ORCID Profile
0000-0001-5430-3275
Current Organisation
Federation University
Does something not look right? The information on this page has been harvested from data sources that may not be up to date. We continue to work with information providers to improve coverage and quality. To report an issue, use the Feedback Form.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 05-2015
Publisher: Elsevier BV
Date: 2014
DOI: 10.1016/J.RESUSCITATION.2013.08.276
Abstract: Medical emergency team performance including non-technical skills, is receiving increased attention due to the influences on patient safety. The Team Emergency Assessment Measure (TEAM) was developed to enable standardized performance assessment and structured team debriefing. From several studies, the TEAM has demonstrated a substantial body of normative data confirming its validity and reliability. This includes high uni-dimensional validity, significant subscale relationships between Teamwork and Leadership and between Teamwork and Task Management (p<0.001), a Cronbach alpha of 0.92 and adequate construct validity. The tool has potential for team training to improve team's non-technical performance. Further testing is required in 'real' clinical settings.
Publisher: Elsevier BV
Date: 2020
DOI: 10.1016/J.IENJ.2019.06.008
Abstract: Emergency nurses are at risk of compassion fatigue. Compassion fatigue caused by exposure to suffering may compromise the in idual's personal wellbeing and reduce work efficiency. A quantitative cross-sectional survey with open responses was conducted using the Professional Quality of Life: Compassion Satisfaction and Compassion Fatigue (ProQOL) scale and open-ended questions. Responses from a convenience s le of 86 nurses from two hospital emergency departments in Victoria, Australia, were analysed. The median score for Compassion Satisfaction was 78% with all nurses reporting average to high scores. Most had average levels of Compassion Fatigue: Burnout median score was 53% and Secondary Traumatic Stress median score 49%. No statistically significant correlation was found between scales nor with influencing demographic characteristics. A qualification in emergency nursing was predictive of Compassion Satisfaction. Six descriptive job-associated factors contributed to nurses' stress: human resources, the organisation, job-specific components, patient mix and professional and personal components. Average to high levels of Compassion Satisfaction and low to average levels of Compassion Fatigue were found in emergency nurses. Issues contributing to stress were work and role related. An understanding of these stressors may help nurses and nurse managers to ameliorate emergency nurses' levels of stress and help limit staff burnout.
Publisher: Springer Science and Business Media LLC
Date: 05-2015
Publisher: Wiley
Date: 03-2008
Publisher: Elsevier BV
Date: 11-2017
DOI: 10.1016/J.NEPR.2017.08.012
Abstract: Simulation modalities are numerous in nursing education, with a need to reveal their range and impact. We reviewed current evidence for effectiveness of medium to high fidelity simulation as an education mode in pre-licensure re-registration nurse education. A state-of-the-art review and meta-analyses was conducted based on a systematic search of publications in English between 2010 and 2015. Of 72 included studies, 43 were quantitative primary studies (mainly quasi-experimental designs), 13 were qualitative studies and 16 were reviews of literature. Forty of 43 primary studies reported benefits to student learning, and student satisfaction was high. Simulation programs provided multi-modal ways of learning. A meta-analysis (8 studies, n = 652 participants) identified that simulation programs significantly improved clinical knowledge from baseline. The weighted mean increase was 5.0 points (CI: 3.25-6.82) on a knowledge measure. Other objectively rated measures (eg, trained observers with checklists) were few. Reported subjective measures such as confidence and satisfaction when used alone have a strong potential for results bias. Studies presented valid empirical evidence, but larger studies are required. Simulation programs in pre-licensure nursing curricula demonstrate innovation and excellence. The programs should be shared across the discipline to facilitate development of multimodal learning for both pre-licensure and postgraduate nurses.
Publisher: Elsevier BV
Date: 05-2018
DOI: 10.1016/J.NEDT.2018.01.037
Abstract: There are international concerns relating to the management of patient deterioration. The "failure to rescue" literature identifies that nursing staff miss cues of deterioration and often fail to call for assistance. Simulation-based educational approaches may improve nurses' recognition and management of patient deterioration. To investigate the educational impact of the First2Act web-based (WB) and face-to-face (F2F) simulation programs. A mixed methods interventional cohort trial with nursing staff from four Australian hospitals. Nursing staff working in four public and private hospital medical wards in the State of Victoria. In 2016, ward nursing staff (n = 74) from a public and private hospital completed three F2F laboratory-based team simulations with a patient actor in teams of three. 56 nursing staff from another public and private hospital in idually completed a three-scenario WB simulation program (First2ActWeb) [A 91% participation rate]. Validated tools were used to measure knowledge (multi-choice questionnaire), competence (check-list of actions) and confidence (self-rated) before and after the intervention. Both WB and F2F participants' knowledge, competence and confidence increased significantly after training (p ≤0.001). Skill performance for the WB group increased significantly from 61% to 74% (p ≤ 0.05) and correlated significantly with post-test knowledge (p = 0.014). No change was seen in the F2F groups' performance scores. Course evaluations were positive with median ratings of 4/5 (WB) and 5/5 (F2F). The F2F program received significantly more positive evaluations than the WB program (p < 0.05), particularly with regard to quality of feedback. WB and F2F simulation are effective education strategies with both programs demonstrating positive learning outcomes. WB programs increase ease of access to training whilst F2F enable the development of tactile hands on skills and teamwork. A combined blended learning education strategy is recommended to enhance competence and patient safety.
Publisher: Elsevier BV
Date: 08-2018
DOI: 10.1016/J.PEC.2018.03.010
Abstract: To identify communication patterns of Registered Nurses regarding patients' use of complementary therapies. A cross-sectional online survey conducted in 2017 recruited Australian Registered Nurses working in any area of nursing. Responses of 614 Registered Nurses were analysed. Patient-initiated discussion of complementary therapies were common for 77% of nurses nurse-initiated discussions were perceived by 73% (sometimes/almost always/always). Nurses' personal use of complementary therapies predicted discussion with patients and education-based, oncology, or aged care/rehabilitation nurses were most likely to initiate dialogue. Many (55%) did not 'recommend' a particular therapy, although 12% 'almost always/always' did so. Four out of five nurses (84%) documented patients' use and communicated with medical/nursing colleagues about this use. Conversely, 61% 'never' or 'almost never' communicated with a complementary therapy practitioner. Nurses working in Australia often discuss complementary therapies, however they rarely specifically recommend their use. Their workplace environment and clinical context influenced nurses' willingness to communicate about complementary therapy use. PRACTICE IMPLICATIONS EVIDENCE: suggests the need for policy development to promote communication between mainstream healthcare providers and complementary therapy practitioners to support the delivery of safe, high quality patient care.
Publisher: Elsevier BV
Date: 11-2017
Publisher: Springer Science and Business Media LLC
Date: 05-06-2018
Publisher: Wiley
Date: 04-2009
Publisher: Elsevier BV
Date: 11-2019
Publisher: Elsevier BV
Date: 08-2018
Publisher: Elsevier BV
Date: 03-2016
DOI: 10.1016/J.IENJ.2015.08.002
Abstract: To explore the potential of mobile eye-tracking to identify healthcare students' area of visual interest and its relationship to performance ratings. Eye-tracking identifies an in idual's visual attention focus, and has been used as a training technique in medicine and in nursing. In this study participants wore a point of view (PoV) camera within a spectacle frame during simulation education experiences. Thirty-nine final year nursing and paramedicine students in idually participated in three 8 minute clinical simulations with debriefing using videoed eye-tracking recordings. Coloured dots on the video depicted the participant's pupil fixation on five targeted areas. Data extracted from the video camera were collated to report time spent on each target (their 'gaze'). The mean total gaze of expert designated targets in the environment for three 8 minute scenarios was 40-77%. Of 35 participants' focus on three main areas of interest, their priority was the patient's head (34%), the patient's trunk (24%) and their clinical assistant (5%), with significant differences between nursing and paramedic disciplines (P < 0.05). Objectively rated clinical performance improved significantly by the third scenario (P ≤ 0.001). Participants were positive regarding use of eye tracking during debriefing. Eye tracking has the potential to enhance debriefing and educational outcomes, although there are limitations to gaze capture in high fidelity environments and resource cost is high. Further study is warranted to enable better understanding of how expert clinicians achieve high levels of performance.
Publisher: Informa UK Limited
Date: 26-05-2022
Publisher: Wiley
Date: 05-09-2008
Publisher: Elsevier BV
Date: 09-2017
DOI: 10.1016/J.IENJ.2017.04.002
Abstract: Internationally, non-urgent presentations are increasing the pressure on Emergency Department (ED) staff and resources. This systematic review aims to identify the impact of alternative emergency care pathways on ED presentations - specifically GP cooperatives and walk-in clinics. Based on a structured PICO enquiry with either walk-in clinic or GP cooperative as the intervention, a search was made for peer-reviewed publications in English, between 2000 and 2014. Medline plus, OVID, PubMed, and Google Scholar were searched. The Critical Appraisal Skills Program (CASP) guidelines were used to assess study quality and data was extracted using an adapted JBI Qualitative Assessment and Review Instrument (QARI). Subsequent reporting followed the PRISMA guideline. Eleven high quality quantitative studies met the inclusion criteria. Walk-in clinics do have the potential to reduce non-urgent emergency department presentations, however evidence of this effect is low. GP cooperatives offer an alternative care stream for patients presenting to the ED and do significantly reduce local ED attendances. Community members need to be made aware of these options in order to make informed treatment choices. GP cooperatives in particular do have the potential to reduce ED workload. Further research is required to uncover recent trends and patient outcomes for walk-in clinics and GP cooperatives.
Publisher: Elsevier BV
Date: 04-2010
DOI: 10.1016/J.RESUSCITATION.2009.11.027
Abstract: To develop a valid, reliable and feasible teamwork assessment measure for emergency resuscitation team performance. Generic and profession specific team performance assessment measures are available (e.g. anaesthetics) but there are no specific measures for the assessment of emergency resuscitation team performance. (1) An extensive review of the literature for teamwork instruments, and (2) development of a draft instrument with an expert clinical team. (3) Review by an international team of seven independent experts for face and content validity. (4) Instrument testing on 56 video-recorded hospital and simulated resuscitation events for construct, consistency, concurrent validity and reliability and (5) a final set of ratings for feasibility on fifteen simulated 'real time' events. Following expert review, selected items were found to have a high total content validity index of 0.96. A single 'teamwork' construct was identified with an internal consistency of 0.89. Correlation between the total item score and global rating (rho 0.95 p<0.01) indicated concurrent validity. Inter-rater (k 0.55) and retest reliability (k 0.53) were 'fair', with positive feasibility ratings following 'real time' testing. The final 12 item (11 specific and 1 global rating) are rated using a five-point scale and cover three categories leadership, teamwork and task management. In this primary study TEAM was found to be a valid and reliable instrument and should be a useful addition to clinicians' tool set for the measurement of teamwork during medical emergencies. Further evaluation of the instrument is warranted to fully determine its psychometric properties.
Publisher: Wiley
Date: 25-05-2010
Publisher: Elsevier BV
Date: 06-2014
DOI: 10.1016/J.NEDT.2013.12.013
Abstract: Nursing work often occurs in complex and potentially hazardous settings. Awareness of patient and practice environments is an imperative for nurses in practice. To explore nursing students' situation awareness while engaging in simulated patient deterioration scenarios. The educational process of FIRST(2)ACT was the model for the nurse intervention. Situation awareness was measured quantitatively using the Situation Awareness Global Assessment tool. Four domains were measured: physiological perception (patient parameters), global perception (surroundings), comprehension (interpretation of information), and projection (forecasting outcomes). Clinical laboratories at each of three participating universities. Ninety-seven nursing students from three Australian universities. Between March and July 2012, students participated in three video-recorded simulation events, in which a trained actor played patient roles and groups of three students worked as teams. To measure situation awareness, following the simulation each team leader was taken to a separate room and asked to report on a question set regarding the patient's vital signs, bedside setting and medical diagnosis. Overall, situation awareness was low (41%). Of the four domains, physiological perceptions scored the lowest (26%) and projection the highest (59%). Final year nursing students may not have well developed situation awareness skills, especially when dealing with these types of scenarios. Education providers need to consider ways to assist students to fully develop this attribute. Findings suggest that this is an aspect of undergraduate nursing education that requires significant consideration by curriculum developers.
Publisher: Elsevier BV
Date: 12-2015
Publisher: Wiley
Date: 21-01-2020
DOI: 10.1111/JOCN.15137
Abstract: This paper has two aims : first, to explain the concept of empathy derived from an integrative review of contemporary nursing literature and second, to profile a new conceptual model that can be used to inform the teaching of empathy. Empathy is fundamental to therapeutic communication and integral to quality patient care. However, the lack of agreement on the definition or conceptualisation of empathy in the nursing literature can make teaching and evaluating this skill challenging and inconsistent. Integrative review of literature. Publications from January 2000 to July 2018 in Ovid Medline, Scopus, CINAHLPlus, PsycINFO, and PubMed. As no integrative review checklists are currently available, a PRISMA checklist was adapted to guide this review. A two-stage approach was used to explore the concept of empathy. Key definitions and attributes of empathy were identified from 11 primary studies and tabulated to allow for display and comparison. Next, the definitions and attributes of empathy drawn from a purposeful s le of 18 nursing education studies were examined, tabulated and summarised. Finally, the two s les were integrated and synthesised to form a cohesive summary, which was then illustrated with teaching and learning exemplars. Despite the lack of consensus on the definitions of empathy evident in the literature, recurring attributes and elements of empathy were evident, leading to the development of a new empathy model. Patterns of consistency in the attributes of empathy that emerged from the review provided the basis for a new conceptual model, termed "The Empathy Continuum." Each of the stages in the Empathy Continuum can be used to teach learners the meaning, attributes and application of empathy in practice. The model will be relevant to nurse educators as well as educators from other disciplines.
Publisher: Elsevier BV
Date: 03-2016
Publisher: Elsevier BV
Date: 05-2020
Publisher: Wiley
Date: 15-05-2009
Publisher: Wiley
Date: 13-08-2019
DOI: 10.1111/JOCN.14965
Abstract: To extract, examine and report the highest available levels of evidence from healthcare disciplines in the use of simulation-based education as substitution for clinical placement in prelicensure programmes. Simulation is widely employed across prelicensure health professional education to create safe, realistic clinical learning experiences for students. Whether simulation can be employed to substitute for actual clinical placement, and if so, in what proportion, replacement ratio and duration, is unclear. A systematic review and quality appraisal of primary studies related to prelicensure students in all health disciplines, guided by the PRISMA checklist. Ten primary studies were included, representing 2,370 students from three health disciplines in four countries. Nine studies were experimental and quasi-experimental and methodological quality was assessed as moderate to high with good to very good inter-rater agreement. Direct substitution of simulation for clinical practice ranged from 5% to 50%. With one exception, replacement ratios were 1:1 and duration of replacement ranged from 21 hr-2 years. Levels of evaluation included measures of reaction, knowledge and behaviour transfer no negative outcomes were reported. We appraised practicalities for design of substitution, design limitations and knowledge transfer to accreditation standards for prelicensure programmes. This review synthesised highest levels and quality of available evidence for substitution of simulation for clinical placement in health professional education. Included studies were heterogenous in simulation interventions (proportion, ratio and duration) and in the evaluation of outcomes. Future studies should incorporate standardised simulation curricula, widen the health professions represented and strengthen experimental designs. Current evidence for clinical educational preparation does not appear to be translated into programme accreditation standards governing clinical practice experience for prelicensure programmes in relevant jurisdictions. Overall, a stronger evidence base is necessary to inform future curricula and policy development, to strengthen clinical practice in health.
Publisher: Elsevier BV
Date: 12-2019
Publisher: Elsevier BV
Date: 06-2012
DOI: 10.1016/J.WOMBI.2011.03.004
Abstract: To critically examine the evidence for simulation based learning in midwifery education. Simulated Learning Programs (SLPs) using low to high fidelity techniques are common in obstetric professionals' education and focus on the development of team work, labour and obstetric emergencies. A systematic review incorporating critical appraisal approaches, setting clear objectives and a defined search and analysis strategy. Evidence from obstetrics, neonatology, technical and non-technical skills (teamwork) was included where it informed the development of midwifery curricula. Studies in English from 2000 to 2010 were included searching CINAHL Plus, OVID Medline, Cochrane, SCOPUS and ProQuest and Google Scholar. Twenty-four papers were identified that met the inclusion criteria. All were quantitative reports outcomes and levels of evidence varied with two notable papers indicating that simulation had an impact on clinical practice. Benefits of SLP over didactic formats were apparent, as were the development of non-technical skills confidence and competence. The study outcomes were limited by the range of evidence and context of the reports which focussed on obstetric emergency training using a number of simulation techniques. There is evidence that simulated learning of midwifery skills is beneficial. Simulation learning has an educational and clinical impact and advantages over didactic approaches. Where clinical practice is infrequent i.e. obstetric emergencies, simulation is an essential component of curricula. Simulation enhances practice and therefore may reduce the time taken to achieve competence however there is no evidence from the literature that simulation should replace clinical practice.
Publisher: CSIRO Publishing
Date: 2010
DOI: 10.1071/PY09024
Abstract: The aim of this project was to describe general practitioners’ (GPs’) decision-making process for reducing nutrition risk in cardiac patients through referring a patient to a dietitian. The setting was primary care practices in Victoria. The method we employed was mixed methods research: in Study 1, 30 GPs were interviewed. Recorded interviews were transcribed and narratives analysed thematically. Study 2 involved a survey of statewide random s le of GPs. Frequencies and analyses of variance were used to explore the impact of demographic variables on decisions to refer. We found that the referral decision involved four elements: (i) synthesising management information (ii) forecasting outcomes (iii) planning management and (iv) actioning referrals. GPs applied cognitive and collaborative strategies to develop a treatment plan. In Study 2, doctors (248 GPs, 30%) concurred with identified barriers/enabling factors for patients’ referral. There was no association between GPs’ sex, age or hours worked per week and referral factors. We conclude that a GP’s judgment to offer a dietetic referral to an adult patient is a four element reasoning process. Attention to how these elements interact may assist clinical decision making. Apart from the sole use of prescribed medications/surgical procedures for cardiac care, patients offered a dietetic referral were those who were considered able to commit to dietary change and who were willing to attend a dietetic consultation. Improvements in provision of patients’ nutrition intervention information to GPs are needed. Further investigation is justified to determine how to resolve this practice gap.
Publisher: Elsevier BV
Date: 07-2017
DOI: 10.1016/J.NEPR.2017.04.011
Abstract: Bullying in health workplaces has a negative impact on nurses, their families, multidisciplinary teams, patient care and the profession. This paper compares the experiences of Australian and UK baccalaureate nursing students in relation to bullying and harassment during clinical placement. A secondary analysis was conducted on two primary cross-sectional studies of bullying experiences of Australian and UK nursing students. Data were collected using the Student Experience of Bullying during Clinical Placement (SEBDCP) questionnaire and analysed using descriptive and inferential statistics. The total s le was 833 Australian and 561 UK students. Australian nursing students experienced a higher rate of bullying (50.1%) than UK students (35.5%). Students identified other nurses as the main perpetrators (Aust 53%, UK 68%), although patients were the main source of physical acts of bullying. Few bullied students chose to report the episode/s. The main reason for non-reporting was fear of being victimised. Sadly, some students felt bullying and harassment was 'part of the job'. A culture of bullying in nursing persists internationally. Nursing students are vulnerable and can question their future in the 'caring' profession of nursing after experiencing and/or witnessing bullying during clinical placement. Bullying requires a zero tolerance approach. Education providers must develop clearer policies and implement procedures to protect students - the future nursing workforce.
Publisher: Elsevier BV
Date: 12-2017
Publisher: Wiley
Date: 08-03-2022
DOI: 10.1111/WVN.12572
Abstract: Virtual simulation is an interactive teaching and learning strategy used in undergraduate nursing student education, especially since the onset of the COVID‐19 pandemic. Few published studies have reviewed the impact of virtual simulation as a strategy for teaching nursing students the elements of evidence‐based practice. To describe types of virtual simulation that are relevant to nursing student education and examine how these modalities are applied to teach elements of evidence‐based practice. A rapid review of literature was conducted to discern the use and impact of virtual simulation. Thirty‐seven studies published between 2017 and May 2021 that addressed nursing students' educational outcomes were reviewed and summarized as a narrative analysis. Virtual simulation and virtual reality simulation engage learners in role‐plays via a computer screen or hand‐held phone. Various levels of realism and immersion were apparent across different modalities and with the utilization of educational games. Most studies related to the teaching of best practice evidence‐based clinical nursing topics. Twenty primary studies reported objective measures of students' improvement such as knowledge, performance, better documentation, or communication accuracy. Sixteen studies that measured knowledge identified significant knowledge gains. All studies endorsed virtual simulation as a teaching method. Virtual simulation approaches offer an innovative and feasible option for teaching nursing students. Such approaches should be included in undergraduate nursing curricula. While it is apparent that evidence‐based practice guidelines inform the design of the virtual simulation scenarios, the effectiveness of the modality for teaching specific elements of evidence‐based practice to nursing students is not yet confirmed. Nursing curricula need to include ways of teaching nursing students to search for and critically appraise trustworthy sources of knowledge for clinical practice.
Publisher: Wiley
Date: 19-02-2009
Publisher: Wiley
Date: 26-05-2011
Publisher: Elsevier BV
Date: 09-2012
DOI: 10.1016/J.COLEGN.2012.03.011
Abstract: Early recognition and management of patient deterioration are essential nursing skills, and can be improved through education and experience. However, both nursing students and registered nurses may have few opportunities to develop and maintain the emergency management skills necessary to ensure patient safety. Using both theory and empirical evidence, we have developed a simulation-based educational model, 'FIRST2ACT' (Feedback Incorporating Review and Simulation Techniques to Act on Clinical Trends), to provide nurses with a high-fidelity learning experience. The model has been tested in three different settings: it is highly acceptable to learners, adaptable to different training needs, and shows promise in improving actual clinical performance.
Publisher: Elsevier BV
Date: 08-2022
Publisher: Wiley
Date: 08-02-2007
Publisher: Elsevier BV
Date: 2021
Publisher: Wiley
Date: 15-06-2012
Publisher: Elsevier BV
Date: 11-2020
Publisher: Sciedu Press
Date: 26-08-2015
Publisher: Elsevier BV
Date: 12-2018
Publisher: Elsevier BV
Date: 10-2015
DOI: 10.1016/J.NEDT.2015.08.003
Abstract: High-fidelity simulation pedagogy is of increasing importance in health professional education however, face-to-face simulation programs are resource intensive and impractical to implement across large numbers of students. To investigate undergraduate nursing students' theoretical and applied learning in response to the e-simulation program-FIRST2ACT WEBTM, and explore predictors of virtual clinical performance. Multi-center trial of FIRST2ACT WEBTM accessible to students in five Australian universities and colleges, across 8 c uses. A population of 489 final-year nursing students in programs of study leading to license to practice. Participants proceeded through three phases: (i) pre-simulation-briefing and assessment of clinical knowledge and experience (ii) e-simulation-three interactive e-simulation clinical scenarios which included video recordings of patients with deteriorating conditions, interactive clinical tasks, pop up responses to tasks, and timed performance and (iii) post-simulation feedback and evaluation. Descriptive statistics were followed by bivariate analysis to detect any associations, which were further tested using standard regression analysis. Of 409 students who commenced the program (83% response rate), 367 undergraduate nursing students completed the web-based program in its entirety, yielding a completion rate of 89.7% 38.1% of students achieved passing clinical performance across three scenarios, and the proportion achieving passing clinical knowledge increased from 78.15% pre-simulation to 91.6% post-simulation. Knowledge was the main independent predictor of clinical performance in responding to a virtual deteriorating patient R(2)=0.090, F(7, 352)=4.962, p<0.001. The use of web-based technology allows simulation activities to be accessible to a large number of participants and completion rates indicate that 'Net Generation' nursing students were highly engaged with this mode of learning. The web-based e-simulation program FIRST2ACTTM effectively enhanced knowledge, virtual clinical performance, and self-assessed knowledge, skills, confidence, and competence in final-year nursing students.
Publisher: SAGE Publications
Date: 2021
DOI: 10.1177/23779608211035845
Abstract: Clinical placements are a mandatory component of nursing students’ education internationally. Despite clinical education being a key to nursing students’ achievement of nursing competencies, few studies have reviewed students’ narratives to describe their experiences of learning during clinical placement. Such studies may be important in offering a deeper insight into clinical learning experiences than quantitative surveys. A systematic thematic synthesis of qualitative studies between 2010 and June 2020 was conducted. English language studies that offered a thematic analysis of undergraduate nursing students’ experiences of learning during placement were sought. A search was made of five databases PubMed, Ovid Medline, CinahlPlus, SCOPUS, and Google Scholar. The study was guided by the ENTREQ statement for enhancing transparency in reporting the synthesis of qualitative research. Twenty-seven qualitative studies were included in the review. A thematic synthesis showed over 100 themes and subthemes across the studies. A cluster analysis revealed positive elements and others that were seen in the studies as a barrier (hindrance) to clinical learning. Positive elements included supportive instructors, close supervision, and belonging (in the team). Unsupportive instructors, a lack of supervision and not being included were seen as a hindrance. Three key overarching themes that could describe a successful placement were revealed as “Preparation,” “Welcomed and wanted” and “Supervision experiences”. A conceptual model of clinical placement elements conducive to nursing students’ learning was developed to enhance understanding of the complexities associated with supervision. The findings and model are presented and discussed. The conceptual model presents positive elements that influence students’ clinical placement experiences of learning. This model may provide a framework to guide professional development programs and strategies to support students and supervisors alike, an important step forward in moving beyond the current clinical placement rhetoric.
Publisher: Wiley
Date: 26-05-2009
Publisher: Wiley
Date: 06-04-2018
DOI: 10.1111/JAN.13554
Abstract: To explore Registered Nurses' attitudes and behaviour towards patients' use of complementary therapies. Despite high rates of use of complementary therapies by the general population, little is known of how nurses respond to patients' use of these therapies. A two-phase sequential exploratory mixed methods design. Nineteen Registered Nurses working in Australia participated in a semi-structured interview in 2015-2016 and emerging themes informed the development of a quantitative survey instrument administered online nationwide in 2016. Emerging key themes "Promoting safe care" "Seeking complementary therapies knowledge" " Supporting holistic health care" and "Integrating complementary therapies in practice" were reflected in survey results. Survey responses (N = 614) revealed >90% agreement that complementary therapies align with a holistic view of health and that patients have the right to use them. Most nurses (77.5%) discussed complementary therapies with patients and 91.8% believed nurses should have some understanding of the area. One-third did not recommend complementary therapies and there was a lack of overall consensus as to whether these therapies should be integrated into nursing practice. Nurses with training in complementary therapies held more positive views than those without. Nurses were generally supportive of patients' interest in complementary therapies, although their primary concern was safety of the patient. Despite broad acceptance that nurses should have a basic understanding of complementary therapies, there was a lack of consensus about recommendation, integration into nursing practice and referral. Further research should explore how nurses can maintain safe, patient-centred care in the evolving pluralistic healthcare system.
Publisher: Bentham Science Publishers Ltd.
Date: 24-01-2013
Publisher: Wiley
Date: 28-07-2016
Abstract: This prospective descriptive study aimed to test the validity and feasibility of the Team Emergency Assessment Measure (TEAM™) for assessing real-world medical emergency teams' non-technical skills. Second, the present study aimed to explore the instrument's contribution to practice regarding teamwork and learning outcomes. Registered nurses (RNs) and medical staff (n = 104) in two hospital EDs in rural Victoria, Australia, participated. Over a 10 month period, the (TEAM™) instrument was completed by multiple clinicians at medical emergency episodes. In 80 real-world medical emergency team resuscitation episodes (283 clinician assessments), non-technical skills ratings averaged 89% per episode (39 of a possible 44 points). Twenty-one episodes were rated in the lowest quartile (i.e. ≤37 points out of 44). Ratings differed by discipline, with significantly higher scores given by medical raters (mean: 41.1 ± 4.4) than RNs (38.7 ± 5.4) (P = 0.001). This difference occurred in the Leadership domain. The tool was reliable with Cronbach's alpha 0.78, high uni-dimensional validity and mean inter-item correlation of 0.45. Concurrent validity was confirmed by strong correlation between TEAM™ score and the awarded Global Rating (P < 0.001), with 38.4% of shared variance. RNs praised the instrument as it initiated staff reflection and debriefing discussions around performance improvement. Non-technical skills of medical emergency teams are known to often be suboptimal however, average ratings of 89% were achieved in this real-world study. TEAM™ is a valid, reliable and easy to use tool, for both training and clinical settings, with benefits for team performance when used as an assessment and/or debriefing tool.
Publisher: Elsevier BV
Date: 05-2018
DOI: 10.1016/J.IENJ.2017.12.006
Abstract: Non-technical skills (NTS) teamwork training can enhance clinicians' understanding of roles and improve communication. We evaluated a quality improvement project rating teams' NTS performance to determine the value of formal rating and debriefing processes. In two Australian emergency departments the NTS of resuscitation teams were rated by senior nurses and medical staff. Key measures were leadership, teamwork, and task management using a valid instrument: Team Emergency Assessment Measure (TEAM™). Emergency nurses were asked to attend a focus group from which key themes around the quality improvement process were identified. Main themes were: 'Team composition' (allocation of resuscitation team roles), 'Resuscitation leadership' (including both nursing and medical leadership roles) and 'TEAM™ ratings promote reflective practice' (providing staff a platform to discuss team effectiveness). Objective ratings were seen as enabling staff to provide feedback to other team members. Reflection on practice and debriefing were thought to improve communication, help define roles and responsibilities, and clarify leadership roles. Use of a non-technical skills rating scheme such as TEAM™ after team-based clinical resuscitation events was seen by emergency department nurses as feasible and a useful process for examining and improving multi-disciplinary practice, while improving team performance.
Publisher: Research Square Platform LLC
Date: 21-08-2020
DOI: 10.21203/RS.3.RS-32906/V2
Abstract: 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 1,263 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 minutes) 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.
Publisher: SLACK, Inc.
Date: 02-2020
DOI: 10.3928/01484834-20200122-02
Abstract: The purpose of this article is to describe the Nominal Group Technique and its application as a consensus-generating approach in nursing research. The approach incorporates face-to-face meetings to explore opinions, generate ideas, and determine priorities. The nominal group technique process, which is based on a study designed to develop a nursing student clinical placement (clinical practicum) evaluation tool, is described. Advantages of the approach include creative face-to-face discussions with minimal resource demands. The nominal group technique is beneficial and can be used to achieve consensus in nursing research, but a lack of anonymity may preclude the process in some investigations. [ J Nurs Educ . 2020 (2):65–67.]
Publisher: Springer Science and Business Media LLC
Date: 28-09-2012
Publisher: Elsevier BV
Date: 04-2012
DOI: 10.1016/J.IENJ.2011.05.005
Abstract: This paper explores the prevalence of 'near death experience' phenomena associated with a resuscitation event and examines the current state of evidence for causation. Patients' reports of unusual recollections associated with a period of unconsciousness (perceived as approaching death) have fascinated in iduals and the medical fraternity. Near death experiences (NDE) are reported in 4-9% of general community members and up to 23% of critical illness patients, although they can occur in healthy in iduals who may think they are in peril. One explanation is that paranormal visions that include seeing bright lights, a tunnel and having feelings of peace may be a stage of enlightenment as death approaches. More objective explanations point to neuro-chemical changes in a stressed or dying brain as explanation for nearly all the elements of near death experience. However if this is so, NDE should occur in all patients who are critically ill and near death. In general, patients report positive psychological outcomes after a near death experience. Nurses can support patients during a time of crisis by assisting them and their families to comprehend the experiential event using effective communication and listening skill.
Publisher: Elsevier BV
Date: 03-2014
DOI: 10.1016/J.NEPR.2013.07.013
Abstract: How willing are today's medical, nursing and other healthcare students to undertake some of their studies as shared learning? There is a lack of evidence of students' views by discipline despite this being a priority task for higher education sectors. This study explored the views of nursing, midwifery, nursing-emergency health (paramedic), medical, physiotherapy and nutrition-dietetics students. Senior undergraduate students from six disciplines at one university completed the Readiness for Interprofessional Learning Scale prior to participating in interprofessional clinical learning modules. For 741 students, the highest ranked response was agreement about a need for teamwork (mean 4.42 of 5 points). Nursing students held significantly more positive attitudes towards Teamwork/Collaboration, and were more positive about Professional Identity than medical students (p < .001). Midwifery and nursing-emergency-health students rejected uncertainty about Roles/Responsibilities compared with medical students (p < .001). One-third of all students who had prior experience of interprofessional learning held more positive attitudes in each of four attitude domains (p < .05). Overall, students' attitudes towards interprofessional learning were positive and all student groups were willing to engage in learning interprofessionally. Early introduction of IPL is recommended. Further studies should explore the trajectory of students' attitudes throughout the university degree.
Publisher: Wiley
Date: 05-05-2022
DOI: 10.1111/NAE2.12039
Publisher: Elsevier BV
Date: 2015
DOI: 10.1016/J.MIDW.2014.09.008
Abstract: to explore the views of midwives and maternal-child health nurses regarding factors that influence breast feeding initiation and continuation, focusing on how support for women could be improved to increase breast feeding duration. a focus group study. hospital or domiciliary (home-visiting) midwives and community-based maternal and child health (MCH) nurses in one region of Victoria, Australia. twelve MCH nurses and five midwives who provided supportive services to women in the immediate postnatal period attended one of three audio-recorded focus groups. Thematic findings were identified. four key themes were: 'Guiding women over breast-feeding hurdles', 'Timing, and time to care' 'Continuity of women's care' and 'Imparting professional knowledge'. Given the a pattern of hospital discharge of mother and infant on day one or day two after birth, participants thought the timing of immediate postnatal breast-feeding support was critical to enable women to initiate and continue breast feeding. Community-based MCH nurses reported time gaps in uptake of new mother referrals and time-pressured face-to-face consultations. Both groups perceived barriers to continuity of women's care. health services subscribe to the Baby Friendly Health Initiative and government policies which support breast feeding, however providers described time pressures and a lack of continuity of women's care, including during transition from hospital to community services. there is a need to examine administration of service delivery and how domiciliary and community nurses can collaborate to establish and maintain supportive relationships with breast feeding women.
Publisher: Sciedu Press
Date: 04-08-2014
Publisher: Wiley
Date: 09-2019
DOI: 10.1111/DAR.12979
Abstract: Treatment of opioid dependence through opioid replacement therapy is widely recognised as effective. Nonetheless, while there has been a community-based program in the state of Victoria for over two decades, consumer experiences have received little attention. This study aimed to describe the experiences of opioid replacement therapy consumers living in rural and regional areas of the state. A qualitative design employed an interpretative phenomenological approach. Sixteen consumers were interviewed. Thematic analysis was conducted by the researchers to examine the phenomena of consumers' experiences and findings were verified by a stakeholder group. Findings centred on themes of consumers' experience of becoming recipients consumer perceptions of pharmacists and pharmacy settings and psychosocial impacts on consumers. A majority of participants believed opioid replacement therapy brought increased normality to their life, however systemic and psychosocial barriers impacted on well-being. The pharmacy setting itself as a public dosing space commonly provoked feelings of stigma and discrimination among consumers. Other barriers prominently reported were restrictions on number of takeaways, cost of dispensing and lack of access to medical practitioners and allied supports. There were psychosocial impacts on opioid replacement therapy consumers relating to financial and social burdens, stigma and discrimination. Access to medical care and a choice of pharmacy appeared to be restricted in rural regions. The findings suggest a need to address, in particular, the financial and dispensing point burdens experienced by consumers to facilitate program retention.
Publisher: Elsevier BV
Date: 02-2015
Publisher: Wiley
Date: 26-05-2009
Publisher: Springer Science and Business Media LLC
Date: 07-09-2016
Publisher: MDPI AG
Date: 04-2010
DOI: 10.3390/NU2040438
Publisher: Wiley
Date: 08-05-2013
DOI: 10.1111/JOCN.12234
Publisher: Elsevier BV
Date: 09-2013
DOI: 10.1016/J.COLEGN.2013.04.003
Abstract: Urinary incontinence is a common and distressing condition. Using focus groups, we explored the views of ten ethnic language groups in Melbourne about knowledge and awareness of incontinence. The 218 participants (with or without incontinence) spoke with trained interpreters. Twenty focus group discussions of single and mixed sex groups were audio-recorded and transcribed into English. Narratives were analyzed using thematic analysis with open coding and also incorporated themes from literature. Participants' knowledge of incontinence was low and incontinence was thought to be an inevitable consequence of ageing. There was little understanding of treatments or assistance available under government-funded programmes. No group was aware of the national continence programme or phone helpline. Sensitivities of the topic plus language barriers in immigrant culturally and linguistically erse communities may impose barriers to accessing help. Several groups thought they would cope with incontinence by themselves, while all groups suggested they would be able to discuss the condition with a doctor. Various preferences voiced about social limitations and permissible communications with others are described. Nurses should be aware of the needs and communication preferences of ethnic language groups regarding continence information and continence service delivery.
Publisher: Elsevier BV
Date: 11-2017
DOI: 10.1016/J.NEDT.2017.07.016
Abstract: Simulation-based learning is an approach recommended for teaching undergraduate health professionals. There is a scarcity of research around interprofessional simulation training for pre-professional students in obstetric emergencies that occur prior to arrival at the maternity ward. The primary aims of the study were to examine whether an interprofessional team-based simulated birth scenario would improve undergraduate paramedic, nursing, and midwifery students' self-efficacy scores and clinical knowledge when managing birth in an unplanned location. The secondary aim was to assess students' satisfaction with the newly developed interprofessional simulation. Quasi-experimental descriptive study with repeated measures. Simulated hospital emergency department. Final year undergraduate paramedic, nursing, and midwifery students. Interprofessional teams of five students managed a simulated unplanned vaginal birth, followed by debriefing. Students completed a satisfaction with simulation survey. Serial surveys of clinical knowledge and self-efficacy were conducted at three time points. Twenty-four students participated in one of five simulation scenarios. Overall, students' self-efficacy and confidence in ability to achieve a successful birth outcome was significantly improved at one month (p<0.001) with a magnitude of increase (effect) of 40% (r=0.71) and remained so after a further three months. Clinical knowledge was significantly increased in only one of three student groups: nursing (p=0.04 r=0.311). Students' satisfaction with the simulation experience was high (M=4.65/5). Results from this study indicate that an interprofessional simulation of a birth in an unplanned setting can improve undergraduate paramedic, nursing and midwifery students' confidence working in an interprofessional team. There was a significant improvement in clinical knowledge of the nursing students (who had least content about managing birth in their program). All students were highly satisfied with the interprofessional simulation experience simulation.
Publisher: Elsevier BV
Date: 11-2013
DOI: 10.1016/J.AENJ.2013.08.001
Abstract: Caring for dying patients and their families presents many challenges, and may be negatively affected by nurses' Fear of Death. This study investigates attitudes of emergency and palliative care nurses towards death and dying. A mixed methods design including questionnaire and interview, was utilised. This paper reports questionnaire results from the Death Attitude Profile-Revised Scale and coping skills. Twenty-eight emergency nurses and 28 palliative care nurses from two health services participated. Nurses held low to moderate Fear of Death (44%), Death Avoidance (34%), Escape Acceptance (47%) and Approach Acceptance (59%). Emergency nurses reported higher death avoidance and, significantly lower coping skills than palliative care nurses. Both reported high acceptance of the reality of death (Neutral Acceptance 82%), and indicated they coped better with a patient who was dying than with, the patient's family. Nurses generally held positive attitudes towards death and dying. Participants could cope with caring for dying patients, but were significantly less comfortable coping with patients' family members. Nurses should be aware of the impact their attitude towards death may have on providing supportive nursing care for the dying.
Publisher: Wiley
Date: 20-03-2015
Publisher: Wiley
Date: 27-04-2018
DOI: 10.1111/INM.12467
Abstract: Nursing management of physical deterioration of patients within acute mental health settings is observed, recorded, and actively managed with the use of standardized Adult Deterioration Detection System (ADDS) charts. Patient deterioration may require the urgent assistance of a hospital rapid response or Medical Emergency Team. A five-and-a-half-year (2011-2016) audit of hospital-wide Medical Emergency Team attendances was conducted in an acute mental health unit of a single large 250 bed regional hospital in Victoria, Australia. Data were extracted from the hospitals' quality and patient safety program, RISKMan, and entered into a statistical data program for analysis. A total of 140 patient records were analysed, and the 'Worried' category (34%, n = 47) was the principle reason for a Medical Emergency Team call in a mental health ward, followed by hypotension (23%, n = 31) and a low Glasgow Coma Score (16%, n = 22). Upon further investigation of the 'Worried' category, the most common conditions recorded were an altered conscious state (22%, n = 9), low oxygen saturation (20%, n = 8), or chest pain (17%, n = 7). Activation of Medical Emergency Team calls predominantly occurred in the daylight morning hours (6am-12md). When data were compared to the general hospital patients, the context of the physiological deterioration of the mental health patients was strikingly similar. Further research is recommended to ascertain the extent and frequency with which staff working in mental health units are performing vital signs monitoring as an essential component of detection of early signs of physiological deterioration.
Publisher: Wiley
Date: 12-2009
DOI: 10.1111/J.1741-6787.2009.00163.X
Abstract: The purpose of the study was to ascertain the place of knowledge and evidence in the context of Australian general practice nursing. General practice nursing is a rapidly developing area of specialized nursing in Australia. The provision of primary care services in Australia rests largely with medical general practitioners who employ nurses in a small business model. A statistical research design was used that included a validated instrument: the developing evidence-based practice questionnaire (Gerrish et al. 2007). A total of 1,800 Victorian practice nurses were surveyed with a return of 590 completed questionnaires, equaling a response rate of 33%. Lack of time to access knowledge for practice was a barrier for participants in this study. In-service education and training opportunities were ranked as the number one source of knowledge for general practice nurses. Experiential learning and interactions with clients, peers, medical practitioners, and specialist nurses were also considered very important sources of knowledge. Research journals were ranked much lower than experiential learning and personal interactions. Participants assessed their own skills at sourcing and translating evidence into practice knowledge as low. Younger general practice nurses were more likely than older nurses to assess themselves as competent at using the library and Internet to locate evidence. The predominantly oral culture of nursing needs to be identified and incorporated into methods for disseminating evidence from research findings in order to increase the knowledge base of Australian general practice nurses. Findings from this study will be significant for policy makers and funders of Australian nursing in general practice. The establishment of a career structure for general practice nurses that includes salaried positions for clinical nurse specialists would assist in the translation of evidence into knowledge for utilization at the point of care.
Publisher: Elsevier BV
Date: 03-2013
DOI: 10.1016/J.COLEGN.2012.02.004
Abstract: The purpose of pre-service nursing education programs is to prepare competent graduates who are able to function as safe, professional registered nurses. An extensive element of these programs is the teaching of physical assessment skills, with most programs educating students to perform over 120 such skills. Previous research from North America suggests that the majority of skills taught to nurses in their pre-service programs are not used in practice. As part of a larger study, an online survey was used to explore use of 121 physical assessment skills by Australian nurses. Recruitment occurred via mailed invitation to members of the Australian Nursing Federation. Data were extracted from 1220 completed questionnaires returned by nurses who were mostly employed in New South Wales, were female and experienced nurses. Respondents indicated that they used only 34% of skills routinely. Results reinforce evidence found in the literature that many of the skills taught to nurses are either not used at all (35.5%) or are used rarely (31%). These findings have implications for the teaching of physical assessment skills in pre-service nursing programs, and raise questions about the value of extensive skills teaching in the context of contemporary health care. Further research into barriers to the use of physical assessment skills in nursing and the need for comprehensive skills preparation for the generalist nurse is likely to offer some solutions to these questions.
Publisher: Wiley
Date: 06-11-2009
Publisher: Elsevier BV
Date: 07-2023
Publisher: Elsevier BV
Date: 2023
Publisher: Elsevier BV
Date: 05-2014
DOI: 10.1016/J.APNR.2013.07.003
Abstract: This study aims to describe how senior nursing students viewed the clinical learning environment and matured their professional identity through interprofessional learning in a student-led hospital 'ward'. Undergraduate nursing and medical student teams participated in a trial of ward-based interprofessional clinical learning, managing patients over 2 weeks in a rehabilitation ward. Qualitative and quantitative program evaluation was conducted using exit student focus groups and a satisfaction survey. Twenty-three nursing and medical students in three placement rounds provided positive feedback. Five main themes emerged describing their engagement in 'trying on' a professional role: 'experiencing independence and autonomy' 'seeing clearly what nursing's all about' 'altered images of other professions' 'ways of communicating and collaborating' and 'becoming a functioning team'. Ward-based interprofessional clinical placements offer senior students authentic ideal clinical experiences. We consider this essential learning for future interprofessional collaboration which should be included in senior nursing students' education.
Publisher: Elsevier BV
Date: 04-2019
DOI: 10.1016/J.NEDT.2019.01.006
Abstract: The objective of this systematic review was to identify, critically appraise and synthesize evidence for the effectiveness of empathy interventions in undergraduate nursing education. A systematic review of literature. A three-stage systematic search of six electronic databases was conducted. The Preferred Reporting Items for Systematic reviews and Meta-Analyses guided the review. English language articles published between 2000 and 2018 were eligible. Methodological rigour was examined using the Medical Education Research Study Quality Instrument. Changes in empathy were assessed using Cohen's effect size correlation (r) and reported as effective when the variance was >0.2 standard deviations (r ≥ 0.2). Of 23 included studies, four were experimental and four were case-control studies. Of these, the mean effect size was r = 0.45 and three were regarded as effective empathy interventions. Although 10 of 13 single group studies demonstrated a significant change in empathy between pre-test and post-test (p 0.2. The most effective empathy education involved immersive and experiential simulation-based interventions. Simulation modalities ranged from role plays, manikin-based scenarios, to 3D e-simulations and point-of-view simulations where students wore a hemiparesis suit\\ CONCLUSIONS: Nine of 23 empathy education studies in undergraduate nurse education demonstrated practical improvements in empathy. The most effective interventions were immersive and experiential simulations that focused on vulnerable patient groups and provided opportunities for guided reflection. We noted the research designs were limited in terms of levels of evidence and use of subjective measures. Larger experimental studies are required to provide higher levels of evidence to identify unequivocal outcomes in terms of empathy research. Future studies should consider transfer to practice and longer-term changes in empathy as study outcomes.
Publisher: Elsevier BV
Date: 05-2014
DOI: 10.1016/J.NEDT.2013.09.015
Abstract: Early recognition and situation awareness of sudden patient deterioration, a timely appropriate clinical response, and teamwork are critical to patient outcomes. High fidelity simulated environments provide the opportunity for undergraduate nursing students to develop and refine recognition and response skills. This paper reports the quantitative findings of the first phase of a larger program of ongoing research: Feedback Incorporating Review and Simulation Techniques to Act on Clinical Trends (FIRST2ACTTM). It specifically aims to identify the characteristics that may predict primary outcome measures of clinical performance, teamwork and situation awareness in the management of deteriorating patients. Mixed-method multi-centre study. High fidelity simulated acute clinical environment in three Australian universities. A convenience s le of 97 final year nursing students enrolled in an undergraduate Bachelor of Nursing or combined Bachelor of Nursing degree were included in the study. In groups of three, participants proceeded through three phases: (i) pre-briefing and completion of a multi-choice question test, (ii) three video-recorded simulated clinical scenarios where actors substituted real patients with deteriorating conditions, and (iii) post-scenario debriefing. Clinical performance, teamwork and situation awareness were evaluated, using a validated standard checklist (OSCE), Team Emergency Assessment Measure (TEAM) score sheet and Situation Awareness Global Assessment Technique (SAGAT). A Modified Angoff technique was used to establish cut points for clinical performance. Student teams engaged in 97 simulation experiences across the three scenarios and achieved a level of clinical performance consistent with the experts' identified pass level point in only 9 (1%) of the simulation experiences. Knowledge was significantly associated with overall teamwork (p=.034), overall situation awareness (p=.05) and clinical performance in two of the three scenarios (p=.032 cardiac and p=.006 shock). Situation awareness scores of scenario team leaders were low overall, with an average total score of 41%. Final year undergraduate nursing students may have difficulty recognising and responding appropriately to patient deterioration. Improving pre-requisite knowledge, rehearsal of first response and team management strategies need to be a key component of undergraduate nursing students' education and ought to specifically address clinical performance, teamwork and situation awareness.
Publisher: Elsevier BV
Date: 07-2020
Publisher: Elsevier BV
Date: 12-2014
DOI: 10.1016/J.WOMBI.2014.06.007
Abstract: To examine factors that influence the establishment and continuation of breastfeeding among women living in a southern region of Victoria. Sequential mixed methods design including paper-based survey and focus group enquiry. Women who had breastfed their infants (n=170) reported reliance on midwives, lactation consultants and maternal and child health nurses for breastfeeding advice and support in the immediate and medium postnatal periods. Women who chose a private hospital appeared to receive less immediate postnatal support than those in a public hospital. Access to in idual guidance from midwives and MCH nurses was regarded as critical to overcoming breastfeeding difficulties, in the face of the alternative suggested by people to 'give up'. They described themes of: 'Women's experience of nurses/midwives', 'Expectations versus reality', 'Not giving up despite difficulties', and 'Breastfeeding support'. Sources of lay support were not universal. The duration of breastfeeding might be extended by early problem resolution. To enhance breastfeeding participation, further examination of the extent and timeliness of service provision by health service providers is necessary.
Publisher: Elsevier BV
Date: 10-2011
DOI: 10.1016/J.NEDT.2011.03.006
Abstract: Delayed assessment and mismanagement of patient deterioration is a substantial problem for which educational preparation can have an impact. This paper describes the development of the FIRST(2)ACT simulation model based on well-established theory and contemporary empirical evidence. The model combines evidence-based elements of assessment, simulation, self-review and expert feedback, and has been tested in undergraduate nurses, student midwives and post-registration nurses. Participant evaluations indicated a high degree of satisfaction and substantial self-rated increases in knowledge, confidence and competence. This evidence-based model should be considered for both undergraduate and post-registration education programs.
Publisher: Wiley
Date: 04-11-2008
Publisher: Wiley
Date: 23-09-2012
DOI: 10.1111/J.1440-1584.2012.01296.X
Abstract: To measure the impact of the Feedback Incorporating Review and Simulation Techniques to Act on Clinical Trends (FIRST(2) ACT) simulation program on nursing observations and practice relevant to patient deterioration in a rural Australian hospital. Interrupted time series analysis. A rural Australian hospital. All registered nurses (Division 1) employed on an acute medical/surgical ward. The FIRST(2) ACT simulation program. Appropriate frequency of a range of observations and administration of oxygen therapy. Thirty-four nurses participated (83% of eligible nurses) in the FIRST(2) ACT program, and 258 records were audited before the program and 242 records after. There were statistically significant reductions in less than satisfactory frequency of observations (P = 0.009) and pain score charting (P = 0.003). There was no measurable improvement in the administration of oxygen therapy (P = 0.143), while the incidence of inappropriate nursing practice for other measures both before and after the intervention was too low to warrant analysis. FIRST(2) ACT was associated with measurable improvements in nursing practice.
Publisher: Bentham Science Publishers Ltd.
Date: 18-11-2011
Publisher: Informa UK Limited
Date: 29-08-2016
DOI: 10.1080/10376178.2016.1238773
Abstract: The nursing profession comprises Australia's largest regulated health workforce yet its practice boundaries are poorly understood. The ambiguity surrounding the practice scope of nurses limits the profession's ability to fully respond to Australia's current and emerging health system challenges. The aim of this review is to explore the concept of scope of practice of registered nurses (RN) in Australia, as reflected in contemporary literature. An integrative review of literature relating to the scope of practice of the Australian registered nurse published between 2007 and 2014 was conducted. Twenty primary papers and nine secondary source papers were included in the review. Themes that arose from the analysis are: Scope of practice - an elusive concept Scope of practice and context Scope of practice and boundaries and Scope of practice and advanced practice. Discussion of these themes includes consideration of the professional, legal and ethical significance of scope of practice for the RN, as well as the legislative, professional and contextual influences on, and challenges to, defining scope of practice at both a professional and in idual level. For the Australian registered nursing workforce to continue to be a significant and influential contributor to Australia
Publisher: Wiley
Date: 24-02-2011
Publisher: Wiley
Date: 21-09-2011
Publisher: Wiley
Date: 21-02-2018
DOI: 10.1111/JOCN.14277
Abstract: To explore service provision for Victorian regional refugee families from the perspective of maternal and child health nurses. Increasingly, more families from a refugee background are resettling in regional Victoria. The refugee journey has significant effect on families. Refugee families with infants and young children can be provided with support by maternal and child health services however, many families experience barriers to ongoing engagement with this service. This descriptive study used focus group and questionnaire. A purposive s le of 26 maternal and child health nurses was drawn from six municipalities throughout regional Victoria, where higher numbers of people from a refugee background resettle. Six focus groups were held in 2014. Audio-recorded narratives were transcribed, prior to inductive thematic analysis. This descriptive study used focus group and questionnaire. A purposive s le of 26 Maternal and Child Health nurses was drawn from six municipalities throughout regional Victoria where higher numbers of people from a refugee background resettle. Six focus groups were held in 2014. Audio-recorded narratives were transcribed verbatim, prior to inductive thematic analysis. Participating nurses were experienced nurses, averaging 12 years in the service. Four major themes emerged from thematic analysis: "How to identify women from a refugee background" "The Maternal and Child Health nurse role when working with families from a refugee background" "Interpreting issues" and "Access to other referral agencies." Nurses worked to develop a relationship with families, attending to a complex mix of issues which were complicated by language barriers. Nurses found their role in supporting refugee families required additional time and more home visits. To provide best practice, maternal and child health nurses need (i) ongoing professional development (ii) time, flexibility and creativity to build relationships with refugee families and (iii) better access to services that enhance communication, such as interpreting services and translated resources. Nurses require ongoing professional development to help them address the multifaceted needs of families of refugee background. With limited resources available in regional areas, accessing further education can be challenging. Distance education models and organisational support could provide nurses with educational opportunities aimed at improving service provision and clinical practice.
Publisher: CSIRO Publishing
Date: 2010
DOI: 10.1071/AH08724
Abstract: A national survey was used to examine patterns of delivery of dietetic care for patients referred to private practitioners under Medicare Chronic Disease Management (CDM). This asked dietitians about referrals from general practitioners, patient management, fees charged and patient billing. There were 356 (47%) Australian private practice dietitians who responded to the questionnaire 330 (94%) were Medicare providers. They described a counselling-type service and inability to complete initial patient education within funded consultation time. Many provided a longer consultation than was reported as being funded by Medicare. Fees for initial appointments were generally higher than the scheduled Medical Benefit Scheme fee of AU$56.25 (median $80), requiring patients to pay a fee gap. For review appointments, two of every five dietitians bulk-billed or charged an identical fee ($47.85). Providers communicated by written reports (as required under Medicare policy). There was little evidence of team-based chronic care management. The dietetics Medicare CDM process should mirror other counselling-type Medicare services which provide for both longer and more frequent consultations and higher payment. System integration between dietitians and general practitioners is required to achieve true collaboration and team care of chronic disease patients. What is known about the topic?Medicare ‘Chronic Disease Management’ program allows eligible patients with chronic or complex medical conditions subsidized consultations with accredited dietitians in private clinics. We know little about how this program is delivered by GPs and dietitians. What does this paper add?This paper reports data on a first evaluation. Surveyed dietitians viewed chronic cases as complex and described barriers to their practice imposed by Medicare policy. What are the implications for practitioners?Changes in Medicare CDM policy and dietetic practices are required to achieve true collaboration and team care of dietetic patients with chronic diseases.
Publisher: Wiley
Date: 09-12-2009
DOI: 10.1111/J.1365-2648.2009.05240.X
Abstract: This paper is a report of a review of the quantitative evidence for medium to high fidelity simulation using manikins in nursing, in comparison to other educational strategies. Human simulation is an educational process that can replicate clinical practices in a safe environment. Although endorsed in nursing curricula, its effectiveness is largely unknown. A systematic review of quantitative studies published between 1999 and January 2009 was undertaken using the following databases: CINAHL Plus, ERIC, Embase, Medline, SCOPUS, ProQuest and ProQuest Dissertation and Theses Database. The primary search terms were 'simulation' and 'human simulation'. Reference lists from relevant papers and the websites of relevant nursing organizations were also searched. The quality of the included studies was appraised using the Critical Appraisal Skills Programme criteria. Twelve studies were included in the review. These used experimental or quasi-experimental designs. All reported simulation as a valid teaching/learning strategy. Six of the studies showed additional gains in knowledge, critical thinking ability, satisfaction or confidence compared with a control group (range 7-11%). The validity and reliability of the studies varied due to differences in design and assessment methods. Medium and/or high fidelity simulation using manikins is an effective teaching and learning method when best practice guidelines are adhered to. Simulation may have some advantage over other teaching methods, depending on the context, topic and method. Further exploration is needed to determine the effect of team size on learning and to develop a universal method of outcome measurement.
Publisher: Elsevier BV
Date: 12-2011
DOI: 10.1016/J.COLEGN.2011.08.001
Abstract: Rural registered nurses' experiences of advanced clinical nursing practice were explored whilst they were enrolled in an advanced primary care course of study. Thirty-two nurses employed in rural health services in Victoria, Australia, studied advanced practice nursing by distance education with a clinical component. At course conclusion, focus groups and a quantitative on-line survey were conducted to explore outcomes. Nurses reported positive self-perceptions of their educational preparation with scores of >7/10 for competence, confidence, preparedness for advanced practice and job satisfaction. Focus group discussions concurred with positive survey results. The course was valuable in developing skills and knowledge, enabling more holistic patient care. The main themes that emerged related to the advancement of the nurse as a professional, and enhancement of patient care. Within their scope of practice, nurses assessed, diagnosed and treated minor patient illness presentations either independently or collaboratively with medical advice. The context of rural health services dictated practice and levels of autonomy. Nurses perceived the new role reduced an overload of medical work, whilst increasing patients' access to care. As a result of the course 24% of participants reported a change in their work role. Nurses employed in rural health services reported positive potential for advanced collaborative practice in rural health care, in association with medical professionals. Defined role boundaries, role responsibilities and dedicated advanced practice positions will be required to achieve implementation of the role.
Publisher: Wiley
Date: 04-2013
DOI: 10.1111/IJN.12053
Abstract: Nursing students are required to develop clinical knowledge, skills and attitudes for professional practice. However, objectivity and parity of students' clinical assessments has been questioned. In the last decade, more objective techniques have been developed, with increased use of Objective Structured Clinical Examinations. We reviewed objective clinical assessment measures used in preregistration nursing courses to determine utilization and the validity and reliability of assessment techniques. A systematic search was made of quantitative research publications between 2000 and May 2011, identifying 16 studies that were subsequently reviewed. The validity and reliability of studies varied, with six studies judged as high quality, using various methodologies. This paper describes methods of instrument development and reports on their application in preregistration nursing programs.
Publisher: Wiley
Date: 07-02-2020
DOI: 10.1111/IWJ.13308
Abstract: The purpose of this review was to identify the role and contribution of community‐based nurse‐led wound care as a service delivery model. Centres increasingly respond proactively to assess and manage wounds at all stages – not only chronic wound care. We conducted an integrative review of literature, searching five databases, 2007–2018. Based on inclusion and exclusion criteria, we systematically approached article selection and all three authors collaborated to chart the study variables, evaluate data, and synthesise results. Eighteen studies were included, representing a range of care models internationally. The findings showed a need for nurse‐led clinics to provide evidence‐based care using best practice guidelines for all wound types. Wound care practices should be standardised across the particular service and be integrated with higher levels of resources such as investigative services and surgical units. A multi‐disciplinary approach was likely to achieve better patient outcomes, while patient‐centred care with strong patient engagement was likely to assist patients' compliance with treatment. High‐quality community‐based wound services should include nursing leadership based on a hub‐and‐spoke model. This is ideally patient‐centred, evidence‐based, and underpinned by a commitment to developing innovations in terms of treatment modalities, accessibility, and patient engagement.
Publisher: Elsevier BV
Date: 02-2017
DOI: 10.1016/J.NEDT.2016.11.015
Abstract: To conduct a systematic review to appraise and review evidence on the impact of simulation-based education for undergraduate re-licensure nursing students, using existing reviews of literature. An umbrella review (review of reviews). Cumulative Index of Nursing and Allied Health Literature (CINAHLPlus), PubMed, and Google Scholar. Reviews of literature conducted between 2010 and 2015 regarding simulation-based education for pre-licensure nursing students. The Joanna Briggs Institute methodology for conduct of an umbrella review was used to inform the review process. Twenty-five systematic reviews of literature were included, of which 14 were recent (2013-2015). Most described the level of evidence of component studies as a mix of experimental and quasi-experimental designs. The reviews measured around 14 different main outcome variables, thus limiting the number of primary studies that each in idual review could pool to appraise. Many reviews agreed on the key learning outcome of knowledge acquisition, although no overall quantitative effect was derived. Three of four high-quality reviews found that simulation supported psychomotor development a fourth found too few high quality studies to make a statistical comparison. Simulation statistically improved self-efficacy in pretest-posttest studies, and in experimental designs self-efficacy was superior to that of other teaching methods lower level research designs limiting further comparison. The reviews commonly reported strong student satisfaction with simulation education and some reported improved confidence and/or critical thinking. This umbrella review took a global view of 25 reviews of simulation research in nursing education, comprising over 700 primary studies. To discern overall outcomes across reviews, statistical comparison of quantitative results (effect size) must be the key comparator. Simulation-based education contributes to students' learning in a number of ways when integrated into pre-licensure nursing curricula. Overall, use of a constellation of instruments and a lack of high quality study designs mean that there are still some gaps in evidence of effects that need to be addressed.
Publisher: Elsevier BV
Date: 12-2014
DOI: 10.1016/J.NEDT.2014.08.001
Abstract: The objective of this article was to review the literature on utilisation and place of Web-based simulation within nursing education. Web-based simulation combines electronic multimedia options with a central video or virtual world to produce interactive learning activities mediated by the learner. An integrative review. A search was conducted of healthcare databases between 2000 and 2014 and of Internet sources for hosted simulation programs in nursing. Eighteen primary programs were identified for inclusion. A strategy for integrative review was adopted in which studies were identified, filtered, classified, analysed and compared. Of 18 programs, two game-based programs were identified which represented a 'virtual world' in which students could simultaneously or in idually immerse themselves in a character role-play. However, most programs (n=10) taught an aspect of procedural patient care using multimedia (e.g. video, audio, graphics, quiz, text, memo). Time-limited sequences, feedback and reflective activities were often incorporated. Other studies (n=8) taught interpersonal communication skills or technical skills for equipment use. Descriptive study outcomes indicated ease of program use, strong satisfaction with learning and appreciation of program accessibility. Additionally, four studies reported significant improvements in knowledge post-intervention. Web-based simulation is highly acceptable to students and appears to provide learning benefits that align with other simulation approaches and it augments face-to-face teaching. Web-based simulation is likely to have a major place in nursing curricula in the next decade, yet further research is necessary to objectively evaluate learner outcomes and to justify its use.
Publisher: MDPI AG
Date: 20-04-2010
Publisher: Elsevier BV
Date: 04-2016
DOI: 10.1016/J.RESUSCITATION.2016.01.026
Abstract: To test the resuscitation non-technical Team Emergency Assessment Measure (TEAM) for feasibility, validity and reliability, in two Australian Emergency Departments (ED). Non-technical (teamwork) skills have been identified as inadequate and as such have a significant impact on patient safety. Valid and reliable teamwork assessment tools are an important element of performance assessment and debriefing processes. A quasi experimental design based on observational ratings of resuscitation non-technical skills in two metropolitan ED. Senior nursing staff rated 106 adult resuscitation team events over a ten month period where three or more resuscitation team members attended. Resuscitation events, team performance and validity and reliability data was collected for the TEAM. Most rated events were for full cardiac resuscitation (43%) with 3-15 team members present for an average of 45 min. The TEAM was found to be feasible and quickly completed with minimal or no training. Discriminant validity was good as was internal consistency with a Cronbach alpha of 0.94. Uni-dimensional and concurrent validity also reached acceptable standards, 0.94 and >0.63 (p=<0.001), respectively, and a single 'teamwork' construct was identified. Non-technical skills overall were good but leadership was rated notably lower than task and teamwork performance indicating a need for leadership training. The TEAM is a feasible, valid and reliable non-technical assessment measure in simulated and real clinical settings. Emergency teams need to develop leadership skills through training and reflective debriefing.
Publisher: Elsevier BV
Date: 08-2020
Publisher: Elsevier BV
Date: 05-2021
Publisher: Wiley
Date: 25-05-2010
Publisher: Wiley
Date: 25-03-2011
Publisher: CSIRO Publishing
Date: 2011
DOI: 10.1071/AH10938
Abstract: Objective. To critically examine utilisation of the 13 allied health services provided through Medicare Chronic Disease Management program and related general practitioner (GP) care planning initiatives. Methods. Statistics generated from national billing data from July 2005 to June 2009 were extracted from Medicare data and compared by profession, State or Territory and population. Results. Most services grew over 4 years although nationally consistent service levels were not found for any allied health provider profession. On referral from GPs, podiatry, physiotherapy and dietetics provided most services (82%) in 2008–09. Professions had unique patterns of referral instanced by age range and sex of clientele. Wide variation was apparent in per capita utilisation of allied health services by State or Territory some with far less than average national use and others with high use. Annual number of GP Management Plans or Team Care Arrangements was low (mean: ≤22 per GP in 2008–09), indicating low use of care planning. Conclusion. Inequality of accessibility for patients was apparent. Five years into the program, a review of Medicare Allied Health CDM policy is warranted. Implications. Research and evaluation is needed to identify whether the program is meeting the needs of GPs, allied health providers and chronic disease patients. What is known about the topic? Since 2004, Medicare Chronic Disease Management program has offered Australian patients with chronic or complex disease access to 13 allied health professions via private clinics on referral from their general practitioner – with costs subsidised by Medicare. Little is known about the demographics of referred patients or which allied health services are utilised. What does this paper add? We take a multidisciplinary perspective to describe program use and find wide variation by profession nationally. Per capita State and Territory data indicate inequality of accessibility. Podiatry, physiotherapy and dietetics provided 82% of all services in 2008–09. Referrals initiated by GPs via patient care plans are increasing, but at present referrals per each GP are low. What are the implications for practitioners? More needs to be known about the dynamics that affect referral, the local accessibility of allied health providers and issues that affect uptake by patients.
Publisher: Elsevier BV
Date: 04-2018
Publisher: Wiley
Date: 20-12-2015
DOI: 10.1111/NHS.12250
Abstract: Clinical placement shortages and rising costs have created demand to provide low-resource, high value student learning opportunities. Malnutrition screening provides a vehicle for achieving this. A mixed methods explanatory sequential intervention study investigated time costs, and students' perceptions of preparedness after performing routine patient screening tasks, as well as students' overall views on their feelings of confidence and preparedness when commencing their first clinical placements. Pre-clinical student dietitians commencing initial placements participated (n=58), with 16 of these forming a subgroup who performed malnutrition screening tasks while the others attended usual placement orientation. The time saved when students undertook screening tasks usually assigned to nurses was substantial. Questionnaires revealed that student perceived confidence increased in the screening group when compared with controls. Focus group themes included "anxiety and confidence," "learning in the clinical learning environment," "communication skill development," and "the pre-placement screening experience." Students performing routine patient-screening tasks prior to initial clinical placement has potential cost savings for healthcare organizations and was perceived to be valuable for learning.
Publisher: SAGE Publications
Date: 14-05-2021
Abstract: A scoping review aims to systematically explore and map the research available from a wide range of sources. The objective of this study was to produce a scoping review checklist to guide future scoping studies to enable rigorous review and critique of phenomena of interest. The methods used included a review of literature, expert consensus group meetings, a modified Delphi survey and, finally, verification against recent scoping study ex les. Results showed that the checklist was able to identify key elements of scoping reviews. The 22-item Scoping Review Checklist (SRC), which includes two optional stakeholder consultation items, has been developed using rigorous recommended approaches. The checklist can be used to guide the conduct and critique of scoping studies.
Publisher: Elsevier BV
Date: 02-2019
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 03-2015
Publisher: Springer Science and Business Media LLC
Date: 29-10-2020
DOI: 10.1186/S12912-020-00491-1
Abstract: 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. 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. 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. 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.
Publisher: Informa UK Limited
Date: 06-2014
DOI: 10.2147/AMEP.S61189
Publisher: Elsevier BV
Date: 09-2014
DOI: 10.1016/J.NEPR.2014.05.009
Abstract: Pre-professional healthcare courses, including nursing, are increasingly focused on interprofessional learning and experimentation with clinical education in 'training wards'. This involves students from at least two disciplines who, under supervision, are responsible for patients' care. There is no consensus on how students' clinical learning experiences in this context are evaluated. We report the development and testing of the Interprofessional Clinical Placement Learning Environment Inventory (ICPLEI) in the Australian context. A question set was developed to measure student's perceptions of key variables in an interprofessional clinical learning environment: orientation, supervision, roles, learning and autonomy. An expert nursing panel rated items for a Content Validity Index of .93. Reliability was tested with 38 students. After a 2-week interprofessional ward placement nursing, medical and allied health students (n = 38) rated their learning environment highly, with median responses 4 or 5 of five (mean total 83%). The scale was reliable with a Cronbach alpha of .80 and moderate item-to-total correlations for 22/26 items. The Interprofessional Clinical Placement Learning Environment Inventory is a reliable, feasible, fast to complete tool, suitable for use with pre-registration healthcare students in this setting. Further testing of the tool's psychometric properties is recommended.
Publisher: Hindawi Limited
Date: 03-04-2013
DOI: 10.1155/2013/930901
Abstract: The study examined various methods of peer learning and their effectiveness in undergraduate nursing education. Using a specifically developed search strategy, healthcare databases were systematically searched for peer-reviewed articles, with studies involving peer learning and students in undergraduate general nursing courses (in both clinical and theoretical settings) being included. The studies were published in English between 2001 and 2010. Both study selection and quality analysis were undertaken independently by two researchers using published guidelines and data was thematically analyzed to answer the research questions. Eighteen studies comprising various research methods were included. The variety of terms used for peer learning and variations between study designs and assessment measures affected the reliability of the study. The outcome measures showing improvement in either an objective effect or subjective assessment were considered a positive result with sixteen studies demonstrating positive aspects to peer learning including increased confidence, competence, and a decrease in anxiety. We conclude that peer learning is a rapidly developing aspect of nursing education which has been shown to develop students’ skills in communication, critical thinking, and self-confidence. Peer learning was shown to be as effective as the conventional classroom lecture method in teaching undergraduate nursing students.
Publisher: Elsevier BV
Date: 09-2014
DOI: 10.1016/J.COLEGN.2013.05.001
Abstract: Health assessment is a fundamental aspect of the professional nursing role. The teaching of skills in physical assessment is therefore a large component of pre-registration nursing programmes. As the nursing curriculum becomes more crowded with what is deemed to be essential content, there is a need to rationalise what is taught in preparatory nursing programmes to ensure readiness for practice. The study outlined in this paper, as part of a larger project, explored the teaching of physical assessment skills in pre-registration nursing programmes across Australia. Fifty-three academics completed the 121 item online survey, indicating whether each skill was taught with practice, taught with no practice or not taught at all. The results suggest that only half the skills were being taught by more than 80% of the academics and 23 skills (19%) were taught by more than 90%. Of the 121 skills commonly taught--69 skills (57%) were taught with student practice and 29 (24%) were taught with no student practice. The results of this study raise questions about the teaching of physical assessment in pre-registration nursing programmes. The suggestion is not that skills that are used regularly or infrequently should be removed from the curriculum, rather, the authors propose that consideration be given to whether the teaching of skills that are never likely to be used is occurring at the expense of comprehensive mastery of core skills.
Publisher: BMJ
Date: 19-05-2013
DOI: 10.1136/EMERMED-2012-201312
Abstract: To assess the ability of rural Australian nurse teams to manage deteriorating patients. This quasi-experimental design used pre- and post-intervention assessments and observation to evaluate nurses' simulated clinical performance. Registered nurses (n=44) from two hospital wards completed a formative knowledge assessment and three team-based video recorded scenarios (Objective Structured Clinical Examinations (OSCE)). Trained patient actors simulated deteriorating patients. Skill performance and situation awareness were measured and team performance was rated using the Team Emergency Assessment Measure. Knowledge in relation to patient deterioration management varied (mean 63%, range 27-100%) with a median score of 64%. Younger nurses with a greater number of working hours scored the highest (p=0.001). OSCE performance was generally low with a mean performance of 54%, but performance was maintained despite the increasing complexity of the scenarios. Situation awareness was generally low (median 50%, mean 47%, range 17-83%, SD 14.03) with significantly higher levels in younger participants (r=-0.346, p=0.021). Teamwork ratings averaged 57% with significant associations between the subscales (Leadership, Teamwork and Task Management) (p<0.006), the global rating scale (p<0.001) and two of the OSCE measures (p<0.049). Feedback from participants following the programme indicated significant improvements in knowledge, confidence and competence (p<0.001). Despite a satisfactory knowledge base, the application of knowledge was low with notable performance deficits in these demanding and stressful situations. The identification and management of patient deterioration needs to be taught in professional development programmes incorporating high fidelity simulation techniques. The Team Emergency assessment tool proved to be a valid measure of team performance in patient deterioration scenarios.
Publisher: Wiley
Date: 27-02-2023
Abstract: The present study aims to explore the utility of the Team Emergency Assessment Measure (TEAM) in relation to the enhancement of emergency team non‐technical skills based on research conducted over the last decade. In this mapping review, a citation mining process identified 22 primary studies for inclusion, published between 2012 and 2022. It provides outcome data on emergency teams' non‐technical skills following team training and/or real‐life patient emergencies. Emergency team studies related to resuscitation teams (adult, paediatric, newborn and obstetric cases) and medical emergency team (MET) management of patient deterioration. Team performance ratings varied, ranging from approximately 90% for experienced clinical teams down to 38% for students. Statistically significant improvements in performance were notable following training and/or repeated practice. Validity evidence, across 11 studies that provided change data described positive learning outcomes and moderate intervention effects. However, according to Kirkpatrick's model of educational evaluation the studies were limited to professional development phases of learning and immediate post‐training assessments rather than care quality improvement. The review highlights a lack of studies evidencing quality improvement or clinical impact such as change of patient care practice or health service performance. There is a need to conduct well‐designed studies that explore both technical and non‐technical skills of resuscitation teams and METs. Currently, non‐technical skills training and repeated performance evaluations using the TEAM contribute immensely to the proficiency of emergency teams.
Location: Australia
No related grants have been discovered for Robyn Cant.