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When it comes to determining what constitutes nursing workload, there are a number of approaches that represent and characterise the work of nursing across the three traditional shift patterns (morning/day, afternoon/evening and night). These are observational, self-reporting and work-sampling techniques. A review of the quantitative and qualitative literature to examine workload distributions between the three nursing shifts was undertaken. Using data sourced from the CINAHL, Scopus and Medline databases, the findings suggest that there is an inadequacy in establishing nursing productivity that is perhaps representative of the methods used to decipher nursing workload. This may contribute to poor quality care, and the high cost of excess nursing time contributes to the increasingly high costs of care. Linked to this is the nurse's job satisfaction. Quality of care and job satisfaction are important factors for the sustainability of the nursing workforce. There are few high-quality nursing articles that detail the workload distributions across the three nursing shifts and this is a potential area for further research. [ABSTRACT FROM AUTHOR]

Presentations to the emergency department with a diagnosis of hypocalcaemia‐induced tetany secondary to total thyroidectomy are rare. A patient presented to the emergency department of a regional Australian hospital with hypocalcaemia‐induced tetany. A case study was employed to reflect on the care provided and identify knowledge practice deficits within this unusual patient presentation. Calcium plays a central role within the nervous system and is vital for both cardiac and muscular contraction. The clinical manifestations of electrolyte disturbances such as hypocalcaemia can be life threatening, and therefore, appropriate assessment, monitoring and management are essential to ensure positive patient outcomes. Understanding the importance of calcium imbalance for the emergency and critical care nurse is paramount in preventing complications associated with cardiac conduction and muscle tone, especially the potential for airway compromise. Education is central to this and may include clinical case reviews, the application of pathophysiological presentations of electrolyte imbalance and a review of electrolyte administration guidelines. Understanding the role of calcium within the body will assist emergency and critical care nurses to assess, monitor and intervene appropriately, thereby preventing the life‐threatening manifestations of hypocalcaemia. [ABSTRACT FROM AUTHOR]

The satellite university campus is becoming more prominent in Australia, and may consist of a large proportion of students of low socio-economic status (SES). Concurrently, there is a governmental target to increase the proportion of low SES students at university. However, there are concerns that students of low SES may be less successful at university, and accordingly, this study aimed to identify whether SES impacted on student success. Retrospective analysis was undertaken of satellite campus students to relate their SES and university entry rank to their academic results. There was no strong relationship between students' entry rank and their results, nor was there a significant effect of SES on results. This demonstrates that students of low SES, and those of lower entry ranks, were successful in their first year. These results indicate that universities can recruit low SES students to meet governmental policy, without the concerns of increased failure rates. [ABSTRACT FROM AUTHOR]

Managing sickness and absenteeism in the workplace is challenging, and nurse managers must consider their various causes so they can implement effective management strategies. It is also vital to consider the factors that influence absenteeism and turnover among newly graduated registered nurses (RNs), whose retention can help to address staff shortages. This article describes a literature review that aimed to identify the potential causes of sickness absence in newly graduated RNs. It also discusses strategies that nurse managers can use to retain and maintain their workforce. [ABSTRACT FROM AUTHOR]

Background and context: Implementation of current research in practice is challenging for ward-based nursing staff. However, university-based nursing academics are seen as the research experts and are perhaps well placed to support clinical nursing research. The problem lies with the divide between practice and academia; universities often use the clinical environment as the place to conduct research but this is often not translated effectively into practice. The development of a nursing professorial unit for acute and critical care was undertaken to meet this challenge. The unit's key aim is to develop, mentor and support a nursing research culture that is wholly situated within and driven by the requirements of the clinical environment. Aim: The aim of this article is to offer some insights as to how staff set about engaging with and developing the nursing professorial unit to support nursing research in our local hospital. Conclusions: The article highlights how an effective and coordinated approach to supporting clinical nursing research is possible. The nursing professorial unit has been successful in bridging the divide between academia and practice by using a non-university approach to supporting nursing research. Instead we have adopted the philosophy that practice is the sole driver for research and as academics our role is to support that position. Implications for practice: • The adoption of the nursing professorial unit model for supporting clinical nursing research is beneficial in closing the divide between clinical practice and the university • The continual presence of the academics in the clinical environment has had a positive impact on research development and implementation in practice • The nursing professorial unit has become an integral part of the nursing culture in the hospital environment [ABSTRACT FROM AUTHOR]

Aims and objectives To explore new graduate registered nurses' reflections of bioscience courses during their nursing programme and the relationship between bioscience content and their clinical practice. Background Undergraduate nursing students internationally find bioscience courses challenging, which may be due to the volume of content and level of difficulty of these courses. Such challenges may be exacerbated by insufficient integration between bioscience theory and nursing clinical practice. Design A descriptive, cross-sectional mixed methods study was conducted. Methods A 30-item questionnaire with five written response questions which explored recently registered nurses' reflections on bioscience courses during their nursing degree was employed. Descriptive analyses were reported for individual items. Thematic analysis of qualitative responses was grouped to reveal emerging themes. Results Registered nurses' ( n = 22) reflections revealed that bioscience courses were a significant challenge during their undergraduate programme, and they lacked confidence explaining the biological basis of nursing. Participants would like improved knowledge of the relevant bioscience for nursing and agreed that bioscience courses should be extended into the undergraduate final year. The importance of relating bioscience content to nursing practice was elaborated extensively throughout written responses. Conclusions Although registered nurses reflected that bioscience courses were difficult with large volumes of content, having more bioscience with greater relevance to nursing applications was considered important in their current clinical practice. It is suggested that bioscience academics develop greater contextual links between bioscience content and clinical practice relevant to nursing. Relevance to clinical practice After working as a registered nurse, there was appreciation of bioscience relevance for clinical practice, and the nurses believed they would have benefitted from more nursing-related bioscience during their undergraduate programme. Focussed integration of bioscience with clinical nursing courses should be driven by academics, nurse educators and clinical nurses to provide a biological basis for patient care to nursing students. [ABSTRACT FROM AUTHOR]

Devising authentic assessments for subjects with large enrolments is a challenge. This study describes an electronic role-play assessment for approximately 600 first-year nursing students to learn and apply pathophysiology (bioscience) concepts to nursing practice. Students used Microsoft Office PowerPoint® to prepare electronic role-plays both between a nurse and patient, and between two nurses, thus simulating workplace scenarios. Student feedback demonstrated that respondents found this assessment useful for learning pathophysiology, and for applying pathophysiology to a nursing clinical setting. This electronic presentation circumvented issues associated with a traditional oral presentation such as embarrassment and logistics of scheduling groups, and rated well with students of non-English speaking background. The electronic role-play assessment initiative encouraged students to apply their bioscience knowledge to a clinical setting, and allowed students to conceptualise the importance of bioscience within both the nursing degree and the profession. [ABSTRACT FROM AUTHOR]

Aims Bioscience content within undergraduate nursing degrees provides foundational knowledge of pathophysiology, anatomy, physiology, microbiology and pharmacology. However, nursing students often find studying the bioscience components of undergraduate nursing program daunting (Friedel & Treagust 2005, Craft et al. 2013). This is related to factors such as the volume of content, degree of difficulty and insufficient linkage between bioscience concepts and nurses' clinical practice. Students who are unable to conceptualise the relevance of bioscience with nursing subjects and subsequent nursing practice may not appreciate the broader importance of bioscience, and hence may adopt a surface approach to learning (Craft et al. 2013). The aim of this study was to develop a model within Nursing Practice in the Context theory subject, to include a bioscientist lecturing to complement the nursing lecturer, in order to explicitly demonstrate links between physiology, pathophysiology and nursing practice. Background A deep understanding of bioscience and the ability to draw on this information in the context of nursing clinical practice is integral to achieving high standards of patient care. For example, registered nurses with appropriate bioscience knowledge can contribute to diagnosis and hence influence patient outcomes (Prowse & Health 2005). Nurses' foundational knowledge, including bioscience understanding, is critical to their role as a 'knowledge broker' by being an advocate for patient safety (Logan & Angel 2011). Hence, the importance of bioscience is apparent within the workplace. In addition, during undergraduate studies, the importance of bioscience is appreciated by some students, who agree that bioscience forms the foundation of nursing and hence we believe that a good level of bioscience knowledge is required for nursing clinical practice (Friedel & Treagust 2005, Craft et al. 2013). Although bioscience has been shown to be integral to effective nursing practice, bioscience content requires con-textualisation. To demonstrate the relevance of bioscience to nursing students, nursing academics have been included within a bioscience unit, whereby the nursing academic within a bioscience laboratory session on the pulmonary system would discuss the clinical aspects of lung volume testing and what inaccuracies may arise if the patient is not relaxed (Larcombe & Dick 2003). On the other hand, almost half of nursing educators agreed that their science background was insufficient to their understanding of bioscience relevant to nursing (Friedel & Treagust 2005). This lack of confidence in nursing educators bioscience knowledge may limit their ability to teach bioscience effectively to nursing students. In our project, we approached the contextualisation of bioscience by developing a model that incorporated a bioscientist into a nursing subject, to show the relevance of bioscience for patient care. As far as we are aware, our project reports for the first time on a bioscientist teaching into a clinical nursing unit to strengthen the pathophysiology content, which may improve the integration of these subject topics. Methods The model developed in this project was a unique, two-part lecture structure: (1) the bioscientist teaching the physiology and pathophysiology in the first component of the lecture, followed by (2) the nurse academic focussing on the context of nursing practice, which included the referring to pathophysiology taught by the bioscientist. The bioscience-clini-cal nursing team teaching approach was conducted during the 2nd year of the Bachelor of Nursing course, after all bioscience subjects had been completed (prior content taught by bioscientists included anatomy, physiology and pathophysiology). A 15-item quantitative questionnaire was developed, with responses scored on a Likert scale (1=strongly disagree; 5=strongly agree). Questionnaire items related to patient care, pathophysiology-nursing links, and the relevance of the bioscientist contribution. Questionnaires were paper based and distributed to all students who attended a lecture towards the end of the semester (lecture attendance not compulsory). Time during the lecture was provided for completion and return; students were advised that participation was optional and anonymous. Convenience sampling was used; of the 88 students enrolled, a total of 43 students returned completed surveys. Means and frequency distributions of survey items were calculated, and internal consistency was determined using Cronbach's alpha test (value 0-7). Results The most important findings from this study are that more than 90% of respondents agreed that having a bioscientist who focused on nursing student needs helped to increase knowledge of patient conditions, and bioscientist teaching was beneficial to relate physiology and pathophysiology to nursing care (Table 1). This demonstrated that the teaching approach used was successful, emphasising the relevance of physiology and pathophysiology to patient conditions and outcomes. Similarly, most respondents saw the relevance of pathophysiology to clinical nursing practice, and were confident in their ability to apply pathophysiology to nursing practice. The majority of respondents also valued having a bioscientist teach with the nursing lecturer in this unit. Conclusions The results of our study show overwhelming support for this model, including a bioscientist who is focussed on the needs of nursing students, complementing the nursing lecturer, in a nursing practice subject. Students indicated that they could contextualise bioscience concepts with clinical nursing practice, and importantly, made links with patient care. First-year students have been shown to be confident that when they reach the workplace, they will recognise the relevance of bioscience to nursing (Craft et al. 2013), and our study of second-year students indicated that our teaching approach was effective in enhancing these connections. Registered nurses who draw on bioscience knowledge have been shown to improve patient care (Prowse & Health 2005, Logan & Angel 2011), and strategies to link bioscience content with clinical nursing practice that are integral for effective nurses. Relevance to clinical practice Our data strongly supported our model of physiology and pathophysiology teaching team delivered by a bioscientist and nursing academic, was successful in providing students with the ability to conceptualise pathophysiology for patients and clinical practice. Improved understanding of the knowledge and application of pathophysiology will better inform clinical decisions, and ultimately improve quality of patient care. [ABSTRACT FROM AUTHOR]

Background: Type 1 and 2 diabetes care, especially within primary health‐care settings, has traditionally involved doctor‐led clinics. However, with increasing chronic disease burden, there is scope for nurses to expand their role in assisting diabetes self‐management. Aims: This study aimed to determine the effectiveness of nurse‐led care in reducing glycated haemoglobin in adults with Type 1 or 2 diabetes. Methods: Methodology from the Joanna Briggs Institute Method for Systematic Review Research and the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA) guidelines were followed, including identifying publications, assessing study quality, summarizing evidence and interpreting findings. The search strategy involved using the Medical Subject Headings and keyword variations when searching MEDLINE (Ovid), Scopus, PubMed and the Cumulative Index to Nursing and Allied Health Literature (CINAHL) databases. Inclusion criteria were samples with Type 1 or 2 diabetes, mean age of ≥18 years, English language studies and publication date of January 2011–December 2021. Results: Overall, 34 articles from 16 countries met inclusion criteria. Though not always clinically significant, results indicated that nurse‐led care had beneficial impacts on glycated haemoglobin values, with reductions from 0.03% to 2.0%. This was evident when nurses received formal training, used treatment algorithms, had limited medical support, utilized technology and offered defined culturally sensitive and appropriate diabetes care. Conclusions: Findings support nurse‐led Type 1 and 2 diabetes care. Although further research is required, changes may necessitate increased recognition of nurse‐led care and funding. Nurse‐led care models should differ according to health‐care settings. Summary statement: What is already known about this topic? Diabetes is the world's fastest growing chronic condition and is widely recognized as a leading global challenge to the health and well‐being of individuals, families and societies.What this paper adds? Findings highlight the effectiveness of nurse‐led care in reducing glycated haemoglobin values in patients with Type 1 or 2 diabetes. This was evident when nurses received formal training, used treatment algorithms, had limited medical support, utilized technology and offered defined culturally sensitive and appropriate diabetes care. The implications of this paper: There is scope for nurses to expand their role and assist diabetes self‐management. [ABSTRACT FROM AUTHOR]

Background: Performing cardiopulmonary resuscitation in non‐critical care hospital wards is a stressful event for the registered nurse; stress may negatively affect performance. Delays in initiating basic life support and following current basic life support algorithms have been reported globally. Aim: The aim of this review was to investigate factors that can affect registered nurses' experiences of performing basic life support. Methods: Using the five‐step integrative literature review method from Whittemore and Knafl, this review searched articles published between January 2000 and June 2022 for qualitative and quantitative primary studies from the databases CINAHL Complete (EBSCO), Medline (Web of Science), Scopus and PubMed. Results: Nine studies from eight countries met the inclusion criteria and were appraised here. Five themes relating to factors affecting the performance of basic life support were found during this review: staff interaction issues, confidence concerns, fear of harm and potential litigation, defibrillation concerns and basic life support training issues. Conclusions: This review revealed several concerns experienced by registered nurses in performing basic life support and highlights a lack of research. Factors affecting nurses' experiences need to be understood. This will allow education to focus on consideration of human factors, or non‐technical skills during basic life support training, as well as technical skills, to improve outcomes for patients experiencing an in‐hospital cardiopulmonary arrest. Summary statement: What is already known about this topic? In‐hospital basic life support is not always performed at expected levels.There is very little information on factors affecting registered nurses' experiences in performing basic life support, especially in non‐critical areas.Although human factors, such as teamwork, have recently been added to cardiopulmonary resuscitation education, these are poorly understood regarding ward nurses' real‐life experiences. What this paper adds? Factors impacting registered nurses' performance of basic life support in non‐critical care wards included staff interaction issues, confidence concerns, fear of harm and potential litigation, defibrillation concerns and basic life support training issues. The implications of this paper: Factors affecting nurses in performing basic life support need to be understood in order to improve performance.The identification of barriers from the literature allows educators to include targeted discussion and education within basic life support training to improve patient outcomes. [ABSTRACT FROM AUTHOR]

Aims and objectives: This integrative review aimed to draw conclusions from evidence on how registered nurses are measuring respiratory rates for acute care patients. Background: Despite the growing research supporting respiratory rate as an early indicator for clinical deterioration, respiratory rate has consistently been the least frequently measured and accurately documented vital sign. Design: An integrative review. Methods: A systematic literature search was conducted in June 2022 in four databases: CINAHL, PubMed, Medline and Scopus. Quality appraisal was undertaken using the Joanna Briggs Institute's Checklist. PRISMA guidelines were followed to ensure explicit reporting and reported in the PRISMA checklist. Results: Overall, 9915 records were identified, and 19 met the inclusion criteria. Of these 19 articles, seven themes emerged: estimation and digit preference, lack of understanding and knowledge, not valuing the clinical significance of respiratory rate, oxygen saturation substitute, interobserver agreement, subjective concern and count duration. A high prevalence of bias, estimation and incorrect technique was evident. A total of 15 articles reported specifically on how registered nurses are measuring respiratory rates on general medical and surgical wards. Conclusions: Despite its importance, this integrative review has determined that respiratory rates are not being assessed correctly by nursing staff in the acute care environment. Evidence of using estimation, value bias or quick count and multiply techniques are emerging themes which urgently require further research. No patient or public contribution. [ABSTRACT FROM AUTHOR]

Medication errors can have deleterious effects on patient safety and care. Interruptions, patient acuity and time pressures have all been cited as contributing factors in the incidence of medication errors. Yet, despite the number of different strategies that can be taken to reduce the incidence of medication errors, they still occur. The strategies often focus on refining systems and processes, depending on the root cause of the error. However, less recognised as contributory elements are human factors such as anger, hunger or tiredness. The aim of this quality improvement initiative was to reduce medication errors by 25% on a medical ward, through the introduction of the hunger, angry, lonely, tired (HALT) model to address the human factors associated with medication errors. Post-implementation, the HALT model appeared to have resulted in a total reduction in medication errors over a 2-month period by 31%. Mistakes related to human error were reduced by 25%, and those linked to communication and documentation errors by 22%. While this was a small-scale study, this is a significant reduction in medication errors. However, caution should be used when addressing other contributing factors associated with medication errors as using HALT alone will not address these. [ABSTRACT FROM AUTHOR]

Background Phenomenology is a useful methodological approach in qualitative nursing research. It enables researchers to put aside their perceptions of a phenomenon and give meaning to a participant's experiences. Exploring the experiences of others enables previously unavailable insights to be discovered. Aim To delineate the implementation of Colaizzi's (1978) method of data analysis in descriptive phenomenological nursing research. Discussion The use of Colaizzi's method of data analysis enabled new knowledge to be revealed and provided insights into the experiences of nurse academics teaching on satellite campuses. Local adaptation of the nursing curriculum and additional unnoticed responsibilities had not been identified previously and warrant further research. Conclusion Colaizzi's (1978) method of data analysis is rigorous and robust, and therefore a qualitative method that ensures the credibility and reliability of its results. It allows researchers to reveal emergent themes and their interwoven relationships. Researchers using a descriptive phenomenological approach should consider using this method as a clear and logical process through which the fundamental structure of an experience can be explored. Implications for research Colaizzi's phenomenological methodology can be used reliably to understand people's experiences. This may prove beneficial in the development of therapeutic policy and the provision of patient-centred care. [ABSTRACT FROM AUTHOR]

There is a great deal of literature surrounding the needs of regional Australia. This integrative review of the literature focuses on the experience of nursing academics teaching on a satellite campus, many of which are located in regional Australia. Four themes were identified: (1) challenges specific to regional satellite campuses, (2) student characteristics, (3) student experiences and (4) the academics’ experiences. These themes identified not only significant benefits but also considerable challenges to the provision of higher education on regional university campuses. The experience of nursing academics and indeed their students is remarkably different from the experience of their metropolitan counterparts, and therefore the local context needs to be considered in regional education provision. Australian regional nursing academics need to be multi-skilled to address the workload and social inequity in support service provision. [ABSTRACT FROM PUBLISHER]

The aim of this study is to explore the different handover models and processes available and their efficacy in improving handover communication within nursing practice. The handover of information is a key nursing responsibility that ensures patient outcomes through continuity of care. This process is widely recognised as an opening for error that may comprise patient safety. This paper is an integrative literature review that employed an inductive exploratory design. A computerised database search was employed including CINAHL, PubMed and Science Direct and a manual citation search with included papers limited to papers published 2005-2016, in English with full text freely available. This included a systematic search strategy, a critical appraisal of the papers utilising the Critical Appraisal Skills Programme, an inductive data extraction and thematic analysis. Sixteen papers were included in this review. The results detailed that there are various handover models in use, yet there is no evidence that any one model displays superior efficacy. The iSoBAR model and its adaptations remain the only model employed across various specialties. More research is warranted to determine if any handover model displays superior efficacy or transferability. [ABSTRACT FROM AUTHOR]

Nursing students have reported bioscience to be challenging and difficult to understand. This might have a negative impact upon their ability to understand patients' clinical conditions and nursing practice. We sought information about students' experiences with bioscience. A total of 126 final year nursing students completed a questionnaire. The findings showed that the majority of participants considered bioscience subjects to require more work compared to nursing subjects (65.9%), and that they would like a better understanding of bioscience (73.8%), but understood that bioscience forms the foundation of nursing practice (76.2%). Younger participants without secondary school science rated bioscience harder than nursing subjects and spent more time studying bioscience compared to older participants. Participants without any secondary school science lacked an ability to apply bioscience concepts to patient conditions. These results showed that nursing students, especially those without secondary school science, would benefit from improved bioscience integration with nursing practice. Nursing and bioscience educators should consider greater alignment of bioscience with nursing practice subjects, especially earlier in the curriculum. [ABSTRACT FROM AUTHOR]

Background The transition shock or Imposter Phenomena sometimes associated with moving from student to Registered Nurse can lead to feelings of self-doubt and insecurity especially with the increased expectations and responsibilities that registration brings. Aim The aim of this study was to examine the extent at which imposter phenomenon is evident in four final year nursing student cohorts in Australia, New Zealand and the UK. Design A survey design. Settings The study took place at four higher education institutes - two metropolitan campuses and two regional campuses between October 2014 - February 2015 in Australia, New Zealand and the UK. A sample of 223 final year nursing students undertaking nationally accredited nursing programmes were approached. Results Each cohort exhibited mild to moderate feelings of Imposter Phenomena. A positive weak correlation between imposter phenomena and preparedness for practice was found. The New Zealand cohort scored higher than both the Australian and UK cohorts on both feelings of imposterism and preparedness for practice. Conclusions Nursing students possess internalized feelings which suggest their performance and competence once qualified could be compromised. There is some speculation that the respective curriculums may have some bearing on preparing students for registration and beyond. It is recommended that educational programmes designed for this student cohort should be mindful of this internal conflict and potential external hostility. [ABSTRACT FROM AUTHOR]