ORCID Profile
0000-0002-0049-7665
Current Organisation
University of Adelaide
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Publisher: Elsevier BV
Date: 11-2019
DOI: 10.1016/J.IJOTN.2019.04.003
Abstract: Nurses transitioning into the specialty of orthopaedics gradually develop the skills required to provide care for patients with musculoskeletal conditions or injuries, but during the early stages this can be challenging and lead to a lack of confidence. Strategies aimed at developing confidence in these nurses to make sound decisions and clinical judgements in their professional practice will assist in strengthening their practice and delivery of quality care. This study aimed to investigat if the delivery of an orthopaedic workshop improved the ongoing confidence of advanced beginner nurses, as recognised in Benner's exploration of skill acquisition, to undertake skills required to assess and manage patients with musculoskeletal injuries or conditions and assist in their decision making to achieve optimal patient outcomes. A quasi experimental pre-test, post-test study was chosen to measure nurses' confidence to undertake the scope of practice in orthopaedics at the advanced beginner level of expertise. A questionnaire was designed and administered to measure the level of confidence pre-intervention, immediately post intervention and twelve weeks following participation at an orthopaedic workshop. The workshop was designed specifically for nurses transitioning into the specialty of orthopaedics. The intervention had a positive impact on the confidence of advanced beginner nurses. The measurement prior to participation at the workshop indicated confidence levels were generally low. Immediately post participation the level of confidence had increased for all participants. When measured again at twelve weeks' post intervention the level of confidence had been maintained or continued to increase in the majority of orthopaedic practice areas. The overall level of confidence between pre-interven tion to twelve weeks post intervention demonstrated a clear improvement in all areas of practice. It was evident that nurses transitioning into the speciality of orthopaedics had lower confidence levels in relation to specialty-specific skills and knowledge. The use of an education workshop improved the confidence of nurses, not only immediately post intervention, but also in the longer term. Supporting a pathway to transition in the specialty which includes specific education delivered at key times is recommended as it could beneficial to advanced beginner nurses, the specialty, patients and the profession.
Publisher: Elsevier BV
Date: 02-2019
Publisher: Elsevier BV
Date: 11-2017
DOI: 10.1016/J.IJOTN.2016.11.001
Abstract: This paper describes a collaboration between orthopaedic nurses in Myanmar (Burma) and Australia. It aims to explores how that collaboration began and how it can grow and has grown. The unique needs and challenges of healthcare delivery in developing nations are discussed. Understanding these unique needs and challenges is vital in tailoring strategies to provide orthopaedic nurses in those countries with resources that are suitable to assist them in providing the highest level of quality care to their patients. The authors hope that this ex le may inspire other orthopaedic nurses and organisations around the globe to participate in this type of activity with the understanding that it benefits all those involved, nurses from both developed and developing countries, as well as improving patient care.
Publisher: Elsevier BV
Date: 05-2018
DOI: 10.1016/J.IJOTN.2018.02.005
Abstract: A major goal of care for orthopaedic surgical patients is the achievement of their pre-morbid functional level or at least an improvement of their functional ability. However, patients with altered mental status can significantly impact this and other outcomes and influence the delivery of care. Patient mobilisation is a role shared by both nurses and physiotherapists. To enhance the understanding of nurses and physiotherapists' experience in mobilising postoperative orthopaedic patients with altered mental status. Three nurses and three physiotherapists were recruited using purposive s ling. Data was collected through interviews and analysed using Burnard's 14 stages of thematic content analysis. Four main categories emerged from the study: altruism, interprofessional specialist practice, patient dynamics and challenges. Nurses and physiotherapists' experience have more similarities than differences under the four categories. Nurses and physiotherapists experience numerous challenges from both patient and resources related factors such as environment, staffing and time limitations safety risks to patient and staff and communication barriers due to patient's altered mental state. While tensions and variations in priorities of care delivery exist between the two groups, interdisciplinary collaboration of both professional groups was clearly evident and enabled optimisation of mobilisation goals for this patient population and revealed more similarities than differences in their experience. Patient and staff safety takes precedence over mobilisation and safety risks in this patient group can be mitigated by adequate resources, competence, and teamwork.
Publisher: Elsevier BV
Date: 08-2018
DOI: 10.1016/J.IJOTN.2018.05.002
Abstract: Nurses are involved in delivering care for patients following acute traumatic spinal cord injury throughout the entire care journey. An injury of this type is significant for the in idual and their family and can be challenging for nurses delivering care for patients with life changing injuries, especially for nurses new to this setting. There is a lack of research that examines the experience of nurses caring for these patients in the acute setting. A hermeneutic phenomenological approach was used to understand the experience of nurses caring for patients in the acute setting who had sustained a traumatic spinal injury with associated neurological deficit. Using the phenomenological approach guided by the insight of Gadamer and Max Van Manen, participants with a broad range of experience were recruited and interviewed. The responses were transcribed into a text and subjected to hermeneutic analysis. Burnard's (1991) 14-step process and the hermeneutic approach were used to interpret and understand the phenomenon of interest. The study highlights the experience and challenges of providing care to these in iduals. Although patients had significant physical disabilities and were often dependent physically, the nurses' concerns were directed more towards fulfilling their psychological needs. Nurses identified grieving patients and felt their role was to provide realistic hope to motivate them. They felt an internal tension regarding desensitisation towards their patients, but this was often an internal protective mechanism to deal with the significance of the events surrounding these patients. Nurses new to this setting took time to learn the routines and manage the unique challenges effectively. Caring for these patients gave the nurses the opportunity to understand their patients and their families, and appreciate that both groups will fluctuate in their behavior throughout the acute process, as they adjust to grief and loss.
No related grants have been discovered for Paul McLiesh.