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Aim Design Methods Results Conclusion Impact Statement Reporting Method Patient or Public Contribution To examine the experiences of emergency nurses and develop a substantive theory that describes the processes they use to support or prevent sustainability in their nursing practice.Constructivist grounded theory.Between February 2018 and January 2019, observations and semi‐structured interviews were conducted with 29 emergency nurses. Data underwent constant comparison, and coding was performed in three phases: open, focused, and theoretical, employing constructivist grounded theory. Additionally, some situational analysis mapping was undertaken and integrated as a method to explore the broader context affecting nursing practice. The study achieved theoretical saturation and rigour was ensured through evaluations of credibility, transferability, and confirmability.A substantive grounded theory was constructed to describe the basic social process of ‘Achieving Personal and Professional Sustainability’ with subprocesses that included ‘Driving forces’, ‘Developing and using armouries’, ‘Balancing work‐life’, and ‘Making emergency work effective’. This theory delineates two phases, ‘exploration and establishment’ and ‘maintenance’, and two key properties: ‘Constructing and evolving professional identity’ and ‘Perceiving and reshaping the meaning of effective work and care’. The theory also highlights the dynamic interplay of individual, social, and institutional elements.‘Achieving Personal and Professional Sustainability’ is important for emergency nurses to sustain themselves personally and professionally in their work.This research has substantial and global impacts. Emergency nursing can use this information as a guide to better understand strategies for both personal and professional sustainability. Policymakers may use the findings to foster a supportive work environment and enhance nurse well‐being. Implementation of recommendations can lead to improved patient care outcomes. The methodological approach offers potential for future research, positively impacting emergency nursing practice and workforce sustainability worldwide.Reporting adheres to EQUATOR's COREQ guidelines for qualitative studies.No patient or public contribution. [ABSTRACT FROM AUTHOR]

Aims and objectives: The aim of this integrative review was to assess how emergency nurses cope and motivate themselves to sustain their caring work. Background: The need to enhance sustainability of the workforce creates a demand to consolidate contemporary evidence related to emergency nurses' motivations, how they cope and sustain themselves for caring work. Design and methods: The integrative literature review informed by Whittemore and Knafl involved searching four databases, which yielded 977 published research papers (2008–2021). A total of 33 studies met the inclusion and quality assessment criteria. The PRISMA checklist for review was followed. Results: No studies addressing all three areas (motivations, coping and caring sustainability) together were identified. Integration of evidence from quantitative and qualitative research was achieved in three categories: (1) emergency nurses' motivations to sustain their work, (2) emergency nurses' coping strategies and (3) sustaining care as emergency nurses. Conclusion: To sustain themselves in caring work, emergency nurses need to be intrinsically and extrinsically motivated and know how to cope effectively with stressors and work demands. There is need for research examining the relationships between these aspects of emergency nursing work. Relevance to clinical practice: To ensure the sustainability of emergency nurses' work and careers understanding of the factors that influence and sustain their motivations and coping strategies is important for nurses and their clinical leaders and managers. [ABSTRACT FROM AUTHOR]

Introduction: The OSCE is a sociomaterial assemblage—a meshing together of human and material components producing multiple effects. Materials matter because they shape candidate performance, with potentially calamitous career consequences if materials influence performance unjustly. Although the OSCE literature refers to materials, few papers study the sociomateriality of OSCEs. Therefore, we explored OSCE stakeholders' talk about sociomaterial assemblages to better understand their importance for candidate performance. Methods: We conducted 15 focus groups with OSCE candidates (n = 42), examiners (n = 20) and simulated patients (n = 17) after an Australian postgraduate nursing OSCE. Sociomateriality informed our team‐based framework analysis of data. Results: Participants identified a multiplicity of OSCE materials (objects, technologies and spaces) thought to matter for candidate performance. Candidates' unfamiliarity with materials and missing or malfunctioning materials were reported to yield numerous negative impacts (eg cognitive overload, negative affect, time‐wasting), thereby adversely affecting candidate performance. Both examiners and candidates made micro‐adjustments to sociomaterial assemblages during the OSCE in order to make it work (eg candidates saying what they would do rather than doing it). Sometimes, such tinkering extended so far that sociomaterial assemblages were ruptured (eg examiners ignoring rubrics to help pass candidates), potentially influencing OSCE standardisation. Discussion: Our novel empirical study extends previous conceptual work by illustrating wide‐ranging sociomaterial assemblages influencing OSCE candidate performance. Further research is now needed employing sociomaterial approaches to further elucidate sociomaterial entanglements in diverse OSCEs. We encourage OSCE stakeholders to become more attuned to the productive nature of materials within all stages of OSCE design and implementation. The authors demonstrate the extent to which materials really matter in shaping candidate performance in OSCEs [ABSTRACT FROM AUTHOR]

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

When another person's actions are observed it appears that these actions are simulated, such that similar motor processes are triggered in the observer. Much evidence suggests that such simulation concerns the achievement of behavioural goals, such as grasping a particular object, and is less concerned with the specific nature of the action, such as the path the hand takes to reach the goal object. We demonstrate that when observing another person reach around an obstacle, an observer's subsequent reach has an increased curved trajectory, reflecting motor priming of reach path. This priming of reach trajectory via action observation can take place under a variety of circumstances: with or without a shared goal, and when the action is seen from a variety of perspectives. However, of most importance, the reach path priming effect is only evoked if the obstacle avoided by another person is within the action (peripersonal) space of the observer.

Aim: To examine health care managers' and health and safety staff experiences of prevention and management of workplace violence against staff. Background: Employers have a responsibility to protect employees from workplace violence. The varied care settings present challenges for those responsible for ensuring safety. Method: Descriptive exploratory study using semi‐structured interviews with 99 participants responsible for workplace safety, from 29 health services across metropolitan and regional Victoria, Australia. Interviews were audio‐recorded, transcribed and thematically analysed. Results: Five themes were identified: Workplace violence was accepted as "part of the job"; Participants relied on government resources and networking to guide them; Working alone and home visiting was a risk factor; Participants demanded a single, state‐wide training programme; Sharing information is vital. Conclusions: Participants were acutely aware of the risks of violence towards staff, and of their responsibility in managing risks. Knowledge sharing and consistent, regular education can reduce the risks. Additional resources were required, particularly during home visits, or when working alone. Implications for Nursing Management: Managers need to prioritize resources such as reliable rapid response systems to prevent and manage violence, particularly against staff working alone or home visiting. Information sharing between health services and other agencies is important to reducing risk. [ABSTRACT FROM AUTHOR]

Aim: The study aimed to evaluate the reporting, monitoring and use of workplace violence data in Victorian health services. Background: Surveillance of workplace violence is important in understanding the circumstances in which workplace violence occurs and development of relevant and appropriate prevention and intervention strategies. Method: A descriptive exploratory approach was used. Fifteen staff from occupational health and safety, quality and safety, and nurse unit managers, from five major metropolitan health services were interviewed. Recorded interviews were transcribed verbatim and thematically analysed. Results: Three themes were identified: (a) "under‐reporting of workplace violence," (b) "inconsistent guidance" caused subjective and variable data coding and (c) "application of data" described how health services used the data available to them, to inform the development and implementation of systems designed to prevent workplace violence. Conclusions: Improved reporting systems may increase consistency in reporting, enable data sharing across organisations and assist in planning of prevention strategies. Implications for nursing management: Staff should be encouraged to complete incident reports for each episode of workplace violence. Incident reporting systems must be simplified to reduce the burden of reporting. Nurse managers should advocate for the sharing of health service workplace violence data, to enable improved prevention across all services. [ABSTRACT FROM AUTHOR]

Aims: To examine the relationship between workplace violence perpetrated by clients, their innate neurophysiological response to dis‐ease and the resulting interactions with healthcare providers. Background: Client‐on‐worker violence remains a problem globally. Workplace violence risk factors have been documented. A gap remains in understanding what has happened to clients that perpetrate violence, and the link between adverse childhood experiences (ACE), the neuroscience of threat and trauma‐informed care. Design: This explanatory study was part of a larger descriptive study. Methods: Managers, directors, health/safety staff, nurses and educators (n = 99) from Australian rural and metropolitan health services participated in individual and group interviews. Following inductive thematic analysis, a secondary analysis, informed by understandings of ACE, polyvagal theory and trauma‐informed care, was conducted. Analysis was guided by the question: What happens to clients that causes them to instigate violence against healthcare workers? Reporting of this research adheres to the COREQ guidelines. Results: Clients can react aggressively when under perceived threat. Themes included are as follows: client stress and trauma, previous client trauma, impact of care provision on client and trauma‐informed care. Conclusion: Healthcare services can be experienced as stressful environments. Coupled with high incidences of past trauma, clients' assessment of risk and safety can be compromised resulting in inappropriate reactivity when staff are trying to provide care. Care provision can be perceived as a threat to clients' physical and psychological safety, activating the fight protective response resulting in aggression. Understanding and applying neuroscience and implementing a cultural change of trauma‐informed care have the potential to reduce workplace violence. Even with these understandings, it is imperative that healthcare staff are protected and feel safe at work. Relevance to clinical practice: Understanding trauma and the neuroscience of threat and safety can assist staff to understand what happens to clients that causes them to instigate violence against healthcare providers and implement systems and strategies to respond to such threat. [ABSTRACT FROM AUTHOR]

Adopting evidence-based practice (EBP) principles in undergraduate education can facilitate nursing students’ appreciation of EBP. Using grounded theory method, this study aimed to explore processes used by nurse academics while integrating EBP concepts in undergraduate nursing curricula across Australian universities. Twenty-three nurse academics were interviewed and nine were observed during teaching of undergraduate students. In addition, 20 unit/subject guides were analyzed using grounded theory approach of data analysis. The theory “On a path to success: Endeavoring to contextualize curricula within an EBP framework” reflects academics’ endeavors toward linking EBP concepts to practice, aiming to contextualize curricula in a manner that engages students within an EBP framework. However, academics’ journeys were influenced by several contextual factors which require strategies to accomplish their endeavors. In conclusion, initiatives to minimize barriers, faculty development, and provision of resources across educational and clinical settings are fundamental to achieving undergraduate curricula underpinned by EBP concepts. [ABSTRACT FROM AUTHOR]

Aims and objectives: To determine, from the perspectives of enrolled nurses and registered nurses, the current scope of enrolled nurse practice and to identify the activities that most enrolled nurses frequently performed in their workplace. Background: Enrolled nurse scope of practice in Australia has evolved and expanded over the past decade. However, the unclear role, function and competency differentiation between enrolled nurse and registered nurse leads to role confusion and ongoing professional debate. Design: Exploratory Descriptive Study. Methods: A cross‐sectional online survey of enrolled nurses and registered nurses across Australia was conducted examining their levels of agreement on statements related to the scope of practice and the clinical and nonclinical activities that enrolled nurses were required to perform in their workplace. Results: Valid responses were received from 892 enrolled nurses and 1,198 registered nurses. Enrolled nurses mostly agreed that they understood their scope of practice; did not undertake roles for which they were unprepared; sometimes undertook activities other than direct patient care; and believed that they operated equally to many registered nurses. The majority of enrolled nurses reported that they performed tasks mostly related to basic patient care in their workplace. There were a number of significant differences between perspectives of registered nurses and enrolled nurses. Conclusions: Clarifying the roles and scope of practice between the registered nurse and the enrolled nurse is important, and explicit differences in responsibility and accountability between their roles must be clearly articulated to harmonise perceptions about role and capability. Health service providers, policymakers and education providers need to work collaboratively to ensure that facets of enrolled nurse education and scope of practice in line with regulation are affirmed by all concerned. Relevance to clinical practice: Health service providers, policymakers and education providers need to work collaboratively to ensure that facets of enrolled nurse education and scope of practice in line with regulation are affirmed by all concerned. [ABSTRACT FROM AUTHOR]

Aims The study aimed to explore the processes undertaken by nurse academics when integrating evidence-based practice ( EBP) into their teaching and learning practices. This article focuses on pedagogical approaches employed by academics to influence evidence-based practice integration into undergraduate programs across Australian universities. Background Nursing academics are challenged to incorporate a variety of teaching and learning strategies to teach evidence-based practice and determine their effectiveness. However, literature suggests that there are limited studies available focusing on pedagogical approaches in evidence-based practice education. Design A constructivist grounded theory methodology, informed by Charmaz was used for this study. Methods Data were collected during 2014 from 23 nurse academics across Australian universities through semi-structured interviews. Additionally, nine were observed during teaching of undergraduate students. Twenty subject outlines were also analysed following Charmaz's approach of data analysis. Findings 'Influencing EBP integration' describes the pedagogical approaches employed by academics to incorporate EBP knowledge and skills into undergraduate curricula. With the use of various teaching and learning strategies, academics attempted to contextualize EBP by engaging students with activities aiming to link evidence to practice and with the EBP process. Although, some strategies appeared to be engaging, others were traditional and seemed to be disengaging for students due to the challenges experienced by participants that impeded the use of the most effective teaching methods. Conclusion Study findings offer valuable insights into the teaching practices and identify some key challenges that require the adoption of appropriate strategies to ensure future nurses are well prepared in the paradigm of evidence-based practice. [ABSTRACT FROM AUTHOR]

Interprofessional education is an important element in the preparation of healthcare students who can communicate effectively and work collaboratively. A grant from Health Workforce Australia funded a shared nursing, paramedicine, and physiotherapy simulation suite and a staff member dedicated to interprofessional simulation, with the aim of increasing high fidelity simulation within and across the three professions. This article describes the development process and pilot testing of four purpose-designed interprofessional handover scenarios for paramedic, nursing, and physiotherapy students. The scenarios tracked an elderly patient (manikin) with a fractured neck of femur from pre-hospital to postoperative assessment and handover. The National League of Nursing Simulation Design Scale was used to evaluate the scenarios. Students’ feedback indicated they considered the simulations to be relevant to their practice, with a high level of fidelity. This study re-emphasises the importance of pilot testing simulations before use in large-scale studies. [ABSTRACT FROM PUBLISHER]

The demand for emergency department (ED) services has increased significantly, due to our increasingly ageing population and limited access to primary care. This article reports outcomes from a transprofessional model of care in an ED in Victoria, Australia. Nurses, physiotherapists, social workers, and occupational therapists undertook additional education to increase the range of services they could provide and thereby expedite patient flow through the ED. One hundred patients who received this service were matched against 50 patients who did not. The most common reasons for patient admission were limb injury/limb pain (n = 47, 23.5%) and falls (n = 46, 23.0%). Transprofessional interventions included applying supportive bandages, slings, zimmer splints and controlled ankle motion (CAM) boots, and referral to new services such as case management and mental health teams. The rate of hospital admissions was significantly lower in the transprofessional group (n = 27, 18.0%) than in the reference group (n = 19, 38%, p = 0.005). This group also had a slightly lower re-presentation rate (n = 4, 2.7%) than patients in the reference group (n = 2, 4.0%). There are many benefits that support this model of care that in turn reduces ED overcrowding and work stress. A transprofessional model may offer a creative solution to meeting the varied needs of patients presenting for emergency care. [ABSTRACT FROM AUTHOR]

Background Many pregnant women use complementary and alternative medicine. Although midwives are often supportive, how they communicate with women about the safe use of these therapies has received limited research attention. Aim The aim of this study was to explore how midwives interact with women regarding use of complementary and alternative medicine during pregnancy. Methods We utilised grounded theory methodology to collect and analyse data. Twenty-five midwives who worked in metropolitan hospitals situated in Melbourne, Australia, participated in the study. Data were collected from semi structured interviews and non-participant observations, over an 18-month period. Findings How midwives communicate about complementary and alternative medicine is closely associated with the meaning they construct around the woman's role in decisionmaking. Most aim to work in a manner consistent with the midwifery partnership model and share the responsibility for decisions regarding complementary and alternative medicine. However, although various therapies were commonly discussed, usually the pregnant woman initiated the dialogue. A number of contextual conditions such as the biomedical discourse, lack of knowledge, language barriers and workplace constraints, limited communication in some situations. Conclusion Midwives often interact with women interested in using CAM. Most value the woman's autonomy and aim to work in partnership. However, various contextual conditions restrain overt CAM communication in clinical practice. [ABSTRACT FROM AUTHOR]

Objective. Violence is widespread in Australian emergency departments (ED) and most prevalent at triage. The aim of the present study was to identify the causes and common acts of violence in the ED perceived by three distinct groups of nurses. Methods. The Delphi technique is a method for consensus-building. In the present study a three-phase Delphi technique was used to identify and compare what nurse unit managers, triage and non-triage nurses believe is the prevalence and nature of violence and aggression in the ED. Results. Long waiting times, drugs and alcohol all contributed to ED violence. Triage nurses also indicated that ED staff, including security staff and the triage nurses themselves, can contribute to violence. Improved communication at triage and support from management to follow up episodes of violence were suggested as strategies to reduce violence in the ED Conclusion. There is no single solution for the management of ED violence. Needs and strategies vary because people in the waiting room have differing needs to those inside the ED. Participants agreed that the introduction and enforcement of a zero tolerance policy, including support from managers to follow up reports of violence, would reduce violence and improve safety for staff. Education of the public regarding ED processes, and the ED staff in relation to patient needs, may contribute to reducing ED violence. [ABSTRACT FROM AUTHOR]

The article focuses on the denial of medical care or treatment by patients in a clinical environment and how medical practitioners and nurses respond to the refusal of active treatment. Topics include the limits of patient autonomy, the right to self-determination in relation to medical care, and the patient's knowledge of consent laws.

Background Increasing numbers of residents are transferred from aged care facilities to emergency departments. Frequently, residents arrive with inadequate documentation regarding their presenting complaint or medical history, making it difficult for emergency department staff to make decisions about care. Methods A retrospective review of emergency department records was undertaken for residents transferred from residential aged care facilities to two emergency departments in Melbourne, Victoria in 2012. Results 2880 resident transfers were included in the sample, of which 408 transfers were randomly selected for documentation review. Clinically important documentation was frequently absent including: the reason for transfer to the ED (n = 197, 48.2%); baseline cognitive function (n = 244, 59.7%); and vital signs at time of complaint (n = 285, 69.9%). When the reason for transfer was absent, residents with an altered conscious state had more investigations and spent longer in the emergency department than when the reason for transfer was recorded. Conclusion Inadequate documentation negatively impacted the resident's journey through the emergency department. There is evidence that inadequate documentation contributes to poor patient outcomes. To minimise the gaps in the transfer documentation regular staff development and quality assurance programs may be required in residential aged care facilities. [ABSTRACT FROM AUTHOR]