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Aim: To develop and test the psychometric properties of an expanded catheter self‐management scale for patients with in‐dwelling urinary catheters. Design: A cross‐sectional validation study. Despite the utility of the original 13‐item catheter self‐management scale, this instrument did not include bowel management, general hygiene and drainage bag care, which are fundamental skills in urinary catheter self‐management to prevent common problems resulting in unnecessary hospital presentations. The expanded catheter self‐management scale was developed with 10 additional items to comprehensively assess all five essential aspects of urinary catheter self‐management. Methods: A total of 101 adult community‐dwelling patients living with indwelling urinary catheters were recruited from Western Sydney, Australia. Using exploratory factor analysis with Varimax rotation, the number of factors to be extracted from the expanded 23‐item expanded catheter self‐management scale was determined using a scree plot. The reliability of the overall scale and subscales was measured using Cronbach's alpha. Convergent validity was assessed using Spearman's correlations between clinical characteristics, overall scale and subscales. Results: The 23‐item expanded catheter self‐management scale yielded a 5‐factor solution, labelled as: (i) self‐monitoring of catheter function, (ii) proactive, help‐seeking behaviour function, (iii) bowel self‐care function, (iv) hygiene‐related catheter site function and (v) drainage bag care function. Cronbach's alpha of the expanded catheter self‐management scale indicating all 23 items contributed to the overall alpha value. Convergent validity results showed a negative correlation between the overall expanded catheter self‐management scale and catheter‐related problems. Conclusion: The 5‐factor structure provided a comprehensive assessment of key aspects of urinary catheter self‐management essential to reduce the likelihood of catheter‐related hospital presentations. Implications: The expanded catheter self‐management scale can be used to assess and monitor effective patient‐centred interventions for optimal self‐management to prevent catheter‐related problems and improve the quality of life of patients. Impact: Many patients start their journey of living with a urinary catheter unexpectedly and are not supported with quality information to care for their catheter.The findings of this study show the correlation between catheter self‐management skills and catheter‐related problems.The expanded catheter self‐management scale (E‐CSM) assists with analysing the self‐management skills of patients living with a catheter and developing tailored interventions to prevent problems and improve their quality of life. In addition, this screening tool can be included in policies, guidelines, and care plans as a standard for improving catheter management and developing educational resources for patients. Reporting Method: STROBE checklist was used to report all aspects of this study comprehensively and accurately. Patient or Public Contribution: Patients living with indwelling urinary catheter and their carers have participated in surveys, interviews and co‐designing interventions. This paper reports the psychometric analysis of the expanded catheter self‐management scale (E‐CSM) used in the patient survey as part of the main study 'Improving Quality of Life of Patients Living with Indwelling Urinary Catheters: IQ‐IDC Study' (Alex et al. in Collegian, 29:405–413, 2021). We greatly value our consumers' contributions and continue to communicate the progress of the study to them. Their contributions will be acknowledged in all publications and presentations. In addition, all participants will be provided the option of receiving the interventions and publications generated from this study. [ABSTRACT FROM AUTHOR]

Objective: Health literacy is an important predictor of health outcomes. The Health Literacy Questionnaire has been widely adopted to measure health literacy and has been translated into multiple languages including Chinese. This study aims to evaluate the psychometric properties of the simplified Chinese Health Literacy Questionnaire. Methods: Data were obtained from a sample of 362 Chinese immigrants from Chinese community organizations in New South Wales, Australia. Statistical analyses include descriptive and exploratory factor analyses. Results: A seven‐factor solution was derived from 39 of the original 44 items, all with acceptable to excellent internal consistency but differing from the original construction. The health literacy subscale scores were negatively associated with age and with age at immigration, but positively associated with duration of stay (years) in Australia, better English proficiency and current employment. Differing interpretations of the questions based on Chinese culture could possibly explain the variations between the two versions. Conclusion: The simplified Chinese Health Literacy Questionnaire measures some central concepts of health literacy well. However, the questionnaire may require further development, especially in linguistic and cultural aspects. SUMMARY STATEMENT: What is already known about this topic? The Health Literacy Questionnaire has been translated and validated in multiple languages with good reliability and validity. What this paper adds? The study addresses issues that may be related to cultural adaptation and language interpretation of the simplified Chinese version of the Health Literacy Questionnaire. The implications of this paper: It is important for researchers and clinicians to evaluate the cultural sensitivity of translated questionnaires within the specific context before application. [ABSTRACT FROM AUTHOR]

Aims and objectives The aim of the Paediatric International Nursing Study was to explore the utility of key performance indicators in developing person-centred practice across a range of services provided to sick children. The objective addressed in this paper was evaluating the use of these indicators to benchmark services internationally. Background This study builds on primary research, which produced indicators that were considered novel both in terms of their positive orientation and use in generating data that privileges the patient voice. This study extends this research through wider testing on an international platform within paediatrics. Design The overall methodological approach was a realistic evaluation used to evaluate the implementation of the key performance indicators, which combined an integrated development and evaluation methodology. Methods The study involved children's wards/hospitals in Australia (six sites across three states) and Europe (seven sites across four countries). Qualitative and quantitative methods were used during the implementation process, however, this paper reports the quantitative data only, which used survey, observations and documentary review. Results The findings demonstrate the quality of care being delivered to children and their families across different international sites. The benchmarking does, however, highlight some differences between paediatric and general hospitals, and between the different key performance indicators across all the sites. Conclusions The findings support the use of the key performance indicators as a novel method to benchmark services internationally. Whilst the data collected across 20 paediatric sites suggest services are more similar than different, benchmarking illuminates variations that encourage a critical dialogue about what works and why. Relevance to clinical practice The transferability of the key performance indicators and measurement framework across different settings has significant implications for practice. The findings offer an approach to benchmarking and celebrating the successes within practice, while learning from partners across the globe in further developing person-centred cultures. [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]

Aims and objective: To capture the experiences of nurses in relation to the acutely physiologically deteriorating consumer. Background: Improving the physical health care of consumers with mental illness has been widely adopted as a priority for mental health nursing. Much of the effort thus far has focused on routine screening, prevention and treatment of common comorbidities including cardiovascular disease, diabetes mellitus and cancer. There has been less focus on the acutely physiologically deteriorating consumer in the mental health setting. Further study is warranted since this issue poses a set of highly complex challenges for nurses within the inpatient setting. Method: An exploratory, descriptive study was employed using focus groups to gather narrative data, which was then subject to qualitative analysis. Eleven mental health inpatient wards within a local health district in Sydney, Australia, were studied, comprising ward‐based nurses (n = 64) and nurse unit managers (n = 8). This paper follows the COREQ guidelines for reporting qualitative health research. Results: Qualitative data analysis revealed three themes central to the nurses' experience: (a) lack of clarity (subthemes: procedures and leadership accountability); (b) confidence in the workforce (subthemes: knowledge and skills, training needs, relevant experience, collaboration with emergency and medical teams, stigmatising attitudes); and (c) complexity (subthemes: complexity as the new norm and suitability of the mental health environment). Conclusion: The themes found in this study can be used to guide and inform healthcare policy, protocols, education and processes around building a more confident nurse workforce for the acutely physiologically deteriorating consumer. Relevance to clinical practice: Findings provide a rich data set for the generation of measurement tools and protocols to guide physical health care and evaluate performance. [ABSTRACT FROM AUTHOR]

Background: Strict patient isolation in hospital is associated with adverse health outcomes. However, there is a lack of high‐quality evidence for effective interventions to improve safety and quality of care for these patients. Aims: To identify patient reported areas for improvement in the care of patients in hospital isolation and to determine the feasibility of collecting patient reported outcomes using validated tools. Methods: Design: An exploratory mixed methods study. Setting: A major metropolitan teaching hospital in Melbourne, Australia. Participants: Patients in hospital isolation for transmissible infections. Data collection: Data were collected by (1) phone interviews with patients in isolation and (2) seven validated measurement tools to assess cognition, loneliness, nutritional status, quality of life, anxiety and depression and physical activity. Data were collected between September and December 2021. Data analysis: Interviews were transcribed and analysed using thematic analysis. Quantitative data were analysed descriptively including participant characteristics and outcome data. Results: Participants identified areas for improvement including activities to decrease boredom, more contact with staff to mitigate loneliness and increase comfort care, and formalised communication about clinical treatment and discharge plan. Patients with gastrointestinal symptoms were happier to be alone. There were operational challenges within the health service including delays and miscommunication. Only 70% of the participants completed all questionnaires. Conclusion: This study identified areas for improvement in care of patients in isolation and demonstrated that collecting patient reported outcomes using validated tools was feasible. The results of this research will inform development of an intervention to manage adverse effects. Implications for the Profession and/or Patient Care: Patients in hospital isolation require additional consideration to ensure that their needs are met to avoid adverse outcomes. The patient experience and comfort can be negatively affected when fundamental care is lacking. Reporting Method (EQUATOR): EQUATOR guidelines for Mixed Methods Reporting in Rehabilitation & Health Sciences (MMR‐RHS). Patient or Public Contribution: Thirteen patients in hospital isolation agreed to participate in this study, sharing their experiences through interviews and assessment. [ABSTRACT FROM AUTHOR]

Aims and objectives: This qualitative study explored the experiences of neonatal nurses with facilitating closeness between parents and babies with congenital abnormalities in the neonatal intensive care unit (NICU). Background: Babies with congenital abnormalities often require admission to the neonatal intensive care unit. Parents may experience emotional distancing from their baby, due to their response to their baby's congenital abnormality, as well as physical separation due to their baby's hospitalisation in the NICU. NICU nurses can help facilitate the development of closeness between babies and parents in the NICU. Method: This qualitative interpretive description study involved face‐to‐face, semi‐structured interviews with twelve neonatal nurses following which the data collected were thematically analysed. The consolidated criteria for reporting qualitative research (COREQ) checklist were used in preparing this paper. Results: Three major themes emerged from the analysis—"Everyone copes differently," "You have to focus on what is the normal thing" and "It's very much an individualised approach." Participants often felt unprepared to care for babies with congenital abnormalities and implemented coping mechanisms to overcome the emotional labour they experienced. Skin‐to‐skin cuddles were considered the most beneficial strategy for parents to develop closeness with their baby. Participants recognised that they sometimes "pushed" parents into engaging with their baby. Participants highlighted the importance of individualised, supportive care for these parents. Conclusions: Neonatal nurses require increased education about congenital abnormalities and individualised care to support them in caring for babies with congenital abnormalities. Relevance to clinical practice: Further research is needed on parental experience of developing closeness with a baby with a congenital abnormality in the NICU. [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.)

Accessible summary What is known on the subject? The only previous quantitative study that examined nurses' use of assessment tools to identify antipsychotic medication side effects found that about 25% of mental health nurses were using assessment tools., No previous studies have examined factors that influence the manner in which mental health nurses assess antipsychotic medication side effects., What this paper adds to existing knowledge? One-third of the respondents were not aware of any antipsychotic medication side-effect assessment tool, and only one-quarter were currently using an assessment tool., 'Service responsibility' was significantly associated with ongoing use of antipsychotic medication assessment tools, indicating that respondents with more positive attitudes to their service were more likely to continue using antipsychotic medication assessment tools., What are the implications for practice? The low level of awareness and use of antipsychotic medication side-effect assessment tools indicates that nursing educational institutions should incorporate more detail about these tools in course content, and emphasize in particular the benefits that result from the use of these tools in clinical practice., Service processes contributed significantly to the use of antipsychotic medication assessment tools, which indicates that managers need to foster workplace cultures that promote routine use of these tools., Abstract Introduction Limited evidence suggests that only a minority of mental health nurses regularly use standardized assessment tools to assess antipsychotic medication side effects, but the factors that contribute to the non-routine use of these tools remain unknown. Aim To examine Australian mental health nurses' awareness of, and attitudes towards, side-effect assessment tools, and also identify factors the influence the use of these tools. Methods A cross-sectional survey was undertaken through distributing an online questionnaire via email to members of the Australian College of Mental Health Nurses. Completed questionnaires were received from 171 respondents. Linear regression was used to examine the relationship between the 'service responsibility' and 'personal confidence' scale scores, and awareness, previous use and ongoing use of antipsychotic medication assessment tools. Results Only one-quarter of the respondents (26.5%) were currently using an assessment tool. 'Service responsibility' was significantly associated with ongoing use of antipsychotic medication assessment tools ( Β = 3.26; 95% CI 0.83-5.69). 'Personal confidence' did not influence the ongoing use of assessment tools ( Β = −0.05; 95% CI −1.06-1.50). Implications for clinical practice Stakeholders can incorporate 'service responsibility' processes to foster increased use of assessment tools, which may enhance the identification antipsychotic medication side effects and improve the quality of care for service users. [ABSTRACT FROM AUTHOR]

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]

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]

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]

Aim and objectives: To determine the factors influencing nurses' decisions and capacity to reduce sedentary behaviour in hospital inpatients in sub‐acute hospital settings. Background: Sedentary behaviour in hospital inpatients is a complex issue that can be resistant to resolution. There is little research investigating factors influencing nurses' promotion of reduced levels of sedentary behaviour in sub‐acute hospital settings. Design: An explanatory sequential design was employed, comprising quantitative and qualitative phases. Methods: An online survey was conducted with a convenience sample of 138 nurses from five Australian states. Logistic regression modelling identified demographic and behavioural characteristics of nurses who often encouraged patients to reduce their sedentary behaviour. In‐depth interviews were conducted with 11 ward nurses and nurse managers, with the content subjected to thematic analysis. STROBE and GRAMMS checklists were employed. Results: Nurses recognised their role in promoting reduced sedentary behaviour but faced a range of personal and organisational barriers in achieving this outcome for patients. Few nurses were aware of national physical activity and sedentary behaviour guidelines. Five themes emerged from interviews (nursing role, care challenges, expectations of advocates, teamwork and improving the experience). Overall, many nurses experienced a lack of agency in promoting reduced sedentary behaviour and cognitive dissonance in feeling unable to undertake this role. Conclusions: The results of this study are significant in confirming that reducing sedentary behaviour in hospital inpatients is influenced by a range of complex and multi‐level factors. There is a fundamental need for organisational and clinical leadership in building a culture and climate in which staff feel empowered to promote reduced sedentary behaviour in their patients. Relevance to clinical practice: The results of this study highlight the importance of taking action to reduce sedentary behaviour in sub‐acute hospital settings. A co‐design approach to developing interventions in local health services is warranted. [ABSTRACT FROM AUTHOR]

Background: The role of stroke nurses in patient selection and administration of recombinant tissue plasminogen activator (rt‐PA) for acute ischaemic stroke is evolving. Objectives: To compare differences in stroke nurses' practices related to rt‐PA administration in Australia and the United Kingdom (UK) and to examine whether these differences influence rt‐PA treatment rates. Methods: A cross‐sectional, self‐administered questionnaire administered to a lead stroke clinician from hospitals known to provide rt‐PA for acute ischaemic stroke. Chi‐square tests were used to analyse between‐country differences in ten pre‐specified rt‐PA practices. Non‐parametric equality of medians test was used to assess within‐country differences for likelihood of undertaking practices and association with rt‐PA treatment rates. Reporting followed STROBE checklist. Results: Response rate 68%; (Australia: 74% [n = 63/85]; UK: 65% [n = 93/144]). There were significant differences between countries for 7/10 practices. UK nurses were more likely to: request CT scan; screen patient for rt‐PA suitability; gain informed consent; use telemedicine to assess, diagnose or treat; assist in the decision for rt‐PA with Emergency Department physician or neurologist; and undergo training in rt‐PA administration. Reported median hospital rt‐PA treatment rates were 12% in the UK and 7.8% in Australia: (7.8%). In Australia, there was an association between higher treatment rates and nurses involvement in 5/10 practices; read and interpret CT scans; screen patient for rt‐PA suitability; gain informed consent; assess suitability for rt‐PA with neurologist/stroke physician; undergo training in rt‐PA administration. There was no relationship between UK treatment rates and likelihood of a stroke nurse to undertake any of the ten rt‐PA practices. Conclusion: Stroke nurses' active role in rt‐PA administration can improve rt‐PA treatment rates. Models of care that broaden stroke nurses' scope of practice to maximise rt‐PA treatment rates for ischaemic stroke patients are needed. Relevance to clinical practice: This study demonstrates that UK and Australian nurses play an important role in thrombolysis practices; however, they are underused. Formalising and extending the role of stroke nurses in rt‐PA administration could potentially increase thrombolysis rates with clinical benefits for patients. [ABSTRACT FROM AUTHOR]

Aim: To explore chronic disease education, self‐management and health literacy abilities from First Nations Australian adults with chronic disease through the integration of qualitative and quantitative findings. Background: Chronic disease management requires good health literacy abilities to manage long‐term health needs. First Nations people have a higher burden of chronic disease although little is known regarding chronic disease health literacy of First Nations people. Design: A concurrent embedded mixed methods study reported using the Consolidated Criteria for Reporting Qualitative Research guidelines. Methods: Data were collected from First Nations people with one or more chronic diseases living in remote Australia between February–November 2017. Quantitative data (n = 200) were collected using the Health Literacy Questionnaire along with demographic and health data. Qualitative data (n = 20) were collected via face‐to‐face interviews to examine chronic disease education and self‐management experiences. Data were analysed separately then integrated to develop meta‐inferences. Results: Poor communication from healthcare providers coupled with low health literacy abilities is a major barrier to both active and successful management of chronic disease. Communicating in medical jargon resulted in individuals being placed in a power differential causing lack of trust and relationship breakdowns with healthcare providers affecting active chronic disease self‐management. The perception of inevitability and ambivalence towards chronic disease and the notion of futility towards self‐management were concurred with the low level of active engagement in health care. Conclusions: Yarning is an important strategy used by First Nations people for communication. For nurses, understanding and developing skills in yarning will facilitate cultural safety, communication and understanding about chronic disease self‐management in contexts where health literacy abilities are challenged. Relevance to Clinical Practice: Using yarning, and plain language visual aids, and teach‐back will readdress the power differential experienced by First Nations people and may also improve understanding of chronic disease self‐management. [ABSTRACT FROM AUTHOR]

Aim: To use expert consensus to develop guidance for nurse leaders implementing e‐health tools to support nursing work in hospitals. Background: Nurse leaders are increasingly required to make decisions about the selection, development, implementation and optimisation of e‐health tools for nursing work in hospitals. Guidance in this rapidly evolving and complex space is limited. Design: A two‐phase modified Delphi study. Methods: Phase one involved in‐depth interviews with five nursing informatics experts. Analysis used the qualitative framework method, informed by the Theoretical Domains Framework (TDF), to develop statements for an anonymous online Delphi scoring survey. This was distributed using snowball sampling methods to Australian nurse informatics leaders and experts. Final analysis involved synthesis of qualitative and quantitative data. The study adheres to the COnsolidated criteria for REporting Qualitative research (COREQ) checklist. Results: Ten guidance statements to support nurse leaders to implement e‐health tools in hospitals were developed from the synthesis of qualitative interview data and 29 experts' responses to the 55‐item Delphi response survey. Conclusion: Implementation of e‐health tools for nursing work is complex in health settings and requires careful examination of multiple factors and interactions between clinicians, tools, service users and the health organisation. This research proposes ten statements to support nurse leaders with decisions about implementing e‐health tools to support nursing work in hospitals. Relevance to clinical practice: The ten statements developed by this research provide a resource to assist policy and practice decisions about e‐tools to ensure they are suited to supporting nursing work. Nurse leaders can use the ten statements for guidance in the selection, development, implementation and optimisation of e‐health tools to ensure suitability and adaptation for nursing work in hospitals. [ABSTRACT FROM AUTHOR]

Aims and objectives: To explore the ways in which Irish and Australian Nurse Practitioners (NPs) implement leadership and research in their roles and whether there is a difference in how leadership and research are demonstrated between NPs in Ireland and Australia. Background: The original concept of the NP role was to expand nursing practice in order to provide high‐quality, accessible health care to patients. This placed NPs at the crux of changes to healthcare delivery. Implementing these changes requires leadership. Research demonstrates the effects of these changes to healthcare delivery and contributes to healthcare knowledge from the nursing profession. Design: In the qualitative phase of a mixed methods study, an interpretative descriptive approach was used to draw on participant experiences. Methods: Thirty‐eight respondents agreed to be interviewed following an online survey. Ten interviews were recorded and transcribed verbatim. Data were analysed using Braun and Clarke thematic analysis method. The research complied with the consolidated criteria for reporting qualitative research, COREQ. Results: Ten participants, five NPs from Ireland and five from Australia were interviewed. Four themes emerged from the analysis: (a) Innovative leadership, which included the categories of leadership activities, the work of NPs and trailblazers; (b) Optimism, incorporating pride in achievements, the future outlook for the role and continued innovation of NPs over time; (c) Research, which included the NP research role, research challenges, support and research leadership; and (d) Resilience, which included overcoming resistance, isolation and seeking positive support systems. Conclusion: Nurse Practitioners are clinical leaders focused on improving healthcare delivery for patient populations. There is a lack of understanding of the NP role. Nurse Practitioners lack confidence to be independently research active. Research by NPs requires support from nurses in academia. There is no difference in the role in Ireland and Australia. Relevance to clinical practice: Nurse Practitioners are engaged in healthcare transformation. Nurse Practitioners require support from research experts in academia to make a significant contribution to nursing knowledge in healthcare delivery. [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.)

Aims and objectives: To empirically test a conceptual model of confidence and competence in rural and remote nursing practice. Background: The levels of competence and confidence of nurses practising in rural settings have been highlighted as essential to the quality of health outcomes for rural peoples. However, there is limited research exploring these constructs in the context of rural/remote nursing practice. Design: Structural equation modelling was used to verify the conceptual model with data from the cross‐sectional pan‐Canadian Nursing Practice in Rural and Remote Canada II Survey. The STROBE guidelines for cross‐sectional research were followed in the design/reporting of this analysis. The sample consisted of 2,065 registered nurses and nurse practitioners who were working in direct rural/remote nursing practice. Results: The maximum likelihood ratio χ2 = 0.0822, df = 2, p = 0.959 indicated model fit, with final model estimates explaining 53% of the variance in work confidence and 17% of the variance in work competence. The model also accounted for 40% of the variance in work engagement, 39% of the variance in burnout and 15% of the variance in perceived stress. The complexity of competence and confidence in rural nursing practice was evident, being influenced by nursing experience in rural settings, rural work environment characteristics, community factors and indicators of professional well‐being. Conclusions: The factors influencing nurses' competence and confidence in rural/remote nursing practice are more complex than previously understood. Our model, created and tested using structural equation modelling, merits further research, to extend our understanding of how nurses can be prepared and supported for practice in rural and remote settings. Relevance to clinical practice: This study highlights the importance of supporting new nurses' exposure to rural nursing experiences, reducing professional isolation and improving decision‐making support for those who are working at a greater distance from colleagues and/or those with fewer opportunities for interprofessional collaboration. [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 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 and objective: To explore the accuracy with which nursing students can identify the fundamentals of care. Background: A challenge facing nursing is ensuring the fundamentals of care are provided with compassion and in a timely manner. How students perceive the importance of the fundamentals of care may be influenced by the content and delivery of their nursing curriculum. As the fundamentals of care play a vital role in ensuring patient safety and quality care, it is important to examine how nursing students identify these care needs. Design: Cross‐sectional descriptive design. Methods: A total of 398 nursing students (pre‐ and postregistration) from universities in Sweden, England, Japan, Canada and Australia participated. The Fundamentals of Care Framework guided this study. A questionnaire containing three care scenarios was developed and validated. Study participants identified the fundamentals of care for each of the scenarios. All responses were rated and analysed using ANOVA. Results: The data illustrate certain fundamentals of care were identified more frequently, including communication and education; comfort and elimination, whilst respecting choice, privacy and dignity were less frequently identified. The ability to identify all the correct care needs was low overall across the pre‐ and postregistration nursing programmes in the five universities. Significant differences in the number of correctly identified care needs between some of the groups were identified. Conclusions: Nursing students are not correctly identifying all a patient's fundamental care needs when presented with different care scenarios. Students more frequently identifying physical care needs and less frequently psychosocial and relational needs. The findings suggest educators may need to emphasise and integrate all three dimensions. Relevance to clinical practice: To promote students' ability to identify the integrated nature of the fundamentals of care, practising clinicians and nurse educators need to role model and incorporate all the fundamental care needs for their patients. [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 and objectives To determine potential facilitators and barriers and tailor interventions to optimise future implementation of a patient-assessment framework into emergency nursing practice. Background An evidence-informed patient-assessment framework HIRAID (History, Identify Red flags, Assessment, Interventions, Diagnostics, communication and reassessment) improves the quality of patient assessments performed by emergency nurses. Facilitators and barriers must be understood and tailored interventions selected to optimise implementation. Design A mixed-method convergent study design was used. Methods Thirty eight early career emergency nurses from five Australian hospitals participated in an education workshop on the HIRAID assessment framework. Simulated clinical scenarios enabled participants to experience conducting a patient assessment with and without using the framework. All participants completed surveys, interviews and focus groups to identify potential facilitators and barriers. Twenty three participants completed follow-up telephone surveys 4-6 months later. Quantitative and qualitative data were analysed separately using descriptive statistics and inductive content analysis, prior to integration. Implementation interventions were selected using the Behaviour Change Wheel. Results Nine facilitators and nine barriers were identified to potentially effect implementation of the HIRAID assessment framework. Twelve of the 23 participants (52.2%) who completed follow-up surveys reported using the framework in the clinical setting. To optimise future implementation, the education workshop needs refinement, and environmental restructuring, modelling and social support are required. Conclusion A multimodal strategy is needed to promote future successful implementation of the HIRAID assessment framework into emergency nursing practice. Relevance for clinical practice The successful implementation of the HIRAID assessment framework has the potential to improve nursing assessments of patients in emergency and other acute care settings. This study demonstrates how to systematically identify facilitators and barriers to behaviour change and select interventions to optimise implementation of evidence-informed nursing practices. [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]

Aims and objectives Investigate effects of teamwork on missed nursing care across a healthcare network in Australia. Background Missed care is universally used as an indicator of quality nursing care, however, little is known about mitigating effects of teamwork on these events. Design A descriptive exploratory study. Methods Missed Care and Team Work surveys were completed by 334 nurses. Using Stata software, nursing staff demographic information and components of missed care and teamwork were compared across the healthcare network. Statistical tests were performed to identify predicting factors for missed care. Results The most commonly reported components of missed care were as follows: ambulation three times per day (43·3%), turning patient every two hours (29%) and mouth care (27·7%). The commonest reasons mentioned for missed care were as follows: inadequate labour resources (range 69·8-52·7%), followed by material resources (range 59·3-33·3%) and communication (range 39·3-27·2%). There were significant differences in missed care scores across units. Using the mean scores in regression correlation matrix, the negative relationship of missed care and teamwork was supported ( r = −0·34, p < 0·001). Controlling for occupation of the staff member and staff characteristics in multiple regression models, teamwork alone accounted for about 9% of missed nursing care. Conclusion Similar to previous international research findings, our results showed nursing teamwork significantly impacted on missed nursing care. Teamwork may be a mitigating factor to address missed care and future research is needed. Relevance to clinical practice These results may provide administrators, educators and clinicians with information to develop practices and policies to improve patient care internationally. [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]

Data from the Patients and Families Psychological Response to the Home Automated External Defibrillator Trial were used to examine the relationship between biopsychosocial variables and patients' coping strategies postmyocardial infarction. This study is the secondary data analysis of longitudinal observational study. A total of 460 patient-spouse pairs were recruited in January 2003 to October 2005. Hierarchical linear regression analysis examined biological/demographic, psychological and social variables regarding patients' coping scores using the Family Crisis Oriented Personal Evaluation Scale. Lower social support and social support satisfaction predicted lower total coping scores. Being younger, male gender and time since the myocardial infarction predicted lower positive coping strategy use. Higher anxiety and lower social support were related to fewer positive coping methods. Lower educational levels were related to increased use of negative coping strategies. Reduced social support predicted lower total coping scores and positive coping strategy use and greater passive coping style use. Social support from a broad network assisted with better coping; those living alone may need additional support. Social support and coping strategies should be taken into consideration for patients who have experienced a cardiac event. [ABSTRACT FROM AUTHOR]

Aims and objectives To examine user acceptance with a new format of charts for recording observations and as a prompt for responding to episodes of clinical deterioration in adult medical-surgical patients. Background Improving recognition and response to clinical deterioration remains a challenge for acute healthcare institutions globally. Five chart templates were developed in Australia, combining human factors design principles with a track and trigger system for escalation of care. Two chart templates were previously tested in simulations, but none had been evaluated in clinical practice. Design Prospective multisite survey of user acceptance of the charts in practice. Methods New observation and response charts were trialled in parallel with existing charts for 24 hours across 36 adult acute medical-surgical wards, covering 108 shifts, in five Australian states. Surveys were completed by 477 staff respondents, with open-ended comments and narrative from short informal feedback groups providing elaboration and context of user experiences. Results Respondents were broadly supportive of the chart format and content for monitoring patients, and as a prompt for escalating care. Some concerns were noted for chart size and style, use of ranges to graph vital signs and with specific human factors design features. Information and training issues were identified to improve usability and adherence to chart guidelines and to support improved detection and response for patients with clinical deterioration. Conclusions This initial evaluation demonstrated that the charts were perceived as appropriate for documenting observations and as a prompt to detect clinical deterioration. Further evaluation after some minor modifications to the chart is recommended. Relevance to clinical practice Explicit training on the principles and rationale of human factors chart design, use of embedded change management strategies and addressing practical issues will improve authentic engagement, staff acceptance and adoption by all clinical users when implementing a similar observation and response chart into practice. [ABSTRACT FROM AUTHOR]

Aims and objectives. This study examined the impact of an Integrated Nursing Handover System - structured content, a minimum data set and an electronic module within the patient clinical information system - on nurses' satisfaction with handover and changes to practice. Background. Poor transfer of patient information between clinicians at handover has been associated with adverse patient outcomes. Design. A mixed methods pre-post evaluative approach was used. Methods. The Integrated Nursing Handover System was introduced and evaluated within an Australian hospital. Changes to nurses' satisfaction were measured using the modified Bradley Clinical Handover Survey (n = 40 pre, n = 80 post). Three focus groups with clinicians (2) and mangers and educators (1) examined changes to clinical practice. The location of handover was observed. Results. Nurses' satisfaction with handover was improved. A two stage approach to handover emerged: nurses received handover of all patients within meeting rooms followed by handover delivered at the bedside. Major categories identified through content analysis included: implementation and the transition, work practice changes and bedside handover, accessible and standardised patient information, accountability for information transfer and a central repository of patient information. Conclusion. An integrated system has been implemented with positive outcomes of: improved nurse satisfaction with handover, nurses being informed about all patients, enhanced patient transfers and improved patient information for all health professionals. Further research into the potential use of stored patient handover data for research is recommended. Relevance to clinical practice. This comprehensive system of nursing handover represents the first integrated system of this nature ever reported in the nursing and health literature. This integrated nursing handover system has been successfully implemented resulting in delivery of more comprehensive, logical and standardised patient information at handover. [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 and objectives To develop critical care nurse education practice standards. Background Critical care specialist education for registered nurses in Australia is provided at graduate level. Considerable variation exists across courses with no framework to guide practice outcomes or evidence supporting the level of qualification. Design An eDelphi technique involved the iterative process of a national expert panel responding to three survey rounds. Methods For the first round, 84 statements, organised within six domains, were developed from earlier phases of the study that included a literature review, analysis of critical care courses and input from health consumers. The panel, which represented the perspectives of four stakeholder groups, responded to two rating scales: level of importance and level of practice. Results Of 105 experts who agreed to participate, 92 (88%) completed survey round I; 85 (92%) round II; and 73 (86%) round III. Of the 98 statements, 75 were rated as having a high level of importance - median 7 ( IQR 6-7); 14 were rated as having a moderate level of importance - median 6 ( IQR 5-7); and nine were rated as having a low level of importance - median 4 ( IQR 4-6)-6 ( IQR 4-6). The majority of the panel rated graduate level of practice as 'demonstrates independently' or 'teaches or supervises others' for 80 statements. For 18 statements, there was no category selected by 50% or more of the panel. The process resulted in the development of 98 practice standards, categorised into three levels, indicating a practice outcome level by the practitioner who can independently provide nursing care for a variety of critically ill patients in most contexts, using a patient- and family-focused approach. Conclusion/relevance to clinical practice The graduate practice outcomes provide a critical care qualification definition for nursing workforce standards and can be used by course providers to achieve consistent practice outcomes. [ABSTRACT FROM AUTHOR]

Aims and objectives To identify issues, from the emergency department clinicians' viewpoint, with the management of patients presenting to the emergency department with a mental illness. Background Despite the introduction of several statewide and national initiatives, barriers remain affecting the care and management of consumers presenting with an mental illness to the emergency department. Improving the responsiveness of mental health services, including the provision of more efficient emergency responses for people in crisis, is a key goal. To achieve responsive mental health services in emergency departments, services are required to work together to ensure appropriate referrals between mainstream services and to those services developed to meet the unique needs of specific population groups. Design A mixed method approach using surveys and focus groups. Methods Data were collected from patients with mental illness and their next of kin/carers, as well as staff working within the emergency department and the mental health services of the healthcare network. Results The study found that there were inconsistencies and deficits in the educational preparation of emergency department staff to manage consumers presenting with mental illness. Further, the inadequate physical environment of the emergency department contributed to difficulties in assessing and managing this group of patients. Conclusions Staff members working within mental health services and the emergency department summarised the key improvement areas as the need for electronic case notes, improvements to the emergency department environment, mental health training, implementation of a referral service and increasing the number of staff. Relevance to clinical practice Although initiatives have been implemented, there needs to be a greater focus on educating the staff in emergency departments in relation to the policies and strategies which aim to improve the care and management of patients presenting with a mental health problem. [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 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 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]

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 and objective. To investigate health differences between nurses who report meeting the daily physical activity recommendations in or away from the workplace. Background. Adhering to the national physical activity recommendations has known health benefits. Whilst often considered a workplace active profession, data are emerging of poor health amongst nurses. However, health differences between workplace or leisure-time physically active nurses are understudied. Design. The investigation is an observation study of Australian and New Zealand nurses. Data were generated from the longitudinal, population-based, observational e-Cohort nursing survey. Methods. Data were informed and groups defined by the self-reported minutes per day of moderate physical activity collected from a large international survey of practicing nurses ( n = 2264). Groups were: Group (G) 1 - high workplace (≥30 minutes/day)/high leisure (≥30 minutes/day), G2 - high workplace/low leisure (<30 minutes/day), G3 - low workplace/low leisure (<30 minutes/day) and G4 - low workplace/high leisure. Results. G2 had a high BMI and were younger than G4. G4 were significantly more active away from work and more likely to report cycling to work than G2. In contrast, G2 were most likely to have taken sick days because of their health (χ2 = 19·101), have difficulty sleeping most of the time and have a medical history of diagnosed anxiety and depression. Conclusions. This study shows that improved well-being can be achieved in nursing cohort through leisure-time physical activity. Relevance to clinical practice. This research shows that nurse should consider leisure-time physical activity necessary to maintain and prolong health and that workplace activity is not a sufficient stimulus. This has important implications for workforce planners and administrators. [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]

Aims and objectives. The main aim of this study is to develop a path model to examine the effect of administrative stressors on nursing work outcomes in a sample of Australian public and non-profit nurses. Background. The implementation of managerial reform initiatives has negative consequences on work outcomes. However, less is known about the effects of these stressors in public and non-profit health care organisations. Design. An online, self-completion questionnaire was sent to a random sample of nurses, employed in nursing-related occupations. Participants. Useable surveys were received from 251 nurses. Methods. The path model was analysed using SmartPLS software (SmartPLS, Hamburg, Germany). Results. Public and non-profit nurses experienced time and resource administrative-related stressors (such as resource shortage and pay not as good as other people doing similar work). They relied on work-related social support to reduce the negative consequences. Resource stressors led to job dissatisfaction while time stressors led to psychological strain. Nursing staff who reported better psychological health reported higher job satisfaction and higher level of commitment towards their organisations. Conclusions. Context-specific administrative stressors have a negative impact on the work outcomes of public and non-profit nurses. Work-related social support mechanisms were found to mediate the negative consequences of administrative resourcing stressors on nursing job satisfaction. Relevance to clinical practice. Nursing managers have to be sympathetic and care for the negative experiences of nursing staff, especially when there is an increasing level of administrative expectations during organisational change. Senior management should take note of the stressors caused by the lack of resources such as information, staffing and resources, as these were found to lead to an increase in nurses seeking work-related social support from their peers and supervisors. Effective implementation of these strategies would lead to a nursing workforce, which has higher level of psychological health, job satisfaction and organisational commitment. [ABSTRACT FROM AUTHOR]