Small‐scale models of dementia care are a progressive approach to improve care for people living with dementia. These models intend to provide a home‐like environment with a small number of residents ...in each living unit, easy access to services and facilities, a dedicated team of staff and flexible routines. This study was undertaken during the construction phase of a new village and provided a unique opportunity to explore expectations of the village among the local community. Twelve community members participated in two sequential online focus groups over a 2‐month period. Focus group discussions were recorded, transcribed and analysed using a reflexive thematic analysis approach. Knowledge of the village varied and was informed by familiarity with other village developments and local marketing about the new village. The findings indicate that the community expect the village to provide residents with optimum dementia care, a safe and enabling physical environment and a vibrant daily life where they are engaged in ‘normal’ activities. While participants expected the village to be self‐contained, they also anticipated strong connections with the wider community. Participants acknowledged that the community need dementia education to ensure these interactions are positive. Community expectations of a new village development for people living with dementia are largely positive and often idealistic. Organisations need to consider these expectations when developing new small‐scale facilities and be mindful of how they market these developments to foster realistic expectations. While community enthusiasm about dementia care is encouraging, education is needed to ensure the success of the model.
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BFBNIB, DOBA, FZAB, GIS, IJS, IZUM, KILJ, NLZOH, NUK, OILJ, PILJ, PNG, SAZU, SBCE, SBMB, SIK, UILJ, UKNU, UL, UM, UPUK, VSZLJ
Aims and objectives
To present findings from a study that explored nursing students' experiences of bullying in clinical and academic settings, the strategies used to negotiate bullying and ...recommendations for empowering future students.
Background
Nursing students are identified as a group who are at particular risk of bullying. Numerous studies have examined students' experiences of bullying in clinical contexts by qualified nurses; however, there has been far less attention to the bullying that occurs in academic settings where the perpetrators are university staff and other students.
Design
The qualitative findings presented in this paper form one component of a mixed‐methods, multisite study that examined the nature and extent of bullying in one cohort of nursing students.
Methods
A convenience sample of 29 first‐, second‐ and third‐year undergraduate nursing students from one semimetropolitan Australian university was recruited for semistructured interviews in 2014. Interview data were analysed using NVivo.
Findings
Participants described multiple examples of bullying occurring in both clinical and academic settings. Perpetrators included clinicians, facilitators, academics and fellow students. Bullying ranged from incivility to physical attacks. The impact of the bullying was profound; it caused many of the participants to feel anxious and distressed, it undermined their confidence and perception of competence, and it often led them to question their career choice.
Strategies described by participants to cope with or manage the bullying included avoidance, trying to “just survive” and seeking support from trusted academic staff, family and friends. No episodes of bullying were formally reported.
Conclusion
Bullying remains a pervasive phenomenon occurring in both clinical and academic settings. Students are, in many respects, a vulnerable and disempowered population who often fear the consequences of making a formal complaint. Thus, reporting structures and support strategies need to be re‐examined, and resilience training is imperative.
Relevance to clinical practice
Bullying remains a continuing concern in undergraduate nursing degrees. Efforts must be made in clinical and academic settings to heed the advice of undergraduates using broader strategies to address the issues.
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BFBNIB, FZAB, GIS, IJS, KILJ, NLZOH, NUK, OILJ, SBCE, SBMB, UL, UM, UPUK, VSZLJ
courtney‐pratt h., fitzgerald m., ford k., marsden k. & marlow a. (2012) Quality clinical placements for undergraduate nursing students: a cross‐sectional survey of undergraduates and supervising ...nurses. Journal of Advanced Nursing68(6), 1380–1390.
Aim. This article is a report of a mixed method study of the quality of clinical placements for second year undergraduate nursing students in an acute care hospital.
Background. In response to the current and predicted workforce shortages, greater numbers of nursing undergraduate places are being offered at tertiary institutions. This means that requests for clinical places in hospitals to support undergraduate students has risen. Little is known about the impact of increased numbers on the quality of clinical placement as a learning experience and this is of concern as demand grows and the means of assessing capacity is still unknown.
Methods. A 5‐point Likert Scale questionnaire, including free text fields, was administered to undergraduates (n = 178), clinical facilitators (n = 22) and supervising ward nurses (n = 163) at two time points in 2009. The survey targeted the quality of the clinical placement in four domains: welcoming and belongingness; teaching and learning; feedback; confidence and competence.
Findings. The findings demonstrated consistently high scoring of the clinical placement experience by both undergraduates and registered nurses. There were higher ratings of levels of support from clinical facilitators compared to supervising ward nurses evident in data associated with the items on the questionnaire relating to teaching and learning.
Conclusion. The results are indicative of the professional commitment of nursing staff to support the next generation of nurses. The findings also give a mechanism to communicate outcomes of undergraduate support to nurses in practice, and highlight steps which can be taken to ensure high quality clinical placement continues.
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BFBNIB, FZAB, GIS, IJS, KILJ, NLZOH, NUK, OILJ, SBCE, SBMB, UL, UM, UPUK, VSZLJ
Aims
This study aimed to identify behaviours and cues that nurses recognise as indications of unsafe practice, perceived factors that contribute to unsafe practice and actions nurses take in ...response.
Design
Cross‐sectional survey.
Methods
National cross‐sectional survey of a random sample of registered nurses (n = 231) in New Zealand, in 2017–2018. The STROBE Checklist was used to report this study.
Results
Nurses reported a high rate of episodes of unsafe practices and recognised a range of behaviours and cues that alerted them to the potential for unsafe practice. Several organisational issues were perceived to contribute to unsafe practice occurring. The reporting of episodes of unsafe practice and perceived organisational support was low for nurses compared with managers.
Conclusion
Failure to recognise and respond to unsafe practice may indicate a tolerance for substandard practice by individual nurses, or by the organisation. Nurses who recognise unsafe practice must be supported by the organisation.
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BFBNIB, FZAB, GIS, IJS, KILJ, NLZOH, NUK, OILJ, SBCE, SBMB, UL, UM, UPUK, VSZLJ
Objectives
To investigate dementia knowledge within a rural Australian general public cohort and understand demographic predictors of knowledge in this population.
Design
A cross‐sectional study ...comprising quantitative surveys.
Setting
321 participants were recruited from the Tasmanian general public (February‐September 2017).
Participants
28% of participants were from remote or outer regional postcodes; the remainder were from inner regional areas. The median age was 46 years; 35% were male. 30% had participated in prior dementia education, 29% had worked with people living with dementia, and 23% had no identified personal experience of people living with dementia.
Interventions
No interventions were conducted as part of this study.
Main outcome measures
Dementia knowledge was assessed using the Dementia Knowledge Assessment Scale. Demographic variables were also collected.
Results
Mean dementia knowledge was moderate and participants scored highest on the care considerations subscale. Those with personal experience with a person living with dementia scored significantly higher on all subscales, and overall, than those without. Dementia education, general education, and previous work, care or close relationship with people living with dementia were all significant predictors in a regression model explaining nearly a third of the variance in overall dementia knowledge.
Conclusion
While personal experience of dementia improves knowledge of the condition, dementia education is the most important predictor. Deficits identified in knowledge of risk factors, and incomplete knowledge about aspects important to quality care, suggest a need for further education for the general public, particularly in the light of the rising prevalence of dementia in ageing rural populations.
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DOBA, FZAB, GIS, IJS, IZUM, KILJ, NLZOH, NUK, OILJ, PILJ, PNG, SAZU, SBCE, SBMB, SIK, UILJ, UKNU, UL, UM, UPUK, VSZLJ
Aims and objectives
To examine nursing student placement preferences submitted as online comments to a university's placement management system, to inform strategies for positive residential aged ...care experiences.
Background
There are predicted shortages of nurses to service an ageing population. Clinical placements undertaken by undergraduate nursing students help shape their attitudes and are a key determinant of career decision‐making, yet there is little research about why students prefer particular placement areas.
Design
Analysis of qualitative data from a placement management system.
Methods
Of 6,610 comments received between 2007–2014, 607 related to aged care and were coded according to preferences for being placed in a residential aged care facility, with reasons for this preference thematically coded and quantified.
Results
Four hundred and one comments (66.1%) related to students requesting not to be allocated residential aged care for the upcoming placement, primarily due to previous experience in the sector; 104 (17.1%) referred to aged care in a neutral manner, focusing on conflict of interest; 102 (16.8%) related to a request for an aged care placement.
Conclusions
The student nurse comments characterise students as being focused on maximising their learning, while considering prior experience. In some cases, increased exposure to aged care is considered to offer limited learning opportunities, which is concerning and suggests that both the tertiary and aged care sectors have a joint responsibility to pursue recognition of aged care nursing as a specialised, highly skilled role.
Relevance to clinical practice
Nursing programme providers should ensure curriculum content and exposure to aged care placement clearly identify the complexities of care and provide genuine opportunities for knowledge acquisition and skill development based on multifaceted resident care needs. This will support both those interested in a future aged care career and those undecided.
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Person-centred approaches to practice recognise the global call to humanise healthcare, where people are valued and their preferences and needs are respected (WHO, 2015). Researchers must also ...embrace person-centred approaches to further inform person-centredness as the foundation of healthcare policy and practice. Healthcare researchers, policymakers, leaders, educators, and multi-disciplinary practitioners are invited to consider how person-centred methodologies enhance the value and authenticity of research. Person-centred research principles to guide researchers are available (Dewing et al., 2021; McCormack et al., 2017), and one approach proposes an overarching research principle of connectivity; the being, doing, and knowing of the researcher throughout the development, implementation, and dissemination of the research study (Jacobs et al., 2017). An exploration of the principles of attentiveness and dialogue, empowerment and participation, critical reflexivity, and loving kindness that inform connectivity (Jacobs et al., 2017; van Leishout & Peelo-Kilroe, 2021) is presented here. No single methodology is associated with person-centred research, and researchers are encouraged to consider how to incorporate person-centred principles in many different contexts. This paper explores the innovative use of person-centred principles to underpin a constructivist grounded theory (CGT) study illuminating the person-centred nursing process of engaging authentically (McCormack & McCance, 2021). Synergies and connections between the person-centred research principles and Charmaz’s CGT approaches are explored, and further considerations are highlighted. We contend that person-centred research principles support CGT research, explicitly building on Charmaz’s relational approaches and enabling a rigorous foundation for engaging in research, where valuing and respect are central.
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DOBA, IZUM, KILJ, NUK, ODKLJ, PILJ, PNG, SAZU, UILJ, UKNU, UL, UM, UPUK
Aims and objectives
To evaluate the impact of an arts in health programme delivered by a specialised artist within an acute older person's unit.
Background
Acute hospitals must meet the increasingly ...complex needs of older people who experience multiple comorbidities, often including cognitive impairment, either directly related to their admission or longer term conditions, including dementia. A focus on physical illness, efficiency and tasks within an acute care environment can all divert attention from the psychosocial well‐being of patients. This focus also decreases capacity for person‐centred approaches that acknowledge and value the older person, their life story, relationships and the care context. The importance of arts for health and wellness, including responsiveness to individual need, is well established: however, there is little evidence about its effectiveness for older people in acute hospital settings. We report on a collaborative arts in health programme on an acute medical ward for older people.
Design
The qualitative study used collaborative enquiry underpinned by a constructivist approach to evaluate an arts programme that involved participatory art‐making activities, customised music, song and illustration work, and enlivening the unit environment.
Methods
Data sources included observation of art activities, semi‐structured interviews with patients and family members, and focus groups with staff. Data were transcribed and thematically analysed using a line by line approach.
Results
The programme had positive impacts for the environment, patients, families and staff. The environment exhibited changes as a result of programme outputs; patients and families were engaged and enjoyed activities that aided recovery from illness; and staff also enjoyed activities and importantly learnt new ways of working with patients.
Conclusions
An acute care arts in health programme is a carefully nuanced programme where the skills of the arts health worker are critical to success. Utilising such skill, continued focus on person‐centeredness and openness to creativity demonstrated positive impacts for patients, families, staff and the ward environment.
Implications for practice
This study affirms the contribution of an arts in health program for older persons in an acute care setting in challenging the dominance of a task based medical model and emphasising person‐centred care and outcomes.
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BFBNIB, FZAB, GIS, IJS, KILJ, NLZOH, NUK, OILJ, SBCE, SBMB, UL, UM, UPUK, VSZLJ
Aims and objectives
To determine the effect of immersive 3D cultural simulation on nursing students' empathy towards culturally and linguistically diverse patients.
Background
Accelerated ...globalisation has seen a significant increase in cultural diversity in most regions of the world over the past forty years. Clinical encounters that do not acknowledge cultural factors contribute to adverse patient outcomes and health care inequities for culturally and linguistically diverse people. Cultural empathy is an antecedent to cultural competence. Thus, appropriate educational strategies are needed to enhance nursing students' cultural empathy and the capacity to deliver culturally competent care.
Design
A one‐group pretest, post‐test design was used for this study. The simulation exposed students to an unfolding scene in a hospital ward of a developing county.
Methods
A convenience sample of second‐year undergraduate nursing students (n = 460) from a semi‐metropolitan university in Australia were recruited for the study. Characteristics of the sample were summarised using descriptive statistics. T‐tests were performed to analyse the differences between pre‐ and post simulation empathy scores using an eight item modified version of the Kiersma‐Chen Empathy Scale.
Results
Students' empathy towards culturally and linguistically diverse patients significantly improved after exposure to the 3D simulation experience. The mean scores for the Perspective Taking and Valuing Affective Empathy subscales also increased significantly postsimulation.
Conclusions
The immersive 3D simulation had a positive impact on nursing students' empathy levels in regards to culturally and linguistically diverse groups. Research with other cohorts and in other contexts is required to further explore the impact of this educational approach.
Relevance to clinical practice
Immersive cultural simulation experiences offer opportunities to enhance the cultural empathy of nursing students. This may in turn have a positive impact on their cultural competence and consequently the quality of care they provide to culturally and linguistically diverse patients.
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BFBNIB, FZAB, GIS, IJS, KILJ, NLZOH, NUK, OILJ, SBCE, SBMB, UL, UM, UPUK, VSZLJ
Aim
To determine how nurses recognize and respond to unsafe practice.
Background
Practice guidelines and standards outline safe practice. Nurses face challenges in recognizing and responding unsafe ...practice.
Design
Whittemore and Knafl's revised framework for integrative reviews guided the analysis.
Data sources
A comprehensive search of literature exploring the identification and response to unsafe practice, was undertaken in CINAHL, Medline, Embase and PsychoINFO databases for the period 2004–2014.
Review methods
Nineteen articles from 15 studies were included in the review. A mixed method integrative approach was used to review data and draw conclusions.
Results
Behaviours and cues that indicate unsafe practice are influenced by organizational and individual characteristics. Individual nurses responses are variable and there are professional and personal costs associated with being reported or reporting unsafe practice.
Conclusion
The small number of studies reviewed limits the conclusions that can be drawn from the review but suggest that nurses can identify unsafe practice in their peers. Individual nurses’ recognition and response to unsafe practice in their peers contributes to patient outcomes and safety. Nurses need awareness training and strategies to respond to unsafe practice and reporting systems that protect reporters from repercussions. Further research investigating organizational factors and individual factors that contribute to a shift in practice across safety boundaries is required.
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BFBNIB, FZAB, GIS, IJS, KILJ, NLZOH, NUK, OILJ, SBCE, SBMB, UL, UM, UPUK, VSZLJ
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