Aim
This study aimed to profile the community nurse in Australia.
Background
The need for nurses in the community health care sector is increasing in response to shorter hospital stays, an aging ...population and chronic disease. The increase in demand has not been followed by appropriate workforce planning, leading to structural issues and lack of qualified nursing workforce in the community sector.
Evaluation
MEDLINE and ProQuest Public Health and grey literature were searched for records published between 2010 and 2020 relative to the profile of the community nurse in Australia. Twenty‐five records (21 publications, 2 databases and 2 reports) were included in the review. ed data followed the principles of workforce planning and included demographics, qualifications and roles.
Key Issues
Inconsistent definitions, self‐reported data and a focus on practice nurses have contributed to data irregularities. Little is known about the specific aspects of community nursing work.
Conclusion
A lack of concrete data has overshadowed a community nursing workforce crisis with implications for patients' health and safety across the lifespan.
Implications for Nursing Management
There is urgent need for nurse managers globally to refocus nursing recruitment to the community sector to maintain quality and ensure sustainability of the nursing workforce.
Full text
Available for:
BFBNIB, FZAB, GIS, IJS, KILJ, NLZOH, NUK, OILJ, SBCE, SBMB, UL, UM, UPUK, VSZLJ
Caregivers and family members of Intensive Care Unit (ICU) survivors can face emotional problems following patient discharge from hospital. We aimed to evaluate the impact of a multi-centre ...integrated health and social care intervention, on caregiver and family member outcomes.
This study evaluated the impact of the Intensive Care Syndrome: Promoting Independence and Return to Employment (InS:PIRE) programme across 9 sites in Scotland. InS:PIRE is an integrated health and social care intervention. We compared caregivers who attended this programme with a contemporary control group of ICU caregivers (usual care cohort), who did not attend.
The primary outcome was anxiety measured via the Hospital Anxiety and Depression Scale at 12 months post-hospital discharge. Secondary outcome measures included depression, carer strain and clinical insomnia. A total of 170 caregivers had data available at 12 months for inclusion in this study; 81 caregivers attended the InS:PIRE intervention and completed outcome measures at 12 months post-hospital discharge. In the usual care cohort of caregivers, 89 completed measures. The two cohorts had similar baseline demographics. After adjustment, those caregivers who attended InS:PIRE demonstrated a significant improvement in symptoms of anxiety (OR: 0.42, 95% CI: 0.20-0.89, p = 0.02), carer strain (OR: 0.39; 95% CI: 0.16-0.98 p = 0.04) and clinical insomnia (OR: 0.40; 95% CI: 0.17-0.77 p < 0.001). There was no significant difference in symptoms of depression at 12 months.
This multicentre evaluation has shown that caregivers who attended an integrated health and social care intervention reported improved emotional health and less symptoms of insomnia, 12 months after the delivery of the intervention.
Aims and objectives
To summarise the literature describing new graduate nurse transition to professional practice within the primary health care (PHC) setting.
Background
There is a plethora of ...research literature spanning several decades about new graduate nurse transition in the acute care setting. Yet, the experiences of new graduate nurse in the PHC setting is unremarkable particularly considering the increasing demand for skilled health care workers and focus of health reform to provide care where people work and live.
Design
Electronic data bases, Academic Search Complete, EBSCO, Medline, PsycINFO, CINHAL, and ERIC were searched using a combination of terms and synonyms arising from three key concepts which identify the phenomenon; ‘transition’, ‘new graduate registered nurse’ and ‘primary health care. An inclusive search strategy placed no limits on language or publication date.
Results
Of the 50 articles located and examined for relevance; 40 were sourced through databases and 10 from Google Scholar/Alerts and hand‐searching references. None of the 19 articles retained for analysis addressed all key concepts.
Conclusions
Some challenges of researching the professional transition of graduate nurses in PHC settings included, an absence of definitive transition models, a dearth of literature and deference to acute care research.
Relevance to clinical practice
Nursing in PHC settings, particularly the client's home is notably different to hospital settings because of higher levels of isolation and autonomy. Societal changes, health reform and subsequent demand for skilled workers in PHC settings has caused health care providers to question the logic that such roles are only for experienced nurses. Implications arise for education and health service providers who desire to close the theory practice gap and mitigate risk for all stakeholders when next generation nurses have limited opportunities to experience PHC roles as undergraduates and newly graduated registered nurses are already transitioning in this setting.
Full text
Available for:
BFBNIB, FZAB, GIS, IJS, KILJ, NLZOH, NUK, OILJ, SBCE, SBMB, UL, UM, UPUK, VSZLJ
In response to the pandemic, healthcare providers rapidly transitioned from in-person to virtual patient examinations. The problem addressed in this qualitative empirical phenomenological study aimed ...to explore the experiences of healthcare providers regarding the technical challenges they faced due to this accelerated shift. The purpose of this research sought to explore the technological limitations inherent in telemedicine systems and their impact on the quality of care during virtual services. Guided by the Unified Theory of Acceptance and the Unified Theory of Acceptance and Use of Technology models, the researcher conducted 19 in-depth, open-ended interview questions with 21 healthcare providers via a social networking site on Facebook. The researcher recorded the interviews via Zoom and harnessed NVivo software to identify emerging themes. These themes included issues related to database management, technology equipment, service metrics, and technology barriers. Two central research questions drove the study. Firstly, the researcher investigated how healthcare providers' technological experiences influenced the quality of care during virtual patient examinations. Secondly, the researcher examined key technological challenges that emerged during the transition from in-person to virtual patient examination. The findings highlighted crucial technical constraints, including database management, equipment adequacy, service metrics considerations, and technology barriers. In response to these challenges, the researcher proposed several recommendations, including comprehensive training for both healthcare providers and patients, strengthening data security and privacy, enhanced system reliability, and improved access to care in remote regions. Integrating technology with operational practices emerged as pivotal in delivering high-quality virtual patient care, with a notable role for hospital physicians. Furthermore, the researcher highlighted the need for greater technology adoption among physicians in the private sector, nurses, and nurse technicians. This adoption would improve the monitoring of chronic illnesses and enhance patient outcomes. Future research endeavors could delve into contrasting perspectives among healthcare professionals working in hospital settings versus those in private clinics to advance the understanding of this domain. Additionally, examining the long-term effects of virtual patient examination on care quality would contribute significantly to the body of knowledge in this area.
This paper reports a two-year longitudinal study of the effects of cooperative learning on science attainment, attitudes towards science, and social connectedness during transition from primary to ...high school. A previous project on cooperative learning in primary schools observed gains in science understanding and in social aspects of school life. This project followed 204 children involved in the previous project and 440 comparison children who were not as they undertook transition from 24 primary schools to 16 high schools. Cognitive, affective, and social gains observed in the original project survived transition. The implications improving the effectiveness of school transition by using cooperative learning initiatives are explored. Possibilities for future research and the implications for practice and policy are discussed.
Full text
Available for:
BFBNIB, NUK, PILJ, SAZU, UL, UM, UPUK
A two-year randomised controlled trial of peer tutoring in mathematics using the Duolog Math technique was operated in 80 schools. The aim was to achieve adequate implementation quality with modest ...pre-intervention training for teachers, who received brief didactic training and no process feedback (but they were to train pupils using modelling, practice and feedback). Implementation integrity was observed in Year 1 in 29 randomly selected schools; in Year 2 in 30 randomly selected schools. In both years some observed variables of class-wide context and individual technique were high; however, some were lower. There were deficits in: teachers introducing the problem, suggesting ways to concretise the problem and holding plenary sessions. Crucially, there was very little summarising or generalising. Thus, implementation was partial in both years, but better in Year 2. The implications for future intensity of training are explored.
Full text
Available for:
BFBNIB, NUK, PILJ, SAZU, UL, UM, UPUK
Previous research has suggested that children of 5/6 years fail to understand that they are the authority on their own self‐knowledge. That is, when asked questions like, ‘Who knows best when you are ...feeling tired?’, they tend to cite their mother rather than themselves. Here we report a study that, rather than asking about generalities (‘Who knows best what you are thinking?’), presented 5‐, 7‐ 9‐ and 11‐year‐children with hypothetical vignettes about specific circumstances in which they were described as either disclosing or not disclosing a specified state to their mother. Children were subsequently asked to judge who would best know the state. Over all age groups children were significantly more likely to identify themselves as authorities on their own self‐knowledge when states had not been disclosed to mother than when they had. However, in the case of disclosed states, young children (though not older ones) asserted that, ‘mum knows best’. These findings are interpreted as suggesting not that young children entirely fail to understand first person authority, but instead that they make the relatively sophisticated assumption that mothers' interpretive competence is greater than their own.
Full text
Available for:
BFBNIB, DOBA, FZAB, GIS, IJS, IZUM, KILJ, NLZOH, NUK, OILJ, PILJ, PNG, SAZU, SBCE, SBMB, SIK, UILJ, UKNU, UL, UM, UPUK
The importance of primary health care PHC is receiving increasing attention. The demand for skilled workers is due to an increased emphasis on community-based care but until recent times ...pre-registration preparation for nurses, including clinical placements, have focussed on acute care specialties.
To systematically review, measure and describe the PHC content in the undergraduate nursing curriculum in Australian schools of nursing over time.
A cross-sectional study of all Australian universities offering undergraduate (pre-registration) baccalaureate degrees was undertaken in February 2017. Curriculum artifacts were retrieved from university websites. A terminology matrix guided retrieval of PHC content.
All 29 universities offering pre-registration undergraduate nursing degrees in Australia were included in this study. While most universities cite PHC principals as core values underpinning their undergraduate curriculum, only 12 (<2%) of the 694 subject titles had obvious or manifest “primary health care” content and these were mainly offered in 1st and 3rd year. Subject outlines tended to demonstrate more explicit content than subject titles.
This study confirms ambiguity in PHC interpretation and nomenclature, and opportunities for undergraduate preparation for nursing roles in the home setting is limited. Prospective undergraduate nurses seeking careers in PHC might be deterred by a lack of manifest PHC content in the public domain, which may or may not accurately represent the actual content provided.
The predominance of acute episodic care in both curricula and clinical experiences potentially diminishes the importance of PHC. This study offers some direction for education providers and policymakers wishing to attract and prepare next generation nurses for roles in PHC.
Full text
Available for:
GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
BackgroundAdvances in medical knowledge and surgical procedures have resulted in people living longer with chronic disease or discharged earlier from hospital following surgery. An increasing ...expectation of quality health care and provision of services where people work and live requires a practice ready and sustainable primary health care PHC nursing workforce. However, preparing nurses for these roles is challenging when the emphasis of undergraduate education is acute care focused and exposure to authentic community nursing roles is limited.AimThe aim of this research was to explore experiences of new graduate nurse NGN transition and their preparation for PHC roles.MethodsA six-phase convergent mixed methods research design used qualitative and quantitative arising data from five discrete studies. These studies employed various techniques to explore and examine the phenomena of NGN transition to practice in the community nurse role. Data were analysed individually then converged in Phase IV an anchor point from which to identify barriers and enablers of transition and to develop and refine the products of research following stakeholder feedback.ResultsThere was no consensus found in the literature about transition models or best practice guidelines for transition programs in either the acute or PHC setting. Online curricula artifacts (n=694) from 29 Australian nursing schools were analysed revealing an acute care focus with minimal 2% explicit PHC content and limited exposure to authentic roles. Experiences of 54 participants arising from studies, 3) interviews, 4) expert panel/ Delphi survey and 5) focus groups were used to triangulate data, highlight barriers and enablers to NGN transition and validated the products of research.DiscussionThis research produced a model of transition and expert consensus, and best practice guideline framework for NGN transition in PHC validated by stakeholders. Findings also challenged long-held assumptions that only experienced nurses can work in PHC roles or whether acute care hospital experience is necessary for skills consolidation.ConclusionThis study has cast a spotlight on an area of nursing that is of critical importance. As we grapple a rising burden of chronic illness across the life span, the role of community nurses are increasingly important. A future workforce reflective of this shift in care requires critical attention in policy, practice, education and research.
PDF
