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Aim: The aim of the study was to investigate why registered nurses seek forensic mental health employment and explore their initial impressions of this setting. Design: Explanatory sequential mixed methods. Methods: Registered nurses employed in a forensic mental health hospital completed an online survey about their reasons for seeking work in forensic mental health and their transition into the setting. To fully explore findings, semi‐structured interviews were conducted with a sub‐group of survey respondents. Descriptive statistics were used to analyse survey data, and thematic analysis was used to analyse the interviews. Results: Sixty‐nine respondents completed the survey, and 11 interviews were conducted. Prior interest in forensic mental health and encouragement from hospital staff were considered important influences in seeking forensic mental health employment. New knowledge, changes in clinical responsibility, exposure to patients' background offences and security processes overwhelmed some participants initially. However, participants reported that the initial challenges of their transition revealed opportunities to develop genuine connections with patients. Conclusion: This study provides a new understanding of the reasons why nurses seek employment in forensic mental health and the challenges and opportunities experienced when first working in this setting. Such professional and personal elements need to be considered by organizations to strengthen recruitment strategies and support future nurses' transition into forensic mental health settings. Impact: This study provides new knowledge about recruiting and supporting nurses' transition into forensic mental health employment. As such, it informs policymakers, clinical services and managers about strategies needed to attract and retain this workforce. Patient or Public contribution: No public or patient involvement. [ABSTRACT FROM AUTHOR]

Gallagher R, Sullivan A, Hales S, Gillies G, Burke R, Tofler G. International Journal of Nursing Practice 2012; 18: 133-139 Symptom patterns, duration and responses in newly diagnosed patients with heart failure This study investigated the symptom patterns and duration and associated predictors occurring prior to first heart failure (HF) admission. Data from the Managing Cardiac Function (MACARF) program from January to December 2007 were reviewed in relation to preadmission symptoms and contacts with health professionals. Patients ( n = 242) were aged 78.7 years (SD 12 years), male (54%) and married (45%). Patients experienced up to seven symptoms (Mean 2.7, SD 1.4) for a median of 4.47 days (range 1-7) before admission, most commonly increased dyspnoea on exertion (88%), and for the shortest duration chest discomfort. Less than half (48%) contacted a health professional before hospitalization, most often a general practitioner (37%). The duration patients experienced before presenting to hospital was increased if they presented during business hours (beta = 2.68) or the evening (beta = 1.88) (and therefore less from midnight to 8:30 am), or with a change in symptom (beta = 1.4), whereas duration was reduced by chest discomfort (beta = −2.01) and older age (beta = −0.07). There is a significant time window during which patients and health professionals may detect and act on worsening HF symptoms. Newly diagnosed patients with HF need support to recognize and respond to these symptoms to avoid hospital admission. [ABSTRACT FROM AUTHOR]

Richardson G, Whiteley I. International Journal of Nursing Practice 2011; 17: 621-627 A comparison of nurses' perceptions of elective laparoscopic or elective open colorectal resections The purpose of this study was to develop an instrument to measure the perceived benefits nurses observe in the recovery of patients who have undergone elective laparoscopic colorectal resections vs. traditional open elective colorectal resections. Secondly, to determine if there are perceived differences in the intensity of nursing required to care for these patients. A twenty-three-point questionnaire was developed and distributed to 23 colorectal nurses working in a single tertiary referral hospital. There was an 83.6% response rate. The findings demonstrate that the participants believe there are significantly better outcomes for the laparoscopic patients in the postoperative period. These benefits include more rapid resumption of independence, decreased pain and fewer complications. The nurses also perceived less time and effort was required when caring for these patients. [ABSTRACT FROM AUTHOR]

Chow J, Miguel SS. International Journal of Nursing Practice 2010; 16: 484-491 Evaluation of the implementation of Assistant in Nursing workforce in haemodialysis units The aim of this project was to evaluate the introduction of Assistant in Nursing (AINs) in the haemodialysis units at a major tertiary Area Health Service in Sydney, Australia. All nursing staff were asked to complete a baseline and follow-up survey to determine changes to their attitudes to the new skill mix model and their satisfaction with the new organization of care delivery in their dialysis units. Comparison of the baseline and follow-up surveys in the paired data was favourable with nurses acknowledging that they would cope well with the introduction of AINs, and they were more likely to disagree with the statement that their workload would increase after the introduction of AINs in the follow-up survey. There was little difference in (i) the workload of the dialysis units before and during the intervention; and (ii) the incidence of patient and nursed related adverse outcome events. [ABSTRACT FROM AUTHOR]

Aims and objectives To describe the challenges of, and steps taken to successfully collect video ethnographic data during and after caesarean sections. Background Video ethnographic research uses real-time video footage to study a cultural group or phenomenon in the natural environment. It allows researchers to discover previously undocumented practices, which in-turn provides insight into strengths and weaknesses in practice. This knowledge can be used to translate evidence-based interventions into practice. Design Video ethnographic design. Methods A video ethnographic approach was used to observe the contact between mothers and babies immediately after elective caesarean sections in a tertiary hospital in Sydney, Australia. Women, their support people and staff participated in the study. Data were collected via video footage and field notes in the operating theatre, recovery and the postnatal ward. Conclusions Challenges faced whilst conducting video ethnographic research included attaining ethics approval, recruiting vast numbers of staff members and 'vulnerable' pregnant women, and endeavouring to be a 'fly on the wall' and a 'complete observer'. There were disadvantages being an 'insider' whilst conducting the research because occasionally staff members requested help with clinical tasks whilst collecting data; however, it was an advantage as it enabled ease of access to the environment and staff members that were to be recruited. Despite the challenges, video ethnographic research enabled the provision of unique data that could not be attained by any other means. Relevance to clinical practice Video ethnographic data are beneficial as it provides exceptionally rich data for in-depth analysis of interactions between the environment, equipment and people in the hospital environment. The analysis of this type of data can then be used to inform improvements for future care. [ABSTRACT FROM AUTHOR]

Aims and objectives This study aimed to establish the scale of alcohol-related injuries originating in the home. Background Despite recent media and public attention on alcohol-related injuries occurring at licensed venues, many occur in other locations including the home. Design A retrospective observational study. Methods Emergency department surveillance data sourced from the Queensland Injury Surveillance Unit were interrogated for alcohol-related emergency department presentations from 2003-2012 (n = 12,296). Descriptive analysis was undertaken to assess alcohol involvement in injury, and analysis of variance was used to determine the differences among group means and their associated presentations. The relationship between demographic variables and injury location was assessed using p value of <0·05 as statistically significant. Results Of all injuries that were positively identified as being alcohol related, 41·07% occurred at the 'other' location, 36·14% 'at home', 13·00% on the street and 9·78% at licensed premises. Of these, males ( n = 2635; 59%) represented a higher proportion than females ( n = 1807; 41%). Of injuries identified as domestic violence by spouse or partner ( n = 510), 59·5% occurred 'at home'. Conclusions This is the first study to investigate alcohol-related injuries occurring at home. The home accounts for a greater proportion of injuries than the frequently assessed licensed premises location. Further research is required to validate these findings in a wider setting. Relevance to clinical practice A public health campaign is required to minimise harm associated with alcohol-related injuries in the home, and nurses are positioned to inform health policy makers around this issue. Furthermore, emergency department nurses are in a unique position to provide brief interventions around safe alcohol consumption and injury prevention. [ABSTRACT FROM AUTHOR]

Aims and objectives. To describe the nature of falls in an inpatient traumatic brain injury rehabilitation setting. Background. Falls are the most frequently recorded patient safety incident in the inpatient context. However, higher rates of falls are reported in rehabilitation settings compared to acute care settings. In the rehabilitation setting, patients with a traumatic brain injury have been identified as at a high risk of falling. However to date, research into the nature of falls involving this patient population is limited. Design. Five-year retrospective cohort study design. Methods. Falls data from an inpatient traumatic brain injury rehabilitation unit were retrieved from the NSW Ministry of Health Incident Information Management System and patient clinical notes; nursing shift data were retrieved from the local rostering system. Results. The fall rate was 5-18 per 1000 patient bed days. Over a 24-hour period falls (n = 103) occurred in a trimodal pattern. The median fall free period after admission was 14 days and 22% of traumatic brain injury patients had at least one fall. 53% of falls occurred in the patient's bedroom and 57% were attributed to loss of balance. At time of fall, 93% of fallers had impaired mobility and 85% required assistance for transfers. Conclusion. Falls within inpatient traumatic brain injury rehabilitation are a significant and complex clinical issue. While many patients continued to be at risk of falling several months after admission, a repeat faller's first fall occurred earlier in their admission than a single faller's. Relevance to clinical practice. Generic falls prevention measures are insufficient for preventing falls in the brain injury rehabilitation population. Falls prevention initiatives should target times of high patient activity and situations where there is decreased nursing capacity to observe patients. Rehabilitation clinicians need to be mindful that a patient's risk of falling is not static and in fact, may increase over time. [ABSTRACT FROM AUTHOR]

Aim To report findings from a qualitative study of the experiences of long-term survivors of multiple myeloma. Background Multiple Myeloma is a malignant disease of the bone marrow. Until recently, it was rapidly fatal. Although it remains incurable, people diagnosed with it are living longer on average, largely due to new treatments, some of which have onerous side effects. Design Prospective descriptive study. Method A series of 47 in-depth interviews were conducted at 6-12 month intervals over 18 months in 2008-2010 with 10 long-term survivors of myeloma and their primary support person. Interviews were analysed using the constant comparative method (Grounded Theory). Findings To adapt to the effects of both the disease and ongoing medical treatments, participants undertook extensive 'illness work'. Most of this work fell into two broad categories. Risk work aimed to mitigate risks to the well-being of both the person with myeloma and his/her carer. Emotion work aimed to manage the feelings of self and others in a protracted cycle of remission and relapse. Conclusion The experience of myeloma is increasingly characterized by issues associated with chronic disease and 'survivorship'. It is important for nurses working with people with myeloma to understand the overwhelming nature of illness work in this context. Nurses can put in place supportive measures to address the two main 'drivers' of this work: constant risk to well-being of survivors (including carers) and the recurrent need to manage emotions in social interactions. [ABSTRACT FROM AUTHOR]

Aims and objectives To explore West African migrant women's knowledge, attitude and usage of cancer screening in Australia. Background Despite strong evidence that cancer screening saves lives through early detection and treatment, there is lack of empirical studies on West African migrant women's knowledge, attitude and usage of cancer screening in Australia. Design Qualitative naturalistic inquiry. Methods Twenty-one West African migrant women who consented to participate in the study were recruited through a snowballing technique. These women were engaged in face-to-face audiotaped in-depth interviews which lasted for about 90 minutes. Interviews were transcribed verbatim and thematically analysed. Results The following three themes emerged from the data: knowledge of cancer screening, attitude towards cancer screening and usage of cancer screening Irrespective of the women's place of birth in Africa, twenty of the participants had no knowledge of cancer screening prior to migration, and most had a negative attitude towards screening. Women who had given birth after migrating to Australia were more likely to have had cervical cancer screening. Women who had passed their child-bearing years or had not presented to healthcare facilities for medical issues were more likely to be unaware of cancer screening. Conclusions Improved health promotion strategies that provide accessible information and education to West African migrant women regarding cancer screening are required to enhance the uptake of such screening in this migrant group. Relevance to clinical practice Nurses who encounter West African migrant women in their day-to-day practice have the opportunity to provide this group with education related to the importance of cancer screening. [ABSTRACT FROM AUTHOR]

The article discusses the results of a study on the job perceptions of graduates from two different courses in midwifery in Australia. According to the authors, graduates from two midwifery courses, one for registered nurses at a postgraduate level and the other for non-nurses at an undergraduate level, revealed philosophical differences on concepts of job satisfaction and ways their jobs could be improved. They also mention differences in graduates age and intention to work as part time.

To examine the factor structure and internal consistency of the Chronic Disease Compliance Instrument-Diabetes in an Australian sample of adolescents with diabetes, to modify the instrument and re-examine factor structure and internal consistency of subsequent scales and to examine the relationship between compliance behaviour and theoretically relevant explanatory factors. Compliance is a key challenge for adolescents with a chronic disease; however, valid and reliable self-report measures of compliance behaviour and explanatory factors for diabetes remain elusive, particularly applied in an Australian setting. Correlational design. Participants were 133 adolescents (12-17 years) diagnosed with diabetes and receiving treatment at several health care settings in New South Wales. Participants voluntarily completed the self-report instrument while waiting to see their Physician/Clinical Nurse Consultant/Diabetes Educator. On logical modification of the instrument based on exploratory factor analysis and thorough review of item content, the instrument was shown to have sufficient factor structure and internal consistency. Further, eight of the 11 explanatory factor scales were significantly related to compliance behaviour (accounting for 31% of variance). The present study represents the first application of an established instrument to measure compliance to diabetes treatment among adolescents in an Australian sample and demonstrates that the instrument has sufficient factor structure and internal consistency in this setting. Findings provide a list of relevant factors for explaining compliance, which may be employed to guide the development of initiatives to increase the level of compliance to treatment among Australian adolescents with diabetes. The Chronic Disease Compliance Instrument-Diabetes is a tool that can help nurses with their clinical practice by allowing for more efficient identification of adolescent compliance to diabetes treatment, which may be used in conjunction with HbA1c values already employed. [ABSTRACT FROM AUTHOR]