ORCID Profile
0000-0002-8846-5827
Current Organisations
La Trobe University
,
Deakin University - Melbourne Burwood Campus
,
College of Emergency Nursing Australasia (CENA)
,
Alfred Health
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Publisher: Elsevier BV
Date: 03-2017
Publisher: Elsevier BV
Date: 11-2018
DOI: 10.1016/J.IENJ.2018.05.006
Abstract: Postgraduate emergency nursing studies strengthen the emergency nursing workforce and contribute to specialist patient care. Formative and summative assessments in postgraduate study are important for student learning as they enable self-reflection and feedback. To compare formative and summative appraisal assessments between postgraduate emergency nursing students and nurse educators. Retrospective review of assessments completed by postgraduate student and educator in the final multi-system complex subject of the postgraduate emergency nursing course during 2015. Data were extracted from university records. Data for the two appraisal periods were compared using chisquare test of independence. Data from 52 emergency nursing students and 16 educators were extracted. Significant differences were detected between most student and educator ratings for both assessment appraisals. The lowest self-ratings of independence for students and educators at the summative assessment were for the provision and coordination of patient care and critical analysis of research evidence. Educators did agree that students were performing independently on domains relating to legal, professional and ethical frameworks. Postgraduate emergency nursing study is important for the emergency nursing workforce. Examining student learning and educator assessment in this context enables a broader understanding of student learning and transition to emergency nursing speciality practice.
Publisher: Elsevier BV
Date: 08-2017
DOI: 10.1016/J.AENJ.2017.05.002
Abstract: Emergency nurses working in non-Major Trauma Service (non-MTS) facilities face the challenge of providing immediate care to seriously injured patients, despite infrequent presentations at their workplace. A one-day education programme endorsed by the Australian College of Nursing was developed to provide contemporary trauma education for nurses. The aim of this study was to report participants' perceptions of their experience of this programme. Peer reviewed lesson plans were developed to guide educational activities. Of 32 participants, 24 consented to and completed pre and post-programme surveys. Thematic analysis and descriptive statistics were used to report study findings. Most participants were nurses with greater than two years' experience in Emergency Nursing (92%). Trauma patient transfers each year from a non-MTS to a Major Trauma Service occurred infrequently eight nurses (33.3%) reported greater than10 trauma transfers per year. Participant expectations of the programme included personal growth, knowledge acquisition, increased confidence and a focus on technical skills. Participants reported the day to be worthwhile and valuable improved confidence, increased knowledge, and the opportunity to discuss current evidence based practice were highly regarded. Recommendations for future programmes included extending to two days and include burns and more complex pathophysiology. With centralisation of trauma care to major trauma services, frequent and continuing education of nurses is essential. Nurses from non-Major Trauma Service facilities in Victoria found this programme worthwhile as they gained knowledge and skills and increased confidence to care for trauma patients.
Publisher: Elsevier BV
Date: 08-2022
Publisher: Elsevier BV
Date: 08-2016
DOI: 10.1016/J.AENJ.2016.06.003
Abstract: The service profile of wound, skin and ulcer presentations to emergency departments is an area that lacks an existing published commentary. Knowledge of these presentations would inform the allocation of resources, staff training, and, in turn, patient outcomes. The aim of this study was to describe the discharge and referral status of adult patients presenting to one Australian emergency department with a wound, skin or ulcer condition. A retrospective descriptive review was conducted of all emergency presentations including discharge and referral statuses for skin, wound and ulcer related conditions from 1st January 2014 until 31st December 2014. A total of 4231 wound, skin and ulcer conditions were managed, accounting for 7% of the total emergency presentations. Wound conditions were the most prevalent (n=3658 86%). Males were more likely to present for all three conditions. For all conditions, discharge to home was the most common destination. Following discharge to home, over half all patients were referred to the local medical officer. Nursing workforce models, education and training needs to reflect the skill set required to respond to wound, skin and ulcer conditions to ensure that high quality skin and wound care continues outside of the emergency department.
Publisher: Wiley
Date: 24-04-2017
DOI: 10.1111/WVN.12201
Abstract: The policy of single over double checking of medications has been adopted by many health services however, nurses' attitudes toward single-checking medications remains unclear. The aim of this study was to explore the attitudes of nurses who single check and administer medications in a setting where single checking has been in place for over a decade. A cross-sectional survey design using the validated Single Checking Administration Medication Scale-II to registered nurses (n = 299) working in one metropolitan teaching hospital in Victoria, Australia. Descriptive analyses for participants' demographics were examined and confirmatory factor analysis (CFA) was performed on the survey items to represent the main themes of nurses' attitudes toward single checking. Nurses reported single checking allowed a greater accountability as a professional nurse and more control over drug administration. The efficiency of single checking was welcomed by nurses through reductions in administration time and workplace interruptions. Nurses were more likely to adhere to drug administration procedures when single checking and this process facilitated drug knowledge updates. There was significant variance in attitudes amongst nurses based upon current appointment and years of clinical experience. Free text responses indicated nurses' attitudes were situated in the context of the traditional double-checking system. Understanding nurses' attitudes toward single checking may assist health care services to positively address medication safety. Accountability, efficiency and knowledge are important for nurses when administering medications. Nurses' attitudes are varied when correlated with demographic characteristics.
Publisher: Informa UK Limited
Date: 04-05-2019
DOI: 10.1080/10376178.2019.1641419
Abstract: The internet and social media have changed the way society communicates, requiring the nursing workforce to develop effective digital literacy skills and attain levels of e-professionalism. The internet provides a unique environment that both connects and disrupts with powerful and unpredictable consequences for healthcare. A networked nursing workforce can influence and create collaborative communities of practice that will develop and shape healthcare. Nurse education must engage with technology and social media to provide a future-ready workforce capable of delivering future eHealth reforms.
Publisher: Elsevier BV
Date: 02-2016
DOI: 10.1016/J.AENJ.2015.11.001
Abstract: Emergency Department pain management is an often overlooked aspect of acute care and is of paramount importance. Patients are often forced to wait extended periods of time without pain assessment or being offered analgesia for their painful condition. This has been associated with poor psychological and physiological consequences both for the health system and the patient. This is suggestive of a lack of clarity around best practice standards for time to analgesia and pain score documentation in the ED. A literature review was undertaken to investigate best practice in relation to acute pain management. Key outcomes were pain score documentation and time to analgesia. After a search of the electronic databases, a total of 992 abstracts were screened and 38 potentially relevant full articles were reviewed. There were 23 articles excluded for a variety of reasons including poor methodology, indirect specialty and inappropriate focus or age of study. A total of 15 studies were appropriate for inclusion in the review. Of the 15 studies, only eight included pain score as an outcome and 13 used time to analgesia as a measure. Four studies specifically investigated nurse initiated analgesia programs in relation to improving acute pain management. A higher incidence of pain assessment, reassessment and pain score documentation was generally correlated with decreased time to analgesia. Whilst there is an abundance of evidence available on the current practice and challenges of quality acute pain management in the ED, there is a lack of well-controlled studies on best practice standards for health care services to benchmark their practice and improve. Mandating pain score reporting, pain assessment and reassessment within specific timeframes and analgesia administration within 30 min of arrival is highly recommended. The implementation of nurse led analgesia protocols should be encouraged to increase incidence of documented pain assessment and reduce time to analgesia.
Publisher: Wiley
Date: 13-10-2015
DOI: 10.1111/WVN.12115
Abstract: Single checking medications has been increasingly adopted over the past decade by nurses in Australian healthcare services. However, attitudes toward the practice of only one nurse checking medications remain unclear. The aim of this article is to report on the development, reliability, and validity of a tool to measure nurses' attitudes to single checking medications in a health service in which single checking has been in place for over a decade. In a cross-sectional survey design, the Single Checking and Administration of Medications Scale (SCAMS-II) was used to measure the attitudes of 299 registered nurses (RNs) who were single checking medications in one metropolitan teaching hospital in Australia. Exploratory factor analysis was used to explore the dimensions that best represented the SCAMS-II. Cronbach's α was used to assess internal consistency of the identified subscales. To test the construct validity of the emergent questionnaire, Confirmatory Factor Analysis and Rasch analyses were performed. The psychometric properties of the SCAMS-II revealed 12 items with three reliable subscales: a five-item accountability model a four-item efficiency model and a three-item knowledge model. In settings where single checking is current practice, the SCAMS-II is recommended as a reliable tool to measure nurses' attitudes toward the single checking of medications. The findings from this study may assist healthcare organizations in the development of policy and procedure guidelines for the safe administration of medications.
Publisher: Elsevier BV
Date: 2017
DOI: 10.1016/J.IENJ.2016.06.005
Abstract: To evaluate the health service requirements of obese patients admitted to an Emergency Short Stay Unit (ESSU) and specifically compare length of stay (LOS), failure of ESSU management, and rates of investigations and allied health interventions among obese and non-obese patients. A prospective cohort study, using convenience s ling was conducted. The body mass index (BMI) of participants was calculated and those with a BMI of ⩾30 were allocated to the obese group, and those that had a BMI of <30 to the non-obese group. Data collected included demographics, admission diagnosis, time and date of ESSU admission and discharge, discharge disposition, radiological investigations, and referrals made to allied health personnel during ESSU admission. There were 262 patients that were recruited sub-grouped into 127 (48.5%) obese participants and 135 (51.5%) non-obese participants with similar sex and diagnostic category distributions. The mean LOS in ESSU was similar - 11.5h (95% CI: 9.9-13.1) for obese patients and, 10.2h (95% CI: 8.8-11.6) for non-obese patients (p=0.21). Failure rates of ESSU management, defined as inpatient admission to hospital, were also similar with 29 (22.8%) obese patients admitted to hospital compared to 25 (18.5%) non-obese patients (p=0.39). Plain X-ray requests were significantly higher among obese patients (71.6 vs 53.3% p=0.002), as was the rate of allied health interventions (p=0.001). There was no significant difference in inpatient admission rates or LOS between obese and non-obese patients managed in the ESSU. Provisions for increased rate of investigations and allied health interventions for obese patients may facilitate timely assessment and disposition from ESSU.
Publisher: Wiley
Date: 23-10-2019
DOI: 10.1111/JOCN.14679
Abstract: To examine nursing handover of vital signs during patient care transition from the emergency department (ED) to inpatient wards. Communication failures are a leading cause of patient harm making communication through clinical handover an international healthcare priority. The transition of care from ED to ward settings is informed by nursing handover. Vital sign abnormalities in the ED are associated with clinical deterioration following hospital admission. Understanding the role and perceived value of vital sign content in clinical handover is important for patient safety. An integrative design was used. A search of electronic databases was undertaken using MEDLINE, CINAHL, EMBASE, Cochrane, Web of Science and SCOPUS. Identified records were screened to elicit further studies for inclusion. A comprehensive peer-review screening process was performed. Studies were included that described the surrounding issues of handover, vital signs, ED, transition of care and ward. Five studies were included in the final review, one specific to nursing and four specific to emergency medicine. Vital signs were perceived to be an important inclusion in clinical handover, and the communication of vital signs in handover was perceived to be indicators for patient safety and risk factors for future clinical deterioration. The ED environment had an influence on effective communication within handover. Vital signs were an important inclusion for clinical handover. Deficiencies in vital sign content were perceived to be risk factors for patient adverse events following hospital admission. The quality of vital sign information in clinical handover may be important for accurate decision-making. Vital signs are an important component of clinical handover and are perceived to be indicators for patient safety and risk of future adverse events.
Location: United Kingdom of Great Britain and Northern Ireland
Location: United Kingdom of Great Britain and Northern Ireland
No related grants have been discovered for Rachel Cross.