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The use of complementary and alternative medicine during pregnancy is common. However, many modalities have not been well researched and safety concerns have been raised. This article describes a grounded theory study which explored how midwives interact with women regarding use of these therapies. Participants were recruited from metropolitan hospitals in Victoria, Australia. Twenty-five midwives were interviewed and a subgroup was also observed. The findings revealed that when working with women interested in complementary and alternative medicine, midwives usually aimed to facilitate informed decisions whilst prioritising safety. However, participants assessed the risk associated with various therapies differently. Although many endorsed the use of various therapies, only a few were integrated into practice. In conclusion, midwives play an important role in mediating women's behaviour towards complementary and alternative medicine. Yet, currently many do not have the appropriate education to appreciate the associated risks, as well as the potential benefits. [ABSTRACT FROM AUTHOR]

Objective Residents from aged care facilities make up a considerable proportion of ED presentations. There is evidence that many residents transferred from aged care facilities to EDs could be managed by primary care services. The present study aimed to describe the characteristics of residents transferred from residential aged care facilities to EDs, and to evaluate the appropriateness and cost of these presentations. Methods A retrospective review of ED records was undertaken for residents transferred from residential aged care facilities to two EDs in Melbourne, Victoria, in 2012. Data examined included residents' mode and time of arrival to ED, presenting complaint, triage category, procedures within ED, diagnosis, length of stay, and disposition. Data were examined against a previously established tool to identify resident transfers that might be 'potentially avoidable'. Results There were 2880 resident transfers included in the sample, of which 408 transfers were randomly selected for scrutiny of documentation. Seventy-one residents (17.4%) were identified as being potentially avoidable transfers. Conclusion Many resident transfers might have been avoided with better primary care services in place. Future strategies to improve resident care might include aged care staff skill mix and the availability of outreach or primary care services. [ABSTRACT FROM AUTHOR]

Currently there is very limited research on efficacy and safety of complementary and alternative medicine when consumed by pregnant women. Yet the lack of scientific validation does not appear to be a deterrent and these therapies are becoming increasingly popular with both expectant mothers and midwives. Evidence-based practice provides a structure to encourage good care in a clinical setting. However, there are a number of limitations when applying this approach to complementary therapies as much of the expertise is based on traditional knowledge and empirical wisdom, rather than contemporary scientific experimentation. This article considers the ongoing debate regarding the role of complementary and alternative medicine in a modern maternity setting and how the effectiveness of therapies should be assessed. [ABSTRACT FROM AUTHOR]

Aims and objectives: To describe the risk and frequency of challenges in acute care nursing, and the practice priorities in Australian hospital wards based upon expert consensus. Background: Health care is facing increasing demands that are negatively impacting upon the safety and quality of nursing care. Design: Delphi Method. Method: A three‐round electronic Delphi method was used to collect and synthesise expert consensus opinion of 30 participants in Rounds One and Two of the survey, and 12 participants in Round Three. The study was carried out from July to December 2016. This study complied with the STROBE checklist. Results: High patient acuity or complexity, as well as inadequate bed space on wards, are "very high" risks that occur "often" and "very often," respectively. The pressure to admit patients, delayed medical review and patient boarding are all "high" risks that occur "often." Though only occurring "sometimes," inadequate numbers and skill mix of staff, suboptimal communication and early or inappropriate discharge all pose a "very high" risk to patient care. Conclusion: The key practice priorities for nurse managers should include the design, implementation and evaluation of sustainable system‐wide frameworks, processes and models of care that address patient boarding, communication and discharge processes, job satisfaction, staffing numbers and expertise. Relevance to clinical practice: This study provides a description of the challenges that face acute care nursing in the provision of safe and high‐quality care. [ABSTRACT FROM AUTHOR]