BACKGROUND: Climate-fuelled disasters are increasing in frequency and duration, with impacts known to disproportionately affect vulnerable populations, such as perinatal women and young families. Local healthcare workfor...BACKGROUND: Climate-fuelled disasters are increasing in frequency and duration, with impacts known to disproportionately affect vulnerable populations, such as perinatal women and young families. Local healthcare workforce engagement into planning responses is required to ensure improved healthcare for these populations. One important component of perinatal care in Australia occurs through the maternal and child health nurses (MCHN). Attempted research engagement with the maternal child health nurse sector regarding the impact of disasters on the care of perinatal women during times of disaster has encountered structural barriers. AIM: To understand the structural barriers that impact the research engagement of rural MCHN particularly during times of disasters. METHODS: A facilitated focus group with semi-structured questions was conducted with five participant-researchers. The focus group discussion underwent reflexive thematic analysis. RESULTS: Identified themes were and An overarching fourth theme identified elements that may improve the research engagement of primary healthcare staff, including MCHN. CONCLUSION: There is a need to overcome structural challenges to MCHN engagement in meaningful research around the impacts of multiple disasters. Appropriate research design, including utilising co-design, adequate resourcing, and planned and considered participant communication may help to improve participant engagement for this important research. With improved sector engagement, the ongoing care of perinatal women in the current environment of multiple and compounding climate-fuelled disasters will be improved.
BACKGROUND: The rapid growth of artificial intelligence in healthcare is transforming how nurses deliver care and make clinical decisions. From supporting diagnostics to providing virtual health assistants, artificial in...BACKGROUND: The rapid growth of artificial intelligence in healthcare is transforming how nurses deliver care and make clinical decisions. From supporting diagnostics to providing virtual health assistants, artificial intelligence offers new ways to enhance patient outcomes and streamline healthcare processes. However, these advancements also bring challenges, particularly around ethics, potential biases, and ensuring technology complements rather than replaces human expertise. METHODS: A discussion paper designed to break down key artificial intelligence terms and demonstrate real-world applications to guide nurses to develop the skills needed to navigate this evolving technological landscape. FINDINGS: This discussion emphasises the importance of maintaining the critical role of human clinical judgment, highlighting that artificial intelligence should support nurses' expertise rather than diminish it. The need for continuous education to keep nurses equipped with the knowledge to effectively integrate artificial intelligence into their practice is argued. With an inclusive approach, artificial intelligence has the potential to become a powerful tool that supports nurses in improving patient care while preserving the essential human touch in healthcare.
BACKGROUND: In an undergraduate Bachelor of Nursing course, students enrol in an evidence-based Practice (EBP) subject. Three scaffolded tasks assess students' ability to find, summarise and synthesise professional liter...BACKGROUND: In an undergraduate Bachelor of Nursing course, students enrol in an evidence-based Practice (EBP) subject. Three scaffolded tasks assess students' ability to find, summarise and synthesise professional literature. For each assessment task, students are provided feedback that informs subsequent assessments. It is unclear how students use the feedback, and what elements of feedback are perceived as being most useful. AIM: This study aimed to examine nursing students' perspectives of receiving feedback from scaffolded assessments and how feedback received influenced the development of the final assessment task. DESIGN: A mixed-methods approach was used with a cross-sectional survey and online qualitative interviews. SETTING: This research was conducted at Deakin University, School of Nursing and Midwifery in Melbourne, Australia. PARTICIPANTS: One hundred forty-eight students (17.4%, = 851) participated in the cross-sectional survey. Seven students participated in the online qualitative interviews. METHODS: Students enrolled in the EBP subject in Trimester, 2023 were invited to participate in a survey where they rated their experience of assessment feedback using a Likert scale. Students were also invited to participate in an online qualitative interview that further explored their perceptions. RESULTS: Assessment exemplars were highly beneficial to understanding the assessment task (87.8% agree/strongly agree, = 107). Responding to feedback was challenging (38.5%, = 47). Qualitative themes identified were , , and . CONCLUSIONS: This study highlights that scaffolded feedback is valuable for student learning. Feedback in each rubric criterion helps with the alignment of learning outcomes. Resources that support students in how to respond to feedback are important.
Indigenous Australians are disproportionately affected by diabetes, with a diagnosis rate nearly four times higher than people from a non-Indigenous background. This health disparity highlights the urgent need for health...Indigenous Australians are disproportionately affected by diabetes, with a diagnosis rate nearly four times higher than people from a non-Indigenous background. This health disparity highlights the urgent need for healthcare providers to develop cultural empathy - a critical competency for delivering culturally safe and person-centered care. Cultural empathy is essential for building trust and effective communication in diabetes education and management within Indigenous people. However, there is a significant gap in targeted interventions to enhance this skill among healthcare providers. The aim of this study was to evaluate the effectiveness of a digital storytelling intervention for enhancing cultural empathy levels of postgraduate diabetes education students. This study has a pre-post survey design to measure changes in participants' cultural empathy levels after exposure to a digital story. Students enrolled in a postgraduate diabetes education course at an Australian university were eligible to participate. The intervention included a first-person digital story about an Indigenous man with type 2 diabetes, accompanied by group-based discussions and self-reflection. The Comprehensive State Empathy Scale was utilised to assess empathy levels. A total of 98 students completed both pre- and post-intervention surveys. There was a statistically significant increase in mean Comprehensive State Empathy Scale scores post-intervention ( < 0.001), indicating higher empathy levels. Improvements were observed across all six Comprehensive State Empathy Scale subscales, suggesting a multidimensional impact of the intervention. The digital story intervention significantly enhanced the cultural empathy levels of postgraduate diabetes education students. This study contributes to the evidence base for narrative-based pedagogies in cultivating empathy among healthcare providers. The findings highlight the potential of digital storytelling as a tool for improving cultural competency in healthcare education and practice, ultimately contributing to more empathic care for Indigenous people with diabetes.
BACKGROUND: The number of patients with neurological disorders and severe disability is increasing globally. These patients often need help with positioning and the amount of support varies with their level of impairment...BACKGROUND: The number of patients with neurological disorders and severe disability is increasing globally. These patients often need help with positioning and the amount of support varies with their level of impairment. High rates of work-related musculoskeletal disorders are observed among healthcare professionals (HCP) with patient contact due to injuries during manual handling. There is insufficient research on manual handling by nurses and other HCP. OBJECTIVES: The primary aim of this study was to explore manual handling strategies by HCP in neurological inpatient and outpatient settings. A secondary aim was to explore pain during and post manual handling activities. DESIGN: A convergent parallel mixed methods design. METHODS: A quantitative survey was combined with qualitative semi-structured telephone interviews of HCP. The inclusion criteria were licensed allied HCP with at least seven years of experience with neurological patients in inpatient and/or outpatient settings and expertise in manual handling. Exclusion criteria included insufficient proficiency in German and pre-existing illness prior to start of professional education. The survey data were analysed using descriptive statistics and interviews were evaluated through inductive-reflexive thematic analysis. RESULTS: Ten nurses, 10 occupational, 12 physiotherapists participated. Survey findings showed moderate time pressure, body strain, and low back and neck pain during patient transfers. HCPs spent an average of 7.3 (± 5.5) hours per week on personal endurance and strength training. They considered transfer aids moderately important and accessible, predominantly using the transfer board. Interdisciplinary collaboration in patient transfers was reported as crucial and usually available. We identified three themes from interviews: (1) individualised manual handling; (2) facilitating active patient participation during transfers; (3) maintaining personal physical fitness. CONCLUSIONS: Neurological symptoms, patient fears, and goal setting necessitated personalised transfer strategies. Patient characteristics, lack of space and time complicated transfers, prompting HCPs to use perception-oriented techniques, leverage, gravity, and momentum.
BACKGROUND: A shift from a content-focused curriculum to a competency-based curriculum has occurred in nursing education. Competency-based education (CBE) is highly debated within higher education despite the need for co...BACKGROUND: A shift from a content-focused curriculum to a competency-based curriculum has occurred in nursing education. Competency-based education (CBE) is highly debated within higher education despite the need for competency. Competency-based education (CBE) is a form of education that takes a curriculum from a focus on an actual role or analysis perspective to an individual student's progress based on their demonstrated performance of aspects of the role. While debate exists regarding the pros and cons of CBE, theories of expertise exist to understand competency via the worldview of expert performance. Researchers and educational scholars are delving into the role of knowledge, particularly clinical knowledge, in developing and enhancing expertise and the practice of experts. In addition, CBE focuses on individual students' development and skill performance into experts. Many competency frameworks prioritize applying clinical knowledge, skills, and abilities as the building blocks of professional expertise. However, these models often overlook the capability of a nurse to handle unforeseen challenges effectively in practice as an expert. AIM AND DESIGN: This discussion piece is dedicated to exploring the ongoing debates and developments in the conceptualization of expertise. It also serves to underscore the urgent and crucial need for a paradigm shift in our approach to competency-based education (CBE) in nursing. The discussion will delve into various cognitive perspectives on expertise, particularly how accumulated knowledge is conceptualized in expert development and practice models and the implications for understanding competence through expert performance. This piece will also provide critical implications for understanding competence through expert performance, such as the conceptualizations of knowledge. Finally, this discussion will highlight the significant impact of competence as expertise within CBE, emphasizing the weight and importance of competency as expertise in nursing education. FINDINGS AND CONCLUSION: Literature has found that expertise in nursing practice is a result of a developmental pathway involving appropriate training and substantial practice. We propose that an integrated understanding of expertise could lead to a more comprehensive set of expert nursing practice competencies. This integration of educational concepts and situated knowledge into competency and expertise understanding requires a shift in learning environments where future experts are educated.
AIMS AND OBJECTIVES: This discussion paper proposes four new nursing leadership roles to address planetary health challenges. BACKGROUND: Nurses are essential in reducing healthcare's greenhouse emissions. The Planetary...AIMS AND OBJECTIVES: This discussion paper proposes four new nursing leadership roles to address planetary health challenges. BACKGROUND: Nurses are essential in reducing healthcare's greenhouse emissions. The Planetary Health Education Framework (PHEF) supports integrating planetary health concepts into sustainable healthcare practice. Nurse educators with planetary health expertise should teach the PHEF, while nurse climate advocates promote it to health professionals, with nurse-led planetary health researchers undertaking climate-change research and Planetary Health Nurse Practitioners practicing sustainable healthcare. DESIGN: Discussion paper. DATA SOURCES: A PICO framework was used to identify relevant articles: In nursing (P) should new roles be introduced (I) compared to no new roles (C) to understand climate change impacts on both nursing and planetary health (O). DISCUSSION: Barriers to sustainable healthcare include denial, group-think, and ignorance. National and International organisation enablers highlight the importance of climate change in nurse education. The Australian College of Nursing recommends government funding for nurse-led planetary health research. CONCLUSION: Educators should focus on curricula development, nurse climate advocates on education and policy, researchers on supporting planetary health research, and PHNPs on climate justice, environmental protection, and emissions reduction.
BACKGROUND: The Australian Commission on Safety and Quality in Health Care 'National Standards' require general hospitals to have systems for clinicians to recognise and respond to patients' deteriorating mental state. T...BACKGROUND: The Australian Commission on Safety and Quality in Health Care 'National Standards' require general hospitals to have systems for clinicians to recognise and respond to patients' deteriorating mental state. The lack of an evidence-based operational definition and clear guidance challenges this requirement. OBJECTIVE: To review governance mechanisms and assessment processes for deteriorating mental state in a metropolitan general hospital and propose an organisational framework. METHODS: A qualitative document analysis using the READ approach systematically reviewed hospital committee reports, health district policies, and training programs to identify and synthesise key assessment points and processes. FINDINGS: The study mapped assessment points for recognising and responding to deteriorating mental state across patient journey stages. An organisational systems infographic provides a blueprint for meeting National Standards accreditation criteria. CONCLUSIONS: Hospitals should establish comprehensive systems to observe, monitor, assess, and refer individuals with deteriorating mental state, involving multiple governance processes and frameworks.
AIM: This study aims to gain an in-depth understanding of the experience and requirements of newly employed nurses during their transition into professional roles. Furthermore, it aims to analyze the effects of transitio...AIM: This study aims to gain an in-depth understanding of the experience and requirements of newly employed nurses during their transition into professional roles. Furthermore, it aims to analyze the effects of transition shock on these nurses, identify the typical coping mechanisms they employ, and provide a reference for nursing administrators to explore and improve relevant interventions. BACKGROUND: In the early stages of their careers, newly graduated nurses frequently encounter various challenging situations that might impact their job performance and professional growth. Over the past few years, experts have increasingly focused on transition shock. However, limited studies have been undertaken on the role adaptation factors related to freshly graduating nurses during their transition. METHODS: The study's design and implementation were guided by the phenomenological method. Purposive sampling and semi-structured in-depth interviews were used to recruit 16 participants. Interviews were transcribed verbatim, and the data were analyzed using thematic techniques assisted by Nvivo coding software. RESULTS: We analyzed interview data based on Duchscher's transition shock theoretical framework. A total of 3 themes and 12 sub-themes were distilled, which include perceptions and feelings when facing transition shocks (4 sub-themes), impacts of transition shocks (4 sub-themes), and strategies for coping with transition shocks (3 sub-themes). DISCUSSION AND CONCLUSION: Newly recruited nurses are prone to suffer multidimensional problems and impacts during the transition process, mostly characterized by physical discomfort, psychological anxiety, and the need for social support and career development. Nursing managers should pay attention to the mental health status and changes of new nurses at different stages and proactively investigate and implement personalized interventions.
BACKGROUND: Our understanding of how nursing and midwifery students in Australia are prepared to support people in unintended pregnancy prevention and care is currently limited. OBJECTIVE: This study examined Australian...BACKGROUND: Our understanding of how nursing and midwifery students in Australia are prepared to support people in unintended pregnancy prevention and care is currently limited. OBJECTIVE: This study examined Australian nursing and midwifery students and recent graduates' perspectives on their preparation and confidence in providing unintended pregnancy prevention and care. METHODS: A descriptive, cross-sectional online survey of nursing and midwifery students and graduates was undertaken. An invitation email with information sheet and link to the survey was sent to heads of departments at Australian universities for distribution to nursing and midwifery students. Social media platforms of professional organisations were used to promote the study to nurses and midwives within two years of graduation. The survey instrument was based on US educational competencies for unintended pregnancy prevention and care, adapted for the Australian context. RESULTS: Participants ( = 109) from 14 institutions completed the survey. The majority of (92%) expressed that nursing and midwifery graduates should possess unintended pregnancy prevention and care knowledge and skills. Five competencies, out of 29, were identified as taught as core curriculum by 50% or more of participants; reproductive anatomy and physiology (72%); effective communication skills encompassing culture, sexual orientation, and gender identity (58%), understanding how contraceptives work (54%), obtaining a sexual/reproductive history (53%), and identifying preconception health risks (50%). Students felt well prepared to provide independent care related to pregnancy testing (44%), pregnancy prevention (26%), sexual history taking (23%), ethical/legal considerations around abortion (9%), options counseling/referral (5%), and pre/post-abortion care (5%). CONCLUSION: With the decriminalization of abortion care, the Australian nursing and midwifery workforce must prepare students to care for people in all aspects of pregnancy prevention, early pregnancy decision-making, and abortion services. Our data show students are interested in this preparation but the entry-to-practice curricula has not yet been standardized to enable this.
BACKGROUND: Quality improvement partnerships between healthcare organisations and higher education require further research to explore their potential to provide a valuable education experience for pre-registration nursi...BACKGROUND: Quality improvement partnerships between healthcare organisations and higher education require further research to explore their potential to provide a valuable education experience for pre-registration nursing students. AIMS: Develop and validate a questionnaire for nurse academics to evaluate quality improvement content in pre-registration nursing curricula and the extent of partnership with higher education providers in developing this content. Conduct a pilot test of the questionnaire.: Use a content validity approach. METHODS: The Australian higher education sector was the setting and participants were nurse academics with knowledge of the quality improvement content taught in pre-registration nursing courses. The quality improvement collaboration (QuIC) questionnaire was informed by the literature and sent to ten quality improvement and higher education experts for content validation. Each question was scored on a Likert scale for relevance and clarity. The QuIC questionnaire was distributed by email to the 37 higher education organisations offering pre-registration programmes in Australia. Descriptive statistics were used to analyse the questionnaire data. RESULTS: Eight experts completed the content validity questionnaire in full, with the QuIC questionnaire achieving an excellent content validity score of 0.94 for relevance and clarity. The QuIC questionnaire was completed by 24 participants. The results indicated that quality improvement education partnerships are only used occasionally in Australia. The education methods used to teach this content were case studies (online cases n = 11, 46%; patient cases n = 9, 38%) and the development of quality improvement education materials (n = 7, 29%). CONCLUSIONS: The QuIC questionnaire demonstrates excellent relevance and clarity, and is the first in the literature to address the constructs of quality improvement education and partnerships. The pilot results provide insight into quality improvement education methods used in Australia and the presence of partnerships. These results may be used to assist in the implementation of quality improvement education partnerships into curricula across the health professions.
BACKGROUND: The COVID-19 pandemic and recovery period have exacerbated workforce challenges for nurses and midwives. The increasingly complex nature of healthcare, combined with rising workloads and staff attrition highl...BACKGROUND: The COVID-19 pandemic and recovery period have exacerbated workforce challenges for nurses and midwives. The increasingly complex nature of healthcare, combined with rising workloads and staff attrition highlights the need for initiatives that improve workplace satisfaction and retention. In response, mentoring programs aimed at enhancing job satisfaction and retention are being increasingly implemented. AIMS: This study sought to measure the workplace satisfaction of nurses and midwives across five New South Wales local health districts, utilising data captured from a wider study investigating the implementation of the Deadly Aboriginal and Torres Strait Islander Nursing and Midwifery Mentoring program. DESIGN: An exploratory, mixed methods study using purposive sampling was employed. METHODS: A secondary analysis of a modified version of the Nursing Workplace Satisfaction Questionnaire, was used to quantify intrinsic, extrinsic, and relational workplace satisfaction constructs among nursing and midwifery staff. Open ended questions included in the survey were thematically analysed using methods developed by Braun and Clarke (2022). RESULTS: Between June-October 2023, 106 participants returned the survey. Differences between intrinsic (items 2 & 5), extrinsic (item 9) relational (items 13-15) constructs were observed for health districts, Aboriginality, age, and professional role characteristics ( < 0.05). Five qualitative themes emerged from the data: and CONCLUSIONS: Overall, our findings indicate noticeable differences in workforce satisfaction and retention across various factors, including workforce areas, Aboriginality, age, and professional roles. For these groups, initiatives aimed at improving satisfaction and retention should prioritise fostering teamwork and a sense of belonging, as these elements have significant impact on job satisfaction for nurses and midwives and provide valuable guidance for nursing leaders.
: Falls are the most reported patient safety incident for patients >65 years in acute hospital settings worldwide. While multifactorial fall interventions reduce the number of falls in subacute and rehabilitation setting...: Falls are the most reported patient safety incident for patients >65 years in acute hospital settings worldwide. While multifactorial fall interventions reduce the number of falls in subacute and rehabilitation settings, fall interventions in acute hospital settings are unknown.: To evaluate the effectiveness of multifactorial fall interventions on the number of falls using codesigned education targeting staff and the patient and review the environment in acute hospital settings in NSW, Australia for patients over 65 years of age.: A pre-post-test design with a non-equivalent group was conducted. All acute hospital inpatient falls occurring both pre- and post-intervention within one health district were included in this study. The use of Quality Improvement methodology identified gaps in risk screening and assessment, education and information, communication of risk, and standardised fall prevention equipment. Codesigned interventions to address these gaps were undertaken.: The number of falls ( = 0.038) and injurious falls ( < 0.001) significantly decreased in the post-intervention group. There was a significant improvement in fall assessments ( < 0.001), delirium risk screening ( < 0.001), the provision of fall information ( < 0.001) and fall risk discussed at shift handover ( < 0.001) in the post-intervention group. Following the intervention, staff were significantly more likely to undertake fall education modules ( < 0.001) and develop a fall management plan ( < 0.001).: Falls continue to have a significant economic impact on the acute hospital setting. Our findings highlight multifactorial fall interventions that included staff and patients in the development phases reduced the number of falls. Multifactorial fall interventions targeting staff, patients and the environment may influence a reduction in the number of falls and the severity of falls in the acute hospital setting.