bluuebunny/crossref_metadata_2025 huggingface dataset:
CLINICAL PATHWAYS FOR FRACTURED NECK OF FEMUR: A COHORT STUDY OF HEALTH RELATED QUALITY OF LIFE, PATIENT SATISFACTION AND CLINICAL OUTCOME
Authors: Santamaria Nick , Houghton Liza , Kimmel Lara , Graham Allisa
Published: June 2024

The aim of this study was to compare the health related quality of life (HRQoL), satisfaction and functional outcomes of patients with fractured neck of femur treated with standard care to those treated with a clinical pathway at a major Melbourne university teaching hospital. A 12-month prospective cohort study was conducted comprising 57 patients admitted via the emergency department with a primary diagnosis of fractured neck of femur. Of these, 28 were treated with standard care and 29 using a coordinated multidisciplinary clinical pathway for fractured neck of femur. Outcome measures included; Medical Outcomes Study Short Form (SF-36), Modified Barthels Index (MBI), Timed Up and Go (TU&G), Patient Satisfaction and Perception Form (PSPF) and clinical indicators including; length of stay, time to mobilise, and, complication rates.
Results indicated that there was no significant difference between the groups on clinical and functional outcome, quality of life and satisfaction. Pathway patients had a 3.3 day shorter length of stay and less complications than standard care patients. We conclude that patients cared for under a clinical pathway for fractured neck of femur in this study did not experience decreased health related quality of life or satisfaction with care.
NURSING STUDENTS’ PERCEPTIONS OF OLDER PEOPLE: CONTINUING SOCIETY’S MYTHS
Authors: Moyle Wendy
Published: June 2024

This study aimed to identify student nurses’ views of older people as a means of offering insight into how these perceptions might influence where students choose to work and the care they might provide to older people. A structured questionnaire comprising of eight questions and demographic data was used to survey undergraduate nursing students (n=103). Findings indicate that nursing students are continuing society’s myths of older people being frail and declining in health. There is a need to challenge society’s attitudes so older people become valued and the aged care working environment also becomes a desirable place in which to work. Changes needed in nursing education are also suggested.
THE COURSE OF DEPRESSION IN MOTHERS OF PREMATURE INFANTS IN HOSPITAL AND AT HOME
Authors: Davis Leigh , Edwards Helen , Mohay Heather , Wollin Judy
Published: June 2024

The risk of continuing depression in mothers of very premature infants after discharge has not been studied in any depth. This study compared reports of maternal depressive symptomatology at one month after infant birth (Phase 1) and three months following infant hospital discharge (Phase 2). Fifty-two mothers completed the Edinburgh Postnatal Depression Scale at these two points in time. Results indicate that the percentage of mothers who reported high levels of depressive symptoms significantly decreased between Phase 1 and Phase 2. Logistic regression analysis indicated that depression scores at Phase 1 and maternal stress at Phase 2 were important factors in explaining depression scores at Phase 2.
THE COURAGE TO CARE: NURSES FACING THE MORAL EXTREME
Authors: Ben Sefer Ellen
Published: June 2024

Many European nurses were caught up in the horror of what happened to Jewish people during the Second World War, trapped in ghettoes and concentration camps. The advanced age of the nurses, however, decreases the number of firsthand accounts available. This paper reports on the experience of nurses in one camp, Westerbork, in the Netherlands, highlighting their work and relating their stories. Facing extreme suffering, they chose to care about others when it would have been easier to distance themselves. Until recently, historians’ interest in medical practices in the transit and concentration camps has centered on medicine and sanitation. Utilisation of a nursing framework allows new material that has previously been overlooked to provide a broader understanding of the context of health care within the camps. Westerbork is an ideal camp to study since it had a genuine hospital with medicines and equipment available and a number of wards that provided care. Data collection was through oral interviews, archival documents and literature. The conclusion is that these nurses provide powerful role models of care that are as significant today as they were then.
THE ROLE OF SPECIALIST NURSES IN IMPROVING TREATMENT ADHERENCE IN CHILDREN WITH A CHRONIC ILLNESS
Authors: Goode Michele , Harrod Mary , Wales Sandra , Crisp Jackie
Published: June 2024

Adherence to medical treatment is an ongoing challenge for families and young people with chronic medical conditions. One factor that is likely to influence treatment success is the quality of professional relationships both within the health care team and between the family, child and professionals. This paper explores the topic of professional relationships and adherence and provides an example of how a multidisciplinary team can improve the health and quality of life of paediatric patients. More specifically, the paper argues for the crucial role of the specialist nurse in supporting patients and their relationships with the health care team.
BEYOND THE RHETORIC: WHAT DO WE MEAN BY A ‘MODEL OF CARE’?
Authors: Davidson Patricia , Halcomb Elizabeth , Hickman L , Phillips J , Graham B
Published: June 2024

Background: Contemporary health care systems are constantly challenged to revise traditional methods of health care delivery. These challenges are multifaceted and stem from: (1) novel pharmacological and nonpharmacological treatments; (2) changes in consumer demands and expectations; (3) fiscal and resource constraints; (4) changes in societal demographics in particular the ageing of society; (5) an increasing burden of chronic disease; (6) documentation of limitations in traditional health care delivery; (7) increased emphasis on transparency, accountability, evidence-based practice (EBP) and clinical governance structures; and (8) the increasing cultural diversity of the community. These challenges provoke discussion of potential alternative models of care, with scant reference to defining what constitutes a model of care.
Aim: This paper aims to define what is meant by the term ‘model of care’ and document the pragmatic systems and processes necessary to develop, plan, implement and evaluate novel models of care delivery.
Methods: Searches of electronic databases, the reference lists of published materials, policy documents and the Internet were conducted using key words including ‘model*’, ‘framework*’, ‘models, theoretical’ and ‘nursing models, theoretical’. The collated material was then analysed and synthesised into this review.
Results: This review determined that in addition to key conceptual and theoretical perspectives, quality improvement theory (eg. collaborative methodology), project management methods and change management theory inform both pragmatic and conceptual elements of a model of care. Crucial elements in changing health care delivery through the development of innovative models of care include the planning, development, implementation, evaluation and assessment of the sustainability of the new model.
Conclusion: Regardless of whether change in health care delivery is attempted on a micro basis (eg. ward level) or macro basis (eg. national or state system) in order to achieve sustainable, effective and efficient changes a well-planned, systematic process is essential.
NURSING SANS FRONTIERES: A THREE YEAR CASE STUDY OF MULTI-STATE REGISTRATION TO SUPPORT NURSING PRACTICE USING INFORMATION TECHNOLOGY
Authors: Clark Robyn , Yallop Julie , Wickett Di , Krum Henry , Tonkin Andrew , Stewart Simon
Published: June 2024

Objective: To highlight the registration issues for nurses who wish to practice nationally, particularly those practicing within the telehealth sector.
Design: As part of a national clinical research study, applications were made to every state and territory for mutual recognition of nursing registration and fee waiver for telenursing cross boarder practice for a period of three years. These processes are described using a case study approach.
Outcome: The aim of this case study was to achieve registration in every state and territory of Australia without paying multiple fees by using mutual recognition provisions and the cross-border fee waiver policy of the nurse regulatory authorities in order to practice telenursing.
Results: Mutual recognition and fee waiver for cross-border practice was granted unconditionally in two states: Victoria (Vic) and Tasmania (Tas), and one territory: the Northern Territory (NT). The remainder of the Australian states and territories would only grant temporary registration for the period of the project or not at all, due to policy restrictions or nurse regulatory authority (NRA) Board decisions. As a consequence of gaining fee waiver the annual cost of registration was a maximum of $145 per annum as opposed to the potential $959 for initial registration and $625 for annual renewal.
Conclusions: Having eight individual nurses Acts and NRAs for a population of 265,000 nurses would clearly indicate a case for over regulation in this country. The structure of regulation of nursing in Australia is a barrier to the changing and evolving role of nurses in the 21st century and a significant factor when considering workforce planning.
Concordance with phase‑one cardiac rehabilitation guidelines in the inpatient setting
Authors: Murphy Maria , George Marcia , Driscoll Andrea
Published: June 2024

Objective: To examine concordance with phase‑one cardiac rehabilitation (CR) guidelines, undertake an intervention that might optimise adherence to the guidelines, and establish a benchmark for practice in the coronary care unit (CCU) setting.
Design: Pre‑post intervention medical record review.
Setting: Level 1, university-affiliated coronary care unit (CCU), Melbourne, Australia.
Subjects: Inpatients of the CCU with a discharge diagnosis of acute coronary syndrome, ischaemic‑induced acute pulmonary oedema, myocardial infarction, arrhythmia, or cardiac arrest, and patients for elective coronary interventions (eg. angioplasty).
Interventions: Medical record review of concordance with phase‑one CR guidelines and staff in‑services to communicate the results; distribution of a questionnaire post-in-service to collate staff perceptions of barriers to undertaking phase‑one CR; and repeated medical chart audit to re‑assess concordance.
Main outcome measures: Concordance with the guidelines for phase‑one CR.
Results: Data was complete for 89 cases. Concordance rates ranged from 5 to 100%. Good concordance with guidelines was recorded in advising the patient of their medical diagnosis (98‑100%); and in assessing the patient and their family’s psychological adjustment to their condition and the impact it had on their well-being (80‑83%). The only significant improvement post-intervention was a written invitation to a phase two CR program (5 vs. 14%).
Conclusions: The audit raised awareness of barriers to undertaking phase‑one CR but did not appreciably alter the concordance rates. This suggests other strategies and resources to increase the delivery of phase‑one CR need to be considered
Turkish nurses’ concerns about home health care in Turkey
Authors: Kisa Sezer
Published: June 2024

Objective: The purpose of this study was to explore nurses’ concerns regarding the introduction of home health care in Turkey.
Design: The study was a descriptive research design using a self administered questionnaire.
Setting: The setting was a 400 bed general public hospital in Ankara, Turkey.
Subjects: 243 staff nurses were invited to participate in the study with 187 nurses returning the self administered questionnaire (response rate 76.95%).
Main outcome measure: The main outcome measure was the level of support by participating nurses for the delivery of home care in the Turkish health system as a way of cost effective health service provision.
Results: The results show that about 60% of the participating nurses supported the introduction of home health services in Turkey.
Conclusions: The results of the study can be used to support the introduction by health policy makers and health professionals of home care as an alternative delivery system in the Turkish health sector.
How general practice nurses view their expanding role
Authors: Elizabeth
Published: June 2024

Objective: The purpose of this research was to explore the barriers and enablers that nurses working in general medical practice experience in relation to the Australian Government driven expansion of their roles (nurses working in general medical practice are titled general practice nurses in Australia). The study design was part of a Masters of Public Health course. The research was conducted as part of employment with the Greater South Eastern Division of General Practice (GSEDGP), Victoria, Australia.(now called the Greater Monash General Practice Network, Victoria, Australia). The Executive Director of the GSEDGP gave permission for the study to be undertaken.
Design: The study used an exploratory descriptive design.
Setting: The setting was general medical practices.
Subjects: The subjects were 22 registered and enrolled nurses working in general medical practices in Victoria, Australia (registered nurses are titled RN Division 1 and enrolled nurses are titled RN Division 2 in Victoria, Australia).
Main outcome measures: The main outcomes measures were: attitudes of the nurse’s toward role expansion; number of nurses moving into expanded roles; adoption of government expansion initiatives; and barriers and enablers.
Results: Over 90% of the respondents identified their role as a practice nurse had expanded since the introduction of the Australian Government general practice initiatives. 86.4% were happy with the expansion of their roles and positive about government plans for further role expansion. General practitioners (GPs) were seen as supportive of the nurses’ role expansion, however half the sample identified that it was up to the nurses to initiate their own role expansion. Variables were compared with attitudes toward expansion between registered nurses and enrolled nurses; nurses over and under 40 years of age; and those who had been in general practice differing lengths of time. No significant differences (p> 0.01) were found when any of the variables were compared.
Conclusions: The majority of practice nurses have experienced role expansion and are positive about this. Most practice nurses indicated they were the driving force behind the expansion. Nurses felt that role expansion had improved the quality of care provided to patients and enhanced their job satisfaction. The major inhibitors were lack of physical space within general practices and lack of time. The major enablers were physical space within the general practice office for a nurse to see patients and agreement from the GPs working within the practice for the nurse to expand into new areas.
Nurses’ views and practices regarding use of validated nutrition screening tools
Authors: Rubina  , Simone  , Turner Alana , Porter Judi , Cant Robyn , Aroni Rosalie
Published: June 2024

Objective: To explore nurses’ views and practices regarding use of the Malnutrition Screening Tool (MST) and the Malnutrition Universal Screening Tool (MUST) in acute hospital wards.
Design: The study used a combined methods design with both qualitative and quantitative techniques including focus groups and survey of patient records.
Setting: Four medical or surgical wards in three hospitals within a single health service in Melbourne, Victoria, Australia.
Subjects: Registered nurses (n=54).
Main outcome measures: Audit results and themes from narrative data.
Results: The initial screening rate was 25% and 61% on spot audit of two wards using the MUST, with only 4% (2/47) of patients screened in two wards using the MST. Application of screening was limited by priority of other nursing duties, a nurse’s skill in use of a tool, and interpretation of patients’ weight status. Some nurses applied individual judgment rather than a tool to assess malnutrition risk. After nurse education and support over four months in wards using the MUST, compliance improved to 46% and 70%, Barriers were identified in use of either tool.
Conclusions: Implementation of evidence‑based screening tools within patient admission procedures does not automatically translate into nursing practice. Nurses’ time and nutrition screening knowledge were the main barriers to efficient screening. This suggests a need for induction programs for new staff and increased feedback to nurses regarding screening practice. A nutrition screening team might provide leadership and advocate for such screening practice and enable development of an audit cycle, including regular performance reporting, to increase compliance.
Exploring women’s reactions to a diagnosis of endometrial carcinoma: a pilot study of Australian women
Authors: Linford Wendy , Forster Della
Published: June 2024

Objective: Endometrial carcinoma (cancer of the uterus) is the fifth most common cancer in women world wide and the most common gynaecological cancer. Each woman confronted with such a diagnosis will respond in different ways, as will their family and friends; therefore each will vary in their supportive needs. This study aimed to acquire some insight into the initial impact of a diagnosis of endometrial carcinoma on women and factors relating to support for them.
Design: Semi-structured interviews were used to collect in-depth data on women’s views. Interviews were audio-taped. Demographic data were collected prior to interview by structured questionnaire.
Setting: The setting was a tertiary women’s hospital in Melbourne, Victoria, Australia.
Subjects: The subjects were seven women with newly diagnosed endometrial carcinoma.
Main outcome measures: Interviews were transcribed verbatim and coded into themes.
Results: The findings include an acceptance of the diagnosis and adequate friend and family support. Some women experienced initial denial from immediate family members; for others the diagnosis led to a new appreciation of life and values. Most women received adequate education regarding endometrial carcinoma, while others used varied means including the internet to find further information. Health care facilities for rural versus urban women; the means by which women were told of their diagnosis; and appropriate follow up and support, were issues that arose which require further exploration.
Conclusions: The needs of a woman diagnosed with endometrial carcinoma will vary between individuals. Further research in the area of psychosocial care for women newly diagnosed with endometrial carcinoma would be of value. Women need individualised and accessible education. If women are provided with a variety of educational tools, they can individualise the information they need for themselves.
A stocktake of existing aged care clinical placements for undergraduate nursing students in Australia
Authors: Neville Christine , Yuginovich Trudy , Boyes Joanne
Published: June 2024

Objective: The aim of this study was to survey selected universities on a variety of aspects of the aged care clinical placement component of undergraduate nursing courses.
Design: A cross‑sectional, descriptive design using a questionnaire was employed.
Setting: Selected Australian universities offering undergraduate nursing courses.
Subjects: Australian universities having a faculty, department or school of nursing (n=32).
Results: It was found that placements occurred in the first and third years of academic study largely in an aged care facility close to the university site. There was often competition between universities in trying to access the same facilities for student placements. Not all universities performed a formal assessment of the facility’s suitability for an aged care clinical placement and often universities struggled to find university educators suitably qualified in aged care.
Conclusions: Recommendations include the use of sites other than aged care facilities that offer aged care specific services. Use of services away from the immediate locality may expand student experience, while better university co‑ordination of placements may ensure fairer access to all students. The development and implementation of a clinical audit tool, together with incentives for experienced aged care nurses to participate in higher education may contribute to the development of quality aged care specific skills
The Australian diabetes educators’ skills and readiness for the tsunami of diabetes in the 21st century
Authors: Hill Pauline , Clark Robyn
Published: June 2024

Objective: The objective of the study was to identify the knowledge, skills and practices of diabetes educators in relation to teaching and learning.
Design: Quantitative and qualitative analysis of an online survey.
Setting: Diabetes educators across Australia.
Subjects: A convenience sample self‑selected from the Australian Diabetes Educators Association (ADEA) data base.Main Outcome
Measures: Attributes and barriers to effective teaching and learning.
Results: The survey response rate was 16.2% (n=212) of the 1306 ADEA members. 79% were aged >40years and 10% were >60years; 93% were female; and 34% worked in the role of diabetes educator full‑time. ADEA respondents spent 50% of their day on client education; 20% on administration; and 30% equally distributed between research, quality improvement, staff education and other duties. Barriers to effective teaching and learning were a lack of time, resources and issues associated with bedside teaching. Text responses indicated the desire to provide individualised, culturally, age and gender specific education. The majority of respondents (range 99.1%‑95.5%, p=0.000) reported that providing education that allowed informed choices; helping clients learn from their choices and decisions; collaboratively writing goals and objectives; developing specific and tailored education programmes; teaching in a way that matched the clients’ experiences; using interpreters; and involving families or significant others, were important.
Conclusion: Respondents were aware of the teaching and learning needs of their clients. However strategies to address barriers to effective teaching and learning and the need to maintain advanced skills and knowledge in the context of continuously changing practice and client demographics need to be considered.
Distress levels in Turkish parents of children with congenital heart disease
Authors: Yildiz Aynur , Celebioglu Ayda , Olgun Haşim
Published: June 2024

Objective: The purpose of this research was to determine the distress levels of parents of children with congenital heart disease and identify factors that influenced the levels of distress.
Design: The research used a cross‑sectional, descriptive study design.
Setting: The setting was a Paediatric Cardiology Outpatient Clinic at a university hospital in Erzurum, Turkey.
Subject: The subjects for the research were 262 parents (130 fathers and 132 mothers) of 147 children with congenital heart disease.
Main outcome measure: The Symptom Check List (SCL‑ 90‑R), developed by Derogatis (1997) was used to measure parents’ distress.
Results: Mothers had higher scores than fathers on all distress dimensions (somatisation 1.17 ± 0.43; anxiety 1.78 ± 0.52; depression 1.54 ± 0.50 ‑ p<0.001). Additionally, the intensity of distress for both mothers and fathers increased with the severity of the child’s disease.
Conclusion: Parents were seriously affected by the illness of their children. Parents (especially mothers) of children with congenital heart disease should receive psychological and emotional support from health professionals for distress stemming from parenting a child with special needs.
Verbal, physical and sexual abuse among children working on the street
Authors: Celik Sevilay Senol , Baybuga Media Subasi
Published: June 2024

Purpose: The purpose of this study was to explore the verbal, physical and sexual abuse experienced by children working on the street in Ankara, Turkey to determine the type of abuse occurred, the reactions to being abused, sources of abuse and coping methods against abuse.
Design and Methods: A qualitative and descriptive study was conducted with children working on the street in Ankara, Turkey. Five focus group discussions were held with 40 children. The data collection form contained questions about age, educational status, gender, abuse types, reactions to being abused, sources of abuse and coping methods against abuse. Data were assessed by frequency and percentages by using the Statistical Package for Social Sciences for Windows (version 9.5).
Findings: Children working on the street in the sample said they were subjected to verbal, physical and sexual abuse (50%, 50% and 65%, respectively). More than half the participants were exposed to physical abuse from other working children who were selling different things to help their families (55.0 %) and street children who were homeless and live on the streets (65.0 %). ‘Responding with same methods’ was the most used coping method among children for all types of abuse. Of total participants, 36 children stated they needed information about abuse. The results indicate verbal, sexual and physical abuse have a negative effect on children working on the street.
Conclusions: The number of children working on the street in Turkey increases each day (Polat 2009; Kurt et al 2005) and these children are most at risk for all types of abuse. Children working on the street need information and training to develop their awareness about abuse and their skill in avoiding abuse and/or dealing with the consequences. The present health education available to children working on the street in Turkey does not include information about various types of abuse. Nurses are in a position to play an important role in determining whether children they encounter are experiencing any type of abuse and should be directly involved in identifying the physical, social and psychological consequences of abuse as well as providing avenues for the protection and treatment of children affected by abuse. In order for nurses to be able to provide effective care for children working on the street, they need to be knowledgeable about them and the abuse, violence and other problems the children experience.This paper concludes children have the right to be protected against all types of abuse. Children should be educated to increase their awareness of the various types of abuse and they should also be provided with support by government institutions and health professionals, particularly nurses. Furthermore, preventive measures should be adopted to reduce all types of abuse against children in Turkey.
Predictors of nurses’ commitment to health care organisations
Authors: Al-Hussami Mahmoud
Published: June 2024

Background: Nurses’ commitment in the workplace is a psychological state linking them to their organisations. It has been viewed as a dimension of organisational effectiveness.
Objectives: The purpose of this study was to determine the multiple correlations between the four predictors (job satisfaction, perceived organisational support, transformational leadership behaviour and level of education) on the degree of organisational commitment among nurses in South Florida’s long‑term care facilities.
Method: The analytical procedure of multiple regression was utilised to determine the predicting strength among organisational commitment and the independent variables: job satisfaction, perceived organisational support, transformational leadership behaviour and nurses’ level of education. To obtain the participants for this study, the researcher chose randomly four nursing homes located in Miami‑Dade County. The participants were randomly chosen from a list of nursing staff provided by each facility.
Results: Pearson product‑moment correlation coefficients were computed and revealed that positive correlation existed between nurses’ commitment to their organisations, the dependent variable and job satisfaction, perceived organisational support, transformational leadership and level of education, the independent variables. Of the four independent variables, a multiple regression analysis indicated that job satisfaction and perceived organisational support were most strongly related to nurses’ commitment to their organisations.
Conclusions: The study provides new support to previous research about the importance of nurses’ commitment and satisfaction for organisational effectiveness and performance. It also provides further evidence that the more committed they are to their organisations, the more they will be productive in their organisations.
Australian practice nurse immunisation scholarships: an evaluation study
Authors: Smith Colleen , Heartfield Marie
Published: June 2024

Objective: This paper reports on an evaluation of an Australian Government program to improve immunisation services in primary care settings through the provision of scholarships to support access to education for Practice Nurses (PNs).
Design: The study used a constructivist evaluation methodology to evaluate satisfaction with and effectiveness of a scholarship program to support PNs access to immunisation education and changing nursing immunisation practice.
Setting: Australian Divisions of General Practice and General Practices
Subjects: Twenty-seven PNs who had received immunisation scholarships completed an online survey. Sixty four Division of General Practice (DGP) staff, representing state and territory, urban and rural regions of Australia, participated in telephone focus group interviews.
Results: The scholarships and scholarship processes were viewed positively by PNs. The access to scholarship information, the selection process and the time the scholarship allowed to complete an immunisation course were rated highly. Online learning was seen as an effective means to undertake immunisation education particularly for PNs in the rural sector. Overall, there was overwhelming support for the continuation of scholarships to assist PNs access to education opportunities to improve immunisation services. These opportunities were reported to improve their knowledge and skills which lead to changes in immunisation practice and the quality of care they provided to patients. They also helped overcome geographical and professional isolation.
Conclusions: As PNs emerge as key players in the improvement of immunisation services in Australia, the provision of government assistance for continuing education is an important strategy to produce this appropriately skilled workforce.
The experience of socially isolated older people in accessing and navigating the health care system
Authors: Greaves Moira , Rogers-Clark Cath
Published: June 2024

Objective: This article reports findings from a study exploring the challenges experienced by socially isolated and unwell older people as they attempted to access the health care system. Understanding the specific issues confronting these individuals would inform the development of more appropriate models of community‑based aged care.
Design: A longitudinal qualitative, interpretive study using a case study approach with indepth interviewing.
Setting: This study was conducted in metropolitan Brisbane, with frail older people who were accessed via their GP service.
Participants: Six participants who met pre‑determined selection criteria were recruited to this longitudinal study, and interviewed twice over a six month period.
Findings: Fear emerged as a common experience embracing aspects of daily life such as depletion of social networks, being dependent on others, loss of mobility and diminishing ability to drive. Inadequate or unreliable public transport resulted in extended waiting times to attend medical appointments.
Conclusions: Despite efforts to address the specific issues of frail older people living independently, this study highlights the suffering experienced by those who are socially isolated and lack the knowledge, skills, physical wellbeing and support to locate and access relevant health services.
Inflammatory bowel disease management: a review of nurses’ roles in Australia and the United Kingdom
Authors: Reid Lai Wan , Chivers Sarah , Plummer Virginia , Gibson Peter
Published: June 2024

Objective: To explore the role of Australian nurses in the provision of inflammatory bowel disease (IBD) health services.
Design: A questionnaire survey.
Setting: Hospitals in Australia and the South West of the United Kingdom (UK).
Subjects: Inflammatory bowel disease nurses.
Main outcome measure: The diversity of IBD services.
Results: Twelve Australian and 19 UK nurses returned completed questionnaires (approximately 40% response rate). Most participants were registered nurses, aged between 25 and 55 years. More UK participants were IBD specialist nurses (84% vs 42%; p = 0.019) and the majority of Australian nurses being clinical trial coordinators. The UK nurses had more interest in IBD (100% vs 75%; p = 0.049) and spent more time in IBD nursing (63% vs 25%; p = 0.043). Nurses in the UK provided more IBD services and tended to perceive a higher level of support from management (52% vs 25%; p = 0.12). Fewer IBD services were provided by Australian nurses despite their equivalent educational attainments, years of IBD experience and level of autonomous practice. Australian nurses identified the lack of funding, time and management support as barrier to service development. Australian nurses were less likely to be employed as dedicated IBD nurses and were required to provide nursing services to a wider clientele.
Conclusion: In this study, Australian IBD nurses had less specialised roles, attracted less funding and management support. Australian nurses were more focused on clinical trial coordination and provided for a wider clientele.
Practice nurses best protect the vaccine cold chain in general practice
Authors: Carr Christine , Byles Julie , Durrheim David
Published: June 2024

Objective: Maintenance of the vaccine cold chain is integral to administering potent vaccines thereby protecting individuals and communities against vaccine preventable diseases. Previous studies have highlighted threats to vaccine cold chain integrity. The aim of this study was to assess vaccine cold chain integrity and to identify local factors affecting vaccine cold chain integrity in Hunter general practices, where approximately 85% of vaccines are administered.
Design: A quasi experimental research design was used to conduct a site audit of general practice vaccine storage facilities in both urban and rural areas of the Hunter region of New South Wales. Practice staff who handled vaccines completed a practices and knowledge questionnaire during the audit visit.
Setting: General Practice.
Subjects: This study was an area‑wide survey of all Hunter general practice immunisation service provider sites (n=256) where an audit was conducted of all vaccine refrigerators in use at the time of the audit, and one questionnaire per site was completed with respect to the cold chain management of all vaccine consignments delivered within the previous three months (n=924).
Main Outcome Measures: Main outcome measures were adherence to acceptable vaccine cold chain management practices as identified by National Health and Medical Research Council guidelines and maintenance of vaccine refrigerator temperatures within the World Health Organization’s (WHO) recommended range of 2°C and 8°C.
Results: A key finding from this study was the positive influence of general practice nurses on general practices achieving vaccine cold chain integrity as defined by WHO. Ninety‑eight percent (98%) of general practices where a general practice nurse was employed maintained vaccine cold chain integrity whereas only 42% of general practices where no general practice nurse was employed (95% CI: 10, 58) achieved the same result.Two types of vaccine refrigerators were identified in Hunter general practices; these were non‑bar type and bar‑type. Of 150 non‑bar type refrigerators in Hunter general practices 97% operated within the safe temperature range for the storage of vaccines, while only 58% of the bar‑type fridges maintained acceptable temperatures for vaccine storage (95% CI: 8 ‑ 69).
Conclusions: Study findings highlighted the value of employing general practice nurses in general practice in relation to maintaining vaccine cold chain integrity, and encouraging such nurses to become authorised immunisers so they can participate in ongoing immunisation education. The study findings supported the argument to outlaw bar‑type refrigerators for storing vaccines as these posed an unacceptable threat to vaccine cold chain integrity.
Side effects of treatment in patients with hepatitis C - implications for nurse specialist practice
Authors: Grogan Anne , Timmins Fiona
Published: June 2024

Objective: To identify patients’ perceptions of the side effects of Hepatitis C treatment.
Design: The research used a self‑reporting postal survey design to identify reported side effects, related to hepatitis C treatment, suffered by patients attending a specialist nurse clinic.
Setting: The setting for this study was an outpatient hepatology clinic in a large general hospital in Ireland.
Subjects: The questionnaire was distributed to a convenience sample of 201 patients receiving hepatitis C treatment at the hospital.
Main outcome measure(s): To determine what side effects are most common during hepatitis C treatment; to identify whether or not patients are satisfied with the nurse specialist/nurse led service and to identify the unmet support needs of patients on treatment.
Results: Several side effects were reported, including fatigue, sleep disturbances and weight loss. Another high scoring side effect was sexual dysfunction. Patients reported a high satisfaction with nurse specialist services.
Conclusions: Manifestations of treatment have implications for care management of this group. Routine assessment of quality of life or symptom related needs is suggested in addition to personalised support from nurse specialists. Raising patients’ awareness of the potential side effects is very important in the approach to care, particularly in relation to compliance. In addition, providing information and advice to patients about how to manage their symptoms is essential.
The effectiveness of a follow‑up program on blood pressure and cardiovascular risk factors for hypertensive patients
Authors: Irmak Zohre , Duzoz Gulsen , Bozyer Inci
Published: June 2024

Objective: The purpose of this study was to evaluate the effectiveness of a follow‑up program on blood pressure and cardiovascular risk factors in hypertensive patients.
Design: A time series (one group pretest‑posttest) quasi‑experimental study was used.
Setting: This study was conducted at the Hypertension, Obesity and Diabetes Center of a State Hospital in Turkey.
Subjects: Forty‑five (45) hypertensive patients were recruited.
Intervention: An education program was implemented with hypertensive patients whereby patients were monitored at each month for a total of six times following an initial appointment. Follow‑up by nurses included checking weight and blood pressure (BP), reviewing of diaries, education, counseling or referrals to other disciplines.
Measurement: Patients’ BP and cardiovascular risk factors were assessed at the baseline and six months later. The findings were then compared to evaluate the effects of intervention on the patient’s BP and cardiovascular risk factors.
Results: After intervention there was a significant decrease between the mean systolic BP and diastolic BP when compared with the baseline. BMI was decreased from 29.6±3kg/m2 to 29.3±3kg/m2 (p=0.033). Total cholesterol did not change. Triglycerides decreased. However, LDL‑cholesterol increased and HDL‑cholesterol decreased.
Conclusion: To manage hypertension and to reduce cardiovascular risk factors, a program is needed and should be implemented which includes antihypertensive treatment options, lifestyle changes and lipid‑lowering drug therapy. The long-term effects of such a program should be monitored while implementing.
Creating a new cardiac service: the Brisbane experience
Authors: Jauncey-Cooke Jacqueline , Franklin Donna
Published: June 2024

Objective: This article discusses the creation of a new paediatric cardiac surgical service via the merging of two units.
Setting: In 2005, the Queensland Government made a commitment to improve health outcomes for Queensland’s children. This pledge included a review of paediatric cardiology and paediatric cardiac surgery. A recent cluster of deaths following cardiac surgery at The Prince Charles Hospital (TPCH) and concerns expressed by clinicians regarding the adequacy of the service, resulted in the review being commissioned. A panel of well respected, eminent professionals were appointed with the brief to review the adequacy of paediatric cardiac services in Queensland, to determine the optimal configuration of the cardiac service and to also make recommendations to ensure a high quality of service in the future.
Conclusion: The process of amalgamating the two units and creating a new cardiac service has increased output in terms of surgical cases. The care of cardiac children in Queensland is now undertaken from a major specialist children’s hospital. However, the costs associated with the amalgamation have been high, particularly in terms of training staff and development of infrastructure. The dynamics of change whilst prioritised by management resulted in a highly stressful working environment and a number of staff resigned. Eighteen months post merge, the morale within the unit has improved and staff are working positively towards a cohesive unit.
Flexible delivery: on‑line versus bottom‑line
Authors: Warelow Philip , Wells Samantha , Irwin Pauletta
Published: June 2024

Objective: In using a flexible delivery of learning approach to nursing education, and taking into account the globalisation of education, this research argues that universities need to consider and take into account both the positive and negative aspects of this decision.
Setting: Tertiary educational settings. 
Subjects: All undergraduate/postgraduate students.
Primary Argument: As nursing education is undergoing some significant changes this study argues that universities must be prepared to adopt some changes to harmonise with the needs of learners, the major stakeholders and to remain financially competitive in the marketplace.
Conclusion: These arguments need to be considered using the backdrop of what might be described as the globalisation of education and universities need to respond to the challenges that flexible online learning presents. Flexible delivery for nursing education may need to proceed forward with a degree of caution because financial considerations shouldn’t be a determinant of pedagogical quality.
Lecture Capture: first year student nurses’ experiences of a web‑based lecture technology
Authors: Cooke Marie , Watson Bernadette , Blacklock Edward , Mansah Martha , Howard Matylda , Johnston Amy , Tower Marion , Murfield Jenny
Published: June 2024

Objectives: This exploratory evaluation sought to examine students’ experiences of receiving lectures via a web‑based digital lecture technology, Lecture Capture.
Design: A descriptive, online survey undertaken during weeks 8‑10 of semester one in May, 2010.
Setting: An Australian University in Brisbane, South‑East Queensland.
Subjects: 128 first‑year students enrolled in a Bachelor of Nursing Program.
Main outcome measure: Student experiences of Lecture Capture measured by a 14‑item survey developed for the evaluation.
Results: Students largely perceived Lecture Capture to be useful in aiding understanding and learning, both during the course and in preparation for assessment. It particularly helped the two older groups of students (22‑30 & >30 years) understand lectures and revise content at their own pace. Lecture Capture assisted first‑year students in adjusting to university life, and this was most noticeable for the youngest group of respondents (<19 years). On‑line lectures helped students become familiar with the program’s websites and web resources and provided an opportunity to practice note‑taking. With the exception of those aged 22‑30, Lecture Capture was not regarded as a more effective use of time than face‑to‑face lectures. Predominantly, students would have preferred face‑to‑face lectures with optional Lecture Capture, and this was strongest amongst the two older groups. Students overwhelming noted satisfaction when live lectures became available from week four.
Conclusions: Findings support the use of web‑based digital lecture technology during the initial weeks of university for first‑year Bachelor of Nursing students, but indicate this should be to supplement, rather than replace, traditional face‑to‑face lectures.
Discovering Constructivist Grounded Theory’s fit and relevance to researching contemporary mental health nursing practice
Authors: Gardner Andrew , McCutcheon Helen , Fedoruk Maria
Published: June 2024

Objective: This paper explores the Constructivist Grounded Theory research methodology informed by Charmaz (2006). Comparisons are drawn between the Constructivist Grounded Theory position and the ethical principles of Deontology, Utilitarian, Virtue ethics and fidelity that inform contemporary mental health nursing practice. Conclusions are made between the relative fit of the interpretivist nature of constructivism and contemporary mental health nursing practice. The aim of the paper is to describe the synthesis that exists between Constructivist Grounded Theory as a research methodology and its consistency with contemporary mental health nursing practice.
Primary argument: Constructivist Grounded Theory as a research methodology is an appropriate and consistent approach to use when researching in the area of contemporary mental health nursing practice.
Conclusion: This paper explores the origins of Constructivist Grounded Theory and the theoretical underpinnings of symbolic interactionism and constructivism. Comparisons are drawn between the ethical principles that inform contemporary mental health nursing practice and relative fit between the interpretivist nature of constructivism and the contemporary nature of mental health nursing practice. Concluding that Constructivist Grounded theory as a research methodology is an appropriate and consistent approach to use when researching mental health nursing practice.