Collegian: Journal of the Royal College of Nursing Australia

No Issue Number

• Guidelines for Contributors
  Publication year: 2010
  Source: Collegian: Journal of the Royal College of Nursing Australia, Volume 17, Issue 1, March 2010, Pages I-II
  
  [No author name available]
  
  
• Reclaiming nursing care
  Publication year: 2010
  Source: Collegian: Journal of the Royal College of Nursing Australia, Volume 17, Issue 1, March 2010, Pages 1-2
  
  Alison, Kitson
  
  
• Cultural safety and its importance for Australian midwifery practice
  Publication year: 2010
  Source: Collegian: Journal of the Royal College of Nursing Australia, In Press, Corrected Proof, Available online 1 March 2010
  
  Jasten, Phiri , Elaine, Dietsch , Ann, Bonner
  
  Cultural safety is an important concept in health care that originated in Aotearoa (New Zealand) to address Maori consumer dissatisfaction with health care. In Australia and internationally, midwives are now expected to provide culturally safe midwifery care to all women. Historically, Australia has received large numbers of immigrants from the United Kingdom, European countries and the Middle East. There have also been refugees and immigrants from South-East Asia, and most recently, from Africa. Australia continues to become more culturally diverse and yet to date no studies have explored the application of cultural safety in Australian midwifery practice. This paper explores...
  
  
• E-Portfolios for the aspiring professional
  Publication year: 2010
  Source: Collegian: Journal of the Royal College of Nursing Australia, In Press, Corrected Proof, Available online 10 March 2010
  
  Kate, Andre
  
  The introduction of the ANMC's Continuing Competence Framework means that an increasing number of Australian Registered Nurses and Registered Midwives will be required to submit a portfolio if audited in order to maintain their registration. As several professional organisations and State regulatory authorities have already demonstrated, nurses and midwives will be supported to do this. However there is a risk that individuals commencing a portfolio for the first time will attempt to deal with the requirement by focussing on the minimum standards set by the regulatory authorities. Critics of the use of professional portfolios are quite correct, compiling and managing...
  
  
• The theory-practice gap and skill acquisition: An issue for nursing education
  Publication year: 2010
  Source: Collegian: Journal of the Royal College of Nursing Australia, In Press, Corrected Proof, Available online 23 May 2010
  
  Natashia Josephine, Scully
  
  Matching textbook descriptions of clinical situations with the reality of practice is an ongoing problem faced by members of the nursing profession and is commonly referred to as the “theory-practice gap”. This ubiquitous gap is inevitably encountered by all nurses at various times; yet it is widely agreed that it is student nurses – given their novice, rule governed status – who find themselves in the midst of the theory-practice void.This paper will discuss the nature of the theory-practice gap and skill acquisition, in relation to a personal experience of mine as an undergraduate nursing student, and its significance in...
  
  
• Meeting the challenges of chronic illness: A nurse-led collaborative community care program in Thailand
  Publication year: 2010
  Source: Collegian: Journal of the Royal College of Nursing Australia, Volume 17, Issue 2, July 2010, Pages 93-99
  
  Siriorn, Sindhu , Chennet, Pholpet , Somjai, Puttapitukpol
  
   Background: Chronic illness is of concern to health care systems globally. Although a significant evidence base supports the concept of nurse-led interventions, less data is available to address unique features of health care systems in the developing world. Aim: The purpose of this study aimed to undertake preliminary testing of an intervention of nurse-led community care program, the Network Collaborative Action Plan (N-CAP), to assess the impact on disease severity and patient satisfaction. Method: A quasi-experimental study, using historical controls, evaluated a collaborative nurse-led intervention to promote coordination and continuity of care for patients with chronic illness. Results: Participants, diagnosed with chronic obstructive lung disease (COPD), coronary...
  
  
• Integrating palliative care content into a new undergraduate nursing curriculum: The University of Notre Dame, Australia – Sydney experience
  Publication year: 2010
  Source: Collegian: Journal of the Royal College of Nursing Australia, Volume 17, Issue 2, July 2010, Pages 85-91
  
  John M., Ramjan , Catherine M., Costa , Louise D., Hickman , Margot, Kearns , Jane L., Phillips
  
   Background: The majority of society's deaths occur in a health care environment. Regardless of whether a death occurs in acute care, hospice, residential aged care or community settings, nurses are the health professionals that will spend the largest proportion of time with the patient who has a terminal condition and their families. As few nurses have specialist palliative care qualifications it is essential that nursing education prepares graduates to achieve the core capabilities required for the delivery of best evidenced based palliative care. This reality makes the integration of palliative care content into the undergraduate nursing curricula an important priority. Aim: This paper...
  
  
• Uptake of Medicare chronic disease items in Australia by general practice nurses and Aboriginal health workers
  Publication year: 2010
  Source: Collegian: Journal of the Royal College of Nursing Australia, Volume 17, Issue 2, July 2010, Pages 57-61
  
  Elizabeth J., Halcomb , Patricia M., Davidson , Nicola, Brown
  
  The Australian health care system is currently in a state of reform and there is increasing pressure to provide care in community settings. Rising costs, demands and population ageing underscore the importance of adopting models of health care delivery to address changing epidemiological patterns. Population ageing and the increase of chronic conditions challenge models based on acute care. Changes to the Medicare benefits schedule have facilitated the development of a range of expanded nursing services in the general practice setting. In particular, item number 10997 was introduced to reimburse practice nurses and Aboriginal health workers (AHWs) for providing monitoring and...
  
  
• Patients’ perspectives of bedside nursing handover
  Publication year: 2010
  Source: Collegian: Journal of the Royal College of Nursing Australia, In Press, Corrected Proof, Available online 7 July 2010
  
  Anne, McMurray , Wendy, Chaboyer , Marianne, Wallis , Joanne, Johnson , Tanya, Gehrke
  
   Background: Patient participation in handover is one aspect of patient-centred care, where patients are considered partners in care. Understanding the patient perspective provides a foundation for nurses to tailor their bedside handovers to reflect patients’ thoughts and beliefs and encourage their active involvement in decision-making. Aim: This study examined patients’ perspectives of participation in shift-to-shift bedside nursing handover. Methods: A descriptive case study was conducted with 10 patients in one Queensland hospital who had experienced bedside handover during their hospitalisation in 2009. Participants were asked their views about bedside handover including its benefits and limitations, their existing and potential role in handover, the role of...
  
  
• The Healthy Ageing Model: Health behaviour change for older adults
  Publication year: 2010
  Source: Collegian: Journal of the Royal College of Nursing Australia, Volume 17, Issue 2, July 2010, Pages 51-55
  
  Kathleen M., Potempa , Susan W., Butterworth , Marna K., Flaherty-Robb , William L., Gaynor
  
  Proposed is a model of primary care for older adults with chronic health conditions that focuses on active engagement in health care. The Healthy Ageing Model is anchored in established theory on motivation and health behaviour change. The model draws on empirical and applied clinical underpinnings in such diverse areas as health promotion and education, treatment of addictions or obesity, management of chronic diseases, goal-setting, and coaching techniques. The conceptual foundation for the Healthy Ageing Model is described first, followed by a brief description of the key characteristics of the model. In conclusion, suggestions are offered for the clinical application...
  
  
• Sustaining and growing the rural nursing and midwifery workforce: Understanding the issues and isolating directions for the future
  Publication year: 2010
  Source: Collegian: Journal of the Royal College of Nursing Australia, In Press, Corrected Proof, Available online 23 September 2010
  
  Karen L., Francis , Jane E., Mills
  
  Nurses and midwives represent the largest group of health professionals in the Australian health care system. In rural environments nurses and midwives make up a greater proportion of the health workforce than in urban settings, which makes their role in service provision even more significant. The role and scope of these nurses and midwives’ practice is by necessity more generalist than specialist, which results in disciplinary strengths and weaknesses. As generalist health professionals they work in diverse settings such as public hospitals, multi-purpose services, community health, aged care and in non-government and private for profit and no-profit organisations including general...
  
  
• The nurse educator role in Australian hospitals: Implications for health policy
  Publication year: 2010
  Source: Collegian: Journal of the Royal College of Nursing Australia, Volume 17, Issue 2, July 2010, Pages 77-84
  
  Jan M., Sayers , Michelle, DiGiacomo
  
  To date, the nurse educator role in the Australian hospital setting has been poorly described. Current pressures for health care reform have prompted reviews of nursing roles. This paper discusses the literature pertaining to the nurse educator role within the context of the Australian health care environment and current health care policy. Building on this synthesis, barriers and facilitators impacting on the nurse educator role are identified and strategic directions for policy, role clarification and advanced practice role development are highlighted. Further research identifying the impact of the hospital-based nurse educator on patient outcomes and professional nursing practice are proposed.
  
  
• The role of parents in managing asthma in middle childhood: An important consideration in chronic care
  Publication year: 2010
  Source: Collegian: Journal of the Royal College of Nursing Australia, Volume 17, Issue 2, July 2010, Pages 71-76
  
  Nicola, Brown , Robyn, Gallagher , Cathrine, Fowler , Sandra, Wales
  
  Asthma is a significant illness for Australian children and their families. In childhood, parents have the primary responsibility for managing asthma on a day-to-day basis, and therefore understanding the management of asthma by parents is important to nursing practice. Middle childhood (5–12 years) is an important time in the lives of children and families with asthma, as children commence school and spend increasing amounts of time away from direct parental care. In order to manage asthma during middle childhood, parents need to understand asthma as an illness, understand the treatment of asthma, be able to monitor and respond to changes...
  
  
• Can principles of the Chronic Care Model be used to improve care of the older person in the acute care sector'
  Publication year: 2010
  Source: Collegian: Journal of the Royal College of Nursing Australia, Volume 17, Issue 2, July 2010, Pages 63-69
  
  Louise D., Hickman , John X., Rolley , Patricia M., Davidson
  
   Background: There is increasing evidence that hospitals are failing to meet the needs of older people. As a consequence acute care needs to be adapted to meet the needs of older people. Although initially developed for chronic conditions the Chronic Care Model (CCM) provides useful strategies for improving continuity and quality of care. Method/aim: This paper describes the elements of the CCM and discusses how a chronic care approach can improve models of care delivery for older persons in the acute care hospital settings. Discussion: The CCM provides a potentially useful approach to improve health care for older people in the acute care setting. Positive...
  
  
• Piloting a mass gathering conceptual framework at an Adelaide Schoolies Festival
  Publication year: 2010
  Source: Collegian: Journal of the Royal College of Nursing Australia, In Press, Corrected Proof, Available online 3 November 2010
  
  Alison, Hutton , Rebecca, Munt , Kathryn, Zeitz , Lynette, Cusack , Mayumi, Kako , ...
  
  During the summer months in Australia, school leavers celebrate their end of school life at schoolies festivals around the nation. These events are typically described as a mass gathering as they are an organised event taking place within a defined space, attended by a large number of people. A project was undertaken to analyse the usefulness of Arbon's (2004) conceptual model of mass gatherings in order to develop a process to better understand the Adelaide Schoolies Festival. Method: Arbon's conceptual framework describes the inter-relationship between the psychosocial, environmental and bio-medical domains of a mass gathering. Each domain has set characteristics which help...
  
  
• Climate change, health and the need to increase resilience and capacity
  Publication year: 2010
  Source: Collegian: Journal of the Royal College of Nursing Australia, In Press, Corrected Proof, Available online 27 October 2010
  
  Lidia, Mayner , Paul, Arbon
  
  
• Vipassana meditation: One woman's narrative
  Publication year: 2010
  Source: Collegian: Journal of the Royal College of Nursing Australia, In Press, Corrected Proof, Available online 13 December 2010
  
  Pamela, van der Riet
  
  In Thailand there is cultural acknowledgement of a range of traditional therapies (including complementary therapies) used in Thai health care. Meditation enjoys wide acceptance within Thai culture and attracts strong participation from western visitors to Thai Buddhist Centres because of growing interest in personal health for future preventative health problems. The extensive use of complementary therapies in health care and the cultural acceptance of such therapies as meditation for stress-release and as a personal health strategy for maintenance of well-being are possible lessons to be learned in contemporary western healthcare. In this paper the practise of vipassana meditation offers a...
  
  
• Changes to Australian nursing and midwifery registration: Implications for interstate disaster response
  Publication year: 2010
  Source: Collegian: Journal of the Royal College of Nursing Australia, In Press, Corrected Proof, Available online 27 October 2010
  
  Jamie, Ranse , Lynette, Cusack
  
  
• The role of child health nurses in supporting parents of young infants
  Publication year: 2010
  Source: Collegian: Journal of the Royal College of Nursing Australia, In Press, Corrected Proof, Available online 23 May 2010
  
  Ritva, Eronen , Jan, Pincombe , Helen, Calabretto
  
   Objective: As a part of an action research project to determine a model of service to meet the needs of parents, this non-experimental study explored the role of child health nurses in supporting parents of young infants. It also examined whether changes to the service altered parents’ views of that support. Methods: Two surveys were conducted at eight month interval during which changes had been implemented in the child health service. The participants, recruited from well child health clinics, comprised 413 parents of infants younger than 12 months of age (206 in the first survey and 207 in the second survey). Data were...
  
  
• Empowerment and enterprise: The political economy of nursing☆
  Publication year: 2010
  Source: Collegian: Journal of the Royal College of Nursing Australia, In Press, Corrected Proof, Available online 23 May 2010
  
  Anne, McMurray
  
  Throughout the past decades, Australian nursing has made significant advances in the clinical, research, and political arenas. Capitalising on these advances is a critical step in empowering the professions and a sound investment in the health of the nation. There remains a need to energise and empower the professions, to see our work as an enterprise that has value and a sense of worth because of our professional activities as well as for the political and economic contributions we make to health and wellbeing, quality of life and social justice. The contributions made by nurses and midwives need to be...
  
  
• “The Food Here Is Tasteless!” Food taste or tasteless food' Chemosensory Loss and the Politics of Under-Nutrition
  Publication year: 2010
  Source: Collegian: Journal of the Royal College of Nursing Australia, In Press, Corrected Proof, Available online 23 May 2010
  
  Kim, Wylie , Monica, Nebauer
  
  A common complaint voiced by older people living in residential care is that the food lacks taste. When older people find food tasteless, the pleasure gained from eating and therefore, their appetite may be compromised, as will their food choices, nutrition, immune systems, functional status and well-being. However, often nurses overlook these symptoms as ‘inevitable and irreversible’ aspects of ageing, which they are not. In fact, many older people experience chemosensory (taste and smell) disorders or loss which means they lose the ability to taste the flavour of food. Commonly overlooked is the fact that chemosensory loss may well be...
  
  
• Family resilience: Towards a new model of chronic pain management
  Publication year: 2010
  Source: Collegian: Journal of the Royal College of Nursing Australia, In Press, Corrected Proof, Available online 25 September 2010
  
  Caryn, West , Kim, Usher , Kim, Foster
  
  This paper presents a critical appraisal of the potential of family resilience as a new model of care for chronic pain. For nurses, this model offers new strategies for working with families where a member experiences chronic pain.Chronic pain is characterised by one or more of the following: pain that lasts more than six months, from a non-life-threatening cause; and/or which is not responsive to available treatment. Chronic pain has the potential to be longstanding and difficult to treat and may result in negative outcomes for individuals and their families. However, a family resilience model of care moves the nurse...
  
  
• How do Specialist Breast Nurses help breast cancer patients at follow-up'
  Publication year: 2010
  Source: Collegian: Journal of the Royal College of Nursing Australia, In Press, Corrected Proof, Available online 2 June 2010
  
  Moyez, Jiwa , Georgia, Halkett , Kathleen, Deas , Paul, Ward , Moira, O’Connor , ...
  
   Background: As the proportion of survivors from breast cancer increases it is possible that follow-up care could be delivered wholly by generalists to relieve over subscribed hospital clinics. However, guidelines seldom take into account the nature of interactions between patients and health care professionals involved in hospital-based follow-up. Methods: Consultations between four Specialist Breast Nurses (SBNs) and 21 consecutive women attending a hospital-based breast cancer follow-up clinic in Western Australia were audio recorded and subjected to a thematic analysis. Recording of consultations ceased with saturation of themes. We analysed the data with reference to theoretical frameworks which postulate that social support is a...
  
  
• Facilitating consumer participation: An approach to finding the ‘right’ consumer
  Publication year: 2010
  Source: Collegian: Journal of the Royal College of Nursing Australia, In Press, Corrected Proof, Available online 4 June 2010
  
  Brenda, Happell
  
  Contemporary health care increasingly dictates that consumers of services should become active participants in the health care system. This has placed responsibility on administrators, managers and clinicians to include consumers in key strategic and decision making initiatives. However, this direction has not been accompanied by clear policies or guidelines. Consequently confusion about selecting consumers able to provide valuable input is identified as a barrier to active consumer involvement. The purpose of this paper is to address some concerns raised in the quest to find the “right” consumer, including: finding a consumer without an axe to grind; ensuring the consumer is...
  
  
• Cancer as a chronic disease
  Publication year: 2010
  Source: Collegian: Journal of the Royal College of Nursing Australia, Volume 17, Issue 2, July 2010, Pages 47-50
  
  Jane Louise, Phillips , David C., Currow
  
   Background: Over the past two decades the number of people living with cancer has increased. Many cancer survivors end up with long term disabilities requiring ongoing care and support. For many people, cancer survival now means living with a chronic and complex condition. Aim: The purpose of this paper is to provide an overview of the long term management issues for cancer survivors and strategies to enhance their care. Discussion: Cancer survivors require ongoing support in four key areas: prevention; surveillance; intervention for consequences of cancer and its treatment; and coordination between specialist and generalist providers. Conclusion: Cancer survivors experience significant physical and psychological morbidity which makes...
  
  
• The fragmented story of pain: A saga of economic discourse, confusion and lack of holistic assessment in the residential care of older people
  Publication year: 2010
  Source: Collegian: Journal of the Royal College of Nursing Australia, In Press, Corrected Proof, Available online 6 July 2010
  
  Kim, Wylie , Monica, Nebauer
  
  The long-standing problem of overlooked and/or undertreated pain experienced by so many older people living in Australian residential care facilities condemns these people to a life robbed of quality. Such a degree of suffering experienced by older people calls into question the pain assessment skills of staff who work in residential care. However, the problem of undetected and unresolved pain experienced by older people is not simply a skill or knowledge issue. It is much broader than that.In this paper we portray pain as likened to a story; a narrative that only the older person, as the author, can impart...
  
  
• Guidelines for Contributors
  Publication year: 2010
  Source: Collegian: Journal of the Royal College of Nursing Australia, Volume 17, Issue 3, September 2010, Pages I-II
  
  [No author name available]
  
  
• Statement by the Hon. James McGinty, Chairman, Health Workforce Australia
  Publication year: 2010
  Source: Collegian: Journal of the Royal College of Nursing Australia, Volume 17, Issue 3, September 2010, Pages 103-104
  
  [No author name available]
  
  
• Trends and developments in the use of health care simulation
  Publication year: 2010
  Source: Collegian: Journal of the Royal College of Nursing Australia, Volume 17, Issue 3, September 2010, Pages 101-102
  
  Michelle, Kelly , Brendan, Flanagan
  
  
• Contents
  Publication year: 2010
  Source: Collegian: Journal of the Royal College of Nursing Australia, Volume 17, Issue 3, September 2010, Page vii
  
  [No author name available]
  
  
• An exploration of the role and scope of the Clinical nurse consultant (CNC) in a metropolitan health service
  Publication year: 2010
  Source: Collegian: Journal of the Royal College of Nursing Australia, In Press, Corrected Proof, Available online 20 October 2010
  
  Melissa J., Bloomer , Wendy M., Cross
  
   Introduction: Clinical nurse consultants have been a part of the nursing workforce for some time however a lack of clarity regarding this role has led to significant variations in health service expectations, workloads and scope for the Clinical nurse consultants working within this metropolitan health service. Aim: The aim of this study was to explore the role of the CNC as it is perceived by them, in the context of this health service. Method: A qualitative approach was used for this study. Following ethics approval a single audio-taped focus group was undertaken to gather data. Guiding questions were used to elicit responses from the group,...
  
  
• A literature review of disaster nursing competencies in Japanese nursing journals
  Publication year: 2010
  Source: Collegian: Journal of the Royal College of Nursing Australia, In Press, Corrected Proof, Available online 28 October 2010
  
  Mayumi, Kako , Satoko, Mitani
  
  Introduction: Competencies is an important concept used for assessing health professionals’ capability to perform their role. By means of a literature review of Japanese professional journals this paper will investigate the competencies concept, particularly with relation to disaster nursing. Methods: The literature research was conducted using the database ichu-shi (ver. 4). All literature is written and published in Japanese and was published between 2001 and 2008. Due to an unfamiliarity of the term ‘competencies’ in Japanese, the key words were sought while deconstructing the meaning and concepts of ‘competencies’ into terms more recognisable in the Japanese context. Twelve key words:...
  
  
• Nurses addressing the challenges of chronic illness: From primary to palliative care
  Publication year: 2010
  Source: Collegian: Journal of the Royal College of Nursing Australia, In Press, Corrected Proof, Available online 11 June 2010
  
  Patricia M., Davidson , Sabina, De Geest , Martha N., Hill
  
  

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• Factors influencing the supervision of nursing students administering medication: The registered nurse perspective
  Publication year: 2011
  Source: Collegian: Journal of the Royal College of Nursing Australia, In Press, Corrected Proof, Available online 1 July 2011
  
  Kerry, Reid-Searl , Brenda, Happell
  
  Administering medication is an important function of registered nurses. It is therefore necessary that nursing students develop knowledge and skill in this field. Given the propensity for, and negative consequences of, medication errors, it is essential that nursing students are properly supervised in this role. There is currently a paucity of research examining the practices of supervising medication administration by nursing students, particularly from the perspectives of registered nurses. The aim of this study was to explore the opinions and insights of registered nurses regarding the supervision of nursing students administering medication. Focus groups were conducted with registered nurses with...
  
  
• Nurses involved in whistleblowing incidents: Sequelae for their families
  Publication year: 2011
  Source: Collegian: Journal of the Royal College of Nursing Australia, In Press, Corrected Proof, Available online 29 June 2011
  
  Lesley M., Wilkes , Kath, Peters , Roslyn, Weaver , Debra, Jackson
  
  Nurses involved in whistleblowing often face economic and emotional retaliation, victimization and abuse. Yet for many nurses, one major part of their whistleblowing experience is the negative impact it has on their families. This paper reports findings from a qualitative study pertaining to the effects of whistleblowing on family life from the perspective of the nurses. Using a narrative inquiry approach, fourteen nurses were interviewed who were directly involved in whistleblowing complaints. Data analysis drew out three themes: strained relationships with family members, dislocation of family life, and exposing family to public scrutiny. The harm caused to the nurses involved...
  
  
• Women with breast cancers’ preferences for surveillance follow-up
  Publication year: 2011
  Source: Collegian: Journal of the Royal College of Nursing Australia, In Press, Corrected Proof, Available online 16 January 2011
  
  Moyez, Jiwa , Georgia, Halkett , Kathleen, Deas , Xingqiong, Meng
  
   Background: On completion of treatment people with breast cancer are offered surveillance at a hospital clinic and/or in primary care. It is unclear whom patients prefer to consult about their problems following cancer treatment. Method: Patients being followed up by a hospital nurse were surveyed at their follow-up appointment and three months later. The survey included demographic information, symptom profile, and the Patient Enablement Index (PEI). A subsequent survey of the patients’ general practitioners (GPs)s confirmed which patients had consulted their GP prior to the nurse appointment. Three months after their appointment patients completed the PEI and were surveyed about their preference of...
  
  
• The role of nurses and midwives in the governance of local health networks
  Publication year: 2011
  Source: Collegian: Journal of the Royal College of Nursing Australia, In Press, Corrected Proof, Available online 16 February 2011
  
  Richard, Baldwin
  
  Current health reforms in Australia will establish local health networks of public hospitals each with a governing body. The establishment of these governing bodies, particularly in states like NSW where these entities do not currently exist within the public hospital system, provides opportunities for nurses, midwives and other clinicians to seek appointment to them. The policy and discussion papers on the establishment of the local health networks promise that local clinicians will be appointed to these governing bodies. Debate within the nursing and midwifery profession seems focused on the management of nursing and midwifery services within the new local health...
  
  
• Mandatory continuing professional education: What is the prognosis'
  Publication year: 2011
  Source: Collegian: Journal of the Royal College of Nursing Australia, In Press, Corrected Proof, Available online 4 May 2011
  
  Ainsley, James , Karen, Francis
  
  Each year registered nurses apply for registration renewal. The Nursing and Midwifery Board of Australia stipulate all nurses and midwives are expected to take responsibility and accountability for participating in continuing professional development (CPD) as a declaration that their practice is current, safe and competent. The code of professional conduct and Australian Nursing and Midwifery Council (ANMC) competencies governing registered nurses and midwives, outline the professional and personal responsibility nurses hold in order to maintain clinical competence; which may be achieved through continuing nurse education and professional development. As the health care industry shifts focus to keep up with changes...
  
  
• Trends in publication of research papers by Australian-based nurse authors
  Publication year: 2011
  Source: Collegian: Journal of the Royal College of Nursing Australia, In Press, Corrected Proof, Available online 4 May 2011
  
  Lesley, Wilkes , Debra, Jackson
  
  Analysis of Australian nursing research output is becoming more important as academic institutions move into implementing quality programs of research output. Notable in determining research quality is the publication of research papers in journals with a high ranking within the Institute for Scientific Information (ISI) or Excellence in Research for Australia (ERA). This paper reports an analysis of Australian nurse researcher output in journals highly ranked by the ISI and ERA. Research abstracts were analysed for topic, sources of data, location of research and methodological paradigm. A total of 530 articles from five Australian and from five USA and UK...
  
  
• The dual roles of rural midwives: The potential for role conflict and impact on retention
  Publication year: 2011
  Source: Collegian: Journal of the Royal College of Nursing Australia, In Press, Corrected Proof, Available online 28 May 2011
  
  Karen, Yates , Kim, Usher , Jenny, Kelly
  
  Nurses and midwives continue to make up the largest proportion of the health workforce. As a result, shortages of nurses and midwives have a significant impact on the delivery of effective health care. Shortages of nurses and midwives are known to be more pronounced in rural and remote areas where recruitment and retention remain problematic. However, rural nurses are often required to be multi-skilled, which has led to expectations that nurses who are also midwives, are required to work across areas of the hospital to help to address shortages. For midwives this issue is even more problematic as they may...
  
  

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• Being inclusive of diversity in nursing care: A discussion paper
  Available online 21 December 2012
  Publication year: 2012
  Source: Collegian: Journal of the Royal College of Nursing Australia
  
  
  
  The Australian health care system is responsible for delivering health services to an increasingly diverse health population. Nurses are in a position to positively influence health-related outcomes by actively addressing the differences individuals bring to their health care experiences. By focusing diversity on health inequities, nurses can play an important role in identifying those at risk of poorer health. This paper discusses diversity in the health population through health inequities and proposes directions for nursing practice. These suggested directions include application of a definition of diversity that include health determinants; targeting specific groups with programmes and services designed to reduce health inequalities; engaging in political action to promote effective policy development; preparing nurses at an undergraduate and graduate level to build capacity for addressing diversity and health inequities; and identifying effective interventions through research studies that address inequities in the health population.
  
  
  
  
  
  
• Reclaiming caring in nursing leadership: A deconstruction of leadership using a Habermasian lens
  December 2012
  Publication year: 2012
  Source: Collegian: Journal of the Royal College of Nursing Australia, Volume 19, Issue 4
  
  
  
  Nursing leaders function in an environment of increasing demands coupled with decreasing resources. This paper explores the landscape of nursing leadership from a critical theory perspective, particularly Habermas's theory of communicative action. We not only deconstruct contemporary nursing leadership, discussing the potential negative consequences for those who fulfil roles of both ‘nurse’ and ‘leader’, but also offer possibilities for a more positive future.
  
  
  
  
  
  
• Organisational intervention to reduce occupational stress and turnover in hospital nurses in the Northern Territory, Australia
  December 2012
  Publication year: 2012
  Source: Collegian: Journal of the Royal College of Nursing Australia, Volume 19, Issue 4
  
  
  
  Objective To evaluate the impact of an organisational intervention aimed to reduce occupational stress and turnover rates of 55% in hospital nurses. Design The evaluation used a pre- and post-intervention design, triangulating data from surveys and archival information. Setting Two public hospitals (H1 and H2) in the Northern Territory (NT) Australia participated in the intervention. Subjects 484 nurses from the two NT hospitals (H1, Wave 1, N = 103, Wave 2, N = 173; H2, Wave 1, N = 75, Wave 2, N = 133) responded to questionnaires administered in 2008 and in 2010. Measures The intervention included strategies such as the development and implementation of a nursing workload tool to assess nurse workloads, roster audits, increased numbers of nursing personnel to address shortfall, increased access to clinical supervision and support for graduates, increased access to professional development including postgraduate and short courses, and a recruitment campaign for new graduates and continuing employees. We used an extended Job Demand-Resources framework to evaluate the intervention and 17 evaluation indicators canvassing psychological distress, emotional exhaustion, work engagement, job satisfaction, job demands, job resources, and system factors such as psychosocial safety climate. Turnover rates were obtained from archival data. Results Results demonstrated a significant reduction in psychological distress and emotional exhaustion and a significant improvement in job satisfaction, across both hospitals, and a reduction in turnover in H2 from 2008 and 2010. Evidence suggests that the intervention led to significant improvements in system capacity (adaptability, communication) in combination with a reduction in job demands in both hospitals, and an increase in resources (supervisor and coworker support, and job control) particularly in H1. Conclusions The research addresses a gap in the theoretical and intervention literature regarding system/organisation level approaches to occupational stress. The approach was very successful on a range of health, work outcome, and job design indicators with results providing compelling evidence for the success of the system/organisational level intervention. The quasi-experimental design enabled us to conclude that improvements for the nurses and midwives could be attributed to the organisational intervention by the NT Department of Health (DoH). Further research should be undertaken to explore longer-term impacts, and particularly the influence on turnover. Levels of stress in hospital nurses remain high and present important implications for the psychological well-being of staff.
  
  
  
  
  
  
• Evaluating and improving a model of nursing care delivery: A process of partnership
  December 2012
  Publication year: 2012
  Source: Collegian: Journal of the Royal College of Nursing Australia, Volume 19, Issue 4
  
  
  
  Introduction Evaluating and improving a model of nursing care is a fundamental part of clinical practice improvement. While Australian nurses are showing increasing interest in improving models of care delivery, more research is needed that addresses and articulates the processes attendant upon evaluating, re-designing and implementing improvements to the provision of nursing care. Providing nurses with an open opportunity to plan, act, observe and reflect on their practice promotes successful partnerships between academics and clinicians. Aim The aim of this study was to evaluate and improve the model of nursing care delivery to patients in a general surgical ward using participatory action research. Method Researchers conducted non-participant observations ( n = 9) of two hours duration across the 24 h period. Focus groups ( n = 3) were used to share non-participant observation data with staff, providing them with an opportunity to reflect on their practice and explore possible solutions. Data was collected in 2008–2009. Results Two main problem areas were identified as impeding the nurses’ ability to provide care to patients: (i) practices and behaviours of nurses and (ii) infrastructure and physical layout of the ward. An overview of issues within each problem area is presented. Conclusion Shifting the focus of task-centred care towards a more patient-centred care approach, results directly in improvements in resource utilisation, improved cost-effectiveness and job satisfaction for nursing staff. New ways of thinking about nursing processes and systems, workflow design and skill allocation will guide hospital administrators and managers in the effective and efficient allocation of nursing work in similar settings.
  
  
  
  
  
  
• Effective leadership, teamwork and mentoring – Essential elements in promoting generational cohesion in the nursing workforce and retaining nurses
  December 2012
  Publication year: 2012
  Source: Collegian: Journal of the Royal College of Nursing Australia, Volume 19, Issue 4
  
  
  
  Despite recent increases in nurse recruitment in Australia, the current nursing workforce is still below the predicted numbers for the future demands. The combination of an ageing workforce, high nursing staff turnover and an inability to attract and retain nurses is eroding the capacity of the health care sector to appropriately respond to the care needs of the community. Currently, the nursing workforce may have as many as four generations working together. Differences in employment needs and values, work ethics, attitudes towards authority, and professional aspirations, contribute to some of the cross-generational problems that emerge and the turnover of nursing staff. Strategies to improve the retention rates of nurses need to focus on building a cohesive workforce by utilising the strengths and skill sets that characterise different generations of nurses, and creating the conditions in which nurses across all generations feel supported and valued. The aim of this article is to explain how effective leadership, teamwork and mentoring can assist efforts to promote generational cohesion and address the decline in the number of nurses in the workforce.
  
  
  
  
  
  
• How nurses cope with occupational stress outside their workplaces
  Available online 24 September 2012
  Publication year: 2012
  Source: Collegian: Journal of the Royal College of Nursing Australia
  
  
  
  Nursing is acknowledged as a stressful occupation, and the negative impact of high stress levels have been widely researched. Less attention has been paid to methods for coping with stress. The researchers conducted a study to explore and identify investigate how nurses cope with work-related stress away from their work environments. Six focus groups were conducted with 38 nurses, including nursing directors, nurse unit managers, and ward nurses from a wide range of clinical areas. From the interview material, 11 coping strategies were identified: drinking alcohol, smoking, using the staff social club, using social networking websites, exercising, family activities, home-based activities, outdoor activities, avoiding people, displacement, and sleep. Although several adaptive strategies appear in this list (e.g., exercising, home-based activities), some nurses were using unhealthy behaviours to cope with work-related stress (e.g., drinking alcohol, smoking, displacement). This study clearly demonstrates the value of using qualitative approaches to understanding how nurses cope with stress. Knowledge produced locally, such as that generated for the hospital in this study, should serve as the foundation for organisational strategies to enhance the health of nurses.
  
  
  
  
  
  
• Interprofessional clinical education: Clinicians’ views on the importance of leadership
  December 2012
  Publication year: 2012
  Source: Collegian: Journal of the Royal College of Nursing Australia, Volume 19, Issue 4
  
  
  
  The current shortage of health professionals necessitates new approaches to clinical education that can expand the number of undergraduate students undertaking clinical placements without increasing the burden on clinical staff or placing patients at risk. Interprofessional education has the potential to help increase clinical capacity whilst enriching students’ clinical experience. This paper reports on a project which investigated the potential for interprofessional education to increase undergraduate clinical placement capacity in clinical settings. The project utilised an exploratory descriptive methodology to obtain the views of health care professionals about the use of interprofessional education in clinical education at three rural health facilities in Victoria, Australia. Participants ( n = 57) had a key role with each health care facility in coordinating and facilitating undergraduate clinical placements. This paper examines the clinicians’ views about the central role that leadership plays in actioning interprofessional education in the clinical setting. Whilst interprofessional education was regarded favourably by the majority of participants, data indicated that leadership from education providers, health services, and regulatory authorities was crucial to enable interprofessional education to be implemented and sustained within the clinical learning environment. Without leadership from each of these three spheres of influence, interprofessional education will continue to be difficult to implement for undergraduate students and compromise their exposure to an important aspect of the working life of health care professionals. Such a failure will limit graduates’ readiness for collaborative and cross-disciplinary practice.
  
  
  
  
  
  
• Meeting the needs of rural and regional families: Educating midwives
  December 2012
  Publication year: 2012
  Source: Collegian: Journal of the Royal College of Nursing Australia, Volume 19, Issue 4
  
  
  
  
  
  
  
  
  
  
• Health promotion by primary care nurses in Australian general practice
  Available online 25 September 2012
  Publication year: 2012
  Source: Collegian: Journal of the Royal College of Nursing Australia
  
  
  
  The pressures brought about by the increasing prevalence of poor health among some population groups as well as the rise in prevalence of chronic and complex conditions requires a nursing workforce skilled in health promotion. Primary care nurses have increasingly important roles in general practice settings but there is little exploration of the nature or extent of their health promotion work. This paper reports on a survey that investigated primary care nurses’ perceptions of their current and potential roles in health promotion in general practice settings. The survey respondents were primary care nurses in general practice. 78 nurses responded to advertisements seeking participation, and 58 surveys were completed and returned. Data were analyzed through a framework of downstream–upstream health promotion actions. We found that the health promotion practices of primary care nurses were most commonly in the downstream realm of disease prevention and health education but nurses aspired to take on roles in more upstream work of partnerships and collaboration. Nurses’ opportunities are undoubtedly constrained by both the general practice setting and their educational preparation. However, nurses were very positive about the opportunities that their role and position offered for expansion of their health promotion work.
  
  
  
  
  
  
• Graduate registered nurse practice readiness in the Australian context: An issue worthy of discussion
  Available online 17 November 2012
  Publication year: 2012
  Source: Collegian: Journal of the Royal College of Nursing Australia
  
  
  
  An ageing Australian population coupled with declining nursing numbers is predicted to have a significant impact on the Australian Healthcare industry, with numbers of nurses expected to be in greater demand at a time when the need for nursing care is on the rise. The report released recently by Health Workforce Australia predicted a potential shortage of approximately 110,000 nurses by 2025. In Queensland alone, the Queensland Nursing Union estimates the shortage of nurses to be closer to 10,000 positions by 2016 and 14,000 positions by 2020 based on the anticipated Queensland Health hospital expansions. The Commonwealth Government has responded by increasing funding to train more registered nurses across Australia. Hence a significant number of graduate registered nurses are expected and required to join the workforce. However, an analysis of the literature reveals that opinions differ between clinicians and education providers as to whether recently graduated registered nurses are adequately prepared for the challenges of the current healthcare system. Even though much research has been done in Australia on the issue of transition support programmes, graduate registered nurses’ transition to practice remains problematic and is perceived to pose a significant challenge to healthcare industry. This paper contributes to the contemporary discourse on graduate registered nurses’ practice readiness at a time when a forecasted nursing shortage, the difficulties in accessing sufficient quality clinical placements and the need for fiscal responsibility pose added challenges to education providers and the healthcare industry.
  
  
  
  
  
  
• Cross-sectional survey of the health behaviour of southeast Queensland women with cancer-treatment induced menopause: Implications for cancer and primary care nurses
  Available online 27 October 2012
  Publication year: 2012
  Source: Collegian: Journal of the Royal College of Nursing Australia
  
  
  
  Purpose Women who experience cancer treatment-induced menopause are at risk of long-term chronic morbidity. This risk can be prevented or offset with adherence to health promotion and risk reduction guidelines. The purpose of this study was to explore health behaviours in younger female survivors of cancer and the variables (quality of life and psychological distress) believed to moderate health behaviours. Design Cross-sectional survey of a convenience sample of women ( n = 85) in southeast Queensland. Methods Health behaviour and health status were elicited with items from the Australian Health Survey and the Behavioural Risk Factor Surveillance System. The WHO Quality of Life (Brief) measured participants’ self-reported quality of life and their satisfaction with their health. The Brief Symptom Inventory-18 measured psychological distress. Findings Higher self-reported health status was associated with regular exercise and better quality of life. However, a substantial proportion of participants did not engage in the physical activity, dietary or cervical screening practices recommended by Australian guidelines. Conclusions The participants require education regarding the benefits of diet, exercise, weight loss and decreased alcohol intake, as well as information on future health risks and possible comorbidities. These education sessions could be addressed by a nurse-led health promotion model of care at the time of discharge or in the community.
  
  
  
  
  
  
• Factors influencing functional recovery in patients with acute ischemic stroke
  Available online 23 November 2012
  Publication year: 2012
  Source: Collegian: Journal of the Royal College of Nursing Australia
  
  
  
  Aim This study examined factors influencing functional recovery, including neurological and psychological function and activity of daily living (ADL), in individuals hospitalized with acute ischemic stroke. Methods A prospective observational study was undertaken in a sample of 141 hospitalized adults with acute ischemic stroke in three hospitals in metropolitan Bangkok and one in regional Thailand. Sociodemographic and clinical data were collected using a standardized questionnaire. Co-morbidity burden was assessed using the Charlson Co-morbidity Index-Modified-Thai version (CCI-T) and acute stroke care services usage using the Measurement of Acute Stroke Care Services Received form. Recovery of neurological function was measured by the National Institutes of Health Stroke Scale-Thai (NIHSS-T), and ADL function was measured by the Modified Barthel Index Measurement-Thai Version (BI-T). Psychological function was assessed using the Center for Epidemiologic Studies Depression Scale-Thai version (CES-D-T). Multivariate logistic regression was used to analyze the predictive ability of pre-specified variables. Results Receiving thrombolytic therapy was a significant predictor of functional recovery in terms of neurological (OR = 4.714; P = .004) and ADL functions on the day of discharge (OR = 5.408; P = .002). Accessing acute stroke care service was the only factor predicting improved psychological function on hospital discharge (OR = 1.312; P = .049). Conclusion The best predictor for physical functional recovery was receiving thrombolytic therapy. In addition, acute stroke care services demonstrated to have an association with psychological function.
  
  
  
  
  
  
• Nursing work directions in Australia: Does evidence drive the policy'
  December 2012
  Publication year: 2012
  Source: Collegian: Journal of the Royal College of Nursing Australia, Volume 19, Issue 4
  
  
  
  A significant body of research has shown a relationship between nurse staffing (in particular, skill-mix : the proportion of Registered Nurses [RNs]) and both morbidity and mortality. This relationship is typically investigated by measuring the incidence of Nursing Sensitive Outcomes (NSOs) under different skill-mix levels. Yet whilst the evidence suggests that richer skill-mix is associated with a lower incidence of NSOs, recent Australian policy reforms have proposed the replacement of Registered Nurses with less qualified staff. The present study sought to examine the relationship between staffing, skill-mix, and incidence of NSOs at two hospitals in one Australian state. The study sought to determine the rate of occurrence of several NSOs, the relationship of skill-mix to that rate, and the number of patients affected per annum. It was found that the current rate of NSOs across wards ranged from 0.17% to 1.05%, and that there was an inverse relationship between the proportion of hours worked by RNs and NSO rates: an increase of 10% in the proportion of hours worked by RNs was linked to a decrease in NSO rates by between 11% and 45%. It was estimated that increasing the RN staffing percentage by 10% would mean 160 fewer adverse outcomes for patients per year across these two hospitals. Importantly, increases in nursing hours overall (without increases in skill-mix) had no significant effect on patient outcomes. These findings challenge current policy recommendations, which propose increasing the number of unregistered staff without increasing skill-mix.
  
  
  
  
  
  
• The role of clinical trial nurses: An Australian perspective
  December 2012
  Publication year: 2012
  Source: Collegian: Journal of the Royal College of Nursing Australia, Volume 19, Issue 4
  
  
  
  Over the past two decades, the number of clinical trials conducted globally has increased thereby increasing demand for nurses working as Clinical Trial Nurses (CTNs), sometimes known as Clinical Research Nurses. The role and professional issues for these nurses in Australia has not been empirically formulated. Sixty-seven clinical trial nurses were surveyed nationally using a modified version of the Clinical Trials Nursing Questionnaire (CTNQ). Findings revealed the complex CTN role can include the coordination of the trials on one or more sites. This involves all domains listed in the questionnaire from protocol development, ethics approval applications, recruitment and consenting of participants in trials, to administering or assisting with treatments within the bounds of their practice code and the evaluation of protocols. Professional issues documented were: being undervalued in the nursing workforce, having no formal educational preparation for the role and minimal recognition in publications emanating from research in which they were involved. These nurses bring their practice knowledge to benefit research outcomes that may contribute to improving patient/client care.
  
  
  
  
  
  
• ‘eSimulation’ Part 2: Evaluation of an interactive multimedia mental health education program for generalist nurses
  Available online 12 December 2012
  Publication year: 2012
  Source: Collegian: Journal of the Royal College of Nursing Australia
  
  
  
  This paper reports on an evaluation of an eSimulation mental health education program for generalist nurses; developed using the following five key attributes of simulation: (1) creating a hypothetical opportunity; (2) authentic representation; (3) active participation; (4) integration; (5) repetition, evaluation and reflection. Four themes emerged from a qualitative thematic analysis of semi-structured interview data involving fourteen generalist nurses. The following four themes: (1) authenticity; (2) participation; (3) clinical reasoning; (4) control of learning provide supporting evidence that these attributes are positioned within the learning resource. Participants found the scenarios within the resource realistic, engaging and relevant to their scope of practice. This type of learning resource may help in developing the knowledge, skills and confidence of generalist nurses in delivering safe and competent mental health care in the generalist setting, when access to specialist services and appropriate means of training are unavailable.
  
  
  
  
  
  
• Collaboration: A solution to the challenge of conducting nursing research in cardiac rehabilitation
  Available online 14 December 2012
  Publication year: 2012
  Source: Collegian: Journal of the Royal College of Nursing Australia
  
  
  
  Clinical nurse leaders such as clinical nurse consultants are required to conduct research and incorporate outcomes of this research into their every day practice. However, undertaking research presents issues for cardiac rehabilitation clinical nurse consultants because they may have competing demands, difficulty with finding replacements and may be relatively isolated from other researchers. The solution to this situation is the formation of a collaborative research team with other cardiac rehabilitation clinical nurse consultants, with the inclusion of an experienced university academic as a mentor for the cardiac rehabilitation clinical nurse consultants working in an Area Health Service encompassing both rural and metropolitan hospitals in New South Wales, Australia. The related research project aimed to evaluate and improve the clients’ knowledge and practices related to the use of sublingual glyceryl trinitrate. The team's experiences and suggestions for clinical nurse leaders are presented in this paper. Essential team characteristics include having shared motivation, good communication practices, flexibility and tolerance, an effective team size, achieving success, willingness to accept challenges and an experienced mentor. The benefits of developing a collaborative team for research led by clinical nurse consultants in cardiac rehabilitation by far outweigh the time and effort involved in the process.
  
  
  
  
  
  
• A review of undergraduate interprofessional simulation-based education (IPSE)
  September 2012
  Publication year: 2012
  Source: Collegian: Journal of the Royal College of Nursing Australia, Volume 19, Issue 3
  
  
  
  Interprofessional simulation-based education (IPSE) is becoming an increasingly popular educational strategy worldwide within undergraduate healthcare curricular. The purpose of the literature review was to examine qualitative, quantitative and mixed/multi-method research studies featuring undergraduate IPSE. A literature review was conducted using CINAHL, MEDLINE, and PsycINFO databases from January 1999 to September 2011 and pre-set criteria. The criteria used to screen all 120 abstracts included: (a) the article pertained to both simulation and undergraduate IPE and (b) the article reported a research study. Eighteen articles which met the pre-set criteria were included in the literature review. All studies featured outcome measures; many were purposely designed and lacked psychometric development and evaluation. Key IPSE drivers included capacity planning, preparedness for disaster management and improving patient care through the evaluation of teambuilding, teamwork skills or communicating within inter-disciplinary teams. Studies evaluated/explored either student or teacher perspectives of learning within the context of IPSE or both. The IPSE learning processes varied considerably in relation to duration, fidelity and professions involved. The scenarios ranged from managing adults admitted to hospital settings, mass casualty/mock disaster patient management to the use of training wards. The majority of the articles identified common IPSE outcomes relating to increased confidence, knowledge, leadership, teamwork, and communication skills. Based on the findings of this review, the authors suggest that further multi-site, longitudinal research studies are required to provide evidence of the transferability of skills developed during IPSE and their overall impact on both undergraduate education and healthcare.
  
  
  
  
  
  
• Interdisciplinary collisions: Bringing healthcare professionals together
  September 2012
  Publication year: 2012
  Source: Collegian: Journal of the Royal College of Nursing Australia, Volume 19, Issue 3
  
  
  
  Since the publication of its reports, Health professions education: A bridge to quality (2003) and To err is human: Building a safer health system (2000), the Institute of Medicine has continued to emphasize interprofessional education (IPE), founded on quality improvement and informatics, as a better way to prepare healthcare professionals for practice. As this trend continues, healthcare education will need to implement administrative and educational processes that encourage different professions to collaborate and share resources. With greater numbers of students enrolled in health professional programs, combined with ethical imperatives for learning and reduced access to quality clinical experiences, medical and nursing education increasingly rely on simulation education to implement interdisciplinary patient safety initiatives. In this article, the authors describe one approach, based on the Core Competencies for Interprofessional Collaborative Practice released by the Interprofessional Education Collaborative (2011) , toward providing IPE to an audience of diverse healthcare professionals in academia and clinical practice. This approach combines professional standards with the authors’ practical experience serving on a key operations committee, comprising members from a school of medicine, a school of nursing, and a large healthcare system, to design and implement a new state-of-the-art simulation center and its IPE-centered curriculum.
  
  
  
  
  
  
• High fidelity simulation in critical care: A Canadian perspective
  September 2012
  Publication year: 2012
  Source: Collegian: Journal of the Royal College of Nursing Australia, Volume 19, Issue 3
  
  
  
  The use of high fidelity human simulation has exploded into the nursing education context over the last decade. In Ontario, Canada an innovative Critical Care e-learning program was established in 2007 to create accessible critical care education for nurses across Ontario and Canada. The program has a three-pronged approach including online, simulation and practicum components. The purpose of this paper is to present lessons learned during the last five years of development and growth of this program. The paper will focus on the use of simulation to build confidence and prepare registered nurses for critical care nursing practice. In addition, subsequent development of a network of ten simulation partners that deliver critical care simulation will be discussed. High fidelity simulation delivery in the critical care context will be explored and the use of summative or ‘high stakes’ simulation competency evaluation will be elaborated on.
  
  
  
  
  
  
• Patient deterioration simulation experiences: Impact on teaching and learning
  September 2012
  Publication year: 2012
  Source: Collegian: Journal of the Royal College of Nursing Australia, Volume 19, Issue 3
  
  
  
  Early recognition and management of patient deterioration are essential nursing skills, and can be improved through education and experience. However, both nursing students and registered nurses may have few opportunities to develop and maintain the emergency management skills necessary to ensure patient safety. Using both theory and empirical evidence, we have developed a simulation-based educational model, ‘FIRST ² ACT’ (Feedback Incorporating Review and Simulation Techniques to Act on Clinical Trends), to provide nurses with a high-fidelity learning experience. The model has been tested in three different settings: it is highly acceptable to learners, adaptable to different training needs, and shows promise in improving actual clinical performance.
  
  
  
  
  
  
• An evaluation of a complex simulated scenario with final year undergraduate children's nursing students
  September 2012
  Publication year: 2012
  Source: Collegian: Journal of the Royal College of Nursing Australia, Volume 19, Issue 3
  
  
  
  The last decade has witnessed the emergence of simulation as a useful, but sometimes challenging teaching methodology. This is supported by a number of sources of evidence, which focus strongly upon student evaluation of the learning experience. The challenges are equally worth consideration. These include issues such as the commissioning of space, staff expertise in resourcing and creating a situation which is as close to real practice as possible. It is against this backdrop, following a number of years developing innovative clinical simulation at Cardiff University; children's nursing students were exposed to a complex simulated clinical shift. The activities included: managing the clinical area; the transfer of a sick child; managing a medication error; subsequent discussion with the parents; and prioritising and organising care. The use of role-play was utilised throughout, to create a realistic experience and the simulation activity took place in two settings to enable the transfer from one area to another. The simulation experience was undertaken at the end of the third year undergraduate program by three cohorts of students ( n = 41). Following the experience, data were collected through a post-simulation de-briefing and a Likert style questionnaire, enabling the collection of qualitative and quantitative data concerned with the student's experience of the simulation. Overwhelmingly, the results showed that this was a positive experience for the students, demonstrating a number of perceived improvements in the application of their clinical skills. These included: development of specific management skills; enhanced confidence; development of self-awareness; and the transferability of skills to practice. Students also demonstrated strong agreement in terms of the realism of the experience.
  
  
  
  
  
  
• Providing simulation experiences for large cohorts of 1st year nursing students: Evaluating quality and impact
  September 2012
  Publication year: 2012
  Source: Collegian: Journal of the Royal College of Nursing Australia, Volume 19, Issue 3
  
  
  
  To provide each student within a large cohort the opportunity to participate in a small group simulation that meets recognised quality indicators is a challenge for Bachelor of Nursing programmes in Australia. This paper, as part of a larger longitudinal study, describes one approach used to manage a simulation for 375 1st year nursing students and to report on the quality of the experience from the student's perspective. To ensure quality was maintained within the large cohort, aspects of the simulation were assessed against the following indicators: alignment with curriculum pedagogy and goals; preparation of students and staff; fidelity; and debriefing. Data obtained from a student focus group were analysed in the context of the quality indicators. The following themes emerged from the data: knowing what to expect; assuming roles for the simulation; authenticity and thinking on your feet; feeling the RN role; and, preparation for clinical practice. This paper demonstrates it is possible to provide students in large cohorts with active participatory roles in simulations whilst maintaining quality indicators.
  
  
  
  
  
  
• Palliative care needs of terminally ill people living alone: A service provider perspective
  Available online 6 September 2012
  Publication year: 2012
  Source: Collegian: Journal of the Royal College of Nursing Australia
  
  
  
  Background Community-based palliative care services face challenges in meeting the needs of terminally ill clients who live alone without a primary caregiver. Yet, there is a dearth of literature on the perceptions of health service providers (HSPs) regarding the care needs and possible management options to assist this growing group to remain at home. Objective This paper investigated the support needs of people living alone with a terminal illness from a service provider perspective. Design In depth semi-structured interviews were conducted with nine HSPs from community based services in three Australian states. Results Four main themes emerged: care challenges, differences in care provision, appropriate approaches to care and essentials for an effective service such as 24 h care, cost-free provision of personal alarm systems, supported and coordinated housekeeping services, funded respite care and financial care packages. HSPs expressed a respect for the autonomy and independence of the clients, yet felt pressured to ensure that safe and attentive care was possible. HSPs recognised the central importance of maintaining the independence and autonomy of palliative care clients living alone. Conclusions This study is the first in-depth account of what HSPs perceive they need to effectively look after home alone dying clients. The study provided directions to inform service planning for this growing and challenging population group regarding adequate and timely services that will lead to more complying with the clients’ wishes, more care being delivered at home, a reduction in hospitalisations, a better quality of life and a capacity to die at home.
  
  
  
  
  
  
• Clinical simulation in health care—Contemporary learning for safety and practice
  September 2012
  Publication year: 2012
  Source: Collegian: Journal of the Royal College of Nursing Australia, Volume 19, Issue 3
  
  
  
  
  
  
  
  
  
  
• Perceptions of clinical safety climate of the multicultural nursing workforce in Saudi Arabia: A cross-sectional survey
  Available online 8 September 2012
  Publication year: 2012
  Source: Collegian: Journal of the Royal College of Nursing Australia
  
  
  
  Purpose The purpose of this study is to explore the safety climate perceptions of the multicultural nursing workforce, and to investigate the influence of diversity of the multicultural nursing workforce on clinical safety in a large tertiary hospital in Saudi Arabia. Background Working in a multicultural environment is challenging. Each culture has its own unique characteristics and dimensions that shape the language, lifestyle, beliefs, values, customs, traditions, and patterns of behaviour, which expatriate nurses must come to terms with. However, cultural diversity in the health care environment can potentially affect the quality of care and patient safety. Method A mixed-method case study (survey, interview and document analysis) was employed. A primary study phase entailed the administration of the Safety Climate Survey (SCS). A population sampling strategy was used and 319 nurses participated, yielding a 76.8% response rate. Descriptive and inferential statistics (Kruskal–Wallis test) were used to analyse survey data. Results The data revealed the nurses’ perceptions of the clinical safety climate in this multicultural environment was unsafe, with a mean score of 3.9 out of 5. No significant difference was found between the age groups, years of nursing experience and their perceptions of the safety climate in this context. A significant difference was observed between the national background categories of nurses and perceptions of safety climate. Conclusion Cultural diversity within the nursing workforce could have a significant influence on perceptions of clinical safety. These findings have the potential to inform policy and practice related to cultural diversity in Saudi Arabia.
  
  
  
  
  
  
• How nurses cope with occupational stress outside their workplaces
  Available online 24 September 2012
  Publication year: 2012
  Source: Collegian: Journal of the Royal College of Nursing Australia
  
  
  
  Nursing is acknowledged as a stressful occupation, and the negative impact of high stress levels have been widely researched. Less attention has been paid to methods for coping with stress. The researchers conducted a study to explore and identify investigate how nurses cope with work-related stress away from their work environments. Six focus groups were conducted with 38 nurses, including nursing directors, nurse unit managers, and ward nurses from a wide range of clinical areas. From the interview material, 11 coping strategies were identified: drinking alcohol, smoking, using the staff social club, using social networking websites, exercising, family activities, home-based activities, outdoor activities, avoiding people, displacement, and sleep. Although several adaptive strategies appear in this list (e.g., exercising, home-based activities), some nurses were using unhealthy behaviours to cope with work-related stress (e.g., drinking alcohol, smoking, displacement). This study clearly demonstrates the value of using qualitative approaches to understanding how nurses cope with stress. Knowledge produced locally, such as that generated for the hospital in this study, should serve as the foundation for organisational strategies to enhance the health of nurses.
  
  
  
  
  
  

  No Issue Number

• Professional regulation, public protection and nurse migration
  Available online 29 January 2013
  Publication year: 2013
  Source: Collegian: Journal of the Royal College of Nursing Australia
  
  
  
  Nurse mobility, developments such as health tourism and the rapid expansion of health systems have increased the need for regulatory bodies to reach beyond their normal stakeholder groups so as to familiarize themselves with the legislation of other jurisdictions. Purpose A systematic examination of a cross-section of nursing legislation, to ascertain the degree of consistency in the number of definitions specified as well as their underlying structure, was conducted to identify opportunities to strengthen public protection and reduce barriers to freedom of movement. Method A purposeful sample of legislation, drawn to maximize differences, was subjected to documentary analysis to identify possible relationships between the variables of interest and the way terms and processes were defined in fourteen nurse practice acts. Results Potential relationships were identified between factors such as geographic region, legal tradition, administrative approach, regulatory model and economic status and the number and approaches used to specify definitions. A major weakness in the precision of definitions was discovered. Discussion Several international organizations have started to develop lexicons but all have weaknesses. By drawing upon these lexicons a more comprehensive and precise dictionary could be formulated to support the development of next-generation nurse practice acts. Conclusions Current legislation lacks precision and, within the context of increased mobility of nurses, there is an urgent need to develop an authoritative source of definitions that can contribute to increasing public safety as well as reducing delays in the freedom of movement of nurses from one jurisdiction to another.
  
  
  
  
  
  
• Factors influencing the stages of breast cancer at the time of diagnosis in Thai women
  Available online 29 January 2013
  Publication year: 2013
  Source: Collegian: Journal of the Royal College of Nursing Australia
  
  
  
  Background Early diagnosis of breast cancer leads to early treatment therefore improving women's health. However, most Thai women are diagnosed at a late stage. Objective This cross-sectional correlational study was designed to explore factors influencing the diagnosis of early stage breast cancer in Thai women. Method Thai women ( n = 400) newly diagnosed breast cancer at all clinical stages from public hospitals in Bangkok Metropolitan completed a questionnaire about knowledge of breast cancer and screening. The questionnaire addressed pre-diagnosis data about: (1) health care provider's recommendations to undertake breast screening, (2) health coverage for mammography (MM) costs and (3) regularity of breast screening behaviors in terms of breast self-examination (BSE), clinical breast examination (CBE) and MM including stage breast cancer at diagnosis. Data analysis was determined by PASW Statistics version 18 as univariate and multivariate logistic regression. Results Health coverage for MM costs and all three behaviors were significantly related to and could predict the early stages breast cancer at diagnosis ( p < 0.05): health coverage for MM costs (OR = 0.32, 95% confidence interval [CI], 0.17–0.63), BSE (OR = 8.08, CI 95%, 3.93–16.63), CBE (OR = 12.54, CI 95%, 2.29–68.65) and MM (OR = 5.89, CI 95%, 1.13–30.73). Conclusions All three behaviors are essential and related to one another. CBE on a regular basis is the best predictor for early stages breast cancer at diagnosis in Thai context. Nurses should provide information and teach including re-check the women's skills to perform BSE regularly.
  
  
  
  
  
  
• ‘Two dead frankfurts and a blob of sauce’: The serendipity of receiving nutrition and hydration in Australian residential aged care
  Available online 11 March 2013
  Publication year: 2013
  Source: Collegian: Journal of the Royal College of Nursing Australia
  
  
  
  Background This paper explores the serendipity of residents accessing adequate food and fluids in aged care facilities. It draws on the findings of two discrete but interrelated research projects conducted in 2009 and 2011 relating to the experience of living in, or having a friend or family member living in, residential aged care. Methods Participants were recruited through media outlets. Indepth interviews with participants were audiotaped, transcribed verbatim and thematically analysed. Findings This paper discusses a theme that was iterated by participants in both projects that is, the difficulty residents in aged care facilities experienced in receiving adequate and acceptable food and fluids. Unacceptable dining room experiences, poor quality food and excessive food hygiene regulations contributed to iatrogenic malnutrition and dehydration. Implications for staffing, clinical supervision, education of carers and the impact of negative attitudes to older people are discussed. Conclusion The inability of dependent residents in aged care facilities to receive adequate nourishment and hydration impacts on their health and their rights as a resident, and is an ongoing issue in Australian residential aged care.
  
  
  
  
  
  
• Response to Editorial
  Available online 9 January 2013
  Publication year: 2013
  Source: Collegian: Journal of the Royal College of Nursing Australia
  
  
  
  
  
  
  
  
  
  
• ‘eSimulation’ Part 1: Development of an interactive multimedia mental health education program for generalist nurses
  Available online 4 January 2013
  Publication year: 2013
  Source: Collegian: Journal of the Royal College of Nursing Australia
  
  
  
  Generalist health care professionals are increasingly challenged to provide mental health care within their own clinical specialties. Educators are challenged with providing innovative, engaging and accessible education programs to increase the mental health knowledge and skills of generalist health care professionals. Simulation is increasingly being used within learning curricula to optimise learning and the use of information and communication technology has emerged as a novel way of providing simulated learning. This paper describes the development process of an interactive, multimedia ‘eSimulation’ mental health education program for generalist health care professionals. The resulting eSimulation education program incorporated the following five key attributes of simulation: (1) Creating a hypothetical opportunity; (2) Authentic representation; (3) Active participation; (4) Integration; and (5) Repetition, evaluation and reflection. This process can be used to guide nursing educators in the development of tailored eSimulation education programs. An evaluation of the eSimulation will be reported elsewhere, in Part 2 of this paper.
  
  
  
  
  
  
• A midwife is a midwife is a midwife…
  Available online 21 January 2013
  Publication year: 2013
  Source: Collegian: Journal of the Royal College of Nursing Australia
  
  
  
  
  
  
  
  
  
  
• Response to letter to Editor: “Meeting the needs of rural and regional families: Educating midwives”
  Available online 7 February 2013
  Publication year: 2013
  Source: Collegian: Journal of the Royal College of Nursing Australia
  
  
  
  
  
  
  
  
  
  
• Stressors and coping strategies of 20–45-year-old hemodialysis patients
  Available online 19 March 2013
  Publication year: 2013
  Source: Collegian: Journal of the Royal College of Nursing Australia
  
  
  
  Objectives This study attempted to describe stressors, levels of stress, and coping strategies of 20–45-year-old Taiwanese patients undergoing chronic hemodialysis. Methods A cross-sectional descriptive design was used. A convenience sample of 88 patients with a mean age of 38.55 years was recruited at six dialysis centers in southern Taiwan. Data were collected using the Hemodialysis Stressor Scale and the Jalowiec Coping Scale. Results The results show that this group of patients had higher levels of stress than those reported in previous studies. The three most frequently reported stressors were limitations of liquids, limitations of food, and fatigue. The two most frequent coping methods were trying to find meaning in the situation and trying out different ways of solving problems to see which works the best. These patients had more physiological stressors than psychosocial stressors and used more problem-oriented coping strategies than affective-oriented ones. Additionally, the longer the patients had received hemodialysis, the lower stress level they had, and patients with jobs, with partners, or with children used significantly more coping strategies than those without jobs, partners, or children. Gender differences were not found in the total stress level or coping strategies of these patients, except that female patients had greater psychosocial stressors than male patients. Conclusions The 20–45-year-old hemodialysis patients experienced considerable levels of stress and had a unique ranking order of stressors and coping strategies. These findings will provide healthcare professionals with detailed information to identify priority areas for future intervention development.
  
  
  
  
  
  
• Cancer care coordinator: Promoting multidisciplinary care—A pilot study in Australian general practice
  March 2013
  Publication year: 2013
  Source: Collegian: Journal of the Royal College of Nursing Australia, Volume 20, Issue 1
  
  
  
  Aim We hypothesised that patients treated for breast cancer would benefit from targeted therapeutic action delivered by general practitioners on the recommendations of a multidisciplinary team based in primary care. Methods Patients scheduled for follow-up visits at a hospital surgical clinic were invited to complete a self-administered care needs assessment and be interviewed by a breast care nurse. Members of the multidisciplinary team discussed the audio-recorded interviews within 2 weeks. The team made recommendations for each patient, which were presented to the general practitioner as a suggested ‘care plan’. Health status information was collected via the Short Form 36 and Anxiety and Depression data via the Hospital anxiety and Depression Scale at recruitment and 3 months later. Results Among the 74 women who were invited to participate, 21 were recruited over a 6-month period (28%), 19 of whom completed the study (90%). The mean age was 55 years (range 38–61 years) and the mean time in follow-up was 23 months (range 16–38 months). The team identified a median of three problems per patient (range 2–7) and made an average of two recommendations per patient for referral to an allied health professional (range 0–5). At 3 months, 17 women had attended their general practitioner, 11 of whom felt their condition had improved as a result of the intervention. There was no significant change in Short Form 36 or Hospital Anxiety and Depression Scale score after the intervention. Conclusions Primary care-based multidisciplinary review of treated breast cancer patients is feasible and, for most, results in benefit. However, only a minority of eligible patients participated in this pilot study and the logistics of organising the reviews warrants careful consideration.
  
  
  
  
  
  
• The core business of caring: A nursing oxymoron?
  Available online 6 April 2013
  Publication year: 2013
  Source: Collegian
  
  
  
  Nursing has always regarded caring as its core business. The historical record about caring in nursing is non-specific, and little direct evidence exists about caring as part of nursing. Caring is not restricted to nursing, is possibly influenced by public perceptions of nursing, and can be subverted for maleficent ends. This paper discusses these points, and then moves to explain how caring fares in the Australian health care system. Australia has been blighted by a “cultural cringe” which sees anything from overseas as more valuable than anything Australian. This is as true for nursing, and caring within that, as for any other aspect of Australian life. However, Australia has one of the best health care systems in the world, and nursing as a profession is a world leader. The argument of this paper is that the core business of caring could be under threat in Australia unless nurses recognize their particularly good contribution to the profession and subsequent patient/client care, and celebrate that. Examples are taken from the United Kingdom where there is a crisis of caring within nursing and health. These are used to explain how Australian nursing can avoid the pitfalls and retain caring as its core business.
  
  
  
  
  
  
• Accidental insider: Living the PhD study
  March 2013
  Publication year: 2013
  Source: Collegian: Journal of the Royal College of Nursing Australia, Volume 20, Issue 1
  
  
  
  This paper explores the concept of ‘insider’ and ‘outsider’ and the challenges involved in conducting research when the researcher finds themself living the phenomenon under study. Recent literature has been drawn on to explain the context of the ‘insider’ and ‘outsider’ in regard to the stance of the researcher. This is followed by an overview of the personal experiences of the author. The advantages and disadvantages of being an insider within the context of the phenomenon of study are discussed along with the challenges and implications for a researcher ‘living their PhD research’.
  
  
  
  
  
  
• The foster carer's experien An integrative review
  Available online 9 January 2013
  Publication year: 2013
  Source: Collegian: Journal of the Royal College of Nursing Australia
  
  
  
  Background Foster carers have a significant responsibility in caring for children who are unable to live with their birth families and represent a key determinant in child outcomes. Difficulties in recruiting and retaining quality foster carers have resulted in an increase in research investigating foster carers and their experiences in recent years. Aim To synthesise current literature investigating foster carers and their experiences to enable a better understanding of their unique care-giving context. Method The electronic databases CINAHL, Health Source, MEDLINE, Pscyh-articles, PsycINFO and sociINDEX were searched using the key terms; ‘foster carer’, ‘foster parent’, ‘foster mother’ and ‘foster father’. Articles were included if they reported primary data about foster carers experiences in the English language. Papers published prior to 2000 were excluded in order to provide a contemporary perspective of the foster carer experience. Data was extracted, tabulated and thematically analysed. Findings The findings from this review revealed the provision of foster care to have both positive and negative effects on foster carers personal well-being. These effects are largely reliant of foster carers perception of their role as either parental or professional, the nature of their relationships with child welfare personnel, and their ability to manage children's difficult behaviours. Conclusion It is important for nurses to understand caregiving as it occurs in a variety of contexts. Nurses need to have an awareness and understanding of the value and role foster carers have in the lives of vulnerable children. In so doing, nurses are well positioned to assist foster carers to identify and express their needs in relation to their important caregiving role.
  
  
  
  
  
  
• Collegial relationship breakdown: A qualitative exploration of nurses in acute care settings
  Publication date: June 2013
  Source: Collegian, Volume 20, Issue 2
  
  Author(s): Leanne S. Cowin , Sandy C. Eagar
  
  Poor collegial relations can cause communication breakdown, staff attrition and difficulties attracting new nursing staff. Underestimating the potential power of nursing team relationships means that opportunities to create better working environments and increase the quality of nursing care can be missed. Previous research on improving collegiality indicates that professionalism and work satisfaction increases and that staff attrition decreases. This study explores challenges, strengths and strategies used in nursing team communication in order to build collegial relationships. A qualitative approach was employed to gather nurses experiences and discussion of communication within their nursing teams and a constant comparison method was utilised for data analysis. A convenience sampling technique was employed to access both Registered Nurses and Enrolled Nurses to partake in six focus groups. Thirty mostly female nurses (ratio of 5:1) participated in the study. Inclusion criteria consisted of being a nurse currently working in acute care settings and the exclusion criteria included nursing staff currently working in closed specialty units (i.e. intensive care units). Results revealed three main themes: (1) externalisation and internalisation of nursing team communication breakdown, (2) the importance of collegiality for retention of nurses and (3) loss of respect, and civility across the healthcare workplace. A clear division between hierarchies of nurses was apparent in how nursing team communication was delivered and managed. Open, respectful and collegial communication is essential in today's dynamic and complex health environments. The nurses in this study highlighted how important nursing communication can be to work motivation and how leadership fosters teamwork.
  
  
  
  
  
  
• Nursing students and the supervision of medication administration
  Publication date: June 2013
  Source: Collegian, Volume 20, Issue 2
  
  Author(s): Kerry Reid-Searl , Brenda Happell , Karena J. Burke , Cadeyrn J. Gaskin
  
  Up to one in five medication administrations in Australian hospitals involve an error. As registered nurses (RNs) are at the forefront of medication administration, they have been the focus of attempts to reduce errors. Given that nursing students have reported errors or experiences of near misses , their practices, as well as the supervision they receive from RNs, also deserves investigation. The aim of this study was to investigate student nurses’ experiences of supervision while administering medications. Students ( N = 45) completed a questionnaire on their supervision experiences while administering medications. The findings revealed that 88% of students agreed that they had been directly supervised during the entirety of administration procedures. Although 7% of students reported not receiving supervision throughout medication administration, higher percentages of students indicated that they received lower levels of supervision when wards were busy (66%), when they felt under pressure to comply with the wishes of RNs (40%), when students had been in clinical settings for extended periods of time (51%), and when the RNs trusted the student nurses (37%). Approximately one third (29%) of student nurses disagreed that RNs followed the six rights when administering medications. These findings suggest that student nurses are not always adequately supervised and are at times administering medications outside the parameters of the law. Healthcare organisations need to adapt their policies and practices to ensure that the legal requirements surrounding student nurse administration of medications are being met, as well as the educational and welfare needs of neophyte nurses.
  
  
  
  
  
  
• Instructional immediacy in elearning
  Available online 29 March 2013
  Publication year: 2013
  Source: Collegian
  
  
  
  Instructor immediacy has been positively associated with many desirable academic outcomes including increased student learning. This study extends existing understanding of instructional immediacy behaviours in elearning by describing postgraduate nursing students’ reflections on their own experience. An exploratory, descriptive survey design was used to collect qualitative data. Participants were asked what behaviours or activities help to create rapport or a positive interpersonal connection (immediacy) between students and their online teacher(s). Thematic analysis of the data revealed three main themes: acknowledging and affirming student's personal and professional responsibilities; providing clear and timely information; and utilising rich media. These findings give lecturers insight into instructional strategies they may adopt to increase immediacy in elearning and hence improve student learning outcomes.
  
  
  
  
  
  
• Response to letter to Editor: “Meeting the needs of rural and regional families: Educating midwives”
  Available online 8 February 2013
  Publication year: 2013
  Source: Collegian: Journal of the Royal College of Nursing Australia
  
  
  
  
  
  
  
  
  
  
• Bachelor of midwifery graduates can provide quality care in rural maternity units
  Available online 9 February 2013
  Publication year: 2013
  Source: Collegian: Journal of the Royal College of Nursing Australia
  
  
  
  
  
  
  
  
  
  
• Exploring resilience in paediatric oncology nursing staff
  March 2013
  Publication year: 2013
  Source: Collegian: Journal of the Royal College of Nursing Australia, Volume 20, Issue 1
  
  
  
  Resilience has been suggested as an important coping strategy for nurses working in demanding settings, such as paediatric oncology. This qualitative study explored paediatric oncology nurses’ perceptions of their development of resilience and how this resilience underpinned their ability to deal with work-related stressors. Five paediatric oncology nurses were interviewed about their understanding of the concept of resilience, their preferred coping mechanisms, and their day-today work in paediatric oncology. Using thematic analysis, the interviews were subsequently grouped together into seventeen initial themes. These themes were then grouped into seven major aspects that described how the participants perceived resilience underpinned their work. These “seven aspects of forming resilience” contributed to an initial understanding of how paediatric oncology nurses develop resilience in the face of their personal and professional challenges. Several key strategies derived from the findings, such as improved rostering, support to a nurse's friend and family, and a clinical support nursing role, could be implemented at an organizational level to support resilience development within the paediatric oncology setting.
  
  
  
  
  
  
• The use of physical assessment skills by registered nurses in Australia: Issues for nursing education
  March 2013
  Publication year: 2013
  Source: Collegian: Journal of the Royal College of Nursing Australia, Volume 20, Issue 1
  
  
  
  The purpose of pre-service nursing education programs is to prepare competent graduates who are able to function as safe, professional registered nurses. An extensive element of these programs is the teaching of physical assessment skills, with most programs educating students to perform over 120 such skills. Previous research from North America suggests that the majority of skills taught to nurses in their pre-service programs are not used in practice. As part of a larger study, an online survey was used to explore use of 121 physical assessment skills by Australian nurses. Recruitment occurred via mailed invitation to members of the Australian Nursing Federation. Data were extracted from 1220 completed questionnaires returned by nurses who were mostly employed in New South Wales, were female and experienced nurses. Respondents indicated that they used only 34% of skills routinely. Results reinforce evidence found in the literature that many of the skills taught to nurses are either not used at all (35.5%) or are used rarely (31%). These findings have implications for the teaching of physical assessment skills in pre-service nursing programs, and raise questions about the value of extensive skills teaching in the context of contemporary health care. Further research into barriers to the use of physical assessment skills in nursing and the need for comprehensive skills preparation for the generalist nurse is likely to offer some solutions to these questions.
  
  
  
  
  
  
• How acceptable are primary health care nurse practitioners to Australian consumers'
  March 2013
  Publication year: 2013
  Source: Collegian: Journal of the Royal College of Nursing Australia, Volume 20, Issue 1
  
  
  
  International evidence indicates that nurses working in primary care can provide effective care and achieve positive health outcomes for patients similar to that provided by doctors. Nurse practitioners employed in primary health care perform some tasks previously exclusive to the GP role due to their advanced skills, knowledge and training. In November 2010 Medicare provider rights and Pharmaceutical Benefits Scheme rights were provided for nurse practitioners working in private practice, and in collaboration with a medical practitioner. However, there is limited evidence about how acceptable nurse practitioners are to Australian consumers and what knowledge consumers have of the nurse practitioner role in the delivery of primary health care. The aim of this study was to examine Australian health care consumers’ perceptions of nurse practitioners working in primary health care. This paper reports on the results of seven focus groups ( n = 77 participants) conducted around Australia. Focus groups participants were asked how acceptable nurse practitioners are as provides of primary health care. Although there was some confusion about the role of nurse practitioners and how this role differed from other primary health care nurses, participants in the focus groups were very positive about nurse practitioners and would find them acceptable in providing primary health care.
  
  
  
  
  
  
• Barriers to providing school-based health care: International case comparisons
  March 2013
  Publication year: 2013
  Source: Collegian: Journal of the Royal College of Nursing Australia, Volume 20, Issue 1
  
  
  
  Background This article reports on an international collaborative study which compared school-based health care in the United States of America, Canada and Australia. Method Tri-nation school-based health care was compared and contrasted through the utilisation of a series of interpretive case studies. Grounded theory approaches informed the data analysis and reporting processes. Findings Unlike the US, Canadian and Australian school students rarely have access to school-based health care on site. All three nations face structural, cultural and societal barriers, often related to limited resources which limit the effectiveness of school-based health care. Discussion The benefits of school-based health care and providing comprehensive services through schools can include healthier children, better learning, healthier parents, and healthier communities. Unfortunately, based on our research, comprehensive school health services have not been adequately implemented in the US, Canada or Australia. Implications for practice Given the findings of this study, increased comprehensive school-based health services are urgently needed in the US, Canada and Australia.
  
  
  
  
  
  
• Embedding international benchmarks of proficiency in English in undergraduate nursing programmes: Challenges and strategies in equipping culturally and linguistically diverse students with English as an additional language for nursing in Australia
  Publication date: June 2013
  Source: Collegian, Volume 20, Issue 2
  
  Author(s): Paul J. Glew
  
  To meet the expected shortfalls in the number of registered nurses throughout the coming decade Australian universities have been recruiting an increasing number of students from culturally and linguistically diverse (CaLD) backgrounds. Given that international and domestic students who use English as an additional language (EAL) complement the number of native English speaking nursing students, they represent a valuable nurse education investment. Although university programmes are in a position to meet the education and learning needs of native English speaking nursing students, they can experience considerable challenges in effectively equipping EAL students with the English and academic language skills for nursing studies and registration in Australia. However, success in a nursing programme and in preparing for nurse registration can require EAL students to achieve substantial literacy skills in English and academic language through their engagement with these tertiary learning contexts. This paper discusses the education implications for nursing programmes and EAL students of developing literacy skills through pre-registration nursing studies to meet the English language skills standard for nurse registration and presents intervention strategies for nursing programmes that aim to build EAL student capacity in using academic English.
  
  
  
  
  
  
• Nurse academics perceptions of the efficacy of the OSCA tool
  Publication date: June 2013
  Source: Collegian, Volume 20, Issue 2
  
  Author(s): Stéphane Bouchoucha , Lolita Wikander , Catherine Wilkin
  
  The use of Objective Structured Clinical Examination/Objective Structured Clinical Assessment (OSCE/OSCA) has been well documented. How assessors currently view the process, and if the OSCA tool still fulfils the assessment requirements, is unclear. In this study, the beliefs and expectations of assessors towards the assessment tool used in an undergraduate nursing degree to assess clinical skills was investigated. A cross-sectional study used semi-structured interviews and focus groups with 16 lecturers in nursing from a rural Australian university. This represents 65% of the total nurse academic staff employed there. The key issues that the academic staff raised reflect those from previous studies, such as the use of OSCA as formative assessment or a quality check process before the clinical practice. The OSCAs were seen as a good assessment tool, which gave students the opportunity to receive feedback on their performance in relation to clinical skills. The drawbacks identified in relation to the use of OSCAs were that the OSCA was seen as stressful to students. This drawback was thought to be further compounded if there was a lack of congruence regarding essential criteria between assessors. If not adequately addressed these drawbacks will erode the potential the OSCA tool has to foster uniformity, which was one of the main reasons for its implementation.
  
  
  
  
  
  
• Becoming willing to role model. Reciprocity between new graduate nurses and experienced practice nurses in general practice in New Zealand: A constructivist grounded theory
  Publication date: June 2013
  Source: Collegian, Volume 20, Issue 2
  
  Author(s): Karen J. Hoare , Jane Mills , Karen Francis
  
  Graduate nurses in general practice became a feature of New Zealand's health care system in 2008 following an expansion of the New Entrant to Practice Programme. General practice in New Zealand comprises general practitioner business owners who employ nursing and administration staff. Practice nurses are an ageing workforce in New Zealand, it is imperative therefore to attract younger nurses into general practice. This paper reports a section of the findings from a constructivist grounded theory study which examines the use of information by practice nurses in New Zealand. Initially data were collected using the ethnographic technique of observation and field notations in one general practice. Theoretical sensitivity to the value of role models was heightened by this first phase of data collection. A total of eleven practice nurses were interviewed from six general practices. One practice nurse agreed to a second interview; five of the interviewees were new graduate nurses and the other six were experienced practice nurses. The grounded theory constructed from this research was reciprocal role modelling which comprises the following three categories, becoming willing , realising potential and becoming a better practitioner. Graduate nurses and experienced practice nurses enter into a relationship of reciprocal role modelling. Becoming willing , the first core category of this grounded theory features three sub-categories: building respectful relationships , proving yourself and discerning decision making which are reported in this paper. Findings from this study may address the reported phenomenon of ‘transition shock’ of newly graduated nurses in the work place.
  
  
  
  
  
  
• Charting a course for the development of ACN
  Available online 12 February 2013
  Publication year: 2013
  Source: Collegian: Journal of the Royal College of Nursing Australia
  
  
  
  
  
  
  
  
  
  
• Asthma self management in adults: A review of current literature
  Available online 24 January 2013
  Publication year: 2013
  Source: Collegian: Journal of the Royal College of Nursing Australia
  
  
  
  Self management programs for chronic conditions, such as asthma, have an important place in healthcare delivery. When properly implemented, they can curb the impact of disease and reduce both the high personal costs for individuals and significant financial costs for health care systems. The purpose of this review was to establish an understanding of current published literature on asthma self management programs in adults and to identify any reported attributes or components which serve to either assist or obstruct the uptake of self management strategies. Electronic data sources including Scopus, Proquest 5000, CINAHL, PubMed and Web of Science were accessed and literature searches were conducted using the key terms: asthma, chronic disease, self management, morbidity, quality of life, health outcomes, patient education and best practice. Inclusion criteria for the search included journal articles relating to adults with asthma published in English in peer reviewed journals from 1995 to 2011. Exclusion criteria included research targeting children, parents of children or families; and articles examining Asthma and COPD (or any other co-morbidity). Sixty four articles were included in this review due to their relevance to the major components of asthma self management, as defined by the Australian Asthma Management Handbook. A major conclusion from this review was that the uptake of asthma self management strategies is poor despite global recommendations for over twenty years; and that a likely reason for this is that generic asthma self management advice does not engage the individual with asthma.
  
  
  
  
  
  
• Looking up to the sky! An exploration of new graduate nurses’ perceptions of remote area nursing
  Available online 4 April 2013
  Publication year: 2013
  Source: Collegian
  
  
  
  Remote area nursing is characterised by two known realities: health inequalities and nursing challenges. The health inequalities are complex consequences of social determinants and health care access. Remote area nurses must negotiate these realities that powerfully interact. Yet we, as new graduate nurses, contemplate a remote area nursing career pathway with additional points of view, including a strong attraction to the long-lasting image of the ‘Flying Nurse’ within aero medical remote health services. This image holds for us the possibilities of excitement, drama, vital service, and intensive care. This paper explores the realities of this career attraction, and consequently explores the aspirations of contemplative new graduate nurses, as they assimilate their knowledge of remote area nursing with their plans for their future transitions into nursing practice.
  
  
  
  
  
  
• Complementary health therapies: Moving towards an integrated health model
  March 2013
  Publication year: 2013
  Source: Collegian: Journal of the Royal College of Nursing Australia, Volume 20, Issue 1
  
  
  
  Background There is increasing use of complementary and alternative medicines (CAMs), particularly amongst patients with cancer. This paper aims to better understand the types of CAM people are using and explore the reasons for using these approaches. This paper will also identify what patients want from health professionals in relation to CAM and the actions and attitudes of health professionals towards CAM. Finally, this paper will discuss the potential implications for health services. Method Two surveys were conducted, a self-administered survey was completed by oncology patients; and a second online survey completed by staff. Results Patients used CAM as an adjunct to services they receive from conventional health services, not as an alternative. The positive and empowering role that complementary health practices play in people's lives was a common theme as was the need for CAM to be used with care. Survey responses by health care staff revealed mixed views of CAM. Most staff had positive views about CAM as a treatment adjunct and said they responded to patients accordingly. Only a minority expressed scepticism and were less inclined to support CAM use by their patients. Nevertheless, few staff instigated discussions around CAM. Conclusion This paper presents key considerations for health services wanting to better respond to CAM and adopt an integrated approach to health care.
  
  
  
  
  
  
• 
  Available online 16 January 2013
  Publication year: 2013
  Source: Collegian: Journal of the Royal College of Nursing Australia
  
  
  
  
  
  
  
  
  
  
• Cluster randomised controlled trial: Educational self-care intervention with older Taiwanese patients with Type 2 diabetes––Impact on blood glucose levels and diabetic complications
  Available online 13 February 2013
  Publication year: 2013
  Source: Collegian: Journal of the Royal College of Nursing Australia
  
  
  
  Aims To investigate whether self care behaviours, medical outcomes and quality of life of Taiwanese elderly with Type 2 diabetes mellitus (DM) can be improved by delivery of an educational health care package. Background DM is a major health problem in developed and developing countries, with older adults constituting about half of the diabetic population. Type 2 DM is the most rapidly increasing chronic disease in Taiwan. Methods During 2005 and 2006, Taiwanese elderly with Type 2 DM ( n = 500) were randomly allocated to either an intervention or control group. Data collection using validated instruments occurred at baseline and 6 months follow-up. Main outcome measures were blood glucose levels and diabetic complications. Results At baseline, 88.4% participants in the control and 78.8% in the experimental group had a blood glucose level above normal range ( p = 0.076); respective results at 6 months were 92.4% for the control group and 60.4% for the experimental group ( p < 0.001). The multivariate adjusted result showed that the intervention group was 11.1 times less likely to have blood glucose levels above normal ( p = 0.002) at 6 months follow-up compared to the control group. Occurrence of complications was significantly fewer in the intervention group at baseline and at 6 month follow-up compared to the control group (baseline: 42.0% versus 82.1%, p = 0.003; 6 month follow-up: 48.4% versus 87.0%; p = 0.006). Conclusion Although overall occurrence of complications remained unchanged, the educational health care package specifically developed for Taiwanese elderly with Type 2 DM improved blood glucose levels.
  
  
  
  
  
  
• An examination of barriers to Nurse Practitioner endorsement in senior rural drug and alcohol nurses in New South Wales
  Publication date: June 2013
  Source: Collegian, Volume 20, Issue 2
  
  Author(s): Stephen Ling , Janette Curtis , Renee Brighton , Adrian Dunlop
  
  Introduction and aims To examine barriers senior rural nurses in New South Wales drug and alcohol clinical settings perceive when considering endorsement to Nurse Practitioner (NP). Design and methods A survey was designed to record views of senior alcohol and drug nurses in rural New South Wales about becoming a NP. Participants were identified by Area Health Service Directors of Drug and Alcohol Services for each Area Health Service in NSW excluding metropolitan Sydney. Forty eight surveys were distributed, with 17 (35%) completed surveys included in the results. Results Of the 17 participants, 12 (70.6%) expressed interest in becoming a NP. The majority (12, 70.6%) were unaware or unsure of endorsement processes. Lack of clarity about the NP role and processes and benefits to becoming a NP was found to be of most concern to all participants. Only 6 participants (35%) indicated they would consider seeking endorsement to NP. Discussion and conclusion Despite agreeing that NP positions in alcohol and drug settings would improve patient access to treatment and care, senior nurses working in these settings in regional areas are unfamiliar with pathways to becoming endorsed. Barriers, such as a lack of internal support from management and colleagues, as well as the fact that respondents reported no foreseeable financial gain in endorsement, also need to be addressed, before more nurses will consider endorsement. Further evaluation of the views of senior nurses in metropolitan alcohol and other drug settings in the process to NP endorsement is needed before clients will benefit from the expertise and enhanced care that NP's may provide.
  
  
  
  
  
  
• Cues that predict violence in the hospital setting: Findings from an observational study
  Available online 31 March 2013
  Publication year: 2013
  Source: Collegian
  
  
  
  Background The prevalence of violent acts in the health care environment has been the cause of increasing concern. Several cues associated with violence towards nurses in the acute care setting have been identified qualitatively. However, larger scale observational studies to determine the potential of these cues to predict physical violence, are lacking in the acute health setting. Purpose To report an observational study determining whether particular behavioural cues are predictive of patient-to-nurse physical violence. Method Non-participant structured observations. Discussion Clinical observation ( n = 1150 h) resulted in 1501 observed cues for violence in 220 patients; 36 of whom were observed to become violent. Five (5) behavioural cues were found to predict violent acts. Conclusions Findings suggest five behavioural cues could be used to assess potential physical violence. Additional research needs to be undertaken to further validate the efficacy of these cues in the acute hospital setting.
  
  
  
  
  
  
• Community safety, consistency and competence - national accreditation for nursing and midwifery education programs
  Publication date: June 2013
  Source: Collegian, Volume 20, Issue 2
  
  Author(s): Amanda Adrian
  
  
  
  
  
  
  
  
• Physical and psychosocial wellbeing of nurses in a regional Queensland hospital
  Available online 30 March 2013
  Publication year: 2013
  Source: Collegian
  
  
  
  Occupational stress is common among nurses. Two factors that may influence stress levels are diet and physical activity. The purpose of this study was to investigate the diets and physical activity levels of nurses and to quantify the relationships between these behaviours and anxiety, depressed mood, stress, and burnout. Nurses ( N = 52) from one regional hospital completed a survey assessing physical activity, nutrition, and psychological functioning. Almost two-thirds (65%) of participants had met recommended levels of both moderate and vigorous physical activity in the week prior. Participants met recommended levels for fruit, but not vegetable, consumption. Burnout and stress levels were close to norms for physicians and nurses. Scores for depressed mood, anxiety, and stress symptoms were within one standard deviation of norms for the Australian adult population. Several moderately sized correlations were found between the psychological constructs measured and both physical activity and nutrition. Although most of the participants were physically active and seemed to be consuming nutritious diets, some nurses may need encouragement to adopt similarly healthy behaviours.