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0000-0003-2464-7653
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Publisher: Elsevier BV
Date: 1996
DOI: 10.1016/S1322-7696(08)60172-9
Abstract: This national study compares the social and gender characteristics of an earlier group of 1551 students in higher-education programs in 1987 and 1990 with the national study group of 2295 students s led in 1995. Using a specially constructed socio-economic variable for comparison, the analyses demonstrated a significant difference in the socio-economic level of the household for the female but not the male group. There was a significant difference in the proportion of males entering nursing between the earlier and latter groups. Further, in the latter group, these males were more likely to enter nursing programs directly from school. Members of the female group in the latter s le were more likely to have attended a school in a less populated area, come from households with a reduced family size, have mothers who were earning an income and have mothers who had achieved a higher level of education than was found in the earlier group. Logic analysis revealed that there was a significant interaction between the household variables, socio-economic status, number of siblings and income received by the mother of the respondents in the early and latter groups for females but not for males. This interaction for the female group, plus the finding that members of the latter group were more likely than other university students to defer their Higher Education Contribution Scheme (HECS) payments, suggests that if politicians were to make changes to the HECS it may affect the delicate social balance currently achieved in nursing recruitment in Australia.
Publisher: Informa UK Limited
Date: 02-01-2017
DOI: 10.1080/10376178.2016.1268063
Abstract: Regional and remote areas are often disadvantaged in terms of access to palliative care services. The impact of reduced access to services on people living in regional or remote areas of Australia is poorly understood. Identify and examine current literature relating to the palliative care experiences of adults living in regional and remote areas of Australia. CINAHL, Medline, PubMed, Cochrane Review Library and grey literature were searched using a combination of keywords. A thematic analysis was applied. Thirteen articles were included in the final review. Poor access, relocation and hardship were identified as issues affecting participants. Limited literature was available addressing the palliative care experiences of adults living in regional and remote areas of Australia. To identify and address any inequities in palliative care provision and access, the experiences of palliative care patients living outside major cities need to be examined.
Publisher: CSIRO Publishing
Date: 1996
DOI: 10.1071/AH960040
Abstract: A two-phase descriptive study involving a questionnaire survey was undertakenduring 1994 and 1995 to evaluate the extent of implementation of total qualitymanagement practices in New South Wales hospitals accredited by the AustralianCouncil on Healthcare Standards.A survey response rate of 72- per cent was attained. Results indicated that mosthospitals were aware of and consciously implemented aspects of the total qualitymanagement philosophy in some way. There is little evidence that whole systemshave embraced the total quality management approach as a fully integratedendeavour.
Publisher: Elsevier BV
Date: 05-2019
DOI: 10.1016/J.NEDT.2019.01.032
Abstract: This study was developed to assist academics and curriculum designers to understand the perspectives and expectations of students when designing a program of study and inclusive of students as partners. The purpose of this qualitative study was to explore the perceptions and experiences of students enrolled in the Bachelor of Nursing (BN). The setting is a multi-c us university in Australia. Participants were currently enrolled and recruited from the Bachelor of Nursing, Bachelor of Nursing Advanced and Bachelor of Nursing Graduate Entry. Semi-structured focus group interviews and thematic analysis was used to collect and analyse the data. Three major themes were identified from the focus group interviews: 1. Expectations 2. Interesting and stimulating and 3. Preparedness for study and clinical practice. Students held strong personal reasons for pursuing a nursing degree. The geographic location and international rankings were factors for choosing the university in this study. Student's perceptions and experiences of the curriculum and support identified that their BN program was interesting and adequately prepared them for clinical practice. Some areas for improvement were more detail during program orientation related to clinical practice requirements and more assistance with engaging with learning and teaching technologies.
Publisher: CSIRO Publishing
Date: 1997
DOI: 10.1071/AH970049
Abstract: Analysis of data collected in a 1994?95 survey of accredited New South Waleshospitals examined the adoption of key elements of total quality management practicein the public and private sectors. In a number of areas of practice widely consideredto be central to a hospital?s total quality management efforts, there was no statisticallysignificant difference between the two sectors. Where differences existed, total qualitymanagement practices more likely to be adopted by public hospitals were limited intheir scope and likely to be explained by structural peculiarities. In contrast, privatehospitals were more likely to adopt practices more critical to the successfulimplementation of total quality management.
Publisher: Elsevier BV
Date: 03-2021
Publisher: Springer Science and Business Media LLC
Date: 03-06-2022
DOI: 10.1186/S12873-022-00650-4
Abstract: Appropriate and timely administration of intravenous fluids to patients with sepsis-induced hypotension is one of the mainstays of sepsis management in the emergency department (ED), however, fluid resuscitation remains an ongoing challenge in ED. Our study has been undertaken with two specific aims: firstly, for patients with sepsis, to identify factors associated with receiving intravenous fluids while in the ED and, secondly to identify determinants associated with the actual time to fluid administration. We conducted a retrospective multicentre cohort study of adult ED presentations between October 2018 and May 2019 in four metropolitan hospitals in Western Sydney, Australia. Patients meeting pre-specified criteria for sepsis and septic shock and treated with antibiotics within the first 24 h of presentation were included. Multivariable models were used to identify factors associated with fluid administration in sepsis. Four thousand one hundred forty-six patients met the inclusion criteria, among these 2,300 (55.5%) patients with sepsis received intravenous fluids in ED. The median time to fluid administration from the time of diagnosis of sepsis was 1.6 h (Interquartile Range (IQR) 0.5 to 3.8), and the median volume of fluids administered was 1,100 mL (IQR 750 to 2058). Factors associated with patients receiving fluids were younger age (Odds Ratio (OR) 1.05, 95% Confidence Interval (CI (1.03 to 1.07), p 0.001) lower systolic blood pressure (OR 1.11, 95% CI (1.08 to 1.13), p 0.001) presenting to smaller hospital (OR 1.48, 95% CI (1.25 to 1.75, p 0.001) and a Clinical Rapid Response alert activated (OR 1.64, 95% CI (1.28 to 2.11), p 0.001). Patients with Triage Category 1 received fluids 101.22 min earlier (95% CI (59.3 to131.2), p 0.001) and those with Category 2 received fluids 43.58 min earlier (95% CI (9.6 to 63.1), p 0.001) compared to patients with Triage Category 3–5. Other factors associated with receiving fluids earlier included septic shock (-49.37 min (95% CI (-86.4 to -12.4), p 0.001)) each mmol/L increase in serum lactate levels (-9.0 min, 95% CI (-15.7 to -2.3), p 0.001) and presenting to smaller hospitals (-74.61 min, 95% CI (-94.0 to -55.3), p 0.001). Younger age, greater severity of sepsis, and presenting to a smaller hospital increased the probability of receiving fluids and receiving it earlier. Recognition of these factors may assist in effective implementation of sepsis management guidelines which should translate into better patient outcomes. Future studies are needed to identify other associated factors that we have not explored.
Publisher: Elsevier BV
Date: 12-2022
Publisher: Informa UK Limited
Date: 1996
Publisher: Hindawi Limited
Date: 18-06-2019
DOI: 10.1155/2019/2679680
Abstract: Objectives . Continuing to live at home is arguably one of the most important challenges older persons face as they age. The aim of this study was to clarify how older adults conceptualise home through age-related lifestyle changes. Methods . Principles from grounded theory were used to examine the perspectives of 21 older adults obtained from three focus group discussions and 10 in-depth semistructured interviews. Results . Four major categories were developed: “anchoring self,” “enabling freedom,” “being comfortable,” and “staying in touch.” Discussion . For the participants in this study remaining at home enabled a sense of independence and freedom, self-worth and identity, comfort, and an ongoing active role in the community. However, some aspects of home could be renegotiated despite changes to living location, with new social connections able to be forged and personal comforts being transferrable. This holds important implications for supporting older persons to both sustain living at home and to adjust to changing circumstances, suggesting the importance of drawing on the experiences of older persons themselves in developing strategies to promote successful aging.
Publisher: SLACK, Inc.
Date: 12-2018
DOI: 10.3928/01484834-20181119-07
Abstract: A lack of specialized knowledge about providing health care to older people decreases their health outcomes and quality of life. This article presents an innovative learning strategy for preregistration nursing students to raise awareness of person-centered care of the older adult. This report is based on the authors' own experience and includes comments from students to the authors who taught the unit of study from 2010 to 2015, supported by current literature and theory discussing contemporary educational strategies. Students came to value the older adult as a person to whom they could relate and the learning promoted person-centered care delivery. Although many students found this approach to learning to be challenging, student feedback demonstrated that the overall reception of the strategy was very positive. This strategy facilitated learning to improve person-centered care and addressed negative attitudes toward older adults, which improved health outcomes and their quality of life. [ J Nurs Educ . 2018 (12):742–746.]
Publisher: Elsevier BV
Date: 02-2019
DOI: 10.1016/J.CTIM.2018.12.016
Abstract: Lavender and Lemon Balm essential oils are popular in the management of older person agitation due to their ease of application, minimal side effects and low interaction with concurrent medications. This study addressed limitations in the literature to evaluate and compare effectiveness of Lavender and Lemon Balm essential oils on the agitated behaviour of older people with and without dementia living in residential aged care facilities [RACFs]. Forty-nine nursing home residents with dementia (n=39) and without dementia (n=10) exhibiting agitation participated in this study. Participants were randomised to a counterbalanced, repeated measures design experiment that tests the treatments Lavender, Lemon Balm, and Placebo (Sunflower oil). Treatments were administered once daily for two-weeks followed by a two-week washout period before commencing the subsequent treatment. All participants trialed all three treatments over a 10-week period. Data were collected on the Neuropsychiatric Inventory (NPI) and Cohen-Mansfield Agitation Inventory (CMAI). A significant difference was shown when essential oils effect were compared between the cognitive groups. Post hoc analysis reports Lemon Balm more effective in reducing NPI agitation (p = .04) and CMAI physical non-aggressive behaviour (PNAB) (p = .02) in residents without dementia. Lemon Balm less effective in reducing NPI irritability (p = 0.01) and Lavender more effective in reducing CMAI PNAB (p = 0.04) in dementia. The findings support an opposing effect of Lemon Balm and Lavender in reducing agitated behaviour between the participant cognitive groups. There was no reduction in agitation with treatments when compared to placebo independent of cognitive groups.
Publisher: Springer Science and Business Media LLC
Date: 11-01-2022
DOI: 10.1186/S12873-021-00558-5
Abstract: Early intravenous fluids for patients with sepsis presenting with hypoperfusion or shock in the emergency department remains one of the key recommendations of the Surviving Sepsis C aign guidelines to reduce mortality. However, compliance with the recommendation remains poor. While several interventions have been implemented to improve early fluid administration as part of sepsis protocols, the extent to which they have improved compliance with fluid resuscitation is unknown. The factors associated with the lack of compliance are also poorly understood. We conducted a systematic review, meta-analysis and narrative review to investigate the effectiveness of interventions in emergency departments in improving compliance with early fluid administration and examine the non-interventional facilitators and barriers that may influence appropriate fluid administration in adults with sepsis. We searched MEDLINE Ovid/PubMed, Ovid EMBASE, CINAHL, and SCOPUS databases for studies of any design to April 2021. We synthesised results from the studies reporting effectiveness of interventions in a meta-analysis and conducted a narrative synthesis of studies reporting non-interventional factors. We included 31 studies out of the 825 unique articles identified in the systematic review of which 21 were included in the meta-analysis and 11 in the narrative synthesis. In meta-analysis, interventions were associated with a 47% improvement in the rate of compliance [(Random Effects (RE) Relative Risk (RR) = 1.47, 95% Confidence Interval (CI), 1.25–1.74, p -value 0.01)] an average 24 min reduction in the time to fluids [RE mean difference = − 24.11(95% CI − 14.09 to − 34.14 min, p value 0.01)], and patients receiving an additional 575 mL fluids [RE mean difference = 575.40 (95% CI 202.28–1353.08, p value 0.01)]. The compliance rate of early fluid administration reported in the studies included in the narrative synthesis is 48% [RR = 0.48 (95% CI 0.24–0.72)]. Performance improvement interventions improve compliance and time and volume of fluids administered to patients with sepsis in the emergency department. While patient-related factors such as advanced age, co-morbidities, cryptic shock were associated with poor compliance, important organisational factors such as inexperience of clinicians, overcrowding and inter-hospital transfers were also identified. A comprehensive understanding of the facilitators and barriers to early fluid administration is essential to design quality improvement projects. CRD42021225417.
Publisher: Springer Science and Business Media LLC
Date: 12-1991
DOI: 10.1007/BF03219497
Publisher: Elsevier BV
Date: 02-1998
DOI: 10.1016/S0260-6917(98)80013-0
Abstract: This national study compares the social and demographic characteristics of direct and delay entry students in a control group of 1551 students in higher education programmes in 1987 and 1990 with the national study group of 2295 students s led in 1995. Using a specially constructed socioeconomic variable for comparison the analyses demonstrated a significant difference in the socioeconomic level of the household for the younger aged group but not for the mature aged group. There was also a significant difference between males and females in their age of entry patterns. Furthermore, there was a significant difference in the location of school attended for most of their secondary education for the younger aged group but not for the mature aged group. For both groups there was a significant difference in the number of siblings, the level of education attained by the mother and the income received by the mother in the households of the control and study groups. Logit analysis revealed that there was a significant interaction between the household variables: socioeconomic status, number of siblings, and income received by the mother of the respondents in the control and study groups for the younger age group but not for the mature age group. This interaction for the younger age group, plus the finding that nursing students were more likely to delay their Higher Education Contribution Scheme (HECS) payment than other university students suggests that politicians need to take great care in any changes to current HECS payments as such changes could upset the delicate social balance that has been achieved in nursing recruitment in Australia.
Publisher: Wiley
Date: 07-07-2015
DOI: 10.1002/PON.3900
Abstract: We aim to systematically review studies that identify factors influencing cancer treatment decision-making among indigenous peoples. Following the outline suggested by the Preferred Reporting Items for Systematic Review and Meta-analysis, a rigorous systematic review and meta-synthesis were conducted of factors that influence cancer treatment decision-making by indigenous peoples. A total of 733 articles were retrieved from eight databases and a manual search. After screening the titles and abstracts, the full text of 26 articles were critically appraised, resulting in five articles that met inclusion criteria for the review. Because the five articles to be reviewed were qualitative studies, the Critical Appraisal Skills Program toolkit was used to evaluate the methodological quality. A thematic synthesis was employed to identify common themes across the studies. Multiple socio-economic and cultural factors were identified that all had the potential to influence cancer treatment decision-making by indigenous people. These factors were distilled into four themes: spiritual beliefs, cultural influences, communication and existing healthcare systems and structures. Although existing research identified multiple factors influencing decision-making, this review identified that quality studies in this domain are scarce. There is scope for further investigation, both into decision-making factors and into the subsequent design of culturally appropriate programmes and services that meet the needs of indigenous peoples.
Publisher: Informa UK Limited
Date: 10-2003
Abstract: The aim of this study was to identify clinical research priorities in aged care from the perspectives of rehabilitation aged care nurses in Hong Kong. The Delphi method was used whereby 33 registered nurses working in an aged care rehabilitation ward identified 28 research questions pertaining to areas in which nurses could take a leadership role: clinical research that is of highest value to patients and nurse specialists clinical research which would provide improved community care facilitate health promotion and disease prevention and be of value to the professional needs of clinical nurses. Study findings have implications and provide direction for clinical nursing research in aged care.
Publisher: Elsevier BV
Date: 06-2022
DOI: 10.1016/J.NEDT.2022.105379
Abstract: Increasing demand and limited supply of clinical placements in nursing underscore the need to better understand the role of clinical placements in students' learning. Identifying pedagogically rich activities that support work place learning alongside factors that influence educational outcomes has the potential to optimise professional placement experiences. To explore student nurses perceptions of the value of nursing clinical placements to their learning. A descriptive research design was employed using a sequential mixed method approach. A cross-sectional student survey captured students' perceptions of work integrated learning based on the perceived contribution of a pre-determined list of activities undertaken on clinical placement. Four Australian universities took part. Participants included students undertaking entry to practice programs. Four hundred and sixty-nine students completed the survey. Thirty-eight students participated in 12 focus groups. Participants rated PRA including interacting and time with patients and performing assessments as the most useful activities. Less useful, were activities that took them away from the patient. To maximise workplace learning, consideration must be given to ensuring students are presented with goal directed activities that support learning and are focused on an expanding scope of practice with opportunities to discuss and engage with staff.
Publisher: Wiley
Date: 27-10-2021
DOI: 10.1111/JOCN.15530
Publisher: Wiley
Date: 23-12-2021
DOI: 10.1111/AJAG.13029
Abstract: This study aimed to identify the core content and design issues in developing an online training course in the effective use of music for people with dementia. A co‐design approach was taken in which focus groups were conducted with aged care staff and family caregivers (n = 17 76.5% female). A general inductive approach was taken to data analysis. The consolidated criteria for reporting qualitative research (COREQ) guidelines were followed to ensure rigour in this study. Participants identified five core concepts for inclusion in the training program including the benefits of music, the need to assess for vulnerability to negative responses, music selection strategies, timing of use and equipment selection. Themes on design and implementation such as the need for role‐specific content for care staff at all levels and scenario‐based learning were identified. The development of online training in music use for carers of people with dementia needs to consider the demands on carers and develop training that is informative and engaging without placing large time demands on the user. Support at a management and executive level will be important to the implementation of such training in residential aged care contexts.
Publisher: Wiley
Date: 29-10-2021
DOI: 10.1111/JOCN.16104
Abstract: The aim of this integrative review was to investigate current literature exploring relationships between general self‐efficacy and the healthy ageing of older people. Enhancing the health and well‐being of older adults, while mitigating consequences of illness and frailty are important priorities in healthy ageing. General self‐efficacy is closely associated with human behaviour and has been linked with improved health and well‐being. An integrative review using the five‐stage method described by Whittemore and Knafl (Journal of Advanced Nursing, 2005, 52, 546). Academic databases CINAHL, MEDLINE and APA PsycInfo were searched between 2010 and 2020 for original, peer‐reviewed papers, published in English that investigated general self‐efficacy and factors associated with the healthy ageing of older people. Included papers were critically appraised using the Appraisal tool for Cross‐Sectional Studies (AXIS tool) and Critical Appraisal Skills Programme, and underwent data abstraction and synthesis via a constant comparative method. This review was also evaluated using the PRISMA checklist. Twenty‐one papers were included in this review. Two main themes emerged. The first highlights positive relationships between general self‐efficacy and health and ageing perceptions, with subsequent influence on health behaviours. The second includes two sub‐themes, which explores general self‐efficacy’s role in maintaining well‐being through its effects on psychological health and overcoming physical decline through adaption to changing physical and health conditions. Promoting general self‐efficacy has potential benefits for the healthy ageing of older people through positive effects on ageing and health perceptions, health behaviours, psychological health and overcoming physical decline. Understanding how general self‐efficacy facilitates healthy ageing can guide nursing practices that reduce or mitigate consequences of illness and physical decline on the health and well‐being of older people. Strategies aimed at increasing older people’s general self‐efficacy can help to facilitate subsequent positive effects on factors that promote healthy ageing.
Publisher: Elsevier BV
Date: 2018
DOI: 10.1016/J.NEDT.2017.10.003
Abstract: Nurses have a pivotal role in changing the focus of the health system toward a primary health care approach, yet little is known about the effectiveness of nursing students' educational preparation for this role. The aim of the study was to investigate undergraduate Australian nursing students' knowledge of and attitudes toward the primary health care approach. A cross-sectional, descriptive research design was applied. Two Australian universities, one with a rural base and one in the metropolitan area of Sydney, were involved. Both universities offer undergraduate and postgraduate nursing courses on multiple c uses. A convenience s le of 286 undergraduate nursing students, each of whom had completed a unit of study on PHC. All provided consent to participate in the study. Data was collected using the Primary Health Care Questionnaire via online survey platform SurveyMonkey for a period of three weeks in June 2015. Total knowledge scores ranged from 19.68 to 95.78 with the mean knowledge score being 69.19. Total attitude scores ranged from 33.12 to 93.88 with a mean score of 70.45. Comparison of knowledge scores showed mean scores of students born in Australia were significantly higher than those of students who were born overseas (p=0.01), and mean scores of students enrolled in the metropolitan university were also significantly higher than mean scores of students' enrolled in the rural university (p=0.002). In terms of attitudes scores, mean scores of Australian-born students were significantly higher than those of students born overseas (p=0.001), and older students' mean attitude scores were shown to be significantly higher than younger students' (p<0.005). Student's age, country of origin and university location were shown to be significant influences on student's knowledge of and attitudes toward primary health care.
Publisher: Informa UK Limited
Date: 2019
Publisher: Elsevier BV
Date: 02-2020
Publisher: Wiley
Date: 12-11-2022
Abstract: To investigate the association between timing and volume of intravenous fluids administered to ED patients with suspected infection and all-cause in-hospital mortality. Retrospective cohort study of ED presentations at four metropolitan hospitals in Sydney, Australia, between October 2018 and May 2019. Patients over 16 years of age with suspected infection who received intravenous fluids within 24 h of presentation were included. During the study period, 7533 patients with suspected infection received intravenous fluids. Of these, 1996 (26.5%) and 231 (3.1%) had suspected sepsis and septic shock, respectively. Each 1000 mL increase in intravenous fluids administered was associated with a reduction in risk of in-hospital mortality (adjusted odds ratio [AOR] 0.87, 95% confidence interval [CI] 0.76-0.99). This association was stronger in patients with septic shock (AOR 0.66, 95% CI 0.49-0.89), and those admitted to intensive care unit (ICU) (AOR 0.74, 95% CI 0.56-0.96). Patients with suspected sepsis and septic shock who received a total volume of >3600 mL had lower in-hospital mortality (AOR 0.44, 95% CI 0.22-0.91 AOR 0.16, 95% CI 0.05-0.57) compared to those administered <3600 mL within the first 24 h of presenting to the ED. There was no association between the time of initiation of fluids and in-hospital mortality among survivors and non-survivors (2.3 vs 2.5 h, P = 0.50). We observed a reduction in risk of in-hospital mortality for each 1000 mL increase in intravenous fluids administered in patients with septic shock or admitted to ICU suggesting illness severity to be a likely effect modifier.
Publisher: Informa UK Limited
Date: 05-2021
DOI: 10.2147/JMDH.S293764
Publisher: Elsevier BV
Date: 04-2019
Publisher: Informa UK Limited
Date: 08-2013
DOI: 10.5172/CONU.2013.45.1.79
Abstract: At least three decades after primary health care (PHC) took nursing by storm it is time to re-examine the philosophical shift to a PHC framework in pre-registration nursing curricula and overview factors which may hinder or promote full integration of PHC as a course philosophy and a contemporary approach to professional practice. Whilst nurse education has traditionally focused on preparing graduates for practice in the acute care setting, there is continuing emphasis on preparing nurses for community based primary health roles, with a focus on illness prevention and health promotion. This is driven by growing evidence that health systems are not responding adequately to the needs and challenges of erse populations, as well as economic imperatives to reduce the burden of disease associated with the growth of chronic and complex diseases and to reduce the costs associated with the provision of health care. Nursing pre-registration programs in Australia and internationally have philosophically adopted PHC as a curriculum model for preparing graduates with the necessary competencies to function effectively across a range of settings. Anecdotal evidence, however, suggests that when adopted as a program philosophy PHC is not always well integrated across the curriculum. In order to develop a strong and resilient contemporary nursing workforce prepared for practice in both acute and community settings, pre-registration nursing programs need to comprehensively consider and address the factors impacting on the curricula integration of PHC philosophy.
No related grants have been discovered for Deborah Hatcher.