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Background: A skin tear is a traumatic wound that occurs in up to one in five hospitalized patients. Nursing care includes application of a dressing to create a moist wound healing environment. Aim: To compare the effectiveness of two standard dressings (adhesive silicone foam vs. meshed silicone interface) to heal hospital‐acquired skin tear. Methods: An intention‐to‐treat pilot study was designed using a randomized, non‐inferiority trial in an Australian tertiary hospital setting. Consenting participants (n = 52) had acquired a skin tear within the previous 24 h and had agreed to a 3‐week follow‐up. Data were collected between 2014 and 2020. The primary outcome measure was wound healing at 21 days. Results: Baseline characteristics were similar in both arms. Per protocol, 86% of skin tears were fully healed at 3 weeks in the adhesive silicone foam group, compared to 59% in the meshed silicone interface group. Greater healing was observed across all skin tear categories in the adhesive silicone foam dressing group. In the intention‐to‐treat sample, healing was 69% and 42%, respectively. Conclusions: Results suggest the adhesive silicone foam dressing may be superior, as it produced clinically significant healing of skin tears at 3 weeks compared to the meshed silicone interface dressing. Accounting for potential loss to follow‐up, a sample of at least 103 participants per arm would be required to power a definitive study. Summary statement: What is already known about this topic? A skin tear is a traumatic wound that is commonly acquired during hospitalization that affects older adults in particular. In hospital settings, it may occur in up to one in five patients.A variety of skin tear dressings have been used in previous studies, with healing rates ranging from 34% to 97% at 21 days; however, evidence for the most effective dressing type is inconclusive.If treated inappropriately, or left untreated, minor skin tears can become chronic or complicated wounds, yet prevalence and treatment of hospital‐acquired injuries are under‐reported. What this paper adds? Based on our per‐protocol results, an adhesive silicone foam dressing may be superior, as it produced clinically significant healing of 86% of skin tears at 3 weeks compared to 59% with the meshed silicone interface dressing.Based on the methods and results from this pilot study, a future definitive trial would be feasible but would need to account for a relatively large loss to follow‐up rate. The implications of this paper: Using our intention‐to‐treat results, a future study would need a sample size of 103 per arm to be sufficiently powered, which may be impractical to achieve within a single hospital setting; thus, a multi‐site study would be advisable. [ABSTRACT FROM AUTHOR]

In 2001, a study into issues of concern to assistant-in-nursing, registered and enrolled nurse members of the Queensland Nurses Union was undertaken. Approximately equal numbers of nurses from each of the aged care, acute private and acute public sectors were surveyed. Overall, 1477 nurses responded, representing a response rate of 53%. This article focuses on one aspect of the study—the perceived adequacy of support offered to new nursing graduates as they exit university and begin their transition into the workplace. In particular, responses from nurses are compared with professional level or current role designation, age, time spent in the workplace and health sector. Considerable divergence of opinion among the respondents, particularly across designation, age and years of experience, was found within the three sectors. For example, in the public and private employment sectors, older and more experienced nurses were more likely to perceive the support for new nurses as adequate compared to younger and less experienced nurses. Additionally, in the acute private sector, the more senior the nurse the more likely the perception that there was adequate preparation for new graduates entering the workforce. [ABSTRACT FROM AUTHOR]

Aim: To describe for areas of improvement in the management of COPD and reduction in emergency department presentations in Queensland. Background: If current trends in the management of COPD do not change, the predicted 4.5 million Australians diagnosed with COPD by 2050 will place significant burdens on already over-utilised frontline ED services. Separately COPD is more costly per case than cardiovascular disease and is a more common presentation to Emergency Departments in any year than most types of cancer, road traffic accidents and heart disease. Study Design and Methods: This study used a qualitative thematic analysis methodology in which field convergent interviews were employed to generate data. Sixteen staff and nine patients across three major Southern Queensland Health acute care facilities participated in the study. The authors analysed interview data using qualitative thematic analysis. Results: This research has revealed several noteworthy concepts worthy of further exploration. Thematic analysis from both staff and patient interviews identified the following issues: 1. Nurse case management, 2. Integrated communication of patient assessment and history data, 3. Failure in COPD management, and 4. Knowledge utilisation among ED clinicians. Inherent among these key concepts is a primary goal of coordinated congruent COPD management that optimise a patient's functional status and quality of life, improving symptoms management, and avoiding recurrent exacerbations. Discussion: These insights into the experience of patients and hospital staff into the management of COPD provides valuable insight into current and desired practices that can help to minimise presentations to Emergency Departments. The findings of the research provide insights and future direction for improvements by addressing the inconsistency in disease management. The need for more accessible and consistent patient management and a more congruent centralised patient support framework was also identified. Conclusion: There is indication of support stemming from the voices of patients and hospital staff around the need for COPD case management to become the dominant method of care. Future research should consider the cost benefit and patient outcomes of the implementation of such a role and the avoidance of ED presentations. Implications for research, policy, and practice: The findings of this research imply a need to streamline the patient support and disease management discharged planning process by ensuring one health professional maintains ongoing education, support, and assessment to the patient. Future research needs to better ascertain the positive economic benefits to healthcare organisations by employing Case Managers for patients with COPD. What is already known about the topic? * Case management roles can be effective in reducing ED usage for adults with chronic illnesses. * The World Health Organization (WHO) has called for planned ongoing assessment, care and support coordinated by a proactive investment in real time solutions that address the increasing burden of this disease on the healthcare sector. * The WHO has endorsed targeted patient support strategies that coordinate care over time, addressing the physical and mental health needs of people with chronic illness. What this paper adds: * Findings from this research show that discharged planning support practices with Southern Queensland Healthcare Organisations require review and ongoing evaluation. * This may include, streamlining the patient support and disease management discharged planning; or designated case management or integration of systems to prevent ED presentations. * This research adds to the voices of patients and staff that confirm published research recommendations. [ABSTRACT FROM AUTHOR]

Background: Patient‐ and family‐centred care practices are a recommended part of contemporary care for the acutely ill hospitalized adult patients. However, how patient‐ and family‐centred care is enacted in an adult hospital setting is not well understood. Aims and Objectives: The aim of this study is to explore the perceptions of patients, family members and nurses regarding family participation and collaboration in patient care within an acute care setting, including the barriers and facilitators. Design This study used a mixed‐methods sequential design. Methods: Observer‐as‐participant observations and semistructured interviews were undertaken. Integration of the data was achieved through triangulation. Results: Triangulation revealed two metathemes. The first metatheme, 'continuum of family involvement', explained the central viewpoint of how family participation and collaboration in the care of acutely ill hospitalized adult patients was enacted. The second metatheme, 'nurses value family involvement', helped to explain and understand the barriers and facilitators to enacting family participation in the acute care setting. Conclusion: Promoting family participation in the acute care setting requires supporting multiple levels of engagement. Developing a relationship, clear communication and open sharing of information amongst patients, family members and nurses is critical to supporting family involvement. SUMMARY STATEMENT: What is already known about the topic? Health service policy emphasizes that patients and families should be treated with dignity and respect, be active partners in all aspects of care and contribute to the development and improvement of health care.In the acute care setting, both patients and family members express the desire for a larger role in health‐care decision making; yet how this is enacted in an adult hospital setting is not well understood.Research in other settings has demonstrated the clinical benefits of family involvement in care include decreased mortality, reduced hospital length of stay, improved adherence to treatment regimens and decreased readmission rates. What this paper adds? Supporting meaningful family participation in the acute care setting requires supporting multiple levels of engagement. When families felt empowered and participated in care, patients and family members believed it helped nurses to keep the patient safe and individualize care.The tripartite relationship amongst patients, family members and acute care nurses is essential in empowering family members to participate in the care of acutely ill hospitalized adult patients. However, nurses' values, beliefs and attitudes towards involving families in patient care are seen to be crucial to the possibility of embedding family participation in the acute care setting. The implications of this paper: Policies that incorporate the patient and families' voice and behavioural change interventions may lead to the normalization of patient‐ and family‐centred practices in the adult acute care hospital setting. [ABSTRACT FROM AUTHOR]

Aims: To investigate effectiveness of the nurse clinician as a Non‐Medical Surgical Assistant compared with the Medical Surgical Assistant. Background: Non‐Medical Surgical Assistants are clinicians who are not medical practitioners. The surgical assistant works directly with the primary surgeon intraoperatively. Design A pragmatic, retrospective, observational study on patients undergoing Laparoscopic Inguinal Hernia Repair or Primary Unilateral Total Hip Arthroplasty. Each patient received intraoperative care from a consultant surgeon and a Medical Surgical Assistant or Non‐Medical Surgical Assistant. All surgical assistants were registered with the Australian Health Practitioner Regulation Agency. Methods: Data were collected between 01/07/2014 and 30/06/2017. The effect that surgical assistant choice had on patient outcomes was estimated using regression statistical models. Six dependent variables, including length of stay, for clinical outcome assessment were specified. Results/Findings The groups were equivalent in age, gender, and American Society of Anaesthesiologists scores. There were more emergency procedures in the Medical Surgical Assistant group and more hip surgery in the Non‐Medical Surgical Assistant group. Patient outcome assessment showed no statistically significant differences for surgical assistant types. Conclusion: The nurse clinician in the role of Non‐Medical Surgical Assistant was shown to be effective with equivalent patient outcomes compared with the Medical Surgical Assistant. SUMMARY STATEMENT: What is already known about this topic? There is limited international research and no research conducted in Australia, investigating quality of care of the Non‐Medical Surgical Assistant.Existing research on Non‐Medical Surgical Assistants has been limited to a single specialty, which is often cardiac surgery.International research reports equal patient outcomes for the Non‐Medical Surgical Assistant using the comparator of the Medical Surgical Assistant; however, the Non‐Medical Surgical Assistant does not exclusively have a nursing‐based qualification in these studies. What this paper adds? Our study focuses on the two most common surgical specialties in Australia and the Non‐Medical Surgical Assistant with a nursing qualification of either a Registered Nurse or Nurse Practitioner.The results show that the choice of nursing or medical surgical assistant did not affect patient outcomes. The implications of this paper: In Australia, Registered Nurses and Nurse Practitioners can provide effective care in the role of surgical assistant compared with the Medical Surgical Assistant.While patient outcomes are equal, the Registered Nurse and Nurse Practitioner in Australia are not remunerated by the government similarly to the medical personnel undertaking the role of surgical assistant. This raises issues of inequity in the Australian health‐care system for patients accessing surgical care and making the role of surgical assistant unsustainable to non‐medical health‐care personnel.Findings are relevant to the Medicare Benefits Schedule Review Taskforce and access to the Medical Benefits Schedule for Non‐Medical Surgical Assistants. [ABSTRACT FROM AUTHOR]

Background: Patients with complex chronic conditions experience fragmentation of care, unnecessary hospitalization and reduced quality of life, with an increased incidence of poor health outcomes. Aim(s): The aim of this paper was to explore how nurse navigators manage client care. This was achieved through an examination of narratives provided by the nurse navigator that evaluated their scope of practice. Method(s): All nurse navigators employed by Queensland Health were invited to participate in a study evaluating the effectiveness of the service. Eighty‐four self‐reported vignettes were thematically analysed to understand the work from the nurses' perspectives. Results: Two themes emerged from the vignettes. Theme 1, the layers of complexity, is comprised of three sub‐themes: the complex patient, the complex system and patient outcomes. Theme 2, professional attributes, has two sub‐themes: person‐centred care and clinical excellence. Conclusion: Navigators innovatively integrate services and address the fragmented nature of the health system. They apply expert clinical and social skills, through consistent and robust communication, to meet the needs of those with multiple chronic conditions. Implications for nursing management: Results provide insight into the new role, illuminating the work they achieve, despite system complexities. [ABSTRACT FROM AUTHOR]

Background: Public policy across the world is increasingly focusing on the role of mental health promotion in whole of health strategies. There is a growing evidence-base that mental health promotion, delivered by trained facilitators, is effective in promoting self-awareness and self-care to prevent the damaging effects of ongoing stress in one's life and to promote early detection of any possible emerging mental health problems. Within Australia, however, few clinicians or school staff are confident or trained in mental health promotion. Aims: This paper reports the results of a two-day training designed for facilitators of a mental health program for secondary-school students. The goal was to develop facilitators' knowledge and understanding of best practice in youth mental health promotion and to increase their confidence in delivering the program. Design: A mixed methods evaluation assessed the impact that a solution-focused training program had on participating facilitators. Methods: A questionnaire was created and included eight quantitative items and one open ended, qualitative question. Twenty-seven nurses and guidance officers from central Queensland were recruited via convenience sampling and data were analysed using descriptive statistics and thematic analysis. Results: The evaluation revealed that participants' perception of their ability to facilitate a youth mental health program significantly improved after completing the training. Qualitative data indicated that participants found the professional development experience to be valuable, provide useful and transferable skills, and believed it to be necessary for mental health promotion work. Conclusion: By providing detailed description of the program's content and processes, other mental health professionals may be inspired to further develop effective learning experiences. [ABSTRACT FROM AUTHOR]

This paper presents the findings of a study that interviewed Aboriginal nurses to explore their experiences of the whiteness of nursing. Despite concerted efforts to improve the health of Aboriginal Australians, it still remains equivalent to third world countries. One strategy identified to address this is to increase the participation rates of Aboriginal registered nurses within the Australian healthcare workforce. Presently Aboriginal nurses account for only a small percentage of the nursing workforce. While there has been research into the recruitment and retention strategies dedicated to improving the numbers of Aboriginal registered nurses, this paper focus on the experiences of Aboriginal registered nurses within Australia's mainstream healthcare system, where they are exposed and subjected on a daily basis to the 'whiteness of nursing.' [ABSTRACT FROM AUTHOR]

In Queensland, Aboriginal nurses are limited in number in comparison to the mainstream nursing workforce. More Aboriginal registered nurses are needed to cater for Aboriginal patients in our Australian healthcare system in view of today's burgeoning Indigenous health crisis. It is a foregone conclusion that Aboriginal nurses are the most suitable nurses to provide optimal cross cultural care for Aboriginal patients, due to having similar cultural backgrounds. The following paper will show how two Aboriginal registered nurses are optimistic about the possibilities of expanding the ranks of Aboriginal registered nurses through role modelling, and are channelling their research to achieve this with the aim of promoting better health outcomes for their people. A qualitative research approach has been used to examine the subjective human experience of the participants. Three dominant themes emerged from the research and will be expanded upon within the body of this paper to support the authors' thesis that Aboriginal nurses are a valuable commodity to address the Aboriginal health crisis. [ABSTRACT FROM AUTHOR]

Hegney D, Tuckett A, Parker D, Eley RM. International Journal of Nursing Practice 2010; 16: 188–202 Workplace violence: Differences in perceptions of nursing work between those exposed and those not exposed: A cross-sector analysis Nurses are at high risk of incurring workplace violence during their working life. This paper reports the findings on a cross-sectional, descriptive, self-report, postal survey in 2007. A stratified random sample of 3000 of the 29 789 members of the Queensland Nurses Union employed in the public, private and aged care sectors resulted in 1192 responses (39.7%). This paper reports the differences: between those nurses who experienced workplace violence and those who did not; across employment sectors. The incidence of workplace violence is highest in public sector nursing. Patients/clients/residents were the major perpetrators of workplace violence and the existence of a workplace policy did not decrease levels of workplace violence. Nurses providing clinical care in the private and aged care sectors experienced more workplace violence than more senior nurses. Although workplace violence was associated with high work stress, teamwork and a supportive workplace mitigated workplace violence. The perception of workplace safety was inversely related to workplace violence. With the exception of public sector nursing, nurses reported an inverse relationship with workplace violence and morale. [ABSTRACT FROM AUTHOR]

From the mid nineteenth to mid twentieth century sanatoria loomed large in the popular consciousness as the space for the treatment of tuberculosis (TB). A review of the historiography of sanatoria at the beginning of this paper shows that the nursing contribution to the care of TB patients is at best ignored and at worst attracts negative comment. Added to this TB nursing was not viewed as prestigious by contemporaries, leading to problems attracting recruits. Using a case study approach based on surviving archival material, this paper sets out to provide a glimpse of the work of TB nurses in a rural sanatorium at Westwood, Queensland, Australia. For the nurses geographical isolation was compounded by professional stagnation, which created a working environment influenced by friction and discord among the staff. It reveals how despite this, nurses coped with working in hostile conditions, to make the long stay of their patients, separated from their families and familiar life style more bearable. [ABSTRACT FROM AUTHOR]

This paper documents the relationships between pedagogy and e-assessment in two nursing courses offered at the University of Southern Queensland, Australia. The courses are designed to build the academic, numeracy and technological attributes student nurses need if they are to succeed at the university and in the nursing profession. The paper first outlines the management systems supporting the two courses and how they intersect with the e-learning and e-assessment components of the course design. These pedagogical choices are then reviewed. While there are lessons to be learnt and improvements to be made, preliminary results suggest that students and staff are extremely supportive of the courses. The e-assessment is very positively received with students reporting increased confidence and competency in numeracy, as well as IT, academic, research and communication skills. [ABSTRACT FROM AUTHOR]

Objective This study aims to ascertain if differences exist in the perception of the professional practice environment and personal well-being of nurses across different geographical areas in Queensland. Design This paper was performed on a prospective, self-report cross-sectional on-line survey. Setting The study was conducted among the nurses employed in public and private health care settings: acute hospitals, community health and aged care in Queensland, Australia. Participants Participants of this study were 1608 registered and enrolled nurses and assistants in nursing, current members of the Queensland Nurses Union in 2013 and who provided a workplace postcode. One thousand eight of these participants worked in major cities, while 382 in rural locations and 238 in remote areas. Interventions None. Main outcome measures Scores of well-being as determined by the following scales: the Depression, Anxiety and Stress Scale, the Professional Quality of Life Scale version 5, the Connor-Davidson Resilience Scale and of the Professional Practice Environment using the Practice Environment Scale - Nursing Work Index Revised. Results Nurses employed in major cities perceived 'nursing foundations for quality care' more favourably than those from other settings. Remote area nurses had lower levels of secondary traumatic stress than nurses in major cities and rural areas. There was no difference between nurses across their geographical locations for stress, anxiety, depression, compassion satisfaction, burnout, resilience and the four other measures of the Practice Environment Scale. Conclusions The study findings provide new data suggesting that, with the exception of secondary traumatic stress, the personal well-being of nurses does not differ across geographical settings. Similarly, with the exception of the subscale of 'nursing foundations for quality care' there was no difference in perceptions of the professional practice environment. As secondary traumatic stress is associated with burnout, this finding needs to be investigated further. [ABSTRACT FROM AUTHOR]

Aim To develop and psychometrically test a survey instrument to identify the factors influencing the provision of end-of-life care by critical care nurses. Background Following a decision to withdraw life-sustaining treatment, critical care nurses remain with the patient and their family providing end-of-life care. Identification of factors influencing the provision of this care can give evidence to inform practice development and support nurses. Design A cross-sectional survey of critical care nurses. Method An online survey was developed, reviewed by an expert panel and pilot tested to obtain preliminary evidence of its reliability and validity. In May 2011, a convenience sample of critical care nurses ( n = 392, response rate 25%) completed the survey. The analytical approach to data obtained from the 58 items measured on a Likert scale included exploratory factor analysis and descriptive statistics. Results Exploratory factor analysis identified eight factors influencing the provision of end-of-life care: emotional support for nurses, palliative values, patient and family preferences, resources, organizational support, care planning, knowledge and preparedness. Internal consistency of each latent construct was deemed satisfactory. The results of descriptive statistics revealed a strong commitment to the inclusion of families in end-of-life care and the value of this care in the critical care setting. Conclusion This paper reports preliminary evidence of the psychometric properties of a new survey instrument. The findings may inform practice development opportunities to support critical care nurses in the provision of end-of-life care and improve the care that patients and their families receive. [ABSTRACT FROM AUTHOR]

Aim In this paper, we describe a trial protocol used to assess feasibility related to: study administration (recruitment, randomization, retention, compliance, eligibility criteria, suitability of protocol instructions and data collection questionnaires); resource and data management (suitability of site, time and budget allocation, management of personnel and data); intervention fidelity (treatment dose, violations); and effect size. Background Pressure injury can lead to increases in hospital length of stay and cost. The sacrum is identified as one of the most common anatomical pressure injury sites for hospitalized patients. Silicone foam border dressings have been proposed as one strategy to reduce pressure injury incidence; however, rigorous testing of benefit in a general medical-surgical population is required. Design Randomized controlled trial. Methods Eighty patients will be recruited after assessment of high risk of pressure injury in a large tertiary hospital in south-east Queensland, Australia. Eligible, consenting participants will be randomly allocated to either a control group (routine care) or an intervention group (routine care and a sacral prophylactic dressing). The primary outcomes comprise feasibility criteria as identified above. The secondary measure is the presence and severity of sacral pressure injury via blind assessment of digital photographs. Research ethics approval was received in October 2013. Discussion Prophylactic dressings applied to the sacrum may be an effective method for reducing pressure injury in high-risk general medical-surgical patients. However, more rigorous studies to confirm benefit are required. This pilot study will determine the feasibility and effect size to inform a larger randomized controlled trial. [ABSTRACT FROM AUTHOR]

Aim. This paper is a report of a correlational study of the relationships between work-related injury-risk events and modifiable risk factors in a nursing population after controlling for socioeconomic factors. Background. Nurses are at high risk for work-related injury. Work-related injury is strongly influenced by psychosocial factors and physical job-related exposures, but the magnitude of effect from modifiable factors remains unclear. Method. Data were based on the Work Outcomes Research Cost-benefit survey conducted in Australia during 2005 and 2006. The study sample of 5724 represented ~14% of nurses in Queensland, Australia. Logistic regression was used to determine the magnitude of association of psychological distress (represented by the Kessler 6 score: six-item scale of psychological distress), the number of health conditions and various socioeconomic factors with work place injury. Results. High psychological distress was associated with a 5% probability of injury. As the number of health conditions increased, the probability of injury increased; 3 and ≥6 health conditions increased the chance of injury by 5% and 15% compared with no health conditions. Compared with the total sample, nurses who reported high levels of psychological distress demonstrated greater sensitivity to the number of health conditions. Computation of the marginal effects showed little difference in the likelihood of injury when the total sample was compared with nurses with <5 years of work experience. Conclusion. Effective occupational health and safety workplace programmes that target modifiable factors such as psychological distress and physical health conditions may improve the health capital of nurses and productivity levels within the profession. [ABSTRACT FROM AUTHOR]

To enhance the understanding of the skills and attitudes of mental health nurses working in the Australian Mental Health Nurse Incentive Program. The Mental Health Nurse Incentive Program places qualified mental health nurses alongside community-based general practitioners, private psychiatric practices and other appropriate organisations to provide clients with mental health conditions with a more integrated treatment plan. An exploratory, qualitative approach was undertaken, given the paucity of relevant research in this area. Exploratory individual interviews were conducted with ten mental health nurses working in this scheme. Data analysis was organised and managed using QSR NVivo qualitative analysis software. Respondents identified specific skills and attitudes required for practice under the Mental Health Nurse Incentive Program. Eight areas of skill and attitude were identified as essential for mental health nurses working in this field. This study highlights that many of these skills and attitudes are specific to the setting where mental health nurses are working. Mental health nurses working under this programme have a role to play in the dissemination of knowledge about their practice. More needs to be done by governments and other institutions to ensure that general practitioners and other health professionals understand the role played by mental health nurses in the provision of care. The extent to which the Mental Health Nurse Incentive Program becomes a sustainable strategy to promote quality and accessible mental health care will depend to some degree on the capacity to identify the skills and attitudes necessary for practice. The findings presented in this paper provide a significant contribution to articulating the essential characteristics required for this area of practice. [ABSTRACT FROM AUTHOR]

In 2009, a nursing education model was locally designed and delivered to support the interest of a group of Aboriginal community members living in a rural and remote town in Queensland, specifically to prepare for entry into further nursing education. Named 'Tjirtamai' by the traditional owners of the area, the program was offered in recognition of the challenges faced by Aboriginal people when they enter nursing education courses and as a way to increase the local number of Aboriginal nurses. This program, while funded by the Government, had unprecedented support and involvement from both the local Aboriginal and wider community. The model offered multiple exit points, assistance with financial and other known challenges for Aboriginal and Torres Strait Islander students, and included contextualised literacy and numeracy. Of the 38 Aboriginal students who enrolled in the course, 26 students completed. Of those students, 18 have since enrolled in a bachelor degree in nursing while another 4 enrolled in a diploma of nursing. This paper provides an overview of the course and its outcomes. [ABSTRACT FROM AUTHOR]

School nursing was introduced a century ago as part of a range of public health measures. However, the roles and responsibilities of school nurses varied considerably throughout the Western World. This paper explores these responsibilities during the early part of the twentieth century, with a particular emphasis on the role of school nursing in Queensland, Australia. While school nurses were initially employed to support the medical officers within the school setting, the school health system evolved to be essentially a nursing service. However, it was not a well resourced service. This meant there were unrealistic expectations placed on school nurses. Furthermore, because of the nature of the work undertaken by school nurses there were potential conflicts that needed to be negotiated on a daily basis between the nurse and the schools, parents, doctors and government departments. [ABSTRACT FROM AUTHOR]

The aim of the study was to identify the factors having an impact upon nursing work and to use the results to inform strategic planning of the Queensland Nurses Union. Background. In 2001 and 2004, a study was undertaken to gather data on the level of satisfaction of nurses with their working life. This paper reports the 2004 results on workload, skill mix, remuneration and morale. Where applicable, the results are compared with 2001 data. Methods. A questionnaire was mailed to 3000 Assistants-in-Nursing, Enrolled and Registered Nurses in October 2004. All participants were members of the Queensland Nurses Union. The results are reported in three sectors - public, private and aged care. A total of 1349 nurses responded to the survey, a response rate of 45%. Results. Nurses in the 2004 study believed: their workload was heavy; their skills and experience poorly rewarded; work stress was high; morale was perceived to be poor and, similar to 2001, deteriorating; the skill mix was often inadequate; and the majority of nurses were unable to complete their work in the time available. Nursing morale was found to be associated with autonomy, workplace equipment, workplace safety, teamwork, work stress, the physical demand of nursing work, workload, rewards for skills and experience, career prospects, status of nursing and remuneration. Conclusions. Overall the findings of the study are consistent with those determined by the 2001 survey. Relevance to clinical practice. The findings of this study indicate the importance of factors such as workplace autonomy, teamwork, the levels of workplace stress, workload and remuneration on nursing morale. The data also indicate that workplace safety and workplace morale are linked. These findings provide information for policy makers and nurse managers on areas that need to be addressed to retain nurses within aged care, acute hospital and community nursing. [ABSTRACT FROM AUTHOR]

This paper presents the results on workplace violence from a larger study undertaken in 2004. Comparison is made with the results of a similar study undertaken in 2001. The study involved the random sampling of 3000 nurses from the Queensland Nurses’ Union’s membership in the public (acute hospital and community nursing), private (acute hospital and domiciliary nursing) and aged care (both public and private aged care facilities) sectors. The self-reported results suggest an increase in workplace violence in all three sectors. Although there are differences in the sources of workplace violence across the sectors, the major causes of workplace violence are: clients/patients, visitors/relatives, other nurses, nursing management and medical practitioners. Associations were also found between workplace violence and gender, the designation of the nurse, hours of employment, the age of the nurse, morale and perceptions of workplace safety. Although the majority of nurses reported that policies were in place for the management of workplace violence, these policies were not always adequate. [ABSTRACT FROM AUTHOR]

hegney d, plank a, watson j, raith l & mc keon c (2005) Journal of Clinical Nursing 14, 855–862 Patient education and consumer medicine information: a study of provision by Queensland rural and remote area Registered Nurses The aim of the larger study was to ascertain the medication practices of registered and enrolled nurses in rural and remote areas of Queensland after the introduction of the Health (Drugs and Poisons) Regulation. This paper reports on the findings of the role of registered nurses and their confidence in the ability to provide information on medications in a way that the client understands; the frequency of the provision of information to clients prior to discharge; and the frequency of Indigenous Health Workers or interpreters for people without English as a first language. Queensland employs approximately 17% of the Australian registered nurse workforce. In 1996 Queensland changed the Health (Drugs and Poisons) Regulation to allow specific registered nurses, who had undertaken approved postgraduate education and training programmes, to become endorsed for an expanded medication practice role. In particular, it allowed endorsed nurses to administer and supply (but not prescribe) drugs listed in a drug formulary to certain clients using protocols. It was not clear, however, whether the changes to the Regulation reflected the scope of practice, thereby providing adequate legal protection for the nurse. During 2001–02 an exploration of the medication practices of rural and remote area nurses was conducted by the use of a cross-sectional postal survey. Phase 1 of the study used a facility audit to ascertain facility medication practices and phase 2 of the study used a postal survey to ascertain nurses’ medication practices. All nurses employed in rural and remote health facilities in Queensland were eligible to participate in the study. The nurse registering authority's (the Queensland Nursing Council) register was used to generate a non-proportional stratified random sample. Of the 1999 questionnaires sent, there were 668 respondents. Of these, 520 were registered nurses. The data indicated that there was a difference between endorsed and unendorsed registered nurses’ medication practice. In particular, it was apparent that endorsed registered nurses were more likely to believe they could explain the side-effects of medication to clients in a way the patient understood; provided medication education to clients on discharge; and used Indigenous Health Workers or interpreters to explain medications to those clients for whom English was not a first language. However, it was apparent that <50% of all Registered Nurses were providing client medication education or using Indigenous Health Workers or interpreters. It is apparent that the changes to the Regulation have ensured that Registered Nurses who have undergone postgraduate education to enhance their medication practice are more likely to provide client education and consumer medication information. However, the results suggest that the majority of registered nurses in Queensland, whilst believing they have sufficient knowledge of pharmacology to provide client education, often do not provide appropriate medication advice to clients, particularly on discharge from the acute setting. It is well recognized that the provision of medication education to clients has several benefits to both the client and the health care system. The lack of client medication education indicated in this study compromises patient's safety as well as their compliance with their medication regime. [ABSTRACT FROM AUTHOR]

To evaluate the experiences of a group of rural and remote nurses in providing palliative care and to discuss the implications of this evaluation for the development and implementation of professional support strategies. Semi-structured survey comprising 23 items measuring perceptions of the nature of rural and remote practice, the provision of palliative care in these settings and the appropriateness of various professional development strategies; as well as 12 open-ended questions to obtain qualitative descriptions relating to key concepts in rural and remote practice. Rural and remote communities in the Southern zone of Queensland Health. Thirty-one registered and enrolled nurses, all female, who attended a two-day professional development workshop. Identification of characteristics of, barriers against and strategies to support the practice of palliative care in rural and remote communities. High levels of agreement with key statements relating to issues evident in contemporary literature regarding rural and remote nursing practice; qualitative descriptions show congruence with key statements. This evaluation demonstrated congruence between the challenges faced by this group of nurses and those reported in the literature. These nurses identified the importance of peer networking as an integral part of their work, which enhanced their potential as rural and remote palliative care providers. The issues faced by nurses in rural and remote communities have been described in previous studies. For the most part, these had not specifically targeted the practice of palliative care in this setting. It was not clear whether the practice of palliative care brought distinct challenges to nurses. This paper adds to the growing body of knowledge about the professional development needs of nurses in rural and remote communities in relation to the practice of palliative care. It suggests that the nurses surveyed in this study share many challenges in common with nurses practising rural and remote settings. Palliative care is understood to be an integral part of practice, despite the infrequency of palliative care clients and the diverse roles they carry out. Barriers to professional development related to geographical and professional isolation are shared in common. An imperative emerges to identify professional development strategies that are directly relevant to rural and remote settings, to improve access to professional development resources and to promote sustainable peer support networks. [ABSTRACT FROM AUTHOR]

This paper reports on workplace violence, self-reported as part of a survey among members of the Queensland Nurses’ Union (QNU) in October 2001. The aim of the overall study was to ascertain how nurses perceived their work and their working conditions and to use the results of the study to inform strategic planning of the QNU. The participants of this study were drawn from a stratified random sample of 2800 QNU members employed in the public, the private acute and the aged care sectors. The total number of completed surveys analysed was 1436: 441 aged care, 497 public and 498 private acute sector surveys. The results suggest that the rate of workplace violence differs significantly across sectors. In the three months immediately prior to the survey, 50% of aged care sector nurses experienced some form of workplace violence compared to 47% of public sector nurses and 29% of acute private sector nurses. The major source of workplace violence was from patients. The second most common source of violence varied. Nurses in the public sector signified visitors and relatives while nurses in the aged care and acute private sectors indicated other nurses. The study found that inexperienced nurses are more likely to report workplace violence than experienced nurses. Additionally, the more experienced the nurse, the less likely they are to perceive workplace policies and procedures for workplace violence as effective. Additional findings include an apparent lack of policies and procedures for workplace violence in rural and remote areas, and an association between the designation of a nurse and the reported level of workplace violence. [ABSTRACT FROM AUTHOR]