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mHealth applications (apps) are tools that can enhance research by efficiently collecting and storing large amounts of data. However, data collection alone does not lead to change. Innovation and practice change occur through utilisation of evidence. The volume of data collected raises questions regarding utilisation of data by nurses and midwives, and how data from mHealth apps can be used to improve person-centred practice. There is limited empirical evidence and a lack of direction from global health authorities to guide nurses and midwives in this area. To describe strategies for nurses and midwives that could enhance the effective use of data generated by mHealth apps to inform person-centred practice. The purpose of this paper is to stimulate reflection and generate actions for data utilisation when using mHealth apps in nursing research and practice. This discussion paper has been informed by current evidence, the integrated-Promoting Action on Research Implementation in Health Services (i-PARIHS) framework, and research experience as part of doctoral study. Before engaging in data collection using mHealth apps, nurses and midwives would benefit from considering the nature of the evidence collected, available technological infrastructure, and staff skill levels. When collecting data and interpreting results, use of a team approach supported by engaged leadership and external facilitation is invaluable. This provides support to operate apps, and more importantly use the data collected to inform person-centred practice. This paper addresses the limited available evidence to guide nurses and midwives when using mHealth apps to collect and use data to inform practice change. It highlights the need for appropriate technology, external facilitative support, engaged leadership, and a team approach to collect meaningful evidence using mHealth apps. Clinicians, leaders, and researchers can apply the strategies provided to enhance the use of mHealth apps and ensure translation of evidence into practice. [ABSTRACT FROM AUTHOR]

The purpose of this paper is to provide discourse regarding awareness of institutional racism, from a non-Indigenous, Australian nursing student's perspective. The discussion has a focus on the presence of institutional racism in the Australian healthcare system, its impact on the health of First Nation Peoples and a commitment to ensuring culturally safe practice. It will be argued that institutional racism is pervasive in healthcare as a consequence of three factors: exclusion of First Nations Peoples from governance roles, inherent racism impacting on socio-cultural treatment bias, and institutional racism influencing key relationships in healthcare delivery. [ABSTRACT FROM AUTHOR]

Development of the Nurse practitioner role and the specialisation of practice is an increasing focus in healthcare. To date, a bibliometric evaluation of scholarly work referring to Nurse Practitioners, has not been located in the published literature. With the aim of identifying the top 100 cited articles in the Nurse Practitioner domain, the Scopus™ database was searched for Nurse Practitioner studies during 2007–2021. Using bibliometric analysis we identified prolific authors; annual trend; citation rates; countries of origin; and study design. There were 1768 papers identified across 360 peer reviewed journals in 33 countries. Finding from this analysis provides evidence of an evolving research area of inquiry which contributes to knowledge of the Nurse Practitioner role and scope of practice. [ABSTRACT FROM AUTHOR]

Objective/Aim: To examine the experiences of culturally safe mentoring programmes described by Aboriginal and Torres Strait Islander nurses and midwives in Australia. Design: A systematic scoping review. Data Sources: The following databases were accessed: CINAHL Plus with Full Text (EBSCO), EMCARE (Ovid), MEDLINE (Ovid), INFORMIT (Health Collection/Indigenous Collection) and SCOPUS. Support relating to key words and appropriate databases was provided by a university librarian. Review Methods: Search terms across databases were sourced from 1997–2021, identifying a total of 161 papers. Title/abstract searches were screened against the inclusion/exclusion criteria, resulting in 18 papers reaching full-text review. Of the 18 full-text papers reviewed, six were eligible for inclusion in the final review. Results/Findings: Culturally safe mentorship was a positive experience for Aboriginal and Torres Strait Islander nurses and midwives. Thematic discussion identified three key themes: Mentorship as a way forward, Culture in mentorship, and Cultural safety's role in mentorship. Discussion: Culturally safe mentoring has been a key recommendation in the nursing literature for over 20 years. There is limited knowledge on what constitutes an effective programme as mentoring programmes have not been empirically evaluated or reviewed. Conclusion: This review provides evidence that Cultural Safety and the exploration of culture impact culturally safe mentoring and can impact workforce cultural capability. Impact Statement: This review indicates that culturally safe mentoring has been a key recommendation in nursing literature for over 20 years. This review provides evidence that Cultural Safety and the exploration of culture impact culturally safe mentoring and can impact workforce cultural capability. However, there is limited knowledge of what constitutes an effective programme, as mentoring programmes have not been empirically evaluated or reviewed providing an opportunity for further research. Plain Language Summary: Little is known about Aboriginal and Torres Strait Islander nurses' and midwives' perspectives of culturally safe mentoring programmes in Australia. However, mentoring programme are seen as a key workforce retention strategy. This scoping review aims to explore and interpret Aboriginal and Torres Strait Islander nurses' and midwives' perspectives of culturally safe mentoring programmes in Australia. This review concludes that mentoring programmes require content in Cultural Safety and that programmes need to be empirically evaluated. [ABSTRACT FROM AUTHOR]

Background: The experience of workplace violence and aggression is a common occurrence among the nursing and midwifery workforce, however, it is largely under-reported. Reasons for underreporting are not well understood. Aim: To review factors that influence nurses' and midwives' reporting of workplace violence and aggression from patients and visitors in hospital inpatient settings. Method: In this integrative review papers were identified through a search of electronic databases Embase, Emcare, PsychInfo, Medline, and CINAHL for literature between 2009 and 2020. Findings: Five papers met the inclusion criteria. Three themes were identified which influence reporting: organisational culture; accepting violence as part of the job; and type of violence. Discussion: Workplace policies supported by management and education programmes are required to improve the reporting of workplace violence and aggression by nurses and midwives. Conclusion: Workplace violence and aggression is under-reported by nurses and midwives in hospital inpatient settings. Reporting systems are not valued and nurses have come to accept workplace violence and aggression. Further research is required to explore strategies to improve workplace violence and aggression reporting culture and assess current education programmes using validated tools. [ABSTRACT FROM AUTHOR]

For Indigenous Peoples the disparities in health status are largely associated with the direct social determinants of invasion and colonisation, marginalisation, intergenerational traumas, and lack of conscious government policy to address these ongoing effects. There is currently limited evidence in the literature on what Cultural Safety practices mean in acute care settings. We aimed to understand the extent and type of evidence in relation to current knowledge and evidence regarding Cultural Safety practices for Indigenous Peoples in acute care settings. This is a scoping review. We searched six databases in consultation with a librarian experienced in health research. A total of 16 papers were included in the scoping review. Four main barriers to Cultural Safety in practice were identified; Among the included studies, only one quality improvement study reported an intervention, which improved culturally safe care. The four barriers identified each have a variable impact on Indigenous Peoples' health outcomes and are dependent upon the circumstances and experiences of both Indigenous Peoples and healthcare professionals. [ABSTRACT FROM AUTHOR]

There have been 188 rural hospital closures in the United States since 2010 with approximately 20% of these in Appalachia. Telehealth has become a way that nurses can reach rural patients who might not otherwise receive health care. The purpose of this paper is to (1) outline the federal policies enacted during COVID-19 for broadband expansion; and (2) suggest how advanced practice nursing care might be affected by broadband expansion and telehealth in the region. A search of PubMed was conducted in January 2023, using the search words, "policy", "telehealth", "broadband", and "Appalachia". New laws appropriated funds to expand broadband infrastructure that made it possible for telehealth to be used by nurses to deliver health care to rural patients. This discussion paper found that broadband legislation was instrumental in expanding telecommunications and telehealth by NPs. There is a great need for broadband to continue to expand and for trained nurses to provide care via telehealth. [ABSTRACT FROM AUTHOR]

Nurses, the largest healthcare workforce, are well placed to provide leadership in initiatives that promote planetary health. Yet, few practical examples of nurse leadership in the health sector's response to climate change are evident in the scholarly literature. The aim of this discussion paper is to profile Australian nurses who are leading initiatives designed to champion planetary health and promote sustainable practice. The paper presents a series of case studies derived from interviews conducted in October and November 2023. The nurses' experiences and insights, along with the challenges they have encountered, are presented as evidence of Kouzes and Posner's five practices of exemplary leadership. The case studies demonstrate that appointment of more nurses with climate and sustainability expertise will accelerate the implementation of responsive strategies that target waste management, emissions reduction and climate resilience across healthcare organisations. [ABSTRACT FROM AUTHOR]

Background: The COVID-19 pandemic has exacerbated the global nursing shortage. As the shortage worsens, reliance on internationally educated nurses is expected to increase, presenting challenges and opportunities for health care systems and nurse leaders worldwide. While internationally educated nurses bring cultural and ethnic diversity to domestic workforces, they face significant hurdles in successfully integrating due to racism, discrimination, and isolation, which can have a negative impact on their self-determination. The challenges encountered by internationally educated nurses can not only affect their self-determination, but they can also pose risks to patient safety. Objectives: This purpose of this paper was to examine the extant literature to describe the experiences of internationally educated nurses through the lens of Ryan and Deci's Self-Determination Theory. Another aim was to offer nurse managers and administrators strategies for supporting internationally educated nurses within their health care facilities. Design: Discussion Paper. Conclusions: Health care organizations should allocate time and resources to facilitate the professional transition of internationally educated nurses, promoting their psychological well-being and self-determination by fostering autonomy, competence, and relatedness. [ABSTRACT FROM AUTHOR]

The enrolled nurse is the second-level regulated nursing role in Australia and internationally. Reports and research indicate that the nursing profession requires greater understanding of the role, so it can be utilised to its potential. To explore issues that may impact the EN role in the Australian nursing workforce. An integrative review. A seven-step framework was used to review scholarly papers, government documents, and grey literature. Three themes from 24 documents were identified: understanding the EN's scope of practice, standardised practice, and career development. A lack of understanding of their scope of practice creates role confusion and a lack of standardised practice, with an expected progression to become a registered nurse. These factors contribute to ENs' not feeling valued. The nursing profession do not understand the enrolled nurse role, and further work is required to value its place in the Australian nursing workforce. [ABSTRACT FROM AUTHOR]

To conduct an integrative literature review to reveal any evidence supportive of the integration of traditional therapies for First Nations peoples in Australia within a western healthcare model, and to identify which, if any, of these therapies have been linked to better health outcomes and culturally safe and appropriate care for First Nations peoples. If so, are there indications by First Nations peoples in Australia that these have been effective in providing culturally safe care or the decolonisation of western healthcare practices. Integrative literature review of peer-reviewed literature. Online databases searched included CINAHL, Medline, Scopus, ScienceDirect InformitHealth, and ProQuest. Databases were searched for papers with full text available and published in English with no date parameter set. The PRISMA guidelines were used during the literature review and the literature was critiqued using the Critical Appraisal Skills tool. Seven articles met the inclusion criteria and were included in the review. Four articles selected were qualitative, two used a mixed method design, and one used a quantitative method. Six themes arose: (i) bush medicine, (ii) traditional healers, (iii) traditional healing practices, (iv) bush tucker, (v) spiritual healing, and (vi) therapies that connected to cultures such as yarning and storytelling. There is limited literature discussing the use of traditional therapies in Western healthcare settings. A need exists to include traditional therapies within a Western healthcare system. Creating a culturally safer and appropriate healthcare experience for First Nations people in Australia and will contribute to advancement in the decolonisation of current healthcare models. [ABSTRACT FROM AUTHOR]

Objective: This paper aims to spur thought-provoking practical debates on current nurse workforce staffing and scheduling systems in relation to a critical review of Ang and colleagues' (2018) article entitled "Nurse workforce scheduling in the emergency department: A sequential decision support system considering multiple objectives." Design: Discussion paper on a practical discourse in connection with the aforementioned published article. Discussion: Mathematical Programming (optimisation) (MP)-based nursing research has been published for nearly thirty years almost exclusively in industrial engineering or health business administration journals, demonstrating a widening gap between nursing research and practice. Nurse scientists' knowledge and skill of MP is insufficient, as are their interdisciplinary collaborations, setting back the advancement of nursing science. Above all, nurse scientists skilled in decision science are desperately needed for that analytic intellection which is rooted in the 'intrinsic nature and value of nursing care.' It is imperative that nurse scientists be well-prepared for the new age of the Fourth Industrial Revolution through both an education in MP and interdisciplinary collaboration with decision science experts in order to prevent potential stereotyped MP-based algorithm-driven destructive influences. Conclusions: The current global nursing shortage makes optimal nursing workforce staffing and scheduling more important. MP helps nurse executives and leaders to ensure the most efficient number of nurses with the most effective composition of nurse staffing at the right time for a reasonable cost. Nurse scientists urgently need to produce a new nursing knowledge base that is directly implementable in nursing practice. Impact Statement: Nurse scientists should take the leading role in producing the mathematical programming-integrated knowledge base that is directly implementable in practice. [ABSTRACT FROM AUTHOR]

The nursing/midwifery professions are facing a sea change with the inclusion of cultural safety in the Code of Conduct for Registered Nurses [Nursing and Midwifery Board of Australia. (2018a). Midwife standards of practice. Retrieved January 30, 2021, from ], the Code of Conduct for Midwives [Nursing and Midwifery Board of Australia. (2018b). Code of conduct for nurses. Retrieved January 30, 2021, from ], the Registered Nurse Accreditation Standards (Australian Nursing and Midwifery Accreditation Council. (2019). Registered Nurse Accreditation Standards. Retrieved from ), and the Midwife Accreditation Standards [Australian Nursing and Midwifery Accreditation Council. (2021). Midwife Accreditation Standards. Retrieved from ]. In this paper, we focus on the theme of enabling cultural safety seeking to overcome the barrier of confusion surrounding it. The inclusion of cultural safety in codes and accreditation standards highlights the pressing need for these professions to attain deep understanding of cultural safety so that clinicians and educators can confidently practice and teach in this area. This need is underscored by the context of heightened awareness, that developed amongst mainstream Australians with Black Lives Matter in 2020, of inequity including health inequity. Our concern as academics responsible for staff development, curriculum development and implementation in university Schools of Nursing/Midwifery is to enable and support the teaching and practice of cultural safety. Its focus on working in partnership, addressing power imbalances, racisms and related systems of discrimination constitutes it as a vastly different model to cultural other-awareness and notions of cultural competency which have held sway on matters of culture in health service provision up to now. Our approach was to undertake a reflection on our combined decades of studying, leadership, teaching, and practice of cultural safety, which consistently showed the confusion in Australia about the model overall and about the definition of culture underpinning it. This paper supports the profession by addressing the need to educate academics and clinicians on cultural safety itself and on the role of all nurses/midwives, Indigenous and non-Indigenous, in these endeavours. This paper encourages a coherent development and confident implementation of cultural safety curriculum and practice to meet current requirements. [ABSTRACT FROM AUTHOR]

Background: Nurses and midwives predominately work in western-centric health care settings, which may not align with Indigenous perspectives of health and wellbeing. Nurses and midwives will also view care through their own cultural lens. Culturally inappropriate health care can reduce access and engagement in services and contribute to reduced health outcomes for Indigenous peoples. Australian codes of conduct for nurses and midwives now advocate for care that is holistic, free of bias and racism, challenges beliefs based on assumption, and is culturally safe for Indigenous peoples. However, there are varying understandings of cultural care, what it looks like, and how to best achieve it. Aim: To highlight the importance of cultural safety in health care and discuss the integration into nursing and midwifery practice. Design: Discussion paper. Discussion: Cultural safety has emerged in Australia as the framework to improve the access and quality of health care for Indigenous people and to improve disparities in health care outcomes. However, the application of these principles for nurses and midwives has not been widely explored. Misconceptions around the concept remain despite the inclusion in national standards and practice frameworks. Conclusion: Evaluation and research that contributes to evidence-based knowledge specifically on the integration of cultural safety in nursing and midwifery practice is required. Impact Statement: This paper provides an overview of the importance of cultural safety in nursing and midwifery practice. Although cultural safety is now embedded in professional codes and standards, there is limited evidence of how this is translated to clinical care. Research and evaluation are needed to evaluate the application of cultural safety principles by nurses and midwives. [ABSTRACT FROM AUTHOR]

A focus on community engagement is encouraged when educating nursing students on preventative care and advocacy. Students often struggle to connect theory to practice and benefit from real-world experiences. This paper describes the effect of a student-led health project on student development. A descriptive, correlational design was used to explore end of semester feedback from undergraduate nursing students (N = 174) completing a semester long community project. Chi-square analyses and thematic coding were performed to determine measures of association and student perceptions. Across 83 completed surveys (47.7%), self-efficacy was a key factor in project completion, development, bias awareness, and commitment to community. Civic duty and professional responsibility are challenging concepts for students, thus, impacting transition to practice. Engagement in self-efficacious experiences is encouraged. Community engagement influences undergraduate nursing students' development. Enhanced support of student self-efficacy may promote attainment of nursing values and improved care delivery. [ABSTRACT FROM AUTHOR]

Background: Worldwide, nursing students comprise a large portion of students in higher education institutions (HEIs). The expectation that HEIs will educate professionally competent nurses is high. To ensure adequate competence, exit examinations play a significant role in evaluation in many countries. However, there has been no comprehensive analysis of the instruments used and the content evaluated in exit examinations globally. Purposes: The aim of this study was to identify and describe the instruments used in undergraduate nursing students' exit examinations. Methods: Five databases were systematically searched, and eleven studies were included. The data of content used in exit exams were analysed using inductive content analysis. The instruments used in exit exams were tabulated and described. The systematic process was followed to identify included papers. Results: Eleven different instruments were identified, including nine theoretical instruments and two clinical instruments. The exit examinations of undergraduate nursing students varied considerably depending on the country and educational organisation. The content evaluated in the exit examinations covered the holistic nursing perspective. Conclusions: The findings of this review suggest that HEIs should develop and implement more comprehensive evaluation methods and instruments to ensure students' competence upon graduation. The results are important for developing exit examinations in nursing education because they indicate that summative evaluation is needed. Clinical examinations have been used marginally in HEIs, which should be considered when implementing new examinations. Digitalisation (e.g. virtual environments) could be one solution for offering objective assessment, validity and cost-effectiveness. This review provides a comprehensive analysis of undergraduate nursing students' exit examinations and indicates that more clinical evaluation methods should be developed to ensure adequate competence. [ABSTRACT FROM AUTHOR]

Objectives: Vital signs assessment is a critical component of acute clinical care. Despite this, research has consistently found that the assessment of these signs is often neglected in clinical practice. This paper highlights three recent cases reported in the media where the neglect of vital signs assessment resulted in patient mortality. Results: Recent media reports highlighted the potentially devastating consequences of vital signs not being rigorously assessed, including avoidable death. The public needs to be confident they will receive safe, quality health care when they are admitted to hospital. Conclusion: The neglect of vital signs assessment places patients at risk of poor outcomes. Early detection of clinical deterioration via the assessment of vital signs facilitates prompt medical intervention. Factors contributing to the neglect of vital signs assessment need to be identified and corrective action is taken to improve the safety of clinical care. [ABSTRACT FROM AUTHOR]

The older adult population in the US is burgeoning and nurses will be at the forefront of providing the skilled, compassionate care needed for them. Undergraduate nursing students do not commonly desire to work with older adults after graduation, likely related to negative attitudes, which can adversely impact the care provided. To determine the effect of a course using a suite of teaching techniques designed to positively shift nursing students' attitudes toward older adults. A one group pre and post-test design was used to test the effect of completion of the Nursing Care of the Older Adult course on baccalaureate undergraduate junior level nursing students' attitudes toward older people at a large University in the Midwest for two consecutive years (2019 and 2020). A quality assurance evaluation using a voluntary anonymous survey (Kogan's Attitude Toward Older People Instrument) on paper (2019) or online (2020) took place on the first and last day of class. Normality was assessed and the central limit theorem was applicable, therefore, independent samples t-tests were performed on the primary outcome, total score, with the primary predictor as pre vs post. This process was repeated on a 2020 cohort in the same course with a paired samples t-test, as paired subject ID's were recorded in 2020 but not in 2019. Due to the impact of the COVID-19 pandemic on all parts of academic life, no direct comparisons were made between the 2019 and 2020 samples. Course content included lectures, videos, MaskEd™ simulation, group work, case studies and clinical experiences. Both cohorts had significant improvement in the total Kogan instrument score, indicating a positive change in attitudes toward older adults [2019 pre M 167.2, SD 20.3 to post M 176.9, SD 22.4, t (292.43) = 3.96, p < 0.001 and 2020 pre M 179.4, SD 21.3 to post M 188.1, SD 22.2, t (70) = −5.61, p < 0.001]. The innovative, intentional teaching strategies incorporated into this gerontology course were effective in promoting positive attitudes toward older adults. [ABSTRACT FROM AUTHOR]

Background: As a result of the intergenerational trauma impact and experience, Native Americans continue to exhibit trauma-related issues such as high rates of substance use. After leaving high school, the pressures and stress of continuing an education, finding work/employment, and the responsibilities related to family and tribal community obligations result in the Native American young adult being more vulnerable to substance use. Objective: The purpose of this paper is to report findings of the Talking Circle intervention impact on the outcome variables of Native-Reliance, substance use, stress, and behavioural health, depression, and cumulative trauma. Methods: Native-Reliance was the theoretical underpinning for the study, demonstrating culturally safe research. A pre-test/post-test one-group design was utilised to examine how the Talking Circle intervention influenced the outcome variables. In total, 75 Native American participants, ages 18–24, participated in the Talking Circle intervention sessions. Baseline pre-intervention measures were completed and were repeated at 6-month post-intervention. Results: At 6-month post-intervention, Native-Reliance significantly revealed an increase of 40.55 (t = 22.13, p <.001), sources of stress (SS) revealed a significant decline of 3.68 (t = −18.39, p <.001), behavioural health issues (BH) showed a significant decline of 3.63 (t = −15.36, p <.001), substance-related issues (SR) showed a significant decline of 3.57 (t = −15.24, p <.001), depression (PHQ-9) showed a significant decline of 4.85 (t = −17.02, p <.001), and cumulative trauma revealed a significant decline of 2.77 (t = −13.39, p <.001). Conclusions: The use of a culturally safe Talking Circle intervention evidenced a research approach that resulted in a positive impact on reducing substance use and increasing the well-being of young Native American young adults. Impact Statement: Culturally safer intervention environments are conducive to results in outcomes that are positive and effective. [ABSTRACT FROM AUTHOR]

Cultural safety has been a constituent in nursing education for more than two decades. As evidence of racism and interpersonal violence in the health care system is mounting there is speculation on the meaning of cultural safety for nurses working in the field and with Indigenous peoples regarding the clarity of its intent. Objectives: Discussion Paper to revisit the foundation of Ramsden's work and articulate the rationale for specific antiracist language. Conclusions: Antiracist practice is a necessity for cultural safety to be successful. Impact Statement: Nurse educators must clarify the intention of cultural safety to explicitly include antiracist language, skills-based training, and pedagogy building on critical race theory. [ABSTRACT FROM AUTHOR]

The study's aim was two-fold: (1) to explore the experiences and perceptions of industry, academic, and research professionals concerning technologies used within aged care; and (2) to identify needs-led priorities for the future development and application of technologies within aged care. Global population ageing requires a recalibration of aged care policies, systems, and services to promote and support healthy ageing. It is expected that technology will play an important role in this regard. This study qualitatively assessed the landscape of technology use in aged care from the perspective of industry, academic, and research professionals. A purposefully designed cross-sectional survey collecting experiences, perspectives, and barriers about technology through open responses. Using convenience sampling, thirty-five participants completed an online survey between April and October 2020. A descriptive qualitative content analysis approach was used to analyse the written responses. Reporting of findings followed the EQUATOR's Standards for Reporting Qualitative Research checklist. Four themes were identified that characterised the use of technologies within aged care: (1) User Perceptions and Attitudes: wariness and reluctance to technology; (2) Systemic Issues within Aged Care: Under-resourced with opportunities for innovation; (3) Technology-Related Barriers: Equity, costs, privacy, integration, and interoperability and (4) Research Priorities: Co-design and integration of technology. The existing technology does not meet the needs of older people, aged care personnel and the system in general, which prevents its successful implementation and uptake. [ABSTRACT FROM AUTHOR]

An editorial is presented on the significance of the Indigenous Voice to Parliament referendum for Australian nurses. It emphasizes the challenges of systemic racism and promoting healthcare equity. It highlights the collaboration between the nursing and midwifery professions with Aboriginal and Torres Strait Islander Peoples and their support for the referendum's impact on health outcomes.

Background: Poor hospital discharge processes can result in the readmission of patients and potentially increase the stress levels of carers. Therefore, this study sought to understand the factors related to the discharge planning process for patients with dementia. Methods: The researchers interviewed 32 carers of patients with dementia and 20 hospital staff who worked on medical wards in a United Kingdom (UK) hospital. The semi-structured interviews were analysed thematically using a systems theory (patient–carer–staff relationships, hospital equipment and policies). Results: The findings indicated that the following factors could either have a positive or negative impact on discharge planning: patient (e.g. cognitive capacity), carer (e.g. preconceived ideas about care homes), staff (e.g. communication skills), policy (e.g. procedures such as discharge meetings), equipment (e.g. type of service provider delivering the equipment) and the wider social context (e.g. availability of specialist dementia beds in care homes). Conclusion: It is important for hospital staff to adopt a systems perspective and to integrate the different elements of the hospital system when planning for patients' discharge. [ABSTRACT FROM AUTHOR]

Redeployment of healthcare workers is one of the strategies that has been successfully used to manage increased workload and shortage of staff during the COVID-19 pandemic. However, little is known about how best to do this in the pandemic and beyond. The purpose of this study was to explore the lived experiences of haemodialysis nurses who were redeployed across five haemodialysis units affiliated with a large metropolitan teaching hospital in Australia during the COVID-19 pandemic. Qualitative design utilizing a hermeneutic (interpretive) phenomenology approach. Interviews were conducted in March 2022 among nurses who had been redeployed to other haemodialysis units during the COVID-19 pandemic (N = 16). Audiotaped interviews were transcribed verbatim and analysed independently by two researchers following specific steps of hermeneutic phenomenological analysis. Five themes were derived from the analyses. These were: (1) Nurses' immediate reaction; (2) Barriers to redeployment; (3) Benefits of redeployment; (4) Local and organisational support and (5) Opportunities for improvement. Redeployment of nurses across different haemodialysis units is associated with personal and organisational benefits and number of barriers that need to be addressed. Future studies should explore the long-term effects of redeployment due to the COVID-19 pandemic on haemodialysis nurses and other healthcare workers. [ABSTRACT FROM AUTHOR]

This study reports on the process of competence assessment in undergraduate nursing programmes in New Zealand. To identify current competence assessment practice and determine how competence assessment is constructed in order to reflect student development. This research utilised a qualitative exploratory-descriptive design. Nurse educators from nine tertiary institutions opted to participate in the research. Semi-structured interviews were conducted and data were analysed using a thematic analysis approach. Three themes are reported in this article; clinical assessment pedagogy, measure of competence, and relational assessment practice. There was significant variation between and within institutions in conducting competence assessment while scaffolding competence assessment throughout the degree programme was highlighted as a challenge. This study highlights the need for an assessment process that allows for the developing competence of nursing students and competencies that are designed to adequately assess students in each year of the nursing programme. [ABSTRACT FROM AUTHOR]

As Artificial Intelligence and social robots are increasingly used in health and social care, it is imperative to explore the training needs of the workforce, factoring in their cultural background. Explore views on perceived training needs among professionals around the world and how these related to country cultures. Cross-sectional, descriptive, mixed-methods international online survey. Descriptive statistical analysis explored the ranking across countries and relationships with three Hofstede cultural dimensions. Thematic analysis was conducted on the open-ended text responses. A sample of N = 1284 participants from eighteen countries. Knowing the capabilities of the robots was ranked as the top training need across all participating countries and this was also reflected in the thematic analysis. Participants' culture, expressed through three Hofstede's dimensions, revealed statistically significant ranking differences. Future research should further explore other factors such as the level of digital maturity of the workplace. Training needs of health and social care staff to use robotics are fast growing and preparation should factor in patient safety and be based on the principles of person- and culture-centred care. [ABSTRACT FROM AUTHOR]

There are a few screening tools to detect psychological symptoms among people with multiple chronic conditions (MCCs) in China. The aim of this study was to examine the validity and reliability of a translated version of the Emotional Thermometer (ET) tool. This cross-sectional study consisted of two phases: (1) translation and content validity testing; and (2) assessment of psychometric properties, including internal consistency, test-retest reliability, and construct validity. For the first phase, the authors used a forward-backward translation approach for the Chinese version of the instrument and tested its content validity with a panel of six experts. For the second phase, the data, including the ET tool and demographic characteristics were collected in a convenience sample of 197 Chinese people with MCCs recruited from a university hospital. The first 50 participants participated in the two-week retest. The Chinese version of the ET tool had satisfactory psychometric properties; content validity index (0.83), internal consistency (0.92), and ICC (0.93 to 0.98 [p < 0.01]). Principal component analysis showed that there was only one component with an eigenvalue greater than 1 (value = 3.80), with 76.67% of the variance responding. All items loaded significantly onto this factor and demonstrated strong loadings of > 0.70. The Chinese-version of the ET tool is psychometrically sound. It has the potential to be used as a screening tool for psychological symptoms in Chinese people with MCCs. Findings from testing the Chinese translation of the Emotional Thermometer indicate this could be a convenient and useful screening tool to detect psychological symptoms in patients with multiple chronic conditions. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to measure learning gains during an ICT training intervention in first-year students completing a four-year undergraduate nursing degree. Methodology: This study adopted a quasi-experimental, one group pre-test and post-test design. The intervention effectiveness was measured using individual single-student normalised gains, g; class average normalised gain, 〈g〉; and average single-student normalised gain, g(ave). Results: In this study, the class average normalised gains, 〈g〉 ranged from 34.4% to 58.2%, and the average of single student normalised gains, g(ave) ranged from 32.4% to 50.7%. The overall class average normalised gain 〈g〉 was 44.8%, and the average of the single student normalised gain was 44.5%, with 68% of students having a normalised gain of 30% and above, indicating that the intervention was effective. Conclusion: Similar interventions and measurements are recommended to all health professional students during their first academic year to pave a foundation for ICT usage for academic purposes. [ABSTRACT FROM AUTHOR]

Nursing applicants' desire to work in nursing has been identified as an important aspect to consider in nursing student selection, but relevant instruments are missing. To describe the development and psychometric testing of the Desire to Work in Nursing instrument. A mixed-methods design. The development phase included the collection and analysis of two types of data. First, three focus group interviews were organised with volunteer nursing applicants (n = 18) after the entrance exams of three universities of applied sciences (UAS) (in 2016). The interviews were analysed inductively. Second, scoping review data from four electronic databases were collected. Thirteen full-text articles (published between 2008 and 2019) were included in the review and analysed deductively based on the results of the focus group interviews. The items for the instrument were generated by synthesising the results of the focus group interviews and the scoping review. The testing phase included 841 nursing applicants who participated in the entrance exams of four UAS on 31 October 2018. The psychometric properties were analysed by examining internal consistency reliability and construct validity by principal component analysis (PCA). The desire to work in nursing was classified into four categories: nature of the work, career opportunities, suitability for nursing and previous experiences. The internal consistency reliability of the four subscales was satisfactory. The PCA found only one factor with an eigenvalue over one, explaining 76% of the total variance. The instrument can be considered reliable and valid. Although theoretically the instrument contains four categories, a one-factor solution should be considered in the future. Evaluation of applicants' desire to work in nursing may provide a strategy to retain students. Individuals choose the nursing profession for variety of reasons. However, there is very little understanding of why nursing applicants desire to work in nursing. With the current challenges in the adequate staffing in the nursing workforce, it is important to understand any aspects that may be associated with student recruitment and retention. In this study, it was identified that nursing applicants desire to work in nursing because of the nature of the work, career opportunities, being suitable for nursing and of previous experiences. Instrument to measure this desire was developed and tested. The tests revealed that the instrument can be used reliably in this context. It is suggested that the developed instrument could be used as a pre-screening or self-assessment tool before applying to nursing education to provide further insights to applicants about their reasons for applying and an opportunity to reflect on their decision. [ABSTRACT FROM AUTHOR]

Background: A review and meta- analysis of empathic communication and patients' expectations of interventions has shown that if positive messages are delivered there is a small but measurable reduction of pain and anxiety and some improvements in physical outcomes. Aim: To identify elements of health messages that may have a positive impact on patient health outcomes to guide effective nurse-patient- communication. Methods: Data were extracted from each study in a qualitative analysis of a systematic review investigating the health effects of positive messages, and analysed following the principles of thematic analysis. Findings: Central to effective positive messages were good communication skills. Five key features were identified. Discussion: The non-treatment care categories such as cognitive care and emotional care can significantly influence health outcomes across a range of interactions. Conclusion: Strategies to facilitate positivity can be incorporated into nursing education programs designed to improve patient outcomes. [ABSTRACT FROM AUTHOR]

Aim: To highlight the role of secondary aeromedical services and required knowledge of Critical Care Flight Nurses (CCFN), in facilitating the safe inter-hospital transfer of patients with acute Spinal Cord Impairment (SCI) from a Major Trauma Centre (MTC) to a specialist SCI centre. Method: Literature search. Results: There is significant demand for secondary aeromedical services in order for patients with acute SCI to be transferred to a SCI centre within 24 h of injury. CCFN play an important role in triaging patients, coordinating patient care, arranging logistics of transport as well as providing direct clinical care inflight. CCFN must have knowledge regarding the pathophysiology of acute SCI, altitude physiology and interventions to manage stressors of flight in the aeromedical environment. Specific clinical challenges encountered by CCFN include the prevention of hypobaric hypoxic hypoxia and achieving appropriate immobilisation of the spine. Conclusion: Mitigating the increased risk associated with transporting critically unwell patients with SCI in the aeromedical environment, relies on aeromedical clinicians with education and training within the clinical specialty of aeromedical retrieval. The availability of secondary aeromedical services to undertake urgent inter-hospital retrieval of patients with acute SCI will be promoted by the continued development of Retrieval Nurse Practitioner (RNP) roles. [ABSTRACT FROM AUTHOR]

The transition from practicing nurse to nurse academic can be stressful as novice nurse academics need to assume new roles and acquire new skills in addition to having demonstrated mastery over their field of clinical practice. In this reflection, the authors use Gibbs' reflective cycle to reflect on the experience of transition from being senior nurses to novice nurse academics in the Australian university context. A description of the experience of transition is outlined alongside the feelings encountered. The positive and negative aspects of the experience are then evaluated and an analysis of the experience put forward with a conclusion related to the overall experience. An action plan for future practice is offered, which we hope will be of interest to anyone contemplating such a journey or supporting others in this process. The complex and challenging journey ahead for novice nurse academics is outlined, which offers opportunities for growth and development. [ABSTRACT FROM AUTHOR]

Introduction of mental health service users and their family within undergraduate health profession courses has become routine in many curriculums. Few studies have explored the expectations and perceptions of such presenters. This study reports the perceptions of nine carers and consumers in a regional Australian University. A descriptive design was utilised. Participants were recruited via a consumer and carer support group. A semi-structured interview and thematic analysis of the data were used to generate themes. The analysis identified six common themes that addressed personal benefits, an imperative to increase the awareness of others, a desire to do something worthwhile, personal changing of perspectives, expectations of the presentation role and characteristics of the presenter. Several points of difference between presenters and non-presenters and issues relating to rural and regional settings were identified. These findings suggest that in rural and regional areas participation is more likely when life circumstances exhibit employment stability as some feel threatened by stigma. The theme of 'expectations' adds to current knowledge, with presenter's expectations often being exceeded in terms of student attitudes across different study programs. [ABSTRACT FROM AUTHOR]

Misconceptions about men in nursing may influence recruitment and retention, further perpetuating the gender diversity imbalance in the nursing workforce. Identifying misconceptions and implementing early intervention strategies to address these deep-rooted stereotypes remain challenging but is considered critical to support students who are commencing a nursing career. To develop and evaluate the psychometric properties of the 'Gender Misconceptions of meN in nursIng (GEMINI) Scale. Cross-sectional survey. Pre-registration nursing students enrolled in undergraduate nursing programmes across 16 nursing institutions in Australia were surveyed from July to September 2021. The 17-item self-report GEMINI Scale measured the gender misconceptions of men in nursing. Of the 1410 completed surveys, data from 683 (45%) women were used for exploratory factor analysis showing a one factor structure, while data from 727 men (47%) were used for confirmatory factor analysis of the 17-item GEMINI Scale, which showed a good model fit. The scale demonstrated high internal consistency (Cronbach's alpha of 0.892). Men were found to have higher gender misconceptions (p < 0.001) while respondents who: (a) identified nursing as their first career choice (p = 0.002); (b) were in their final year of programme enrolment (p = 0.016); and (c) engaged in health-related paid work (p = 0.002) had lower gender misconceptions. The GEMINI Scale is a robust, valid, reliable, and easy to administer tool to assess misconceptions about men in nursing, which may potentially influence academic performance and retention. Identifying and addressing specific elements of misconceptions could inform targeted strategies to support retention and decrease attrition among these students. Genderism harms nursing, as well as the men and women working in the profession. Recruitment and retention of men into nursing is needed to cultivate male role models and diversify the workforce, however this is impeded by negative portrayals in popular culture and misconceptions entrenched in society. [ABSTRACT FROM AUTHOR]

In the transitional period following registration, newly qualified nurses may feel socially isolated and easily overwhelmed by increases in accountability, workplace pressures and the psychological demands of the role. Such experiences place them at risk of burnout and leaving the profession. To explore newly qualified nurses' support needs and their experiences of an online peer support intervention. Eighteen newly qualified nurses participated in online peer support groups. After 3 months participants took part in interviews exploring their support needs and experiences of the groups. Eight one-to one interviews were conducted between October 2019 and January 2020. Qualitative thematic analysis was used. Two themes identified were; "The Support needs of newly qualified nurses" with two subthemes, "The role of the newly qualified nurse" and "Unmet support needs"; "The online experience" with three subthemes, "Barriers to participation", "Anticipated benefits" and "Unmet expectations". Our findings suggested that there is insufficient support for newly qualified nurses. The newly qualified nurses wanted to use online support to help manage their stress. However, the organisation of online peer support needs careful consideration to ensure participation can be beneficial. Online support requires careful design and clear support from employing organisations to promote improved transition experiences. Further research should focus on evaluating adjusted online support interventions. [ABSTRACT FROM AUTHOR]

Objective: To provide a critical analysis of evidence describing the implementation and effectiveness of cranberry products for the prevention of urinary tract infections in the setting of residential aged care. Methods: A critical analysis of the literature. Results: The current evidence indicates that cranberry products decrease the occurrence of urinary tract infections in aged care residents who are likely to benefit from the use of cranberry products as a preventative measure; however, some of the results were limited and contradictory, because of gaps and insufficient research in relation to the active ingredients of cranberries – proanthocyanins. Conclusion: This critical analysis demonstrates benefits in the use of cranberry products in the prevention of urinary tract infections for residents of aged care facilities. Further research and education on preventative measures could potentially lower the use of antibiotics and the incidence of urinary tract infections in residential aged care. [ABSTRACT FROM AUTHOR]

Neurological conditions produce considerable disease burden. To describe quality of life in patients with neurological conditions and informal caregivers receiving postdischarge generic community neurological nursing services, and caregiver burden. A descriptive cross-sectional design was used with researchers administering the WHOQOL-BREF Australian Version questionnaire and Zarit Burden Interview. Most patients and caregivers rated quality of life as 'Good'. The patients' physical, psychological and environment domain scores, and caregivers' physical domain scores, were below norms. Half of the caregivers experienced burden and 42% had risk for depression. A heterogeneous group of patients with neurological conditions had considerable care and support needs for fundamental functioning postdischarge. Quality of life and caregiver burden measures highlight the impact of their circumstances on their health and wellbeing. Research is warranted to determine a comprehensive set of generic needs to guide integrated community nursing services for building patient and caregiver self-management capacity. [ABSTRACT FROM AUTHOR]

Background: The COVID-19 pandemic has presented unprecedented levels of prolonged strain on healthcare systems and healthcare workers (HCWs) globally, with nurses at the forefront. Objectives: To describe types and prevalence of occupational disruptions and exposure to COVID-19, and their impacts on mental health, moral distress, coping strategies, and help-seeking behaviours of Australian nurses. Design: A cross-sectional online anonymous survey distributed amongst Australian HCWs between 27 August and 23 October 2020. Methods: Data was collected on demographics, workplace disruption, personal relationships, and mental health. Predictors of mental health impacts and coping strategies were identified through multivariate regression analyses. Results: 7845 complete responses were returned, of which 3082 (39.3%) were from nurses and 4763 (60.7%) were from all other professions ('other HCWs'). Occupational disruption was common, with nurses specifically reporting additional paid hours (p < 0.001). Nurses were exposed to, and infected with, COVID-19 more frequently than other HCWs (p < 0.001) and were more likely to report concerns around stigmatisation from the broader community (p < 0.001). Symptoms of mental illness (anxiety, depression, PTSD and burnout) were significantly more prevalent in nurses than other HCWs, despite both groups scoring high on resilience. Common predictors of mental health symptoms included exposure to COVID-19 and worsening of personal relationships. Nurses reported a variety of coping strategies and were more likely than other HCWs to increase alcohol consumption. Engagement with formal support services was low for both groups. Personal and professional predictors for coping strategy use were identified. Conclusions: Urgent action is needed to address staff shortages and burnout which have been exacerbated by COVID-19. Initiatives that recognise the importance of nursing staff and incentivise current and future nurses to join and remain in the workforce are essential. [ABSTRACT FROM AUTHOR]

An editorial is presented on the reality of lived experience of Indigenous peoples, and the growing evidence that racism in our health care systems traumatize. It expresses the actions of Indigenous and non-Indigenous nursing and midwifery academics to enact Cultural Safety. An overview of the Cultural Safety in nursing and midwifery is presented.

Background: Cultural safety is mandated for Australian nursing practice and education. Cultural safety privileges the knowledge of the client, who determines whether healthcare is culturally safe. Understanding and learning cultural safety requires critical self-reflection to expose clinicians' assumptions, unconscious biases, beliefs and actions, and their impact on clients. More research is required on best-practice strategies on how students learn about cultural safety in nursing education. Experiential pedagogical methods may be one such strategy to promote understanding of principles that underpin safe environments. Objectives: To explore the influence of "Teaching in Circle" to enhance students' understanding of cultural safety within the classroom environment. Methods: Students in first-year undergraduate Bachelor of nursing units participated. Teachers facilitated tutorials using a respectful adaptation of "Teaching in Circle" methodology; it was underpinned by the principles of Yarning, an Aboriginal and Torres Strait Islander Peoples way of learning and communicating in groups. Students developed principles to guide the facilitation of a more culturally safe classroom, providing written feedback on the environment and their participation in the circle. Results: Student feedback was reflected in three themes: "Journey through unfamiliar territory"; "More personable way of learning and sharing" and "Relational engagement creates safety". Student perspectives resonated strongly with the principles of cultural safety or lack of within healthcare settings. The method disrupted normative classroom/learning environments and supported experiential learning about the principles of cultural safety. Conclusions: "Teaching in circle" provided an experiential means of enhancing first-year nursing students' understanding of the principles of cultural safety. This learning should be embedded in the nursing curriculum and on-going education to prepare nurses to provide culturally safer care to Aboriginal and Torres Strait Islander Peoples. The study supports similar research calling for innovative learner-focused, experiential methods for the development of the practice of cultural safety in Australian nursing education. Impact statement: Exploratory research project, "Teaching in Circle" with student nurses contributes to experiential understanding of cultural safety principles. [ABSTRACT FROM AUTHOR]

Background: Given the continued disparity between the health of Indigenous Australian people's health and that of the broader Australian population, cultural safety is mandated as a component of undergraduate education as a strategy to improve health care. Evidence suggests that academics are not confident to teach cultural safety to undergraduate nursing students. Objectives: To explore the efficacy of an Indigenous teaching method (Teaching in Circle) to create culturally safe classrooms and to build the capacity and confidence of teachers to teach about cultural safety. Design: An Indigenous pedagogy was adapted for use in tutorials by teachers, with mentorship provided by an Indigenous knowledge expert. Teaching in Circle (TiC) methodology was implemented by teachers in tutorials. Methods: All nurse academics teaching in the Bachelor of Nursing program at a small regional Australian university were eligible to participate. Information about the project was provided in team meetings, with invitations to participate. Teachers provided a written reflection on the method and participated in regular on-line mentored support meetings throughout the teaching session. Data were analysed, using a reflective, inductive systematic process. Results: Final themes were "Sticking with initial disconcertment and discomfort"; "A renewed enjoyment of teaching"; "Learning and adapting", "The influence of the method on safety" and "Shifts in classroom dynamics". Impact Statement: 'Teaching in Circle', underpinned by respectful practice, positively influences culturally safe teaching and learning environments. The method enhances academics' confidence to teach cultural safety to undergraduate nursing students and supports an understanding of the essential components of culturally safe health care. Conclusions: Evidence suggests the method built capacity to teach and foster experiential learning of safety, and thus what is required to create a culturally safe teaching and learning space. [ABSTRACT FROM AUTHOR]

Background: A model employing entry to practice nursing students as health assistants in nursing (HANs) was developed to support the nursing workforce. Objective: This research examines the perceived benefits of being employed as a HAN to graduate entry to practice nursing students. Design: Cross-sectional study Methods: A web-based 33-item questionnaire was open to entry to practice nursing students employed as a HAN. Categorical measures were summarised using descriptive statistics. Qualitative comments were analysed thematically. Results: Of the 39 enrolled participants, 38 (97.4%) completed the study. Fifteen students (39.5%) commenced a graduate year in 2019, 12 (31.6%) commenced a graduate year in 2020 and 11 (28.9%) will commence a graduate year in 2021. The participants viewed HAN employment as an opportunity to further develop as nurses and suggested that the HAN scope of practice expand to include their existing nursing scope of practice, thereby optimising their learning experience. Conclusion: The HAN model is viewed as a valuable model of employment by entry to practice nursing students; however, the HAN scope of practice is viewed as too limited and not conducive to self-development. This may impact on the retention of HAN employees as they transition to registered graduate nurse employment. Impact statement: Graduate entry to practice nursing students offer direction on how to improve the Health Assistants in Nursing employment model. [ABSTRACT FROM AUTHOR]

Background: Unplanned representation of patients with diabetes recently discharged from the emergency department or in-patient hospital settings is a common but complex problem world-wide. This study set out to examine the feasibility of a risk screening interview and whether component characteristics may be associated with the unplanned representation of patients with diabetes to a tertiary metropolitan hospital. Methods: A screening interview comprised of demographic, social and clinical characteristics was developed and piloted using a prospective cross-sectional survey design. A convenience sample of 55 patients was recruited and screened. Outcomes were the occurrence of unplanned representation to hospital within 28 or 90 days of hospital discharge from the index presentation. Results: The screening interview was shown to be broadly feasible and acceptable for use by staff and patients, with identified areas for modification. Seventeen participants (30.9%) experienced unplanned representation within 90 days of hospital discharge; for 13 participants (23.6%) this occurred within 28 days. Characteristics linked with unplanned representation to hospital were identified. Conclusions: Preliminary data indicated the feasibility of tool use and informed refinement for future testing of the ability of the screening interview to predict those patients with diabetes at high risk of unplanned representation to hospital, to enhance effective care planning. Impact statement: Patients with diabetes commonly present to Emergency Departments, and demonstration of the feasibility of a screening interview to determine those at elevated risk of unplanned representation is an important step towards effective management. Data supported refinement and future testing of the new screening interview. [ABSTRACT FROM AUTHOR]

Objectives: Oxygen was commonly used in the early management of patients presenting with Acute Coronary Syndrome (ACS) regardless of their oxygen saturation. Inappropriate administration of supplemental oxygen could potentially result in adverse patient health outcomes. Aim: To identify the effects of supplemental oxygen administration on the health outcomes of patients presenting with ACS and oxygen saturations >93%. Method: Systematic review. The CINAHL, PubMed, Cochrane and Medline databases were searched for relevant literature. Inclusion criteria included articles published from 2008-2019, adult participants, primary studies, and participants with uncomplicated ACS and have oxygen saturation >93%. Eligible studies were assessed for rigour using a critical appraisal tool. Results: Seven randomised controlled studies were included for analysis. Themes were also used to group the assessed endpoints. The three main outcomes analysed were: infarct size and cardiac function; adverse cardiac events; and mortality. Two of the seven studies found a statistically significant relationship between oxygen administration, infarct size, and adverse cardiac events. Conversely, five of the seven studies reported that supplemental oxygen did not have statistically significant benefit over room air. Conclusion: This review identified that oxygen should not be administered to patients who present with ACS and have oxygen saturations >93%. This is due to the potential risk of adverse outcomes: increased infarct size, mortality, and adverse events. Impact statement: Recent update of guidelines despite evidence opposing oxygen delivery in ACS means the education of nurses is imperative for safe practice. [ABSTRACT FROM AUTHOR]

Newly Graduated Nurses in different socio-cultural contexts confront dissimilar situations and influences on role transfer. It is important to understand how newly graduated nurses reconstruct their own professional concept of clinical nurses. This study aimed to explore how Taiwanese newly graduated nurses perceived their new role and the process through which they transition into the professional role. Charmaz's constructivist grounded theory guided the study's design and implementation. Purposive and theoretical sampling and the snowball technique were used to recruit 30 participants from 3 tertiary and 2 community hospitals in Taiwan. Interviews were audio-recorded and transcribed verbatim into a readable format. Initial, focused and theoretical coding was utilized for data analysis. The criteria of credibility, originality, resonance and usefulness guided assessment of the study's quality and ensured the trustworthiness of the study process. The process of role transition to become a nurse comprised four stages: hesitation, psychological preparation, development and appreciation. The hesitation stage was interpreted as a phase of passive learning. In the psychological preparation, newly graduate nurses began to take full work responsibility. The development stage saw them gain work confidence and, in the appreciation stage, they acquired a full picture of their roles. To bridge the gap between theoretical learning and practice and reduce the time new graduate nurses need for role adjustment contributes to an early stage of Hesitation rather than the Appreciation stage of role transition. The findings suggest the need for further research to explore newly graduated nurses' needs during the process of role transition. [ABSTRACT FROM AUTHOR]

Background: There is a growing amount of literature that links missed nursing care (MNC) to negative patient outcomes, reduced patient safety and poor quality of care. However, only few studies have investigated this phenomenon in long-term rehabilitation settings. Aim: To explore MNC occurrence, type, reasons and predictors in three rehabilitation units. Design: A cross-sectional study was performed between August and September 2017. Method: 95 registered nurses and nursing assistants completed section A (interventions missed) and section B (perceived reasons for MNC) of the MISSCARE Survey tool. Descriptive, bivariate and linear regression analyses were performed. Findings: The top missed elements were patient ambulation (score 2.4 out of 5, Standard Deviation [SD] 0.8), mouth care (2.3, SD 0.8) and participation to multidisciplinary meetings (2.3, SD 1.1). Lack of personnel was the most frequent reason reported for MNC with a score of 2.9 out of 4 (SD 0.9). At the linear regression analysis, advanced nursing education (β = 3.58, CI 95% 1.32–5.84) and inadequate handovers (β = 3.64, CI 95% 0.37–6.91) both increased the perception of MNC occurrence. Conclusion: MNC occurrence in rehabilitation settings appears to be lower than in other contexts; however, the most commonly missed elements are similar to those reported in other settings. As good strategies to detect the difference between expected nursing care and the one delivered to patients, advanced education and good quality handovers seem beneficial. Further research is needed to establish more evidence on predictors by developing longitudinal study designs. [ABSTRACT FROM AUTHOR]

Mindfulness-based psychoeducation program (MBPP) has been proposed as a new approach to improve the overall outcomes for individuals with schizophrenia spectrum disorders. However, to date, limited studies have examined the participants' experiences of MBPP for schizophrenia. The aim of this study was to explore the experiences of individuals with schizophrenia spectrum disorders (SSDs) who underwent an 8-week MBPP with respect to their perception of the benefits and unusual challenges of mindfulness training and self-practices. Twenty-four (n = 24) individuals with SSDs were invited to participate in an 8-week MBPP. A total of eight participants were invited for semi-structured interview one week after the final class of MBPP. The semi-structured interview was conducted in Cantonese and data were transcribed by the first author. Of the eight participants, five participants had unusual experiences and three participants had a positive experience with MBPP. They were included to provide more candid understanding on the constituents of diverse experience towards MBPP. An interview guide was developed to understand the patients' perceptions of MBPP, the challenege in self-practising mindfulness, and the changes in how they coped with their illness during and after taking part in MBPP. Qualitative data from the semi-structured interview were recorded by a research assistant and the transcripts were proof-read by the participants to ensure accuracy. The Software NVivo 12 Pro was used to manage the qualitative data from the semi-structured interview. Thematic analysis was adopted to identify the major themes from the qualitative data. Five themes emerged: developing a state of mindfulness, empowering illness management, learning a new way to regulate emotion, encountering barriers in self-practising mindfulness and preference for bodily mindfulness. The findings provide comprehensive knowledge and deeper insights into treatment processes of mindfulness psychoeducation as an intervention for schizophrenia spectrum disorders. This study establishes a body of knowledge regarding people with schizophrenia spectrum disorders who received mindfulness psychoeducation intervention. The results suggest that patients can develop a new way to regulate emotion and manage their illness through mindfulness psychoeducation. The perceived negative experience of some patients also warrants closer attention in mindfulness practice, especially for individuals with schizophrenia spectrum disorders. Further research could focus on factors leading to the negative consequences of mindfulness practice and the ways to minimize the negative consequeces. [ABSTRACT FROM AUTHOR]

Background: Cultural Safety is a mandatory training requirement for the 16 regulated health practitioners in Australia. Tools measuring outcomes need to be appropriate for different education and training contexts. Aim: To test refinements to the 25 item Cultural Capability Measurement Tool (CCMT). Methods: Framed by decolonising and relational ways of knowing, being, and doing in the tool development process. New items of the CCMT were generated through engagement with key knowledge holders. New items were piloted with expert reviewers and modified accordingly to produce a 41-item scale. Two online surveys conducted with 875 students and then 276 health professionals were collected for analysis. Exploratory factor analysis and a parallel analysis were conducted. Results: The newly named Ganngaleh nga Yagaleh (GY) tool contained 28 items loaded on 3 factors accounting for 47.95% of variance. Factor 1 (Commitment to Culturally Safe Practice; α =.89) comprised 12 items, Factor 2 (Understanding of History and Power; α =.86) contained 9 items, and Factor 3 (Attitudes, Values, and Beliefs; α =.52) contained 7. Total scale reliability was good (α =.87). Impact statement and conclusion: The GY Scale can be used in education and practice settings. Challenges remain about how educational providers and health services approach cultural safety as a life-long learning journey, and how education and clinical practice embed cultural safety standards. Future directions for use of the GY tool include expanding it for use in other contexts and more explicit separation of what is emerging as a separate scale the 'Keeping Culture Strong' scale which evaluates the unique learning experiences of First Peoples. [ABSTRACT FROM AUTHOR]

An editorial is presented on reflections of a settler teaching an Indigenous health and wellbeing subject in Australia. Topics include discussion with Peoples in keeping with the nomenclature of the Indigenous Health and Wellbeing subject; and Nurses, as the largest group of health professionals, are in the position to impact health outcomes and the experience of health care provision for Indigenous Peoples.

To improve health equity, especially for American Indian/Alaska Native peoples, cultural safety must be included in the nursing education curricula. Cultural safety requires self-reflection with an examination of one's own culture and an ongoing analysis of biases and power imbalances. Using a case study approach, a description and discussion of an ongoing Baccalaureate nursing clinical immersion experience on an American Indian Reservation is presented. With travel to the Pine Ridge Reservation, nursing students offer health promotion at community events and partner sites, with a focus on prevention of heart disease, diabetes, and unintentional injury. Transformative Learning Theory provides the foundation for the nursing clinical immersion experience at the Pine Ridge Reservation. Nursing students reflect throughout and after the Pine Ridge clinical experience via blogging. Cultural safety themes identified in nursing student reflections include critical consciousness; providing a safe place; seeking to understand historical trauma; and acknowledging power imbalances. Satisfaction surveys are completed by Lakota screening participants, and results provide further evidence of emerging cultural safety. A clinical immersion experience at an American Indian Reservation can foster cultural safety while also encouraging transformative learning. Nursing educators should consider clinical experiences focused on American Indian/Alaska populations. With a service component, the clinical immersion at the Pine Ridge Reservation requires that participants reflect on their experiences. A transformative change in perspective, required for cultural safety, is often the end result for nursing student participants. [ABSTRACT FROM AUTHOR]