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AIM: To test and validate a measure of primary health care (PHC) engagement in the Australian remote health context. BACKGROUND: PHC principles include quality improvement, community participation and orientation of health care, patient-centred continuity of care, accessibility, and interdisciplinary collaboration. Measuring the alignment of services with the principles of PHC provides a method of evaluating the quality of care in community settings. METHODS: A two-stage design of initial content and face validity evaluation by a panel of experts and then pilot-testing the instrument via survey methods was conducted. Twelve experts from clinical, education, management and research roles within the remote health setting evaluated each item in the original instrument. Panel members evaluated the representativeness and clarity of each item for face and content validity. Qualitative responses were also collected and included suggestions for changes to item wording. The modified tool was pilot-tested with 47 remote area nurses. Internal consistency reliability of the Australian Primary Health Care Engagement scale was evaluated using Cronbach's alpha. Construct validity of the Australian scale was evaluated using exploratory factor analysis and principal component analysis. FINDINGS: Modifications to suit the Australian context were made to 8 of the 28 original items. This modified instrument was pilot-tested with 47 complete responses. Overall, the scale showed high internal consistency reliability. The subscale constructs 'Quality improvement', 'Accessibility-availability' and 'population orientation' showed low levels of internal consistency reliability. However, the mean inter-item correlation was 0.31, 0.26 and 0.31, respectively, which are in the recommended range of 0.15 to 0.50 and indicate that the items are correlated and are measuring the same construct. The Australian PHCE scale is recommended as a tool for the evaluation of health services. Further testing o

Aims: To explore and summarise the literature on the concept of ‘clinical deterioration’ as a nurse-sensitive indicator of quality of care in the out-of-hospital context. Design: The scoping review adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Review and the JBI best practice guidelines for scoping reviews. Methods: Studies focusing on clinical deterioration, errors of omission, nurse sensitive indicators and the quality of nursing and midwifery care for all categories of registered, enrolled, or licensed practice nurses and midwives in the out-of-hospital context were included regardless of methodology. Text and opinion papers were also considered. Study protocols were excluded. Data Sources: Data bases were searched from inception to June 2022 and included CINAHL, PsychINFO, MEDLINE, The Allied and Complementary Medicine Database, EmCare, Maternity and Infant Care Database, Australian Indigenous HealthInfoNet, Informit Health and Society Database, JSTOR, Nursing and Allied Health Database, RURAL, Cochrane Library and Joanna Briggs Institute. Results: Thirty-four studies were included. Workloads, education and training opportunities, access to technology, home visits, clinical assessments and use of screening tools or guidelines impacted the ability to recognise, relay information and respond to clinical deterioration in the out-of-hospital setting. Conclusions: Little is known about the work of nurses or midwives in out-of-hospital settings and their recognition, reaction to and relay of information about patient deterioration. The complex and subtle nature of non-acute deterioration creates challenges in defining and subsequently evaluating the role and impact of nurses in these settings. Implications for the profession and/or patient care: Further research is needed to clarify outcome measures and nurse contribution to the care of the deteriorating patient in the out-of-hospital setting to reduce the rate

Aims: This work aims to explore staff perceptions of (1) the effectiveness of organizational communication during the COVID-19 pandemic and (2) the impact of organizational communication on staff well-being and ability to progress their work and patient care. Background: Effective coordination and communication are essential in a pandemic management response. However, the effectiveness of communication strategies used during the COVID-19 pandemic is not well understood. Design: An exploratory cross-sectional research design was used. A 33-item survey tool was created for the study. Methods: The study was conducted at a tertiary teaching hospital in Western Australia. Convenience sampling was used to recruit participants from nursing, medical, allied health services, administrative and clerical, and personal support services (N = 325). Data were collected between December 2020 and May 2021. Results: Overall, all occupational groups found working during the COVID-19 pandemic stressful, and all groups wanted accessible and accurate communication from management and new policies, procedures, and protocols for future outbreaks. Conclusions: The use of occupational group-relevant strategies and COVID-19 protocols, as well as the on-going use of email, face-to-face meetings with debrief sessions, are needed to improve communication and support staff to fulfil their roles.

Aim: The aim of this study is to synthesize available literature describing the development, implementation and evaluation of a Professional Practice Model. Background: A Professional Practice Model is an overarching theory-based framework that depicts nursing values and defines the structure and process of nursing care. No research has synthesized available literature on this topic in recent times. Evaluation: A review of English language papers was published from 2015 to 2022. Fourteen studies met the inclusion criteria. Key Issues: All studies highlighted the importance of having a Professional Practice Model that reflects nursing care activities and resonates with nurses across an organization. This is achieved through strong leadership and clinical nurse involvement during the development, implementation and evaluation phases. In addition, a model should be adapted to keep up to date with scientific changes relevant to nursing. Conclusions: This review adds to the body of knowledge on the development, implementation and evaluation of a Professional Practice Model. Future research exploring the benefit of a Professional Practice Model on patient outcomes would be useful. Implications for nursing management: The key elements of a Professional Practice Model including six components and theoretical foundation have been summarized in this review. Nurse leaders should consider these key elements in the creation of a Professional Practice Model. For successful enculturation, a Professional Practice Model needs to be relevant to all nurses and easy for them to articulate.

Aim Aim of this study is to systematically review and synthesize available evidence to identify the association between nurse staffing methodologies and nurse and patient outcomes. Design Systematic review and narrative synthesis. Data sources A search of MEDLINE (EBSCO), CINAHL (EBSCO) and Web of Science was conducted for studies published in English between January 2000 and January 2020. Review methods The reporting of this review and narrative synthesis was guided by the preferred reporting items for systematic and meta-analysis guidelines (PRISMA) statement and data synthesis guided by the Synthesis Without Meta-analysis (SWiM) guideline. The quality of each article was assessed using the Mixed Methods Appraisal Tool. Results Twenty-two studies met the inclusion criteria. Twenty-one used the mandated minimum nurse-to-patient ratio methodology and one study assessed the number of nurse hours per patient day staffing methodology. Both methodologies were mandated. All studies that reported on nurse outcomes demonstrated an improvement associated with the implementation of mandated minimum nurse-to-patient ratio, but findings related to patient outcomes were inconclusive. Conclusions Evidence on the impact of specific nurse staffing methodologies and patient and nurse outcomes remains highly limited. Future studies that examine the impact of specific staffing methodologies on outcomes are required to inform this fundamental area of management and practice.

AIMS AND OBJECTIVES: To conduct an integrative review of the factors associated with why midwives stay in midwifery. BACKGROUND: Midwifery retention and attrition are globally acknowledged as an issue. However, little is known as to why midwives stay in midwifery as the focus has previously focussed on why they leave. DESIGN: A structured six-step integrative review approach was used, and this involved the development of a search strategy, study selection and critical appraisal, data abstraction and synthesis, interpretation of findings and recommendations for future practice. METHODS: The review was conducted using the databases MEDLINE, CINAHL and PsychInfo. Included studies were in the English language with an unlimited publication date. RESULTS: Six studies were included in this review: one qualitative, two quantitative and three using mixed methods. Seven themes emerged from synthesisation of the data reported for the six included studies that together help answer the question of why midwives stay in midwifery. CONCLUSION: This integrative review has highlighted some important factors that assist in answering the question why midwives stay in midwifery. However, it has also highlighted the need for quality data that reflects the range of contexts in which midwifery is practised. RELEVANCE TO CLINICAL PRACTICE: There is an abundance of literature focussing on why midwives leave the profession; however, the gap exists in the reasons why midwives stay. If we can uncover this important detail, then changes within the profession can begin to be implemented, addressing the shortage of midwives issue that has been seen globally for a large number of years.

Objective: To examine literature surrounding suicidal ideation and suicidality in the perinatal period. Design: Systematic Literature Review of published 15 research studies. Findings: There is a scarcity of prospective studies conducted in suicidal ideation during the perinatal period. More research is needed to ensure childbearing women at risk of suicidal ideation during pregnancy receive the appropriate care and maternity services required to support them throughout this period. Key conclusions: Midwives play an important role in screening women for possible emotional distress and mood disorders during pregnancy. Therefore, midwives need to have knowledge of risk factors so vulnerable women are monitored and supportive maternity services can be implemented if indicated. Implications for practice: Suicidal ideation can have serious consequences for the women and the product if left untreated. Screening for suicidal ideation, antenatal and postnatal depression is imperative. Women with a pre-existing mental health disorders are a particularly vulnerable population group and should be monitored closely for suicidal ideation. Women who experience intimate partner violence or are from low socioeconomic backgrounds also present a risk of suicidal ideation, all of which require complex mental-health care.

Effective communication is the most central process within an organisation and is essential to organisational values, norms and expectations. There is a documented connection between job satisfaction, work commitment and organisational communication. However, nurses’ and nursing middle managers’ satisfaction with organisational communication has not been extensively studied in recent years and not at all among paediatric nurses. Therefore, the purpose of this study was to develop and test a theoretical model that examined paediatric nurses’ and middle managers’ satisfaction with organisational communication and the effect this has on paediatric nurses’ job satisfaction and intention to stay in their job. Employing a quantitative research design, a series of surveys were distributed to paediatric nurses (including middle managers) in both electronic and hard copy formats. A total of 165 surveys were returned for a response rate of 42.4%. A Mann-Whitney U test was used to identify the difference in organisational communication perceptions between paediatric nurses and middle managers. A statistically significant difference was identified, with middle managers displaying greater dissatisfaction in seven communication satisfaction areas. Structural Equation Modelling tested and refined the hypothesised model. Final analysis showed adequate fit data (ꭓ²=2.040, p value= .728, SRMR= .0302, CFI=1.00, RMSEA=.000, pCLOSE= .827). In the final model, supervisor relationships, media quality and communication climate had a direct effect on job satisfaction and an indirect effect on intention to leave ones’ job and looking for another job. Job satisfaction had a direct effect on intention to leave and looking for another job. Study findings suggest that changes to upward and downward communication systems are needed to improve the nursing voice within healthcare organisations. In addition, more support and guidance is required for middle managers, including mentorship and intense

Doleman, G., Twigg, D., Bayes, S., & Chivers, P. (2020). Paediatric nurses’ satisfaction with organisational communication, job satisfaction, and intention to stay: A structural equation modelling analysis. Collegian, 28(4), 376-384. https://doi.org/10.1016/j.colegn.2020.11.005

Doleman, G., & Duffield, C. (2021). Administrative applications. In P. Hussey & M. A. Kennedy (Eds.), Introduction to nursing informatics (pp. 233-265). Springer, Cham. https://doi.org/10.1007/978-3-030-58740-6_9

Twigg, D. E., Whitehead, L., Doleman, G., & El‐Zaemey, S. (2021). The impact of nurse staffing methodologies on nurse and patient outcomes: A systematic review. Journal of Advanced Nursing, 77(12), 4599-4611. https://doi.org/10.1111/jan.14909

This is an Author's Accepted Manuscript of: O'Connor, A., Geraghty, S., Doleman, G., & De Leo, A. (2018). Suicidal Ideation in the Perinatal Period: A Systematic Review. Mental Health & Prevention. 12, 67-75. Available here.

Doleman, G., Di, T., & Bayes, S. (2020). A comparison of middle managers and paediatric nurses’ satisfaction with organisational communication. Journal of Nursing Management, 28(6), 1223-1232. https://doi.org/10.1111/jonm.13064

This is the pre-peer reviewed version of the following article:Bloxsome, D., Ireson, D., Doleman, G., & Bayes, S. (2019). Factors associated with midwives’ job satisfaction and intention to stay in the profession: An integrative review. Journal of Clinical Nursing, 28(3-4), 386-399. which has been published in final form here. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions.

Geraghty, S., Doleman, G., & De Leo, A. (2018). Midwives’ attitudes towards pregnant women using substances: Informing a care pathway. Women and Birth, 32(4), e477-e482. Available here.

Doleman, G., Geraghty, S., & DeLeo, A. (2019). Midwifery student's perceptions of caring for substance-using pregnant women. Nurse Education Today, 76, 26-30. Available here

Twigg, D. E., Whitehead, L., Doleman, G., & El‐Zaemey, S. (2021). The impact of nurse staffing methodologies on nurse and patient outcomes: A systematic review. Journal of Advanced Nursing, 77(12), 4599-4611. https://doi.org/10.1111/jan.14909

Doleman, G., Duffield, C., Li, I. W., & Watts, R. (2022). Employment of the Australian graduate nursing workforce: A retrospective analysis. Collegian, 29( 2), 228-235. https://doi.org/10.1016/j.colegn.2021.12.002