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Background: Nurse Practitioners work independently and collaboratively within multidisciplinary teams to fill unmet service delivery needs. Despite strong evidence of the benefits of the nurse practitioner service model, organisational support for nurse practitioners varies in terms of resources and support from leadership and other healthcare professionals. Aims: The study aimed to explore healthcare practitioners' experiences of implementation of a NP service in a rural setting. Methods: Semi-structured interviews were conducted with ten healthcare practitioners to investigate their perspectives of a recently implemented NP service. Data were analysed inductively using thematic analysis. Findings: Themes emerged related to facilitating collaborative practice, person-centred continuity of care and positive health outcomes for the community. Challenges and limitations related to operational role clarity, scopes of practice and leadership. Conclusion: Healthcare practitioners were mostly satisfied with the service however challenges caused tension. Change management principles provide a framework to strengthen the effective clinical alignment of the service. [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 explore the expected and achieved competency levels of new graduate nurses. Background: There are global concerns about a perceived disconnect between the educational preparation of new graduates and the expectations of employers about their work readiness. It is important to understand competency levels expected and achieved of new graduate nurses. Method(s): The study was conducted in three phases: the identification of competencies, development of a survey instrument and exploration of levels of competency from the perspectives of key stakeholders. Results: New graduates were well prepared for demonstrating respect to patients, but needed to be closely supported when providing emergency care. Results highlighted that new graduates felt less competent than graduating students in those competencies related to legal and ethical practice. Importantly, expectations about new graduates' competency varied between educators and managers. Conclusion(s): The findings provide important information about new graduates' competency levels, revealing a mismatch in the perception of key stakeholders about competency levels. This has important implications for building new graduates readiness for practice and highlights the importance of collaboration between key stakeholders to address competency gaps. Implications for Nursing Management: Supportive opportunities should be provided to new graduate nurses to fill gaps in beginner competency. [ABSTRACT FROM AUTHOR]

Aims and objectives: To investigate final‐year nursing students' use of situation awareness when making clinical decisions about patients' progress postsurgery. Background: Making clinical decisions about patient care is a generic nursing competence, developed in preregistration nursing programmes and critical to providing safe patient care. Situation awareness is an important precursor to making decisions and is linked to improved clinical outcomes. However, there is evidence to suggest that nursing students feel inadequately prepared to make clinical decisions. Design: Endsley's (Situation awareness analysis and measurement. Hillsdale, NJ: Lawrence Erlbaum Associates, 2000) 3‐level situation awareness framework was used to guide the study. Level 1 situation awareness is perception of information required to make a decision. Level 2 relates to comprehending the information. Level 3 situation awareness is projecting how this information will inform the future. Twelve final‐year nursing students were recruited to participate. Think‐aloud research method was used to capture students' decision‐making, followed by semi‐structured interviews. Data were analysed using an adapted protocol analysis and were encoded inductively. The COREQ checklist has been used in reporting the study. Results: Students demonstrated level 1, 2 and 3 situation awareness when making clinical decisions. However, it was not demonstrated consistently and at times subsequent decision‐making was inappropriate. Three themes emerged: "systems approach to assessment of postoperative patients"; "policy drives practice"; and "deferring decisions to registered nurses". Within the themes, students demonstrated differing levels of situation awareness. Conclusion: Making safe clinical decisions is a paramount skill for nurses; however, student nurses are ill‐equipped to undertake this skill. Situation awareness is important in informing safe decision‐making, but students' use of situation awareness is variable. Cognitive apprenticeship, applied to supporting development of situation awareness, affords the opportunity to develop students' decision‐making. Relevance to clinical practice: Clinical decision‐making is a generic competence for all registered nurses and imperative for safe practice. However, student nurses are unprepared to undertake this skill once registered. [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]

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]

Aim: To demonstrate the methodological usefulness of interpretive interactionism by applying it to the example of a study investigating healthcare experiences of women affected by domestic violence. Background: Understanding patients' experiences of health, illness and health care is important to nurses. For many years, biomedical discourse has prevailed in healthcare language and research, and has influenced healthcare responses. Contemporary nursing scholarship can be developed by engaging with new ways of understanding therapeutic interactions with patients. Research that uses qualitative methods of inquiry is an important paradigm for nurses who seek to explain and understand or describe experiences rather than predict outcomes. Discussion: Interpretive interactionism is an interpretive form of inquiry for conducting studies of social or personal problems that have healthcare policy implications. It puts the patient at the centre of the research process and makes visible the experiences of patients as they interact with the healthcare and social systems that surround them. Interpretive interactionism draws on concepts of symbolic interactionism, phenomenology and hermeneutics. Conclusion: Interpretive interactionism is a patient-centred methodology that provides an alternative way of understanding patients' experiences. It can contribute to policy and practice development by drawing on the perspectives and experiences of patients, who are central to the research process. It also allows research findings to be situated in and linked to healthcare policy, professional ethics and organisational approaches to care. Implications for research/practice: Interpretive interactionism has methodological utility because it can contribute to policy and practice development by drawing on the perspectives and experiences of patients who are central to the research process. Interpretive interactionism allows research findings to be situated in and linked to health policy, professional ethics and organisational approaches to caring. [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]

The article presents a study on nursing student experiences in a web-based lecture technology. It mentions that study aim to evaluate the student's experiences of getting lectures through web-based digital lecture technology. It says that an online survey during the eight to ten weeks of the first semester in May 2012 were conducted. Result shows that lectures capture helps the students in understanding and learning the course and assists first year students in adapting to universities life.