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We investigated nurses' experiences of hospital‐acquired pressure injury (PI) prevention in acute care services to better understand how PI prevention may be optimised. We used the Theoretical Domains Framework to systematically identify barriers and enablers to evidence‐based preventive practices as required by the International Guideline. This study was one element of a complex capacity building project on PI surveillance and prevention within the acute health service partners of Monash Partners Academic Health Science Centre, an accredited academic health partnership located in Melbourne, Australia. We adopted a qualitative descriptive design. We interviewed 32 nurses that provided care in intensive care units, general wards and COVID wards of four acute care services. Nurses were recruited from four large acute care services (three public, one private) located in Melbourne. Most of them worked with patients who were at high risk of hospital‐acquired PI on a daily basis. Interview transcripts were coded and analysed using thematic analysis guided by the Theoretical Domains Framework. The domains referred to most frequently by all participants included: Knowledge, Skills, Social/Professional Role and Identity, Beliefs about Capabilities, and Environmental Context and Resources. The key barriers discussed by nurses included gaps in nurses' knowledge and skills related to identification and staging of PI, heavy nursing workload and inadequate staffing levels, stigma and self‐blame related to PI identification, and exacerbating impacts of the COVID‐19 pandemic. Main facilitators discussed were training programmes, nursing audits and feedback, and teamwork. Participants suggested improvements including accessible and tailored training, visual reminders, and addressing heavy workloads and emotional barriers nurses face. Investing in tailored training initiatives to improve nurses' knowledge and organisational changes to address low level staffing and heavy workloads are urgently needed to support nurses in delivering optimal care and preventing hospital‐acquired PI. [ABSTRACT FROM AUTHOR]

The management of consumer-related risk is paramount in a secure forensic mental health facility. However, the consequent risk aversion presents a major barrier to consumers forming sexual relationships in a manner that is open and accepted. Investigation of the views of nurses working in forensic mental health settings on this topic is limited, and even more so for consumers of services. This qualitative exploratory study was undertaken to elicit the views of consumers and nurses about forming sexual relationships within this long-term and secure setting. Individual in-depth interviews were conducted with 12 nurses and 10 consumers. The benefits of, and barriers to, sexual relationships was identified as a major theme, and these findings are the focus of this paper. Nurse responses included the subthemes 'supportive factors' and 'potential dangers', reflecting their qualified support. Consumer responses included the subthemes 'therapeutic', 'feeling normal', 'restrictions and barriers', and 'lack of support and secrecy'. The importance of sexual relationships was clearly articulated, as was the difficulties in forming and maintaining them within the forensic setting. More open discussion about this commonly-avoided issue and the education of nurses and other health professionals is required. [ABSTRACT FROM AUTHOR]

Although there is a growing body of international work on barriers to engaging fathers in child and family services, there is limited research on factors that promote father engagement. In this article, we draw on case study data from the Australian Baby Makes 3 (BM3) programme to explore factors that promote father engagement in parenting support programmes. Our analysis shows single‐gender group work supported father engagement. BM3's father group work provided a safe space in the parenting support context where men could form intimate connections with other fathers and talk openly about their parenting experiences without fear of criticism from partners. These findings suggest that men often feel silenced and marginalized in the parenting sphere. [ABSTRACT FROM AUTHOR]

People with severe mental illness have significantly reduced life expectancy and higher risk of cardiovascular diseases than the general population. There is a critical need for quality physical health care to improve consumers' health outcomes. There is minimal knowledge, however, on the impact of mental health nurse practitioner candidate (NPC) practices on consumers' health outcomes. The aim of this proof‐of‐concept study was to describe the impacts of NPC practices on the quality of physical healthcare provision and physical health outcomes (cardiovascular and cardiometabolic) of consumers in community mental health service settings. Using a mixed methods design, quantitative data were collected for 12 months prior to (Period 1), and 12 months during (Period 2), the candidacy period. Qualitative interviews were conducted with a purposive sample of n = 10 consumers to explore their perspectives on physical healthcare provision by the NPCs. During the 12‐month candidacy period, the number of metabolic monitoring assessments rose from n = 55 in Period 1 to n = 146 in Period 2 (P < 0.01, χ2 = 41.20). Advanced practices provided by NPCs included taking an extensive holistic history and clinical examination, ordering diagnostic pathology, and clinical simulation of physical health medication prescription (under medical supervision). Analysis of consumer interviews resulted in two themes: (i) positive and helpful NPC health care and (ii) improvements in physical and mental health. The findings add new knowledge on specialist mental health nurse practitioner candidate roles and demonstrate the benefits these roles can have in reducing the significant morbidity and mortality of mental health consumers. [ABSTRACT FROM AUTHOR]

Background: Affected family members (AFMs) play an important role in supporting relatives with alcohol and/or other drug (AOD) misuse. However, they frequently lack support and experience considerable challenges to their own well‐being. Aim: To explore the experience of AFMs who support a close relative with AOD misuse. Method: Thirty‐one AFMs were recruited through AOD helplines and through their social media accounts in the Australian state of Victoria. A semi‐structured interview guide was used to inform data collection, focusing on their general experiences, impact of support‐giving and support options. Interviews were audio‐recorded and conducted by telephone. Results: One overarching theme and six related subthemes were abstracted from the data. The overarching theme was conceptualised as Feeling overwhelmed by, and struggling with, the experience. Subthemes were as follows: Emotionally draining and exhausting, Maintaining constant vigilance: curbing social activities, Grappling with the financial impact, Struggling to cope with harmful family dynamics, Avoiding and containing aggression and Fearfulness and hopelessness about the future. Conclusion: Affected family members experienced wide‐ranging harms, which affected their emotional, social and financial well‐being, safety and family dynamics, and instilled a persistent sense of fearfulness and hopelessness about the future. The findings have implications for mental health nurses and other clinicians in AOD services to identify AFMs' needs and provide them with timely, accessible and appropriate support to help sustain their important role. [ABSTRACT FROM AUTHOR]

Background Care gaps for stroke lead to preventable disability and deaths. The Victorian State Government implemented a programme of employing clinical Facilitators on a fixed-term basis for up to 3 years (2008-2011) in eight hospitals to improve stroke care. The Facilitators were to establish stroke units where absent, implement evidence-based management protocols and provide staff education within an agreed work plan. Aim To determine if the Facilitator role was associated with improved stroke care and to describe factors supporting or mitigating enhancements to care. Methods A mixed methods design was employed with historical control using patient-level audit data (pre-Facilitator: n = 600; post-Facilitator: n = 387) and qualitative data from independently conducted semistructured interviews with hospital staff, including clinicians, executives and facilitators ( n = 10 focus groups; 75 respondents). Results Stroke units, clinical pathways and outpatient clinics for managing transient ischaemic attacks ( TIA) were established. Compared with the pre-Facilitator period, significant increases in patient access to stroke unit care (53% vs 86%, P < 0.001) and intravenous thrombolysis (2% vs 9%, P < 0.001) were achieved. Hospital staff reported that the Facilitator was integral to system improvements by fostering communication, encouraging team motivation and cohesiveness and increasing interest in stroke care. Ongoing barriers included limited resources to operate TIA clinics effectively, staff turnover requiring ongoing education, inconsistency in compliance with protocols and, in some hospitals, the need for formalised medical leadership. Conclusion Fixed-term employment of Facilitators was effective in positively influencing stroke care in hospitals through a range of change management strategies where stroke-specific expertise had been previously limited. [ABSTRACT FROM AUTHOR]

When people telephone rural health services with unscheduled healthcare needs, rural nurses manage these telephone presentations. However, there is professional controversy surrounding the practice, and paucity in research outside formalized telephone triage services. This article reports on a qualitative study exploring the actions nurses take when people telephone rural health services with unscheduled healthcare needs and the factors that influence these actions. Registered nurses from five rural health services in Victoria, Australia, participated in telephone interviews or focus groups during 2010 and 2011. Descriptions of telephone interactions reflected a structured approach to providing care. Participants described strategies to minimize clinical risk while brokering competing needs and finite resources to achieve a 'best outcome' for all stakeholders. This study reveals a gap in policy and practice support for rural nurses providing care via telephone and differentiates this rural nursing practice from that of formalized telephone triage. [ABSTRACT FROM AUTHOR]