ORCID Profile
0000-0002-3506-8422
Current Organisation
Australian Catholic University
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Publisher: Wiley
Date: 16-05-2021
DOI: 10.1111/JOCN.15849
Abstract: To determine whether the current rural graduate programmes in Western Australia adequately support new graduate nurses transitioning into practice. Graduate nurse's transition to employment is a time of significant change and challenge, often resulting in periods of transition shock. These challenges are magnified in rural areas where graduates have to relocate to commence their career with limited rural nursing experience. Graduate programmes were developed to smooth the transition for university trained bachelor's degree registered nurses into the workforce. Supportive graduate nursing programmes are essential for enabling transition to practice and reduce attrition rates. Longitudinal convergent mixed method parallel design was informed by Duchscher's transition stage model. Thematic analysis was applied to all interviews. COREQ checklist was completed. Descriptive statistics and content analysis were used to analyse the survey responses. New graduates cycled through both transition shock and honeymoon periods on commencement of employment, reporting high levels of satisfaction in simultaneity with signs of transition shock. Satisfaction dropped within 7 months indicating a transition crisis before an adjustment period occurred at the end of their graduate year. Limited resources were highlighted as obstacles to providing adequate support to rural graduate nurses. The honeymoon stage of transition co‐existed with transition shock at the commencement of graduate programmes, which may obscure the need for continuing adequate support. Inadequate and/or a lack of preceptorship was evident throughout the Western Australian rural graduate programmes. Graduate programmes need to be structured but flexible to allow for in idual differences in graduates’ and clinical contexts. Structured but flexible graduate programmes allow for in idual differences in graduates and clinical situations. New graduate nurses would benefit from a break midway through their graduate year to assist and overcome the transition crisis stage. Education of nurses undertaking the preceptor role is required to deliver adequate support to graduate nurses and decrease transition shock.
Publisher: Elsevier BV
Date: 03-2018
DOI: 10.1016/J.NEDT.2017.12.028
Abstract: This study examined the influence that perceptions and stereotypes of the nursing role had on future career choice of rural secondary students. The study was undertaken to identify a method of attracting final year secondary school students to an undergraduate nursing degree at a rural University. A mixed method study using a pre-post-interventional design. The rural c us of an Australian university. 71 secondary students attending a secondary school career development program at a rural Australian university. Semi structured questionnaires were used for data collection. The surveys were analysed using descriptive statistics and content analysis of open-ended survey questions. The research supports the importance of being aware of young people's impressions about nurses and nursing as a career, to ensure the successful implementation of targeted recruitment. Targeted recruitment strategies can increase students' awareness of the wide variety of pathways within nursing, rather than leaving awareness to what family, friends or career advisers tell them, or how nurses are portrayed on television, movies and the media.
Publisher: Elsevier BV
Date: 06-2022
Publisher: Wiley
Date: 30-01-2018
DOI: 10.1111/JOCN.14211
Abstract: To examine international studies that specifically focus on transition to practice for graduate registered nurses in rural and remote areas. Supportive graduate nursing programmes are essential for enabling nursing graduates' transition to practice and reducing attrition rates. Literature examining support measures for nursing graduates within metropolitan areas is abundant. However, there is a paucity of evidence on effective graduate programmes for rural and remote-based nursing graduates. A systematic approach was used to identify robust research within appropriate electronic databases. Eligible articles were critically reviewed using the Mixed Method Appraisal Tool critical appraisal tool. Eligible articles were thematically analysed using the Braun and Clark approach. Eight articles met the selection criteria for inclusion. Findings revealed that while most graduate nurses survived the transition process, they often felt overwhelmed and abandoned with intense feelings of frustration. Many suffered transition shock and did not feel ready for the role. Socialisation of graduates to the clinical environment was lacking. Support offered in many graduate programmes was ad hoc and unstructured. Senior staff were inadequately supported in their roles as preceptors to assist with the transition. Critical support measures recommended included both debrief sessions and regular one-on-one support. Graduate programmes need to be structured yet flexible to accommodate the needs of rural and remote nurse graduates. Graduates need to be transitioned into practice with decremental support processes for both workloads and education. Preceptors require education on how to mentor before they can provide the appropriate support for graduates. Without these measures in place, a decrease in transition shock may not be possible. Graduate programmes need to be structured yet flexible, including assistance with both clinical skills and socialisation. Senior staff require education before they can adequately support new graduates.
Publisher: Elsevier BV
Date: 05-2008
DOI: 10.1016/J.COLEGN.2008.02.002
Abstract: The current workforce crisis mandates that education providers increase the number of graduates from nursing courses. In a practice-based profession however, any growth in student numbers is constrained by the ability of clinical venues to accept students for clinical experience. Factors within the operating environment such as bed capacity, staffing mix and shortage of experienced clinicians to act as preceptors, clinical teachers, mentors or role models limit the number of students that can be accommodated and both the quality and level of educational support provided. These factors are compounded in rural hospitals, where opportunities for placements can be also overlooked or ineffectively utilised. This paper reports on a project undertaken by a rural health service, two universities and a TAFE institute. It demonstrates that a greater number of students can be accommodated when all major stakeholders accept responsibility and agree to work together to create a learning community and find ways to overcome barriers and impediments that constrain capacity. It is concluded that the capacity of a rural hospital to accept students for placement can be increased when cancellation rates are reduced, the clinical timetable rationalised and more collaborative approaches to clinical education are implemented.
Publisher: Informa UK Limited
Date: 28-10-2020
Publisher: Wiley
Date: 03-10-2019
DOI: 10.1111/JAN.14194
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: Elsevier BV
Date: 07-2020
Publisher: Wiley
Date: 16-04-2019
DOI: 10.1111/JOCN.14853
Abstract: To explore the ways in which Irish and Australian Nurse Practitioners (NPs) implement leadership and research in their roles and whether there is a difference in how leadership and research are demonstrated between NPs in Ireland and Australia. The original concept of the NP role was to expand nursing practice in order to provide high-quality, accessible health care to patients. This placed NPs at the crux of changes to healthcare delivery. Implementing these changes requires leadership. Research demonstrates the effects of these changes to healthcare delivery and contributes to healthcare knowledge from the nursing profession. In the qualitative phase of a mixed methods study, an interpretative descriptive approach was used to draw on participant experiences. Thirty-eight respondents agreed to be interviewed following an online survey. Ten interviews were recorded and transcribed verbatim. Data were analysed using Braun and Clarke thematic analysis method. The research complied with the consolidated criteria for reporting qualitative research, COREQ. Ten participants, five NPs from Ireland and five from Australia were interviewed. Four themes emerged from the analysis: (a) Innovative leadership, which included the categories of leadership activities, the work of NPs and trailblazers (b) Optimism, incorporating pride in achievements, the future outlook for the role and continued innovation of NPs over time (c) Research, which included the NP research role, research challenges, support and research leadership and (d) Resilience, which included overcoming resistance, isolation and seeking positive support systems. Nurse Practitioners are clinical leaders focused on improving healthcare delivery for patient populations. There is a lack of understanding of the NP role. Nurse Practitioners lack confidence to be independently research active. Research by NPs requires support from nurses in academia. There is no difference in the role in Ireland and Australia. Nurse Practitioners are engaged in healthcare transformation. Nurse Practitioners require support from research experts in academia to make a significant contribution to nursing knowledge in healthcare delivery.
Publisher: Wiley
Date: 07-04-2021
DOI: 10.1111/JOCN.15744
Abstract: To explore the relationship between blood s ling techniques and haemolysis. Haemolysis rates of blood s les have been thought to be influenced by the method of collection. There is a lack of research evidence available to clearly show the comparative risk of haemolysis across different blood s ling methods, including venepuncture and use of peripheral intravenous cannulas. A prospective cohort study. Reporting followed the STROBE checklist. A trained observer was used to record blood s ling techniques over a 10‐week period between April and June 2019. These records were then linked to pathology haemolysis results. Multivariable logistic regression was used to model patient and blood draw characteristics affecting haemolysis. Most of the blood s les were not haemolysed (n = 324, 87.1%). Multivariable analysis showed haemolysis was associated with increased tourniquet duration and if the level of tube was less than half full. Univariable analysis showed haemolysis was associated with increased age of the patient, the difficulty of cannulation/ venepuncture and increased number of attempts. No difference was found in the haemolysis rate related to the qualification of the blood collector. There was no significant difference in haemolysis rates associated with s ling blood from a PIVC compared with venepuncture. Research should be undertaken to determine whether education on the factors influencing haemolysis is useful in decreasing haemolysis rates. There was no association with increased haemolysis rates when drawing blood via venepuncture compared with a peripheral intravenous cannula. Haemolysis of blood s les was associated with increased tourniquet duration, if level of the tube was less than half‐filled, increased age of the patient and difficulty of blood draw. Awareness of the risk of haemolysis associated with specific blood s ling methods may assist clinicians to improve care.
Publisher: Elsevier BV
Date: 08-2021
Publisher: Wiley
Date: 20-06-2019
DOI: 10.1111/JAN.14078
Abstract: To synthesize the evidence evaluating if blood s les are similar when obtained from peripheral intravenous cannula compared with venepuncture. A systematic review and meta-analysis was undertaken. Searches were conducted in databases for English language studies between January 2000-December 2018. The search adhered to the Meta-analysis of Observational Studies in Epidemiology guidelines. The methodological quality of studies was assessed using Joanna Briggs critical appraisal instruments. The overall quality of the evidence was assessed using the GRADE. Sixteen studies were identified. Findings suggest haemolysis rates are higher in blood s led from peripheral intravenous cannula. However, haemolysis rates may be lower if a peripheral intravenous cannula blood s ling protocol is followed. For equivalence of blood test results, even though some results were outside the laboratory, allowable error and were outside the Bland-Altman Level of Agreement, none of these values would have required clinical intervention. With regard to the contamination rates of blood cultures, the results were equivocal. Further research is required to inform the evidence for best practice recommendations, including, if a protocol for drawing blood from a peripheral cannula is of benefit for specific patient populations and in other settings. Venepuncture can provoke pain, anxiety and cause trauma to patients. Guidelines recommend blood s les from peripheral intravenous cannula be taken only on insertion. Anecdotal evidence suggests drawing blood from existing cannulas may be a common practice. Further research is required to resolve this issue.
Publisher: Elsevier BV
Date: 11-2014
DOI: 10.1016/J.NEPR.2014.07.005
Abstract: Similar to the U.S.A., New Zealand and Singapore, Australia registers two levels of nurse, the degree or postgraduate entry prepared registered nurse and diploma or certificate-prepared enrolled nurse. Over the past decade, significant changes have occurred in educational preparation of enrolled nurses. This has resulted in enrolled nurses undertaking many roles and responsibilities previously undertaken only by registered nurses. An exploratory qualitative research study using interviews with educators of both registered and enrolled nurses was undertaken to investigate differences in educational preparation of registered and enrolled nurses in Australia. This paper describes perceptions around how participants viewed educational approaches and different cohorts, types and levels of students. Similarities included topics covered and the majority skills taught, although high acuity skills remain a difference between the levels of nurse. Differences were also found in type of student, educational background and teaching methods.
Publisher: Elsevier BV
Date: 05-2019
DOI: 10.1016/J.NEDT.2019.02.012
Abstract: In Australia there is no national examination to assess student competency with respect to critical thinking skills on graduation from undergraduate registered nurse program. To describe the use of Rasch analysis for the validation of a tool that measures critical thinking in nursing students in Australia. A cross sectional survey was used to assess students' critical thinking. One Australian university. Seventy-four first year and third year nursing students participated in the project. Nursing students at one university were requested to undertake a multiple choice question survey to determine their level of critical thinking. The survey tool was validated using Rasch analysis software. Rasch analysis enabled identification of the difficulty of each question, enabling the assessment to identify difference between students and for each student cohort. The use of Rasch analysis demonstrated marked differences in the students' critical thinking abilities, showing higher levels of critical thinking for third year students with greater ability to answer the more difficult questions. Rasch analysis enables the matching of test questions to the cognitive skill level of students, and is a useful tool for validating multiple choice questionnaires. Use of this method of analysis can provide a robust assessment in which questions are matched to the level of the learner and enable differentiation between high and low achieving students.
Publisher: CSIRO Publishing
Date: 2014
DOI: 10.1071/AH13216
Abstract: Objective This paper reports on a project to examine the expectations of senior nurses regarding graduate roles of registered and enrolled nurses educated in Victoria, Australia. Methods Participants completed an online survey to indicate whether predetermined competencies were in the roles of graduate enrolled or registered nurses or not in the role of either nurse. Chi-squared analysis was used to identify differences between participant groups. Results Participants expressed variations in role expectations for the different level of graduate nurse. Although basic nursing care was undertaken by both graduate enrolled and registered nurses, no specific role was identified for enrolled nurses. Differences were found in the opinions of senior nurses over the roles of graduate nurses, demonstrating considerable variation in expectations. Management, education and research roles were not identified as the role of either nurse on graduation. Differences were found in the expectations of the different senior nurse groups regarding the roles of the enrolled nurse, particularly in the new skills taught in the enrolled nurse diploma program. Conclusions Confusion exists regarding the roles of both types of nurse on graduation. Further research across Australia is required to clarify the roles of the different level of nurse in different practice contexts. What is known about the topic? Australia, like many other countries, prepares two levels of nurse for entry to practice: the degree-prepared registered nurse and the diploma-prepared enrolled nurse. Role confusion and ambiguity have been reported in the literature by many countries, including Australia, that employ two levels of nurse. What does this paper add? Great variation exists between expectations of senior nursing staff as to the role of both levels of graduate nurse. Role confusion and ambiguity exists for nurses in Australia. Role confusion and ambiguity around the scope of practice for enrolled nurses is seen as both limiting their practice and encouraging them to work at levels for which they have not been prepared. Graduate registered nurses were seen as more prepared for required graduate attributes than enrolled nurses. Care of acute, complex or deteriorating patients remains the role of registered nurses. What are the implications for practitioners? Practising nurses need to be educated as to the skills and knowledge that diploma enrolled nurses are graduating with in order to enable them to use their full range of abilities. To provide safe, quality care, registered nurses must fully understand the roles and abilities of the enrolled nurses to whom they delegate care. Organisational health policies and procedures need to be reviewed to accommodate the increased skills and knowledge of diploma-prepared enrolled nurses and enable best utilisation of their skills. Practising nurses need to be aware that enrolled nurses are not educationally prepared to care for complex or deteriorating patients. Although they are able to undertake basic nursing care, the role of caring for complex, highly acute and deteriorating patients remains in the domain of registered nurses. The increasing acuity of patients admitted to health services requires a higher skill mix of registered nurses to safely care for them.
Publisher: Wiley
Date: 05-2018
DOI: 10.1111/JOCN.14370
Abstract: To determine the impact of intentional rounding on patient and nursing outcomes and identify the barriers and facilitators surrounding implementation. Intentional rounding is an organised approach whereby health professionals' regularly check on patients to ensure their fundamental care needs are met. Despite wide scale adoption of intentional rounding, there is limited evidence to inform practice. This systematic mixed-method review was conducted using the Joanna Briggs Institute methodology. Databases CINAHL, MEDLINE, EMBASE, COCHRANE, SCOPUS and WEB of SCIENCE were searched to identify research studies published in English between January 2006-January 2017 that reported on intentional rounding and patient and nursing staff outcomes. Studies were assessed for methodological quality. The findings were synthesised into themes using a narrative approach. Twenty-one studies were included in the review. Six studies reported a reduction in the number of falls, and a further five studies reported a reduction in call bell use following the introduction of intentional rounding. Nurses' satisfaction and attitudes towards intentional rounding were reported in seven studies with equivocal results. The quality of the studies was weak making comparisons difficult. While results suggest positive outcomes for falls and call bell use, conclusions on the available data are overshadowed by the quality of the studies. Well-designed studies are required to advance evidence in this field. The evidence on intentional rounding is mixed and suggests that the introduction of intentional rounding should be accompanied by a protocol for robust evaluation to measure the impact of this process change. This should be accompanied by standardised reporting measures to enable comparisons and contribute to the quality of available evidence on intentional rounding.
Publisher: Wiley
Date: 04-10-2023
DOI: 10.1002/NOP2.2023
Publisher: Informa UK Limited
Date: 10-2014
Publisher: Springer Science and Business Media LLC
Date: 26-09-2012
DOI: 10.1038/NATURE11450
Abstract: Assessment and characterization of gut microbiota has become a major research area in human disease, including type 2 diabetes, the most prevalent endocrine disease worldwide. To carry out analysis on gut microbial content in patients with type 2 diabetes, we developed a protocol for a metagenome-wide association study (MGWAS) and undertook a two-stage MGWAS based on deep shotgun sequencing of the gut microbial DNA from 345 Chinese in iduals. We identified and validated approximately 60,000 type-2-diabetes-associated markers and established the concept of a metagenomic linkage group, enabling taxonomic species-level analyses. MGWAS analysis showed that patients with type 2 diabetes were characterized by a moderate degree of gut microbial dysbiosis, a decrease in the abundance of some universal butyrate-producing bacteria and an increase in various opportunistic pathogens, as well as an enrichment of other microbial functions conferring sulphate reduction and oxidative stress resistance. An analysis of 23 additional in iduals demonstrated that these gut microbial markers might be useful for classifying type 2 diabetes.
Publisher: SAGE Publications
Date: 07-03-2020
Abstract: A diagnosis of younger onset dementia requires specific care tailored to the in idual and the family. Dementia care workers often do not have the skills and experience necessary to offer this care within the residential and community environment. This article reports the development of an interactive resource to educate those employed to care for people living with younger onset dementia. Prescription for Life, a talking e-Flipbook was developed and piloted in two states of Australia. Feedback from the pilots was incorporated in the resource prior to a national rollout. The project was supported by an expert panel, including experts from national aged care providers.
Publisher: Informa UK Limited
Date: 10-2014
Publisher: Hindawi Limited
Date: 04-11-2021
DOI: 10.1111/JONM.13496
Publisher: Elsevier BV
Date: 2010
DOI: 10.1016/J.NEPR.2009.01.018
Abstract: Worldwide, universities have been encouraged to increase the number of students enrolled in nursing courses as a way to bolster the domestic supply of graduates and address workforce shortages. This places pressure on clinical agencies to accommodate greater numbers of students for clinical experience who, in Australia, may often come from different educational institutions. The aim of this study was to develop and evaluate a collaborative model of clinical education that would increase the capacity of a health care agency to accommodate student placements and improve workplace readiness. The project was undertaken in a medium sized regional hospital in rural Australia where most nurses worked part time. Through an iterative process, a new supported preceptorship model was developed by academics from three institutions and staff from the hospital. Focus group discussions and interviews were conducted with key stakeholders and clinical placement data analysed for the years 2004 (baseline) to 2007. The model was associated with a 58% increase in the number of students and a 45% increase in the number of student placement weeks over the four year period. Students reported positively on their experience and key stakeholders believed that the new model would better prepare students for the realities of nursing work.
Publisher: Hindawi Limited
Date: 23-09-2015
DOI: 10.1111/JONM.12162
Abstract: To investigate the current literature to gain an understanding of skill mix, why it is being manipulated and how it affects patient care and health-care costs. Due to workforce shortages, economic constraints and increasing patient acuity, employers are looking at methods of providing patient care whilst maintaining costs. Registered nurses make up a large percentage of the health-care budget. The manipulation of skill mix (i.e. the percentage of registered nurses available for patient care) is seen as one method of managing the increasing cost whilst still ensuring patient care. Research literature was used to determine the current use of skill mix and its impact on patient care and health-care costs. The use of a higher proportion of registered nurses is associated with better health outcomes, shorter length of stay and reduced patient morbidity. Economic savings from substituting registered nurses with other health professionals may be offset by increased patient length of stay in hospital and increased patient mortality. When evaluating nursing skill mix, a higher percentage of registered nurses may result in health-care facility cost savings by providing a shorter length of stay and decreased patient complications.
Publisher: Wiley
Date: 11-04-2017
DOI: 10.1111/JOCN.13775
Abstract: To explore the contribution of family members in promoting and supporting the self-management of chronic conditions amongst adult family members. The prevalence of chronic disease continues to grow globally. The role of the family in chronic condition management and support for self-management has received little attention. A systematic review of qualitative literature using the Joanna Briggs Institute approach for qualitative systematic reviews. Ovid (MEDLINE, CINAHL and PsycINFO) were searched for the period of database inception-2016. The QARI (Qualitative Assessment and Review Instrument) critical appraisal instrument was used to assess the quality of each study. Using the Joanna Briggs Institute-QARI data extraction tool, findings related to the family role in the self-management of chronic conditions were extracted and each finding rated according to Joanna Briggs Institute-QARI levels of credibility. Findings were categorised and synthesised to produce a final set of aggregated findings. Families were key in constructing an environment that was conducive to family engagement and support. Adaptation within the family included maintaining cohesion between family members, normalisation and contextualisation of the chronic condition. Whilst evidence on the value of the family in promoting positive health outcomes is clear, research on how families can specifically support the self-management of chronic conditions is emerging. Family adaptability has been found to be the most powerful predictor of carer depression. Families may need support to change their home and family organisation to adapt to the challenges they face overtime. Change in roles and subsequent adaptation can be stressful, even for those family members at a distance. Nurses working in hospital and community settings can play an important role in assessing how families are adapting to living with chronic illness and to explore strategies to cope with challenges in the home setting.
Publisher: Wiley
Date: 12-2019
DOI: 10.1111/WVN.12394
Abstract: The charting of daily fluid balances and measurement of body weight changes are two noninvasive methods commonly used in the intensive care unit for estimating body fluid status. The determination of body fluid status plays an important role in the management of critically ill patients where aggressive fluid resuscitation is often required. This can adversely affect patient outcomes if changes in fluid distribution are not detected early in patients who are susceptible to fluid overload. To synthesize the best available evidence on the accuracy of daily fluid balance charting compared with the measurement of body weight for the estimation of body fluid status in critically ill adult patients. The review considered studies that investigated the accuracy of charting daily fluid balances or changes in body weight measurements or used both noninvasive methods in the estimation of body fluid status. The search sought to identify published, English language studies from 1980 until February 2018. Databases searched included MEDLINE, CINAHL, EMBASE, TRIP, Scopus, TROVE, ProQuest Dissertations, Australian and New Zealand Trials Registry, and Cochrane Central Register of Clinical Trials. Three reviewers independently assessed retrieved studies that matched inclusion criteria using standardized critical appraisal instruments. The review included 13 cohort studies. Effectiveness of daily fluid balance charting was affected by inaccuracies observed in seven studies. Inability to obtain consecutive daily body weight measurements reduced the accuracy of monitoring changes in five studies. Seven studies found measurement of daily fluid balance inconsistent with changes in body weight. The accuracy of charting fluid balance is suspect. Measurement of body weight is hard to accomplish. A combination of the two commonly used methods is more likely to be effective in estimating body fluid status than reliance on one single approach.
Publisher: Elsevier BV
Date: 2016
DOI: 10.1016/J.NEPR.2015.05.011
Abstract: In Australia, like other countries, two levels of nurse are registered for entry to practice. Educational changes for second level nurses in Australia have led to questions regarding roles and career options. This paper reports on interviews with nursing course coordinators to examine educator expectations of roles and career pathways of registered and enrolled nurses. Coordinators of eight degree (registered) and diploma (enrolled) nursing programs were interviewed to determine their opinions on roles and careers that students were prepared for. Transcripts were thematically analysed. Educators reported similar graduate roles, although high acuity care was primarily the role of registered nurses. Career expectations differed with enrolled nurses having limited advancement opportunity, and registered nurses greater career options. Health organisations were unprepared to accommodate increased practice scope of enrolled nurses and limited work practice through policies stipulating who could perform procedures. Organisational health policies need to accommodate increased enrolled nurse skill base. Education of practising nurses is necessary regarding increased scope of enrolled nurse practice to ensure they are used to their full potential. Increasing patient acuity requires more registered nurses, as enrolled nurses are unprepared to care for complex or deteriorating patients.
Publisher: Wiley
Date: 08-07-2018
DOI: 10.1111/JAN.13732
Abstract: To develop a critical thinking assessment tool for Australian undergraduate nurses. Critical thinking is an important skill but difficult to assess in nursing practice. There are often many responses a nurse can make to a clinical problem or situation. Some responses are more correct than others and these decisions have an impact on a patient's care and safety. Differences in a response can relate to the depth of knowledge, experience and critical thinking ability of the in idual nurse. This study used a Delphi process to develop five clinical case studies together with the most appropriate clinical responses to 25 clinical questions. The Delphi technique was undertaken using the Qualtrics survey tool between October 2016-January 2017. A panel of 13 nursing experts from various geographical locations in Australia participated in the study to review the case scenarios and answers to questions posed. Four rounds of participation were required to achieve a minimum of 80% agreement between participants. Participants were asked to rank answers for 25 multi-choice questions based on the correct nursing management of case scenarios provided and provide feedback as to the accuracy and relevance of the scenarios and answers. Four rounds of Delphi questions were required to reach consensus on the correct wording and answers for the scenarios. Five case studies have been developed with nursing responses to patient management in rank order from most correct to least correct. Use of the tool should provide confidence that a nurse has met a certain level of critical thinking ability.
Publisher: Wiley
Date: 12-2020
DOI: 10.1111/IJN.12901
Publisher: Informa UK Limited
Date: 10-2013
DOI: 10.5172/CONU.2013.45.2.155
Abstract: Significant changes to the scope of practice for enrolled nurses have occurred in Australia over the past decade. These changes, which are largely a consequence of staff shortages and economic pressure, have resulted in increased role confusion and overlap between enrolled and registered nurses in Australia. This paper presents a brief history of the enrolled nurse in Australia followed by an overview of the current situation and emerging trends in the education and employment of these nurses. Definitions and approaches to scope of practice are described and emerging issues within Australia raised and discussed. A review of the literature found the number of enrolled nurses and the roles they perform have changed significantly in Australia following the introduction of the enhanced scope of practice. Further research is required to better define and delineate between the different nursing roles and to explore broader frameworks to analyze, describe and define these roles.
Publisher: Elsevier BV
Date: 12-2012
DOI: 10.1016/J.COLEGN.2011.10.002
Abstract: The current shortage of health professionals necessitates new approaches to clinical education that can expand the number of undergraduate students undertaking clinical placements without increasing the burden on clinical staff or placing patients at risk. Interprofessional education has the potential to help increase clinical capacity whilst enriching students' clinical experience. This paper reports on a project which investigated the potential for interprofessional education to increase undergraduate clinical placement capacity in clinical settings. The project utilised an exploratory descriptive methodology to obtain the views of health care professionals about the use of interprofessional education in clinical education at three rural health facilities in Victoria, Australia. Participants (n = 57) had a key role with each health care facility in coordinating and facilitating undergraduate clinical placements. This paper examines the clinicians' views about the central role that leadership plays in actioning interprofessional education in the clinical setting. Whilst interprofessional education was regarded favourably by the majority of participants, data indicated that leadership from education providers, health services, and regulatory authorities was crucial to enable interprofessional education to be implemented and sustained within the clinical learning environment. Without leadership from each of these three spheres of influence, interprofessional education will continue to be difficult to implement for undergraduate students and compromise their exposure to an important aspect of the working life of health care professionals. Such a failure will limit graduates' readiness for collaborative and cross-disciplinary practice.
Publisher: Wiley
Date: 12-03-2020
DOI: 10.1111/JOCN.15234
Abstract: To critically review contemporary transition theories to determine how they apply to the newly qualified graduate registered nurse programmes. Graduate nurse transition to employment is the time of significant change which has resulted in high attrition rates. Graduates are often challenged by their expectation of nursing practice and the reality of the role. The transition from hospital‐based training to university‐based training has resulted in the need for primary employment to commence with graduate/orientation/internship programmes to help support new graduates transition into clinical practice. One transition model, Duchscher's stages of transition theory, utilised three former theories to develop a final model. A narrative critical literature review. The theories selected for the review were Kramer's reality shock theory, Benner's novice to expert theory, Bridges transition theory and Duchscher's stages of transition theory. Duchscher's stages of transition theory reflects the experiences of registered nursing transition into the workforce directly from university. The application of the theory is effective to guide understanding of the current challenges that new graduate nurse's experience today. There is a need for new graduates to complete their university degree as advanced beginners in order to decrease the experience of transition shock and keep pace with rapidly changing demands of the clinical environment. This may be achieved by increasing ward‐based simulation in university education. A theoretical framework can provide a deep understanding of the various stages and processes of transition and enable development of successful programmes. Both universities and hospitals need to adapt their current practice to align with the needs of new graduates due to large student numbers and ongoing systematic advancements to decrease the attrition rate.
Publisher: Elsevier BV
Date: 04-2015
Publisher: Wiley
Date: 19-04-2021
DOI: 10.1111/JOCN.15796
Abstract: To determine if extended immersive ward‐based simulation programmes improve the preparedness of undergraduate bachelor's degree nursing students to be ward ready for professional practice as a registered nurse. The practice readiness of new graduate nurses to enter the workforce continues to raise concern among educators and industry. Often the transition period is a vulnerable time when the reality of clinical practice bears little resemblance of their experiences as a student. Simulation of a busy ward offers the opportunity for pre‐registered nurses to practise a variety of situations they are likely to encounter once qualified in a safe and supportive learning environment. The review considered studies that investigated the experiences and learning outcomes of nursing students following participation in extended immersive ward‐based simulation. Databases searched included CINAHL, EMBASE, Medline and Scopus. Two reviewers independently assessed retrieved studies that matched inclusion criteria using standardised critical appraisal instruments. Reporting of review followed PRISMA checklist. Fourteen studies met the inclusion criteria. The majority of studies used a quasi‐experimental mixed methods approach (10). Programme evaluations focused on self‐reporting in learning satisfaction and student perceptions of performance. Six studies used a pre‐ and post‐test design to compare the after effect on preparedness for professional practice. Two studies investigated student learning between simulated experiences and experiences gained during clinical placements. Learning satisfaction was high among students who participated in programmes that incorporated extended immersive ward‐based simulation experiences. Students are able to practise what they need to know and on what will be expected of them in professional practice. Evidence on whether these programmes make a difference in workplace performance, and retention of graduate nurses is yet to be established. Extended immersive ward‐based simulation allows educators the opportunity to meet the perceived needs of students in preparation for professional practice.
Publisher: Elsevier BV
Date: 09-2016
DOI: 10.1016/J.NEDT.2016.05.016
Abstract: Flexible online programs are becoming increasingly popular method of education for students, allowing them to complete programs in their own time and cater for lifestyle differences. A mixture of delivery modes is one way which allows for enhanced learning. Peer learning is another method of learning which is shown to foster collaboration and prepare healthcare students for their future careers. This paper reports on a project to combine peer and online learning to teach pharmacology to nursing students. To explore undergraduate nursing student opinions of working in peer groups for online learning sessions in a pharmacology course. A qualitative study utilising a self-reported questionnaire. A rural c us of an Australian university. Second year nursing students enrolled in a Bachelor of Nursing Program. A hard copy questionnaire was distributed to all students who attended the final semester lecture for the course. Content analysis of open-ended survey questions was used to identify themes in the written data. Of the 61 students enrolled in the nursing subject, 35 students chose to complete the survey (57%). Students reported a mixed view of the benefits and disadvantages of peer online learning. Sixty 6% (66%) of students liked peer online learning, whilst 29% disliked it and 6% were undecided. Convenience and ease of completion were reported as the most common reason to like peer online learning, whilst Information Technology issues, communication and non-preferred learning method were reasons for not liking peer online learning. Peer online learning groups' acted as one further method to facilitate student learning experiences. Blending peer online learning with traditional face-to-face learning increases the variety of learning methods available to students to enhance their overall learning experience.
Publisher: Elsevier BV
Date: 09-2016
Publisher: Wiley
Date: 05-09-2023
DOI: 10.1111/JAN.15430
Abstract: To identify the evidence on factors that impact delegation practices by Registered Nurses to Assistants in Nursing in acute care hospitals. An integrative review. Database searches were conducted between July 2011 and July 2021. We used the 12‐step approach by Kable and colleagues to document the search strategy. The (Whittemore & Knafl. 2005. Journal of Advanced Nursing , 52 (5), 546–553) integrative review framework method was adopted and the methodological quality of the studies was assessed using Joanna Briggs critical appraisal instruments. Nine studies were included. Delegation between the Registered Nurse and the Assistant in Nursing is a complex but critical leadership skill which is impacted by the Registered Nurse's understanding of the Assistant in Nursing's role, scope of practice and job description. Newly qualified nurses lacked the necessary leadership skills to delegate. Further education on delegation is required in pre‐registration studies and during nurses' careers to ensure Registered Nurses are equipped with the skills and knowledge to delegate effectively. With increasing numbers of Assistants in Nursing working in the acute care environment, it is essential that Registered Nurses are equipped with the appropriate leadership skills to ensure safe delegation practice.
Publisher: Elsevier BV
Date: 07-2012
DOI: 10.1016/J.NEDT.2011.08.013
Abstract: In order to identify opportunities to build capacity for clinical placements, we mapped and described the organisation of student placements at three hospitals, each with multiple education providers, in rural Victoria, Australia. Using a cross-sectional, mixed method design, data were collected by survey, interviews and discussion with student placement coordinators representing 16 clinical health disciplines. Teaching and supporting students was regarded as an important part of the service each hospital provided and a useful staff recruitment strategy. There were peaks and troughs in student load over the year, though this was less marked for medicine and dentistry than for nursing and allied health disciplines. Whilst placements were managed largely on a discipline basis, each hospital had taken steps to communicate information about student placements across disciplines and to identify opportunities for interprofessional education (IPE). Placement capacity could be increased by sharing placement data within hospitals, smoothing the utilisation patterns across the year, capitalising on opportunities for IPE when there is concurrent placement of students from different disciplines, and through better employment of underutilised clinical areas.
Publisher: Elsevier BV
Date: 10-2018
Publisher: Wiley
Date: 05-08-2020
DOI: 10.1002/NOP2.559
Publisher: Wiley
Date: 21-04-2017
DOI: 10.1111/JAN.13306
Abstract: The aim of this study was to develop an assessment tool to measure the critical thinking ability of nurses. As an increasing number of complex patients are admitted to hospitals, the importance of nurses recognizing changes in health status and picking up on deterioration is more important. To detect early signs of complication requires critical thinking skills. Registered Nurses are expected to commence their clinical careers with the necessary critical thinking skills to ensure safe nursing practice. Currently, there is no published tool to assess critical thinking skills which is context specific to Australian nurses. A modified Delphi study will be used for the project. This study will develop a series of unfolding case scenarios using national health data with multiple-choice questions to assess critical thinking. Face validity of the scenarios will be determined by an expert reference group of clinical and academic nurses. A Delphi study will determine the answers to scenario questions. Panel members will be expert clinicians and educators from two states in Australia. Rasch analysis of the questionnaire will assess validity and reliability of the tool. Funding for the study and Research Ethics Committee approval were obtained in March and November 2016, respectively. Patient outcomes and safety are directly linked to nurses' critical thinking skills. This study will develop an assessment tool to provide a standardized method of measuring nurses' critical thinking skills across Australia. This will provide healthcare providers with greater confidence in the critical thinking level of graduate Registered Nurses.
Publisher: Wiley
Date: 24-05-2012
Publisher: Elsevier BV
Date: 07-2016
DOI: 10.1016/J.NEPR.2016.05.009
Abstract: Cultural desire is considered to be a prerequisite for developing cultural competence. This study explored cultural desire among student nurses towards Aboriginal peoples and its association with participation in a one-semester unit on Aboriginal health through a cross-sectional survey. Our main outcome, cultural desire, was measured using two items level of agreement with Aboriginal health being an integral component of the nursing curriculum and an expressed interest in Aboriginal health. 220 (74.58%) student nurses completed the survey. Completing the Aboriginal Health and wellbeing unit did not influence students' opinions on inclusion of the unit as part of the nursing curriculum (odds ratio OR 0.73, 95% CI 0.43-1.29) or their overall cultural desire (mean difference = -0.69, 95% CI -1.29 to -0.08, p = 0.026). Students who completed the unit reported a higher understanding of Aboriginal health (OR = 2.35, 95% CI = 1.35-4.08) but lower interest levels in the subject (OR = 0.45, 95% CI: 0.24-0.84). Further research is necessary to explore how and when cultural desire might develop in nurses who are trained in cultural competence particularly in the contexts of post-colonial disparities and political conflict.
Publisher: Springer Science and Business Media LLC
Date: 02-12-2012
DOI: 10.1038/NG.2477
Publisher: Wiley
Date: 27-10-2023
DOI: 10.1111/JAN.15906
Publisher: Elsevier BV
Date: 04-2019
No related grants have been discovered for Elisabeth Jacob.