ORCID Profile
0000-0002-2475-7724
Current Organisations
USDA Agricultural Research Service
,
Edith Cowan University
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Publisher: Wiley
Date: 02-12-2019
DOI: 10.1111/JOCN.15109
Abstract: To explore the challenge of engaging multidisciplinary staff in standardising aseptic technique (AT) in an emergency department (ED) in an Australian tertiary hospital, and to better understand the enablers and barriers to implementing practice change within this setting. Healthcare-associated infections are the most common complication for patients in acute care. A clinical practice framework developed in the United Kingdom (UK) standardised AT practice to reduce potential infection risk. One Australian tertiary hospital drew upon this framework to similarly improve clinical practice. It was understood that standardising practice would require some practitioners only to revisit and demonstrate AT principles already embedded in their practice, while others would be challenged to adopt a new approach. Qualitative, descriptive research design. Data were collected through focus groups held before and after implementation of the AT programme. Data were analysed using the framework method. The (COREQ) checklist was followed. Four emergent themes described the influence of motivation on in iduals' beliefs and attitudes towards practice change, relationships within the ED context, delivery of education and management directives. Implementing practice change is more than just providing technical knowledge and includes changing in iduals' beliefs and attitudes. An understanding of adaptive challenge can assist in implementing practice change that involves the multidisciplinary team. Results provide evidence as to how the adaptive challenge framework could be a suitable approach to manage potential enablers and barriers to implementing change within a multidisciplinary team in an acute hospital.
Publisher: Copernicus GmbH
Date: 12-03-2019
DOI: 10.5194/BG-2019-85
Abstract: Abstract. Evaporation (E) and transpiration (T) respond differently to ongoing changes in climate, atmospheric composition, and land use. Our ability to partition evapotranspiration (ET) into E and T is limited at the ecosystem scale, which renders the validation of satellite data and land surface models incomplete. Here, we review current progress in partitioning E and T, and provide a prospectus for how to improve theory and observations going forward. Recent advancements in analytical techniques provide additional opportunities for partitioning E and T at the ecosystem scale, but their assumptions have yet to be fully tested. Many approaches to partition E and T rely on the notion that plant canopy conductance and ecosystem water use efficiency (EWUE) exhibit optimal responses to atmospheric vapor pressure deficit (D). We use observations from 240 eddy covariance flux towers to demonstrate that optimal ecosystem response to D is a reasonable assumption, in agreement with recent studies, but the conditions under which this assumption holds require further analysis. Another critical assumption for many ET partitioning approaches is that ET can be approximated as T during ideal transpiring conditions, which has been challenged by observational studies. We demonstrate that T frequently exceeds 95 % of ET from some ecosystems, but other ecosystems do not appear to reach this value, which suggests that this assumption is ecosystem-dependent with implications for partitioning. It is important to further improve approaches for partitioning E and T, yet few multi-method comparisons have been undertaken to date. Advances in our understanding of carbon-water coupling at the stomatal, leaf, and canopy level open new perspectives on how to quantify T via its strong coupling with photosynthesis. Photosynthesis can be constrained at the ecosystem and global scales with emerging data sources including solar-induced fluorescence, carbonyl sulfide flux measurements, thermography, and more. Such comparisons would improve our mechanistic understanding of ecosystem water flux and provide the observations necessary to validate remote sensing algorithms and land surface models to understand the changing global water cycle.
Publisher: Wiley
Date: 07-03-2019
DOI: 10.1111/INR.12505
Abstract: This study explored self-management practices in relation to traditional methods for managing illness in newborns and infants and the implications of these practices on infant health. Self-medication with folk remedies is believed to have short- and long-term impacts on well-being. Little is known about how mothers in Arab societies used their traditional beliefs and practices in self-managing their newborns' and infants' health. Data were collected from five focus groups using open-ended questions with 37 mothers. Participants were selected using snowball s ling and were recruited from four different cities in Jordan between June 2016 and August 2016. All identifying information regarding the study participants has been omitted, and this study was approved by the Academic Research Committee at the University of Jordan. Mothers were more willing to try herbal remedies, traditional massage and certain foods to self-manage their infants' health. Folk remedies were not restricted to traditions handed down through generations, but included a representation of newly emerged trends towards 'safety' or 'nature'. While the use of folk remedies have been handed down generations as customs, today, virtual support groups and social media provide modern resources for folk remedies' promotion in care and self-management. Nursing and health policymakers can use our findings for planning and developing strategies and health policies that increase public awareness about adverse health effects associated with herbal remedies. Such strategies are likely to be facilitated through partnerships between nursing and midwifery education institutions, antenatal clinics and social media in the region.
Publisher: Elsevier BV
Date: 07-2023
Publisher: Springer Science and Business Media LLC
Date: 11-10-2022
Publisher: AOSIS
Date: 20-11-2013
Abstract: Critical-care nurses often look after three or more critically-ill patients during a shift. The workload and emotional stress can lead to disharmony between the nurse’s body, mind and spirit. Nurses with a high emotional intelligence have less emotional exhaustion and psychosomatic symptoms they enjoy better emotional health gain more satisfaction from their actions (both at work and at home) and have improved relationships with colleagues at work. The question arises: what is the emotional intelligence of critical-care nurses? A quantitative survey was conducted. The target population was registered nurses working in critical-care units who attended the Critical Care Congress 2009 (N = 380). Data were collected with the use of the Trait Emotional Intelligence Short Form and analysed using the Statistical Package for the Social Sciences software. The s le (n = 220) was mainly a mature, female and professionally-experienced group of registered nurses. They held a variety of job descriptions within various critical-care units. Statistics indicated that the standard deviations were small and no aberrant aspects such as demographics skewed the findings. The conclusion was made that registered nurses who are older and that have more experience in critical care appear to have a higher range of emotional intelligence.Kritiekesorg-verpleegkundiges verpleeg dikwels drie of meer pasiënte wat kritiek siek is, tydens een skof. Die werkslading kan tot emosionele spanning ly wat ’n wanbalans tussen die liggaam, siel en gees van die verpleegkundiges laat ontstaan. Verpleekundiges met ’n hoë emosionele intelligensie ondervind minder emosionele uitbranding en psigosomatiese symptome. Hulle toon ’n beter emosionele gesondheid, ervaar meer werks- en tuisbevrediging en het beter verhoudings met hulle kollegas. The vraag wat ontstaan is ‘wat is die emosionel intelligensie van kritieksorg-verpleegkundiges?’ Die toeganglike populasie (N = 380) was geregistreerde verpleegkundiges wat tans in die kritiek sorgeenhede werksaam was en die Critical Care Congress in 2009 bygewoon het. Die data is deur die gebruikmaking van die ‘Trait Emotional Intelligence Short Form’ vraelys ingesamel. Die data is statisties met behulp van die SPSS ontleed. Die populasie (n = 220) was hoofsaaklik n groepe volwasse, vroulike en professioneel ervare verpleegkundiges. Hulle het ’n verskeidenheid van posbeskrywing in die kritieke-sorgeenhede beklee. Die statistieke het ’n minimale standaardafwyking aangetoon. Die gevolgtrekking van die studie is dat geregistreede verpleegkundiges wat ouer en meer ervaring in kritieke sorgverpleging het, ’n hoër vlak van emosionele intelligensie het.
Publisher: IOP Publishing
Date: 10-2008
Publisher: Wiley
Date: 27-08-2019
DOI: 10.1111/INM.12645
Abstract: To examine risk assessment tools to predict patient violence in acute care settings. An integrative review of the literature. Five electronic databases - CINAHL Plus, MEDLINE, OVID, PsycINFO, and Web of Science were searched between 2000 and 2018. The reference list of articles was also inspected manually. The PICOS framework was used to refine the inclusion and exclusion of the literature, and the PRISMA statement guided the search strategy to systematically present findings. Forty-one studies were retained for review. Three studies developed or tested tools to measure patient violence in general acute care settings, and two described the primary and secondary development of tools in emergency departments. The remaining studies reported on risk assessment tools that were developed or tested in psychiatric inpatient settings. In total, 16 violence risk assessment tools were identified. Thirteen of them were developed to assess the risk of violence in psychiatric patients. Two of them were found to be accurate and reliable to predict violence in acute psychiatric facilities and have practical utility for general acute care settings. Two assessment tools were developed and administered in general acute care, and one was developed to predict patient violence in emergency departments. There is no single, user-friendly, standardized evidence-based tool available for predicting violence in general acute care hospitals. Some were found to be accurate in assessing violence in psychiatric inpatients and have potential for use in general acute care, require further testing to assess their validity and reliability.
Publisher: Wiley
Date: 21-03-2023
DOI: 10.1111/IJN.13149
Abstract: This work aims to explore staff perceptions of (1) the effectiveness of organizational communication during the COVID‐19 pandemic and (2) the impact of organizational communication on staff well‐being and ability to progress their work and patient care. Effective coordination and communication are essential in a pandemic management response. However, the effectiveness of communication strategies used during the COVID‐19 pandemic is not well understood. An exploratory cross‐sectional research design was used. A 33‐item survey tool was created for the study. The study was conducted at a tertiary teaching hospital in Western Australia. Convenience s ling was used to recruit participants from nursing, medical, allied health services, administrative and clerical, and personal support services ( N = 325). Data were collected between December 2020 and May 2021. Overall, all occupational groups found working during the COVID‐19 pandemic stressful, and all groups wanted accessible and accurate communication from management and new policies, procedures, and protocols for future outbreaks. The use of occupational group‐relevant strategies and COVID‐19 protocols, as well as the on‐going use of email, face‐to‐face meetings with debrief sessions, are needed to improve communication and support staff to fulfil their roles.
Publisher: Wiley
Date: 10-03-2015
DOI: 10.1111/INM.12126
Abstract: Historically, mental health services have faced challenges in their ability to attract and retain a competent nursing workforce in the context of an overall nursing shortage. The current economic downturn has provided some respite however, this is likely to be a temporary reprieve, with significant nursing shortages predicted for the future. Mental health services need to develop strategies to become more competitive if they are to attract and retain skilled nurses and avoid future shortages. Research demonstrates that creating and maintaining a positive nursing practice environment is one such strategy and an important area to consider when addressing nurse retention. This paper examines the impact the nursing practice environment has on nurse retention within the general and mental health settings. Findings indicate, that while there is a wealth of evidence to support the importance of a positive practice environment on nurse retention in the broader health system, there is little evidence specific to mental health. Further research of the mental health practice environment is required.
Publisher: Springer Science and Business Media LLC
Date: 19-10-2021
DOI: 10.1186/S12912-021-00692-2
Abstract: Delirium is more prevalent in older people and estimated to occur in up to 50% of the hospital population. Delirium comprises a spectrum of behaviours, including cognitive and attention deficits, and fluctuating levels of consciousness, often associated with an underlying physiological disturbance. Delirium has been increasingly associated with adverse outcomes. Although often preventable or can at least be mitigated, delirium may not be a standard part of assessment and thus may not be recognized in the early stages when it is most likely to be treated successfully. The aim of this study was to evaluate the level of knowledge of delirium amongst clinicians caring for patients at high risk of developing delirium and to determine whether education can improve clinical assessment of delirium. Two hundred and forty-six case notes were audited before and 149 were reviewed after the education intervention and implementation of a delirium screening tool. Clinicians at the hospital were invited to complete a questionnaire on knowledge of delirium. The questionnaire was based on a validated tool which contained 39 questions about delirium. The questionnaire also contained 28 questions on delirium knowledge. Additional questions were included to gather demographic information specific to the hospital. Descriptive statistics, chi square and independent t-tests were conducted to test for differences in knowledge between the pre and post periods. The Squire Checklist Reporting Guidelines for Quality Improvement Studies informed the preparation of the manuscript. The audit demonstrated that the use of a cognitive assessment tool overall increased from 8.5% in pre education to 43% in the post education period. One hundred and fifty-nine staff completed the questionnaire in total, 118 the pre and 41 post. The knowledge subscale score was high pre and post education and no statistically significant difference was observed. The greatest increase in knowledge was related to knowledge of the risk factors subscale. The increase in knowledge (6.8%) was statistically significant. An interprofessional approach to delirium education was effective in not only increasing awareness of the factors associated with this syndrome but also increased the use of a delirium assessment tool.
Publisher: Wiley
Date: 30-05-2022
DOI: 10.1002/HYP.14580
Abstract: Accurate simulation of plant water use across agricultural ecosystems is essential for various applications, including precision agriculture, quantifying groundwater recharge, and optimizing irrigation rates. Previous approaches to integrating plant water use data into hydrologic models have relied on evapotranspiration ( ET ) observations. Recently, the flux variance similarity approach has been developed to partition ET to transpiration ( T ) and evaporation, providing an opportunity to use T data to parameterize models. To explore the value of T / ET data in improving hydrologic model performance, we examined multiple approaches to incorporate these observations for vegetation parameterization. We used ET observations from five eddy covariance towers located in the irrigated San Joaquin Valley, California, to parameterize orchard crops in an integrated land surface—groundwater model. By using ET , or both ET and T data, we examined the impact of multiple model parameterization approaches ranging from simple performance metrics to the generalized likelihood uncertainty estimation method. We find that a simple approach of selecting the parameter sets based on ET and T performance metrics works best at these study sites. Selecting parameters based on performance relative to observed ET creates an uncertainty of 27% relative to the observed value. When parameters are selected using both T and ET data, this uncertainty drops to 24%. Similarly, the uncertainty in potential groundwater recharge drops from 63% to 58% when parameters are selected with ET or T and ET data, respectively. While these improvements are minor in an irrigated setting, the value of partitioning ET data may be more useful in non‐irrigated settings. Additionally, using crop type parameters results in similar levels of simulated ET as using site‐specific parameters. Different irrigation schemes create high amounts of uncertainty and highlight the need for accurate estimates of irrigation when performing water budget studies.
Publisher: Elsevier BV
Date: 02-2020
DOI: 10.1016/J.NEPR.2020.102697
Abstract: It is important to evaluate stakeholder feedback regarding any change to a clinical supervision model to maintain quality. The Quality Practical Experience (QPE) instruments offer both the nurse on the ward involved with supervising student learning and the student nurse the opportunity to evaluate their satisfaction with the supervision model. This paper reports on the evaluation of the construct validity and the reliability of the QPE instruments measuring nurse and nursing student satisfaction with the clinical supervision model. Methodological design for the reliability and validation of a measuring instrument. The nurse and the student QPE instruments were tested with convenience s les of 488 nurses and 1116 student nurses, respectively. Psychometric tests included internal reliability, test-retest reliability and factor analyses. Exploratory factor analysis for both QPEs supported a three-factor solution the nurse QPE explained 48% and student nurse QPE 45% of variance. Internal reliability and test-retest reliability were stable over time (nurse QPE ICC = 0.82 student nurse QPE ICC = 0.71). Both QPE instruments were found to be valid and reliable. Feedback from all stakeholders involved with supporting student nurses during clinical placement is important.
Publisher: Elsevier BV
Date: 05-2017
DOI: 10.1016/J.MIDW.2017.03.002
Abstract: to critically appraise the available literature and summarise the evidence relating to adolescent mothers' use of social networking sites in terms of any social support and social capital they may provide and to identify areas for future exploration. social networking sites have been demonstrated to provide social support to marginalised in iduals and provide psycho-social benefits to members of such groups. Adolescent mothers are at risk of social marginalisation anxiety disorders and depressive symptoms and poorer health and educational outcomes for their children. Social support has been shown to benefit adolescent mothers thus online mechanisms require consideration. a review of original research articles METHOD: key terms and Boolean operators identified research reports across a 20-year timeframe pertaining to the area of enquiry in: CINAHL, Cochrane Library, Medline, Scopus, ERIC, ProQuest, PsychINFO, Web of Science, Health Collection (Informit) and Google Scholar databases. Eight original research articles met the inclusion criteria for this review. studies demonstrate that adolescent mothers actively search for health information using the Internet and social networking sites, and that social support and social capital can be attributed to their use of specifically created online groups from within targeted health interventions. Use of a message board forum for pregnant and parenting adolescents also demonstrates elements of social support. There are no studies to date pertaining to adolescent mothers' use of globally accessible social networking sites in terms of social support provision and related outcomes. further investigation is warranted to explore the potential benefits of adolescent mothers' use of globally accessible social networking sites in terms of any social support provision and social capital they may provide.
Publisher: Wiley
Date: 08-01-2016
DOI: 10.1111/INM.12187
Abstract: The nursing practice environment is an important factor for services to consider in the attraction and retention of a skilled workforce during future nursing shortages. Despite the significant number of international studies undertaken to understand the influence of the practice environment on nurse satisfaction and retention, few have been undertaken within the mental health setting. This paper reports on results from a survey conducted in a large Australian public mental health hospital to examine nurses' perceptions of their practice environment, and identifies interventions that could be implemented to improve the practice environment. The hospital is the only remaining, standalone public mental health hospital in Western Australia.
Publisher: AOSIS
Date: 06-2015
Publisher: Springer Science and Business Media LLC
Date: 08-08-2022
DOI: 10.1186/S12879-022-07649-Z
Abstract: Interventions aimed at reducing risky sexual behavior are considered an important strategy for averting Human Immunodeficiency Virus (HIV) infection among youth (15–24 years) who continue to be at risk of the disease. Enhancing intervention success requires a comprehensive understanding of the barriers and facilitators to interventions targeting youth. However, there is lack of a systematic review of both quantitative and qualitative studies to comprehensively identify and synthesize barriers and facilitators to HIV prevention interventions for reducing risky sexual behavior among youth worldwide. This review aimed to identify and synthesize barriers and facilitators to HIV prevention interventions for reducing risky sexual behavior among youth globally based on original peer-reviewed studies published in the last decade. The Joanna Briggs Institute approach for mixed methods systematic reviews and Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines were used to guide this review. Nine electronic databases, Joint United Nations Programme on HIV/AIDS and World Health Organization websites, and reference lists of included studies and systematic reviews on barriers and facilitators to HIV prevention interventions for reducing risky sexual behavior among youth were searched for eligible articles. Studies that met the inclusion criteria underwent quality appraisal and data extraction. Findings were analyzed using thematic synthesis and underpinned by Nilsen, 2015’s Determinant Framework. Overall 13 studies comprising of eight qualitative studies, four quantitative studies and one mixed methods study were included in the review. Several barriers and facilitators across the five Determinant Framework domains were identified. Most of the barriers fell under the characteristics of the context domain (e.g., gender-biased norms). The next important group of barriers emerged within the characteristics of the end users domain (e.g., fear of relationship breakdown). In terms of facilitators, the majority fell under the characteristics of the strategy of facilitating implementation domain (e.g., implementation of intervention with fidelity) and characteristics of the end users domain (e.g., fear of pregnancy or sexually transmitted infections). The next common set of facilitators appeared within the characteristics of the context domain (e.g., family support). This review identified several multi-level barriers and facilitators to HIV prevention interventions for reducing risky sexual behavior among youth. Multi-level and combination approaches are needed to address these factors and enhance intervention success.
Publisher: Springer Science and Business Media LLC
Date: 25-04-2022
DOI: 10.1186/S12877-022-02978-9
Abstract: Adults who experience homelessness for an extended period of time also experience accelerated ageing and other negative impacts on their general health and wellbeing. Homelessness amongst older adults is on the rise, yet there are few systematic reviews investigating their experiences. Thus, this review classifies and synthesises qualitative research findings of studies published between 1990 to 2020 that have examined the needs and challenges of homeless older adults to elucidate their journey of homelessness. Seven papers met the requirements for inclusion. Three main themes were identified in the review: - (1) Pathways to homelessness, (2) Impact of homelessness, and (3) Outcomes and resolutions. This review collates current evidence on what is known about the experience of homelessness among older adults. In this study, homeless older adults identified a wide range of challenges associated with the experience of homelessness.
Publisher: Elsevier BV
Date: 10-2022
DOI: 10.1016/J.ACTPSY.2022.103757
Abstract: Interventions focused on promoting resilience or protective factors of youth have been proposed as a strategy for reducing risky behaviours associated with HIV infection among youth however few studies have explored their effectiveness. This study assessed the impact of a resilience-based HIV prevention intervention (You Only Live Once) on risky sexual behaviours, resilience and protective factors of youth. A one-group pretest-posttest design was used. One hundred and ninety-seven youth aged 15-24 years were conveniently recruited from a non-profit organisation in Maluti-a-Phofung Local Municipality, South Africa and participated in a 12-session, resilience-based HIV intervention delivered over a 1-week period by trained adult facilitators. Outcomes of interest were assessed at baseline and 3-month follow-up using validated risky sexual behaviour measures, and Child and Youth Resilience Measure. Mixed effect logistic and linear regression models were formulated to assess the impact of the intervention on risky sexual behaviours resilience and protective factors respectively. Compared to baseline, participants at 3-month follow-up were 68 % less likely to have unprotected sex, 22 % less likely to regret their decision to engage in sexual activity and 0.4 % less likely to be pregnant or made someone pregnant. Conversely, participants at the 3-month follow-up had a higher propensity to engage in multiple sexual partnerships, transactional sex and intergenerational sex than baseline. Participants at 3-month follow-up had significant improvements in their scores of resilience, in idual capacities and contextual factors that facilitate a sense of belonging (p < 0.05). You Only Live Once intervention appeared to have mitigated some risky sexual behaviours, and improved resilience and protective factors over a 3-month period. These findings suggest that the intervention has ability to reduce risky sexual behaviours associated with HIV, and improve resilience and protective factors among youth in South Africa. Further evaluation of the intervention with a rigorous study design, larger s le size and longer period for follow-up is warranted.
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: 30-03-2018
DOI: 10.1111/JOCN.14309
Abstract: To measure the prevalence of symptomatic (S-IDH) and asymptomatic intradialytic hypotension (A-IDH) or postdialysis overhydration in a satellite haemodialysis clinic in Western Australia. Intradialytic hypotension is one of the most common side effects of haemodialysis caused by ultrafiltration provoking a temporary volume depletion. The prevalence of asymptomatic hypotension during dialysis has been rarely reported, but is considered to have the same negative consequences as symptomatic hypotension on various end organs like the brain and the gastrointestinal tract. Observational study on a retrospective 3-month period of nursing recorded fluid-related adverse events. Data collection on the occurrence of S-IDH and A-IDH during a total of 2,357 haemodialysis treatments in 64 patients. Body weight of patients at the time of cessation of treatment was recorded, and patients, whose weight exceeded their ideal body weight by at least 0.5 kg, were classified as overhydrated. Data analysis was performed using spss version 24 software. Symptomatic intradialytic hypotension was the most common adverse event measured in this cohort, and occurred during 221 (9.4%) of all treatments, whereas asymptomatic intradialytic hypotension occurred in 88 (3.7%) of all treatments. The total occurrence of intradialytic hypotension was 13.1%, and symptomatic was observed in 30 patients, implying that nearly every second patient had at least one symptomatic episode within 3 months. Overhydration occurred in a total of 103 (4.4%) of all treatments, and involved 17 patients. Symptomatic and asymptomatic intradialytic hypotension were the most commonly observed adverse events in this cohort overhydration occurrence was considerably less common. The high occurrence of hypotension-related events demonstrates that ultrafiltration treatment goals in satellite dialysis clinics are sometimes overestimated, resulting in regular significant symptomatic episodes for the patient. Raising the awareness of the prevalence of IDH amongst renal nurses could be an essential initial step before collectively preventative strategies in haemodialysis satellite units are implemented.
Publisher: Wiley
Date: 28-02-2019
DOI: 10.1111/JOCN.14804
Abstract: To evaluate the accuracy of traditional clinical predialytic fluid assessment by renal nurses and the efficacy of 2 additional fluid assessment methods focussing on the potential preventative effect for intradialytic hypotension (IDH). Predialytic fluid assessment remains a daily challenge for renal nurses, when aiming for adverse event free haemodialysis treatments. Adding further objective parameters obtained through noninvasive methods into pre- and intradialytic fluid assessment could potentially improve health outcomes for haemodialysis patients. Comparative, observational study of three fluid assessment methods on their reliability on volume status and correlation to clinical outcomes. Clinical predialytic nursing fluid assessments in 30 haemodialysis patients were compared with additional initial bioimpedance spectroscopy (BIS) measurements, and 3 serial intradialytic ultrasound scans of the inferior vena cava (IVC-US) performed by a second renal nurse concurrently during the same session. A retrospective data analysis compared all measurements in each in idual for the predictive value for IDH. A STROBE checklist for observational cohort studies was used for the reporting of results. Seven subjects experienced episodes of symptomatic intradialytic hypotension (S-IDH), which would have been anticipated by IVC-US or by BIS in 5 patients (71%). Using an algorithm to predict IDH would have provided a sensitivity of 100% and specificity of 95%. Both additional fluid assessment methods would have provided critical information before and during each haemodialysis session. Therefore, we consider them as being potentially effective for the prevention of intradialytic hypotension, with IVC-US being similar to BIS. Traditional clinical nursing fluid assessment methods in haemodialysis patients do not provide sufficient information to prevent episodes of IDH. Additional objective fluid assessment methods are useful and likely to lead to improved health outcomes in HD patients when applied by renal nurses. A combination of IVC-US, MAP and BIS has potential to reduce the risk of IDH events in HD patients significantly.
Publisher: Copernicus GmbH
Date: 10-2019
Abstract: Abstract. Evaporation (E) and transpiration (T) respond differently to ongoing changes in climate, atmospheric composition, and land use. It is difficult to partition ecosystem-scale evapotranspiration (ET) measurements into E and T, which makes it difficult to validate satellite data and land surface models. Here, we review current progress in partitioning E and T and provide a prospectus for how to improve theory and observations going forward. Recent advancements in analytical techniques create new opportunities for partitioning E and T at the ecosystem scale, but their assumptions have yet to be fully tested. For ex le, many approaches to partition E and T rely on the notion that plant canopy conductance and ecosystem water use efficiency exhibit optimal responses to atmospheric vapor pressure deficit (D). We use observations from 240 eddy covariance flux towers to demonstrate that optimal ecosystem response to D is a reasonable assumption, in agreement with recent studies, but more analysis is necessary to determine the conditions for which this assumption holds. Another critical assumption for many partitioning approaches is that ET can be approximated as T during ideal transpiring conditions, which has been challenged by observational studies. We demonstrate that T can exceed 95 % of ET from certain ecosystems, but other ecosystems do not appear to reach this value, which suggests that this assumption is ecosystem-dependent with implications for partitioning. It is important to further improve approaches for partitioning E and T, yet few multi-method comparisons have been undertaken to date. Advances in our understanding of carbon–water coupling at the stomatal, leaf, and canopy level open new perspectives on how to quantify T via its strong coupling with photosynthesis. Photosynthesis can be constrained at the ecosystem and global scales with emerging data sources including solar-induced fluorescence, carbonyl sulfide flux measurements, thermography, and more. Such comparisons would improve our mechanistic understanding of ecosystem water fluxes and provide the observations necessary to validate remote sensing algorithms and land surface models to understand the changing global water cycle.
Publisher: National Inquiry Services Center (NISC)
Date: 04-08-2023
Publisher: Informa UK Limited
Date: 07-10-2020
Publisher: Elsevier BV
Date: 08-2023
Publisher: Wiley
Date: 11-10-2018
DOI: 10.1111/HDI.12606
Abstract: Ultrasound of the inferior vena cava (IVC-US) has been used to estimate intravascular volume status and fluid removal during a hemodialysis session. Usually, renal nurses rely on other, imprecise methods to determine ultrafiltration. To date, no study has examined whether renal nurses can reliably perform ultrasound for volume assessment and for potential prevention of intradialytic hypotension. This pilot study aimed to determine if a renal nurse could master the skill of performing and correctly interpreting Point of Care Ultrasound on patients receiving hemodialysis. After receiving theoretical training and performing 100 training scans, a renal nurse performed 60 ultrasound scans on 10 patients. These were categorized by the nurse into hypovolemic, euvolemic, or hypervolemic through measurement of the maximal diameter and degree of collapse of the IVC. Scans were subsequently assessed for adequacy and quality by two sonologists, who were blinded to each other's and the nurse's results. The interrater reliability of 60 scans was good, with intraclass correlation 0.79 (95% confidence interval (CI) =0.63-0.87) and with a good interrater agreement for the following estimation of intravascular volume (Cohen's weighted Kappa κ A renal nurse can reliably perform ultrasound of the IVC in hemodialysis patients, obtaining high quality scans for volume assessment of hemodialysis patients. This novel approach could be more routinely applied by other renal nurses to obtain objective measures of patient volume status in the dialysis setting.
Publisher: American Geophysical Union (AGU)
Date: 04-2020
DOI: 10.1029/2019WR026058
Abstract: The ECOsystem Spaceborne Thermal Radiometer Experiment on Space Station (ECOSTRESS) was launched to the International Space Station on 29 June 2018 by the National Aeronautics and Space Administration (NASA). The primary science focus of ECOSTRESS is centered on evapotranspiration (ET), which is produced as Level‐3 (L3) latent heat flux ( LE ) data products. These data are generated from the Level‐2 land surface temperature and emissivity product (L2_LSTE), in conjunction with ancillary surface and atmospheric data. Here, we provide the first validation (Stage 1, preliminary) of the global ECOSTRESS clear‐sky ET product (L3_ET_PT‐JPL, Version 6.0) against LE measurements at 82 eddy covariance sites around the world. Overall, the ECOSTRESS ET product performs well against the site measurements (clear‐sky instantaneous/time of overpass: r 2 = 0.88 overall bias = 8% normalized root‐mean‐square error, RMSE = 6%). ET uncertainty was generally consistent across climate zones, biome types, and times of day (ECOSTRESS s les the diurnal cycle), though temperate sites are overrepresented. The 70‐m‐high spatial resolution of ECOSTRESS improved correlations by 85%, and RMSE by 62%, relative to 1‐km pixels. This paper serves as a reference for the ECOSTRESS L3 ET accuracy and Stage 1 validation status for subsequent science that follows using these data.
Publisher: Wiley
Date: 08-06-2010
DOI: 10.1890/090179
Publisher: Wiley
Date: 02-06-2017
DOI: 10.1111/JAN.13330
Abstract: To compare acute hospital length of stay and cost-savings for patients with hip fracture before and after commencement of the Orthopaedic Nurse Practitioner and identify variables that increase length of stay in hospital. Globally, hip fractures are associated with significant morbidity and mortality. Whilst the practical benefits of the Orthopaedic Nurse Practitioner have been anecdotally shown, an analysis showing the cost-saving benefits has yet to be published. A retrospective cohort study. Data from two population-based cohorts (2010, 2013) of hip fracture patients aged ≥65 years were extracted from the electronic hospital database at a large Western Australian tertiary metropolitan hospital. Multivariate linear regression was used to model factors affecting length of stay in hospital. A simple economic analysis was undertaken and cost-savings were estimated. For comparison (n = 354) and intervention (n = 301) groups, average age was 84 years and over 70% were female. Analyses showed length of stay was shorter in 2013 compared with 2010 (4.4-5.3 days). Shorter length of stay was associated with type of procedure and surgery within 24-hr and longer length of stay was associated with co-morbid conditions of pulmonary disease, congestive heart failure, dementia, anaemia on admission and complications of delirium, urinary tract infection, myocardial infarction and pneumonia. The cost-savings to the hospital over one year was $354,483 and the net annual cost-savings per patient was $1,178. Implementation of the Orthopaedic Nurse Practitioner role for care of hip fracture patients can reduce acute hospital length of stay resulting in important cost-savings.
Publisher: Elsevier BV
Date: 10-2021
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 09-2020
DOI: 10.1097/WON.0000000000000674
Abstract: Determine the prevalence of foot problems in an inpatient population and to describe demographic data, comorbid conditions, and type of footwear worn. Observational point-prevalence cross-sectional design. The study setting was a 722-bed licensed hospital in Western Australia. A convenience s ling was used to include adults hospitalized in the study setting during the period of data collection. A subset of foot questions, guided by a literature review, and input from foot, wound, diabetes, and psychometric researchers and clinicians, was incorporated into the hospital point-prevalence survey conducted annually for nursing safety and quality. Trained nurses collected data during the 1-day survey. Data were analyzed using descriptive statistics and 2-tailed tests associations between study variables were analyzed. Two hundred twenty-one patients participated in the survey a majority (n = 193, 87%) self-reported at least 1 foot problem. More than half (n = 124) reported 3 foot problems and nearly one-third (n = 67) had 5 or more foot problems. Thick nails, damaged nails, and calluses and corns were the most frequently occurring foot problems. Older participants were more likely to have certain foot problems such as calluses and thick nails. Eleven (5%) participants were admitted to the hospital for a foot-related condition. The majority of foot problems in our study were found to be minor and not the primary admitting diagnosis. However, even minor foot problems can pose a risk of worsening, especially in high-risk populations such as those with diabetes. Thus, detection is critical in overall patient assessment, and nurses play a critical role in assessment and management of minor foot problems through the delivery of skin and nail care and through collaboration with other professionals who provide specialized foot care.
Publisher: Wiley
Date: 25-01-2017
DOI: 10.1111/JORC.12191
Abstract: In Western Australia (WA), most stable patients undergoing haemodialysis receive treatment in a satellite setting where no doctors are on-site during treatment hours, so nurses must make critical decisions about fluid removal. Some patients regularly experience adverse events during dialysis (intradialytic), often due to excessive ultrafiltration goals, with intradialytic hypotension being particularly challenging. Ultrasound of the inferior vena cava has been previously demonstrated being a rapid and non-invasive method for volume assessment on haemodialysis patients, thus could hold valuable information for the treating nurse. This paper examines the existing literature in regards to the use of ultrasound measurements of the inferior vena cava in patients on haemodialysis for objective assessment of their intravascular volume status by renal nurses. A systematic literature review was performed within medical and nursing databases including CINAHL Plus with Full Text, SCOPUS, Web of Science and MEDLINE. Renal nurses are conscious of the significance of intradialytic hypotension and have only limited options for its prevention. Ultrasound of the inferior vena cava could add another objective dimension for intravascular volume assessment and prevention of intradialytic hypotension, but to date renal nurses have not been using this technique. Ultrasound of the inferior vena cava has the potential to assist in defining the ultrafiltration goal for that particular dialysis session, thus reducing the risk of intradialytic hypotension. Additionally, it has potential to change current renal nursing practice when added to clinical nursing assessment methods. Further studies are required to validate this assessment tool carried out by a renal nurse compared with a skilled ultrasonographer.
Publisher: Research Square Platform LLC
Date: 24-01-2023
DOI: 10.21203/RS.3.RS-2392849/V3
Abstract: Background: Youth (15-24 years) in South Africa remain at high risk of HIV infection despite interventional efforts to control the disease. Programs directed at promoting resilience or protective factors in youth have been recommended as a multifaceted approach to mitigate risky sexual behaviors associated with HIV infection among youth. However, limited research exists on how relevant stakeholders, such as youth and intervention implementers perceive resilience-based HIV prevention interventions targeting youth. This study explored youth and intervention implementers’ perceptions of a resilience-based HIV prevention intervention ( You Only Live Once ) aimed at reducing risky sexual behaviors among youth in South Africa. Methods: Semi-structured interviews were conducted with 10 youth who participated in the intervention and four intervention implementers at a not-for-profit organization in Maluti-a-Phofung Local Municipality, South Africa. Data were analyzed using thematic analysis. Results: Three main themes emerged from the data: (1) Acceptability and impact of the intervention – the intervention was perceived as important and helpful in fostering positive behavior change among youth and enhancing their sexual health and social skills knowledge self-confidence and relationships with parents and peers. (2) Factors influencing intervention implementation – participants reported several multi-level factors which impeded or promoted the implementation of the intervention. (3) Recommendations to improve intervention implementation – participants made suggestions on how intervention implementation could be enhanced. Conclusion: These findings provide insights into youth and intervention implementers’ perceptions about the acceptability, impact and barriers and facilitators of resilience-based HIV prevention interventions for youth in South Africa and similar contexts. The findings can help researchers, policy makers and healthcare practitioners in the field of HIV prevention to improve interventions targeting young people.
Publisher: Elsevier BV
Date: 09-2015
DOI: 10.1016/J.MIDW.2015.05.002
Abstract: to explore the use of social networking sites (SNS) by adolescent mothers in Western Australia (WA) in relation to social support and the building of social capital. a constructionist narrative inquiry approach was employed to guide the research design and processes. Approval was gained from the university human ethics department. S ling was purposeful and data were collected using in-depth interviews with seven adolescent mothers in WA. interviews were undertaken within the homes of adolescent mothers across WA. from within three fundamental domains of social support tangible, emotional and informational support, provided by SNS use, five key themes were identified from the narratives. 'Social connectedness' was identified as a form of tangible support, sometimes termed 'practical' or 'instrumental' support. This theme incorporates connectedness with family, friends, and peers and across new and existing social groups. Three themes were identified that relate to emotional support 'increased parenting confidence' 'reduced parental stress' and 'enhanced self-disclosure' afforded by use of SNS. 'Access to information' was identified in terms of informational support, with participants often highlighting SNS use as their primary portal for information and advice. the findings of this study suggest that SNS use affords adolescent mothers in WA access to tangible, informational and emotional support and thus is a valuable source of social capital for these mothers. This study provides a platform for further exploration into this phenomenon, and possible implications include the potential for midwives and health care professionals to promote the benefits of SNS use with, and for, this group of mothers, or to incorporate SNS use into modern health care practices to further develop the potential for improved social capital related outcomes for them.
Publisher: AOSIS
Date: 25-02-2016
DOI: 10.4102/CURATIONIS.V39I1.1606
Abstract: Background: Critical care is described as complex, detailed healthcare in a unique, technologically rich environment. Critical care nursing requires a strong knowledge base and exceptional clinical and technological skills to cope in this demanding environment. Many registered nurses (RNs) commencing work in these areas may lack resilience, and because of the stress of the critical care environment, coping mechanisms need to be developed. To prevent burnout and to enable critical care nurses to function holistically, emotional intelligence (EI) is essential in the development of such coping mechanisms.Objective: The aim of this study was to describe the EI of RNs commencing work in critical care units in a private hospital group in Gauteng, South Africa.Method: The design used for this study was a quantitative descriptive survey. The target population were RNs commencing work in critical care units. Data were collected from RNs using the Trait Emotional Intelligence Questionnaire – Short Form and analysed using the Statistical Package for the Social Sciences software.Results: The s le (n = 30) had a mean age of 32 years. Most of the participants (63%) qualified through the completion of a bridging course between 2010 and 2012. The majority (62%) of the s le had less than 2 years’ experience as RNs.Conclusion: The EI of RNs commencing work in a critical care environment was indicative of a higher range of Global EI, with the well-being factor scoring the highest, followed by the emotionality factor, then self-control, with the sociability factor scoring the lowest.
Publisher: Springer Science and Business Media LLC
Date: 31-05-2019
Publisher: SAGE Publications
Date: 2021
DOI: 10.1177/16094069211028345
Abstract: This paper considers the effectiveness of narrative inquiry as a research method in collecting and analyzing stories from a purposive s le of intensive care nurses and doctors, regarding their perceptions of the factors that influence decision-making in relation to the withdrawal of life sustaining treatment. Delaying the withdrawal of treatment when it is clearly indicated, may result in unnecessary patient suffering at the end of life, distress for the family as well as moral distress for staff. In narrative inquiry participants’ first-hand accounts of their experiences are told through story the focus of analysis is the story, with the story becoming the object of investigation. Initially, participants’ stories were restoried to produce narratives that were co-constructed between researcher and participant. Narrative analysis, employing McCormack’s lenses and the interconnected analytical lenses, facilitated vertical analysis of each narrative. Horizontal analysis through thematic analysis facilitated the derivation of themes that were consistent within or across narratives. We detail here how narrative inquiry methodology was effective in revealing the meaning participants gave to their decision-making experiences through story, offering a broader understanding of the factors that impact on decision-making regarding the withdrawal of life-sustaining treatment. The study’s findings were powerful, derived from narratives rich and thick in description, depicting a multi-dimensional interpretation of the participants’ perceptions of their decision-making experiences. Participants experienced transformative learning through the narrative process, which led to changes in ways of working in the study setting. Recommendations arose to enhance clinical practice and education in this vital area of practice as a result of this study. The application of narrative inquiry enabled the discovery of significant findings as an avenue to challenge legislation and current opinion regarding the autonomy and role of the family in decision-making.
Location: United States of America
No related grants have been discovered for Amanda Towell-Barnard.