Nursing Medical and Health News Headlines

Nursing and pre-registration nursing education under the spotlight again.

Collegian. 2008;15(1):1-2

Authors: Jackson D, Daly J

PMID: 18341070 [PubMed - indexed for MEDLINE]

A qualitative investigation of the palliative care needs of terminally ill people who live alone.

Collegian. 2008;15(1):3-9

Authors: Aoun S, Kristjanson LJ, Oldham L, Currow D

This paper investigates the support needs of people living alone with a terminal illness from a client perspective. In depth, interviews were conducted with 11 clients from Silver Chain Hospice Care in Western Australia to capture their personal experiences of managing at home alone and to assess their physical, social and emotional needs. Findings provided useful insights with respect to many of the motivations, beliefs and wishes of individuals who endeavour to cope on their own with minimal assistance. The needs of these individuals are practical, emotional, physical and existential. At the heart of these concerns is a strong need to be independent and maintain a sense of dignity at end of life.

PMID: 18341071 [PubMed - indexed for MEDLINE]

Implications for Australian practice of North American guidelines for the support of the family in patient-centred intensive care.

Collegian. 2008;15(1):11-7

Authors: McKinley S, Elliott RM

Patient-centred care, in which health care professionals inform patients and families, maintain active involvement in decision making, coordinate care across disciplines, provide families with physical comfort and emotional support and ensure care is culturally sensitive, is recommended over clinician- or disease-centred care for better patient outcomes. Patients in intensive care are often too ill to participate in communication and decision making, so the patient's family should be involved in communication and decision making about the patient's care. The Society of Critical Care Medicine published clinical practice guidelines for the support of the family in the patient-centred intensive care unit. The purpose of this paper is to assess whether the 42 recommendations in the guidelines are valid and applicable in Australia. We used a recognised framework for evaluation of clinical practice guidelines. It was found that the guidelines were developed systematically using accepted methods of guideline development as much as possible. An extensive literature review was conducted and publications containing all levels of evidence were considered for inclusion. There were some weaknesses in the guideline development, especially lack of consultation with patients and families and a lack of high-level evidence, however the authors have provided comprehensive recommendations to guide all aspects of patient-centred care. We conclude that the recommendations are largely applicable to the patients and families receiving treatment and support within intensive care units in Australia. Where strong evidence is lacking, the recommendations should be a stimulus to conduct studies that test interventions that may benefit intensive care patients, their families, and intensive care staff.

PMID: 18341072 [PubMed - indexed for MEDLINE]

Designing nursing interventions.

Collegian. 2008;15(1):19-25

Authors: Aranda S

The development of nursing interventions that demonstrate the link between nursing actions and patient outcomes is a high priority for nursing research. The development of intervention research frequently focuses on the methods used to test the intervention while less attention is placed on rigor in intervention development and design. The purpose of this paper is to provide thinking points for researchers considering the development of nursing interventions. The thinking points were developed from the limited literature on this topic in synthesis with the authors own experiences of designing nursing interventions. Adoption of a systematic approach to intervention testing is advocated along with a step-wise intervention development process. This process calls for attention to problem definition, conceptual underpinnings, desired outcomes and measures and evidence-based content along with careful consideration of delivery methods, dose and attention to protecting the integrity of the intervention during testing. The approach advocated will help to ensure that nursing intervention research makes a useful contribution to the development of nursing practice.

PMID: 18341073 [PubMed - indexed for MEDLINE]

'Never mind the quality, feel the width': the nonsense of 'quality', 'excellence', and 'audit' in education, health and research.

Collegian. 2008;15(1):35-41

Authors: Darbyshire P

The worlds of health care and education have been colonised by 'The Audit Society' and managerialism. Under the benign guise of 'improving quality' and 'ensuring value for money' a darker, more Orwellian purpose operates. Academics had to be transformed into a workforce of 'docile bodies', willing to scrutinise and survey themselves and their 'performance' as outcome deliverers and disciples of the new 'Qualispeak'. This paper critiques the current obsession with audit and performativity, the constant and often pointless 'change' is that held to be so self-evidently 'a good thing' and the linguistic wasteland that so often passes for discussion or policy in the Brave New Worlds of health and education.

PMID: 18345590 [PubMed - indexed for MEDLINE]

Shift-work: nursing's sometimes silent partner.

Collegian. 2008;15(2):43-4

Authors: West S

PMID: 18567474 [PubMed - in process]

An overview of the competency movement in nursing and midwifery.

Collegian. 2008;15(2):45-53

Authors: Chiarella M, Thoms D, Lau C, McInnes E

The aim of this paper is to examine the purpose and growth of the development of general, advanced and specialist competency standards in nursing and midwifery in Australia. The definitions, content, types, utility and acceptability of competencies are reviewed. This paper also reports the results of a recent survey of nurses and midwives about the uses of competency standards. Challenges in identifying and assessing the impact of competency standards on practice and professional development; reasons for their proliferation and associated shortcomings such as their lack of cultural sensitivity and inability to reflect the complexity of nursing care are also explored. The rationale for this paper is that charting these issues and identifying gaps in the field will assist the further development and refinement of competency frameworks for Australian nursing. The paper concludes by recommending that future research in this area should focus on: (1) formal analysis of the validity and suitability of competency standards in relation to the purposes for which they are designed; (2) the mapping of competency domains, elements and performance criteria to identify similarities and differences in order to provide insight into the nature of both specialist and advanced practice nursing; and (3) a systematic review of the competency literature to ascertain the level of evidence that exists to support the use of competencies in terms of standard setting, safe practice and enhancement of patient outcomes.

PMID: 18567475 [PubMed - in process]

Building capacity for the clinical placement of nursing students.

Collegian. 2008;15(2):55-61

Authors: Barnett T, Cross M, Jacob E, Shahwan-Akl L, Welch A, Caldwell A, Berry R

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.

PMID: 18567476 [PubMed - in process]

Relating new graduate nurse competence to frequency of use.

Collegian. 2008;15(2):69-76

Authors: Hengstberger-Sims C, Cowin LS, Eagar SC, Gregory L, Andrew S, Rolley J

The healthcare workplace can be a stress-laden environment for new graduates and job performance indicators are an important sign of developing confidence and expertise that will lead to improved patient outcomes. What is not evident from nursing studies is whether new graduate nurse competencies relate to the frequency of their use. This study sought to determine the relationship between perceived nursing competence and self-assessed frequency of use by new graduate nurses. Three cohorts (n = 116) of new graduate nurses undertaking year-long transition to graduate practice programs responded to a questionnaire that utilised the 2001 ANCI competencies and the Nurse Competency Scale and a Visual Analogue scale to self assess their perceived competence and the relative frequency of use for specific competence items. Results indicate that a relationship exists between perceived competence and frequency of use and that research competency scores are substantially lower than all other categories of competency. Implications for education and practice indicate that assessment of nurse competency for the new graduate nurse should focus on the development of generic nursing competencies rather than current expectation of advanced and workplace specific nurse competencies.

PMID: 18567478 [PubMed - in process]

The lure of the bush: do rural placements influence student nurses to seek employment in rural settings?

Collegian. 2008;15(2):77-82

Authors: Lea J, Cruickshank M, Paliadelis P, Parmenter G, Sanderson H, Thornberry P

The aim of this study was to investigate whether rural clinical placements for student nurses at a rural university in New South Wales influence their decision to join the rural and remote Registered Nurse workforce. The study utilised a convenience sample of final year Bachelor of Nursing students at a rural university campus, and consisted of two stages of data collection. Stage One employed a pre- and post-clinical placement survey design that elicited both demographic and qualitative data. Stage Two consisted of individual interviews with a sample of final year nursing students while they were on a rural clinical placement. The findings highlight the factors that influence final year students' decisions to seek employment in rural healthcare facilities. These findings will be of interest to nurse academics concerned with ensuring that undergraduate nursing curricula relate to rural nursing practice in Australia and to those involved in recruitment of new graduate RN's to rural nursing practice.

PMID: 18567479 [PubMed - in process]

Rainbows in the clouds.

Creat Nurs. 2008;14(2):51-2

Authors: Disch J, Steffen L

On October 14, 2007 master storyteller, scholar, and poet Maya Angelou launched the second Summit of Sages, hosted by the University of Minnesota School of Nursing. This event was a forum for people with a common interest in examining social justice--to become informed, engaged, and committed to action. Presented below are our separate, yet complementary, thoughts about the impact of her words.

PMID: 18655512 [PubMed - in process]

Social justice and human caring: A model of caring science as a hopeful paradigm for moral justice for humanity.

Creat Nurs. 2008;14(2):54-61

Authors: Watson J

PMID: 18655513 [PubMed - in process]

Caring for an underserved population: Helping pediatric patients with disabilities transition to adulthood.

Creat Nurs. 2008;14(2):66-9

Authors: Milbrath C

Improving the processes to assist adolescent patients in their transition into the adult health care community reveals the challenges encountered by adults with disabilities. A service gap between pediatric care providers and adult care providers is bridged by a program providing direct care, education, and advocacy.

PMID: 18655515 [PubMed - in process]

Assessing and addressing domestic violence experienced by incarcerated women.

Creat Nurs. 2008;14(2):70-2

Authors: Zust BL

A significant percentage of incarcerated women are victims of domestic violence, forced to be involved in illegal activity orchestrated by their abusive partners. Because intimate partner violence is not routinely assessed in prisons, the impact of partner violence is not always recognized or addressed.

PMID: 18655516 [PubMed - in process]

Stereotypes and social injustice.

Creat Nurs. 2008;14(2):73-4

Authors: Steffen L

A group presentation by nursing students created an opportunity for their classmates to experience firsthand the effects of stereotyping and its impact on the delivery of health care and social services.

PMID: 18655517 [PubMed - in process]

Advocating for universal newborn hearing screening.

Creat Nurs. 2008;14(2):75-81

Authors: Hollenbeck L

Universal newborn hearing screening and follow-up is an important detection and intervention program promoting childhood development and the acquisition of fundamental language, social, and cognitive skills. These skills provide the basis for later success in school and in society. Nursing has an important role to play in advocating for newborn hearing screening and in supporting families throughout the screening process.

PMID: 18655518 [PubMed - in process]