Dissertations / Theses on the topic 'Nurses Education Australia'

The purpose of this portfolio was to establish what educational strategies would enhance the professional education for the nurse of the future. Through an examination of various contemporary educational theorists' work. a conceptual framework was developed using the concepts of Hargreaves (2003) as an overarching model to establish the current positioning of nursing and nursing education in the knowledge society. The preparation ofa nurse who can function effectively and efficiently within a rapidly changing health workplace relies heavily on educational preparation that includes the development of knowledge, skills and attitudes appropriate for the role. This portfolio has examined critical aspects of nursing and nurse education in relation to the development of these necessary areas for future nurse professionals.

Since the introduction of the Internet, there has been an increase in the adoption of this technology for educational purposes. This development and widespread availability of Internet technologies, alterations in the needs of clinical practice and the characteristics of students, have all inspired changes in nursing education (Mallow & Gilje, 1999). In response, nursing education has embraced the opportunity this communication medium offers to the diverse groups of students in nursing. These students may be studying at a distance, or due to other constraints such as time or professional commitments, studying in flexible ways where students may or may not be in the classroom. In other instances, Internet technologies are being used with the aim of enriching learning in nursing. However, despite widespread development and implementation of these innovations, the effects on nursing education have not been extensively researched (Cheek, Gilham & Mills, 1998; Gillham, 2002; Mallow & Gilje, 1999) and little is known about how the Internet contributes to teaching and learning, what learning outcomes are, or what support is required by teachers and students (Billings, 2000). At this time of rapid development of Internet-based and Internet-supported courses in the Australian nursing education system, there is a need to ensure such courses are educationally effective, clinically relevant, and that resources are appropriately assigned. This exploratory study aimed to contribute to effective discipline-specific use of internet learning environments through increased understanding of students’ and academics’ experiences of teaching practices and learning processes. There were two phases to this mixed-method study, a survey of course coordinators, and secondly, interviews with eleven students and sixteen academics. The survey of diverse schools of nursing across Australia provided foundational information about the ways the Internet was integrated into nursing education, and the preparation and supports that were offered to students for Internet-based or Internet-supported learning. Guided by a constructivist theoretical framework, and analysed thematically, the key findings of this study were drawn from the academics’ and students’ experiences in a variety of nursing courses in universities located across Australia. The Internet was employed in these courses in a variety of ways. At the time of data collection for both the survey and the interviews, more courses were Internet-supported than Internet-based. A variety of Internet information and communication features were used in courses. The survey findings provided both a context for the interview findings, and a degree of confirmation of these findings. The context reported was diverse, consistent with an emergent educational environment that has few precedents to guide its implementation. The academics’ experiences revealed that teaching in online environments was vastly different to face-to-face teaching and required different practices of teaching and learning that took into consideration the separation of teachers from learners, and learners from each other. While often enthusiastic about the new environment, many teachers needed specific preparation, support, and adequate resources to teach in this new environment. Similarly, students experienced a dislocation from the learning environments to which they were accustomed. Significant shifts were apparent in the students’ constructions of both individual and collaborative learning that were contingent upon the separation of teachers and learners, and the necessity of communicating in a written medium. Both teachers and learners revealed how, consequent upon their dislocation, they were relocating to a new interpretation of time, place and relationships in Internet learning environments, and were reconstructing teaching and learning. The reconstructions of learning included ways of relating that built learning communities predicated on a shift in focus from teaching to learning. These included both a shift in individual student’s learning, and a constructed understanding that arose variously from shaping a fundamental comprehension or challenging thinking, to expand comprehension in the group. Through new understandings and practices, the participants were beginning to construct a place for students and teachers to realise the possibilities for enriched learning that online communities can provide. The findings of this study are discussed in terms of the possibilities for teaching and learning in nursing education, and recommendations are made.

Rural palliative care nurses (RPCNs) in Western Australia (WA) are a small population, who have embraced the specialist palliative care role since the first palliative care service in rural WA began in 1990. However, there are some challenges involved with being a specialist nurse in a generalist health care setting. fu particular, there is a suggestion in the literature that RPCNs may be professionally isolated, may be prone to burnout, and may therefore experience decreased job satisfaction and may consider leaving the palliative care field.

Aim: To determine if the current rural graduate programs in Western Australia adequately support new graduate nurses transitioning into rural and remote practice. Background: Graduate nurse transition to employment is a time of significant change and challenges often results in periods of transition shock. These challenges are magnified in rural areas when graduates have limited rural nursing experience and move to commence their career. Supportive graduate nursing programs are essential for enabling nursing transition to practice and assist in reducing attrition rates. Graduate programs were developed to smooth the transition for university trained bachelor’s degree registered nurses into the workforce. Design: A parallel convergent mixed method design which was informed by Duchscher’s Stages of Transition Theory, the conceptual framework chosen to guide the study. Method: Through a purposive sample of graduate and senior nurse participants were invited from rural and remote Western Australia during 2015 to mid-2016. The quantitative tool was applied three times to new graduate registered nurses of which a total of 34 completed the survey. The survey was applied once to senior nurses, 40 of whom completed the survey. Semi structured interviews were conducted for both cohorts at three separate time intervals. Ten new graduate registered nurses and 15 senior nurses were interviewed throughout the 12-month timeframe. Braun and Clarke thematic analysis was applied to analyse the qualitative data. Descriptive statistics and content analysis were used to analyse the surveys. Results: In the first three months new graduates cycled through both transition shock and honeymoon periods resulting in a high level of satisfaction overall, however less satisfaction with the preceptorship. The level of satisfaction dropped significantly at seven months resulting in transition crisis before the adjustment period began. The transition occurred in a linear manner over three distinct timeframes. Limited resources were highlighted as an obstacle to providing adequate support in the rural graduate programs. Conclusion: Graduate programs need to be structured but flexible to allow for individual differences in graduates and clinical situations. The honeymoon stage coexisted with transition shock which may hide the need for adequate support to continue. Inadequate and/or a lack of preceptorship was evident throughout the Western Australian rural graduate programs. Relevance to clinical practice: Graduate programs need to be structured but flexible to allow for individual differences in graduates and clinical situations. New graduate nurses would benefit from a break midway through their transition year to assist and overcome the transition crisis stage. Development of the preceptor role through education is required to deliver adequate support to graduate nurses and decrease transition shock. Emphasis on the transition journey is required in undergraduate final semesters to help better prepare new graduates to manage the change from students to registered nurse.

This paper examines the political activities of nurses in Australia, within the context of interest group theory and, in particular, the work of Gamson (1968) and Zeigler and Peak (1972). It spans 1961 to 1984 and takes into consideration the dynamics of both the nursing profession and the political systems during that time. The specific issue dealt with is the transfer of nurse education, from traditional hospital based schools of nursing to tertiary institutions. This transition involved the co-ordination of a national campaign by nurses in an attempt to influence policy makers at both state and federal level. The dissertation is an historical and political analysis which required this writer to study the documents of professional nursing organisations, parliamentary debates and the print media. Interviews were also conducted with some of the key people involved in the transfer. In order to validate the information, and ensure its reliability, multiple methods of triangulation were used. From 1961 to 1984, nursing organisations progressed through a number of stages before finally emerging in 1977 as a fully-fledged pressure group. Until 1983, they were viewed by those in authority as 'alienated' and consequently were unable to achieve any of their goals satisfactorily. However, nurses correctly perceived the political system generally, as being ambivalent to their demands. Gamson terms such ambivalence "neutrality", and hypothesises that when a pressure group identifies neutrality in a political system, it is highly likely to take action. This proved to be the case with nurses. Although their campaign lasted seven long years, it proved ultimately to be fairly successful. However, as will be demonstrated, an 'authority' will only concede to the demands of a particular pressure group to the extent that a counter group is not disadvantaged.

The purpose of this study was to present issues and the paradoxes surrounding advanced nurse specialisation (ANS) and education, This study was conducted in two parts. Part A examined the prospective experiences of 13 registered nurses (RNs) who were advancing in an area of special is III ion: they were working in a specialist area of practice and studying in II course specific 10 their specialisation. Two rounds of interviews were completed over six-month intervals. Part B examined the data gathered from a focus group interview and follow-up feedback from 10 nurse executives as stakeholders. The intersubjective data from this group of nurses expanded on the political, economic, and social complexities surrounding the same phenomenon of interest.

National trends in nurse education have changed from the Nightingale system of on-the-job training to a professional preparation in institutions of higher learning. Western Australia was one of the first States in Australia to commence a professional preparation of nurses at an institution of higher education in 1975. Graduates of the program were presented with their Bachelor of Applied Science from the Western Australian Institute of Technology (now Curtin University of Technology), in March 1979. This thesis seeks to answer the question concerning the genesis of such an event. The focus of the study is primarily to follow the progress of general nurse education in Western Australia and to highlight the accompanying influences that shaped its development. The purpose of this study was to explore, analyse, interpret and describe the history of nurse education in Western Australia from 1962-1975. The study used a pluralistic approach employing a variety of historical methods. The research commenced with broad questions and ideas developed from documents and people. The process of data collection, historical criticism and analysis took place simultaneously. The synthesis was written as a chronological narrative. The material of the study thus 'spoke' for itself by providing answers to questions raised during the investigation. The history of nurse education from 1962 to 1975 revealed visible milestones that represented nurse education reform. Beginning from the antecedents of the study these were the sanctioning of a review of nurse training in 1960 together with the commencement of the Western Australian Nursing Survey and the appointment of the Nurses Registration Board Education Officer. In 1962 the survey was completed.It exposed the deficits of nurse training which led to the development of a new Hospital Based Diploma curriculum and an Associate Diploma in Nursing in 1966. The establishment of the College of Nursing Australia Western Australian Branch in 1966 paved the way to solve the shortage of tutors to implement the Hospital Based Diploma. The Nurses Act in 1970 enhanced the plans for implementing the Hospital Based Diploma and conferred autonomy to the Nurses Registration Board. In 1973 the first independent school of nursing came into being. The Western Australian School of Nursing carried the hopes of a continuation of hospital nurse training. In 1974, however, the entry of students to the Western Australian Institute of Technology School of Nursing saw a turn of events that led to a degree for nurses in 1975 and a decision for the transfer of all nurse education in Western Australia to the Western Australian Institute of Technology. These milestones did not emerge as an accident of history. There were forces that facilitated and impeded the perceptibility of the reform landmarks. These were crucial in the shaping the history of nurse education in Western Australia from 1962-1975.

The health workforce is one of the critical issues facing contemporary Australian health care systems. Therefore carefully defining roles in the health care system is of great importance. The Role of the Nurse Educator in Australian Acute Care Hospitals study used a mixed-method research design to develop a performance self-assessment scale for nurse educators and describe instances of role ambiguity and conflict. These findings will facilitate comprehensive understanding and integration of nurse educator roles throughout healthcare and education.

Primary health care as a model for the provision of health services was introduced by the World Health Organization In the mid 1970s. Initially viewed as a means of health promotion and advancement of wellness in developing countries., it was soon to be adopted by industrialised countries to assist in relieving the demand on acute care services. This was to be achieved through education of the community towards good health practices and the preparation of nurses to practice in the community, outside of the acute care environment Australian nurses were slow to respond to this philosophy of health care and this study has sought to examine why this is so. It has been found that there are a multitude of reasons for the lack of action In the decade or more following the Declaration of Alma Ata and the major Issues have been identified and elaborated. Some of the major reports of the time that were associated with and had some Influence on health care and nurse education have been examined to identify recommendations and how much they support the ethos of primary health care. These include the Sax committee report of 1978 and a submission by the Department of Employment and Industrial Relations In 1987. As part of the investigation, nursing curricula from around Australia in the mid 1980s have been examined to determine the degree of the primary health care content according to guidelines recommended by the World Health Organization. It was found that generally at that time, there was a deficit In the preparation of undergraduate students of nursing for practice In the area of primary health care when the world, including industrialised nations, was making moves towards this model of health care delivery. Factors Influencing the slow response of nursing have been examined and finally recommendations for further studies have been put forward.

National trends in nurse education have changed from the Nightingale system of on-the-job training to a professional preparation in institutions of higher learning. Western Australia was one of the first States in Australia to commence a professional preparation of nurses at an institution of higher education in 1975. Graduates of the program were presented with their Bachelor of Applied Science from the Western Australian Institute of Technology (now Curtin University of Technology), in March 1979. This thesis seeks to answer the question concerning the genesis of such an event. The focus of the study is primarily to follow the progress of general nurse education in Western Australia and to highlight the accompanying influences that shaped its development. The purpose of this study was to explore, analyse, interpret and describe the history of nurse education in Western Australia from 1962-1975. The study used a pluralistic approach employing a variety of historical methods. The research commenced with broad questions and ideas developed from documents and people. The process of data collection, historical criticism and analysis took place simultaneously. The synthesis was written as a chronological narrative. The material of the study thus 'spoke' for itself by providing answers to questions raised during the investigation. The history of nurse education from 1962 to 1975 revealed visible milestones that represented nurse education reform. Beginning from the antecedents of the study these were the sanctioning of a review of nurse training in 1960 together with the commencement of the Western Australian Nursing Survey and the appointment of the Nurses Registration Board Education Officer. In 1962 the survey was completed.
It exposed the deficits of nurse training which led to the development of a new Hospital Based Diploma curriculum and an Associate Diploma in Nursing in 1966. The establishment of the College of Nursing Australia Western Australian Branch in 1966 paved the way to solve the shortage of tutors to implement the Hospital Based Diploma. The Nurses Act in 1970 enhanced the plans for implementing the Hospital Based Diploma and conferred autonomy to the Nurses Registration Board. In 1973 the first independent school of nursing came into being. The Western Australian School of Nursing carried the hopes of a continuation of hospital nurse training. In 1974, however, the entry of students to the Western Australian Institute of Technology School of Nursing saw a turn of events that led to a degree for nurses in 1975 and a decision for the transfer of all nurse education in Western Australia to the Western Australian Institute of Technology. These milestones did not emerge as an accident of history. There were forces that facilitated and impeded the perceptibility of the reform landmarks. These were crucial in the shaping the history of nurse education in Western Australia from 1962-1975.

By the end of the 20th century, hospital-based nurse training was replaced by nursing university programs with a greater focus on theoretically informed practice. This move coincided with the appearance of the competency movement across industries. Nursing competencies were primarily associated with political interests of increasing the flexibility through the demonstration of generic skills that could effectively increased scopes of practice. This flexibility created a blurring between RNs/ENs that contributed to an environment where neither role had clearly defined disciplinary boundaries. Competencies provided financial rewards for the organisation while increasing the workload of ENs and limiting the functions of RNs.

A mixed-method design was used to develop national practice standards for graduates of Australian critical care nurse education and a clinical assessment tool to measure graduate practice. Critical care nursing stakeholders, patients and families informed the multi-phase process. The expected graduate level of practice was identified as the safe practitioner who can care for most critically ill patients, but not as team leader. These findings provide greater consistency in determining graduate practice outcomes.

This thesis is based on a model of critical feminist ethnography, designed to explore how practice nurses experience their daily work life in rural and regional general practice. Here, rural and regional practice includes small and large organisations based outside the metroploitan area that employ practice nurses, some in large regional centres and others in small regional communities. Ownership of the general practicioners, local government, regional health services, Aboriginal medical services, universities and private-for-profit businesses.

In Australia, specialist education in paediatrics is not a requirement for nurses caring for hospitalised children. Thus, nurses can work in paediatrics without any prior knowledge of the unique needs of children such as developmental stages or separation anxiety. As a consequence, there are some clinicians and authors who advocate that when children require health care, they should be cared for by nurses who are educated in, and understand the specific physical, psychological and social needs of children. Despite this, the evidence is lacking as to whether specialist nurse education affects the quality of care in paediatrics. This study investigates whether the quality of care that children and their families receive is different to when they are nursed by specialist paediatric nurses (SPNs) compared to nonspecialist paediatric Registered Nurses (NSPNs). SPNs are Registered Nurses who have undertaken specific or further education in paediatrics and NSPNS are Registered Nurses who have no specific or further education in paediatrics. This research was prompted by national policy changes in Registered Nurse (RN) education which shifted the focus from hospital-based training to the tertiary sector. There has not been a review of paediatric nurse education in Australia since these changes in 1994. Quality measures have been developed for the admission procedure as it is the most common clinical procedure performed in hospital on children. The quality measures were defined by the literature and a Delphi Panel of international paediatric nursing experts. The five stage methodology incorporated: (i) a desk analysis of the literature and policies regarding paediatric nursing and education to identify quality measures (QMs); (ii) development of QMs for the most common hospital procedure for children, the admission procedure; (iii) the development of a consensus definition of QMs using the Delphi method; (iv) observation of RNs using video during the admission of children to the hospital to test the proposed QMs and measure whether SPNs behaved differently to NSPNs; and (v) a follow-up on-line survey of all of the observed RNs regarding their perceptions of other factors influencing their practice. This research found that overall, SPNs meet the quality measures during the admission procedure significantly more often than NSPNs (p=0.009). When the QMs were analysed individually, the analysis showed a significant relationship between education and some of the QMs, but not in others where the relationship was not statistically different. This leads to the assumption that there are other factors than the level of specialist education which affect the quality of care such as prompts on admission forms and/ or the RNs‘ personal experiences. However, in the on-line survey of the sample, the RNs reported that tailored education has played a major role in their care delivery to children and their families. The findings of this research indicate that in Australia, the ‗comprehensive‘ nursing model, which leads to the qualification of RN, may not be the best model for delivering the highest quality of care to children and their families.

Aim This study aimed to determine the impact of the implementation of a ward based Nurse Clinical Educator (NCE) role on students and staff at one health service whilst students were on clinical practicum at a Western Australian regional health care facility. Question The research question was: “What impact does the NCE support intervention have on students and clinical staff during clinical practicum?” Background Clinical experience for undergraduate student nurses (students) undertaking their bachelor’s degree is of utmost importance for gaining both competence and registration. Students encounter difficulties in obtaining opportunities to practice their skills and develop competence when on clinical practicum; and preceptors are often overwhelmed by their responsibility to supervise students, as well as provide holistic patient care. The literature identifies a need for a role which is directly responsible for student learning, which would maximise learning opportunities for students, as well as support preceptors. This role could maintain synergistic relationships and communication between the university and clinical facilities. Although there is literature reporting on the evaluation of either students’ or preceptors’ experience in the clinical setting, there have been only a few studies where both students’ and preceptors’ experiences were evaluated in the same study; or the effectiveness of a support model was implemented into the clinical setting and evaluated. Research focused on the implementation of a partnership intervention support model, would add to the limited body of knowledge on the efficacy of clinical support interventions. Methods This study utilises a convergent parallel mixed methods design, as it was deemed to provide a better triangulation of data obtained. Quantitative and qualitative data were collected in surveys before and after the NCE intervention, whilst students were on clinical practicum. Surveys collected data using both Likert-scale and open text responses. Analysis was performed using descriptive statistics and content analysis to interpret the findings. Participants Participants in this study were undergraduate nursing students and clinical staff who participated in clinical practicum during the implementation of a ward-based NCE support role in a Western Australian regional health care facility. Findings This study found the main impact of the NCE role was upon stress and time. Stress was reduced for both students who had access to increased support networks, and for preceptors who could obtain assistance with students when workloads were heavy. There was an increase in teaching time available for skill development for the students, which in turn led to increased competence of students, less time taken by student to undertake skills, and increased student confidence. There was an increase in available time for the preceptors for their workloads on the wards, and more time for preceptors to assist students, without being hampered by students taking a long time with skills.

The rising incidence of chronic diseases such as diabetes, associated comorbidities, an ageing population and rising health expenditure are all creating a greater burden on the Australian health care system.Purpose of the Study. The role of the practice nurse (PN) working within the general practice setting is expanding in response to health care demands and government policies, yet there is a lack of Australian research into how this role may impact upon the management of diabetes. This study explores current practice of PNs, their diabetes specific education, and driving and restraining forces that influence their involvement in diabetes management.Methodology. A cross sectional design with a postal survey, whereby 758 surveys were distributed to PNs via each of the 13 Western Australian Divisions of General practice, between October 2006 and May 2007. The final response rate was 16% (n = 118) with 118 surveys completed and returned. The Statistical Package for Social Sciences 15.0 was used for data entry and analysis.General Practice Setting. In the current study 85% (n = 94) of practices had a diabetes register, with 75% (n = 83) of PNs involved in operating this system. The PN has a defined role in contributing towards the development of chronic disease care plans and annual diabetes complication screening processes, services that are reimbursed through Medicare. However, current models of primary care delivery and funding appear to support the PN in this role as an adjunct to the general practitioner (GP), which may not permit full utilisation and recognition of the PNs’ professional scope of practice.The Role of the Practice Nurse. A statistically significant association was found between those PNs having completed diabetes related continuing education and the greater likelihood of providing education in insulin initiation, blood glucose monitoring, dietary advice, exercise and sick day education (p < .05). Whilst PNs in the current study displayed a high level of involvement in various areas of diabetes care, not all will be educationally prepared, yet may be undertaking what could be considered a more advanced practice role in diabetes self management education.Diabetes Knowledge Test. There was significantly higher scoring in the Diabetes Knowledge Test (DKT) where questions related to insulin therapy, amongst those PN’s with a role in providing education in self monitoring of diabetes (p = .036). Likewise, where the provision of dietary advice was part of the PN role, scoring was significantly higher in the DKT overall (p = .029). For those spending greater than two hours per week in diabetes related care, scores were significantly higher where questions examined principles surrounding management of blood glucose levels (p = .031). Practice nurses having undertaken a clinical audit related to diabetes care, scored significantly higher in the DKT overall (p = .037), particularly where those questions related to the complications associated with diabetes (p = .009).Barriers and Facilitators to PN Role in Diabetes Self Management Education. Practice nurses in the current study placed a significantly high level of importance on their role in patient teaching. However, time was found to be a significant barrier to this role (p < .05). The current study displays a high level of involvement by PNs in various areas of diabetes self management education and related clinical assessment, with a low level of involvement in diabetes specific continuing formal education. Whilst this facet of their role has more recently been acknowledged within general practice guidelines for diabetes management, the question remains as to the level of educational preparedness of the PN, to meet this expanding role.

The purpose of this study was to examine some of the interrelationships between innovation in nursing education, professional attitudes and wastage from nursing. Five groups of students who participated in innovative nurse education courses in A.C.T. hospitals in the 1970's were surveyed by a self administered questionnaire which gathered biographical data as well as attitudinal information. Their responses were compared with those of students who had undertaken a traditional nursing course at an A.C.T. hospital in the same period. The findings of this study suggested that the instrument used may provide a better measure of satisfaction with nursing than of professional attitudes. One of the unexpected findings from the survey which suggested the need for further study was that many of those who had undertaken further nursing study indicating apparent commitment to continuing education in a chosen career would not encourage others to enter nursing. Another was that those who indicated greater career choice commitment may in fact be those who felt unable to obtain alternative employment. It was found that innovation in hospital based nurse education courses attracted different people and produced graduates with different attitudes to professional issues,who followed different career pathways compared to graduates of traditional nurse education courses. Innovative courses appear to have attracted older and better qualified entrants and to have increased the likelihood of graduates being promoted. Respondents from the innovative courses showed increased interest in continuing education and Professional Association activity than their control group colleagues. They were more frustated with the traditional role of the nurse as the selfless, dedicated worker and were less commited to their career choice, overall these findings perhaps indicated a level of dissatisfaction with nursing higher in the innovative course graduates than in the control group. These findings may support Brief's contention (1976) that expectations raised during the educational process, if not fulfilled, will lead to wastage. wastage from nursing was intimately linked with dissatisfaction with work conditions in nursing. Those who had permanently left nursing had more frequently left for work related reasons and undertaken non-nursing study than those who had left and returned or who had never left. Those who left for work related reasons were less likley to return and less likely to choose nursing again if given the chance than those who left for other reasons. Findings about the institutionalisation of innovation in nursing education were difficult to identify with certainty, since time lapse alone could explain many of the findings. Attitudes to the Professional Association were more favourabe in respondents from the later intakes into the innovative courses than from the earlier. Given the recent increases in industrial activity in nursing, this finding is consistent with time lapse. Later intakes also demonstrated greater commitment to continuing education than earlier. This too can probably be explained by the greater availability of such facilities in more recent times. In a period of shortages of nurses prepared to work in the health care facilities of Australia, and of changes in the educational preparation of nurses, the findings of this study relating to attitudes and wastage should be used as the basis for future workforce planning.

The purpose of this research was to discover the extent to which practising registered nurses in the ACT undertake physical assessment. It was also organized to discover the perceived reasons why, in appropriate instances, it was not undertaken and the extent to which certain variables may have influenced its practice or non-practice. It was directed also at discovering the extent to which the practising registered nurse would be prepared to undertake workshops on the subject, so that, if appropriate, a core of registered nurses could be provided to act as the role-models and to create the necessary learning environment in the ACT hospitals and agencies where most of the Canberra College's graduates would find employment. Since the first undergraduate course in nursing was introduced in the tertiary sector, nurse academics have placed significant emphasis on the teaching of the nursing process. It is within the first phase of this process, the assessment phase, that the physical assessment of the patient/client is conducted. Discussions with practising registered nurses and observations, led to some uncertainty as to the extent to which physical assessment was actually being used. A review of the literature showed that no investigation of the matter had been reported in the Australian literature. It was, therefore, proposed to make good this deficiency and to resolve any uncertainty about the extent of use of physical assessment in the ACT. This study was restricted to registered nurses in the ACT where all beginning nurses are educated at the CCAE with a curriculum which includes a comprehensive study of physical assessment. Even so, it is recognized that such studies will only reach a beginning level of competency. In order to ensure that the graduates of these courses extend their competency in physical assessment they need to be able to use these skills in every day nursing practice. This research, therefore, was conducted using a questionnaire which incorporated questions about the use of 36 physical assessment skills. The survey, on a onetime participation basis, was conducted for all registered nurses rostered on a fortnightly period in April 1987. A 66.7% response rate was achieved. The responses were analyzed and the findings, results and recommendations are included in the appropriate sections of this thesis.

Policies underpinning the processes used by nurse regulatory authorities to assess overseas - qualified nurses ( OQNs ) vary from country to country. Some countries ' policies are to undertake paper - based assessments of nurses ' initial and post registration education and experience, while others require all nurses to undertake a generic examination. How these policies were developed and why, were pivotal questions in this study. The aim of the study was, to critically analyse the policy development and policies relating to assessment of overseas - qualified nurses in thirteen nurse regulatory authorities from Australia and overseas. Using Critical Social Theory as the theoretical underpinning a critical policy analysis was undertaken. Data was obtained from policies and procedures, interviews, organisational websites, annual reports and Nurses Acts. The process of development of these policies and procedures was analysed using Bridgman and Davis ' policy cycle. The study revealed that only one organisation used a framework to develop policies on the assessment of OQNs. Policy analysis in most organisations was based on anecdotal evidence and experiential knowledge of Board staff. No organisation had conducted research on whether overseas - qualified nurses were competent to practice following a paper - based assessment or an examination. This study demonstrated that policies used to assess OQNs were not developed from an evidence - based perspective. This highlights the need to undertake internationally collaborative research on the evaluation of current policies, in order to develop future policies that determine the competence of a nurse to practice in another country.
Thesis (Ph.D.)--School of Population Health and Clinical Practice, 2006.

Policies underpinning the processes used by nurse regulatory authorities to assess overseas - qualified nurses ( OQNs ) vary from country to country. Some countries ' policies are to undertake paper - based assessments of nurses ' initial and post registration education and experience, while others require all nurses to undertake a generic examination. How these policies were developed and why, were pivotal questions in this study. The aim of the study was, to critically analyse the policy development and policies relating to assessment of overseas - qualified nurses in thirteen nurse regulatory authorities from Australia and overseas. Using Critical Social Theory as the theoretical underpinning a critical policy analysis was undertaken. Data was obtained from policies and procedures, interviews, organisational websites, annual reports and Nurses Acts. The process of development of these policies and procedures was analysed using Bridgman and Davis ' policy cycle. The study revealed that only one organisation used a framework to develop policies on the assessment of OQNs. Policy analysis in most organisations was based on anecdotal evidence and experiential knowledge of Board staff. No organisation had conducted research on whether overseas - qualified nurses were competent to practice following a paper - based assessment or an examination. This study demonstrated that policies used to assess OQNs were not developed from an evidence - based perspective. This highlights the need to undertake internationally collaborative research on the evaluation of current policies, in order to develop future policies that determine the competence of a nurse to practice in another country.
Thesis (Ph.D.)--School of Population Health and Clinical Practice, 2006.

Research Doctorate - Doctor of Philosophy (PhD)
Mechanical Ventilation is arguably one of the most common practices in Intensive Care Units and one of the main reason patients need admission to Intensive Care. The research in this thesis focuses on the provision of structured continuing education on mechanical ventilation undertaken in the clinical workplace as a component of nurses’ continuing professional development. A systematic review of the literature was conducted to determine whether the implementation of continuing education on mechanical ventilation for intensive care nurses results in the transfer of learning beyond the individual level and towards better patient outcomes. The aim of the review was to appraise and establish the best available evidence on the effectiveness of education programs that resulted in the improvement of patient outcomes. The next step taken in the research was the investigation of : (1) the role that intensive care unit nurses play in managing ventilated patients; (2) the knowledge registered nurses have about mechanical ventilation after finishing the undergraduate course in Australia; (3) and the quality of continuing education on mechanical ventilation at a post-registration level concerning building on, and maintaining nurses’ knowledge and skills looking after ventilated patients, and potentially influencing patient outcomes. This thesis reports the results of a sequential, two phase mixed methods study, which includes a cross-sectional study (Phase One), followed by individual interviews and focus groups (Phase Two). The research aims are to describe the provision of the continuing education program on mechanical ventilation provided at a major tertiary referral hospital, to explore the intensive care unit nurses’ perceptions of this education, their views of their scope of practice, to identify the barriers and motivators to participating in continuing education, and to investigate the nurses’ recommendations for improvement or change in the program. The research setting during Phase One and Two was a 22 bed intensive care unit of a large, regional tertiary referral hospital in Australia, which employed approximately 160 registered nurses. For Phase One applied in 2011, all nurses from the study intensive care unit were sampled for the survey and asked about their perception of the continuing education on invasive mechanical ventilation with focus on two main components: a Self-directed learning package (SDLP) titled Adult ventilation management and the Recognition in Prior Professional Learning, Experiences, and Skills program (RIPPLES) – titled Care of a ventilated patient in intensive care. The results of Phase One were used to inform Phase Two which was undertaken in 2015 where all nurse managers and nurse educators were sampled for individual interviews and three focus groups with purposively selected samples of expert, experienced and novice intensive care unit nurses were undertaken. The interviews and focus groups explored in-depth the managers’ educators’, and intensive care nurses’ overall perceptions of the continuing education on mechanical ventilation to provide a broader and more comprehensive picture of the phenomenon. The survey addressed content, methods of education, learning styles, factors associated with the completion of the main educational components, and the nurses’ recommendations on the continuing education on invasive mechanical ventilation. The data was collected through a mix of structured closed questions and fewer open-ended questions, where respondents could provide more detailed answers as a better way of getting to the nuances of opinions, which sometimes may be missed when only structured questions with limited responses, are used. Descriptive statistics and multivariate statistical tests were used to analyse the quantitative component, whereas content analysis was used for the open-ended questions. The interviews and focus groups explored in-depth the survey findings and portrayed mechanical ventilation as a whole topic including invasive and non-invasive ventilation. In addition, they included the nurse’s perception of: (1) how important they though this education was, (2) the program and support available for all levels of nursing experience, (3) the responsibility for continuing professional development, and (4) the nurses’ role when looking after ventilated patients. The interview and focus group data were collected by the Candidate using semi-structured and open-ended questions and interpreted using thematic analysis. The findings from the systematic review shows limited empirical evidence of the effectiveness of the continuing education on invasive mechanical on patient outcomes. Phase One and Two suggests there is a mechanical ventilation knowledge gap between students finishing the undergraduate Bachelor of Nursing course and becoming a registered nurse in intensive care. Thus, nurses rely strongly on continuing education provided by their workplace to guarantee patient safety and currency with evidence based practice in the intensive care setting. The two main components used for the continuing education on invasive mechanical ventilation were perceived to be valuable and beneficial. However, experienced nurses perceived them to be relevant mostly at an introductory level. Overall, intensive care unit nurses perceived that the education delivered matched their learning style and acknowledged the diverse education programs available, but they perceived that more interactive and hands-on practice education such as bedside teaching should be more available. Nurses managers’ and nurses educators’ support was viewed as a necessity to increase nurses’ participation in workplace education opportunities, and more funded study days should be offered. Managers and educators on the other hand, perceived that nurses should be willing to participate in education opportunities outside their working hours in their own time. Experienced nurses perceived that most of education opportunities targeted novice nurses. In addition, managers and educators reported more difficulty engaging with experienced nurses about their learning needs and education opportunities than with novice nurses. The intensive care unit nurses, independent of their role and job position perceived that most of the ventilated patient management was within the nurses’ scope of practice. However, managers and educators were hesitant as to whether this scope of practice was supported by the national nursing board and critical care nurse association. Nurses’ autonomy was dependent on organization structure, nurses’ knowledge and individual characteristics. Finally, ICU nurses, managers and educators agreed that nurses have responsibility for their own education and professional development; however, ICU nurses perceived that managers and educators had to facilitate and provide education opportunities and resources for them. In conclusion, this work indicates a need for improvements in the continuing education on mechanical ventilation to match all nurses’ level of experience, and to increase nurses’ participation, especially experienced nurses. Three other points are also important, namely the provision of more interactive teaching activities, more funding to support nurses’ education, and more detailed regulation regarding the ICU nurse’s scope of practice for the management of ventilated patients. These conclusions, along with the detailed analysis of the survey, interviews and focus group responses, might be a valuable source of information for nurses managers, educators, and other health stakeholder involved in the provision of continuing education on mechanical ventilation in similar ICU environments, both in Australia and overseas.