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Aim: This study aimed to understand the lived experience of rural mothers caring for a child with a chronic health condition and to understand their perspectives on the support, services and resources they identify as necessary to effectively manage caregiving. Background: Maternal caregivers in rural areas experience difficulty accessing specialist health care for their child and can also experience geographical and social isolation. Understanding the factors that enable these maternal caregivers to overcome the challenges and adversities faced is crucial to help nurses identify and facilitate avenues for support and resources. Design: This study employed a phenomenological design. The study is reported in line with Consolidated criteria for reporting qualitative research guidelines (COREQ). Methods: Semi‐structured interviews were conducted with 17 maternal caregivers in rural New South Wales, Australia, who had at least one child with a chronic health condition aged between 2–18 years. Data were collected from March to June 2018. Thematic analysis was used to develop a thematic framework. This paper reports on one of the major themes identified in this research, specifically maternal resilience. Results: Participants demonstrated maternal resilience by creating meaningful social connections, cultivating networks, developing problem‐solving skills, enhancing their self‐efficacy and finding a sense of purpose through hope and optimism. These strategies provide nurses insight into how some rural women overcome adversities associated with their maternal labour required in caring for a child with a chronic health condition. Conclusion: This study found that participants overcame the challenges related to their caregiving work, emerging as resilient caregivers. Understanding maternal resilience assists nurses to provide the services rural mothers in Australia need to care for their child with a CHC. Relevance to clinical practice: Findings from this study provide insight into the experiences of rural maternal caregivers of children with a chronic health condition and identify the strategies they adopt to overcome caregiver challenges. Understanding these strategies allows nurses to improve care and support for rural mothers using a strength‐based approach to build maternal resilience. [ABSTRACT FROM AUTHOR]

Aims: This study aims to report on the everyday concern of the 'potential for misinterpretation', which was the basic social problem revealed in a grounded theory study exploring male nurse practice in inpatient rehabilitation in Australia. Background: Male nurses account for approximately 10% of nursing workforce across western countries and they practice in a range of clinical areas; however, how they practice in inpatient rehabilitation remains unexplored. Methods: Constructivist grounded theory was used in this study and was conducted in two phases: (i) involved semi‐structured interviews with 11 male nurses from October 2013 to June 2014 and (ii) observation of practice of 12 male nurses and semi‐structured interviews with male nurses and 15 patients from February to April 2015. Results: Nurse participants encountered the intersection of two pervasive patient ideologies about male nurses. Patients perceived nursing to be women's work and that male nurses are sexual threats. These two intersecting ideologies created a concern for male nurses working in inpatient rehabilitation and that concern was labelled 'potential for misinterpretation'. Conclusion: Gender stereotypes impacted on the ability of male nurses to practise nursing in inpatient rehabilitation. Male nurses were mindful on a daily basis that misinterpretation could, and did, happen in inpatient rehabilitation. Summary statement: What is already known about this topic? Male nurses work in a range of specialties.Male nurses across many specialties commonly find the provision of nursing care requiring touch to be problematic.Nursing practice in inpatient rehabilitation is reported from a gender neutral or female perspective. What this paper adds? Male nurses encountered the intersection of two pervasive patient ideologies 'nursing is perceived as women's work' and that 'male nurses are perceived as sexual threats'.These two intersecting ideologies lead to the 'potential for misinterpretation' for male nurses.Men were mindful that misinterpretation could happen at any time which influenced their ability to practise nursing. The implications of this paper: The 'potential for misinterpretation' is useful for nurses and others to understand a main concern male nurses encounter in inpatient rehabilitation.Research can inform nurse education providers about gaps in nursing curricula with regards to male nurse practice.Rehabilitation service providers can use this research to support and inform male nurse workforce development. [ABSTRACT FROM AUTHOR]

Aim and objective This paper aims to explore the ways in which neonatal nurses understand the experience of parents who have experienced infertility, conceived a baby via in vitro fertilisation and delivered an extremely premature infant. The chance of a poor long-term outcome for the baby is significant; therefore, parental anguish plays out in the neonatal intensive care. Background Current literature suggests that infertility is a significant issue for ageing women and many couples experience multiple cycles of invitro-fertilisation ( IVF) treatment to achieve a pregnancy. Babies conceived through IVF are more likely to have genetic disorders, and be born prematurely. When the baby is born through IVF and is also born extremely prematurely, it creates a crisis situation for the parents. This paper will focus on the parental anguish of achieving a pregnancy through IVF to see the baby born extremely prematurely (defined as ≤ 24-week gestation). It will examine parental anguish from caregiver perspective of the neonatal nurse who supports the parents through this very difficult time. Design This study used interviews with neonatal nurses, and drew insights from interpretative phenomenology. Methods This research used a combination of a questionnaire and a series of interviews in a qualitative study informed by phenomenology. The analysis of the interview data involved the creation of key themes following extensive coding of thematic statements and the analysis of the emerging themes. Results This paper outlines the neonatal nurses' understanding of parental anguish and overwhelming sadness in parents whose baby was conceived by IVF, and was also born extremely prematurely. The theme of 'seeking parenthood' was synthesised from two sub-themes - 'longing for a baby' and 'the desperation to become parents'. Conclusion This study identified that neonatal nurses bear witness to parental anguish as their hopes of taking home a live baby might not be realised. The time, effort and money required to achieve a pregnancy does not mean that the baby will be spared the outcomes of extreme prematurity and the risk factors associated with IVF. The parents may be left empty handed. Therefore, the word precious becomes a metaphor for the IVF baby as the neonatal team try desperately to give the parents their much longed baby. Relevance to clinical practice Delayed child bearing has an impact on fertility, with maternal age having the most impact on the ability to conceive. Babies conceived through IVF technologies have a higher risk of genetic abnormalities and being born prematurely, and this will impact on the neonatal intensive care availability. Extreme prematurity and IVF can significantly impact on the baby's outcome. Witnessing parental anguish can be a major source of stress for the neonatal nurses. Neonatal nurses need to develop strategies not only to help the parents but also to prevent the parents' overwhelming sadness from affecting their ability to function in the neonatal intensive care unit. [ABSTRACT FROM AUTHOR]

Aims and objectives This paper is drawn from a grounded theory study that aimed to investigate processes undertaken by academics when integrating evidence-based practice into undergraduate curricula. This paper focuses on how nurse academics facilitated students to apply evidence-based practice in theory and practice. Background Facilitating undergraduate nursing students to develop skills within an evidence-based practice framework is vital to achieving evidence-based care. Studies on evidence-based practice conducted globally suggests that there is a need to investigate approaches used by nurse academics in facilitating students' understanding and use of evidence-based practice during their nurse education. Methods Employing constructivist grounded theory approach, 23 nurse academics across Australian universities were interviewed and nine observed during their teaching. Some study participants shared their unit guides to enrich analysis. Data analysis was performed by following Charmaz's approach of coding procedures; as a result, four categories were constructed. This paper focuses on the category conceptualised as Envisaging the use of evidence-based practice. Results Findings revealed that most academics-assisted students to use evidence in academic-related activities. Recognising the importance of evidence-based practice in practice, some also expected students to apply evidence-based practice during clinical experiences. However, the level of students' appreciation for evidence-based practice during clinical experiences was unknown to participants and was influenced by practice-related barriers. Acknowledging these challenges, academics were engaged in dialogue with students and suggested the need for academia-practice collaboration in combating the cited barriers. Conclusion Ensuring academics are supported to emphasise clinical application of evidence-based practice requires strategies at school and practice levels. Faculty development, engagement of clinical nurses with evidence-based practice, supportive culture for nurses and students to apply evidence-based practice principles, and collaboration between academia and practice will make facilitation by academics practical and meaningful for students. Relevance to clinical practice Findings from this study point to a number of initiatives for clinical leadership to provide infrastructure and support for academics, practising nurses and undergraduate students to adopt evidence-based practice in practice settings, thereby influencing practice outcomes. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study is to explore how immigrant women and men from India construct mental health and mental illness in the perinatal period. Design: Qualitative interpretive design. Methods: Data were collected by conducting in‐depth interviews with 19 participants. Photo elicitation, free listing and pile sorting were used during the interviews. Purposive sampling was used, and data were collected in 2018 and 2019. Data were analysed using thematic analysis. Finding/Results: One major theme and three subthemes were identified. 'We do not talk about it' was the major theme and the subthemes: (1) 'living peacefully and feeling happy' described the views on mental health; (2) 'that's the elephant in the room still' captures how participants felt when talking about mental illness; and (3) 'why don't we talk about it' offers reasons why the Indian community does not talk about mental health and illness. Conclusion: The findings of this study have highlighted the importance of understanding the impact of immigration and being culturally sensitive when assessing mental health in the perinatal period. Impact: The findings of this study identify some of the reasons for non‐disclosure of mental health issues by immigrants. Incorporating these findings during psychosocial assessment by health professionals in the perinatal period will help translate the cultural aspects into more effective communication. Patient or Public Contribution: Patient and public contribution to the study was provided by the Community Stakeholders Group; these were members of the immigrant community from India who had expertise in mental health. They contributed to the study design and the key terms and phrases for the free list used in interviews. [ABSTRACT FROM AUTHOR]

Aims: To explore adult inpatients' perceptions, understanding and preferences regarding the term 'malnutrition' and to identify the terms that adult inpatients report are used by themselves and health workers to describe malnutrition. Design: This qualitative study was conducted using data collected for a separate qualitative study that investigated factors that influence the dietary intake of long‐stay, acute adult inpatients. Methods: Semi‐structured interviews were conducted with a purposive sample of current inpatients. Data were analysed using inductive content analysis. Results: Nineteen interviews were included (mean age 64 years (standard deviation ±17), 10 female (53%), 12 malnourished (63%)). Four categories were identified. 'Variation in patients' recognition of malnutrition' represents the differing abilities of patients to understand and identify with the term 'malnutrition'. 'Recognising individuals' needs and preferences' highlights patients' varying beliefs regarding whether 'malnutrition' is or is not an appropriate term and participants' suggestion that health workers should tailor the term used to each patient. 'Inconsistencies in health workers' and patients' practice regarding malnutrition terminology' encapsulates the multiple terms that were used to describe malnutrition by health workers and patients. 'Importance of malnutrition education' summarises patients' views that health workers should provide patient education on malnutrition prevention, management and complications. Conclusion: Findings highlight variations in patients' perceptions and understanding of the term 'malnutrition' and differences in the terms used by patients and health workers to describe malnutrition. Implications for the Profession and/or Patient Care: The terminology used by health workers to describe malnutrition risk or malnutrition to their patients can influence patients' recognition of their nutritional status and thus the multidisciplinary management of the condition. To ensure that patients receive information about their malnutrition risk or diagnosis in a way that meets their needs, health workers' practices must be revised. To do this, it is imperative to conduct further collaborative research with patients and health workers to identify optimum terms for 'malnutrition' and how health workers should communicate this to patients. Impact: There is a disparity in patients' perceptions, understanding and preferences for the term 'malnutrition' and there are inconsistencies in how health workers communicate malnutrition to patients.To support patients' recognition and understanding of their nutritional status, it is imperative for health workers to consider how they discuss malnutrition with patients. Reporting Method: Adheres to the Consolidated Criteria for Reporting Qualitative Research (Tong et al., 2007). Patient or Public Contribution: No Patient or Public Contribution. [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]

Aim This paper describes the research protocol for a study exploring if and how clinical supervision facilitates change in practice relating to psychosocial aspects of care for Health Professionals, who have been trained to deliver a psychosocial intervention to adults with cancer. Background There is a recognized need to implement care that is in line with clinical practice guidelines for the psychosocial care of adults with cancer. Clinical supervision is recommended as a means to support Health Professionals in providing the recommended psychosocial care. Design A qualitative design embedded within an experimental, stepped wedge randomized control trial. Methods The study will use discourse analysis to analyse audio-recorded data collected in clinical supervision sessions that are being delivered as one element of a large randomized control trial. The sessions will be attended primarily by nurses, but including physiotherapists, radiation therapists, occupational therapists. The Health Professionals are participants in a randomized control trial designed to reduce anxiety and depression of distressed adults with cancer. The sessions will be facilitated by psychiatrists experienced in psycho-oncology and the provision of clinical supervision. Discussion The proposed research is designed specifically to facilitate exploration of the mechanisms by which clinical supervision enables Health Professionals to deliver a brief, tailored psychosocial intervention in the context of their everyday practice. This is the first study to use discourse analysis embedded within an experimental randomized control trial to explore the mechanisms of change generated within clinical supervision by analysing the discourse within the clinical supervision sessions. [ABSTRACT FROM AUTHOR]

Aim: To explore perceived barriers and enablers to weight management among people with obesity awaiting total knee or hip arthroplasty. Design: A nested qualitative study within a multi‐centre, quasi‐experimental pilot study comparing usual care weight management to a dietitian‐led weight‐loss diet. Methods: Semi‐structured individual interviews were conducted with adults with end‐stage osteoarthritis and a body mass index ≥30 kg/m2 waitlisted for primary total knee or hip arthroplasty. Participants with diverse sociodemographic characteristics and varied success with weight management in the pilot study were purposively sampled. Interviews were analysed using inductive thematic analysis, underpinned by constructivist–interpretivist epistemology. The Patient Activation Measure and Health Literacy Questionnaire were used for context when interpreting the findings. Results: Twenty‐five participant interviews were conducted with a sociodemographically varied sample (aged 44–80 years, 9 born in Australia, 6 in paid employment and 11 lost ≥5% of their baseline weight). Four identified themes underpinned successful weight management: beliefs, adaptability, navigating healthcare and sociocultural context. Beliefs about whether weight was perceived as a problem, the expectation of weight loss and treatment‐related beliefs influenced participants' perspectives towards weight loss. Adaptability, the ability to overcome barriers to weight loss, comprised three subthemes; readiness to act, degree of independence and problem‐solving skills. Approaches towards navigating healthcare influenced uptake and adherence to weight management recommendations. Importantly, these themes were dependent on social and environmental circumstances, which influenced the type of barriers experienced and resources available to the individual. Conclusion: Differences in a person's beliefs, their ability to adapt and navigate healthcare and sociocultural context appear to explain successful weight management among people with end‐stage arthritis. Implications for the profession and/or patient care: Clinicians should allow for individualisation cognisant of the identified themes when providing advice and treatment to promote adherence to weight management interventions. Impact: This study explored perceived barriers and enablers to weight management among people with obesity awaiting total knee or hip arthroplasty. Four identified themes underpinned successful weight management: beliefs, adaptability, navigating healthcare and sociocultural context. Beliefs about whether weight was perceived as a problem, the expectation of weight loss and treatment‐related beliefs influenced participants' perspectives towards weight loss. Understanding and assessing the contribution of each factor may guide weight management from clinicians treating patients with obesity and osteoarthritis. Reporting Method: The data are reported using the COREQ guidelines. Patient or Public Contribution: Patients contributed to the data collected. [ABSTRACT FROM AUTHOR]

Aims: To map the pathway and service provision for pregnant women whose newborns require admission into the surgical neonatal intensive care unit at or soon after birth, and to examine the nature of continuity of care (COC) provided and the facilitators and barriers to woman‐ and family‐centred care from the perspective of women/parents and health professionals. Background: Limited research exists on current service and care pathways for families whose babies are diagnosed with congenital abnormality requiring surgery. Design: A mixed method sequential design adhering to EQUATOR guidelines for Good Reporting of a Mixed Methods Study. Methods: Data collection methods included: (1) a workshop with health professionals (n = 15), (2) retrospective maternal record review (n = 20), prospective maternal record review (17), (3) interviews with pregnant women given a prenatal diagnosis of congenital anomaly (n = 17) and (4) interviews with key health professionals (n = 7). Results/Findings: Participants perceived care delivered by state‐based services as problematic prior to admission into the high‐risk midwifery COC model. Once admitted to the high‐risk maternity team women described care 'like a breath of fresh air' with a 'contrast in support', where they felt supported in their decisions. Conclusion: This study highlights provision of COC, in particular relational continuity between health providers and women as essential to achieve optimal outcomes. Relevance to Clinical Practice: Provision of individualised COC offers an opportunity for perinatal services to reduce the negative consequences of pregnancy‐related stress associated with diagnosis of foetal anomaly. Patient or Public Contribution: No patient or public was involved in the design, analysis, preparation or writing of this review. [ABSTRACT FROM AUTHOR]

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

Aims and objectives: To reduce the likelihood of preventable readmissions, the aim was to investigate how older people (with their family members) managed their chronic health conditions at home following hospital discharge. The objectives explored older people and their family members' perspectives on how discharge plans assisted self‐management of their chronic conditions, their recognition of deterioration and when to seek treatment/re‐attend hospital. Background: Chronic conditions have challenged older adults' self‐management, particularly after hospital discharge and can impact on preventable readmission. Few studies have examined patients' and their family members' perspectives on the management of their conditions at home after hospitalisation. Design: A qualitative exploratory design known as Interpretive Description was utilised. Methods: Purposeful sampling involved 27 community‐dwelling older adults; nineteen were discharged patients with one or more chronic health conditions. Eight nominated family members were also recruited to enhance understanding of the older persons' self‐management at home. Interviews were undertaken and thematic data analysis followed the COREQ guidelines. Results: Five themes emerged: (1) Post‐Discharge Advice; (2) Managing at Home; (3) Recognition and Response to Deterioration; (4) Community Care and Support; and (5) The "Burden" on Others of Post‐Discharge Care. Conclusion: Older people sought a clear plan for self‐management at home prior to discharge. This plan should contain potential signs of deterioration and guidance on future action. We found that support given to older people from family and friends was critical to prevent readmission. In addition, their local General Practitioner and Pharmacist played an essential part in the support of their care. For some, social support services were also important. Nurse telephone follow‐up in the week following discharge was mostly absent. However, this strategy would be strongly recommended. Relevance to clinical practice: To mitigate against preventable readmission, we recommend the above strategies to assist the older person at home with self‐management of their chronic conditions. [ABSTRACT FROM AUTHOR]

Aims: The aim of this study was to explain the process through which Australian nurses and midwives provide abortion care to people affected by gender‐based violence (GBV). Design: A constructivist grounded theory study. Methods: This study took place between 2019 and 2021. The lead author conducted semi‐structured interviews with 18 Australian nurses and midwives who provided abortion care. Participants were recruited through pro‐abortion, nursing and midwifery networks using a snowballing technique. Data collection and analysis proceeded using purposive and theoretical sampling until we reached data saturation. Findings: Participants revealed they underwent a process of working with or against the system contingent on the degree to which the system (the interconnected networks through which a pregnant person, victimized by trauma, travels) was woman centred. When participants encountered barriers to person‐centred abortion care, they bent or broke the law, local policy and cultural norms to facilitate timely holistic care. Though many participants felt professionally compromised, their resolve to continue working against the system continued. Conclusion: Conservative abortion law, policies and clinical mores did not prevent participants from providing abortion care. The professional obligation to provide person‐centred care was a higher priority than following the official or unofficial rules of the organizations. Impact: This study addresses the clinical care of people accessing abortions in the context of GBV. Nurses and midwives may act out against the law, organizational policies and norms if prevented from providing person‐centred care. This research is relevant for any location that restricts abortion through stigma, pro‐life influences or politics. [ABSTRACT FROM AUTHOR]

Aims and Objectives: The aim of this study was to explore healthcare managers' perceptions about older nurses' and midwives' and their contribution to the workplace. Design: A qualitative descriptive methodology. Method: Twenty healthcare managers working in Australia participated in semi‐structured interviews. Data were collected between April 2019 and April 2021. Interviews were recorded, transcribed and then analysed using thematic analysis. Results: All healthcare managers said older nurses and midwives contributed to the workplace through their experience and knowledge. Managers viewed them as a different type of worker and while there were some positive aspects to this, it was mostly negative. Although managers identified a broad age range for the older nurses or midwives, there was a common perception that if they were no longer able to perform their duties, they should leave the workforce. Conclusion: Healthcare managers' perceptions towards older nurses and midwives are mostly negative, and their understanding of older workers' contribution is contradictory and poor. These negative views co‐exist with the lack of agreement on who is the older worker, which explain the reluctance of healthcare organizations to invest in their older workforce. Future research is needed to better understand the unique contribution of older nurses and midwives in healthcare and how they can be supported at work. Impact The global ageing population will result in a rise in complex age‐related health issues and will require an experienced and knowledgeable workforce. Given the greater experience of older nurses and midwives they are an important part of the health workforce. Yet managers' perception of the contribution by older nurses and midwives were often negative. The findings of this study highlight the need for organizational change so that the contribution of older nurses and midwives is recognized and supported by managers. [ABSTRACT FROM AUTHOR]

Background: Nurses' harm prevention practices during the admission of older persons to hospital have important consequences for patient safety, preventable patient harm and length of hospital stay. Novel solutions are needed to assist nurses to balance complexity, high workload burden and patient safety during admission processes. Aim: Explore the nurses' experiences of harm prevention practices during the admission of an older person to the hospital. Design: A multi‐method qualitative study informed by frameworks of behaviour change and human‐centred co‐design. Methods: The purposive sample included 44 nurses, 5 clinicians from other disciplines and 3 consumers recruited from five general medicine wards across three hospitals of a large public health service in metropolitan Melbourne, Australia. Data were collected over 12 h of naturalistic observations of nurses during eight patient admissions, and during four participatory human‐centred co‐design workshops between August 2019 and January 2020. Observation, field notes and workshop artefact data were integrated for qualitative content and thematic analysis. Results: Analysis revealed a 5‐step journey map, with a temporal logic, that captured nurses' experiences, as well as the enablers and barriers to harm prevention practices when admitting an older person to the hospital. The consensus was reached on three priority features to assist nurses to implement harm prevention practices when they admit an older person to the hospital: (1) prioritize important care; (2) tailor care to the individual and (3) see the big picture for the patient. Conclusion: The novel research approach identified five steps in nurses' activities and harm prevention practices during admission of an older person to the hospital, and key features for a solution to assist nurses to keep patients safe. The findings provide the foundation for further research to develop interventions to assist nurses to manage high workloads during this complex activity. [ABSTRACT FROM AUTHOR]

Aims: To describe the care needs of women with pregnancy‐related pelvic girdle pain based on the Caring Life‐Course Theory. Design: A descriptive qualitative research design. Methods: Data were collected between November 2019 and February 2021 from 20 purposively selected pregnant women with pelvic girdle pain aged between 22 and 39 years in antenatal care at a tertiary hospital in Australia. Individual semi‐structured interviews were recorded via a digital audio recorder and transcribed verbatim. Qualitative content analysis method was used to analyse the data. Findings Five broad themes were identified: pain is an added burden to pregnancy; knowledge is power to own what happens to me; engaging in self‐help; care from others is useful; and pain deserves more attention from healthcare professionals. Conclusion: Caring Life‐Course Theory presented a useful and applicable scaffold for describing care needs of pregnant women with pelvic girdle pain. The study revealed experiencing pelvic girdle pain led to additional care needs during pregnancy, highlighting the importance of self‐management strategies and an appreciation of care from others to assist women in limiting the effects of the pain. Participants identified the need for more information and attention from healthcare professionals to be able to better manage their condition. Impact This study presents a comprehensive picture of the change in care needs triggered by experiencing pelvic girdle pain during pregnancy. The findings have the potential to facilitate better care provision by considering novel methods of delivery, such as information and communication technology, whilst acknowledging the value placed on credible and trusted sources. Knowledge acquired through this study may be used by nurses and midwives, along with other healthcare professionals, to enhance the provision of comprehensive care that is acceptable to women with pelvic girdle pain during pregnancy. [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: This study aimed to explore the experiences of alcohol and other drug nurses transitioning to telehealth due to the COVID‐19 pandemic. Background: COVID‐19 has caused immense disruption to healthcare services, and to reduce viral transmission, many services moved to off‐site care delivery modalities such as telehealth. Design: We used a qualitative descriptive design for this study. Methods: Secondary analysis of semistructured interviews with alcohol and other drug nurses from Australia and New Zealand (n = 19) was conducted in July and August 2020. Data were analysed using thematic analysis and reported using COREQ guidelines. Results: Three were identified: '"All our face‐to‐face contact ceased with clients": Changing service delivery', '"How do I do my job when I can't see you?": An anxious shift in service delivery' and '"A lot of Indigenous people don't like the FaceTiming and all that": Challenges to delivery of services through telehealth'. Conclusion: Participants in our study reported challenges in transitioning to telehealth modalities. The perceived loss of therapeutic communication, difficulties in assessing risks to healthcare consumers such as domestic violence and challenges delivering telehealth care to a marginalized consumer cohort need to be overcome before telehealth is considered successful in alcohol and other drug treatment. However, telehealth was a successful adjunct to existing practices for nurses working with consumers in regional or remote areas or where consumers preferred this method of service delivery. Impact: Nurses in this study described substantial issues with the delivery of alcohol and other drug treatment via telehealth, including a perception that telehealth was a barrier to addressing risks to consumers who use alcohol and other drugs, and difficulties working in a therapeutically beneficial way via telehealth. Telehealth is a means to reduce viral transmission through a reduction in face‐to‐face contact, and although it may be useful for some service functions, it may be detrimental to the clinical services nurses provide. [ABSTRACT FROM AUTHOR]

Aims: To explore the experiences of strategic leads for nurse education as they sought to respond to the COVID‐19 pandemic. Design: We utilised a qualitative interpretative approach to explore education leaders' experiences of leading during the early months of the pandemic. Methods: Nineteen leaders with significant strategic responsibility for nurse education in Australia, Canada, New Zealand, Singapore and the United Kingdom were identified via purposive sampling and agreed to participate. Interviews were held between May and July 2020. Results: Four overarching themes arose from the analysis: (1) Crisis driven adaptability & flexibility; (2) Responsive, complex and changing communication; (3) Making decisions for student and staff safety; (4) Looking to the future; stronger partnerships. Conclusion: Internationally, while nursing education leaders faced different problems, they shared a common goal amidst the crisis to remain student‐centred. They demonstrated they were able to face major challenges, respond to large scale logistical problems and make decisions under significant and ongoing pressure. Impact: In responding to the pandemic, nurse leaders shared knowledge and offered mutual support. This bodes well for future collaboration. The move to online learning accelerated an existing trend and it seems likely that this will continue. Given the pressures they experienced over an extended period, the sector may wish to consider how it prepares and supports existing and future leaders. [ABSTRACT FROM AUTHOR]

Aims: This study presents an ethnographic insight into the older hospitalized persons' experiences on how nurses provide pain care provision. The older persons' perceptions of culturally mediated barriers and facilitators are presented. Design: Focused ethnography. Methods: Multi-site across eight acute care units within two tertiary referral hospitals on the east coast of Australia collected over a one-year period from 2014 to 2015. Semi-structured interviews (n = 12) of older persons (11 hr). Twenty-three (23) semi-structured interviews with nine (9) registered nurses (12 hr 38 min). Participant observation (1,041 hr) during day, night and evening shifts. Results: The older person experienced disjunction within pain assessment by the reliance of nurses on objective measurement gained during functional task completion. Tension emerged during pain management when the older person was not included and/or options provided were not deemed effective. For some older persons this meant they undertook a decision to exclude their nurse from involvement in pain management. A thread woven throughout was a lack of communication, continuity of care and input from the older person. Conclusion: This study has implications for the provision of nursing care of the older hospitalized person. Dissonance within pain care provision for the older person occurs during episodes of missed pain care. Understanding and insight is gained into aspects of missed communication opportunities between nurses and the experiences of missed pain care of the older person. [ABSTRACT FROM AUTHOR]

Aims and objectives: To explore the impact of the COVID‐19 pandemic on alcohol and other drug nurses providing treatment for individuals presenting with problematic alcohol and other drug use. Background: COVID‐19 has caused disruption to contemporary health service delivery, including alcohol and other drug treatment. Provisional research on drug and alcohol consumption patterns shows changes attributable to the pandemic, with implications for service delivery. Research also indicates the impact of the pandemic on healthcare staff is significant, leading to workforce challenges that threaten care provision. Design: Qualitative descriptive study design. Methods: Data were collected using semi‐structured, individual telephone interviews with practising alcohol and other drug nurses from Australia and New Zealand (n = 19). COREQ reporting guidelines were used. Results: After thematic analysis, three key themes emerged: 'No room at the inn: Changes to service delivery due to COVID‐19', 'We are providing care to a very vulnerable group of people: Consumer factors during COVID‐19' and 'Personally, we were very, very stressed: Workforce factors due to COVID‐19'. Conclusions: The findings from this study indicate that the impact of the pandemic was felt by alcohol and other drug nurses, services and healthcare consumers alike. The experiences of alcohol and other drug nurses through the COVID‐19 pandemic need further exploration both to ensure workforce sustainability and that disruptions to alcohol and other drug services do not occur in future outbreaks of communicable disease. Relevance to clinical practice: COVID‐19 has had a profound effect on nurses in all settings, and these effects are likely to be felt for some time after the pandemic: nursing specialties require support to ensure ongoing workforce sustainability and well‐being of nursing staff. All nurses need to be aware of changes to alcohol and other drug use during the pandemic and screen healthcare consumers accordingly. [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: The aim of this study was to identify features of well‐performing residential aged care services (RACS) as experienced by family carers. Background: Family carers can have an integral role in residential aged care providing social support and are well‐placed to engage with staff and monitor care. Design: A qualitative descriptive design was used. Semi‐structured face‐to‐face and telephone interviews were conducted with family carers of current or past residents of Australian RACS between November 2018 and January 2019. Interview transcripts were analysed thematically. Results: Rather than reporting features of well‐performing RACS, participants shared stories of sub‐standard care, dysfunctional management and poor resident–staff–family interactions. An overarching theme emerged of 'having to be an advocate' for residents' needs, which covered four major categories: organisational accountability (including transparency and individualised care), good communication, connection and trust. Combined, these constitute what carers perceive are the necessary conditions for determining the features of a well‐performing RACS. Conclusion: Family carers need to feel confident and trust RACS staff when they hand over the role of carer for their relative with dementia. Relevance to clinical practice: This study provides insight into the needs and challenges of family carers when they relinquish the care of an older relative with dementia. Strategies to build confidence and trust between RACS and family carers are essential. Aged care nurses can play a pivotal role to support this through the development of open communication and relational connections with residents and their families. [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: To evaluate healthcare practitioners' perceptions of the feasibility and acceptability of a communication tool, entitled the TRANSITION tool, to communicate with older patients during transition from acute care to a community setting. Background: Transitional care for older patients is challenging due to their complex care needs and rapid care transitions. Research has identified effective models of transitional care. However, optimal communication between healthcare practitioners and older patients remains under‐investigated. Design: Exploratory descriptive qualitative design. Methods: The methods are reported using the Consolidated Criteria for Reporting Qualitative Studies checklist. The setting comprised two acute medical wards in an urban hospital in Australia. Twenty‐two nursing and allied healthcare practitioners used the TRANSITION tool to guide communication about transitional care with an older patient and then participated in an interview about their experience of using the tool. All data were thematically analysed. Findings: Healthcare practitioners reported their perceptions that the TRANSITION tool was feasible and acceptable, and that they perceived the tool supported them to know what to ask and to find out information regarding their patient's transitional care needs. Some ward‐based nurses reported their perception that transitional care was not their role. Conclusions: Findings emphasise transitional care as a continuing care process that requires effective communication between nurses and older patients in acute medical wards. Relevance to clinical practice: Given shorter lengths of stay, complex care needs and slow recovery, ward‐based nurses are vital in communicating with older patients about their transitional care needs. The TRANSITION tool may support communication between ward‐based nurses and older patients to improve assessment and planning. Implementation of the tool will require a planned strategy to facilitate translation of the tool into routine practice of ward‐based nurses to support their roles during older patients' care transitions. [ABSTRACT FROM AUTHOR]

Aims and objectives: This study sought to explore undergraduate nursing students' perceptions of the role and value of their bioscience tutors in a blended learning curriculum. Background: Blended learning approaches typically have reduced face‐to‐face contact with tutors—particularly in bioscience subjects which nursing students have traditionally found difficult, and the move to more web‐based learning resources may compound this difficulty. Design: Qualitative descriptive study. Methods: This qualitative study was conducted with 19 undergraduate nursing students enrolled in bioscience subjects, at a large university in outer metropolitan Sydney, Australia in 2016. Semi‐structured interviews were conducted over the telephone or face‐to‐face. Duration of interviews ranged from 13 to 71 min. Results were thematically analysed. EQUATOR guidelines for qualitative research (COREQ) applied. Results: Two main themes with accompanying sub‐themes were identified. The first theme identified the importance of the tutor in bioscience, including their qualities, expertise and contextualisation of learning. The second theme provided insights into students' perceptions of what they considered good and poor approaches to learning. Conclusions: This study has clearly shown that while nursing students appreciated the flexibility offered by the online component of a blended learning curriculum, they still wanted an experienced bioscience tutor with clinical experience for their face‐to‐face classes. While the tutor was seen as crucial to providing clarification and context for content that was often challenging, they also played a key role in engaging and motivating students and creating a learning environment where students felt empowered to ask questions and debate issues with their peers. Given the increased use of online learning, further research could determine if the current study findings are also applicable in nonscience areas of study. Relevance to clinical practice: The importance of students having a sound understanding of the biosciences for safe, effective clinical practice cannot be underestimated. [ABSTRACT FROM AUTHOR]

Aims and objectives: To explore the experiences of food choice and meal service in residential aged care facilities and its impact on autonomy, self‐determination and quality of life from the perspectives of both residents and staff. Background: Globally, residential aged care is a principal provider of care for older people who can no longer live independently at home. Within this setting, lack of food choice has been identified as a significant factor impacting on residents' self‐determination, sense of autonomy and quality of life. Design: This study used an exploratory descriptive qualitative approach guided by self‐determination theory. Method: A total of 14 participants (seven residents and seven staff members) from two Australian residential aged care facilities were recruited through purposive and snowball sampling with assistance from one independent contact nurse at each facility. In‐depth, semi‐structured interviews were conducted, digitally recorded and transcribed. The COREQ checklist was used in this qualitative study. Results: Three main themes were identified from the interview data provided by residents and staff, which were as follows: (a) catering for the masses; (b) organisational barriers to providing choice; and (c) food impacts well‐being. Conclusions: This study explored the experiences of food choice and service in residential aged care facilities, from the perspectives of both residents and staff. Results of interviews highlighted the importance of providing adequate food choice which has become an enduring issue that requires more attention and commitment to make a positive change for residents living in residential aged care facilities. Relevance to clinical practice: Nurses and other staff working in residential aged care facilities need to be aware of the importance of providing adequate food choice, including for residents who require modified diets. As advocates for residents, nursing staff must address the persistent lack of food choice. However, this will require a radical change in organisational culture and strong leadership. [ABSTRACT FROM AUTHOR]

Aim: To examine the needs, barriers and challenges experienced by family carers of people with dementia concerning the management of their care recipients' functional disabilities, and their experiences and opinions of using mobile health (mHealth) applications in health information seeking. Background: Functional disability is a significant problem among people with dementia and management can be challenging for family carers. Evidence suggests that mHealth applications can support knowledge needs of patients and families. Design: A qualitative descriptive exploratory study. Methodology: In‐depth interviews were conducted with a purposive sample of family carers using a semi‐structured interview guide. An inductive thematic analysis method was used. The COREQ reporting guideline was followed. Results: Five spousal and five child carers participated in this study. Four key themes were identified: (a) Challenges faced that contribute to psychological distress and burden; (b) Essential role of support systems in dementia care; (c) Information and educational needs of family carers, and (d) Experiences and attitudes of mHealth applications as an educational and supportive resource. Conclusion: Providing functional care is demanding, challenging and stressful, and leads to carer burden. The complexity of dementia is a barrier in the organisation of functional care and access to a support network is vital to care provision. The information needs of family carers can potentially be addressed through an mHealth application. Relevance to clinical practice: This study provides important information on family carers' needs, and the barriers and challenges related to functional care for people with dementia. Findings from this study can assist nurses and other health professionals in the planning of educational and supportive programs for family carers. Furthermore, the use of mHealth applications could positively contribute to the delivery of these programs. [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.)

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 explore the context and culture of nursing surveillance on an acute care ward. Background: Prevention of patient deterioration is primarily a nursing responsibility in hospital. Registered nurses make judgements and act on emerging threats to patient safety through a process of nursing surveillance. Organisational factors that weaken nursing surveillance capacity on general wards increase the need for patient rescue at the end point of clinical deterioration with poorer outcomes. Yet little is known about cultures that enable and sustain ward nursing surveillance for patient safety. Design: Workplace observations and semistructured interviews using a critical lens as the first stage of a larger emancipatory practice development project. Methods: Researcher immersion including 96 hr of nonparticipant observation with 12 semistructured interviews during July–August 2017. This study adhered to the COREQ guidelines. Results: We offer a metaphor of nursing surveillance as the threads that support the very fabric of acute care nursing work. These hidden threads enable nurses to weave the tapestry of care that keeps patients safe. This tapestry is vulnerable to internal and external forces, which weaken the structure, putting patients and staff at risk. Conclusion: Understanding local context is essential to supporting practice change. This workplace observation challenges us to find ways to creatively engage nurses with the underlying cultural and systems issues that so often remain hidden from view in the deteriorating patient literature. Relevance to clinical practice: Building cultural values that strengthen nursing surveillance is a prerequisite for safe and effective hospital care. As such, practice‐based research that empowers frontline nurses and teams to develop person‐centred workplace cultures can hold the key to unlocking sustainable improvements in patient safety. [ABSTRACT FROM AUTHOR]

Aims and objectives: (a) Describe the co‐development of a point‐of‐care App to promote uptake of best practice recommendations and consolidate nurses' knowledge for managing symptoms of neurocognitive disorders. (b) Report acceptability, usability and feasibility of the App to nurses for patient care in hospital. Background: Strategies used in hospitals to reduce symptoms, risk of harm, or complications of behavioural and psychological symptoms associated with neurocognitive disorders are frequently inconsistent with best practice recommendations. Design: Three‐stage, mixed‐methods, process and outcome evaluation. Methods: The App was co‐developed with experts, nurse end‐users and a consumer. Evaluation data were collected from a convenience sample of nurses observed during delivery of 80.5 hr of care to 38 patients; the App (n = 32 patients); and individual and focus group interviews with nurses (n = 25). Reporting adhered to an adapted STROBE checklist. Results: The App included three components: cognition and risk assessment; tailored evidence‐based strategies; and monitoring and evaluation of effectiveness. Observation data captured nurses using the App with 44.7% (n = 17) of eligible inpatients. Cognitive screening was completed at least once for each patient, with 146 risk assessments recorded. Interview data indicated the App's acceptability was enhanced by familiarity and perceived benefits, but hindered by perceived increases in workload, inconsistent use, pressure to use the App and resistance to change. Feasibility and usability were enhanced by easy navigation, and clear and useful content, but hindered by unclear expectations, unfamiliarity and device‐related factors. Conclusions: The App provided an evidence‐based tool that was, overall, considered feasible and acceptable to support best practice. Findings provide guidance to enhance usability for future implementation. Relevance to clinical practice: Co‐development using best evidence and key stakeholders enabled creation of a novel, feasible and acceptable technology. Real‐time access to assessment tools and tailored knowledge supported nurses' clinical decision‐making; workload and unfamiliarity were barriers to use. [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 explore allied health staff perceptions on the role of nurses in subacute care wards. Background: A consequence of earlier discharge from acute hospitals is higher acuity of patients in subacute care. The impact on nurses’ roles and required skill mix remains unknown. In the same way, nurses’ integration into the rehabilitation team is ambiguous. Design: Descriptive qualitative inquiry. Methods: Semistructured interviews conducted with 14 allied health staff from one subacute care facility in Melbourne, Australia. Interviews were audio‐recorded and transcribed verbatim. Analysis using the framework approach. Results: Three main themes were evident: (a) the changing context of care: patient acuity, rapid patient discharge and out‐dated buildings influenced care; (b) generalist as opposed to specialist rehabilitation nurses: a divide between traditional nursing roles of clinical and personal care and a specialist rehabilitation role; and (c) interdisciplinary relations and communication demonstrated lack of respect for nurses and integrating holistic care into everyday routines. Conclusions: Allied health staff had limited understanding of nurses’ role in subacute care, and expectations varied. Power relationships appeared to hamper teamwork. Failure to include nurses in team discussions and decision‐making could hinder patient outcomes. Progressing patients to levels of independence involves both integrating rehabilitation into activities of daily living with nurses and therapy‐based sessions. Promotion of the incorporation of nursing input into patient rehabilitation is needed with both nurses and allied health staff. Relevance to clinical practice: Lack of understanding of the nurses’ role contributes to lack of respect for the nursing contribution to rehabilitation. Nurses have a key role in rehabilitation sometimes impeded by poor teamwork with allied health staff. Processes in subacute care wards need examination to facilitate more effective team practices inclusive of nurses. Progressing patients’ independence in rehabilitation units involves activities of daily living with nurses as much as therapy‐based sessions. [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]

Aims and objectives: To explore nursing home staff members’ beliefs and expectations about what constitutes “quality continence care” for people living in nursing homes. Background: Most nursing home residents require assistance to maintain continence or manage incontinence. Best practice guidelines promote active investigation of incontinence, treatment of underlying potentially reversible causes, and initial conservative interventions to prevent, minimise and/or treat incontinence. Despite research showing the positive benefits of implementing active interventions, translating the findings of research into practice in nursing homes has been modest. Understanding the perspectives of individuals who provide continence care may help bridge the gap between evidence and practice. Design: A qualitative exploratory descriptive design. Methods: Qualitative interviews were conducted with 19 nursing home staff: eight registered nurses, four enrolled nurses and seven personal care workers working in a nursing home in Australia between 2014–2015. Data were analysed inductively to identify themes and subthemes that described and explained staff beliefs about quality continence care in nursing homes. Findings: Participants’ understanding and expectations about quality continence care were linked to beliefs about incontinence being an intractable and undignified condition in nursing homes. The key theme to emerge was “protecting residents’ dignity” which was supported by the following six subthemes: (i) using pads, ii) providing privacy, (iii) knowing how to “manage” incontinence, (iv) providing timely continence care, (v) considering residents’ continence care preferences and (vi) communicating sensitively. Conclusion: The findings provide new insight into the basis for continence care practices in nursing homes. Education about continence care should challenge beliefs that limit continence care practice to cleaning, containing and concealing incontinence. There is a need for a multidimensional framework that is informed by social, psychological and biomedical research about incontinence, research about the fundamental elements of care, care‐dependent individuals’ expectations about care, and values about dignity and care. Relevance to clinical practice: The in‐depth exploration led to an understanding of the basis for continence care practices that centre on cleaning, containing and concealing residents’ incontinence in some nursing homes. There is a need to review the quality of education for the aged care workforce about incontinence to ensure it equips them with a broad understanding of the fundamentals of care and how to enact dignity in continence care through a resident‐centred approach. [ABSTRACT FROM AUTHOR]

Aims and objectives: To understand the beliefs, attitudes and perceptions of nurses regarding family participation and collaboration in the care of their hospitalized adult relative. Background: Family participation in care is known to enhance the quality of patient care. Nurses are uniquely placed to support such participation, including the delivery of fundamental care. However, nurses' attitudes and beliefs may help or hinder participation. Design: A mixed methods approach with an exploratory sequential design was used. Setting: A regional referral hospital in Australia. Participants: Nurses were eligible to participate in the study if they were permanent staff of the hospital, and who in their day‐to‐day work had direct contact with adult patients and their families on acute care wards. Methods: Observer‐as‐participant observation data and semi‐structured interviews were undertaken. 30 hr of observational data were gathered, and 14 nurses were interviewed. Data collection occurred between September and December 2016. Following separate analysis, data were triangulated. Results: Analysis uncovered two contrasting categories: (i) enacting family participation (four themes); and (ii) hindering family participation (five themes). Conclusion: The findings of our study demonstrated that the practices of nurses do not always align with healthcare policies, and strategies to support nurses to enact patient‐ and family‐centred practices are needed. Relevance to clinical practice: Nurses can use these findings to make informed evidence‐based changes to the way they practice and communicate with families to ensure fundamental care is delivered. [ABSTRACT FROM AUTHOR]

Aims and objectives: To explore experiences of family-centred care among parents of children with cystic fibrosis living far from tertiary treatment centres and to understand what such distances mean to their care. Background: Australia is a large continent. However, many families with a child with cystic fibrosis live in regional areas, often thousands of kilometres away from the primary treatment centres located in Australia’s coastal capital cities. Design: A qualitative, phenomenological design using a Van Manen (1990) approach. Methods: Individual, semi-structured interviews were conducted with parents (n = 7) of a child with cystic fibrosis who lived in regional Australia. Thematic content data analysis was used. Results: The essence of the participants’ experience was their seeking certainty and continuity in the changeable realm of cystic fibrosis while negotiating a collaborative approach to their child’s care. Five core themes and two subthemes were identified: “Daily care: a family affair,” including the subtheme “Accessing expert care”; “Family- centred care: seeking inclusion”; “Control versus collaboration: seeking mutual trust,” with the subtheme “The team who grows with you”; “Future projections”; and “The CF circle.” Conclusion: Some concerns are not unlike those of their city counterparts, but can be intensified by their sense of distance and isolation. Relevance to clinical practice: Insight into this unique milieu from the parents’ perspective is requisite so that care is appropriate to such a challenging environment and incorporates the whole family. [ABSTRACT FROM AUTHOR]

Aims and objectives To explore in detail how women perceived their experience of domestic violence and leaving or ending the abuse. This research also examined how service providers identified their professional role in assisting women to end such relationships. Background Domestic violence against women continues to occur internationally. Reliable statistics are difficult to capture because of inconsistent definitions, contradictory methods of acquiring data and unreported incidents. Design A qualitative study, undertaken in two phases, was conducted in Australia. Methods Twelve women who had experienced domestic violence and ended those relationships participated in one semistructured interview (Phase 1). Twenty-five professionals from health, social sciences and law, whose work included assisting women experiencing domestic violence, participated in three focus groups (Phase 2). Thematic analysis guided by a narrative inquiry approach forms the framework for information collection and interpretation of data in this project. Findings The barriers that impede women from disclosing abuse and taking action to end domestic violence are complex and varied between participants. Women did not always acknowledge or realise their relationship was precarious and often denied or minimised the abuse to cope with the domestic violence. Professionals identified that women did not always identify or acknowledge abuse inherent in their relationship although this delayed the provision of appropriate services. Conclusion Whether women disclose abuse or deny violence in their relationship, acceptance by service providers and the offer of support is crucial to assisting women in violent relationships. Relevance to clinical practice It is hoped that the findings may assist health practitioners, including nurses, to provide nonjudgemental support to women experiencing domestic violence whether women acknowledge the abusive relationship or not. [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]

Aims and objectives The aim of this study was to evaluate nurses' perceptions of an education programme and screening and referral tool designed for cardiac nurses to facilitate depression screening and referral procedures for patients with coronary heart disease. Background There is a high prevalence of depression in patients with coronary heart disease that is often undetected. It is important therefore that nurses working with cardiac patients are equipped with the knowledge and skills to recognise the signs and symptoms of depression and refer appropriately. Design A qualitative approach with purposive sampling and semi-structural interviews was implemented within the Donabedian 'Structure-Process-Outcome' evaluation framework. Methods Semi-structured interviews were conducted with 14 cardiac nurses working in a major metropolitan hospital six weeks post-attending an education programme on depression and coronary heart disease. Thematic data analysis was implemented, specifically adhering to Halcomb and Davidson's (2006) pragmatic data analysis, to examine nurse knowledge and experience of depression assessment and referral in an acute cardiac ward. Results The key findings of this study were that the education programme: (1) increased the knowledge base of nurses working with cardiac patients on comorbid depression and coronary heart disease, and (2) assisted in the identification of depression and the referral of 'at risk' patients. Conclusions Emphasis was placed on the translational significance of educating cardiac nurses about depression via the introduction of a depression screening and referral instrument designed specifically for use in the cardiac ward. As a result, participants found they were better equipped to identify depressive symptoms and, guided by the screening instrument, to confidently instigate referral procedures. Relevance to clinical practice Much complexity lies in caring for cardiac patients with depression, including issues such as misdiagnosis. Targeted education, including use of appropriate instruments, has the potential to facilitate early recognition of the signs and symptoms of depression in the acute cardiac setting. [ABSTRACT FROM AUTHOR]

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

Aims and objectives. To describe the essence of the lived experience of patients and families in the early phase of long-term haemodialysis therapy. Background. Past qualitative research has taken a long-term view describing established haemodialysis therapy as it impacts on physical limitations and changes in self-concept, psychosocial well-being and sense of dignity with subsequent consequences for family roles and financial status. Design. This study used the qualitative approach of Heideggerian phenomenology. Methods. Eleven patients with end-stage kidney disease who had recently initiated haemodialysis and five family carers engaged in semi-structured interviews. These were recorded and transcribed verbatim and analysed using an hermeneutic framework. Results. The essence of the early dialysis experience was a 'lost life', and participants were overwhelmed by shock and grief. This appeared to result from a lack of mental and physical preparation for dialysis as a long-term management strategy. A loss of sense of self, loss of spontaneity and personal freedom and loss of social connectedness challenged the participants' ability to contribute to family and community. Changed body sensations ranged from improved wellness to a sense of depletion and fatigue. Family caregivers found the caring role was unremitting and required intense vigilance. Conclusions. Patients and family members in the early phase of dialysis may have difficulty perceiving a positive future. Relevance to clinical practice. A greater focus on preparation for the possibility of dialysis and frameworks of care that support adjustment to this new way of life are of vital importance. Family presence during haemodialysis and support groups for patients and family should be actively facilitated. [ABSTRACT FROM AUTHOR]

Aims and objectives To explore patients' perspectives of bedside handover by nurses in the emergency department (ED). Background International guidelines promote standardisation in clinical handover. Poor handover can lead to adverse incidents and expose patients to harm. Studies have shown that nurses and patients have favourable opinions about handover that is conducted at the bedside in hospital wards; however, there is a lack of evidence for patients' perspective of nursing handover in the ED environment. Design Qualitative descriptive study. Methods Semi-structured interviews with 30 ED patients occurred within one hour of bedside handover. Data were analysed using thematic content analysis. Results Two main themes were identified in the data. First, patients perceive that participating in bedside handover enhances individual care. It provides the opportunity for patients to clarify discrepancies and to contribute further information during the handover process, and is valued by patients. Patients are reassured about the competence of nurses and continuum of care after hearing handover conversations. Second, maintaining privacy and confidentiality during bedside handover is important for patients. Preference was expressed for handover to be conducted in the ED cubicle area to protect privacy of patient information and for discretion to be used with sensitive or new information. Conclusions Bedside handover is an acceptable method of performing handover for patients in the ED who value the opportunity to contribute and clarify information, and are reassured that their information is communicated in a private location. Relevance to clinical practice From the patients' perspective, nursing handover that is performed at the bedside enhances the quality and continuum of care and maintains privacy and confidentiality of information. Nurses should use discretion when dealing with sensitive or new patient information. [ABSTRACT FROM AUTHOR]

Aim To report a study in Australian operating theatres of compliance by the anaesthetic team with best peripheral arterial catheter practice for blood gas sampling and infection prevention. Comparisons are made with research recommendations and Centres for Disease Control Guidelines. Background There is wide global usage of peripheral arterial catheters in the operating theatre for haemodynamic monitoring and blood gas analysis. Frequent blood sampling from arterial catheters can lead to statistically significant blood loss and provide an infective potential. Evidence-based research and clinical guidelines prescribe best practice. Design Cross-sectional descriptive survey Methods Data were collected in 2009 from 64 major Australian hospitals using a self-designed internet survey. Results/Findings Hand hygiene prior to catheter insertion was the only infection prevention practice entirely adherent with guidelines. The recommended ratio of discard to dead space volume of 2:1 to decrease unnecessary blood loss during blood gas sampling was reported by only 11 (17%) respondents. Less than 32 (50%) respondents used the preferred solution, chlorhexidine to disinfect the insertion site. Access ports were reported as 'never disinfected' before use by 30 (47%) respondents. Conclusion The complex operating theatre environment presents barriers, which contribute to non-adherence with guidelines. These barriers need to be identified to plan strategies for improvement. A quality audit tool is proposed for development by nurses in collaboration with the anaesthetic team, providing a needed method to assess ongoing compliance with best peripheral arterial catheter care. Further international research would test the generalizability of our Australian findings. [ABSTRACT FROM AUTHOR]

Aims and objectives To explore the perceptions of older patients who re-presented to hospital within 28 days of discharge from an acute medical unit (AMU), their family caregivers and appropriately experienced health professionals. Background Hospitals are increasingly using AMUs to provide rapid assessment and treatment for medical patients. Evidence of efficacy is building, however in-depth exploration of the experiences of older patients who re-present to hospital soon after discharge from an AMU, and those who care for them, appears to be lacking. Design A qualitative, descriptive design was used. Methods In 2007, our team purposively sampled older patients who re-presented to hospital within 28 days of discharge from an AMU ( n = 12), family caregivers ( n = 15), and health professionals ( n = 35). Data were collected using semi-structured interviews and subjected to thematic content analysis. Results Four themes emerged: the health trajectory, communication challenges, discharge readiness and the decision to return. Re-presentation to hospital was seen as part of a declining health trajectory. The AMU was viewed as treating acute illness well, however patients and family caregivers left hospital with limited understanding of underlying health problems and, therefore, ill-prepared for future health crises. Conclusion There are clear benefits for older patients from AMUs, which expedite treatment for acute health crises. However, AMU discharge planning needs to consider patients' overall health status and likely future needs to optimise outcomes. Such a requirement is problematic in the context of acute time pressures. Relevance to clinical practice To ensure prompt and expert attention to key aspects of discharge planning for older people leaving AMUs, there is a role for in-depth clinical expertise in the care of older people facing deteriorating life-limiting conditions. Therefore, a leadership role for nurses with geriatric and palliative care expertise, alongside medical and allied health professionals, merits attention in this context. [ABSTRACT FROM AUTHOR]