bluuebunny/crossref_metadata_2025 huggingface dataset:
Exploration of interaction and shared care arrangements of generalist community nurses and external nursing teams in a rural health setting
Authors: Woodhouse Gay
Published: June 2024

Objective: The purpose of this pilot study was to determine the understanding of nurses within a shared care model and the degree of interaction evident in their practice in the shared care nursing environment in a rural caresetting. Sharing of care between different nursing teams can allow for the improved use of minimal resources available in rural communities. The objectives of the research were firstly, to identify the interactions of nursing teams in a shared care model and secondly, to determine how shared care is evident in their practice. The final objective was to draw attention to the importance of shared care models in rural health settings and to develop recommendationsto support shared care models.
Design: A qualitative, non experimental, grounded theory descriptive study was used in this research.
Setting: Primary care. 
Subjects: The sample comprised the generalist community health team, which consisted of registered nurses with more than 5 years post registration experience in community health nursing and two external nursing teams, comprised of a palliative care team and an aged care team.
Main Outcome Measures: Identification of the nursing interactions and shared care practices in order to develop recommendations to foster and support shared care models in changing health structures.
Results: The study generated four themes: a lack of understanding of each teams’ roles; difficulties in communication of information; the importance of setting shared goals in care planning; and the need for collaboration to ensure clarity in case coordination.
Conclusion: Results suggest that confusion around role, skills, communication, care planning and coordination of care within a shared care model are creating barriers to effective sharing of care. Co‑location of services should enhance sharing of care. These results should facilitate the development of care approaches that maximise health outcomes and contribute to a better understanding of collaborative processes that can assist in the provision of health care in rural settings.
The effect of a Nursing Presence program on reducing stress in older adults in two Korean nursing homes
Authors: An Gyeong‑Ju , Jo Kae-Hwa
Published: June 2024

Objective: The purpose of this study was to determine the effect of a Nursing Presence (NP) program on stress in older adults in two Korean nursing homes.
Design: The design was quasi‑experimental study.
Setting: This study was undertaken in two nursing homes in Daegu, South Korea.
Subjects: The subjects were 39 older female adults 68 to 87 years of age selected by purposive sampling and divided into two groups: experimental and control.
Intervention: The NP program consisted of three stages: introduction, operation and termination. The NP program was applied 8 times over 4 weeks to the experimental group. The time required for each stage was 25~30 minutes. In the control group, care was provided according to the usual routine.
Main outcome measures: Measures were stress levels and problem focused coping as psychological variables and cortisol levels as a physiological variable.
Results: Stress, problem focused coping, and cortisol levels after application of the NP program were significantly improved in the experimental group compared to the control group.
Conclusions: The results of this study suggest that the use of a Nursing Presence program can be considered an effective intervention for reducing stress and improving problem focused coping in older adult nursing home patients.
Population ageing and the politics of demographic alarmism: implications for the nursing profession
Authors: Johnstone Megan-Jane , Kanitsaki Olga
Published: June 2024

Objectives: This article provides a brief examination of the prejudices and politics framing current public debate on population ageing in Australia and the possible implications of this for the allocation of required health and social sector resources. The role and responsibility of nurses and professional nursing organisations to engage in and influence public policy debate concerning the health and social care of older people is highlighted.
Setting: Australia.
Subjects: Australia’s ageing population and succeeding generations over the next 40 years.
Primary argument: According to the Australian government, population ageing in Australia is poised to cause unmanageable chaos for the nation’s public services. The cost of meeting the future health and social care needs of older Australians is predicted to be unsustainable. Officials argue that government has a stringent responsibility to ration current and future resources in the health and social care sector, cautioning that if this is not done, the nation’s public services will ultimately collapse under the strain of the everincreasing demands placed on these services by older people. This characterisation of population ageing and its consequences to the nation’s social wellbeing may however be false and misleading and needs to be questioned.
Conclusion: The nursing profession has a fundamental role to play in ensuring responsible debate about population ageing and contributing to public policy agenda setting for the effective health and social care of Australia’s ageing population.
The relationship between clinical outcomes and quality of life for residents of aged care facilities
Authors: Courtney Mary , O'Reilly Maria , Edwards Helen , Hassall Stacey
Published: June 2024

Objectives: It is widely assumed improving care in residential facilities will improve quality of life (QoL), but little research has explored this relationship. The Clinical Care Indicators (CCI) Tool was developed to fill an existing gap in quality assessment within Australian residential aged care facilities and it was used to explore potential links between clinical outcomes and QoL.
Design and Setting: Clinical outcome and QoL data were collected within four residential facilities from the same aged care provider.
Subjects: Subjects were 82 residents of four facilities.
Outcome Measures: Clinical outcomes were measured using the CCI Tool and QoL data was obtained using the Australian WHOQOL‑100.
Results: Independent t‑test analyses were calculated to compare individual CCIs with each domain of the WHOQOL‑100, while Pearson’s product moment coefficients (r) were calculated between the total number of problem indicators and QoL scores. Significant results suggested poorer clinical outcomes adversely affected QoL. Social and spiritual QoL were particularly affected by clinical outcomes and poorer status in hydration, falls and depression were most strongly associated with lower QoL scores. Poorer clinical status as a whole was also significantly correlated with poorer QoL.
Conclusions: Hydration, falls and depression were most often associated with poorer resident QoL and as such appear to be key areas for clinical management in residential aged care. However, poor clinical outcomes overall also adversely affected QoL, which suggests maintaining optimum clinical status through high quality nursing care, would not only be important for resident health but also for enhancing general life quality.
Basic life support knowledge of undergraduate nursing and chiropractic students
Authors: Josipovic Patricia , Webb Michael , McGrath Ian
Published: June 2024

Objective: The aim of this study was to examine retention of CPR/BLS knowledge of third year nursing and fourth year chiropractic students following instruction and assessment of CPR/BLS skills and knowledge as part of their undergraduate degree program.
Design: Non‑experimental exploratory survey to determine perceived ability and knowledge of CPR/BLS following completion of CPR/BLS instruction.
Setting: University Health Sciences School.
Subjects: 87 third year undergraduate nursing and 43 fourth year undergraduate chiropractic students at Royal Melbourne Institute of Technology (RMIT).
Main outcome measure: The level of knowledge of CPR/BLS was assessed via the number of correct responses to questions regarding CPR/BLS. A visual analogue scale was used for the students to score their self rated perceived knowledge and skill.
Results: The majority of students (78%) felt they were well prepared to perform CPR/BLS, however there were deficiencies in both groups with regards to knowledge of current guidelines. Chiropractic students were less likely to identify the correct compression rate compared to the nursing group (Spearman’s rho 0.669, p‑.001) with 95% of the chiropractic students not able to identify the correct rate. Thirty four percent of the students were unable to identify the correct ventilation compression ratio with nursing students again more likely to respond correctly (Spearman’s rho 0.508, p‑.001). Nursing students scored themselves highly for self rated knowledge and ability to perform CPR. Chiropractic students tended to score themselves at a lower rating in these areas than the nursing students; however the differences were not statistically significant.
Conclusions: Although students from both disciplines had significant gaps in knowledge of CPR/BLS nursing students outperformed chiropractic students in all aspects of CPR/BLS knowledge. Despite the knowledge gap students from both disciplines were confident in their self-assessed ability to perform and assess the need for CPL/BLS.
Surveying general practice nurses’ communication preferences in Tasmania
Authors: Bowers-Ingram Lin , Nelson Mark
Published: June 2024

Objective: To investigate Tasmanian practice nurses preferred means of communication.
Design: A self‑administered postal survey.
Setting: Primary care.
Subjects: In this study a practice nurse was classified as: (a) a trained registered or enrolled nurse who worked with/and for a sole GP/group of GPs in a clinical capacity; and (b) self identified as a practice nurse. At the time this study was conducted, this related to 197 nurses.
Main outcome measures: Tasmanian practice nurses preferred means of communication with agencies / organisations outside their practice and between other practice nurses.
Results: Respondents preferred methods of communication were by telephone (68%) and in person (32%), although the latter was not usually practical. The majority stated there should be more communication between practice nurses and were interested in being involved in a state‑wide network. 140 of 197 nurses responded (71% response rate). The Tasmanian practice nurse demographic data was generally comparable to that of other Australian Practice Nurses obtained by the 2005 Australian General Practice Network (AGPN) survey.
Conclusion: Identifying and meeting communication and networking needs of the evolving practice nursing specialty is essential for future developments nationally and internationally, in developing the professional role and support for practice nurses. This will ultimately reduce professional isolation, improve job satisfaction and improve patient care.
Barriers to the reporting of medication administration errors among nursing students
Authors: Koohestani Hamid Reza , Baghcheghi Nayereh
Published: June 2024

Objective: The main aim of this study was to describe the perceived barriers to medication administration error (MAE) reporting among nursing students.
Design: A cross‑sectional, descriptive study was conducted using self‑report questionnaires. An 18‑item barriers to MAEs reporting questionnaire with 6‑ point Likert‑type scale (1=strongly disagree, to 6=strongly agree) was used for this study.
Setting: Three nursing schools at Arak University of Medical Sciences in Iran.
Subjects: Two hundred and forty nursing students were invited through census method.
Main outcome measure: Nursing students’ perceived barriers to MAE reporting.
Results: Nursing students estimated 80.12% of all medication errors by nursing students are reported to their instructors. Administrative barrier (standardised mean=4.31) and fear (standardised mean=4.24) were the top two reasons for not reporting medication errors among nursing students.
Conclusions: Findings from this study suggest MAE occurrences among nursing students are often underreported. Nursing student’s instructors must demonstrate positive responses to nursing students for reporting medication errors to improve patient safety.
The influence of personal characteristics on student nurse health attitudes
Authors: Moyle Wendy , Park Yeon Suk , Olorenshaw Rachel , Grimbeek Peter , Griffiths Susan , Murfield Jenny
Published: June 2024

Objectives: To measure student nurses’ attitudes toward health and identify the influence of demographic characteristics and psychological wellbeing on these attitudes.
Design: A cross‑sectional survey between April and June 2006.
Setting: An Australian University in South‑East Queensland.
Subjects: 369 students enrolled in the Bachelor of Nursing, Pre‑Registration Program.
Main outcome measures: Attitudes to health, measured by the Health Attitude Scale‑form B and psychological wellbeing, measured by the General Health Questionnaire‑28.
Results: Student nurses were generally positive in their ‘feelings’, ‘beliefs’ and ‘intentions’ towards health behaviour. There was a significant difference in ‘feelings’ towards health by year of BN program (F(2,336) = 3.128, p<0.05), with respondents becoming more positive as they progressed through their study. Those not in employment had more positive ‘feelings’ towards health than those in employment (F(1,366) = 5.642, p<0.05) and the better reported psychological health, the more positive the ‘feelings’ (F(2,366) = 3.862, p<0.05). Older age groups reported more positive health ‘beliefs’ (F(3,350) = 4.414, p<0.01) and ‘intentions to act’ (F(3,350) = 2.986, p<0.05). Males were more positive than females in their health ‘beliefs’ (F(1,337) = 4.246, p<0.05).
Conclusions: Individual characteristics influenced student nurses’ attitudes towards health and measurement which incorporates ‘feelings’, ‘beliefs’ and ‘intentions to act’ as components of health attitudes provide a clearer picture of where these influences lie. Further research is advocated to replicate these findings in a broader sample and determine their implications in the design of primary prevention strategies.
Venous Thromboembolism Prophylaxis: The role of the nurse in changing practice and saving lives
Authors: Collins Renea , MacLellan Lorna , Gibbs Harry , MacLellan Donald , Fletcher John
Published: June 2024

Background: Venous thromboembolism (VTE) predominantly afflicts surgical and medical patients in an acute hospital setting. Responsibility for VTE risk assessment and appropriate prophylaxis to prevent this major health burden rests with a variety of clinical staff. All too frequently, however, patients do not undergo VTE risk assessment on admission. This is regardless of the fact that a number are at risk for VTE, receive no prophylaxis and unknowingly are at risk of serious adverse events including death.
Objective: The broad aims of this paper is to provide evidence based information on VTE and to report on the rate of appropriate VTE prophylaxis pre and post nursing educational sessions.
Setting: This paper describes a nurse led initiative undertaken at a tertiary level acute care facility in Queensland.
Subjects: A clinical audit was conducted on 2,063 hospitalised inpatients. 
Primary argument: Nurses who are empowered through evidence based education sessions can take responsibility for VTE risk assessment of all admitted patients and ensure appropriate VTE prophylaxis is provided. The rates for appropriate prophylaxis in admitted patients at risk of VTE increased from 27% to 85% (p< 0.0001). Through appropriate prophylaxis of patients at risk of VTE, the incidence of VTE will be significantly reduced.
Conclusions: Nurses who are committed to VTE risk assessment and prophylaxis have the ability to contribute significantly to the reduction of VTE and its subsequent complications.
Nursing education: reducing reality shock for graduate Indigenous nurses – it’s all about time
Authors: Hinton Allison , Chirgwin Sharon
Published: June 2024

Objective: Since the decision to transfer nurse education to tertiary institutions in 1984, there have been many follow up inquiries to assess if the issues around training, including the inadequate preparation for the stresses of work, had in fact been addressed. This paper aims to highlight a range of specific strategies explored and implemented during the delivery of a Bachelor of Nursing program in an attempt to improve the retention of Indigenous nursing students and to generate a more enhanced educational preparation for future nursing students.
Setting: Batchelor Institute of Indigenous Tertiary Education in Australia’s Northern Territory and drawing on previous research about aspects of reality shock (identified by neophyte graduate nurses), that is; too much theory, not enough opportunity to practice clinical skills and insufficient mentoring.
Subjects: Indigenous Australian nursing students studying at Batchelor Institute of Indigenous Tertiary Education campus, in Australia’s Northern Territory between 2006 and 2008.
Primary Argument: Ten years after the transition from hospital based to tertiary sector training, the 1994 National Review of Nurse Education in the Higher Education Sector, (presented by Reid et al), acknowledged that the undergraduate curriculum was constrained by the time demands required to cover clinical education and nursing subjects. The committee suggested that the (then) changing health care environment, and in particular the health care of Indigenous Australians, would necessitate an increase in time allocation in some schools of nursing lack of time should never be an excuse for failing to address student needs, such as the broadest possible exposure to, and repeated practice of, key clinical skills.
Conclusion: A nursing curriculum focused on incorporating maximum clinical practice hours both on and off campus; limiting the time between translating theory into practice; implementing intensive theory delivery and developing a hospital based mentoring program provides solutions to reducing much of the reality shock experienced by new graduate nurses.
Premenstrual syndrome and management behaviours in Turkey
Authors: Öztürk Sibel , Tanrıverdi Derya , Erci Behice
Published: June 2024

Objective: To reveal the ways women experience their symptoms of premenstrual syndrome and how they cope with these symptoms.
Design: This is a descriptive study using the Premenstrual Syndrome Scale (PMSS) to measurement. This scale is 5‑point Likert‑type and consisting of 44 items.
Setting: This study focused on the experience of menstruation cycles within a group of women aged between 15‑49 years who attended the Yenişehir primary care centre in Turkey.
Subject: This descriptive study was carried out on 379 women who experienced menstruation between May and December 2006.
Result: The research data were collected by means of an introductory form and premenstrual syndrome scale. Among participants, 79% experienced moderate to high levels of PMS symptoms. The average scores of the subscales were highest regarding sleep changes, pain, fatigue and irritation.
Conclusion: There were limited numbers of women who used management methods oriented to PMS symptoms and these methods were mostly ineffective.
Patient satisfaction with Nurse Practitioner care in primary care settings
Authors: Gagan Mary Jo , Maybee Patricia
Published: June 2024

Objective: To determine the level of satisfaction with care and acceptance of the role of Nurse Practitioner in New Zealand.
Design: A descriptive correlational study was conducted using a 15 item satisfaction survey distributed to participants by the clinic receptionist after a clinic visit to the NP. Demographic data, reason for visit and waiting times were also collected.
Setting: Two clinical sites in the same medium sized city were used for data collection. The first site was a university campus health clinic and the second a primary health care clinic in an industrial area.
Subjects: Convenience sample of the first 100 patients to complete and return the self‑administered survey from each practice site were to be included in the study. In fact 193 useable surveys were included.
Outcome measures: Patient satisfaction and acceptance was measured using modified 15 item version of the Thrasher and Purc‑Stephenson (2008) satisfaction survey.
Results: Patients were satisfied with the care they received and had accepted the role. Mean satisfaction score was 15.59; SD 4.71, range 12‑25. The lower the score the more satisfied the patient. Satisfaction was significantly correlated by only two variables, age (r=.221, p=.003) and role clarity (r=.355, p=.000).
Conclusions: While this study contained limitations, the overall positive findings are similar to previous study findings on patient satisfaction with Nurse Practitioners care. The instrument, methodology, and findings of this study can be used as initial data on the evaluation and continued monitoring of the role in New Zealand (NZ).
Occupational stress in the Australian nursing workforce: a comparison between hospital‑based nurses and nurses working in very remote communities
Authors: Opie Tessa , Lenthall Sue , Walkerman John , Dollard Maureen , MacLeod Martha , Knight Sabina , Rickard Greg , Dunn Sandra
Published: June 2024

Objective: To compare workplace conditions and levels of occupational stress in two samples of Australian nurses.
Design: The research adopted a cross‑sectional design, using a structured questionnaire.
Setting: Health centres in very remote Australia and three major Australian hospitals.
Subjects: 349 nurses working in very remote Australia and 277 nurses working in three major hospitals in South Australia and the Northern Territory.
Main Outcome Measures: The main outcome measures were psychological distress (assessed using the General Health Questionnaire‑12), emotional exhaustion (assessed using the Maslach Burnout Inventory), work engagement (assessed using the Utrecht Work Engagement Scale‑9) and job satisfaction (assessed using a single item measure based on previous relevant research).
Results: Results revealed that nurses working in major Australian hospitals reported higher levels of psychological distress and emotional exhaustion than nurses working very remotely. However, both groups report relatively high levels of stress. Nurses working very remotely demonstrated higher levels of work engagement and job satisfaction. There are common job demands and resources associated with outcome measures for both nurses working very remotely and nurses working in major hospitals.
Conclusion: This research has implications for workplace interventions and the retention of staff in both hospitals and remote area health care facilities.
The role of low intensity laser therapy in community nursing
Authors: Czech Tina , Karimi Leila
Published: June 2024

Objective: To review the effects of low intensity laser therapy (LILT) on healing and to explore its role in community nursing.
Setting: Primary care, outpatient clinic, community health centre.
Primary argument: Low intensity laser therapy encompasses many positive attributes that make it a useful healing mechanism in community nursing.
Conclusions: Laser light is non‑invasive, painless, free from side‑effects, and can support vital bio‑regulating processes, particularly in diabetic and neuropathic conditions. The use of LILT for treatment can bring about positive outcomes for patients, families, communities and governments.
The safety of nurses during the restraining of aggressive patients in an acute psychiatric unit
Authors: Moyo Nompilo , Robinson Priscilla
Published: June 2024

Objective: The aim of the study was to describe patterns of injuries sustained by nurses during the restraining of aggressive patients and to identify factors in the restraining process that can be modified to improve the safety of nurses during restraining.
Design: Within‑method triangulation was used in this study and involved two quantitative data collection methods.
Setting: An adult acute psychiatric unit in Victoria, Australia.
Subjects: Seven male and twenty‑six female nurses.
Main outcome measures: The outcome measures are patterns of injuries and ways of reducing injuries.
Results: Incident reports showed more than half of all injuries occurred in the afternoon shift and during the holding stage of restraining. Eighty percent of the injured nurses sustained multiple injuries. Questionnaire results showed that restraining was associated with an estimated increased risk of being injured of 25% (RR = 1.25, 95% CI= 0.97 to 1.61, p > 0.05). The proportion of injuries was higher among female nurses (52.38%) compared with male nurses (28.57%), (RR=0.51, 95% CI = 0.15 to 1.74, p > 0.05). Lack of group co‑ordination was perceived as the main contributor to injury. Introducing easier restraining techniques and increasing the training period were identified as ways that might improve the safety of nurses.
Conclusion: Most injuries occurred at the holding stage of restraining and in the afternoon shift. Many participants sustained multiple injuries and most of the injuries were caused by physical assaults. There is need for improving group coordination during restraining to increase the safety of nurses.
A glimpse of the future nursing workforce: the Graduate e‑cohort Study
Authors: Huntington Annette , Gilmour Jean , Neville Stephen , Kellett Susan , Turner Catherine
Published: June 2024

Objective: This paper outlines the demographic profile, workforce trajectory and study intentions of the first cohort of newly graduated and registered nurses participating in the Graduate e‑cohort Study.
Design: A longitudinal, electronic cohort of newly graduated and registered nurses was recruited into the first survey and completed the questionnaire by logging on to the e‑cohort web platform www.e‑cohort.net. 
Subjects: Newly graduated and registered nurses completing in 2008 from the University of Queensland, Australia; and Massey University, the University of Auckland and AUT University from New Zealand.
Main outcome measure: The establishment and report on a cohort of newly graduated and registered nurses in Australia and New Zealand. 
Results: All NZ and most Australian participants were employed as nurses. Over half the NZ participants were undertaking a postgraduate qualification compared to 5.9% of the Australian participants. The majority intended to undertake further postgraduate study. All Australian participants working as nurses were currently employed in Australia, 13% of NZ participants were working in Australia. Most participants worked in metropolitan areas (85%) in acute care hospitals (81.1%) in their preferred clinical speciality area (79.4%). Surgical was the most prevalent speciality area (17.8%).
Conclusions: The majority of participants are young, highly mobile, have completed a graduate transition to practice and work in metropolitan areas. Retention of this workforce is essential to meet health care demands and replace the large cohort of older nurses retiring over the next decade.
Consumer perceptions of the effectiveness of a breast care nurse in providing coordinated care to women with breast cancer in Queensland, Australia
Authors: Eley Robert , Rogers-Clark Cath
Published: June 2024

Objective: To assess the effectiveness of a breast care nurse (BCN) in supporting women with breast cancer.
Design: Phone interview using a semi‑structured questionnaire.
Setting: Large Australian regional health service.
Subjects: Women with breast cancer who either received care from the BCN (n=28) or did not receive care from the BCN (n=22).
Main outcome measure: Patient views of the value of information and support between the two groups.
Results: Significant differences were evident between the two groups. For 17 of 18 factors about information needs and quality participants supported by the BCN reported that more information and support needs were met than those without BCN support with statistically greater satisfaction (p<.05) demonstrated for five of the factors. There were also significant differences between the two groups for the timing of support pre and post treatment with those with BCN input indicating higher support in all cases.
Conclusion: The BCN model has been slow to be adopted in Queensland and this study supports continuation of the program and the creation of additional positions. There is clear evidence that a BCN role is accepted and effective in the health service. Furthermore the model of care coordination, support, information and referral has implications for other cancer streams.
Positive patient outcomes in acute care: does obtaining and recording accurate weight make a difference?
Authors: Evans Alison
Published: June 2024

Objective: A crucial part of the assessment process is access to an accurate patient weight. To understand how health care practitioners access recorded weight it is necessary to examine the possible barriers to this in everyday practice and the relationship to patient outcomes. This paper will examine how patient weight is integrated in existing health care systems which require accurate weight to ensure positive patient outcomes.
Setting: Australian hospitals.
Primary Argument: Health care standards would suggest that accurate weight measurement is used by healthcare providers for a variety of inpatient interventions which include safe prescribing practices, radiation and chemotherapies, manual handling, skin integrity management and identifying nutritional risk. The literature supported the notion that the admission process should include the recording of an accurate weight within the primary assessment during admission. However, it is evident that implementation of evidence based screening tools that require documentation of accurate weight, within patient admission procedures, does not automatically translate into every day clinical care.
Conclusions: There may be a difference between how weight measurement should be used and how it is used in practice. All healthcare practitioners require timely access to an accurate weight to inform the planning of interventions to ensure provision of appropriate, safe and quality care. Further work is needed to understand the barriers and drivers involved in obtaining and utilising recorded weight within acute care. Future research has the potential to inform healthcare practitioners of the positive impact of an accurate patient weight on patient outcomes and guide developments in clinical practice.
Clinical assessment and the benefit of the doubt: What is the doubt?
Authors: Deegan Joan , Burton Trish , Rebeiro Geraldine
Published: June 2024

Introduction: Clinical education and associated assessment is an important component of nurse education. A range of factors contribute to a culture that makes the assessment of clinical competence difficult. These factors are environmental, educational, cultural and linguistic diversity amongst students, student expectation, a diverse range of clinical education models. All of which contribute to the variable quality of the clinical education experience and the outcome of clinical assessment. 
Aim: The term ‘benefit of the doubt’ is frequently heard in relation to the  assessment process; and, despite the utilisation of a seemingly comprehensive competency framework to assess clinical learning for close to two decades, it seems that a concerning level of doubt persists. The aim of this paper is to examine the complex factors that impact on the quality of decisions around competence the decision by an assessor to assign a judgement of competent or not, and to explore the reasons that lead to doubt on the part of the assessor and to suggest some possible solutions.
Conclusion: It is suggested that what is needed going forward is a continued commitment on the part of government, the health sector, the tertiary education sector and the National Regulatory Authority to implement, value and extend the initiatives that are currently being developed to insure a viable and sustainable education and training culture for clinical supervisors in the future.
Career choices and destinations of rural nursing students undertaking single and double degrees in nursing
Authors: Hickey Noelene , Harrison Linda
Published: June 2024

Objectives: To identify and compare the location and career preferences of students enrolled in single and transdisciplinary double degrees in a Bachelor of Nursing program at a rural university. To understand what influences and motivates students to enrol in a double degree program that includes nursing.
Design: A cross-sectional cohort study using a semi structured survey.
Setting: Charles Sturt University, Bathurst, New South Wales, Australia.
Subjects: 209 undergraduate students in all years of the Bachelor of Nursing (BN), Bachelor of Nursing/Bachelor of Clinical Practice (Paramedic) (BN/BCP), and Bachelor of Nursing/Bachelor of Early Childhood Teaching (BN/BECT). programs.
Main outcome measures: Demographics of participants; reasons double degree students enrolled in a nursing program; career location and career discipline preferences.
Results: In 2008 the majority (70%) of students in all three groups were from rural areas, but double degree students came from a higher socio-economic background, were younger and were more likely to be male than single degree nursing students. They also had different motivating factors for enrolling and many did not prefer nursing as a career. 40% of BN, 45% of BN/BECT students and 28% of BN/BCP students preferred to work in a rural location for their graduate year.
Conclusions: Students undertaking this rural based double degree nursing program are different to single degree nursing students in a number of important areas. The lack of interest in a nursing career and a rural location by over half of these students is concerning. Targeted strategies are needed to reverse this loss of potential nursing graduates.
Nurses' perceptions of spirituality and spiritual care
Authors: Çetinkaya Bengü , Azak Arife , Dündar Sebahat
Published: June 2024

Objective: The study was conducted to determine the perceptions of nurses regarding spirituality and spiritual care.
Design: This descriptive-type study was carried out in three hospitals in a province in the west of Turkey. The study’s population was made up of 733 nurses working in these hospitals and the sample consisted of 289 nurses who agreed to take part in the study. The data were collected using the nurses’ defining characteristics data form and the Spirituality and Spiritual Care Rating Scale.
Results: It was established that 96.9% of the nurses included in the study had not received any training regarding spirituality and spiritual healing. The Spirituality and Spiritual Care Rating Scale point average for nurses in the study was determined to be 62.43±7.54.
Conclusions: It was established that nurses do not receive sufficient training on the subject of spiritual care, both before and after graduation; but also that their perception of the topic is quite high.
Changing philosophies: a paradigmatic nursing shift from Nightingale
Authors: Warelow Philip
Published: June 2024

Objective: To consider the changing philosophical and theoretical construction of nursing which has moved from an initial focus on positivism and science, and undergone a paradigmatic shift so that it is now being interpreted by some nursing theorists in alternative ways.
Primary Argument: A theoretical review of some nursing theorists and a critical consideration of the wider concepts which have been influential in theoretical constructions gradually moving from the received (positivistic) to the perceived view. The perceived view encompasses the emergence and influence of non-positivist philosophies, which shift the theoretical focus away from causation to a more interpretive, unscientific standpoint, with foundations in phenomenology, humanism, holistic care and qualitative research. The paper demonstrates that many of the theories offered are esoteric, complicated and constructed in an academic way that tends to escape the everyday nurse practitioner.
Conclusion: That multiple options which capture the philosophies and ideologies of both paradigms should/could be considered.
Tailoring Dementia Care Mapping and Reflective Practice to empower Assistants in Nursing to provide quality care for residents with dementia
Authors: Manash Martha , Coulon Lyn , Brown Peter , Reynolds Heather , Kissiwaa Sarah
Published: June 2024

Objective: The study addressed one central aim. This was to explore the experience of Assistants in Nursing being exposed to Dementia Care Mapping coupled with reflection to improve older residents care in a residential aged care facility.
Design and Setting: A qualitative exploratory design was employed to gain an in-depth understanding of Assistants in Nursing  experience of creating new care for older residents using Dementia Care Mapping and feedback. The study was conducted in a dementia specific nursing home, located in urban Sydney, New South Wales, Australia.
Subjects: The study participants were ten Assistants in Nursing and five older residents diagnosed with mild to moderate dementia by a Physician.
Results: For the first time, the study illuminated the Assistants in Nursing innovative care following Dementia Care Mapping feedback and reflection. Their experience was highlighted in three major themes: (i) Reflecting on Care (ii) Creating a Caring Connection and (iii) Empathetic Communication.
Conclusion: These Assistants in Nursing valued and used findings from Dementia Care Mapping feedback coupled with reflection to improve contemporary practice. In addition, they felt empowered to create new nursing strategies for quality care. The study highlighted the usefulness of providing Assistants in Nursing with these types of educational strategies to encourage the development of creative caring for residents with dementia living in a residential aged care facility.
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 evaluate and implement research. This article provides a structured route to questioning the methodology of nursing research as well as aiding the construction of nursing research.
Primary Argument: It is common for students to wonder about the relevance of research (Wright-St Clairand et al 2014). Gaining a degree in the health sector requires the nurse to be familiar with research in a way that informs practice (Wright-St Clair et al 2014). Nurses may benefit from a structured approach that helps them understand the sequence of the text and the subsequent value of a research paper (Moxham 2012).
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 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.
A nurses’ guide to Quantitative Research
Authors: Ingham-Broomfield Rebecca
Published: June 2024

Objective: This article provides a breakdown of the components of quantitative research methodology. Its intention is to simplify the terminology and process of quantitative research to enable novice readers of research to better understand the concepts involved (Benner 1984).
Primary Argument: Globally, evidence-based practice (EBP) has become a major preoccupation of investigators and practitioners involved in the delivery of health care (Liamputtong 2013 pxxi). Working within the health sector requires the nurse to be familiar with research in a way that informs practice, especially if working towards a degree (**Wright-St Clair et al 2014). Nurses may benefit from a discussion that helps them understand the sequence of a research paper (Moxham 2012) that uses quantitative methodology.
Conclusion: The content of a typical quantitative research paper will be discussed in a systematic, logical order. A quantitative grid is provided at the end of the paper. Its intention is to aid the nurse to better understand the differing components of the four main quantitative research methods.
Patient satisfaction with their pain management and comfort level after open heart surgery
Authors: Karabulut Neziha , Aktaş Yeşim Yaman , Gürçayır Dilek , Yılmaz Dürdane , Gökmen Volkan
Published: June 2024

Objective: The aim of this study is to determine patient satisfaction with pain management and comfort levels after undergoing open heart surgery.
Design: This descriptive study was performed between January 31 and April 29, 2011.
Setting: The study was conducted in the cardiovascular surgery clinic of Region Training-Research hospital in Erzurum, Turkey.
Subjects: Fifty two patients (32 males, 20 females; mean age 58.4 years; range 25 to 77 years) who had undergone open heart surgery were included in the study.
Main outcome measure(s): The patient data was collected using Personal Information Form, Pain Satisfaction Surveys and General Comfort Scales at the time of discharge. The Pain Satisfaction Survey is a survey tool which was developed by the ‘American Pain Society’ in 1991. The General Comfort Scale was developed by Kolcaba in 1992 and its validity and reliability in a Turkish setting was tested by Kuğuoğlu and Karabacak in 2004.
Results: In this study, 61.5% of the patients underwent coronary artery bypass graft surgery, 30.7% aorta and/or mitral valve replacement and 7.7% aneurysm repair. The mean scores of pain intensity immediately after surgery, at first post-operative ambulation, at 24 hours before discharge and at discharge were 7.07+2.6, 6.71+2.7, 6.32+2.4 and 4.57+2.3, respectively. Most subjects (88.5%) reported a wait time of 15 min as the longest time they had to wait for pain medication and patient satisfaction with pain management was found to be high. The mean score of comfort level at discharge was 3.16+0.2 and there was no statistically significant difference between the comfort level and pain rating at discharge (r=-0.225, p>0.05).
Conclusion: It was found that pain intensity gradually decreased as patients neared hospital discharge and their overall satisfaction with the nurses’ pain management was high.
Specialist nurses’ experiences of using ‘The Viewer’, a consolidated electronic medical records system: a pre-post implementation survey
Authors: Mills Jane , Woods Cindy , Hitchins Marnie , Summers Glynda
Published: June 2024

Objective: Evaluate changes in specialty areas nurses’ knowledge and perceptions of a consolidated electronic medical record (EMR) system before and after implementation.
Design: A survey deployed pre- and six months post-implementation of ‘The Viewer’.
Setting: Regional Hospital and Health Service, Queensland.
Subjects: Nurses working in specialist areas including community health, palliative care, discharge planning, wound and stoma care, diabetes education and renal dialysis satellite services (n=110) were invited to participate in the study. Response rate of the pre-implementation survey (n=42, 38%) was much higher than the post-implementation subset (n=10, 24%). A major health service restructure that included losses of nursing positions in specialist areas significantly affected postimplementation results.
Intervention: An EMR system called ‘The Viewer’ to access consolidated electronic medical records of patient information produced by different parts of the organisation.
Main Outcome Measures: Changes in participants’ knowledge and perceptions of ‘The Viewer’, and their satisfaction with the quality, ease of use and access to patient information.
Results: Pre-implementation, specialist nurses reported dissatisfaction with most aspects of the current patient information system but high confidence and comfort in using electronic systems. Post implementation satisfaction scores either remained the same or increased. Satisfaction with ease of access to consolidated patient data (U = 125.0, p = 0.038, r = 0.29) and usefulness of electronic systems (U = 115.0, p = 0.031, r = 0.30) increased significantly post-implementation of ‘The Viewer’.
Conclusion: Specialist nurses are positive about the possibilities EMRs offer to centralise, consolidate and improve access to patient data.
Delirium in the intensive care unit and long–term cognitive and psychosocial functioning: literature review
Authors: Bulic Daniella , Bennett Mike , Shehabi Yahya
Published: June 2024

Objective: This paper reviews existing literature on delirium that arises during mechanical ventilation in the Intensive Care Unit (ICU). It looks at the physiology of delirium, its subtypes and risk factors. It further considers the impact of delirium on cognitive and psychosocial function of patients after their discharge from acute care. The aim of this paper was to increase awareness of ICU delirium, accentuate the potential link between different sedation agents and the development of delirium, and inform practitioners, especially nurses, about this common neurocognitive disorder that appears in the Intensive Care Unit (ICU).
Setting: Intensive Care Unit (of any acute hospital) where is ICU located.
Subjects: Mechanically ventilated patients.
Primary argument: This paper argues for the awareness of delirium in the Intensive Care Unit and examines sedation during mechanical ventilation with its potential role in promoting this disorder.
Conclusion: Delirium is the most common neurobehavioral disorder in patients who are critically ill and mechanically ventilated in ICU. It frequently generates psychiatric and psychological outcomes such as depressed mood, anxiety and/ or Post Traumatic Stress Disorder (PTSD). Cognitive and psychological dysfunction following delirium seems to be overlooked, under recognised, and misdiagnosed in the ICU. These impairments are often incorrectly attributed to other processes, such as concurrent psychoactive medication use, substance use, or psychiatric disorders, in particular depression, rather than delirium. Although it is generally accepted that providing sedation for a patient’scomfort is an essential part of bedside care for nearly every patient in ICU, an increasing number of researchers hypothesise there is a strong link between sedation practice and long-term patient centred outcomes, such as quality of life (Dimopoulou et al 2004) and cognitive and psychosocial functioning. Increasing nurses’ awareness ofthis potential link is exceptionally important, as they are instrumental in administration and observing subsequent side effects of any medication, including sedatives.
Using clinical reasoning and simulation-based education to ‘flip’ the Enrolled Nurse curriculum
Authors: Dalton Lisa , Gee Tamara , Levett-Jones Tracy
Published: June 2024

Objective: This paper describes the development and implementation of an innovative Diploma of Nursing curriculum for preparing Enrolled Nursing students for acute care nursing practice.
Setting: Vocational Education and Training at the Health Education and Research Centre in Hobart, Tasmania.
Subjects: Vocational Education and Training students enrolled in the Diploma of Nursing (Enrolled-Division 2 Nursing) (HLT51612).
Primary Argument: The increasing complexity and acuity of contemporary practice environments requires a nursing workforce that is flexible and competent. In 2013 nurse educators developed an innovative approach to offering the national standardised Diploma of Nursing course that integrates three key pedagogical approaches: the ‘flipped classroom’, simulation-based learning and the Clinical Reasoning Cycle.
Conclusion: By ‘flipping the curriculum’ students are provided with opportunities to develop and extend their clinical reasoning skills as they respond to both routine and unpredictable ‘patient’ scenarios in the safety of a simulation environment. These simulated clinical learning experiences are designed to challenge students to ‘think like a nurse’ while actively engaging in the provision of safe and effective ‘patient’ care.