Search

Aim: To explore the satisfaction and experiences of women and staff with the BSOTS in an Australian hospital. Design: Cross‐sectional descriptive survey. Methods: Surveys were distributed to women and staff between February and May 2022. Survey questions reflected satisfaction with triage and provision of care under the BSOTS system (for women) and confidence in using the BSOTS system and its impact on triage‐related care (for staff). Survey data were summarized using descriptive statistics, and qualitative responses were analysed using content analysis. Results: There were 50 women and 40 staff (midwives and doctors) survey respondents. Most women were satisfied with triage wait times, the verbal information they received and the time it took for them to receive care. Nearly all midwife participants indicated they had high knowledge and confidence in using the BSOTS. Most staff indicated that the BSOTS supported the accurate assessment of women and had benefits for women, staff and the hospital. Conclusion: The findings showed that women and staff were satisfied with receiving and providing care in a maternity triage setting under the BSOTS system. Implications for the Profession and/or Patient Care: Implementing standardized maternity triage approaches such as the BSOTS in health settings delivering care to pregnant women is recommended for improving flow of care and perceptions of care quality by women. Impact: Quality of maternity triage processes is likely to impact the satisfaction of women attending services and the staff providing care. The BSOTS was shown to improve maternity triage processes and was associated with satisfaction of women and staff. Maternity settings can benefit from implementing triage approaches such as the BSOTS as it standardizes and justifies the care provided to women. This is likely to result in satisfaction of women and staff engaged in maternity triage and improve the birth outcomes of women and babies. Reporting Method: The reporting of this paper has followed SQUIRE guidelines. Patient or Public Contribution: Women engaged with maternity services were participants in the study but did not contribute to the design, conduct or publication of the study. [ABSTRACT FROM AUTHOR]

Aims To report a systematic review of the psychometric properties of self-report instruments to identify the symptoms of anxiety in pregnancy to help clinicians and researchers select the most suitable instrument. Background Excessive anxiety in pregnancy is associated with adverse birth outcomes, developmental and behavioural problems in infants and postnatal depression. Despite recommendations for routine psychological assessment in pregnancy, the optimal methods to identify anxiety in pregnancy have not been confirmed. Design Psychometric systematic review. Data sources A systematic literature search of the multiple databases (1990-September 2014). Review methods Identification of self-report instruments to measure anxiety in pregnancy using COSMIN guidelines to assess studies reporting a psychometric evaluation of validity and reliability. Results Thirty-two studies were included. Studies took place in the UK, Australia, Belgium, Canada, Germany, Italy, Scandinavia, Spain and the Netherlands. Seventeen different instruments were identified. Measures of validity were reported in 19 papers and reliability in 16. The overall quality of the papers was rated as fair to excellent using the COSMIN checklist. Only one paper scored excellent in more than one category. Conclusion Many instruments have been adapted for use in different populations to those for which they were designed. The State Trait Anxiety Inventory, Edinburgh Postnatal Depression Scale and the Hospital Anxiety and Depression Scale have been tested more frequently than other instruments, yet require further assessment to confirm their value for use in pregnancy. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Advanced Nursing (John Wiley & Sons, Inc.) is the property of John Wiley & Sons, Inc. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Aim: To develop a parsimonious, shortened version of the Perceived Perioperative Competence Scale‐Revised for perioperative nurses to complete as part of their specialty training while retaining good psychometric properties. Design: A longitudinal online survey was adopted. Methods: A national sample of perioperative nurses from Australia completed an online survey at two different time points 6 months apart between February and October 2021. Confirmatory factor analysis was conducted for item reduction and construct validity, while criterion, convergent validity and internal consistency were examined. Results: Usable data for psychometric assessment were obtained from 485 operating room nurses at time 1 and 164 nurses at time 2. The original 40‐item revised scale was reduced to an 18‐item measure, maintaining its six domains. Cronbach's alpha for the 18‐item scale was.92 at time 1 and.90 at time 2. Scale validation demonstrated moderate to weak positive relationships in perceived competence scores relative to general self‐efficacy, years of operating room experience, postgraduate education and recency of training. Conclusions: Results suggest the 18‐item Perceived Perioperative Competence Scale‐Revised Short Form has initial robust psychometric properties and may be implemented in clinical settings as part of perioperative transition‐to‐practice, orientation programs and yearly professional development reviews. Implications for the Profession: This short‐form scale can help prepare perioperative nurses to demonstrate clinical competence in a climate of increasing professional demands using a valid measure of competence required in clinical practice. Impact: Short and validated scales of perioperative competence are needed in clinical practice. Assessment of practising operating room nurses' perceived competence is essential in quality care provision, workforce planning and human resource management. This study provides an 18‐item measure of the previously validated 40‐item Perceived Perioperative Competence Scale‐Revised. This scale can help provide an option for future testing of perioperative nurses' competence in clinical or research settings. Patient or Public Contribution: Perioperative nurses were involved in the design of the study, particularly in the assessment of validation of the tools used in the study. [ABSTRACT FROM AUTHOR]

Aims This study aimed to compare the findings of the quality of nursing doctoral education survey across seven countries and discuss the strategic directions for improving quality. Background No comparative evaluation of global quality of nursing doctoral education has been reported to date despite the rapid increase in the number of nursing doctoral programmes. Design A descriptive, cross-country, comparative design was employed. Methods Data were collected from 2007-2010 from nursing schools in seven countries: Australia, Japan, Korea, South Africa, Thailand, UK and USA. An online questionnaire was used to evaluate quality of nursing doctoral education except for Japan, where a paper version was used. Korea and South Africa used e-mails quality of nursing doctoral education was evaluated using four domains: Programme, Faculty (referring to academic staff), Resource and Evaluation. Descriptive statistics, correlational and ordinal logistic regression were employed. Results A total of 105 deans/schools, 414 faculty and 1149 students/graduates participated. The perceptions of faculty and students/graduates about the quality of nursing doctoral education across the seven countries were mostly favourable on all four domains. The faculty domain score had the largest estimated coefficient for relative importance. As the overall quality level of doctoral education rose from fair to good, the resource domain showed an increased effect. Conclusions Both faculty and students/graduates groups rated the overall quality of nursing doctoral education favourably. The faculty domain had the greatest importance for quality, followed by the programme domain. However, the importance of the resource domain gained significance as the overall quality of nursing doctoral education increased, indicating the needs for more attention to resources if the quality of nursing doctoral education is to improve. [ABSTRACT FROM AUTHOR]

scott k., white k., johnson c. & roydhouse j.k. (2011) Knowledge and skills of cancer clinical trials nurses in Australia. Journal of Advanced Nursing 68(5), 1111-1121. Abstract Aims. This paper is a report of the development and testing of a questionnaire measuring knowledge and skills of cancer clinical trials nurse in Australia. Background. The role of cancer clinical trials nurse, widely acknowledged as an integral member of the clinical research team, has evolved in recent years. Elements of the clinical trials nurse role in cancer have previously been described. To evaluate specific cancer clinical trials nurse educational and training needs, the development of a valid and reliable tool is required. Methods. In 2009, a study was conducted in three stages. Stage I: questionnaire development and pilot testing; stage II: focus group; stage III: national survey. Internal consistency reliability testing and multi-trait analysis of item convergent/divergent validity were employed. Regression analysis was used to identify predictors of clinical trials nurse knowledge and skills. Results. The national survey was a 48-item questionnaire, measuring six clinical trial knowledge and seven skills sub-scales. Of 61 respondents, 90% were women, with mean age 43 years, 19 years as a Registered Nurse and 5 years as a cancer clinical trials nurse. Self-reported knowledge and skills were satisfactory to good. Internal consistency reliability was high (Cronbach's alpha: knowledge = 0·98; skills = 0·90). Criteria for item convergent/divergent validity were met. Number of years as cancer clinical trials nurse was positively related to self-reported knowledge and skills. Conclusion. Preliminary data suggest that the national survey is reliable and valid. Data have contributed to better understanding the knowledge and skills of cancer clinical trials nurse in Australia and development of a postgraduate course in clinical trials. [ABSTRACT FROM AUTHOR]

gardner g., gardner a., middleton s., della p., kain v. & doubrovsky a. (2010) The work of nurse practitioners. Journal of Advanced Nursing 66(10), 2160–2169. Aim. This paper is a report of a study of variations in the pattern of nurse practitioner work in a range of service fields and geographical locations, across direct patient care, indirect patient care and service-related activities. Background. The nurse practitioner role has been implemented internationally as a service reform model to improve the access and timeliness of health care. There is a substantial body of research into the nurse practitioner role and service outcomes, but scant information on the pattern of nurse practitioner work and how this is influenced by different service models. Methods. We used work sampling methods. Data were collected between July 2008 and January 2009. Observations were recorded from a random sample of 30 nurse practitioners at 10-minute intervals in 2-hour blocks randomly generated to cover 2 weeks of work time from a sampling frame of 6 weeks. Results. A total of 12,189 individual observations were conducted with nurse practitioners across Australia. Thirty individual activities were identified as describing nurse practitioner work, and these were distributed across three categories. Direct care accounted for 36·1% of how nurse practitioners spend their time, indirect care accounted for 32·0% and service-related activities made up 31·9%. Conclusion. These findings provide useful baseline data for evaluation of nurse practitioner positions and the service effect of these positions. However, the study also raises questions about the best use of nurse practitioner time and the influences of barriers to and facilitators of this model of service innovation. [ABSTRACT FROM AUTHOR]

Title. Chinese Breast Cancer Screening Beliefs Questionnaire: development andpsychometric testing with Chinese-Australian women. Aim. This paper is a report of the development and psychometric testing of the Chinese Breast Cancer Screening Beliefs Questionnaire, a culturally sensitive questionnaire for measuring Chinese-Australian women’s beliefs, knowledge and attitudes towards breast cancer and breast screening practices. Background. Breast cancer is the leading cause of cancer morbidity among Chinese-Australian women. They are, however, 50% less likely to participate in all types of breast examination. A valid and reliable instrument to explore the breast cancer beliefs is essential for the development of interventions to promote breast cancer screening practices. Method. Items for the questionnaire were drawn from a literature review and in-depth interviews. A panel of professional experts and lay women evaluated face and content validity. The instrument was translated from English to Chinese using back-translation. In 2008, a total of 292 Chinese-Australian women aged 22–78 years who were resident of Australia were included in testing the instrument. Multi-trait analysis and Cronbach’s alpha were used to assess internal consistency reliability and exploratory factor analysis assessed construct validity. Results. The final 13-item questionnaire had satisfactory validity and internal consistency. Cronbach’s alpha for the total scale was 0·76, and for the three subscales ranged from 0·70 to 0·79. Exploratory factor analysis showed that the scale reduced to three factors. Conclusion. Preliminary data suggest that the Chinese Breast Cancer Screening Beliefs Questionnaire is a valid, reliable and culturally sensitive instrument for the measurement of Chinese-Australian women’s beliefs, knowledge and attitudes about breast cancer and breast cancer screening. [ABSTRACT FROM AUTHOR]

tramm r., mccarthy a. & yates p. (2011) Using the Precede-Proceed Model of Health Program Planning in breast cancer nursing research. Journal of Advanced Nursing 68(6), 1870-1880. Abstract Aim. In this article, we discuss the use of the Precede-Proceed model when investigating health promotion options for breast cancer survivors. Background. Adherence to recommended health behaviours can optimize well-being after cancer treatment. Guided by the Precede-Proceed approach, we studied the behaviours of breast cancer survivors in our health service area. Data sources. The interview data from the cohort of breast cancer survivors are used in this article to illustrate the use of Precede-Proceed in this nursing research context. Interview data were collected from June to December 2009. We also searched Medline, CINAHL, PsychInfo and PsychExtra up to 2010 for relevant literature in the English language to interrogate the data from other theoretical perspectives. Discussion. The Precede-Proceed model is theoretically complex. The deductive analytic process guided by the model usefully explained some of the health behaviours of cancer survivors, although it could not explicate many other findings. A complementary inductive approach to the analysis and subsequent interpretation by way of Uncertainty in Illness Theory and other psychosocial perspectives provided a comprehensive account of the qualitative data that resulted in contextually relevant recommendations for nursing practice. Implications for nursing. Nursing researchers using Precede-Proceed should maintain theoretical flexibility when interpreting qualitative data. Perspectives not embedded in the model might need to be considered to ensure that the data are analysed in a contextually relevant way. Conclusion. Precede-Proceed provides a robust framework for nursing researchers investigating health promotion in cancer survivors; however, additional theoretical lenses to those embedded in the model can enhance data interpretation. [ABSTRACT FROM AUTHOR]

Aim: This study aims to evaluate the effectiveness of HealthTracker, a surgical site infection surveillance system that aims to improve the notification of surgical site infection for women after giving birth by caesarean section. Design: This protocol is an intervention study to evaluate the effectiveness of the surveillance system called "HealthTracker" in monitoring surgical site infections post caesarean section. Methods: This study will use a mobile web application to automatically send a text message inviting all women who give birth to a live baby by caesarean section over six months during 2020–2021, at an Australian tertiary referral hospital. The text message invites women to complete a web‐based validated Wound Healing Questionnaire. The estimated number of eligible women in six months is 700 (caesarean section rate: 34% of 4,000 births annually). Intervention: the proposed "HealthTracker" surveillance system facilitates active patient‐reported surgical site infection identification through an automated mobile text message linking women to an individualized online Wound Healing Questionnaire. Discussion: This project aims to provide a consistent, reliable and cost effective surgical site infection surveillance tool to improve post caesarean section surgical site infection reporting, can be scaled for broader utilization and will provide valuable information to decision makers regarding surgical site infection prevention. Impact: Study findings will provide insights into whether HealthTracker is an efficient and cost effective platform for a systematic and consistent approach to surgical site infection surveillance that can be adopted more broadly, across the local health organization, the State and across other surgical specialty areas. This information will equip hospitals and clinicians with knowledge to better identify patient outcomes related to SSI post discharge from hospital and inform decision making related to preventative strategies, providing the necessary momentum to introduce practice change initiatives aimed at reducing surgical site infection rates. Trial Registration: ACTRN12620001233910. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Advanced Nursing (John Wiley & Sons, Inc.) is the property of John Wiley & Sons, Inc. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Journal of Advanced Nursing (John Wiley & Sons, Inc.) is the property of John Wiley & Sons, Inc. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Journal of Advanced Nursing (John Wiley & Sons, Inc.) is the property of John Wiley & Sons, Inc. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Journal of Advanced Nursing (John Wiley & Sons, Inc.) is the property of John Wiley & Sons, Inc. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Journal of Advanced Nursing (John Wiley & Sons, Inc.) is the property of John Wiley & Sons, Inc. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Journal of Advanced Nursing (John Wiley & Sons, Inc.) is the property of John Wiley & Sons, Inc. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Aim: To explore Registered Nurses' attitudes and behaviour towards patients' use of complementary therapies. Background: Despite high rates of use of complementary therapies by the general population, little is known of how nurses respond to patients' use of these therapies. Design: A two-phase sequential exploratory mixed methods design. Methods: Nineteen Registered Nurses working in Australia participated in a semi-structured interview in 2015-2016 and emerging themes informed the development of a quantitative survey instrument administered online nationwide in 2016. Findings: Emerging key themes "Promoting safe care"; "Seeking complementary therapies knowledge";" Supporting holistic health care"; and "Integrating complementary therapies in practice" were reflected in survey results. Survey responses (N = 614) revealed >90% agreement that complementary therapies align with a holistic view of health and that patients have the right to use them. Most nurses (77.5%) discussed complementary therapies with patients and 91.8% believed nurses should have some understanding of the area. One-third did not recommend complementary therapies and there was a lack of overall consensus as to whether these therapies should be integrated into nursing practice. Nurses with training in complementary therapies held more positive views than those without. Conclusion: Nurses were generally supportive of patients' interest in complementary therapies, although their primary concern was safety of the patient. Despite broad acceptance that nurses should have a basic understanding of complementary therapies, there was a lack of consensus about recommendation, integration into nursing practice and referral. Further research should explore how nurses can maintain safe, patient-centred care in the evolving pluralistic healthcare system. [ABSTRACT FROM AUTHOR]

Aim: This study aimed to identify personal, professional and workplace factors that contribute to burnout in midwives. Background: Burnout is prevalent in the midwifery workforce. Burnout adversely affects the well-being of midwives, diminishes the quality of care they provide and can shorten career duration. Design: Self-administered online survey. The survey included the Copenhagen Burnout Inventory and personal and professional variables related to age, children, years of experience, role, model of care and satisfaction with work life. Midwives were invited to participate via an email sent from the Australian College of Midwives and through professional networks between June and July 2014. Variables associated with burnout were entered in a multinomial logistic regression. Results: A total of 1,037 responses were received and 990 analysed. The prevalence of moderate to severe personal (N = 643; 64.9%) and work-related burnout (N = 428; 43.8%) were high. Having children, providing caseload midwifery care and working in a regional area were associated with low burnout. However, midwives registered for 5-10 years were more likely to report work and client-related burnout. Similarly, midwives reporting a lack of satisfaction with work-life balance were also more likely to report personal and work-related burnout. Conclusions: Family-friendly work environments that facilitate work-life balance can help to reduce the personal and organizational costs of burnout. Similarly, providing continuity of midwifery care in a caseload model can facilitate work-life balance and provide significant mental health benefits to participating midwives. [ABSTRACT FROM AUTHOR]

Abstract: Aim: To develop a conceptual model that provides a comprehensive understanding of the structures and processes underpinning patient enablement and satisfaction in general practice nurse consultations. Background: Current evidence regarding patient satisfaction and enablement arising from general practice nursing care is either quantitative or qualitative. To date, no studies have integrated the results of mixed methods research to provide a deeper understanding of processes that facilitate their achievement. Design: A concurrent mixed methods study. Methods: Our 2013–2014 concurrent mixed methods study comprised a quantitative study that analysed variables identified in interviews with general practice nurses, patients and practice managers with data from a cross‐sectional survey of 678 patients receiving nursing care in 21 general practices; and a qualitative study that used a grounded theory approach to in‐depth interviews with nurses and patients from these same practices. Using joint displays, we compared and integrated the results of the multilevel analyses and the grounded theory model derived from these studies. Findings: We conceptualized a model—‘developing a positive patient experience with nurses in general practice’—in which time, continuity of care, nursing scope of practice and autonomy, and patients’ health conditions provide platforms for the processes of triggering healthcare partnerships and tailoring care in nurse consultations. Conclusion: This model builds on previous evidence describing processes and characteristics that optimize the quality of care in general practice nurse consultations. It provides a practical tool to inform education and training for general practice nurses and other clinicians. [ABSTRACT FROM AUTHOR]

Aims To outline the way the culture of austerity arising from the Global Financial Crisis has been used by Australian and New Zealand governments to maintain and extend healthcare budget cuts, through new public management strategies leading to missed nursing care. Background Ten years on the cost of the Global Financial Crisis continues to be borne by tax payers and those employed by the welfare state, yet analysis shows clearly that it was caused by a failure to adequately regulate markets, particularly the banks and multinational corporations. In health care, one of the impacts is increased workload for nurses leading to missed care. Design/Methods Registered Nurses and midwives ( n = 7,302) completed the MISSCARE surveys between 2012 - 2015, in four Australian states and New Zealand providing quantitative and qualitative responses. The qualitative comments were analysed using a template analysis approach based on key features of New Public Management. Findings Sixty-two qualitative responses identified measures in place directly linked to austerity and new public management strategies that impacted on the quality of patient care and nursing work, as well as contributing to missed care. Conclusion Opportunities for resistance may lie outside public and private health organizations in civil society, in the nurse union movements and other health and nursing professional associations. [ABSTRACT FROM AUTHOR]

Aim To use a Delphi panel to determine the relative importance and feasibility of workplace health promotion interventions to promote and support the health of the Australian nursing and midwifery workforce. Background The nursing workforce experiences rates of ill health above that of other workforces, yet there is little investment in workplace health promotion. Design The study used a modified Delphi design conducted between September and November 2015. Methods Eleven of 19 purposively selected expert panellists discussed, rated and provided feedback through two rounds of an electronic questionnaire about the relative importance and feasibility of 46 workplace health promotion interventions and processes for nurses and midwives. Scores for importance and feasibility were calculated and ranked and a composite score of importance multiplied by feasibility. Results Mental health strategies were prioritized as the most important and feasible of the intervention topics, followed closely by healthy eating and physical activity interventions; smoking cessation ranked lowest. The most highly ranked interventions targeted healthy eating, stress management and resilience training. Highest ranked processes to support development of a healthy work environment included intersectoral collaboration and employee wellness groups. Conclusions Study findings prompt consideration of health promotion opportunities to support nurses' health and well-being. Findings identified key workplace health promotion priorities and provide direction for policy makers and managers to promote nursing and midwifery workforce health. [ABSTRACT FROM AUTHOR]

Aims The aim of this study was to explore the extent to which Australian child and family health nurses work with families with complex needs and how their practice responds to the needs of these families. Background Many families with young children face challenges to their parenting capacity, potentially placing their children at risk of poorer developmental outcomes. Nurses increasingly work with families with mental health problems, trauma histories and/or substance dependence. Universal child health services must respond effectively to these challenges, to address health inequalities and to promote the best outcomes for all children and families. Design The descriptive study used cross-sectional data from the first national survey of child and family health nurses in Australia, conducted during 2011. Methods Survey data reported how often, where and how child and family health nurses worked with families with complex needs and their confidence in nursing tasks. Findings Many, but not all, of the 679 respondents saw families with complex needs in their regular weekly caseload. Child and family health nurses with diverse and complex caseloads reported using varied approaches to support their clients. They often undertook additional professional development and leadership roles compared with nurses who reported less complex caseloads. Most respondents reported high levels of professional confidence. Conclusion For health services providing universal support and early intervention for families at risk, the findings underscore the importance of appropriate education, training and support for child and family health professionals. The findings can inform the organization and delivery of services for families in Australia and internationally. [ABSTRACT FROM AUTHOR]

Aims The aim of this study was to investigate the influence of characteristics of nurses' relationship quality with their manager on engagement and trust, onto in-role or discretionary behaviours and intent to quit. Background Nurses having a good relationship with their manager are seen as important, yet the mechanisms of how such relationships are beneficial, or which aspects of the relationship are important, is less clear. Two possible mechanisms are through the nurse being more engaged in work, or through building their trust in their employer. In turn, engagement and trust may impact in-role and discretionary behaviours as well as staff retention. Design Cross-sectional. Method An online survey in 2013 of 459 nurses across Australia. Results Structural analyses indicated that the affect dimension of relationship quality was negatively related to engagement, whereas contribution and respect were positively related to engagement. The affect and respect aspects were positively related to trust. Engagement positively related to discretionary and in-role behaviours. Engagement and trust were negatively related to quit intention, as was the loyalty dimension of the nurses' relationship with their supervisor. However, perceptions of variability in their team's relationship quality with their leader was negatively related to trust and positively related to intent to quit. Conclusions Nurse managers with a nuanced understanding of social exchange at work are likely to maintain more engaged, well-performing and stable nursing teams. In particular, a willingness by the supervisor to come to their nurses' defence and having a consistent standard of relationship quality across their nurses is likely to improve nurse retention. [ABSTRACT FROM AUTHOR]

Background The transition shock or Imposter Phenomena sometimes associated with moving from student to Registered Nurse can lead to feelings of self-doubt and insecurity especially with the increased expectations and responsibilities that registration brings. Aim The aim of this study was to examine the extent at which imposter phenomenon is evident in four final year nursing student cohorts in Australia, New Zealand and the UK. Design A survey design. Settings The study took place at four higher education institutes - two metropolitan campuses and two regional campuses between October 2014 - February 2015 in Australia, New Zealand and the UK. A sample of 223 final year nursing students undertaking nationally accredited nursing programmes were approached. Results Each cohort exhibited mild to moderate feelings of Imposter Phenomena. A positive weak correlation between imposter phenomena and preparedness for practice was found. The New Zealand cohort scored higher than both the Australian and UK cohorts on both feelings of imposterism and preparedness for practice. Conclusions Nursing students possess internalized feelings which suggest their performance and competence once qualified could be compromised. There is some speculation that the respective curriculums may have some bearing on preparing students for registration and beyond. It is recommended that educational programmes designed for this student cohort should be mindful of this internal conflict and potential external hostility. [ABSTRACT FROM AUTHOR]

Aim To determine whether applying forced air warming attenuates the impact of sedation-induced impairment of thermoregulation on body temperature of patients who are sedated during interventional procedures in the cardiac catheterization laboratory. Background A moderate proportion of sedated patients who undergo procedures in the cardiac catheterization laboratory with only passive warming become hypothermic. Hypothermia in the surgical population is associated with increased risk of adverse cardiac events, infections, thrombotic and haemorrhagic complications and prolonged hospital stay. For this reason, investigation of the clinical benefits of preventing hypothermia in sedated patients using active warming is required. Design Randomized controlled trial. Methods A total of 140 participants undergoing elective interventional procedures with sedation in a cardiac catheterization laboratory will be recruited from two hospitals in Australia. Participants will be randomized to receive forced air warming (active warming) or usual care (passive warming with heated cotton blankets) throughout procedures. The primary outcome is hypothermia (defined as temperature less than 36°C) at the conclusion of the procedure. Secondary outcomes are postprocedure temperature, postprocedural shivering, thermal discomfort, major complications, disability-free survival to 30 days postprocedure, cost-effectiveness and feasibility of conducting a larger clinical trial. Discussion The results from this study will provide high-level evidence for practice in an area where there is currently no guidance. Findings will be easily translatable into clinical practice because most hospitals already have forced air warming equipment available for use during general anaesthesia. Registration number: ACTRN12616000013460. [ABSTRACT FROM AUTHOR]

Aim To determine the extent to which competence develops in the first year of nursing practice in a paediatric setting. Background Among all the literature related to nursing competence, there have been few studies that have used a standardized tool to determine the development of professional nursing competence in the first year of practice. Design A quantitative longitudinal design was applied as part of a mixed methods study. Methods Forty seven nurses commencing a 12-month graduate nurse programme were invited to undertake a self-assessment of their level of competence at four time points; commencement, 3 months, 6 months and 12 months, between January 2013-February 2014. The assessment was completed using the Nurse Competence Scale; a questionnaire with 73 items across seven domains of competence. Each item is scored along a visual analogue scale (0-100). Response rates varied from 100% at commencement to 68% at 12 months. Results At commencement, the self-assessed level of overall competence was 41·4, 61·1 at 3 months, 72·9 at 6 months and 76·7 at 12 months. Similar patterns were seen for each domain. Mixed effects model analysis for longitudinal data revealed gains in competence for each of the domains and overall, was statistically significant from commencement to 3 months and 3 months to 6 months. While gains were made between 6-12 months, the results were not statistically significant. Conclusion Graduate nurses showed significant gains in competence in the first 6 months of transition from nursing students to Registered Nurses. [ABSTRACT FROM AUTHOR]

Aim This article describes the rationale, design and methodology of the Building research initiative group: chronic illness management and ad herence in transplantation ( BRIGHT) study. This study of heart transplant patients will: (1) describe practice patterns relating to chronic illness management; (2) assess prevalence and variability of non-adherence to the treatment regimen; (3) determine the multi-level factors related to immunosuppressive medication non-adherence. Background The unaltered long-term prognosis after heart transplantation underscores an urgent need to identify and improve factors related to survival outcomes. The healthcare system (e.g. level of chronic illness management implemented) and patient self-management are major drivers of outcome improvement. Design The study uses a survey design in 40 heart transplant centres covering 11 countries in four continents. Methods Theoretical frameworks informed variable selection, which are measured by established and investigator-developed instruments. Heart transplant recipients, outpatient clinicians and programme's directors complete a survey. A staged convenience sampling strategy is implemented in heart transplant centres, countries and continents. Depending on the centre's size, a random sample of 25-60 patients is selected (N estimated 1680 heart transplant recipients). Five randomly selected clinicians and the medical director from each centre will be invited to participate. Conclusion This is the first multi-centre, multi-continental study examining healthcare system and heart transplant centres chronic illness management practice patterns and potential correlates of immunosuppressive medication non-adherence. The knowledge gained will inform clinicians, researchers and healthcare policy makers at which level(s) interventions need to be implemented to improve long-term outcomes for transplant recipients. [ABSTRACT FROM AUTHOR]

Aims To explore the complex relationships between nurses' personal resources, job satisfaction and 'customer' (patient) orientation. Background Previous research has shown that nursing is highly intensive, emotionally charged work, which affects nurses' job performance and their customer orientation as well as patient or 'customer' satisfaction. This study contributes to the literature by examining how nurses' personal resources relate to their personal satisfaction and customer orientation and the relationships between them. Specifically, this study explores the effects of two facets of emotional labour (deep acting and surface acting), empathic concern, self-efficacy and emotional exhaustion on personal job satisfaction and customer orientation. We also test the moderating effects of inauthenticity and emotional contagion. Design A quantitative survey. Method Data were collected through a self-completion questionnaire administered to a sample of 159 Australian nurses, in a public teaching hospital, in 2010. The data were analysed using Partial Least Square analysis. Results Partial Least Square analysis indicates that the final model is a good fit to the data (Goodness of Fit = 0·51). Deep acting and surface acting have different effects (positive and negative) on job satisfaction and 'customer' orientation, self-efficacy has a positive effect on both and emotional exhaustion has a positive effect on customer orientation and a negative effect on job satisfaction. The moderating effects of emotional contagion and empathic concern, in the final model, are discussed. Conclusions Understanding the complex interactions between personal resources, job satisfaction and customer orientation helps to increase service providers' (nurses in this study) personal satisfaction and 'customer' orientation particularly in difficult contexts. [ABSTRACT FROM AUTHOR]

Aim To develop and psychometrically test the Paediatric Intensive Care Unit-Nursing Knowledge and Skills Test - a multiple-choice test for measuring the key nursing knowledge and skills required for safe, competent practice. Background Intensive care graduate nurse residency or orientation programmes are key strategies in the development of safe and competent practitioners. Essential to these programmes is an evaluation of knowledge and skills. Multiple-choice examinations provide a valuable way of evaluating broad knowledge and skills; however, there has been limited work in this area to date. Design Psychometric evaluation. Methods The instrument was administered to 79 nurses from four paediatric intensive care units in Australia and New Zealand over 18 months between 2008-2010. Internal consistency using Kuder-Richardson 20, item analysis and construct validity using the 'known groups' technique were explored. Results Kuder-Richardson 20 reliability estimate for the 109-item test was 0·85. Instrument scores were significantly higher amongst nurses with postgraduate education and more years of paediatric intensive care experience. Item difficulty indices ranged from 0·08 to 1, with a mean item difficulty of 0·66. Item discrimination ranged from 0·2-0·8. Conclusion Testing of the instrument demonstrated encouraging psychometric properties. With additional refinement, this tool could provide educators and managers with an instrument to assist in the assessment of knowledge and skill acquisition. The instrument requires further testing in different samples of paediatric intensive care nurses to enable validation in other settings and cross-cultural comparisons. [ABSTRACT FROM AUTHOR]

Aim To investigate whether overlapping blood pressure and heart rate graphs improve chart-users' ability to recognize derangements in these vital signs on hospital observation charts. Background Many health professionals prefer blood pressure and heart rate graphs to overlap. One justification is the use of a visual cue called the 'Seagull Sign' to detect physiological abnormalities. Design A 3 × 2 × 2 mixed-design experiment, with three independent variables: participant group, graph format (separate vs. overlapping) and alerting system (integrated colour-based track-and-trigger system present vs. absent). Methods Over 64 experimental trials, 'Seagull-trained' nurses and novices randomly assigned to receive 'Seagull training' or remain untrained, viewed sequences of blood pressure and heart rate observations recorded on four different chart design extracts. The designs represented a crossing of the graph format and alerting system variables. For each design, eight cases contained normal data and eight contained an abnormal systolic blood pressure or heart rate observation (half of which yielded a Seagull Sign on overlapping plots). Participants (tested between January-May 2011) judged whether observations were physiologically normal or abnormal. Results Across all cases, participants from all groups responded faster and made fewer errors when blood pressure and heart rate observations were graphed separately, especially when a track-and-trigger system was present. Even for 'Seagull-trained' participants viewing 'Seagull Sign available' cases, no advantage of overlapping graphs was found. Conclusions These findings suggest that overlapping graphs do not yield the performance advantage that many health professionals assume, either for novices or experienced nurses, even when the Seagull Sign is used. [ABSTRACT FROM AUTHOR]

Aim This report describes the results from the last international prevalence measurement of care problems in the Netherlands, Austria and Switzerland, including the course of the prevalence rates during the past 4 years. Background Basic care problems such as pressure ulcers, malnutrition and falls occur frequently in healthcare organizations. Measuring these care problems provides insight into their occurrence, and, while a measurement is included of the prevention, treatment and structural quality indicators, this gives institutions the possibility of improving their care regarding these care problems. Design An annual cross-sectional multicentre study. Method The prevalence measurement of care problems is conducted annually on one specific day in different healthcare settings, among which are hospitals and care homes. Data are collected by means of a comprehensive, standardized questionnaire that comprises three levels: institutional, ward/department and patient level. Results Besides general characteristics of patients, results are presented for prevalence rates, prevention, treatment and quality indicators regarding each care problem for each country. [ABSTRACT FROM AUTHOR]

Aim To report a study in Australian operating theatres of compliance by the anaesthetic team with best peripheral arterial catheter practice for blood gas sampling and infection prevention. Comparisons are made with research recommendations and Centres for Disease Control Guidelines. Background There is wide global usage of peripheral arterial catheters in the operating theatre for haemodynamic monitoring and blood gas analysis. Frequent blood sampling from arterial catheters can lead to statistically significant blood loss and provide an infective potential. Evidence-based research and clinical guidelines prescribe best practice. Design Cross-sectional descriptive survey Methods Data were collected in 2009 from 64 major Australian hospitals using a self-designed internet survey. Results/Findings Hand hygiene prior to catheter insertion was the only infection prevention practice entirely adherent with guidelines. The recommended ratio of discard to dead space volume of 2:1 to decrease unnecessary blood loss during blood gas sampling was reported by only 11 (17%) respondents. Less than 32 (50%) respondents used the preferred solution, chlorhexidine to disinfect the insertion site. Access ports were reported as 'never disinfected' before use by 30 (47%) respondents. Conclusion The complex operating theatre environment presents barriers, which contribute to non-adherence with guidelines. These barriers need to be identified to plan strategies for improvement. A quality audit tool is proposed for development by nurses in collaboration with the anaesthetic team, providing a needed method to assess ongoing compliance with best peripheral arterial catheter care. Further international research would test the generalizability of our Australian findings. [ABSTRACT FROM AUTHOR]

lodewijckx c., sermeus w., panella m., deneckere s., leigheb f., troosters t., boto p.a., mendes r.v., decramer m. & vanhaecht k. (2012) Quality indicators for in-hospital management of exacerbation of chronic obstructive pulmonary disease: results of an international Delphi study. Journal of Advanced Nursing 69(2), 348-362. doi: 10.1111/j.1365-2648.2012.06013.x Abstract Aim. To report a Delphi study that was conducted to select process and outcome indicators that are relevant to study quality of care and impact of care pathways for patients hospitalized with exacerbation of chronic obstructive pulmonary disease. Background. Management of patients hospitalized with exacerbation of chronic obstructive pulmonary disease is suboptimal and outcomes are poor. To evaluate the impact of care pathways properly, relevant indicators need to be selected. Design. Delphi study. Methods. The study was conducted over 4 months in 2008, with 35 experts out of 15 countries, including 19 medical doctors, 8 nurses and 8 physiotherapists. Participants were asked to rate, for 72 process and 21 outcome indicators, the relevance for follow-up in care pathways for in-hospital management of exacerbation of chronic obstructive pulmonary disease. Consensus (agreement by at least 75% of the participants) that an indicator is relevant for follow-up was sought in two rounds. Results. Consensus was reached for 26 of 72 process indicators (36·1%) and 10 of 21 outcome indicators (47·6%). Highest consensus levels were found for the process indicators regarding oxygen therapy (100%), pulmonary rehabilitation (100%) and patient education (94·5-88·6%) and for the outcome indicators concerning understanding of therapy (91·4-85·7%) and self-management (88·6-88·2%). Conclusion. The selected indicators appear to be sensitive for improvement. Therefore, researchers and clinicians that want to study and improve the care for patients hospitalized with exacerbation of chronic obstructive pulmonary disease should primarily focus on these indicators. [ABSTRACT FROM AUTHOR]

bartram t., casimir g., djurkovic n., leggat s.g. & stanton p. (2012) Do perceived high performance work systems influence the relationship between emotional labour, burnout and intention to leave? A study of Australian nurses. Journal of Advanced Nursing 68(7), 1567-1578. Abstract Aims. The purpose of this article was to explore the relationships between perceived high performance work systems, emotional labour, burnout and intention to leave among nurses in Australia. Background. Previous studies show that emotional labour and burnout are associated with an increase in intention to leave of nurses. There is evidence that high performance work systems are in association with a decrease in turnover. There are no previous studies that examine the relationship between high performance work systems and emotional labour. Design. A cross-sectional, correlational survey. Methods. The study was conducted in Australia in 2008 with 183 nurses. Three hypotheses were tested with validated measures of emotional labour, burnout, intention to leave, and perceived high performance work systems. Principal component analysis was used to examine the structure of the measures. The mediation hypothesis was tested using Baron and Kenny's procedure and the moderation hypothesis was tested using hierarchical regression and the product-term. Results. Emotional labour is positively associated with both burnout and intention to leave. Burnout mediates the relationship between emotional labour and intention to leave. Perceived high performance work systems negatively moderates the relationship between emotional labour and burnout. Perceived high performance work systems not only reduces the strength of the negative effect of emotional labour on burnout but also has a unique negative effect on intention to leave. Conclusion. Ensuring effective human resource management practice through the implementation of high performance work systems may reduce the burnout associated with emotional labour. This may assist healthcare organizations to reduce nurse turnover. [ABSTRACT FROM AUTHOR]

Aim. The aim of the study was to determine current national urinary incontinence management practices in Australian acute stroke units and their concordance with the National Stroke Foundation guidelines. Background. Urinary incontinence is a common consequence after stroke and a statistically significant indicator of poor outcome, including disability and admission to institutional care. The National Stroke Foundation has produced guidelines for the acute and post-acute phase of care, offering Australian nurses evidence-based recommendations regarding stroke management including the management of urinary incontinence. Method. In 2007-2008, dedicated acute stroke units in Australia were identified and a senior nurse from each unit was invited to participate in a 10-minute telephone survey to ascertain their current urinary continence management practices. Results. Representatives from 41 acute stroke units participated in the survey (response rate 98%). Participants from less than half of the units reported that they had a formal plan for urinary incontinence management (n = 19, 46%), and the majority of those who did not would find a formal plan useful (n = 15, 79%). Two-thirds of respondents stated that they would manage urinary incontinence with indwelling catheterization (n = 25, 61%). Only 30% (n = 12) were 'satisfied' or 'very satisfied' with urinary continence management in their acute stroke unit. Conclusion. A large proportion of acute stroke units were yet to establish formal urinary incontinence management plans. The implementation of evidence-based urinary incontinence management plans after stroke is integral to improving patient outcomes. An increase in resources for professional development in the assessment, treatment and management of urinary incontinence is essential to improve and maintain skills in after-stroke care. [ABSTRACT FROM AUTHOR]