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Aims: This work aims to explore staff perceptions of (1) the effectiveness of organizational communication during the COVID‐19 pandemic and (2) the impact of organizational communication on staff well‐being and ability to progress their work and patient care. Background: Effective coordination and communication are essential in a pandemic management response. However, the effectiveness of communication strategies used during the COVID‐19 pandemic is not well understood. Design: An exploratory cross‐sectional research design was used. A 33‐item survey tool was created for the study. Methods: The study was conducted at a tertiary teaching hospital in Western Australia. Convenience sampling was used to recruit participants from nursing, medical, allied health services, administrative and clerical, and personal support services (N = 325). Data were collected between December 2020 and May 2021. Results: Overall, all occupational groups found working during the COVID‐19 pandemic stressful, and all groups wanted accessible and accurate communication from management and new policies, procedures, and protocols for future outbreaks. Conclusions: The use of occupational group‐relevant strategies and COVID‐19 protocols, as well as the on‐going use of email, face‐to‐face meetings with debrief sessions, are needed to improve communication and support staff to fulfil their roles. Summary statement: What is already known about the topic? Effective coordination and communication that is timely and two‐way in nature, is an essential part of a pandemic management response. What this paper adds? All occupational groups found working during the COVID‐19 pandemic stressful; all groups wanted accessible and accurate communication from management and new policies, procedures, and protocols for future outbreaks. The implications of this paper: Managing a pandemic situation in health care settings is challenging for all levels of staff including management and all occupational work groups.The use of occupational group‐relevant strategies and COVID‐19 protocols, as well as the on‐going use of email, face‐to‐face meetings with debrief sessions, are needed to improve communication and support staff to fulfil their roles. [ABSTRACT FROM AUTHOR]

Aim: To explore the satisfaction and experiences of women and staff with the BSOTS in an Australian hospital. Design: Cross‐sectional descriptive survey. Methods: Surveys were distributed to women and staff between February and May 2022. Survey questions reflected satisfaction with triage and provision of care under the BSOTS system (for women) and confidence in using the BSOTS system and its impact on triage‐related care (for staff). Survey data were summarized using descriptive statistics, and qualitative responses were analysed using content analysis. Results: There were 50 women and 40 staff (midwives and doctors) survey respondents. Most women were satisfied with triage wait times, the verbal information they received and the time it took for them to receive care. Nearly all midwife participants indicated they had high knowledge and confidence in using the BSOTS. Most staff indicated that the BSOTS supported the accurate assessment of women and had benefits for women, staff and the hospital. Conclusion: The findings showed that women and staff were satisfied with receiving and providing care in a maternity triage setting under the BSOTS system. Implications for the Profession and/or Patient Care: Implementing standardized maternity triage approaches such as the BSOTS in health settings delivering care to pregnant women is recommended for improving flow of care and perceptions of care quality by women. Impact: Quality of maternity triage processes is likely to impact the satisfaction of women attending services and the staff providing care. The BSOTS was shown to improve maternity triage processes and was associated with satisfaction of women and staff. Maternity settings can benefit from implementing triage approaches such as the BSOTS as it standardizes and justifies the care provided to women. This is likely to result in satisfaction of women and staff engaged in maternity triage and improve the birth outcomes of women and babies. Reporting Method: The reporting of this paper has followed SQUIRE guidelines. Patient or Public Contribution: Women engaged with maternity services were participants in the study but did not contribute to the design, conduct or publication of the study. [ABSTRACT FROM AUTHOR]

Aims: To explore Australian healthcare providers' perspectives on factors that influence disclosure and domestic violence screening through the lens of Heise's (1998) integrated ecological framework. Design: This paper reports the findings that were part of a sequential mixed methods study with survey data informing interview questions. Participants for interviews were recruited after expressing an interest after completing surveys, as well as via snowball sampling. Methods: Semi‐structured interviews were undertaken in 2017 with 12 practicing healthcare providers delivering care to women in the perinatal period in Greater Western Sydney, NSW, Australia. Data were analysed using Braun and Clarke's (2006) six‐step thematic approach. Findings The findings were framed within Heise's integrated ecological framework under four main themes. The main themes were 'Ontogenic: Factors preventing women from disclosing'; 'Microsystem: Factors preventing healthcare providers from asking'; 'Exosystem: Organizational structures not conducive to screening'; and 'Macrosystem: Cultural attitudes and socioeconomic influences affecting screening'. Conclusion: Organizational policies are needed for better systems of reminding healthcare providers to enquire for domestic and family violence and mandating this within their practices. Mandatory domestic and family violence education and training that is suitable for the time constraints and learning needs of the healthcare provider is recommended for all healthcare providers caring for perinatal women. Further research is needed in addressing culturally specific barriers for healthcare providers to enquire about domestic and family violence in a culturally appropriate way. Public and Patient Engagement and Involvement in Research (PPEI): No Patient or Public Contribution was embedded into the research reported in this paper as this research was specifically exploring healthcare providers' perspectives on domestic violence screening within their own practice experience. [ABSTRACT FROM AUTHOR]

Accessible Summary: What is known on the subject: ●Expert by Experience participation in mental health services is embedded in mental health policy in many countries. The negative attitudes of nurses and other health professionals to consumer participation poses a significant obstacle to this policy goal.●Involving mental health Experts by Experience in the education of nursing students demonstrates positive attitudinal change. What the paper adds to existing knowledge: ●The paper presents perspectives from Experts by Experience about the unique knowledge and expertise they derive from their lived experience of mental distress and mental health service use. As a result, they can make a unique and essential contribution to mental health nursing education. They utilize this knowledge to create an interactive learning environment and encourage critical thinking.●The international focus of this research enriches understandings about how Experts by Experience might be perceived in a broader range of countries. What are the implications for practice: ●Mental health policy articulates the importance of service user involvement in all aspects of mental health service delivery. This goal will not be fully achieved without nurses having positive attitudes towards experts by experience as colleagues.●Positive attitudes are more likely to develop when nurses understand and value the contribution experts by experience bring by virtue of their unique knowledge and expertise. This paper provides some important insights to achieving this end. Introduction: Embedding lived experience in mental health nursing education is increasing, with research findings suggesting the impact is positive. To date, research has primarily targeted the perspectives of nursing students and academics from the health professions. Aim: To enhance understanding of the unique knowledge and expertise experts by experience contribute to mental health nursing education. Methods: Qualitative exploratory research methods were employed. In‐depth individual interviews were conducted with experts by experience who delivered a coproduced learning module to nursing students in Europe and Australia. Results: Participants described their unique and essential contribution to mental health nursing education under four main themes: critical thinking, beyond textbooks; interactive and open communication; understanding personal recovery; and mental health is health. Conclusions: These findings present an understanding of the unique knowledge and expertise Experts by Experience contribute to mental health education not previously addressed in the literature. Appreciating and respecting this, unique contribute is necessary as Expert by Experience contributions continue to develop. Implications for Practice: Mental health services purport to value service user involvement. Identifying and respecting and valuing the unique contribution they bring to services is essential. Without this understanding, tokenistic involvement may become a major barrier. [ABSTRACT FROM AUTHOR]

Aim: To explore how compassion is received by patients in a hospital setting and how compassion is expressed by health professionals in a hospital setting. Background: Compassion is important to health professionals and patients. Perceived deficits in compassion in healthcare have led increasing concerns about the quality of care for patients. To better understand compassionate practice in a hospital setting we used narrative inquiry to explore the expression of compassion by health professionals and the experience of receiving compassion by patients. Design: Narrative Inquiry. Reported in line with Consolidated Criteria for Reporting Qualitative Research (COREQ). Methods: Qualitative interviews were conducted with 24 patients and health professionals in Australia. Data were collected between August 2018 and August 2019. Narrative analysis processes were used to develop a thematic framework. Results: Compassionate practice is presented as an overarching theme and comprises of three themes: (1) Amalgamation of various knowledges and skills (2) Delivery of meaningful actions which alleviate suffering and (3) Meeting individual needs and prevention of further preventable suffering. The expression of compassion by health professionals involved the fusion of many skills and knowledges. Patients received compassion through the actions of the health professional which alleviated their suffering. Conclusion: Compassionate practice is both important, and complex. Presence, skilled and purposeful action and the alleviation of suffering are essential to the expression and receipt of compassion in the hospital setting. Impact: Findings from this study contribute to the growing body of literature on compassionate practice in health settings, specifically in how it is expressed and received in a hospital setting. The complexity of compassion is explained for health professionals. Compassion was shown to be embedded in the caring moments between health professionals and patients. This paper explains the different elements that comprise compassion which can guide health professional practice. The importance of seemingly small acts has a big impact on patients, families and health professionals. There is a need for greater stakeholder value and recognition of this aspect of practice. [ABSTRACT FROM AUTHOR]

Aim: This study aimed to estimate the proportion of acute care nurses witnessing end‐of‐life dreams and visions or having these reported by a patient or relative, and to canvass their related attitudes and beliefs. Design: A cross‐sectional survey study was conducted from February 2023 to May 2023. Setting/Participants: Participants were medical and surgical nurses from a 200‐bed acute care hospital in metropolitan Australia. Results: Fifty‐seven nurses participated from a workforce of 169 (34% response rate), of whom 35 (61%) reported they had encountered end‐of‐life dreams and visions. The nature of end‐of‐life dreams and visions encountered was similar to those reported in previous studies by patients and clinicians. Nurses generally held positive attitudes towards end‐of‐life dreams and visions but identified an unmet need for education and training on this aspect of end‐of‐life care. Conclusion: Our results suggest that nurses in acute care encounter end‐of‐life dreams and visions in a similar proportion to oncology and long‐term care but lower than in palliative care settings. Education and training regarding end‐of‐life dreams and visions are needed to ensure the provision of comprehensive, patient‐centred end‐of‐life care. Patient or Public Contribution: No patient or public contribution. Impact: Research in sub‐acute and long‐term care settings suggests that end‐of‐life dreams and visions are a common accompaniment to the dying process. No research has yet focused on the acute care setting, despite this being the place of death for the majority of people in most high‐income countries. This study demonstrates that acute care nurses encounter end‐of‐life dreams and visions in similar proportions to oncology and long‐term care nurses but lower than palliative care nurses. Acute care nurses would benefit from education and training regarding end‐of‐life dreams and visions to enable the provision of holistic person‐centred end‐of‐life care. Reporting Method: This study was reported using the STROBE Checklist for cross‐sectional studies. [ABSTRACT FROM AUTHOR]

Introduction: Globally, healthcare regulatory bodies require providers of academic programs to involve service users in the design and delivery of education, yet concrete and tested directions for operationalising this are lacking. Service users' involvement in education is often passive, ad‐hoc and tokenistic, with limited input at the program development level. Aim: To explore the co‐design processes and outcomes of a collaborative revision of an Australian post‐registration mental health nursing curriculum. Method: Using qualitative case study design, the experiences and collaborative practices of five stakeholders (one mental health service user, two carers and two academics) co‐designing a post‐registration mental health nursing curriculum were explored. Results: Commonly identified barriers to meaningful involvement were overcome through planning and collaborative execution of the group's work. Participants reported a strong sense of successful collaboration in reviewing the curriculum, trusting relationships and mutual respect. Discussion: While it was possible to support and augment stakeholder knowledge in the context of post‐registration education, co‐design processes were ultimately bound by the university's relatively inflexible bureaucratic context. Implications for Practice: To ensure effective stakeholder collaboration beyond classroom teaching, mental health nurse academics must prepare service users for the role, explaining the language and practices of the tertiary health education and nursing context. As part of co‐design processes, organisational mandates must be explored and negotiated, and mutual clarity regarding expectations and roles must be established. A Design Thinking approach can support meaningful engagement of stakeholders in curriculum development. [ABSTRACT FROM AUTHOR]

Aim: To gather and understand the experience of hospital mealtimes from the perspectives of those receiving and delivering mealtime care (older inpatients, caregivers and staff) using photovoice methods to identify touchpoints and themes to inform the co‐design of new mealtime interventions. Methods: This study was undertaken on acute care wards within a single metropolitan hospital in Brisbane, Australia in 2019. Photovoice methods involved a researcher accompanying 21 participants (10 older patients, 5 caregivers, 4 nurses and 2 food service officers) during a mealtime and documenting meaningful elements using photographs and field notes. Photo‐elicitation interviews were then undertaken with participants to gain insight into their experience. Data were analysed using inductive thematic analysis, involving a multidisciplinary research team including a consumer. Results: Themes were identified across the three touchpoints: (1) preparing for the meal (the juggle, the anticipation), (2) delivering/receiving the meal (the rush, the clutter and the wait) and (3) experiencing the meal (the ideal, pulled away and acceptance). Despite a shared understanding of the importance of meals and shared vision of 'the ideal' mealtime, generally this was a time of tension, missed cares and dissatisfaction for staff, patients and caregivers. There was stark contrast in some aspects of mealtime experience, with simultaneous experiences of 'the rush' (staff) and 'the wait' (patients and caregivers). There was an overwhelming sense of acceptance and lack of control over change from all. Conclusions: This study identified themes during hospital mealtimes which have largely gone unaddressed in the design of mealtime interventions to date. This research may provide a framework to inform the future co‐design of mealtime interventions involving patients, caregivers and multidisciplinary staff, centred around these key touchpoints. Practice Implications: Mealtimes are experienced differently by patients, caregivers, nurses and food service officers across three key touchpoints: preparing for, delivering/receiving and experiencing the meal. Improving mealtime experiences therefore necessitates a collaborative approach, with co‐designed mealtime improvement programs that include specific interventions focusing each touchpoint. Our data suggest that improvements could focus on reducing clutter, clarifying mealtime roles and workflows and supporting caregiver involvement. Impact: What problem did the study address?: Mealtimes are the central mechanism to meet patients' nutritional needs in hospital; however, research consistently shows that many patients do not eat enough to meet their nutritional requirements and that they often do not receive the mealtime assistance they require.Interventions to improve hospital mealtimes have, at best, shown only modest improvements in nutritional intake and mealtime care practices. Gaining deeper insight into the mealtime experience from multiple perspectives may identify new opportunities for improvement. What were the main findings?: Patients, caregivers and staff have shared ideals of comfort, autonomy and conviviality at mealtimes, but challenges of complex teamwork and re‐prioritisation of mealtimes in the face of prevailing power hierarchies make it difficult to achieve this ideal.There are three discrete touchpoints (preparing for, delivering/receiving and experiencing the meal) that require different approaches to improvement.Our data suggests a need to focus improvement on reducing clutter, clarifying mealtime roles and workflows and supporting caregivers. Where and on whom will the research have an impact?: The research provides a framework for multidisciplinary teams to begin co‐designing improvements to mealtime care to benefit patients, caregivers and staff, while also providing a method for researchers to understand other complex care situations in hospital. Reporting Method: This manuscript is written in adherence with the Standards for Reporting Qualitative Research. Patient or Public Contribution: Patients and caregivers were involved in the conception and design of the study through their membership of the hospital mealtime reference group. A consumer researcher (GP) was involved in the team to advise on study conduct (i.e. recruitment methods and information), data analysis (i.e. coding transcripts), data interpretation (i.e. review and refinement of themes) and manuscript writing (i.e. review and approval of final manuscript). [ABSTRACT FROM AUTHOR]

Aim: To develop and psychometrically test the Australian Midwifery Workplace Culture instrument. Background: Workplace culture is critical within midwifery settings. Culture determines not only the well‐being and continued retention of maternity staff and managers but it also affects the quality and ultimate safety of the care they provide to women, infants and families. Several studies have identified cultural problems within maternity services. Relatively few instruments take account of the unique aspects of these workplaces and the relationship between midwives and women. Design Three‐stage instrument development involved item generation (based on the Culture of Care Barometer), expert content validation and a pilot test. Methods: During 2016, 38 midwifery experts reviewed the initial items, and 322 midwives then pilot‐tested the draft instrument. We used exploratory factor analysis to identify key domains and to refine the instrument. Results: The refined instrument contained 22 items in three distinct domains: relationship with managers, empowerment and collegiality. Conclusion: The instrument can contribute to understanding important dimensions of the culture in maternity workplaces and thus to examining problematic attitudes and practices. The instrument requires further development and testing with larger and more diverse samples of midwives and validation in specific midwifery settings and models of care. SUMMARY STATEMENT: What is already known about this topic? Previous research reports problems in the organizational culture in maternity services, increasing the stress on midwives and potentially affecting the care they provide to women and infants.Negative workplace culture may contribute to attrition in maternity workforce.There are few measures that specifically address midwifery workplace culture. What this paper adds? This paper presents a new instrument designed to measure dimensions of midwifery workplace culture, detailing item generation and pilot testing.Analysis identified three domains that demonstrated good psychometric properties: relationship with management; empowerment and autonomy; collegiality and relationship with peers. Implications of this paper: The exploratory factor analysis suggests the utility of this instrument for assessing workplace culture in midwifery settings.The study recommends further testing of this instrument and validation in diverse midwifery workplaces, including large and small hospitals, community services and rural and remote areas. [ABSTRACT FROM AUTHOR]

Aim: To explore discharge planning with a range of key stakeholders in subacute care, including consumers. Design: Qualitative descriptive study. Methods: Patients (n = 16), families (n = 16), clinicians (n = 17) and managers (n = 12) participated in semi‐structured interviews or focus groups. Following transcription, data were analysed thematically. Results: The overarching facilitator of effective discharge planning was collaborative communication, leading to shared expectations by all stakeholders. Collaborative communication was underpinned by four key themes: patient‐ and family‐centred decision‐making, early goal setting, strong inter‐ and intra‐disciplinary teamwork, and robust patient/family education. Conclusion: Effective planning for discharge from subacute care is enabled by shared expectations and collaborative communication between key stakeholders. Implications for the profession and/or patient care: Effective discharge planning processes are underpinned by effective inter‐ and intra‐disciplinary teamwork. Healthcare networks should foster environments that promote effective communication between and within multidisciplinary team members as well as with patients and their families. Applying these principles to discharge planning may assist in reducing length of stays and rates of preventable readmissions post‐discharge. Impact: This study addressed a lack of knowledge about effective discharge planning in Australian subacute care. It found that collaborative communication between stakeholders was an overarching facilitator of effective discharge planning. This finding impacts subacute service design and professional education. Reporting method: COREQ guidelines were followed in reporting this study. Patient or public contribution: No patient or public contribution in the design, data analysis or preparation of the manuscript. [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]

Aims: To examine the relationships between challenges, coping and resilience among immigrant parents caring for their children with disabilities; and to explore their coping and resilient experiences and the service centre providers' perspectives on these. Design: A sequential explanatory mixed methods study. Methods: The participants were recruited from seven centres of disability service in Australia between May 2019 and February 2020. Phase 1 consisted of a cross‐sectional survey. Data were collected from 134 immigrant parents. Phase 2 consisted of semi‐structured interviews. Data were collected from nine immigrant parents and nine service providers. The findings from each phase were analysed separately and then integrated to answer the research aims. Results: Immigrant parents experienced challenges such as overwhelming caretaking responsibilities, lack of supportive social networks and feeling embarrassment over their children's behaviours. They used a variety of coping strategies, including reframing and mobilizing family to acquire and accept help from others to overcome their challenges. They had positive gains from the parental experience. Immigrant parents had a reasonable level of resilience. Those with a higher level of perceived challenges had a lower level of coping and resilience. Perceived barriers to parental coping included barriers to establishing social networks and utilizing available disability services. Services from competent service providers and the availability of social support networks were factors facilitating immigrant parents' coping. Conclusion: Sensitive communication and culturally appropriate care provided by service providers and healthcare professionals can facilitate service utilization and reduce perceived stigma over children with disability. Impact Findings from the study support that special training provided to healthcare providers about the challenges of immigrant parents raising children with disabilities may enhance awareness of the experience of these parents. Information and instrumental support may help to enhance parental coping, reduce isolation and promote their mental health. Patient or Public Contribution: We thank the immigrant parents and the service providers who have been instrumental in the conception of this study. [ABSTRACT FROM AUTHOR]

Aim: To investigate the strategies used by nurse leaders to facilitate fundamental care delivery in their clinical area. Design: An interpretative qualitative design study reported in line with the Consolidated Criteria for Reporting Qualitative Research (COREQ). Methods: Twenty‐four self‐identified nurse leaders from across Australia were interviewed between November 2020 and April 2021 to discuss their strategies for facilitating fundamental care. Data was analysed using inductive thematic analysis. Results: Nurse leaders' experience of facilitating fundamental care produced two major themes, delivery of fundamental care (comprising three sub‐themes: valuing fundamental care, understanding and developing staff capacity and supportive relationships), and monitoring of fundamental care (including three sub‐themes: visibility in the clinical area, embedding fundamental care in the practice setting and specific direct actions). Conclusion: Facilitating fundamental care delivery is complex. This study highlighted the importance of nurse leaders' individual characteristics, and nurse leaders' ability to establish and maintain relationships alongside the role of informal and formal monitoring of fundamental care delivery. Impact Findings from this study build on existing research into fundamental care and contribute to our understanding of the role, characteristics and actions of nurse leaders to facilitate fundamental care. The results demonstrate the complexity and intricacy of nursing leadership to facilitate fundamental care, and that a dynamic 'thinking and linking' approach is required. The results show individualized practice which may create challenges for new nurse leaders seeking guidance, and for monitoring nurse leader activity. Further research is advocated to explore insights and tools to optimize nurse leaders' endeavours in facilitating fundamental care. Patient or Public Contribution: This study was designed using insights generated from patient and public involvement in nursing leadership and fundamental care. [ABSTRACT FROM AUTHOR]

Aim: To explore transition experiences of Middle Eastern qualified midwives into practice in Australia. Design: This was a qualitative study using multiple case narrative approach underpinned by structuration theory. Methods: A total of 19 Middle Eastern qualified midwives from different states of Australia participated in this study. Individual semi‐structured interviews were conducted between November 2020 and September 2021, digitally recorded and then transcribed. Transcriptions were analysed in three stages, with three main categories generated in the second stage and a core category that was developed in third. Results: Entering the Australian workforce, Middle Eastern qualified midwives had to reframe their professional identities to fit the new system by adjusting to three aspects of the practice, including preparation for practice, scope of practice and context of practice. While they were prepared by medically oriented curricula, worked in systems that had limitations for midwives to practise in antenatal and postnatal and lacked regulation standards, they learned to practise autonomously in their full scope in a standardized context in Australia. Conclusion: Middle Eastern qualified midwives in Australia re‐evaluated their practice in their home countries, realized the gaps and adjusted to new ways of practising in Australia. Impact To effectively use the potential of Middle Eastern midwives for workforce sustainability in Australia, support should be available to enable them to develop the necessary competencies for safe practice in Australia including provision of context‐specific transition programmes prior to registration and supporting mentorship after their integration into the Australian healthcare workforce. Patient or public contribution: Patient or public contribution does not apply to this study as its purpose was to explore the transition experiences of Middle Eastern qualified midwives themselves. [ABSTRACT FROM AUTHOR]

Aim: To describe current practice, examine the influences and explore barriers and facilitators to accurate documentation, for the administration of intravenous fluids during labour. Design: A descriptive qualitative study was performed. Methods: Qualitative semi‐structured interviews were conducted with Registered Midwives working across Australia. Midwives were recruited via email and social media advertisements. A maximum variation sampling strategy was used to identify potential participants. Interview questions explored four main areas: (i) understanding of indications for IV fluids in labour; (ii) identification of current practice; (iii) barriers to documentation and (iv) benefits and complications of IV fluid administration. Reflexive thematic analysis of recorded‐transcribed interviews was conducted. Results: Eleven midwives were interviewed. Clinical practice variation across Australia was recognized. Midwives reported a potential risk of harm for women and babies and a current lack of evidence, education and clinical guidance contributing to uncertainty around the use of IV fluids in labour. Overall, eight major themes were identified: (i) A variable clinical practice; (ii) Triggers and habits; (iii) Workplace and professional culture; (iv) Foundational knowledge; (v) Perception of risk; (vi) Professional standards and regulations; (vii) The importance of monitoring maternal fluid balance and (viii) barriers and facilitators to fluid balance documentation. Conclusion: There was widespread clinical variation identified and midwives reported a potential risk of harm. The major themes identified will inform future quantitative research examining the impact of IV fluids in labour. Impact The implications of this research are important and potentially far‐reaching. The administration of IV fluids to women in labour is a common clinical intervention. However, there is limited evidence available to guide practice. This study highlights the need for greater education and evidence examining maternal and neonatal outcomes to provide improved clinical guidance. [ABSTRACT FROM AUTHOR]

Aim: To explore the experiences of being an older nurse or midwife employed in the healthcare workplace. Design: A qualitative descriptive study. Method: Semi‐structured interviews were conducted with nurses and midwives who self‐identified as older workers. All Australian states were represented and given recruitment was undertaken nationally, most interviews were conducted via telephone. Data were collected between November 2018 and October 2019. Audio recordings were transcribed verbatim and then thematically analysed. Results: A total of 50 nurses and midwives were recruited, aged between 46 and 74 years. Three themes were identified. Ageing body: Being an older worker meant increased fatigue and physical changes affecting their ability to function at full capacity. Youth focus: For many, being an older worker was about being viewed as a poor‐quality worker, with limited access to education and promotional opportunities because of their age. Wise worker: For a small number of older nurses and midwives, it was about being valued and respected for their knowledge, experience and skills. Conclusion: Participants self‐identifying as older nurses or midwives represented a wide age range. Spanning across the age spectrum, many experienced fatigue, physical changes or loss of value to the workplace which often impacted on their working lives. The findings contributed to an understanding about what it is to be an older nurse or midwife in terms of how their contribution is regarded and valued by others in the workplace. Impact: This study highlighted there is a need for support of older nurses and midwives in managing age‐related fatigue and physical changes. It also suggests consideration of a wise‐worker model as a means to recognize the important contribution that older workers can offer. [ABSTRACT FROM AUTHOR]

Aims and objectives To examine the attitudes to and knowledge and beliefs about homosexuality of nurses and allied professionals in two early parenting services in Australia. Background Early parenting services employ nurses and allied professionals. Access and inclusion policies are important in community health and early childhood service settings. However, little is known about the perceptions of professionals who work within early parenting services in relation to lesbian, gay, bisexual and transgender families. Design This is the final in a series of studies and was undertaken in two early parenting services in two states in Australia using a cross-sectional design with quantitative and qualitative approaches. Methods Validated questionnaires were completed by 51 nurses and allied professionals and tested with chi-squared test of independence (or Fisher's exact test), Mann-Whitney U-test, Kruskal-Wallis one-way analysis of variance or Spearman's rank correlation. Thematic analysis examined qualitative data collected in a box for free comments. Results Of the constructs measured by the questionnaires, no significant relationships were found in knowledge, attitude and gay affirmative practice scores by sociodemographic variables or professional group. However, attitude scores towards lesbians and gay men were significantly negatively affected by conservative political affiliation ( p = 0·038), held religious beliefs ( p = 0·011) and frequency of praying ( p = 0·018). Six overall themes were found as follows: respect, parenting role, implications for the child, management, disclosure, resources and training. Conclusions The study provided an in-depth analysis of the attitudes, knowledge and beliefs of professionals in two early parenting services, showing that work is needed to promote acceptance of diversity and the inclusion of lesbian, gay, bisexual and transgender families in planning, developing, evaluating and accessing early parenting services. Relevance to clinical practice Access and inclusion plans for lesbian, gay, bisexual and transgender families are crucial in early parenting services in Australia and should be included in professional development programmes. [ABSTRACT FROM AUTHOR]

Aims and objectives To examine collaboration in the provision of universal health services for children and families in Australia from the perspective of midwives and child health and family health nurses. Background Collaboration is identified as a key concept contributing to families' smooth transition between maternity and child health services. However, evidence suggests that collaboration between services is often lacking. Few studies have explored how maternity and child health and family health services or professionals collaborate to facilitate a smooth transition. Design This study reports on data collected in phases 1 and 2 of a three-phase mixed-methods study investigating the feasibility of implementing a national approach to child health and family health services in Australia (Child Health: Researching Universal Services study). Methods In phase 1, consultations (via discussion groups, focus groups and teleconferences) were held with 45 midwives and 60 child health and family health nurses. Themes identified were used to develop phase 2 surveys. In phase 2, 1098 child health and family health nurses and 655 midwives returned surveys. Results Midwives and child health and family health nurses reported 'some collaboration'. Midwives and child health and family health nurses indicated that collaboration was supported by having agreement on common goals and recognising and valuing the contributions of others. Organisational barriers such as poor communication and information transfer processes obstructed relationships. Good collaboration was reported more frequently when working with other professionals (such as allied health professionals) to support families with complex needs. Conclusion This study provides information on the nature and extent of collaboration from the perspective of midwives and child health and family health nurses providing universal health services for children and families. Relevance to clinical practice Both professional groups emphasised the impact of service disconnection on families. However, their ability to negotiate professional differences is affected by system constraints and differing perspectives of what constitutes collaboration. Developing the capacity to collaborate is essential to ensure smooth transition of care given ongoing changes to the system. [ABSTRACT FROM AUTHOR]