ORCID Profile
0000-0002-6335-1356
Current Organisations
Edith Cowan University
,
Murdoch University
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Publisher: SAGE Publications
Date: 2021
DOI: 10.33151/AJP.18.861
Abstract: Promotion from paramedic to manager is common in ambulance services, yet there is limited research concerning paramedics’ experience of this role transition. The purpose of this qualitative study was to explore the experiences of paramedics who have transitioned from clinician to manager. A qualitative approach was used for this study. Through purposive s ling, semi-structured interviews were conducted with paramedics who had made the transition to manager. The participants were asked to describe how they felt and what their experiences were concerning this transition. Thematic analysis was undertaken identifying themes within participant responses. Six key themes emerged during the data analysis. Participants described feelings of isolation on moving from the frontline, a lack of feeling part of the team ‘in green’ however, they also reported that previously being a paramedic in some instances gave credibility in their new manager roles. Challenges reported concerned no formal training before transitioning into the role, and the lack of essential managerial experience. This research provided insight into how paramedics feel and perceive the transition from clinician to management roles. A review of the organisational approach to role transition is of benefit to paramedics. Such a review may help identify what changes could be made in support of paramedics transitioning to management roles. Further research is required across other ambulance services to determine the efficacy of these results in the broader ambulance service environment.
Publisher: Wiley
Date: 20-04-2018
DOI: 10.1111/JOCN.13785
Abstract: To critically appraise available literature and summarise evidence pertaining to the patient safety knowledge and practices of new graduate registered nurses. Responsibility for patient safety should not be limited to the practice of the bedside nurses, rather the responsibility of all in the healthcare system. Previous research identified lapses in safety across the health care, more specifically with new practitioners. Understanding these gaps and what may be employed to counteract them is vital to ensuring patient safety. A focused review of research literature. The review used key terms and Boolean operators across a 5-year time frame in CINAHL, Medline, psycINFO and Google Scholar for research articles pertaining to the area of enquiry. Eighty-four articles met the inclusion criteria, 39 discarded due to irrelevant material and 45 articles were included in the literature review. This review acknowledges that nursing has different stages of knowledge and practice capabilities. A theory-practice gap for new graduate registered nurses exists, and transition to practice is a key learning period setting new nurses on the path to becoming expert practitioners. Within the literature, there was little to no acknowledgement of patient safety knowledge of the newly registered nurse. Issues raised in the 1970s remain a concern for today's new graduate registered nurses. Research has recognised several factors affecting transition from nursing student to new graduate registered nurse. These factors are leaving new practitioners open to potential errors and risking patient safety. Understanding the knowledge of a new graduate registered nurse upon entering clinical practice may assist in organisations providing appropriate clinical and theoretical support to these nurses during their transition.
Publisher: RCN Publishing Ltd.
Date: 21-03-2018
Publisher: Wiley
Date: 20-03-2019
DOI: 10.1111/JOCN.14839
Abstract: To explore the transition experiences of newly graduated registered nurses with particular attention to patient safety. New graduate registered nurses' transition is accompanied by a degree of shock which may be in tune with the described theory-practice gap. The limited exposure to clinical settings and experiences leaves these nurses at risk of making errors and not recognising deterioration, prioritising time management and task completion over patient safety and care. Qualitative descriptive approach using semi-structured interviews. Data were collected during 2017-18 from 11 participants consenting to face-to-face or telephone semi-structured interviews. Interviews were transcribed verbatim, and data were analysed using thematic analysis techniques assisted by Nvivo coding software. The study follows the COREQ guidelines for qualitative studies (see Supplementary File 1). Key themes isolated from the interview transcripts were as follows: patient safety and insights time management making a mistake experiential learning and transition. Medication administration was a significant cause of stress that adds to time management anguish. Although the new graduate registered nurses' clinical acumen was improving, they still felt they were moving two steps forward, one step back with regards to their understanding of patient care and safety. Transition shock leaves new graduate registered nurses' focused on time management and task completion over patient safety and holistic care. Encouragement and support needed to foster a safety culture that foster safe practices in our new nurses. Having an understanding of the new graduate registered nurses' experiences and understanding of practice will assist Graduate Nurse Program coordinators, and senior nurses, to plan and provide the relevant information and education during these initial months of transition to help mitigate the risk of errors occurring during this time.
Publisher: Wiley
Date: 04-12-2017
DOI: 10.1111/JOCN.13980
Abstract: To explore the connection between +6 nursing leadership and enhanced patient safety. Critical reports from the Institute of Medicine in 1999 and Francis QC report of 2013 indicate that healthcare organisations, inclusive of nursing leadership, were remiss or inconsistent in fostering a culture of safety. The factors required to foster organisational safety culture include supportive leadership, effective communication, an orientation programme and ongoing training, appropriate staffing, open communication regarding errors, compliance to policy and procedure, and environmental safety and security. As nurses have the highest patient interaction, and leadership is discernible at all levels of nursing, nurse leaders are the nexus to influencing organisational culture towards safer practices. The position of this article was to explore the need to form a nexus between safety culture and leadership for the provision of safe care. Safety is crucial in health care for patient safety and patient outcomes. A culture of safety has been exposed as a major influence on patient safety practices, heavily influenced by leadership behaviours. The relationship between leadership and safety plays a pivotal role in creating positive safety outcomes for patient care. A safe culture is one nurtured by effective leadership. Patient safety is the responsibility of all healthcare workers, from the highest executive to the bedside nurse, thus effective leadership throughout all levels is essential in engaging staff to provide high quality care for the best possible patient outcomes.
Publisher: Hindawi Limited
Date: 22-07-2019
DOI: 10.1111/JONM.12819
Abstract: To explore new graduate registered nurses' knowledge and attitudes concerning medical error and patient safety, during their first 6 months of professional practice. New graduate registered nurses demonstrate basic skills and levels of performance due to limited exposure and experience in actual situations. There is a concern held for their clinical reasoning skills required to recognize patient deterioration, posing a threat to patient safety. An online questionnaire was used to survey new graduate registered nurses at three time points during graduate nurse programmes between August 2016 and February 2018. A decrease in self-reported knowledge and attitudes regarding medical errors was noted over the three time points. These results indicate initial confidence in theoretical knowledge and attitudes upon completion of undergraduate education, and prior to commencing professional practice. Results suggest that a theory practice gap persists with respect to medical error for transitioning new nurses. New nurses lack confidence around compromised patient safety situations and a knowledge gap around actions related to medical error. Nurse managers and educators should be made aware of this gap to implement strategies to decrease risk during novice nurse transition.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 30-09-2019
Publisher: Elsevier BV
Date: 04-2021
Publisher: Hindawi Limited
Date: 22-11-2018
DOI: 10.1111/JONM.12725
Abstract: To evaluate the experience of change fatigue in frontline nursing staff following large-scale organisational change and determine whether improved teamwork perception scores can mitigate the experience of change fatigue in this population. There is limited published research pertaining to the experience of change fatigue in nursing, despite the rapid rate and volume of change within health care organisations. An online questionnaire was used to survey a cross section of frontline nurses from two distinct cohorts those that transitioned to a new build hospital in an established team (n = 225), and those who transitioned into a newly reconfigured team (n = 521). Frontline nurses who transitioned in an established team reported higher levels of change fatigue following large-scale change, compared with those that commenced in a new, reconfigured team (p = 0.013). There is a small significant negative correlation between perception of teamwork and change fatigue scores. Regardless of team type, high levels of change fatigue are reported by frontline nursing staff following large-scale organisational change. Established teams have a higher perceived level of teamwork in all domains when compared with a new team in the same change conditions. It is unlikely that the perception of teamwork has any real-world impact upon the experience of change fatigue. Change fatigue is a real phenomena experienced by frontline nursing staff during large-scale organisational change conditions. Investing in teamwork training prior to or during large-scale organisational change does not affect the experience of change fatigue.
Publisher: Wiley
Date: 17-06-2019
DOI: 10.1111/INM.12622
Abstract: The population of overseas-born Australians continues to grow including the recent increase of immigrants and refugees from African countries. Due to this increase, healthcare services need to assess if current available services are culturally appropriate for African immigrant inpatients. This qualitative study, with a quality improvement focus, examined current services to identify key service gaps and consider recommendation to improve care of African immigrant mental health inpatients in the hospital from the point of view of staff working within the organisation. What was revealed is that services currently offered to African mental health inpatients were culturally inappropriate. Emerging themes included inadequate interpreter services, lack of cultural awareness staff training, lack of organisation link with other services, unmet spiritual needs, use of staff/families as interpreters, culturally inappropriate information, and lack of or inadequate culturally appropriate policies and framework. Changes to current practices are recommended to provide culturally appropriate mental health care to African inpatients.
Publisher: Elsevier BV
Date: 2019
DOI: 10.1016/J.NEPR.2018.12.003
Abstract: The transition to quality and safety in the new graduate registered nurses' practice remains problematic directly impacting patient outcomes. Effective mentoring during transition serves to enhance experiential learning, allowing the development and establishment of safe, quality nursing practice. Comprehensive understanding of the transition process, including the barriers and effective enablers to transition is the key to effective mentoring. A theoretical framework guided by Duchscher's Stages of Transition Theory and Transition Shock Model and Benner's From novice to expert model can facilitate such understanding. Nurse Theorists play an important part in shaping nurse education and practice and have provided nurse educators and leaders an understanding to shape skill acquisition and the transition process for new graduate registered nurses. The res ultantresearchmodels and theory of these influencial nurses are pertinent to transition of new graduate registered nurses. This paper outlines the theories of Duchscher and Benner and how their research formed the theoretical framework to facilitate the measurement, understanding and improvement of the safety and quality of nursing care and impact the future nursing workforce.
Publisher: Elsevier BV
Date: 02-2020
Publisher: Elsevier BV
Date: 02-2023
Publisher: Hindawi Limited
Date: 06-08-2018
DOI: 10.1111/JONM.12654
Abstract: To explore absenteeism trends and absenteeism management from the perspective of nurse unit managers. Unscheduled absenteeism among nurses appears to be a multi-factorial phenomenon and is a source of concern due to the effect absenteeism has on the daily management of human resources, ultimately affecting delivery of safe care. Identifying absenteeism trends among nurses may inform the development of targeted strategies to minimize unscheduled absenteeism. A mixed-methods approach was used with the quantitative phase retrospectively reviewing and analysing nurse absenteeism data, whilst the qualitative phase involved semi-structured interviews with nurse unit managers, exploring their perceptions pertaining to the absenteeism trends. Data analysis revealed that absenteeism in hospitals follows various trends, amongst them seasonal, daily, and demographic trends. A heavy workload, which takes its toll on the nurses' physical and mental health, also contributes to nurse absenteeism. This study reveals absenteeism trends from nurse managers' perspectives, with authentication from official statistics. Any prescriptive measures for absenteeism should take into account absenteeism trend analysis and the work environment. An analysis of absenteeism trends will assist management in initiating tailor-made intervention measures.
Publisher: Hindawi Limited
Date: 12-2020
DOI: 10.1111/JONM.13214
Publisher: Elsevier BV
Date: 12-2021
Publisher: Elsevier BV
Date: 04-2015
DOI: 10.1016/J.RESUSCITATION.2015.01.023
Abstract: Paramedic exposure to out-of-hospital cardiac arrest (OHCA) may be an important factor in skill maintenance and quality of care. We aimed to describe the annual exposure rates of paramedics in the state of Victoria, Australia. We linked data from the Victorian Ambulance Cardiac Arrest Registry (VACAR) and Ambulance Victoria's employment dataset for 2003-2012. Paramedics were 'exposed' to an OHCA if they attended a case where resuscitation was attempted. In idual rates were calculated for average annual exposure (number of OHCA exposures for each paramedic/years employed in study period) and the average number of days between exposures (total paramedic-days in study/total number of exposures in study). Over 10-years, there were 49,116 OHCAs and 5673 paramedics employed. Resuscitation was attempted in 44% of OHCAs. The typical 'exposure' of paramedics was 1.4 (IQR=0.0-3.0) OHCAs per year. Mean annual OHCA exposure declined from 2.8 in 2003 to 2.1 in 2012 (p=0.007). Exposure was significantly less in those: employed part-time (p<0.001) in rural areas (p<0.001) and with lower qualifications (p<0.001). Annual exposure to paediatric and traumatic OHCAs was particularly low. It would take paramedics an average of 163 days to be exposed to an OHCA and up to 12.5 years for paediatric OHCAs, which occur relatively rarely. Exposure of in idual paramedics to resuscitation is low and has decreased over time. This highlights the importance of supplementing paramedic exposure with other methods, such as simulation, to maintain resuscitation skills particularly in those with low exposure and for rare case types.
Publisher: RCN Publishing Ltd.
Date: 21-03-2018
Publisher: Hindawi Limited
Date: 02-11-2020
DOI: 10.1111/JONM.13183
Publisher: RCN Publishing Ltd.
Date: 21-06-2017
Abstract: Nurses are often asked to think about leadership, particularly in times of rapid change in healthcare, and where questions have been raised about whether leaders and managers have adequate insight into the requirements of care. This article discusses several leadership styles relevant to contemporary healthcare and nursing practice. Nurses who are aware of leadership styles may find this knowledge useful in maintaining a cohesive working environment. Leadership knowledge and skills can be improved through training, where, rather than having to undertake formal leadership roles without adequate preparation, nurses are able to learn, nurture, model and develop effective leadership behaviours, ultimately improving nursing staff retention and enhancing the delivery of safe and effective care.
Location: Australia
No related grants have been discovered for Melanie Murray.