC in the neonatal intensive care unit (NICU).
Design: A two-phase research approach was used that included a descriptive survey followed by in-depth interviews with a subset of survey respondents.
Sample: Thirty four nurses working in the NICU of a large public hospital in Melbourne completed a survey questionnaire. Four respondents were subsequently selected for follow-up interview to explore in greater depth issues associated with promoting KC in the NICU.
Outcome measures: Quantitative data were analysed to describe the attitudes, practices and role of the neonatal nurse in promoting KC. Analysis of qualitative responses to survey questions and interviews were coded and major themes identified.
Results: All neonatal nurses surveyed assisted and encouraged parents to provide KC and the majority agreed on the benefits of KC for both infant and parents. There was a general acceptance that KC can be practiced with low birth weight infants requiring intubation and all but two nurses found facilitating KC professionally satisfying. Results also identified practical concerns with the practice of KC and some uncertainty that KC promotes breastfeeding. Notable constraints to promoting KC in the NICU were heavy staff workloads, insufficient education, lack of organisational support and the absence of clear protocols, especially for low birth weight infants.
Conclusions: This study confirms neonatal nurses strongly support the use of KC in the NICU. Although the majority of nurses reported positive attitudes and practices, they did identify a number of educational and practical concerns that need to be addressed to ensure KC with low birth weight infants is safe and effective.
UTILIZATION OF KING’S INTERACTING SYSTEMS FRAMEWORK AND THEORY OF GOAL ATTAINMENT WITH NEW MULTIDISCIPLINARY MODEL: CLINICAL PATHWAY
Authors: Khowaja Khurshid
Published: June 2024

Background: The critical role of research in nursing practice is the application of nursing theories to discover new knowledge. This study uses King’s interacting systems framework and theory of goal attainment to investigate the effectiveness of implementing clinical pathways for patients undergoing transurethral resection of prostate (TURP) at Aga Khan University Hospital (AKUH), Pakistan.
Objective: To assess the impact of the implementation of a clinical pathway for the surgical procedure of TURP on clinical quality, cost, and patient and staff satisfaction.
Study Design: Quasi-experimental, non-equivalent control group study design using clinical pathway intervention.
Setting: Aga Khan University Hospital (AKUH).
Subjects: The study population consisted of a convenience sample of patients undergoing surgery for TURP (control and experimental) and health team members (nurses, physicians and others).
Study Findings: Findings showed a significant difference in variances and outcomes as a result of TURP clinical pathway intervention. The clinical pathway significantly improved all twelve nursing and physician related variances and outcomes, such as: complete documentation; delayed consultation; delayed education; and other variances. Clinical pathway intervention also significantly reduced hospital related variances, and post-operative problems such as electrolyte imbalance, phlebitis, constipation, and urinary tract infection (UTI). The findings also showed significant improvement in patient and staff satisfaction, however no significant difference was observed in patient, hospital and financial related variances. The current investigation identified that successful implementation of integrated clinical pathways can help health professionals, managers and administrators to meet one of their biggest challenges in making optimal use of limited resources while delivering high quality and timely care.
CRITICAL CARE NURSES’ KNOWLEDGE IN PREVENTING NOSOCOMIAL PNEUMONIA
Authors: Lam Soh Kim , Jane  , Wilson Jan , Geok Kim
Published: June 2024

Objective: The purpose of this study was to identify knowledge deficits concerning nosocomial pneumonia (NP) prevention among critical care nurses. The study also determined whether NP knowledge was associated with nurse characteristics.
Design: A survey design using a mailed self-administered questionnaire.
Setting: New Zealand critical care nurses were identified through the Nursing Council of New Zealand.
Subjects: 134 critical care nurses.
Main outcome measures: NP prevention knowledge score (the proportion of 24 items answered correctly).
Results: The NP knowledge score ranged from 21% to 92%. The mean (and median) was 48%. Items related to knowledge about NP risks had the highest mean score (67%) compared to items addressing NP prevention (43%) or the role of devices in the transmission of NP (45%). No nurse demographic or workplace characteristic was associated with NP knowledge.
Conclusions: Several important deficits in nosocomial pneumonia knowledge were identified indicating a need for critical care nurses to have greater exposure to nosocomial pneumonia prevention education, guidelines, and research.
Understanding the importance of effective orientation: what does this mean in psychiatric graduate nurse programs?
Authors: Charleston Rosemary , Hayman-White Karla , Ryan Rob , Happell Brenda
Published: June 2024

Objective: The main purpose of this project was to examine and describe specialist psychiatric graduate nurse programs (PGNP) in Victoria, Australia.
Design: This project used thematic analysis to review information obtained from individual and focus group interviews.
Setting: Twenty-one area mental health services (AMHS) in Victoria, Australia participated in this project.
Subjects: Participants included graduate nurses, nurse educators, nurse unit managers, ward‑based clinical nurses, consumer consultants, mental health nurse academics and future graduates.
Main Outcome: To describe current PGNP practices, identify and make recommendations for improvements.
Results: Many categories relating to PGNP were examined however for the purposes of this paper issues regarding orientation are discussed. Effective orientation was identified as crucial to graduates' confidence and learning in the psychiatric setting.
Conclusions: A substantial amount of information was gathered specific to orientation practices in PGNP. Much of this argues for the need to have a formal, structured and supportive orientation period in PGNP.
An exploration of the education and training experiences of ICU nurses in using computerised equipment
Authors: O'Connell Mary , Reid Beth , O'Loughlin Kate
Published: June 2024

Objective: To explore the education and training experiences of intensive care unit (ICU) registered nurses in using computerised technologies and to assess the relationship it has with role performance and level of clinical experience.
Design: A qualitative study using semi‑structured in‑depth interviews.
Setting: Two general ICUs, one of which was fully computerised with a Clinical Information System (CIS) and the other partially computerised with a Central Monitoring System (CMS).
Subjects: In each setting a clinical nurse consultant (CNC), a clinical nurse specialist (CNS) and a registered nurse (RN) with less than twelve months experience in ICU were interviewed; six nursing staff in total.
Main Outcome measure: Identification of the main themes underpinning ICU nurses’ perceptions and experiences of education and training in using computerised equipment with regard to their perceived roles and clinical experience.
Results: Participants identified a range of formal and informal education and training sources available to them within their ICU setting and articulated both positive and negative experiences associated with using computerised technologies. Their level of confidence in using computerised technologies was clearly related to their years of experience and differentiated clinical nursing roles and reflected whether they worked in a fully or partially computerised unit.
Conclusion: Further research needs to be undertaken to investigate the training needs of ICU nurses to use computerised equipment.
What do we know about the long term medication adherence in patients following percutaneous coronary intervention?
Authors: Fernandez Ritin , Davidson Patricia , Griffiths Rhonda , Juergens Craig , Salamonson Yenna
Published: June 2024

Background: Percutaneous coronary intervention (PCI) is a revascularisation intervention for patients with acute coronary syndrome. It is a common procedure, increasingly used over the past decade. Along with PCI, patients are also prescribed a number of medications and adherence to the pharmacological therapies is vital to improved morbidity and mortality.
Objective: This cross‑sectional study sought to evaluate the long term adherence to medications in patients following PCI.
Subjects: 270 participants who underwent PCI between April 2003 and March 2004 and who met the inclusion criteria were followed up 12‑24 months following the PCI.
Methods: Following obtaining informed consent, a self administered questionnaire was mailed to participants. Information was collected relating to the types of medications taken, medication taking behaviours and storage of medications.
Results: Overall high rates of self‑reported medication adherence were reported. In spite of this, patients continued to miss medications or reported stopping medications if they felt better or worse. Knowledge of storage of medication in particular nitro‑glycerine medications was poor.
Conclusions: Findings suggested that following PCI medication adherence is high, however knowledge about medication storage is limited and patients report cessation of medications which they consider to be deleterious or unnecessary. These findings are useful for informing development of nursing interventions.
Evaluation of a generic integrated care pathway for rehabilitation
Authors: Chew Daniel , Brook Donna , Sheridan Kathryn , Silvagni Heather
Published: June 2024

Objective: The aim of this study was to determine if a process‑oriented integrated care pathway (ICP) was effective in a rehabilitation setting and whether the improvement gained through the rehabilitation process was sustained post discharge.
Design: This study incorporated a quantitative analysis of the Barthel Index Score (BIS) for a retrospective convenience sample of patients who had been discharged from the rehabilitation unit. A longitudinal examination of this sample group was conducted and BIS results were compared between admission, upon discharge, and three months post discharge.
Setting: The study was conducted at a rehabilitation unit (the Unit) at a medium‑sized general hospital in a rural centre northwest of Melbourne, Victoria
Subjects: The sample consisted of a convenience sample of thirty participants who were discharged from the Unit between December 2003 and January 2004. The mean age of participants was 75 years.
Main outcome measures: Health outcomes and improvements in functional and dependency status were determined using the Barthel Index Score (BIS).
Results: The introduction of the generic clinical pathway yielded positive results with the sample group maintaining functional status and independence post discharge.
Conclusions: Although this study is limited by sample size and homogeneity of sample; nevertheless it demonstrates that process‑oriented integrated care pathways may be useful to effectively manage rehabilitation and aged‑care units that contain patients with a wide range of complex presentations and diagnosis‑related groups.
Critical care nurses' knowledge about the care of deceased adult patients in an intensive care unit
Authors: Sevim  , Gülay Altun Uğraş, MSc, RN Gülay Altun Uğraş, MSc, RN , Durdu Sabahat , Kubaş Meryem , Aksoy Güler
Published: June 2024

Objective: The purpose of this study was to identify knowledge deficits about the care of deceased patients among critical care nurses.
Design: The research was conducted as a descriptive study in the adult intensive care units of a university hospital in Istanbul. The data were collected using a questionnaire.
Setting: The study was conducted with nurses working in the medical and surgical intensive care units of a university hospital, including the coronary, neurosurgery, cardiovascular, post‑anaesthesia and emergency intensive care units.
Subjects: The subjects were 61 critical care nurses.
Findings: The majority of nurse respondents (75.4%) did not have a certificate in intensive care nursing and 95.1% had not received education about the care of a deceased patient. There is no standard protocol at the hospital for deceased patient care. The majority of nurses stated they removed instruments, catheters, tubes, dressings from the body and cleaned drainage and secretions, but only 8.1% reported they dressed the patient in a clean gown and combed their hair. Of the nurse respondents, 24.5% did not provideemotional support to the individual’s family.
Conclusion: Nurses implemented appropriate clinical activities after death, however did not demonstrate appropriate support behaviours toward the patient’s family or loved ones.
Where have all the nurses gone?
Authors: Shields Linda , Watson Roger
Published: June 2024

Objective: The aim of this article is to highlight a crisis that has developed in UK nursing.
Setting: The nursing workforce worldwide is diminishing and the UK nursing workforce is no exception.
Subjects: Registered Nurses.
Primary argument: While steps are being taken in the UK to alleviate the nursing shortage by funding more places in university nursing departments, this initiative is no longer viable due to the financial crisis in the NHS, which funds nursing education. The significant influx of international nurses to the UK is likely to be a short‑term solution to a long‑term problem as this incipient form of neo‑colonialism is seen to deplete developing countries of their nurses, and international nursing bodies condemn it.
Conclusions: The outcome of the crisis may well lead to the disappearance of nurses from the UK NHS workforce as they are replaced by the cheaper alternative of health care assistants and technicians. This can only be to the detriment of patients.
A nurses’ guide to the critical reading of research
Authors: Ingham-Broomfield Rebecca
Published: June 2024

Objective: A sound theoretical foundation to guide practice is enhanced by the ability of nurses to critique research. This article provides a structured route to questioning the methodology of nursing research.
Primary Argument: Nurses may find critiquing a research paper a particularly daunting experience when faced with their first paper. Knowing what questions the nurse should be asking is perhaps difficult to determine when there may be unfamiliar research terms to grasp. Nurses may benefit from a structured approach which helps them understand the sequence of the text and the subsequent value of a research paper.
Conclusion: A framework is provided within this article to assist in the analysis of a research paper in a systematic, logical order. The questions presented in the framework may lead the nurse to conclusions about the strengths and weaknesses of the research methods presented in a research article. The framework does not intend to separate quantitative or qualitative paradigms but to assist the nurse in making broad observations about the nature of the research.
Information literacy skill development and life long learning: exploring nursing students’ and academics’ understandings
Authors: Nayda Robyn , Rankin Elaine
Published: June 2024

Objectives: The aim of this study was to map information literacy (IL) skill development in the Bachelor of Nursing (BN) content; identify educational practices in courses to asses students’ information literacy (IL) skills; explore BN students’ understandings of their IL skill development; and explore students’ and academics’ understandings of the link between IL skills and life long learning.
Design: The study used a qualitative exploratory triangulated design using document analysis, questionnaire and focus groups to evaluate BN students’ and academics’ understandings of IL; IL links to life long learning; and subsequent implications for high quality evidence based practice. Thematic analysis was used to review the individual and combined sources of data.
Setting: The setting for the study was one School of Nursing and Midwifery in a South Australian University.
Subjects: Participants included 394 Bachelor of Nursing students who responded to an anonymous questionnaire and 7 academics who participated in a focus group.
Main outcomes: Changes are required to increase BN students’ and academics’ understandings of IL and its links to life long learning, including staff development and collaboration between academics, librarians and study advisors on the design and implementation of a consistent and progressive curriculum approach to teaching IL skills.
Results: The themes resulting from the data were: students’ and academics’ understanding of the term information literacy and the links to lifelong learning; the role of the library; the role of the curriculum; and the roles of lecturers and student peers.
Conclusions: Study outcomes indicated there is a need for staff development and a progressive curriculum approach to ensure students understand IL and its links to life long learning. Such approaches require collaboration between librarians, study skills advisors and academics.
Cardiac patients’ knowledge and use of sublingual glyceryl trinitrate (SLGTN)
Authors: Fan Ming-I , Mitchell Marion , Cooke Marie
Published: June 2024

Objective: This study examined cardiac patients’ knowledge and use of sublingual glyceryl trinitrate.
Design: A non‑experimental, retrospective descriptive design with a convenience sampling strategy was used.
Setting and Subjects: Participants were cardiac in‑patients who were prescribed sublingual glyceryl trinitrate (SLGTN) at thestudy hospital.
Main outcome measure(s): Participants’ knowledge and use of SLGTN was assessed using the Sublingual Nitroglycerin InterviewSchedule (SNIS) which is a valid and reliable tool.
Results: Fifty‑two in‑patients from a general cardiac ward or coronary care unit were approached. A total of 41 (87.2%) participants were enrolled and all completed the survey. Participants’ mean Knowledge score regarding SLGTN was 3.98 (SD=1.21), and the meanUse score was 3.68 (SD=1.12). Approximately one quarter of participants (24.4%) knew using SLGTN to prevent chest pain was an appropriate use for the drug. Males were significantly more likely to incorrectly transport their SLGTN than the females in the study(t=‑5.316, df = 21.8, p=<0.000).
Conclusions: Findings indicate that patients’ have limited knowledge of and do not always appropriately use SLGTN, particularly in terms of the way men transport the medication. Therefore there is a need to develop and implement educational strategies to facilitate greater self‑management of angina.
Living the experience of breast cancer treatment: The younger women‘s perspective
Authors: Coyne Elisabeth , Borbasi Sally
Published: June 2024

Objective: To explore the experience of breast cancer for young women under fifty years of age and describe their personal experience of coping with breast cancer treatment.
Design: An interpretive qualitative design was used to explore the experience of breast cancer in a young women’s life. A purposive sample of six women completed in‑depth interviews. A thematic analysis of the transcripts generated several themes relating to their personal journey through breast cancer treatment.
Setting: The setting for this study was an oncology outpatient’s setting in a large private hospital in Queensland, Australia.
Subjects: Six women aged between 28 and 45 years of age with a diagnosis of breast cancer in the last 12 months.
Results: Treatment for breast cancer began so quickly following diagnosis leaving little time to adjust to the concept of a life threatening disease. The severity of the effects from treatment influenced the women’s sense of person and ability to care for family. Fatigue, nausea and early onset menopausal changes were particularly troubling. Women described a positive resolve to survive.
Conclusions: Treatment concerns for younger women are qualitatively different from those of older women. They consider they are too young to assume ‘the sick role’ and are not prepared for its sudden onset, neither are their support networks. The right kind of support can assist younger women and their families to cope during the early stages of diagnosis and intervention.
Cardiac arrest resuscitation policy and practice: a survey of Western Australian hospitals
Authors: Rogal Sonya , Finn Judith , Jacobs Ian
Published: June 2024

Objective: To determine if cardiopulmonary resuscitation (CPR) policy and practice in Western Australian (WA) hospitals changed since the release of an operational directive from the WA Department of Health.
Design: Cross-sectional postal survey conducted in 2008 compared to the results of the 2001 survey.
Setting: Western Australian public hospitals containing ten or more beds.
Subjects: 66 WA hospitals in 2001; 59 WA hospitals in 2008.
Main outcome measures: Characteristics of defibrillators; CPR and defibrillation training and assessment; who was permitted to undertake defibrillation; type of cardiac arrest management team, whether data was routinely collected on cardiac arrests and outcomes and any other issues related to resuscitation policy and practice.
Results: There was a 15% increase in the number of hospitals with AEDs (15% difference; 95% CI 10%, 29%; p= 0.04) and an increase in proportion of hospitals that allowed nurses to defibrillate from 74% to 98% (24% difference; 95% CI 14%, 34%; p<0.001). There was an increase in the uptake of ARC guidelines (15% difference; 95% CI 5%, 25%; p<0.01).
Conclusions: Since the release of the operational directive following the 2001 survey more hospitals have purchased AEDs and there has been an increase in the proportion of hospitals ‘allowing’ nurses to defibrillate. However, given the overwhelming evidence that time to defibrillation is the major determinant of the likelihood of survival in cardiac arrest, it is indefensible that not all hospitals can provide first responder defibrillation 24 hours per day, seven days per week.
Developing the Nurse Practitioner role in a rural Australian hospital ‑ a Delphi study of practice opportunities, barriers and enablers
Authors: Haines Helen , Critchley Jennifer
Published: June 2024

Objectives: To gain a consensus view of potential roles for Nurse Practitioners (NPs) in a rural Australian hospital and identify the barriers and enablers in their development and implementation. Developing the Nurse Practitioner role in a rural Australian hospital ‑ a Delphi study of practice opportunities, barriers and enablers
Design: A three-round Delphi study.
Setting: A rural hospital.
Participants: Twenty-eight nurses, five doctors, four consumers, two health service managers, two allied health practitioners, one midwife, three community workers, two administrators and three others with hospital affiliation.
Main Outcome Measures: Consensus at 75% level of agreement or greater, identifying service gaps which might benefit from NPs and the barriers and enablers impacting on the success of developing and implementing the role.
Results: Introduce mental health, aged and critical care NPs initially. Barriers and enablers identified as impacting on the development and implementation of the role were:

Educational access for isolated rural nurses ‑ local cohort learning with employment contracts encompassing fee assistance and designated study time.
Acceptance from doctors ‑ supported role provided the proposed service is sustainable. Small teams of NPs would achieve this.
Inappropriate Recruitment ‑ NP role matching service need, not individual.
Policy and Funding Constraints ‑ clients are best served by NPs working across the care continuum. Co-funding by acute and community providers could overcome the current constraints of commonwealth/state payment.

Conclusion: In developing and implementing NP roles at a rural health service the issues of access to tertiary education, creating a sustainable number of NP positions and financial cooperation from community and acute providers must be taken into account. Only then can nurses who wish to take on this NP role in a rural health service have the possibility of success.
The psychosocial needs of families during critical illness: comparison of nurses’ and family members’ perspectives
Authors: Kinrade Trish , Jackson Alun , Tomany Jane
Published: June 2024

Objective: To explore the needs of relatives whose family member is unexpectedly admitted to an Intensive Care Unit and compare ranked need statements between family members and nurses.
Design: This is a descriptive study using the Critical Care Family Needs Inventory (CCFNI) to measure, rank and compare a series of need statements.
Setting: An Intensive Care Unit (ICU) in regional Victoria, Australia.
Subjects: A convenience sampling strategy was used to acquire a total of 58 participants; 25 family members of patients unexpectedly admitted to the ICU and 33 nurses.
Results: Comparative analysis of the data revealed that there were minor differences identified in the rank order of the need statements listed in the CCFNI amongst nurses and family members. A comparison with previous studies also identified minor differences in both the rank order of individual need statements and the five factor analysis categories previously established.
Conclusion: The CCFNI continues to be a good diagnostic tool in family needs assessment.
Investigating people management issues in a third sector health care organisation – an inductive approach
Authors: Rodwell John James , Noblet Andrew James , Steane Peter , Osborne Stephen , Allisey Amanda Faye
Published: June 2024

Objective: To explain use of inductive convergent interviewing to generate the perceived critical people management issues, as perceived by staff, as a prelude to longitudinal surveys in a third sector health care organisation.
Design: Convergent interviewing is a qualitative technique that addresses research topics that lack theoretical underpinning and is an inductive, flexible, evolving research approach. The key issues converged after six rounds of interviews as well as a further round to ensure that all of the common people management issues had been generated.
Setting: Studies in employee behaviour in the health care industry exist, but there is little in the way of tested models of predictors of such behaviour in third sector organisations in the Australian health care industry. The context is what differentiates this study covering a range of facilities and positions in hospitals and aged care situations within one third sector health care organisation.
Subjects:The study proposed twenty seven extensive interviews over a range of facilities and positions. Twenty one interviewees participated in the final convergent process.
Conclusions: Critical issues included: workload across occupational groups, internal management support, adequate training, the appropriate skill mix in staff, physical risk in work, satisfaction, as well as other issues. These issues confirm the proposition of sector‑ness in health organisations that are multi‑dimensional rather than uni‑dimensional.
Shift work and work related injuries among health care workers: A systematic review
Authors: Zhao Isabella , Bogossian Fiona , Turner Catherine
Published: June 2024

Objective: To review the published scientific literature for studies analysing the associations between shift work and work related injuries among health care workers.
Design: Systematic review.
Methods: The following selection criteria were used to systematically search the literature: primary research studies published in English; target populations were health care workers engaged in shiftwork; and outcome measures were work related injury/injuries. Data extraction and quality assessment were performed independently by the authors using a standardised procedure. Synthesis of data is presented in text and tabular format. Meta‑analysis was not possible due to the heterogenic nature of the studies reviewed.
Results: This review retrieved 13 studies that met all inclusion criteria, none of which were conducted in Australia. The majority of study findings have shown that shift work is associated with a higher incidence or risk of sustaining work related injuries. However, most studies were cross sectional in design. The only case control study presented contrary results to the other studies. Furthermore, all study results could have been biased or confounded due to methodological limitations.
Conclusions: The relationship between shift work and work related injuries amongst health care workers could not be determined due to the relatively low level of evidence. High quality analytic studies should be conducted to provide better results explaining the causal relationship.
Nursing resource implications of the unoccupied bed
Authors: Collins Bronwyn , Fleming Lesley , Hine Bette-Anne , Stephenson Johanna , Veach Kate , Anderson Sue , Mawson Tim , Webster Joan
Published: June 2024

Objective: To explore the specific factors that impact on nursing resources in relation to the ‘unoccupied bed’.
Design: A descriptive observational study was used to identify and classify tasks associated with an ‘unoccupied bed’
Methods: Four project nurses held informal discussions with all levels of staff in four divisions of the hospital (surgery, internal medicine, cancer care and women’s and newborn). Field notes were made throughout the process and the project nurses met regularly to compare findings and identify similarities.
Results: This study identified three main areas of nursing work, which centre on the ‘unoccupied bed’: 1) bed preparation for admission; 2) temporary transfer; 3) bed preparation post-patient discharge.
Conclusion: The unoccupied bed is not resource-neutral and may involve considerable nursing time. The time associated with each of the reasons for the bed being unoccupied remains to be quantified.
Trends in workplace violence in the remote area nursing workforce
Authors: Opie Tessa , Lenthall Sue , Dollard Maureen , Wakerman John , MacLeod Martha , Knight Sabina , Dunn Sandra , Rickard Greg
Published: June 2024

Objective: To assess incidence of workplace violence in the remote area nursing workforce and to compare present data to data collected 13 years previously.
Design: The research adopted a cross‑sectional design, using a structured questionnaire.
Setting: Health centres in very remote Australia.
Subjects: 349 nurses working in very remote regions across Australia.
Main Outcome Measure: The main outcome measure was posttraumatic stress disorder (PTSD) symptoms, as assessed using the PTSD Checklist (PCL).
Results: Findings indicate increases in all incidents of reported violence in the workplace between 1995 and 2008. Verbal aggression, property damage and physical violence are the most frequently experienced forms of violence as perpetrated directly towards remote area nurses, with statistically significant positive correlations between all types of workplace violence and PTSD symptoms. Verbal aggression, physical violence and property damage are the most commonly witnessed forms of violence occurring between other people. Statistically significant positive correlations were also found between each type of witnessed violence and PTSD symptoms, excluding sexual abuse/assault. Nurses working in very remote regions in Australia are fearful for their personal safety.
Conclusion: Working in fear for your personal safety can function as a major occupational stressor. The research has implications for the implementation of workplace policies that target the identification, management and prevention of violence in the remote area nursing workforce.
Advanced nursing practice: a futures model derived from narrative analysis of nurses’ stories
Authors: Kucera Karen , Higgins Isabel , McMillan Margaret
Published: June 2024

Objective: To present a model of advanced nursing practice based on a narrative analysis of advanced practice stories provided by nurses.
Design: Using narratives depicting their clinical practice, nurses were asked to provide illustrations of advanced practice. Analysis of fifty nine narratives enabled exploration of aspects of advanced practice.
Setting: Stories depicted contexts of advanced nursing practice including mental health, child and family health, acute and aged care.
Results: Findings revealed six themes: Knowticing; Getting a doctor; Trans‑action; Taleoring care; Experiencing vulnerability and Transporting: facilitating comfort and control. Three narrative aspects representing advanced practice were described: Rescue; Recognition and Responsibility; and Respect. The stories were of complex care situations relating to diverse areas of work highlighting critical incidents. Some incidents gave nurses great satisfaction whilst others were challenging.
Conclusions: The findings are presented as a model of advanced practice. Both the world of advanced practice a diagrammatic representation of the findings, and the futures model of advanced nursing practice incorporate the themes that emerged from the study. They highlight the central, often invisible place of the nurse in patient care. Advanced practice nurses assume responsibility for optimising care. They believe they make a difference and they call for recognition. The models reflect the multi‑dimensional nature of advanced practice, its inherent complexity, dynamism and the potential for amplification of practice roles and functions.
An analysis of nurses’ views of harm reduction measures and other treatments for the problems associated with illicit drug use
Authors: Ford Rosemary
Published: June 2024

Objective: To analyse nurses’ views of harm reduction measures and other treatments for the problems associated with illicit drug use.
Design and setting: The study, a cross‑sectional survey, sampled the entire registered nurse population of the ACT. A self‑complete survey was posted to home or workplace addresses. The views of all nurses registered in the ACT were sought.
Subjects: The study sample (n = 1,605: 50% response rate), was predominantly comprised of nurses working outside specialist drug and alcohol fields (94%), with a small group from specialist fields.
Main outcome measures: A 6‑point Likert scale comprising 7 items (illicit drug treatments). Comparison with the Australian population was achieved through use of the National Drug Strategy Household Survey database.
Results: Nurses mirrored the views of the Australian population, being strongly supportive of two abstinence‑based measures (naltrexone for the maintenance of abstinence – 82% and rapid detoxification therapy ‑ 77%) and one harm reduction measure (the needle and syringe program – 76%). Nurses’ lower support for the methadone maintenance program (66%) was statistically significant.
Conclusions: Nurses reported high approval for the needle and syringe program but were mistakenly optimistic about abstinence‑based measures for problems associated with illicit drugs. They reported significantly less support for important harm reduction measures ‑ the methadone maintenance program and safe injection rooms. Nurses’ low approval rating for these harm reduction measures is at odds with the evidence. This study highlights the need for education on the evidence base for the various illicit drug treatments.
Models of health service delivery in remote or isolated areas of Queensland: a multiple case study
Authors: Birks Melanie , Mills Jane , Francis Karen , Coyle Meaghan , Davis Jenny , Jones Jan
Published: June 2024

Objective: This paper reports on models of health service delivery in remote or isolated areas of Queensland.
Background: There is little research that investigates current models of health service delivery in remote or isolated areas of Australia.
Design: A multiple case study research design was employed that included interviews and focus groups.
Setting: Three types of health care facilities in remote or isolated Queensland.
Subjects: Thirty-five registered nurses.
Results: Findings indicated that nurses and Indigenous health workers are predominantly resident and provide health services in this environment, while medical and allied health care services are usually provided by non‑resident visiting specialists.
Conclusions: Findings suggest that meeting the needs of communities in remote and isolated areas of Queensland requires a change in the focus of health service delivery to accommodate a primary health care philosophy. The introduction of a new model of health service delivery is recommended; however this will only occur if resources are harnessed to prepare staff to reprioritise services offered.
Implications for Health Service Management: Supporting community partnerships with shared responsibility between health service providers and community members for increasing primary care prevention practices is advocated.
Registered nurses’ opinions about patient focused care
Authors: Kjörnsberg Amelie , Karlsson Louise , Babra Anna , Wadensten Barbro
Published: June 2024

Objective: The aim of the present study was to investigate registered nurses’ (RN) opinions about the organisational change to patient focused care (PFC).
Design: A qualitative explorative design and an interview guide with open‑ended questions were used.
Setting: One ward at a university hospital
Subjects: Six female registered nurses
Main outcome measure(s): The interview questions included items about ‘experiences of PFC’, ‘experiences of one’s own professional role’ and ‘opinions about the quality of care in the model’.
Result: All of the interviewed nurses at the ward had overall positive attitudes towards PFC and felt the care model could facilitate nursing practice. The interviewees emphasised, however, that if one is to make a fair evaluation, more experience of working with PFC as well as total implementation of the model is needed. The interviewees did report positive effects of PFC, which they believed gave all employees at the ward greater motivation to work towards continuous development.
Conclusions: The RNs in the present study had overall positive attitudes towards PFC and felt the care model could facilitate nursing practice. The present study illustrates nurses’ experiences of working at a ward that uses PFC as its organisational form, and this knowledge is valuable to nursing managers who are considering organisational changes. The interviewed nurses found that PFC had many advantages and that the organisational form could therefore be suitable in several clinical settings.
Casualisation in the nursing workforce – the need to make it work
Authors: Becker Susanne , McCutcheon Helen , Hegney Desley
Published: June 2024

Objective: The aim of this paper is to highlight some of the challenges faced by the nursing profession in response to increased casualisation of its workforce and why the presence of casualisation needs to be viewed in a positive light.
Setting: The nursing workforce worldwide.
Subjects: Nurses who need or want to work as casuals.
Primary argument: The care‑giving responsibilities of a predominantly female workforce and the ageing of the nursing workforce worldwide means some nurses are choosing or need to work as casual employees in order to remain in the workforce. Historically, casuals have been viewed in a negative light particularly in discussions around commitment and continuity‑of‑care. Without a change in attitude towards nurses who work as casuals, a significant portion of the nursing workforce may be lost.
Conclusions: An ageing nursing workforce coupled with a worldwide shortage of nurses means that employers need to ensure options are available to accommodate nurses requiring flexible rosters in order to encourage recruitment and retention. Policies are needed to ensure that all staff, regardless of their contribution in hours, feel valued and supported and are able to contribute to their profession. Maintaining a portion of the workforce in a flexible form will allow increased staffing options and ensure that sufficient experienced staff are available in order to maintain quality patient care and outcomes.
Nursing double degrees: a higher education initiative in times of nursing shortages
Authors: Hickey Noelene , Sumsion Jennifer , Harrison Linda
Published: June 2024

Objective: The aim of this paper is to raise awareness of nursing double degrees (DD) and pose questions about their possible impact on nursing shortages.
Setting: Nursing education in the Australian higher education sector.
Primary argument: DDs that include nursing are now offered in 13 universities in Australia with over one third of undergraduate nursing students studying by DD mode. The paper argues that the nursing profession should be alert to the growing presence of DD nursing students and graduates and consider the implications of DDs as part of future workforce planning.
Conclusions: To take account of DD graduates who do not choose to take up a career in nursing, there needs to be an increase in Australian Government funded nursing places and more incentives to remain in nursing. Additionally, where a DD includes a second professional qualification (e.g. teaching, paramedicine) there needs to be some relaxation of cross professional regulations and scopes of practice so that DD graduates can practice in both disciplines.