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Accessible Summary: What is known on the subject?: Consumer participation in mental health services is embedded in mental health policy in many countries. The negative attitudes of nurses and other health professionals to consumer participation poses a significant obstacle to this policy goalInvolving mental health "Experts by Experience" in the education of nursing students demonstrates positive attitudinal change What this paper adds to existing knowledge?: More detailed understanding of nursing students' experiences and perspectives about being taught mental health nursing by "Experts by Experience"An international focus, extending understandings about how Experts by Experience might be perceived in a broader range of countries What are the implications for practice?: Positive attitudes towards people labelled with mental illness are essential for quality nursing practiceNurses have an important leadership role in facilitating consumer participation within health services. It is critical that their attitudes are professional and optimistic. Introduction: Consumer participation is central to mental health policy. Negative attitudes of health professionals are barriers to realizing policy goals. Evidence suggests consumers (Experts by Experience) can influence positive attitudes in nursing students. Research in this area to date is limited and primarily from Australia and New Zealand. Aim: To enhance understanding of nursing students' perspectives and experiences of being taught mental health by an Expert by Experience. Method: A qualitative exploratory approach was used. Focus groups were conducted with nursing students from seven universities in Australia and Europe. Data were analysed thematically. Results: Student participants described how exposure to Experts by Experience challenged their views and attitudes and provided a mechanism for reflection, critique and change. The main theme "changing mindset" includes two subthemes: exposing stereotypes and reflection. Discussion: This unique international study demonstrates the capacity for Experts by Experience to contribute to positive attitudinal change towards mental illness in nursing students. This changed mindset must occur for policy goals to be realized. Implications for practice: Nurses in all areas of practice will work with people labelled with mental illness and experiencing mental distress. Overcoming stereotypes and adopting more positive attitudes is essential to deliver quality mental health care. [ABSTRACT FROM AUTHOR]

Aims To synthesize evidence and knowledge from published research about nurses' experiences of nurse-patient relationships with adult patients in general, acute inpatient hospital settings. Background While primary research on nurses' experiences has been reported, it has not been previously synthesized. Design Meta-ethnography. Data sources Published literature from Australia, Europe, and North America, written in English between January 1999-October 2009 was identified from databases: CINAHL, Medline, British Nursing Index and Psyc INFO. Review methods Qualitative studies describing nurses' experiences of the nurse-patient relationship in acute hospital settings were reviewed and synthesized using the meta-ethnographic method. Results Sixteen primary studies (18 papers) were appraised as high quality and met the inclusion criteria. The findings show that while nurses aspire to develop therapeutic relationships with patients, the organizational setting at a unit level is strongly associated with nurses' capacity to build and sustain these relationships. The organizational conditions of critical care settings appear best suited to forming therapeutic relationships, while nurses working on general wards are more likely to report moral distress resulting from delivering unsatisfactory care. General ward nurses can then withdraw from attempting to emotionally engage with patients. Conclusion The findings of this meta-ethnography draw together the evidence from several qualitative studies and articulate how the organizational setting at a unit level can strongly influence nurses' capacity to build and sustain therapeutic relationships with patients. Service improvements need to focus on how to optimize the organizational conditions that support nurses in their relational work with patients. [ABSTRACT FROM AUTHOR]

Aim and objectives: To explore the family's experience being offered memory making during end‐of‐life care in the adult intensive care unit and its use in early bereavement. Background: Family members of individuals who develop a critical illness requiring emergency hospitalisation are unlikely to be prepared for a possible death. This places them at increased risk of poorer bereavement experiences. One potential intervention is memory making, which is an act that provides tangible objects such as a handprint, footprint, lock of hair, or teddy bear, that allows connections with and provides meaningful memories about a person. Families in the adult acute population reportedly have positive reactions regarding the objects, but it is unknown the object's effects on early bereavement experiences. Design: Descriptive qualitative study utilising inductive reflexive thematic analysis. Reporting adheres to the COREQ checklist. Methods: Between May 2019‐December 2020, a purposeful, convenience sample of 21 participants from a tertiary referral, adult intensive care unit in Australia were recruited to explore their experiences being offered memory making during end‐of‐life care and the objects use in early bereavement. Interviews were conducted using a semi‐structured format and occurred at the participants' location of choice. Results: Data analysis generated three themes: guidance during end of life by healthcare professionals that recognises the autonomy of the family; object used as a trigger to access memories; and storage and preservation of the object as an indication of its sentimental value and use in early bereavement Conclusion: Memory making objects such as handprints, locks of hair, or teddy bears received in the adult intensive care unit were valued and utilised during early bereavement by most recipients. Relevance to clinical practice: Findings inform practice evidence gaps regarding the family's experiences of memory making received as a bereavement intervention in the adult acute population. Patient or public contribution: Participants contributed through sharing their first‐hand experiences of receiving memory making in the adult intensive care unit. [ABSTRACT FROM AUTHOR]

Aims: To explore the perceptions of women with lived experience of domestic and family violence on accessing healthcare and to identify how nurses can facilitate and support women experiencing domestic and family violence to receive the care they need. Design: A qualitative single site study. Methods: As part of an evaluation of a nurse‐led domestic and family violence service, a 2‐h focus group was conducted with four women with lived experience of domestic and family violence on 14 December 2021. The Levesque Framework provided a novel approach to identify barriers and facilitators to healthcare access. The focus group guide included eight open‐ended questions. The audio recording was transcribed and analysed using Braun and Clark's thematic analysis process. Results: The Levesque Framework helped highlight individual and structural challenges in accessing healthcare faced by women experiencing domestic and family violence. Dominant themes were first contact, comprehensiveness of services and domestic violence awareness. Conclusion: The growing incidences of domestic and family violence are confounding communities worldwide. Despite the high profile of domestic and family violence in Australia, access to healthcare remains problematic. These preliminary findings suggest that nurses have opportunities to facilitate access in relation to the approachability, acceptability and appropriateness of services. Realizing these opportunities requires education that enables nurses' capacity to provide an effective first contact and facilitate comprehensive care by embodying a no wrong door culture. We intend to explore these concepts in future focus groups. Impact This study explored the factors impacting access to healthcare for women experiencing domestic and family violence. Accessing healthcare when experiencing domestic and family violence in Australia is problematic. Findings suggest that nursing has opportunities to facilitate the approachability, acceptability and appropriateness of services. These findings will be valuable to nurses across all healthcare settings, nursing education providers and health workforce planners. [ABSTRACT FROM AUTHOR]

Aims and objectives To explore the experiences of chronic obstructive pulmonary disease ( COPD) amongst individuals who have a high frequency of presentations to the Emergency Department and their carers. Background Patients with COPD are amongst the most frequent attenders in the Emergency Department despite the chronic nature of their condition. Good self-management has previously been identified as a key to maintaining health and reducing COPD exacerbations. There has been limited investigation of those with COPD who frequently attend the Emergency Department. Design Descriptive qualitative phase of a mixed methods study. Methods Individuals who had attended an Emergency Department within a single health district at least three times in the previous year for COPD were invited to participate in semistructured face-to-face interviews. A total of 19 individuals consented to participate, of whom 12 were male. Half of the interviews included both those with COPD and carers. Data were audio-recorded and transcribed, before being analysed using thematic analysis. Results Five main themes emerged from the data, namely (i) a sense of grief, loss and guilt, yet hope for the future; (ii) the impact on carers; (iii) the end point of self-management; (iv) the healthcare experience; and (v) the primary care experience. Conclusion The experience of individuals with COPD who frequently present to the Emergency Department and their carers highlights the complexity of living with this disease. Providing effective intervention to manage exacerbation requires an understanding of the issues that are faced by patients and their carers. Clear systems and skills for sharing information are essential to decrease avoidable use of the Emergency Department. [ABSTRACT FROM AUTHOR]

Aims and Objectives To explore nurses' views of the barriers and facilitators to the use of a newly devised patient-centred pressure ulcer prevention care bundle. Background Given pressure ulcer prevention strategies are not implemented consistently, the use of a pressure ulcer care bundle may improve implementation given bundles generally assist in standardising care. Design A quality improvement project was undertaken after a pressure ulcer prevention care bundle was developed and pilot-tested. Methods Short, conversational interviews with nurse explored their views of a patient-centred pressure ulcer care bundle. Interviews were audio-taped and transcribed. Inductive content analysis was used to analyse the transcripts. Results A total of 20 nurses were interviewed. Five categories with corresponding subcategories emerged from the analysis. They were increasing awareness of pressure ulcer prevention, prompting pressure ulcer prevention activities, promoting active patient participation, barriers to using a pressure ulcer prevention care bundle and enabling integration of the pressure ulcer prevention care bundle into routine practice. Conclusions Benefits of using a patient-centred pressure ulcer prevention care bundle may include prompting patients and staff to implement prevention strategies and promote active patient participation in care. The success of the care bundle relied on both patients' willingness to participate and nurses' willingness to incorporate it into their routine work. Relevance to Clinical Practice A patient-centred pressure ulcer prevention care bundle may facilitate more consistent implementation of pressure ulcer prevention strategies and active patient participation in care. [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]

Aims and objectives To identify nurse perceptions on the potential value of general and specific nursing approaches to improving physical health outcomes of people with serious mental illness. Background People diagnosed with serious mental illnesses experience heightened rates of physical illnesses and can be supported better via healthcare system prevention and management. Nurses working in mental health are a critical part of a system-wide approach to improving physical health care, but there is little known on their views on specific approaches within Australia (e.g. screening for risks, stigma reduction). Design A national, cross-sectional and nonrandom survey study delivered online. Methods Members of the Australian College of Mental Health Nurses ( n = 643), representing nurses employed in mental healthcare services across Australia (71·6% from public mental health services). Participants were asked to rate the potential of nine nurse-based strategies for improving physical health (options: 'yes', 'no', 'not sure') and the potential value of 10 nursing and general strategies for improving physical health (rating from 'negative value' to 'significant value'). Results There was a high endorsement of all nine nurse-based strategies for physical health (e.g. lifestyle programmes, screening, linking services), although there was less support for reducing antipsychotics or advocating for fewer side effects. Participants mainly viewed all strategies as of moderate to significant value, with the most promising value attached to colocation of primary and mental care services, lifestyle programmes and improving primary care services (reduce stigma, train GPs). Conclusions Australian nurses working in mental health services view a range of nurse-based strategies for improving physical healthcare services and standards as important. Relevance to clinical practice Nurses collectively need to work with consumers, health agencies and the general public to further define how to organise and implement physical health integration strategies, towards more comprehensive health care of people with serious mental illness. [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]

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]

Aim. To identify indicators of quality nursing care by identifying structures, processes and outcomes perceived as valid, feasible, reliable and suitable for Australian paediatric hospitals by nursing experts. Background. Although measuring the quality of nursing care in acute care settings is being practised, there are few indicators validated for use in paediatric nursing. Using adult indicators for quality care measures in children's nursing has inherent problems. To contribute to quality improvement and safety in the paediatric population, it is essential to identify and validate indicators that will be useful in this context. Design. A modified Delphi technique. Method. Fifty-seven indicators that potentially measure the quality of nursing care in paediatrics were identified following a review of the literature. Three online surveys where panellists rated these indicators for perceived validity in paediatric nursing, feasibility of data collection, reliability based on existing documentation and suitability in the paediatric context were completed between March-May 2010. Results. Fifty-two nurses contributed to the expert panel. Consensus of 75% for validity in paediatric nursing was reached on 42 indicators, which were then ranked for suitability of use. Nineteen indicators were deemed inappropriate, which included indicators commonly used in adult settings. Conclusion. Face and content validity were reached for 42 indicators identified as potential valid measures of quality care in paediatric nursing. Further work is required to solve issues of reliability and feasibility of data collection and to ascertain whether the indicators occur frequently enough within Australian hospitals to be clinically useful. Relevance to clinical practice. Identification of nursing-sensitive indicators that are valid in the paediatric setting is the first step in measuring the quality of care provided to children. Once established, measurement of the indicators may lead to improved patient safety and care in hospitals. [ABSTRACT FROM AUTHOR]