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Aim This paper acknowledges the relationship between resilience and the new managerialism of contemporary nursing. Methods Qualitative portraiture methodology. Discussion The new managerialism in hospital settings results in a rapidly increasing turnover of acutely ill or comorbid patients, which directly relates to retention and quality service. In education settings, the management imperative to recruit more students into the profession combined with financial cutbacks leads to similar tensions. In aged care the trend equates care directly with funding, with the same effect. Yet despite this, many registered nurses remain working. Portraiture explored 'why' nurses remain in workplaces often described as awful. The resilience of nurses is seen through their stories and reframed to highlight resilience as a form of resistance to the new managerialism inherent in contemporary healthcare. Conclusion This paper describes some of the hallmarks of new managerialism where workforce pressures force practices that do not value the 'human resource'. Implications for nursing management The quotes from the field give insight into the nurse's world view and have implications for managers, educators and employers, as well as for consumers of nursing care. [ABSTRACT FROM AUTHOR]

Aim: This scoping literature review aimed to answer the question: What are the shared decision-making experiences of adult children in regard to their parent/s' health care in residential aged care facilities?, Background: Shared decision-making has been an important patient-centred approach to nursing care since the 1990s, yet it is becoming increasingly evident that it is still not the reality in aged care facilities fifty years on. Currently, it is not well understood how adult children participate in shared decision-making and the types of decisions they are required to make., Design: A review of original research papers using Kable, Pich and Maslin-Prothero 12-step systematic approach to documenting a search strategy., Method: The researcher screened 597 articles from four databases, published in the English language, during the period 1985-2019. The researcher used the Mixed Methods Appraisal Tool version 2011 to determine the methodological quality of the included studies. The Joanna Briggs Institute QARI data tool was used to appraise the seven selected articles and thematically analyse findings, respectively., Results: Four themes were highlighted: communication; staffing; being involved; and staff-family relationships. Despite these themes being apparent, families have limited opportunities to participate in shared health decision-making in regard to their parents' care., Conclusion: The findings from this literature show how shared decision-making is affected by the RACF environment. There is a need to find out and understand what is important from a family member's point of view to optimise shared decision-making and nursing care of the family member in residential aged care settings., Relevance to Clinical Practice: The limited findings specific to the SDM experiences of adult children of parents in RACFs in this review could help staff and RACFs to develop strategies and staff training to encourage and facilitate the implementation of shared health decision-making with staff and families on older people's care., (© 2021 John Wiley & Sons Ltd.)

Aim: To evaluate the impact of the implementation of a best practice infection prevention and control bundle on healthcare associated burn wound infections in a paediatric burns unit., Background: Burn patients are vulnerable to infection. For this patient population, infection is associated with increased morbidity and mortality, thereby representing a significant challenge for burns clinicians who care for them., Methods: An interrupted time series was used to compare healthcare associated burn wound infections in paediatric burn patients before and after implementation of an infection prevention and control bundle. Prospective surveillance of healthcare associated burn wound infections was conducted from 2012 to 2014. Other potential healthcare associated infection rates were also reviewed over the study period, including urinary tract infections, pneumonia, upper respiratory tract infections and sepsis. An infection prevention and control bundle developed in collaboration between the paediatric burn unit and infection control clinicians was implemented in 2013 in addition to previous standard practice., Results: During the study period a total of 626 patients were admitted to the paediatric burns unit. Healthcare associated burn wound infections reduced from 34 in 2012 to 0 in 2014 following the implementation of the infection prevention and control bundle. Pneumonia and sepsis also reduced to 0 in 2013 and 2014, however one upper respiratory tract infection occurred in 2013 and urinary tract infections persisted in 2013., Conclusion: The implementation of an infection prevention and control bundle was effective in reducing healthcare associated burn wound infections, pneumonia and sepsis within our paediatric burns unit. Urinary tract infections remain a challenge for future improvement., (Copyright © 2019. Published by Elsevier Ltd.)

Objective: to explore ways in which midwives can enhance the support provided by social networking sites for adolescent mothers., Design: a narrative approach was employed to guide the research design and processes. Approval was obtained from Edith Cowan University human ethics department., Setting: focus groups and interviews were undertaken with adolescent mothers and midwives in Western Australia., Findings: the four key themes identified across both groups were validation by midwives, importance of ownership, enhanced community connections and the importance of guideline development., Conclusions: findings suggest both mothers and midwives consider there are a variety of ways in which healthcare professionals could enhance the support afforded to adolescent mothers by their use of SNS. Midwives were more likely to consider the need for guideline development, but the underlying value of accessible, professionally mediated online support and information was consistent across the two groups., Implications for Practice: Midwives would benefit from acknowledging the role played by SNS in providing support to adolescent mothers and by considering ways in which this technology can be used to lend further support to this group of mothers., (Copyright © 2018 Elsevier Ltd. All rights reserved.)

Aim: This article presents a discussion highlighting the relevance and strengths of using narrative inquiry to explore experiences of social networking site (SNS) use by adolescent mothers., Background: Narrative inquiry as a method reveals truths about holistic human experience. Knowledge gleaned from personal narratives informs nursing knowledge and clinical practice. This approach gives voice to adolescent mothers in relation to their experiences with SNS as a means of providing social support., Design: Discussion paper., Data Sources: This paper draws and reflects on the author's experiences using narrative inquiry and is supported by literature and theory. The following databases were searched: CINAHL, Cochrane Library, Medline, Scopus, ERIC, ProQuest, PsychINFO, Web of Science and Health Collection (Informit). Key terms and Boolean search operators were used to broaden the search criteria. Search terms included: adolescent mother, teenage mother, "social networking sites", online, social media, Facebook, social support, social capital and information. Dates for the search were limited to January 1995-June 2017., Implications for Practice/research: Narrative research inherently values the individual "story" of experience. This approach facilitates rapport building and methodological flexibility with an often difficult to engage sample group, adolescents., Conclusion: Narrative inquiry reveals a deep level of insight into social networking site use by adolescent mothers. The flexibility afforded by use of a narrative approach allows for fluidity and reflexivity in the research process., (© 2017 John Wiley & Sons Ltd.)

Aims and Objectives: to critically appraise the available literature and summarise the evidence relating to adolescent mothers' use of social networking sites in terms of any social support and social capital they may provide and to identify areas for future exploration., Background: social networking sites have been demonstrated to provide social support to marginalised individuals and provide psycho-social benefits to members of such groups. Adolescent mothers are at risk of; social marginalisation; anxiety disorders and depressive symptoms; and poorer health and educational outcomes for their children. Social support has been shown to benefit adolescent mothers thus online mechanisms require consideration., Design: a review of original research articles METHOD: key terms and Boolean operators identified research reports across a 20-year timeframe pertaining to the area of enquiry in: CINAHL, Cochrane Library, Medline, Scopus, ERIC, ProQuest, PsychINFO, Web of Science, Health Collection (Informit) and Google Scholar databases. Eight original research articles met the inclusion criteria for this review., Findings: studies demonstrate that adolescent mothers actively search for health information using the Internet and social networking sites, and that social support and social capital can be attributed to their use of specifically created online groups from within targeted health interventions. Use of a message board forum for pregnant and parenting adolescents also demonstrates elements of social support. There are no studies to date pertaining to adolescent mothers' use of globally accessible social networking sites in terms of social support provision and related outcomes., Conclusions: further investigation is warranted to explore the potential benefits of adolescent mothers' use of globally accessible social networking sites in terms of any social support provision and social capital they may provide., (Copyright © 2017 Elsevier Ltd. All rights reserved.)

Aim: The aim of this study was to explore the potential use of visual diarizing to enable intensive care unit (ICU) survivors to create their story of recovery., Background: An ICU experience can have deleterious psychological and physical effects on survivors leading to reductions in quality of life which for some may be of significant duration. Although there has been exploration of many interventions to support recovery in this group, service provision for survivors remains inconsistent and inadequate., Design and Participants: A qualitative interpretive biographical exploration of the ICU experience and recovery phase of ICU survivors using visual diarizing as method. This paper is a component of a larger study and presents an analyses of one participant's visual diary in detail., Methods: Data collection was twofold. The participant was supplied with visual diary materials at 2 months post-hospital discharge and depicted his story in words and pictures for a 3-month period, after which he was interviewed. The interview enabled the participant and researcher to interpret the visual diary and create a biographical account of his ICU stay and recovery journey., Findings: The analysis of one participant's visual diary yielded a wealth of information about his recovery trajectory articulated through the images he chose to symbolize his story. The participant confirmed feelings of persecution whilst in ICU and was unprepared for the physical and psychological disability which ensued following his discharge from hospital. However, his story was one of hope for the future and a determination that good would come out of his experience. He considered using the visual diary enhanced his recovery., Conclusions: The participant perceived that visual diarizing enhanced his recovery trajectory by enabling him to recreate his story using visual imagery in a prospective diary., Relevance to Clinical Practice: Prospective visual diarizing with ICU survivors may have potential as an aid to recovery., (© 2014 British Association of Critical Care Nurses.)

Introduction: Since 2005, the Western Australian paediatric burn unit has provided a state-wide clinical consultancy and support service for the assessment and management of acute and rehabilitative burn patients via its telehealth service. Since then, the use of this telehealth service has steadily increased as it has become imbedded in the model of care for paediatric burn patients. Primarily, the service involves acute and long term patient reviews conducted by the metropolitan-located burn unit in contact with health practitioners, advising patients and their families who reside outside the metropolitan area thereby avoiding unnecessary transfers and inpatient bed days. A further benefit of the paediatric burn service using telehealth is more efficient use of tertiary level burn unit beds, with only those patients meeting clinical criteria for admission being transferred., Aim: To conduct a retrospective audit of avoided transfers and bed days in 2005/06-2012/13 as a result of the use of the paediatric Burns Telehealth Service and estimate their cost savings in 2012/13., Method: A retrospective chart audit identified activity, avoided unnecessary acute and scar review patient transfers, inpatient bed days and their associated avoided costs to the tertiary burn unit and patient travel funding., Results: Over the period 2005/06-2012/13 the audit identified 4,905 avoided inpatient bed days, 364 avoided acute patient transfers and 1,763 avoided follow up review transfers for a total of 1,312 paediatric burn patients as a result of this telehealth service. This paper presents the derivation of these outcomes and an estimation of their cost savings in 2012/13 of AUD 1.89million., Conclusion: This study demonstrates avoided patient transfers, inpatient bed days and associated costs as the result of an integrated burns telehealth service., (Copyright © 2016 Elsevier Ltd and ISBI. All rights reserved.)

Aim: This study explored why nurses chose to remain in the Western Australian workforce and to develop insights into the role of resilience of nurses and to identify the key characteristics of resilience displayed by these nurses., Background: Nursing is a stressful profession. Prolific quantitative research which measures job stress and resilience has been implemented; however, there is a dearth of qualitative studies which hear the personal narratives as to why nurses remain and thrive in a stressful workplace., Design/methods: Vignettes of nursing resilience reveal underlying themes of resilience where personal stories and events are presented as narrative. Portraiture recognises the inherent value of the nurses' stories giving attention to the nature of their resilience. Interpretation illuminates the portraits or verbal canvasses of the told experience, reflecting success and positivity despite disarray in healthcare settings., Results/findings: Eight themes were identified. The portraits highlight a sometimes imperceptible theme of resilience within nursing. Nurses are resilient; they rely on the social support of colleagues, family and friends to continue to bear their mantle of responsibility. They take pride in their work and accomplishments and give to others altruistically. They laugh, they love nursing and they keep the needs of their patients, clients, residents or students foremost., Conclusion: This paper describes the hallmarks of resilience demonstrated by nurses. Resilience and its relationship to coping in times of adversity are captured within the portraits presented.

Objective: to explore the use of social networking sites (SNS) by adolescent mothers in Western Australia (WA) in relation to social support and the building of social capital., Design: a constructionist narrative inquiry approach was employed to guide the research design and processes. Approval was gained from the university human ethics department. Sampling was purposeful and data were collected using in-depth interviews with seven adolescent mothers in WA., Setting: interviews were undertaken within the homes of adolescent mothers across WA., Findings: from within three fundamental domains of social support; tangible, emotional and informational support, provided by SNS use, five key themes were identified from the narratives. 'Social connectedness' was identified as a form of tangible support, sometimes termed 'practical' or 'instrumental' support. This theme incorporates connectedness with family, friends, and peers and across new and existing social groups. Three themes were identified that relate to emotional support; 'increased parenting confidence'; 'reduced parental stress' and 'enhanced self-disclosure' afforded by use of SNS. 'Access to information' was identified in terms of informational support, with participants often highlighting SNS use as their primary portal for information and advice., Conclusions: the findings of this study suggest that SNS use affords adolescent mothers in WA access to tangible, informational and emotional support and thus is a valuable source of social capital for these mothers. This study provides a platform for further exploration into this phenomenon, and possible implications include the potential for midwives and health care professionals to promote the benefits of SNS use with, and for, this group of mothers, or to incorporate SNS use into modern health care practices to further develop the potential for improved social capital related outcomes for them., (Copyright © 2015 Elsevier Ltd. All rights reserved.)

Aims and Objectives: To critically appraise the available literature and summarise the evidence related to the use, prevalence, purpose and potential therapeutic benefits of intensive care unit diaries following survivors' discharge from hospital and identify areas for future exploration., Background: Intensive care unit survivorship is increasing as are associated physical and psychological complications. These complications can impact on the quality of life of survivors and their families. Rehabilitation services for survivors have been sporadically implemented and lack an evidence base. Patient diaries in intensive care have been implemented in Scandinavia and Europe with the intention of filling memory gaps, enable survivors to set realistic recovery goals and cement their experiences in reality., Design: A review of original research articles., Methods: The review used key terms and Boolean operators across a 34-year time frame in: CIHAHL, Medline, Scopus, Proquest, Informit and Google Scholar for research reports pertaining to the area of enquiry. Twenty-two original research articles met the inclusion criteria for this review., Results: The review concluded that diaries are prevalent in Scandinavia and parts of Europe but not elsewhere. The implementation and ongoing use of diaries is disparate and international guidelines to clarify this have been proposed. Evidence which demonstrates the potential of diaries in the reduction of the psychological complications following intensive care has recently emerged. Results from this review will inform future research in this area., Conclusions: Further investigation is warranted to explore the potential benefits of diaries for survivors and improve the evidence base which is currently insufficient to inform practice. The exploration of prospective diarising in the recovery period for survivors is also justified., Relevance to Clinical Practice: Intensive care diaries are a cost effective intervention which may yield significant benefits to survivors., (© 2014 John Wiley & Sons Ltd.)

Background: Burn patients often receive their initial care by non-burn specialist clinicians, with increasingly collaborative burn models of care. The provision of relevant and accessible education for these clinicians is therefore vital for optimal patient care., Design/methods: A two phase design was used. A state-wide survey of multidisciplinary non-burn specialist clinicians throughout Western Australia identified learning needs related to paediatric burn care. A targeted education programme was developed and delivered live via videoconference. Pre-post-test analysis evaluated changes in knowledge as a result of attendance at each education session., Results: Non-burn specialist clinicians identified numerous areas of burn care relevant to their practice. Statistically significant differences between perceived relevance of care and confidence in care provision were reported for aspects of acute burn care. Following attendance at the education sessions, statistically significant increases in knowledge were noted for most areas of acute burn care., Conclusions: Identification of learning needs facilitated the development of a targeted education programme for non-burn specialist clinicians. Increased non-burn specialist clinician knowledge following attendance at most education sessions supports the use of videoconferencing as an acceptable and effective method of delivering burns education in Western Australia., (Copyright © 2014 Elsevier Ltd and ISBI. All rights reserved.)

Background: A growing body of evidence has confirmed that intensive care unit survivors encounter myriad of physical and psychological complications during their recovery. The incidence of psychological morbidity in intensive care survivors is increasingly being recognised. The causes of psychological morbidity are multi-factorial but may be associated with a complete lack of, or delusional recall of events in intensive care. Intensive care unit diaries are an initiative designed to enable survivors to help restore factual memories and differentiate those from delusional., Purpose: To explore survivors' and family members' perceptions and utilisation of diaries following discharge from hospital., Method: A single centre qualitative descriptive study was undertaken in a general intensive care unit in Western Australia. Participants were surveyed 3, 6 and 12 months following discharge from hospital. Eighteen participants completed one or more surveys., Findings: Many of the participants who completed the surveys read their diaries but few made entries in them following discharge. Reading the diaries evoked mixed emotions for these participants; however they still viewed the diaries as a positive initiative in their recovery. Diaries enabled survivors to fill the memory gaps, make sense of their experience and reinforced the human connection when they were immersed in a technological environment., Conclusion: Use of patient diaries was received positively by the participants in this study. Diaries are a simple, cost effective initiative which enabled survivors to piece together the time they had lost, concreted their experience in reality and enabled them to retain a connection with their loved ones whilst immersed in a technological environment., (Copyright © 2013 Australian College of Critical Care Nurses Ltd. Published by Elsevier Ltd. All rights reserved.)

This paper discusses a leadership program implemented in the School of Nursing at Edith Cowan University to develop leadership in fourth semester nursing students enrolled in a three year undergraduate nursing degree to prepare them for the dynamic 'changing world' environment of healthcare. Students were invited to apply to undertake the program in extracurricular time. Nineteen students applied to the program and ten were chosen to participate in the program. The numbers were limited to ten to equal selected industry leader mentors. The leadership program is based on the belief that leadership is a function of knowing oneself, having a vision that is well communicated, building trust among colleagues, and taking effective action to realize one's own potential. It is asserted that within the complexity of health care it is vital that nurses enter the clinical setting with leadership capabilities because graduate nurses must take the lead to act autonomously, make decisions at the point of service, and develop a professional vision that fits with organizational and professional goals Thus, the more practice students have with leadership skills, the more prepared they will be to enter the workforce. The program consists of three components: leadership knowledge, leadership skills and leadership-in-action. The leadership program focuses on the student-participant's ability to be self reflective on personal leadership qualities, critically appraise, and work within a team as well as to take responsibility for ensuring the achievement of team goals as leader. The program is practical and is reliant on the involvement of leader mentors who hold positions of leadership with the health industry in Western Australia. Students completed a pre and post program questionnaire related to abilities and skills in leadership. This paper discusses pre and post evaluation data against program outcomes. The findings demonstrate that participants of the program increased their ability to influence, persuade and motivate others; to effectively communicate; to team build and work collaboratively; to develop problem solving and perseverance skills to overcome obstacles; and to serve as agents for positive change.