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Aim: We aim to investigate nurses' perceptions of support after incidences of Workplace Violence. Background: Nurses experience workplace violence daily. Adequate support following incidents of violence can reduce adverse impacts. Current support systems for coping with workplace violence are lacking. Methods: Focus group interviews were conducted with 23 nurses working in a regional Queensland Hospital. Qualitative data was transcribed and thematically analyzed to determine themes. The consolidated criteria for reporting qualitative research checklist was followed. Results: The primary source of support after a violent incident was from other nurses. Support was needed immediately to empower nurses to be able to continue their caring role. Often the support was not provided nor were nurses aware of the support services available. Although personal family and friends were a valuable support, most nurses were reluctant to disclose their experiences to protect them. Conclusions: This paper discusses nurses' experience of support following violence incidents at work as part of findings from a more extensive study that explored the perceptions of nurses regarding violence, strategies and support in a regional Queensland Hospital. Hospital support following a violent incident was perceived as inadequate and nurses felt unsupported immediately following an incident. Implications for Nursing Management: After an incidence of workplace violence, appropriate effective support may mitigate the enduring impacts of experiencing violence. There is the need for hospital management to provide effective support services and improve staff awareness of available support services. [ABSTRACT FROM AUTHOR]

Background: Scales used to evaluate nurses' perspectives of mentoring programmes are mainly designed in developed countries, making them unsuitable for nurses and midwives working in resource‐poor developing countries. Aim: To explore the psychometric properties of the perceived cost of mentoring (PCM) scale, negative mentoring experiences (NME) scale and relational mentoring index (RMI) for adaptation in hospital settings in Uganda. Methods: A cross‐sectional study design was used. In total, 303 hospital nurses/midwives in Ugandan participated in the study to evaluate the psychometric properties of the three mentoring scales. Results: Revisions based on word choice were made in adapting the scales to the Ugandan context. The PCM showed three factors (risk to reputation, mentoring effort and nepotism) and had an intra‐class correlation (ICC) of 0.609 (95% CI, 0.324–0.793) and Cronbach's alpha of 0.705. The NME scale had two factors (lack of mentor expertise and mismatch between the dyad) consistent with the original scale with an ICC of 0.568 (95% CI, 0.271–0.767) and Cronbach's alpha of 0.841. The RMI showed two factors (individual influence and relational quality) with an ICC of 0.664 (95% CI, 0.410–0.824) and Cronbach's alpha of 0.933. Conclusions: The initial psychometric assessment indicates satisfactory validity and reliability of the scales for implementation among nurses and midwives within Ugandan hospital contexts. Subsequent research is warranted to validate the factor structures of the scales on a different sample. Implications for nursing and health policy: In using mentoring programmes to develop the hospital workforce, nurse and midwifery policymakers need to use culturally adapted and validated PCM, NME, and RMI scales to evaluate the quality of these mentoring programmes to maximise the benefits while avoiding unintended consequences. [ABSTRACT FROM AUTHOR]

Aims and Objectives: To evaluate the impact of a nurse practitioner‐led phase two cardiac rehabilitation and secondary prevention programme on attendance and compliance. Background: Despite strong evidence for the benefits of cardiac rehabilitation, attendance/completion rates remain low. Nurse practitioner‐led services have been reported as more effective than physician‐led services at increasing patient adherence to evidence‐based recommendations. However, nurse practitioner‐led programmes are uncommon and there appears to be no current evidence examining the impact of these programmes on attendance/completion rates. Methods: A retrospective audit of the Country Access to Cardiac Health (CATCH) database was undertaken to identify patients who attended a nurse practitioner‐led cardiac rehabilitation programme between April 2014 and May 2016. Data from key performance indicators were exported to Stata/SE 15.0. The study utilised the Strengthening the Reporting of OBservational Studies in Epidemiology (STROBE) Statement: guidelines for reporting observational studies to ensure quality reporting during this study (See Data S1). Results: Seventy‐seven per cent (n = 199) of participants were men, and participants had a mean age of 67 years. Half (52.5%) of participants completed all CR sessions. Male participants (78%) were more likely to complete the CR programme as compared with women (67%). Participants with a family history of cardiovascular disease and a higher number of risk factors at baseline were more likely to commence and complete the programme. Attendance and completion had a positive impact on smoking cessation. Conclusions: The nurse practitioner‐led programme evaluated in this study demonstrated high levels of attendance and completion rates compared to standard programmes. This high attendance/completion rate could in turn decrease the rate of subsequent cardiac events and improve mortality and morbidity rates. Relevance to clinical practice provides valuable insights into the effectiveness of nurse practitioner‐led cardiac rehabilitation and secondary prevention on attendance/complete rates. These findings could guide future research and clinical practice development. [ABSTRACT FROM AUTHOR]

Mentoring literature explores the dark side of mentoring as factors such as gender and race and how they affect the overall mentoring experience. The sociocultural context of the nursing and midwifery professions presents unique characteristics warranting a qualitative exploration of negative mentoring experiences. We aimed to characterise the dark side of mentoring based on informal mentoring relationships occurring among nurses and midwives working in hospitals. Utilising semistructured interviews in a qualitative descriptive design and reflexive thematic analysis, we examined the perceptions of 35 nurses and midwives from three public hospitals located in the Western, Northern and North‐western regions of Uganda. Findings emerged in four overarching themes mentoring process deficits, mentoring relational problems, organisational challenges in mentoring and implications of negative mentoring experiences. Our study findings underscore that, while mentoring is frequently beneficial, it can also be interspersed with negative experiences arising from relational dynamics, particular mentoring processes and the overarching hospital environment. Notably, nurses and midwives actively transformed these challenges into opportunities for growth and self‐improvement, while introspectively examining their roles in contributing to these negative experiences. Such a proactive approach highlights their resilience and steadfast commitment to professional development, even in the face of adversity. [ABSTRACT FROM AUTHOR]

Aim: To explore how nurse managers perceive and experience their role in supporting the well‐being of intensive care nurses. Background: While it is known that nurse manager behaviours affect nurse well‐being, literature indicates that intensive care nurses may not receive the support they require. Understanding how nurse managers see their role in supporting nurse well‐being is crucial to offer recommendations for improvement. Methods: Qualitative multiple case study design. Twelve semi‐structured, in‐depth interviews were conducted with nurse managers from Australian intensive care unit settings. Data were analysed using thematic analysis. Results: Nurse manages felt unsure about what their supportive role involved, lacked training on how to support nurse well‐being and called for organisational backup to carry out their role effectively. The study also provided insight into the strategies that enabled nurse managers to support nurse well‐being. Conclusion: There is currently no consensus on the role of the nurse manager in supporting nurse well‐being resulting in inconsistencies and wide practice variations. Furthermore, nurse managers need support and training if they are required to support nurse well‐being. Implications for Nursing Management: A clear definition of the nurse manager supportive role describing the purpose and core functions involved in this role must be developed to support nurse well‐being. [ABSTRACT FROM AUTHOR]

Objective: Shortages in the speciality nursing workforce, both nationally and internationally are driving the need for the development of an evidence-based model to inform recruitment and retention into speciality nursing practice. This study aimed to identify the factors influencing rapid and early career transition into speciality nursing practice. Methods: A comprehensive systematic review of the literature was undertaken using a convergent qualitative synthesis design where results from qualitative, quantitative and mixed methods studies were transformed into qualitative findings. Databases included CINAHL, Medline, Scopus and PsycINFO. Search terms were: nurse, early career, rapid career, transition, specialty, and Medical Subject Heading terms included: professional development and educational, nursing, and continuing. Using validated tools, papers were independently assessed by a minimum of two reviewers. Results: Twenty-three research articles were included. There were no randomized control trials. Through thematic analysis and matrix mapping of the results, the TRANSPEC model was developed. The model outlines three phases of transition: pre-entry, incomer and insider. There has been little focus on pre-entry with programs being designed at the incomer and insider phases. Impacting on these phases are three concepts: the self (professional and personal), the transition processes (informal and formal) and a sense of belonging. The overarching theme influencing the phases and concepts is the context of practice. Enablers and inhibitors influence successful transition and therefore impact on recruitment and retention. Each nurse’s transition is influenced by time. Conclusions: For successful transition, the enablers and inhibitors impacting on the three concepts, phases and the context of practice need to be considered when developing any program. It is apparent that while previous studies have focused on the transition processes, such as curricula, the development of the self and a sense of belonging are also essential to successful transition. Further studies should include the pre-entry phase. [ABSTRACT FROM AUTHOR]

Aim Background Methods Results Conclusions Implications for nursing policy To understand clinicians’ motivations to engage in mentoring to support newly graduated nurses and midwives working in hospital settings.Nursing and midwifery literature has established the benefits of mentoring and challenges that affect the effectiveness of formal mentoring programmes. No studies have explored hospital nurses’ and midwives’ motivations to mentor in the absence of the obligatory status and associated rewards of institutionalised mentoring.A qualitative descriptive study with 35 nurses and midwives working in three public hospitals in the western, northern and northwestern parts of Uganda. Data were collected using semistructured interviews. Reflexive thematic analysis was applied to interpret the data. We have adhered to COREQ reporting guidelines.The study revealed three salient themes that capture nursing and midwifery professionals' mentoring perspectives. Participants expressed confidence in their inherent mentoring capacities and were often motivated by a desire to reciprocate prior mentoring experiences. Their mentoring approaches varied between self‐focused and other‐focused motivations, with some overlap in perspectives on hierarchical versus relational mentoring. Across the board, there was a strong consensus on the need of mentoring for individual clinicians, healthcare institutions and the broader profession. The study highlights five opportunities that can be harnessed to design future mentoring programmes.The findings delineate a complex interplay between self‐centred and altruistic mentoring motivations, aligning with hierarchical or mutually beneficial mentoring paradigms.Nurse managers should tailor mentoring programmes to align with these intrinsic motivations, affirm the enduring need for mentoring, and leverage existing institutional resources to create both acceptable and efficient mentoring frameworks. [ABSTRACT FROM AUTHOR]

Objective. Patients commonly show signs and symptoms of deterioration for hours or days before cardiorespiratory arrest. Rapid response teams (RRT) were created to improve recognition and response to patient deterioration in these situations. Activation criteria include vital signs or ‘general concern’ by a clinician or family member. The general concern criterion for RRT activation accounts for nearly one-third of all RRT activity, and although it is well established that communication deficits between staff can contribute to poorer outcomes for patients, there is little evidence pertaining to communication and its effects on the general concern RRT activation. Thus, the aim of the present study was to develop a substantive grounded theory related to the communication process between clinicians that preceded the activation of an RRT when general concern criterion was used. Methods. Qualitative grounded theory involved collection of three types of data details namely personal notes from participants in focus groups with white board notes from discussions and audio recordings of the focus groups sessions. Focus groups were conducted with participants exploring issues associated with clinician communication and how it related to the activation of an RRT using the general concern criterion. Results. The three main phases of coding (i.e. open, axial and selective coding) analysis identified 322 separate open codes. The strongest theme contributed to a theory of ineffective communication and decreased psychological safety, namely that ‘In the absence of effective communication there is a subsequent increase in anxiety, fear or concern that can be directly attributed to the activation of an RRT using the ‘general concern’ criterion’. The RRT filled cultural and process deficiencies in the compliance with an escalation protocol. Issues such as ‘not for resuscitation documentation’ and ‘inability to establish communication with and between medical or nursing personnel’ rated highly and contributed to the debate. Conclusions. This study highlighted that in the surveillance and management of the deteriorating patient and in the absence of effective communication there is a subsequent increase in anxiety, fear or concern that can be directly attributed to the activation of an RRT for the ‘general concern’ calling criteria. [ABSTRACT FROM AUTHOR]

Presents a study which investigated the sources of hearing loss among farmers. Methodology; Results; Discussion.

Background: Rapid response teams generally consist of multidisciplinary specialist staff members with advanced knowledge and skills to manage deteriorating patients outside of the intensive care unit. These teams consist predominantly of intensive care unit nurses, who often undertake intensive care unit and rapid response team duties concurrently. Little has been published on the impact of these nurses' absence while attending a rapid response call on the nursing workforce, patient care, and resource allocation in the intensive care unit. Objective: To explore the impact of nurses' absence due to attending rapid response calls in other areas of the hospital on service delivery and resource allocation in the intensive care unit. Methods: A comprehensive search of 3 databases was performed to identify studies on relationships among the rapid response team, the intensive care unit, and nursing staff. Results: The search yielded 6 quantitative studies, 2 qualitative studies, and a mixed-methods study that were included for analysis. Four key themes were identified: (1) workforce, staffing processes, and resource allocation; (2) alterations to workload and resource allocation; (3) adverse events or incidents; and (4) funding variability of rapid response team models. Review of the studies indicated that dual intensive care unit and rapid response team nursing roles have negative effects on nurses' workload, increase the risk of adverse events, and may compromise patient safety. Conclusion: The staffing of both the intensive care unit and the rapid response team should be examined carefully with an eye toward sustainability, cost-effectiveness, and clear outcome measures. [ABSTRACT FROM AUTHOR]

Aims and objectives: To explore the shared experiences of people with stroke and caregivers in preparedness to manage post‐discharge care. Background: People with stroke and caregivers show dyadic effects in dealing with post‐discharge care challenges. However, few studies have explored their shared experiences and unique challenges for each dyadic member in preparedness to manage post‐discharge care. This study addresses this research gap. Design: An interpretive approach underpinned by Gadamer's philosophical hermeneutics. Methods: Semi‐structured interviews were conducted with people with stroke and caregivers in 5 days before hospital discharge (n = 26) or 2 weeks after discharge (n = 4) between July and December 2019. The study followed a five‐step data analysis method aligning with Gadamerian hermeneutics. The study reporting followed the COREQ checklist. Results: Three themes and six subthemes were identified. First, both people with stroke and caregivers experienced psychological stress, although the sources differed. Second, stroke dyads demonstrated resilience built on positive thoughts, confidence, and support from family and health professionals. Third, stroke dyads exhibited different levels of certainty about post‐discharge care. They desired to be equal partners in co‐developing and co‐implementing discharge plans. Conclusions: Similarities and differences in perceived preparedness to manage post‐discharge care existed between stroke dyadic members. A co‐design approach to developing and implementing discharge plans would enhance planned post‐discharge care. Impact Hospital‐to‐home transition is a challenging time for people with stroke and their caregivers. Understanding the shared experiences of stroke dyads in preparedness for post‐discharge care enables nurses to take proactive actions to enhance managing post‐discharge care. Early identification of those at risk of developing psychological stress will enable nurses to co‐develop stress‐coping strategies. These will have a positive influence on the dyad when facing setbacks due to stroke‐related complications. [ABSTRACT FROM AUTHOR]

Aims: To explore the overall benefits and challenges for the mentee, the mentor, and the hospital (stakeholders) in hospital‐sponsored mentoring programs. Background: Formal mentoring programs are widely used to assist nurses to adapt to clinical practice, facilitate their career development, and improve workforce retention. However, the overall benefits and challenges for stakeholders involved in formal mentoring programs remain largely unknown due to a lack of systematic reviews to synthesize relevant studies in this important area. Design: A systematic integrated review. Data sources: A systematic search of six databases including CINAHL, Web of Science, MEDLINE, Scopus, Science Direct, and ProQuest was undertaken. Review methods: Studies that met the inclusion criteria were assessed for methodological quality using the Joanna Briggs Institute critical appraisal tools. Findings from qualitative, quantitative, and mixed‐methods studies were extracted and synthesized thematically using a convergent synthesis method. Results: Twenty‐two original studies were included in the review. Findings are presented under five themes: the benefits for mentees, the benefits for mentors, the benefits for the hospital, challenges perceived by mentees and mentors, and mismatched mentor–mentee pairs. Conclusion: Mentoring programs that build on reciprocal relationships among mentees and mentors generate substantial benefits for all if mentees are able to navigate the challenges of the complex and dynamic nature of the clinical practice environment. Organizational support is important in overcoming these challenges. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the effects of a nurse-led health coaching programme for stroke survivors and family caregivers in hospital-to-home transition care.Methods: A total of 140 dyads of stroke survivors and their family caregivers were recruited and randomly assigned to either the intervention group (received a 12-week nurse-led health coaching programme) or the usual care group. The primary outcome was self-efficacy, and secondary outcomes were quality of life (QoL), stroke-related knowledge, and caregiver-related burden. The outcomes were measured at baseline, 12 and 24 weeks.Results: Stroke survivors in the intervention group demonstrated a significant improvement in self-efficacy at 12 weeks (x̅: 24.9, 95%CI: 20.2-29.6, p < 0.001) and at 24 weeks (x̅: 23.9, 95%CI: 19.2-28.6, p < 0.001) compared to the usual care group. Findings also demonstrated significant increases in stroke survivors' QoL, stroke-related knowledge, and reduction in unplanned hospital readmissions and caregiver-related burden. There were no statistically significant changes in other outcomes between the two groups.Conclusion: The nurse-led health coaching programme improved health outcomes for both stroke survivors and their caregivers.Practice Impaction: Findings from the study suggest that nurse-led health coaching should be incorporated into routine practice in hospital-to-home transitional care for stroke survivors and their caregivers. [ABSTRACT FROM AUTHOR]

Aims and objectives: To synthesise qualitative research evidence on the experience of stroke survivors and informal caregivers in hospital‐to‐home transitional care. Background: Due to a shortened hospital stay, stroke survivors/caregivers must take over complex care on discharge from hospital to home. Gaps in the literature warrant a meta‐synthesis of qualitative studies on perceived enablers and barriers during this crucial period. Design: A systematic review and meta‐synthesis. Methods: A review was guided by Enhancing Transparency in Reporting the Synthesis of Qualitative Research (ENTREQ) checklist where six databases were searched from April to June 2020 including CINAHL Plus, MEDLINE, PsycINFO, Scopus, Web of Science and ProQuest and ProQuest Dissertations and Theses. There was no date limit to the search. Selected studies were critically appraised. A thematic synthesis approach was applied. Results: The synthesis of 29 studies identified three major findings. First, partnerships with stroke survivors/caregivers empower discharge preparation, foster competence to navigate health and social care systems and activate self‐management capabilities. Second, gaps in discharge planning and the lack of timely postdischarge support contribute to unmet care needs for stroke survivors/caregivers and affect their ability to cope with poststroke changes. Third, stroke survivors/caregivers expect integrated transitional care that promotes shared decision‐making and enables long‐term self‐management at home. Conclusions: Hospital‐to‐home transition is a challenging period in the trajectory of poststroke rehabilitation and recovery. Further research is required to deepen understandings of all stakeholders' views and address unmet needs during transitional care. Relevance to clinical practice: Protocols and clinical guidelines relating to discharge planning and transitional care need to be reviewed to ensure partnership approach with survivors/caregivers in the design and delivery of individualised transitional care. Stroke nurses are in a unique position to lead timely support for survivors/caregivers and to bridge service gaps in hospital‐to‐home transitional care. [ABSTRACT FROM AUTHOR]

Objective: To systematically analyse health coaching strategies in transition care and synthesise the effect of these strategies on health care outcomes for stroke survivors.Methods: A systematic search of nine databases in two languages was conducted. Meta-analysis was conducted when data were available.Results: Twenty-five randomised controlled trials met the inclusion criteria. The meta-analysis revealed that health coaching strategies in transition care interventions significantly improve quality of life (QoL) (p < 0.001), activities of daily living (ADL) (p = 0.002) and reduce depression (p = 0.001) for stroke survivors at 3 months. Further subgroup analysis demonstrated that transition care interventions with a greater number of health coaching strategies are associated with a larger effect size on QoL (SMD=1.15) and ADL (SMD=1.177) at 3 months, and a medium effect size (SMD=0.674) on depression reduction. However, the effects of health coaching strategies on readmission, mortality and falls in stroke survivors remain inconclusive.Conclusions: This review provides evidence that incorporating health coaching strategies in transitional care improves health outcomes of stroke survivors.Practice Implication: More trials of health coaching interventions to improve transition care with a rigorous study design are much needed to address the lack of support for stroke survivors and their caregivers in this crucial care period. [ABSTRACT FROM AUTHOR]

Aim: To identify challenges and opportunities for stroke survivors and caregivers in hospital to home transition care. Background: Due to shortened hospital stays, stroke survivors and caregivers must take responsibility for complex care on discharge from hospital to home. Gaps exist in the literature that synthesizes studies on hospital to home transition care. Design: A systematic integrated review. Data sources: Six databases were searched systematically between 18 June 2018 – 31 October 2018 including Medline, CINAHL, Web of Science, ProQuest, Scopus and Science Direct. The search did not have a date limit. Review methods: Studies that met the selection criteria were critically reviewed. Data were extracted from the studies for analyses. A convergent qualitative synthesis approach using inductive thematic synthesis was applied to the review. Results: The analysis of 23 studies identified three major findings. First, health and social care systems influence transition care by either enabling stroke survivors and caregivers to manage transition care via well‐coordinated services or preventing them from accessing services. Second, health professionals' partnership with stroke survivors and caregivers largely decides tailored support for them. Successful partnerships and engagements with stroke survivors and caregivers depend on organizational resources. Third, survivors and caregivers are at different levels of readiness to cope with challenges. Individualized support for them to develop resilience is highly regarded. Conclusion: Stroke survivors and caregivers encounter enormous challenges in self‐management of hospital to home transition care. Further research is required to address their expectations of support during transition care. Impact: There is a lack of synthesis of studies on factors affecting hospital to home transition care for stroke survivors. Health and social care system designs, health professionals' commitment to individualized care and the self‐management capability of stroke survivors and their caregivers have a profound influence on the transition care experiences. [ABSTRACT FROM AUTHOR]

An amendment to this paper has been published and can be accessed via the original article. [ABSTRACT FROM AUTHOR]

Introduction: This paper reports on the findings of the Nursing and Midwifery Exchange Program, initiated to promote rural and remote nursing and midwifery, and to facilitate clinical skills development and clinical collaboration between health services in Queensland, Australia. The project was undertaken over an 18-month period in one state of Australia, offering structured, temporary exchange of personnel between metropolitan and rural health services. Background: Globally, there is an increasing awareness of nursing shortages, and with it, the need to ensure that nurses and midwives are prepared for specialist roles and practice. This is particularly important in rural and remote areas, where there are pre-existing barriers to access to services, and difficulties in attracting suitably qualified, permanent staff. Methods: A mixed methods approach to the evaluation was undertaken with two cohorts. One cohort was the nurses and midwives who participated in the exchange (n = 24) and the other cohort were managers of the participating health services (n = 10). The nurses and midwives who participated in the exchange were asked to complete a questionnaire that included questions related to embeddedness and job satisfaction. The managers participated in a Delphi series of interviews. Results: Those who participated in exchange reporting a higher score on the reported degree of understanding of rural client, which was accompanied with a moderate-to-large effect size estimate (d = 0.61). Nurses/midwives in the exchange group reported higher scores on their perceptions of aspects of their home community that would be lost if they had to leave, which was accompanied with a large effect size (d = 0.83). Overall, NMEP was reported by the participants to be a positive way to improve professional development opportunities for nurses and midwives. The findings also show the program supported practical collaboration and raised the profile of nursing and midwifery in rural areas. Conclusion: Exchange programs support clinical and professional development, raising the awareness of different contexts of practice and related skills requirements, and thereby supporting a greater understanding of different nursing roles. In the light of increasingly complex care required by patients with chronic conditions being managed in community-based services, programs such as NMEP provide the opportunity to build collaborative networks between referring and referral centres as well as contribute to the ongoing skills development. [ABSTRACT FROM AUTHOR]

Background: Hospital to home transition care is a most stressful period for stroke survivors and their caregivers to learn self-management of stroke-related health conditions and to engage in rehabilitation. Health coaching has been identified as a strategy to enhance self-management of poststroke care at home. However, interventions in this field that are informed by a health coaching framework are scarce. This study will address a gap in research by testing the hypothesis that a nurse-led health coaching intervention can improve health outcomes for stroke survivors and their family caregivers in hospital to home transition care.Methods: This is a single-blind, two-arm parallel randomized controlled trial of a nurse-led health coaching program versus routine care situated in two tertiary hospitals in Chongqing, China. Stroke survivors and their primary family caregivers will be recruited together as "participant dyads", and the estimated sample size is 140 (70 in each group). The intervention includes a 12-week nurse-led health coaching program in hospital to home transition care commencing at discharge from the hospital. The primary outcome is changes in self-efficacy of stroke survivors at 12 weeks from the baseline. The secondary outcomes are changes in stroke survivors' and quality of life, functional ability, stroke-related knowledge, the number of adverse events, and unplanned hospital admissions, and caregivers' self-efficacy and caregiver-related burden at 12 weeks from the baseline. The outcomes will be measured at 12 weeks and 24 weeks from the baseline.Discussion: This study will examine the effect of nurse-led health coaching on hospital to home transition care for stroke survivors and their caregivers. It is anticipated that findings from this trial will provide research evidence to inform policy, and resource and practice development to improve hospital to home transition care for stroke survivors and their caregivers.Trial Registration: The Australian New Zealand Clinical Trials Registry (ANZCTR): ACTRN12619000321145. Registered on 1 March 2019. [ABSTRACT FROM AUTHOR]

Critical care healthcare professionals are at high risk in developing burnout and mental health disorders including depression, anxiety, and post-traumatic stress disorder. High demands and the lack of resources lead to decreased job performance and organizational commitment, low work engagement, and increases emotional exhaustion and feelings of loneliness. Peer support and problem-solving approaches demonstrate promising evidence as it targets workplace loneliness, emotional exhaustion, promotes work engagement, and supports adaptive coping behaviors. Tailoring of interventions have also shown to be effective in influencing attitudes and behavior changes, attending to the individual experience and specific needs of end-users. The purpose of this study is to assess the feasibility and user-perceived acceptability of a combined intervention (Individualized Management Plan (IMP) and Professional Problem-Solving Peer (PPSP) debrief) in critical care healthcare professionals. This protocol was registered in the Australian and New Zealand Clinical Trials Registry (ACTRN12622000749707p). A two-arm randomized controlled trial, with pre-post-follow-up repeated measures intergroup design with 1:1 allocation ratio to either 1) treatment group–IMP and PPSP debrief, or 2) active control group–informal peer debrief. The primary outcomes will be conducted by assessing the recruitment process enrolment, intervention delivery, data collection, completion of assessment measures, user engagement and satisfaction. The secondary outcomes will explore preliminary effectiveness of the intervention using self-reported questionnaire instruments from baseline to 3-months. This study will provide the interventions' feasibility and acceptability data for critical care healthcare professionals and will be used to inform a future, large-scale trial testing efficacy. [ABSTRACT FROM AUTHOR]

Background: To improve nutritional assessment and care pathways in the acute care setting, it is important to understand the indicators that may predict nutritional risk. Informed by a review of systematic reviews, this project engaged stakeholders to prioritise and reach consensus on a list of evidence based and clinically contextualised indicators for identifying malnutrition risk in the acute care setting.Methods: A modified Delphi approach was employed which consisted of four rounds of consultation with 54 stakeholders and 10 experts to reach consensus and refine a list of 57 risk indicators identified from a review of systematic reviews. Weighted mean and variance scores for each indicator were evaluated. Consistency was tested with intra class correlation coefficient. Cronbach's alpha was used to determine the reliability of the indicators. The final list of indicators was subject to Cronbach's alpha and exploratory principal component analysis.Results: Fifteen indicators were considered to be the most important in identifying nutritional risk. These included difficulty self-feeding, polypharmacy, surgery and impaired gastro-intestinal function. There was 82% agreement for the final 15 indicators that they collectively would predict malnutrition risk in hospital inpatients.Conclusion: The 15 indicators identified are supported by evidence and are clinically informed. This represents an opportunity for translation into a novel and automated systems level approach for identifying malnutrition risk in the acute care setting. [ABSTRACT FROM AUTHOR]

To conduct a review of the impact of presenteeism as it relates to the nursing workforce. Presenteeism behaviour has been researched in the broader workforce across multiple industries including business/management, public health and occupational health. Presenteeism in nursing is particularly significant because it puts patients at risk by reducing the capacity of nurses to provide high quality care. Rates of presenteeism are particularly high in the nursing workforce and the impact of nurse presenteeism needs to be further examined and explored. An integrative review of the associated literature. Online databases were searched for research related to presenteeism in the nursing workforce. Original primary research investigating presenteeism in the nursing workforce, in all clinical settings, in the English language and published between 2006 and 2018 were included. A total of 17 studies fit the inclusion criteria and were included in this review: 16 quantitative and 1 qualitative. Five categories emerged from the data synthesis process: 1) the prevalence of presenteeism, 2) the economic cost of presenteeism, 3) presenteeism and related health conditions, 4) presenteeism and nurse well-being, and 5) presenteeism and patient safety. The scale and impact of presenteeism is rarely explicitly discussed. Further research is needed to investigate the link between presenteeism, nurse well-being quality of patient care and costs in the nursing sector. [ABSTRACT FROM AUTHOR]

Aims: This study re‐examines the validity of a model of occupational resilience for use by nursing managers, which focused on an individual differences approach that explained buffering factors against negative outcomes such as burnout for nurses. Background: The International Collaboration of Workforce Resilience model (Rees et al., 2015, Frontiers in Psychology, 6, 73) provided initial evidence of its value as a parsimonious model of resilience, and resilience antecedents and outcomes (e.g., burnout). Whether this model's adequacy was largely sample dependent, or a valid explanation of occupational resilience, has been subsequently un‐examined in the literature to date. To address this question, we re‐examined the model with a larger and an entirely new sample of student nurses. Methods: A sample of nursing students (n = 708, AgeM(SD) = 26.4 (7.7) years), with data examined via a rigorous latent factor structural equation model. Results: The model upheld many of its relationship predictions following further testing. Conclusions: The model was able to explain the individual differences, antecedents, and burnout‐related outcomes, of resilience within a nursing context. Implications for Nursing Management: The results highlight the importance of skills training to develop mindfulness and self‐efficacy among nurses as a means of fostering resilience and positive psychological adjustment. [ABSTRACT FROM AUTHOR]

Introduction: Community nursing and midwifery is changing in response to a shift in care from hospital to home, brought about by increasing costs to care because of an aging population and increasing chronicity. Until now, community nursing positions and scope of practice has been dependent on service focus and location, which has led to the role being unclearly defined. Lack of appeal for a career in community practice and a looming workforce shortage necessitates a review into how community nursing and midwifery transition to practice is supported. Methods: This review sought to identify, assess and summarize available evidence relating to transitioning into community nursing and midwifery practice as a speciality. A systematic review was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses approach. A narrative synthesis was then undertaken on papers that examined community nursing and midwifery pathway perspectives which define, and enable or inhibit a contemporary pathway. Thematic analysis used a theoretical framework developed for early career and rapid transition to nursing specialty practice. Results: There is a paucity of research that identifies community nursing and midwifery as a discreet scope of practice. Twelve papers were eventually included in the review. Verbatim findings were extracted from the papers and clustered into categories based on the chosen theoretical framework. Major themes were ‘the self’ (professional and personal); ‘transition processes’; and, a ‘sense of belonging’. Sub themes included narrative identifying inhibitors and enablers in each theme. Discussion: No definition of community practice or pathway was identified in nursing, although midwifery was clearly defined. Community nursing practice was described as generalist in nature although specialist knowledge is required. Being part of the community in the professional sense and personal sense was considered important. The importance of transition was identified where pre-entry exposure to community practice was seen as important. Stages in transition to practice were recognised as pre-entry; incomer; insider; and, a sense of belonging. The process of transition should be planned and individualised acknowledging past experience whilst acknowledging the specialist nature of community-based practice. [ABSTRACT FROM AUTHOR]

Pictures speak a thousand words. The traditional romantic image of an Australian aeromedical service is a male doctor and male pilot, out to rescue the male stockman from the red dust of the Australian outback. However, the reality is considerably different, particularly in the current context of the Australian healthcare system. This paper examines the images of flight nursing using a critical lens. The images are derived from popular literature sources from the early 1940s through to the present. A textual analysis of the images of flight nursing using the methodology of institutional ethnography reveals a number of themes including the glamorous, the romantic, and the heroic nurse. This study illustrates that the way these nurses are portrayed within popular literature mirrors the Australian cultural ethic of heroic bush pioneer, yet at the same time the work these nurses do is undervalued by various omissions and misrepresentations. The results from this study have the potential to significantly improve recognition of the work performed by flight nurses and to challenge incorrect cultural myths. [ABSTRACT FROM AUTHOR]