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Aim: The aim of this work is to identify factors that impact on early career nurses' intentions to remain in their current position and compare with what impacts on intention to remain in the profession. Background: Early exits of nurses from a position and the profession are a result of evolving factors. A lack of longitudinal follow‐up impedes knowledge about these factors or what proportion of temporary exits become permanent. Method: The study used prospective cohort survey design. The sample was obtained from non‐probability convenience sampling of graduating nursing students from two universities. Data was collected across three time points over 12 months, commencing in November 2016. Results: The professional turnover rate was 6.7% in total. Higher Work Environment, Support and Encouragement scores and Stress in personal life were the only predictors of intending to remain in the profession. Statistical modelling could not predict intention to remain in current position. Conclusion: There were differences identified when comparing intention to remain in a position and the profession. Nurses are satisfied with their career choice and intend to remain in the profession, although many are intending to move positions. Implications for Nursing Management: To effectively retain the nursing workforce, stakeholders must focus on the work environment, appropriate support and remuneration, and facilitate career progression. [ABSTRACT FROM AUTHOR]

Nurses play a vital role in health promotion, and there may be a link between a nurse's own lifestyle practices and how they educate others. Supporting health and well-being in student nurses is critical given they will be educating others once registered and practicing. To explore the health and health behaviours of undergraduate nursing and midwifery students considering the demands of their profession, their public health role and their ability to be role models. Multi-methods study. Undergraduate nursing students in the second and third years of their programme were invited to self-complete a health and health behaviour questionnaire in a Scottish and Australian Higher Education Institution. Qualitative data were collected from a convenience sample of 20 third-year nursing and midwifery students. Two hundred and thirty-five Scottish students and 113 Australian students, 175 (85%) and 84 (74%), respectively, completed the questionnaire. Some differences and similarities were noted across groups, in particular, perceived physical health, the prevalence of binge drinking, smoking and being overweight/obese and some dietary measures were found to be less favourable among Scottish students. There were worryingly high levels of poor mental well-being at both higher education institutions, with scores on a mental well-being scale suggesting that (82) 34.7% of Scottish students and 33 (29.6%) of Australian students were at risk of depression. Nine Scottish students and 11 Australian students were interviewed. Key contributors and barriers to healthy behaviours were noted across both groups of students in relation to lifestyle. Students perceived that certain elements of their curriculum had implications on their ability or motivation to make healthy lifestyle choices. The poor health and health behaviours of future nurses need to be addressed in their higher education to shape resilient role models for future nursing practice. Priority should be given to supportive learning environments for student nurses that foster emotional support and encourage healthy lifestyles. [ABSTRACT FROM AUTHOR]

Aim: To identify the factors influencing employment outcomes and settings for early career nurses. Background: A shortage of nurses attracted to work in out‐of‐hospital settings exists. Despite this, not all nursing graduates can secure work as a nurse. Information on the factors that impact wider graduate employment is available. However, a nursing perspective is missing, especially for hard to recruit to areas. Methods: A prospective cohort study was conducted. Participants were 293 final‐year undergraduate nursing students, recruited from two universities. Data were collected over 12 months, commencing November 2016. Results: English as a first language was the greatest predictor of employment for graduates. Previous health care experience and workplace preferences predicted employment in the out‐of‐hospital setting. Conclusions: Misalignment between English language requirements and industry expectations about language may lead to bias in recruitment of graduate nurses with English as their second language. Recruitment to out‐of‐hospital settings may be promoted by having health care experience and targeting those with a preference. Implications for Nursing Management: Reviewing current employment policies to ensure they reflect the need for cultural diversity in the nursing workforce is critical. Additionally, research that aims to understand how preferences for out‐of‐hospital settings are developed will help target graduate employment strategies. [ABSTRACT FROM AUTHOR]

Student-led interprofessional health clinics offer valuable opportunities for student learning and meeting the health care needs of the community. This case study describes the operation of a new interprofessional student-led community health service over its initial 13-month period of operation. This case study also presents an overview of the service provision, student placement opportunities and focuses on the challenges associated with the service and the impact on future planning. What is known about the topic?: Interprofessional student-led clinics offer an opportunity to meet clinical placement demands and interprofessional training needs while also providing a community service. What does this paper add?: This case study adds to the limited literature around knowledge of service delivery and challenges in the operation of community-based student-led interprofessional health services; future planning to streamline processes is also addressed. What are the implications?: There may be relevance to other university–industry partnerships that intend to explore student-led interprofessional service operations designed to address placement shortages, student training and community needs. [ABSTRACT FROM AUTHOR]

Aims and objectives To report on registered nurses' situation awareness as a precursor to decision-making when recording changes in patients' conditions. Background Progress notes are important to communicate patients' progress and detail changes in patients' conditions. However, documentation is often poorly completed. There is little work that examines nurses' decision-making during documentation. This study focused on describing situation awareness as a precursor to decision-making during documentation. Design This study used Endsley's (Situation Awareness Analysis and Measurement, 2000, Lawrence Erlbaum Associates, NJ) work on situation awareness to guide and conceptualise information. The study was situated in a naturalistic paradigm to provide an interpretation of nurses' decision-making. Methods Think-aloud research methods and semi-structured interviews were employed to illuminate decision-making processes. Audio recordings and interview texts were individually examined for evidence of cues, informed by Endsley's (Situation Awareness Analysis and Measurement, 2000, Lawrence Erlbaum Associates, NJ) descriptions of situation awareness. Results As patients' conditions changed, nurses used complex mental models and pattern-matching of information, drawing on all 3 levels of situation awareness during documentation. Level 1 situation awareness provided context, level 2 situation awareness signified a change in condition and its significance for the patient, and level 3 situation awareness was evident when nurses thought aloud about what this information indicated. Three themes associated with changes in patients' conditions emerged: deterioration in condition, not responding to prescribed treatments as expected and issues related to professional practice that impacted on patients' conditions. Conclusion Nurses used a complex mental model for decision-making, drawing on 3 levels of situation awareness. Hamm's cognitive continuum theory, when related to situation awareness, is a useful decision-making theory to provide a platform on which to draw together components of situation awareness and provide a framework on which to base decision-making regarding documentation. Relevance to clinical practice Understanding how RNs employ situation awareness and providing a framework for decision-making during documentation may assist effective documentation about changes in patients' conditions. [ABSTRACT FROM AUTHOR]

Aims and objectives. To examine registered nurses' decision-making when documenting care in patients' progress notes. Background. What constitutes effective nursing documentation is supported by available guidelines. However, ineffective documentation continues to be cited as a major cause of adverse events for patients. Decision-making in clinical practice is a complex process. To make an effective decision, the decision-maker must be situationally aware. The concept of situation awareness and its implications for making safe decisions has been examined extensively in air safety and more recently is being applied to health. Design and methods. The study was situated in a naturalistic paradigm. Purposive sampling was used to recruit 17 registered nurses who used think-aloud research methods when making decisions about documenting information in patients' progress notes. Follow-up interviews were conducted to validate interpretations. Data were analysed systematically for evidence of cues that demonstrated situation awareness as nurses made decisions about documentation. Results. Three distinct decision-making scenarios were illuminated from the analysis: the newly admitted patient, the patient whose condition was as expected and the discharging patient. Nurses used mental models for decision-making in documenting in progress notes, and the cues nurses used to direct their assessment of patients' needs demonstrated situation awareness at different levels. Conclusions. Nurses demonstrate situation awareness at different levels in their decision-making processes. While situation awareness is important, it is also important to use an appropriate decision-making framework. Cognitive continuum theory is suggested as a decision-making model that could support situation awareness when nurses made decisions about documenting patient care. Relevance to clinical practice. Because nurses are key decision-makers, it is imperative that effective decisions are made that translate into safe clinical care. Including situation awareness training, combined with employing cognitive continuum theory as a decision-making framework, provides a powerful means of guiding nurses' decision-making. [ABSTRACT FROM AUTHOR]

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