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To evaluate the quality of student nurses' experiences and overall satisfaction with professional experience placements at a regional Australian University. Professional experience placements are a crucial component of pre-registration nursing programs. However, the absence of standardised approaches to assess placement quality has created uncertainty on what constitutes a high-quality placement from a student's perspective. Cross-sectional survey. A descriptive cross-sectional survey was administered online to 800 second and third year undergraduate nursing students at an Australian university. The survey contains demographic questions (e.g., year of study, placement specialty, duration, setting and geographic location), a validated Placement Evaluation Tool and free-text comments. The Placement Evaluation Tool is a 20-item questionnaire that measures two key factors: clinical environment (factor 1), learning support (factor 2) and overall satisfaction of students' learning experiences during a professional experience placement. A descriptive analysis was conducted to evaluate the student's overall experience and satisfaction. Multivariate linear regression was used to assess the relationship between the quality of the student experience and demographics and presented as beta coefficient (β) and confidence interval (CI). Free-text comments were thematically analysed. A total of 1104 survey responses were received (as students may rate more than one placement), with an estimated 71% response rate. Most responses (60.3%) were third-year students. Most students experienced high-quality placements, reflected in the overall positive placement experience (PET item 1–19 score: mean 85.9 out of 95) and high student satisfaction (PET item 20: mean 8.53 out of 10). Multiple linear regression analyses revealed that the third year of study and public facilities were independent predictors of positive student experiences (β: 2.61, 95% CI: 0.75, 4.47 and β: 3.72, CI: 0.90, 6.55, respectively). Further analysis of PET items related to factor 1 and factor 2 revealed that high positive experiences in public facilities may be due to the higher learning support (β: 2.54, CI: 0.80, 4.27). Three main themes were perceived to be important to students' professional experience: (i) staff and facilitator attitudes, (ii) learning opportunities and (iii) a team-based learning environment. Most students reported high-quality placement experience and high satisfaction; however, a lack of learning support may contribute to less positive student experiences. This finding emphasises the importance of collaboration between clinical facilities and educational institutions to enhance the student's placement experience. [ABSTRACT FROM AUTHOR]

A scoping review aims to systematically explore and map the research available from a wide range of sources. The objective of this study was to produce a scoping review checklist to guide future scoping studies to enable rigorous review and critique of phenomena of interest. The methods used included a review of literature, expert consensus group meetings, a modified Delphi survey and, finally, verification against recent scoping study examples. Results showed that the checklist was able to identify key elements of scoping reviews. The 22-item Scoping Review Checklist (SRC), which includes two optional stakeholder consultation items, has been developed using rigorous recommended approaches. The checklist can be used to guide the conduct and critique of scoping studies. [ABSTRACT FROM AUTHOR]

Aims and objectives: To explore service provision for Victorian regional refugee families from the perspective of maternal and child health nurses. Background: Increasingly, more families from a refugee background are resettling in regional Victoria. The refugee journey has significant effect on families. Refugee families with infants and young children can be provided with support by maternal and child health services; however, many families experience barriers to ongoing engagement with this service. Design: This descriptive study used focus group and questionnaire. A purposive sample of 26 maternal and child health nurses was drawn from six municipalities throughout regional Victoria, where higher numbers of people from a refugee background resettle. Six focus groups were held in 2014. Audio‐recorded narratives were transcribed, prior to inductive thematic analysis. Methods: This descriptive study used focus group and questionnaire. A purposive sample of 26 Maternal and Child Health nurses was drawn from six municipalities throughout regional Victoria where higher numbers of people from a refugee background resettle. Six focus groups were held in 2014. Audio‐recorded narratives were transcribed verbatim, prior to inductive thematic analysis. Results: Participating nurses were experienced nurses, averaging 12 years in the service. Four major themes emerged from thematic analysis: “How to identify women from a refugee background”; “The Maternal and Child Health nurse role when working with families from a refugee background”; “Interpreting issues”; and “Access to other referral agencies.” Nurses worked to develop a relationship with families, attending to a complex mix of issues which were complicated by language barriers. Nurses found their role in supporting refugee families required additional time and more home visits. Conclusions: To provide best practice, maternal and child health nurses need (i) ongoing professional development; (ii) time, flexibility and creativity to build relationships with refugee families and (iii) better access to services that enhance communication, such as interpreting services and translated resources. Relevance to clinical practice: Nurses require ongoing professional development to help them address the multifaceted needs of families of refugee background. With limited resources available in regional areas, accessing further education can be challenging. Distance education models and organisational support could provide nurses with educational opportunities aimed at improving service provision and clinical practice. [ABSTRACT FROM AUTHOR]

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: To test the resuscitation non-technical Team Emergency Assessment Measure (TEAM) for feasibility, validity and reliability, in two Australian Emergency Departments (ED).Background: Non-technical (teamwork) skills have been identified as inadequate and as such have a significant impact on patient safety. Valid and reliable teamwork assessment tools are an important element of performance assessment and debriefing processes.Methods: A quasi experimental design based on observational ratings of resuscitation non-technical skills in two metropolitan ED. Senior nursing staff rated 106 adult resuscitation team events over a ten month period where three or more resuscitation team members attended. Resuscitation events, team performance and validity and reliability data was collected for the TEAM.Results: Most rated events were for full cardiac resuscitation (43%) with 3-15 team members present for an average of 45 min. The TEAM was found to be feasible and quickly completed with minimal or no training. Discriminant validity was good as was internal consistency with a Cronbach alpha of 0.94. Uni-dimensional and concurrent validity also reached acceptable standards, 0.94 and >0.63 (p=<0.001), respectively, and a single 'teamwork' construct was identified. Non-technical skills overall were good but leadership was rated notably lower than task and teamwork performance indicating a need for leadership training.Conclusion: The TEAM is a feasible, valid and reliable non-technical assessment measure in simulated and real clinical settings. Emergency teams need to develop leadership skills through training and reflective debriefing. [ABSTRACT FROM AUTHOR]

Background: Substantial deficits in performance of hip abductor in patients with common lower extremity injuries are reported in literature. Therefore, assessing hip abductor endurance might be of major importance for clinicians and researchers. Purposes: The purpose of this study was to examine the test-retest reliability of two hip abductor endurance tests in healthy females. Learning effect, systematic difference in the rate of perceived exertion and relationship between endurance performance and some clinical characteristics of participants were also investigated. Design: Observational study, with a test-retest design. Methods: Thirty-six healthy females, aged 18-30 years, were recruited. In two identical assessment sessions, the participants performed an isometric hip abductor strength test and two different hip abductor endurance tests Results: Isometric and dynamic endurance tests demonstrated good test-retest reliability (intraclass correlation coefficients (ICC) = 0.73 and 0.78, respectively). The standard errors of measurement (SEM) and the minimal detectable changes (MDC) were, respectively, 19.8 and 54.9 seconds for isometric endurance test and 21.2 and 58.7 repetitions for dynamic endurance test. Moderate correlation between both endurance tests (r = 0.60, p = 0.0001) and weak correlation between dynamic endurance test and strength (r = 0.44, p =0.008) were found. Conclusions: The results of the present study demonstrate good test-retest reliability of two non-instrumented clinical tests of hip abductor endurance in healthy females. [ABSTRACT FROM AUTHOR]

Background: Professional nursing practice is informed by biological, social and behavioural sciences. In undergraduate pre-registration nursing programs, biological sciences typically include anatomy, physiology, microbiology, chemistry, physics and pharmacology. The current gap in the literature results in a lack of information about the content and depth of biological sciences being taught in nursing curricula. The aim of this study was to establish what priority is given to the teaching of science topics in these programs in order to inform an understanding of the relative importance placed on this subject area in contemporary nursing education. Method: This study employed a cross-sectional survey method. This paper reports on the first phase of a larger project examining science content in nursing programs. An existing questionnaire was modified and delivered online for completion by academics who teach science to nurses in these programs. This paper reports on the relative priority given by respondents to the teaching of 177 topics contained in the questionnaire. Results: Of the relatively small population of academics who teach science to nursing students, thirty (n = 30) completed the survey. Findings indicate strong support for the teaching of science in these programs, with particular priority given to the basic concepts of bioscience and gross system anatomy. Of concern, most science subject areas outside of these domains were ranked as being of moderate or low priority. Conclusion: While the small sample size limited the conclusions able to be drawn from this study, the findings supported previous studies that indicated inadequacies in the teaching of science content in nursing curricula. Nevertheless, these findings have raised questions about the current philosophy that underpins nursing education in Australia and whether existing practices are clearly focused on preparing students for the demands of contemporary nursing practice. Academics responsible for the design and implementation of nursing curricula are encouraged to review the content of current programs in light of the findings of this research. [ABSTRACT FROM AUTHOR]

Aim: Nutrition screening is increasingly conducted in hospitals during the patient admission process. We aimed to explore the ease of use of two tools in the conduct of screening by nutrition technicians (NTs), and to compare validity. The tools are Malnutrition Universal Screening Tool (MUST) and Modified Malnutrition Screening Tool (Mod-MST). Methods: A sample of 262 consecutive adult hospital patients in medical wards was screened during December 2008 to January 2009. Trained NTs used both tools to screen each patient. Dietitians who were blinded to screening results then assessed each patient using Subjective Global Assessment as a reference tool. Time taken for screening was recorded and ease of tool use was explored in interviews with technicians. Results: The specificity of MUST and Mod-MST was 85% and 83%, respectively, with sensitivity of 80% and 77%. Both tools were easy to use and could be applied to all patients, including those unable to answer interview questions. However, the MUST took two to three times longer to complete (5-7 min) using objective data. The Mod-MST collected subjective data that required interpretation by technicians. Conclusion: Specificity and sensitivity of the two tools were less than optimum at ≤85%, as some patients would be misclassified. Both tools were valid and feasible to use with all medical patients, including those with whom communication cannot be established. The Mod-MST is recommended, as choice of malnutrition screening tool needs to balance efficacy with time taken to be useful for mass screening programs. [ABSTRACT FROM AUTHOR]

Palliative care nurses are at risk of work stress because their role involves exposure to frequent deaths and family grieving. Little is known about their degree of stress or whether they suffer stress or burnout more than nurses in other disciplines. Aim: The aim of this paper is to critically examine the current literature concerning stress and burnout in palliative care nurses. Results: Sixteen papers were included in the review. Although work demands were a common cause of stress in the studies reported, there was no strong evidence that palliative care or hospice nurses experienced higher levels of stress than nurses in other disciplines. Common causes of stress were the work environment, role conflict, and issues with patients and their families. Constructive coping styles appeared to help nurses to manage stress. Conclusion: Managers have a key role in providing education and training for palliative care nurses to support their personal development and to help reduce vulnerability to and the impact of stress in the workplace. [ABSTRACT FROM AUTHOR]

Background: Assessment using case based practical exams that require demonstration of clinical practice skills and articulation of clinical reasoning is commonly used in undergraduate allied health and nursing professions. However, the student often struggles in understanding and evaluating their performance of practical skills in preparation for summative practical assessment tasks. The fear of attempting and completing practical tasks does not contribute to learning. Any means of encouraging self evaluation, reflection and facilitating learning that is driven by the learner and not the assessor will contribute to the performance of the student in the short term and the practitioner in the future. Aims: This project used a mixed-methodological approach to explore the use of audio-visual technology to enhance 61 undergraduate physiotherapy students' practice of self evaluation and then sought to explore and understand the student experience of the activity and the teacher feedback provided. Findings: Themes relating to the students concerns, strengths and levels of self-confidence were identified. Reflection on the student feedback provided and the implications for teaching are also discussed. [ABSTRACT FROM AUTHOR]

Mills J, Field J, Cant R. International Journal of Nursing Practice 2011; 17: 455-463 Factors affecting evidence translation for general practice nurses This paper explores the domains of influence affecting practice nurses' ability to find, evaluate and use clinical evidence. A cross-sectional survey of general practice nurses ( n = 590) in Victoria, Australia in 2008 provided data for a principal components analysis. The research replicates a study undertaken in the UK using the Developing Evidence-Based Practice Questionnaire. Five domains of influence on nurses' translation of evidence were identified: skills in finding/reviewing evidence; barriers to finding/reviewing evidence; knowledge from published sources; knowledge from other sources; and barriers or facilitators to change. Each domain was interpreted as underlying the relationship of nurses with evidence-based practice and was comparable to the original study's findings when subjected to factor analysis. Findings from this study show that the Developing Evidence-Based Practice Questionnaire-Au is a valid and useful instrument in determining the influences on practice nurses' ability to effect knowledge translation and conduct practice based on evidence. Given these findings, a new model is proposed that explains the influence of a number of domains on Australian general practice nurses' translation of knowledge into practice. [ABSTRACT FROM AUTHOR]

The article discusses a study which shows the perceived value of the course content of undergraduate nursing students. It says that the study aims to compare student career course and success in relation to entry pathway. It tabulates the student's responses to questionnaires and perceptions of their enjoyment of units in the first and second semesters. It tells that the study indicated association between subjects on skills and the units the students enjoyed.

Aim: Medical and lay concerns about food allergy are increasing. Whilst food allergy may be becoming more common, fatal reactions to food in childhood are very rare and their rate is not changing. We sought to establish how common severe reactions are.Methods: Prospective survey, 1998 to 2000, of hospital admissions for food-allergic reactions-conducted primarily through the British Paediatric Surveillance Unit, covering the 13 million children in the United Kingdom and Ireland.Results: 229 cases reported by 176 physicians in 133 departments, yielding a rate of 0.89 hospital admissions per 100,000 children per year. Sixty-five per cent were male, 41% were under 4 y and 60% started at home. Main allergens were peanut (21%), tree nuts (16%), cow's milk (10%) and egg (7%). Main symptoms were facial swelling (76%), urticaria (69%), respiratory (66%), shock (13%), gastrointestinal (4%). Fifty-eight cases were severe. Three were fatal, six near fatal, and 8 of these 9 had asthma with wheeze being the life-threatening symptom. Three near-fatal cases received excess intravenous epinephrine. None of the non-fatal reactions resulted in mental or physical impairment. Seven of 171 non-severe and 6/58 severe cases might have had a worse outcome if epinephrine auto-injectors had been unavailable. Six of the severe cases might have benefited if auto-injectors had been more widely prescribed.Conclusion: In the United Kingdom and Ireland, the incidence of severe reactions is low. The study highlights that: asthma is a strongly significant risk factor for a severe reaction and therefore warrants optimal management; severe wheeze is a prominent feature of severe reactions and warrants optimal management; intravenous epinephrine should be used with great care if needed. Epinephrine auto-injectors do not always prevent death, but our study design and data do not allow a definite statement about whether overall they are beneficial. [ABSTRACT FROM AUTHOR]

Our objectives were to examine the effect of an i.p. injection of a flooding dose of l-phenylalanine (Phe) containing l-[ring-(2)H(5)]Phe on time courses of physiologic responses, the tracer Phe enrichments, and fractional protein synthesis rates (FSR) in plasma, visceral organs, and muscles. In a randomized complete block design, 5 blocks of 5 littermate piglets were weaned at 16 d of age and injected i.p. with a flooding dose of l-Phe (1.5 mmol/kg body weight) on d 8 postweaning under fed conditions. Tissues were collected at 15, 30, 45, 60, and 75 min postinjection. Plasma glucose concentration increased (cubic effect, P < 0.05) from 4.8 preinjection to 5.8 mmol/L 15 min postinjection and returned to preinjection levels thereafter. Plasma insulin concentration did not change (P > 0.05) over time. Plasma Phe concentration increased logarithmically (P < 0.05) from 85 to 711 micromol/L and reached 95% of the maximum concentration 48 min postinjection, but no changes (P > 0.05) in tissue contents of other free amino acids were observed. The Phe free pools in plasma, visceral organs, and muscles were evenly enriched (32.3 +/- 1.4 mol%) with l-[(2)H(5)]Phe 15 min after the i.p. injection. The FSR in visceral organs did not change (P > 0.05), whereas plasma and muscle protein FSR decreased (P < 0.05) over time. We conclude that the i.p. injected tracer Phe rapidly distributed into plasma and intra- and extracellular spaces, and was effective for measuring FSR in visceral organs, but not in plasma and muscles of pigs. [ABSTRACT FROM AUTHOR]

The article presents a study which explores the incidence and patterns of respiratory rate recording, and its use as a Medical Emergency Team (MET) calling criteria in a medical and surgical ward in a rural hospital in Australia. The background, methods, results and conclusion of the study are offered. The study's relevance to the clinical practice is also discussed.

Background: The quality of nursing clinical placements has been found to vary. Placement evaluation tools for nursing students are available but lack contemporary reviews of clinical settings. Therefore, the aim of this study was to develop a feasible, valid and reliable clinical placement evaluation tool applicable to nursing student placements in Australia. Methods: An exploratory mixed methods co-design project. Phase 1 included a literature review; expert rating of potential question items and Nominal Group Technique meetings with a range of stakeholders for item development. Phase 2 included on-line pilot testing of the Placement Evaluation Tool (PET) with 1263 nursing students, across all year levels at six Australian Universities and one further education college in 2019–20, to confirm validity, reliability and feasibility. Results: The PET included 19-items (rated on a 5-point agreement scale) and one global satisfaction rating (a 10-point scale). Placements were generally positively rated. The total scale score (19 items) revealed a median student rating of 81 points from a maximum of 95 and a median global satisfaction rating of 9/10. Criterion validity was confirmed by item correlation: Intra-class Correlation Co-efficient ICC =.709; scale total to global score r =.722; and items to total score ranging from.609 to.832. Strong concurrent validity was demonstrated with the Clinical Learning Environment and Supervision Scale (r =.834). Internal reliability was identified and confirmed in two subscale factors: Clinical Environment (Cronbach's alpha =.94) and Learning Support (alpha =.96). Based on the short time taken to complete the survey (median 3.5 min) and students' comments, the tool was deemed applicable and feasible. Conclusions: The PET was found to be valid, reliable and feasible. Use of the tool as a quality assurance measure is likely to improve education and practice in clinical environments. Further international evaluation of the instrument is required to fully determine its psychometric properties. [ABSTRACT FROM AUTHOR]

Introduction: Involving stroke patients and carers in planning and designing a stroke research trial has several advantages in informing trial methodology, assessment tools, and consent procedures (Ali K 2006). Planning a trial exploring the use of a creative intervention such as Art Therapy (AT) in stroke warrants meaningful patient involvement.Methods: The research team (4 stroke specialists, 2 stroke survivors, a stroke research nurse, two arts therapists, and a speech and language therapist) designed a study exploring AT in stroke rehabilitation. The study proposal was discussed in a semi-structured focus group meeting (meeting 1) with 4 stroke patients recently discharged from hospital explaining the AT intervention, proposed assessment tools, and follow up measures.Following completion of the pilot study (6 patients were involved over 6 weeks) (Waller D et al 2013) feedback was obtained from all patients through face to face meetings (4 patients), and telephone interview (2 patients).Results: Initial study planning meetings with the two stroke survivors shaped the AT intervention as a group interactive session rather than a 1–1 session, and added a qualitative narrative of the study.Meeting 1 helped select the assessment tools which were finally used (Hospital anxiety and depression scale and Therapy outcome measure) in the study.Communications following completion of pilot study with the stroke survivors informed another 2-centre study proposal, and a current grant application.Conclusions: Engaging stroke survivors in planning research trials is feasible, beneficial in selecting appropriate methodology and preparing grant applications.Funding was provided by the Ageing Research Centre in Sussex. [ABSTRACT FROM AUTHOR]

With rising longevity, increasing numbers of older people are experiencing changes in their everyday family and social life, changes in their financial status, and a greater number of chronic conditions affecting their health. We took the opportunity to explore these relationships with worry in a group of volunteer community-living elderly (n = 310). Findings showed that that those people under 75 years of age had a higher risk of worrying (OR = 1.8, 95% CI = 1.0-3.1) compared to the older age groups. Women worried more than men and an important finding was that those with chronic health conditions such as arthritis of the hip and knee were more prone to worry than those who were healthy or had acute conditions (OR = 3.5, 95% CI = 1.4-8.9). This latter finding suggests the importance placed on the role of the hip and knee in maintaining functional capacity to perform life skills. [ABSTRACT FROM AUTHOR]

Inherited immunodeficiency disorders can be caused by mutations in any one of a large number of genes involved in the function of immune cells. Here, we describe two families with an autosomal recessive inherited immunodeficiency disorder characterized by increased susceptibility to infection and autoimmunity. Genetic linkage studies mapped the disorder to chromosomal region 14q11.2, and a homozygous guanine-to-adenine substitution was identified at the last base of exon 3 immediately following the translational termination codon in the TCRα subunit constant gene (TRAC). RT-PCR analysis in the two affected individuals revealed impaired splicing of the mRNA, as exon 3 was lost from the TRAC transcript. The mutant TCRα chain protein was predicted to lack part of the connecting peptide domain and all of the transmembrane and cytoplasmic domains, which have a critical role in the regulation of the assembly and/or intracellular transport of TCR complexes. We found that T cells from affected individuals were profoundly impaired for surface expression of the TCRαβ complex. We believe this to be the first report of a disease-causing human TRAC mutation. Although the absence of TCRαβ+ T cells in the affected individuals was associated with immune dysregulation and autoimmunity, they had a surprising level of protection against infection. [ABSTRACT FROM AUTHOR]