Journal articles on the topic 'Nurses Selection and appointment Australia'
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Tan, Poh-choo, and Zaki Morad. "Training of Peritoneal Dialysis Nurses." Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis 23, no. 2_suppl (December 2003): 206–9. http://dx.doi.org/10.1177/089686080302302s43.
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Clinical disciplines in which the nurse plays as preeminent a role in total patient care as in peritoneal dialysis (PD) are few. The PD nurse is readily identified by the patient as the principal source of advice on day-to-day aspects of treatment, as a resource manager for supplies of PD disposables and fluids, and as a general counselor for all kinds of advice, including diet, rehabilitation, and medication, among others. The PD nurse is thus the key individual in the PD unit, and most activities involve and revolve around the nursing staff. It is therefore not surprising that most nephrologists pay considerable attention to the selection of PD nurses, particularly in long-term PD programs such as continuous ambulatory peritoneal dialysis (CAPD). The appointment of a PD nurse depends on finding an individual with the right attributes, broad general experience, and appropriate training.
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Hill, Ciaran. "Volunteering at the Wellcome Museum of an Atomy and Pathology." Bulletin of the Royal College of Surgeons of England 91, no. 10 (November 1, 2009): 341. http://dx.doi.org/10.1308/147363509x476014.
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The Wellcome Museum of Anatomy and Pathology is a resource open to all doctors, nurses, allied health professionals, medical students and other technical professions, by prior appointment. It contains an excellent selection of specimens, covering the key surgical areas of head and neck, neurological, dental, orthopaedic, cardiac, respiratory, gastrointestinal, urological, gynaecological, endocrine, integumentary systems and embryology. Each area is subdivided into anatomical and pathological.
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Ridge, Andrew, Gregory M. Peterson, Bastian M. Seidel, Vinah Anderson, and Rosie Nash. "Healthcare Providers’ Perceptions of Potentially Preventable Rural Hospitalisations: A Qualitative Study." International Journal of Environmental Research and Public Health 18, no. 23 (December 3, 2021): 12767. http://dx.doi.org/10.3390/ijerph182312767.
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Potentially preventable hospitalisations (PPHs) are common in rural communities in Australia and around the world. Healthcare providers have a perspective on PPHs that may not be accessible by analysing routine patient data. This study explores the factors that healthcare providers believe cause PPHs and seeks to identify strategies for preventing them. Physicians, nurses, paramedics, and health administrators with experience in managing rural patients with PPHs were recruited from southern Tasmania, Australia. Semi-structured telephone interviews were conducted, and reflexive thematic analysis was used to analyse the data. Participants linked health literacy, limited access to primary care, and perceptions of primary care services with PPH risk. The belief that patients did not have a good understanding of where, when, and how to manage their health was perceived to be linked to patient-specific health literacy challenges. Access to primary healthcare was impacted by appointment availability, transport, and financial constraints. In contrast, it was felt that the prompt, comprehensive, and free healthcare delivered in hospitals appealed to patients and influenced their decision to bypass rural primary healthcare services. Strategies to reduce PPHs in rural Australian communities may include promoting health literacy, optimising the delivery of existing services, and improving social support structures.
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Byrne, Amy-Louise, Adele Baldwin, Clare Harvey, Janie Brown, Eileen Willis, Desley Hegney, Bridget Ferguson, et al. "Understanding the impact and causes of ‘failure to attend’ on continuity of care for patients with chronic conditions." PLOS ONE 16, no. 3 (March 2, 2021): e0247914. http://dx.doi.org/10.1371/journal.pone.0247914.
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Aim To understand the impact and causes of ‘Failure to Attend’ (FTA) labelling, of patients with chronic conditions. Background Nurse navigators are registered nurses employed by public hospitals in Queensland, Australia, to coordinate the care of patients with multiple chronic conditions, who frequently miss hospital appointments. The role of the nurse navigator is to improve care management of these patients. Evidence for this is measured through improvement in patient self-management of their conditions, a reduction in preventable hospital admissions and compliance with attendance at outpatient clinics. Failure to attend (FTA) is one measure of hospital utilisation, identifying outpatient appointments that are cancelled or not attended. Method The cohort for this study was patients with multiple chronic conditions, and nurse navigators coordinating their care. Data describing the concept of FTA were thematically analysed twelve months into this three year evaluation. Results Although the patient is blamed for failing to attend appointments, the reasons appear to be a mixture of systems error/miscommunication between the patient and the health services or social reasons impacting on patient’s capacity to attend. Themes emerging from the data were: access barriers; failure to recognise personal stigma of FTA; and bridging the gap. Conclusion The nurse navigators demonstrate their pivotal role in engaging with outpatient services to reduce FTAs whilst helping patients to become confident in dealing with multiple appointments. There are many reasons why a patient is unable to attend a scheduled appointment. The phrase ‘Failure to Attend’ has distinctly negative connotations and can lead to a sense of blame and shame for those with complex chronic needs. We propose the use of the neutral phrase “appointment did not proceed” to replace FTA. Implications for Nursing management This article advocates for further consideration of collaborative models that engage the patient in their care journey and for consideration of the language used within the outpatient acute hospital setting, proposing the term ‘appointment did not proceed.’
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Noprianty, Richa, and Gendis Kintan Dwi Thahara. "Healthcare Workers Knowledge, Attitude, and Availability of Facilities Toward Compliance Hand Hygiene." Indonesian Journal of Global Health Research 1, no. 1 (November 30, 2019): 13–20. http://dx.doi.org/10.37287/ijghr.v1i1.2.
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Failure to perform good hand hygiene is considered as an major cause of Healthcare Associated Infections (HAIs). From the WHO data, compliance rate of nurses hand hygiene activity at the United States is about 50%, Australia 65% while in Indonesia 47%. This study aims to determine healthcare workers knowledge, attitude, and availability of facilities toward that affect hand hygiene compliance. This research method is analytical descriptive with cross-sectional approach. The object of data collection is an healthcare workers (nurse, doctor, and pharmacy) at General Hospitalin West Java as many as 51 samples. Sample selection using stratified sampling method with research instrument in the form of questionnaire and observation sheet about knowledge and attitude to hand hygiene adopted from WHO. The results of this study that obtained in the group of nurse were 48.6% doing imperfect hand hygiene and group of doctor respectively 80.0% and pharmacy were 100.0%. In terms of nurses knowledge about hand hygiene is 59.5%, doctor80.0% and pharmacy 50.0%. In terms of attitudes about the implementation of hand hygiene, the nurses group is 48.6%, doctors respectively 40% and pharmacy 50.00% have a positive attitude. In terms of facilities is 40.5% nurses stated available, doctors 20% and pharmacy 0.00%. There was a significant relationship between hand hygiene with knowledge (p = 0,019), attitude (0.004) and hand hygiene facility (p = 0.040).
Keywords: attitude, hand hygiene, health care, knowledge
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Sladek, Ruth M., Malcolm J. Bond, and Paddy A. Phillips. "Do doctors, nurses and managers have different thinking styles?" Australian Health Review 34, no. 3 (2010): 375. http://dx.doi.org/10.1071/ah09791.
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A study of the preferred thinking styles among senior health professionals is reported. A total of 49 medical consultants, 50 senior nurses and 53 health managers from two public teaching hospitals in Adelaide, Australia, were invited via a personal letter to complete a questionnaire comprising measures of thinking style (the Rational Experiential Inventory) and cognitive style (two dimensions of the Myers–Briggs Type Indicator®). Managers reported a higher preference for ‘rational’ reasoning than nurses, whereas medical consultants reported a lower preference for ‘experiential’ reasoning than both managers and nurses. Cognitive style was largely homogenous. Although generalisation of the findings may be limited due to small sample sizes and the self-selection of participants, an understanding of the thinking styles of senior health professionals will likely inform the design and evaluation of future change strategies. What is known about the topic?Research outcomes cannot change population health unless they are adopted, but changing the practices of healthcare workers to reduce ‘know–do’ gaps is not simple. Although there is some evidence to support professionally-oriented strategies such as educational outreach, audit and feedback and reminders, success is sometimes limited, potentially reflecting the limited use of theory in informing the choice of implementation strategies. Non-theoretical approaches may obscure the behavioural determinants of, and mechanisms for, change, making it impossible to generalise lessons learned form one situation to other contexts. What does this paper add?This paper highlights the growing recognition of the need for theory in this important field, and examines a psychological theory for its potential use. Findings provide useful preliminary descriptive data about thinking dispositions within and between three key groups of healthcare decision-makers: senior consultants, senior nurses and managers. It adds to a modest but accumulating research base that explores the tenets of a specified theory among healthcare professionals, reporting reliable differences between individuals in terms of cognitive processing (i.e. how they prefer to think). What are the implications for practitioners?Those faced with implementing change should consider theoretically-driven approaches in their selection of strategies. Based on the theory explored herein, two versions of a message, each targeting a different cognitive processing mode, should be more successful than one version only. This should be true for all three professional groups, and represents a testable strategy for future research.
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Olanrewaju, Sherif, Susan Loeb, and Manuel Rosaldo. "INTERNATIONALLY EDUCATED NURSES CARING FOR OLDER ADULTS: A SCOPING REVIEW." Innovation in Aging 6, Supplement_1 (November 1, 2022): 678. http://dx.doi.org/10.1093/geroni/igac059.2492.
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Abstract Internationally Educated Nurses (IENs) are nurses who are born and obtained their licenses in their home country and relocate to work in a different country. IENs are increasing being recruited to work in Western countries to address nursing shortages. Estimates indicate that IENs account for 5-8 percent of registered nurses in the United States (US). The purpose of this scoping review was to identify and synthesize research evidence on IENs' experiences caring for older adults. A 5-step process for Scoping Reviews was applied, which includes: identifying the research question; identifying relevant studies; study selection; charting the data; and collating, summarizing, and reporting the results. A search was conducted in Web of Science, PubMed, CINAHL, PsycINFO, and Google Scholar. Keywords included but were not limited to IENs, older adults, and long-term care setting. Inclusion criteria were (1) empirical studies examining IENs providing direct care for older adults in any healthcare settings and (2) original research published in English. A total of 13 articles were selected for inclusion (nine quantitative and four qualitative studies). The studies were conducted in the US (n=10), the Netherlands (n=1), Australia (n=1), and New Zealand (n=1). Results revealed three primary themes: transitional challenges, IENs' experiences working with older adults, and factors affecting IEN capacity to deliver services. Study findings are relevant to nursing leaders and policymakers in developing culturally relevant programs to help IENs transition successfully into the nursing workforce. Additional qualitative research is required to explore lived experiences of IENs caring for older adults.
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Sporer, Matthias E., Joanna E. Mathy, John Kenealy, and Jon A. Mathy. "Sunscreen compliance with regional clinical practice guidelines and product labeling standards in New Zealand." Journal of Primary Health Care 8, no. 1 (2016): 30. http://dx.doi.org/10.1071/hc15019.
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ABSTRACT INTRODUCTION For general practitioners, practice nurses and community pharmacists in New Zealand, a core duty is to educate patients about sun protection. We aimed to evaluate compliance of locally available sunscreens with regional clinical practice guidelines and sunscreen labelling standards, to assist clinicians in advising consumers on sunscreen selection. METHODS We audited all sunscreens available at two Auckland stores for three New Zealand sunscreen retailers. We then assessed compliance with accepted regional clinical practice guidelines for sun protection from the New Zealand Guidelines Group. We further assessed compliance with regional Australia/New Zealand consumer standards for sunscreen labelling. RESULTS All sunscreens satisfied clinical guidelines for broad-spectrum protection, and 99% of sunscreens met or exceeded clinical guidelines for minimal Sun Protection Factor. Compliance with regional standardized labelling guidelines is voluntary in New Zealand and 27% of audited sunscreens were not fully compliant with SPF labelling standards. DISCUSSION Sunscreens were generally compliant with clinical guidelines for minimal sun protection. However there was substantial noncompliance with regional recommendations for standardized sunscreen labelling. Primary health care clinicians should be aware that this labelling noncompliance may mislead patients into thinking some sunscreens offer more sun protection than they do. Mandatory compliance with the latest regional labelling standards would simplify sunscreen selection by New Zealand consumers. KEYWORDS Sunscreen; Sun Protection Factor; SPF; Skin Neoplasms; Melanoma; Skin Cancer Prevention
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Kang, Kyung Im, and Jaewon Joung. "Outcomes of Consumer Involvement in Mental Health Nursing Education: An Integrative Review." International Journal of Environmental Research and Public Health 17, no. 18 (September 16, 2020): 6756. http://dx.doi.org/10.3390/ijerph17186756.
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This integrative review analyzed the research on consumer involvement in mental health nursing education in the last decade. We aimed to derive the main contents, methods, and outcomes of education using consumer involvement for mental health nursing students. We searched six electronic databases using English and Korean search terms; two authors independently reviewed the 14 studies that met the selection criteria. Studies on the topic were concentrated in Australia and some European countries; most of them used a qualitative design. The main education subject was recovery, and consumers tended to actively participate in education planning. Moreover, students’ perceptions about education using consumer involvement and people with mental health problems changed positively, as well as their experiences of participating in mental health nursing education. There is a lack of interest in the topic in Asian countries, including Korea. Thus, future studies in Asian countries are needed to conduct qualitative and in-depth explorations of students’ experiences regarding an educational intervention that uses consumer involvement as a tool rigorously designed for mental health nursing education. Consumer involvement can be an innovative strategy to produce high-quality mental health nurses by minimizing the gap between theory and practice in the undergraduate program.
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Ames, David. "The 2015 International Psychogeriatric Association Junior Research Awards in Psychogeriatrics." International Psychogeriatrics 27, no. 12 (October 2, 2015): 1927–28. http://dx.doi.org/10.1017/s1041610215001489.
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Early in 2015, I was asked to chair the judging panel for the 2015 International Psychogeriatric Association (IPA) Junior Research Awards in Psychogeriatrics, and was pleased to help in this way for the second Congress in succession. The other five judges who kindly gave up their time to assist with the selection of the three prize winners were Nicola Lautenschlager, an old age psychiatrist from Australia, co-opted to the panel in her role as the current Editor-in Chief of International Psychogeriatrics (the three winning papers are published in this issue as has been traditional for over 25 years), Glenna Dowling, a nurse from the USA who is also an associate editor of International Psychogeriatrics, Karen Ritchie, a psychologist working in France, Martina Roes, a nurse turned sociologist from Germany, the host country for the 2015 IPA Congress, and Huali Wang, a psychiatrist from Beijing, China. Depending on how you look at it, our panel consisted of three psychiatrists, one psychologist, two nurses and a bonus sociologist, five judges from developed countries and one from a developing nation, or five women and one man, which I think is the first time that such an IPA prize judging panel has had a female majority.
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Considine, Julie, Tony Walker, and Debra Berry. "Development, implementation and evaluation of an interprofessional graduate program for nursing–paramedicine double-degree graduates." Australian Health Review 39, no. 5 (2015): 595. http://dx.doi.org/10.1071/ah14258.
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Over the past decade, several Australian universities have offered a double degree in nursing and paramedicine. Mainstream employment models that facilitate integrated graduate practice in both nursing and paramedicine are currently lacking. The aim of the present study was to detail the development of the Interprofessional Graduate Program (IPG), the industrial and professional issues that required solutions, outcomes from the first pilot IPG group and future directions. The IPG was an 18-month program during which participants rotated between graduate nursing experience in emergency nursing at Northern Health, Melbourne, Australia and graduate paramedic experience with Ambulance Victoria. The first IPG with 10 participants ran from January 2011 to August 2012. A survey completed by nine of the 10 participants in March 2014 showed that all nine participants nominated Ambulance Victoria as their main employer and five participants were working casual shifts in nursing. Alternative graduate programs that span two health disciplines are feasible but hampered by rigid industrial relations structures and professional ideologies. Despite a ‘purpose built’ graduate program that spanned two disciplines, traditional organisational structures still hamper double-degree graduates using all of skills to full capacity, and force the selection of one dominant profession. What is known about the topic? There are no employment models that facilitate integrated graduate practice in both nursing and paramedicine. The lack of innovative employment models for double-degree graduates means that current graduate program structures force double-degree graduates to practice in one discipline, negating the intent of a double degree. What does this paper add? This is the first time that a graduate program specifically designed for double-degree graduates with qualifications as Registered Nurses and Paramedics has been developed, delivered and evaluated. This paper confirms that graduate programs spanning two health disciplines are feasible. What are the implications for practitioners? Even with a graduate program specifically designed to span nursing and paramedicine, traditional organisational structures still hamper double-degree graduates using all their skills to full capacity, and force the selection of one dominant profession.
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Salmasi, S., A. Kelly, S. J. Bartlett, M. De Wit, L. March, A. Tong, P. Tugwell, K. Tymms, S. Verstappen, and M. De Vera. "THU0565 RESEARCHERS’ PERSPECTIVES ON ADHERENCE INTERVENTION RESEARCH AND OUTCOMES IN RHEUMATOLOGY: AN INTERNATIONAL QUALITATIVE STUDY." Annals of the Rheumatic Diseases 79, Suppl 1 (June 2020): 524.2–524. http://dx.doi.org/10.1136/annrheumdis-2020-eular.4787.
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Background:Medication non-adherence is a significant problem among patients with rheumatic diseases. Research on adherence interventions in rheumatology is limited and disappointing, with studies using heterogeneous outcomes. Understanding these limitations is needed to inform the design of better interventions and research studies.Objectives:To describe researchers’ perspectives and experiences on adherence intervention research and outcomes in rheumatology.Methods:Semi-structured interviews using video conference were conducted with researchers who had been an investigator on an adherence study of any design in the past 10 years. Interviews were recorded and transcribed verbatim. Participants were asked about their experiences with conducting adherence research and perspectives on introduction of a core domain set of outcomes for adherence intervention trials in rheumatology. Data collection and thematic analysis were conducted iteratively, until saturation.Results:We interviewed 13 researchers from seven countries (Australia, Belgium, Canada, Netherland, Thailand, UK, and USA). A majority worked in academia (75%), specialized in epidemiology and/or health services research (62%) and had led between 2-5 adherence studies in the past five years (62%).Three themes were identified:1) challenges in designing, conducting and evaluating adherence studies;2) current outcomes in adherence intervention studies and their relevance; and3) implementing a core domain set of outcomes for adherence intervention studies.Major challenges in conducting adherence research included inconsistent adherence terminology and measurement. Participants noted a lack of guidance on outcome selection and measurement when evaluating the effectiveness of an adherence intervention and indicated their preference for research to report adherence, intervention-specific, and health-related outcomes. Finally, implementing a core domain set of outcomes was thought to be challenging but valuable in strengthening the evidence (by facilitating meta-analysis), and improving clinical outcomes (by informing clinicians about the effectiveness of interventions).Conclusion:Adherence research in rheumatology has been hindered by lack of standardization and guidance on terminology, measurement and outcome selection. Our findings form the basis for recommendations for improving the design, conduct and evaluation of adherence intervention studies in rheumatology, particularly for developing a core domain set of outcomes to improve consistency and facilitate comparisons.Table 1.Themes and representative quotations.Theme 1: Challenges in designing, conducting and evaluating studies of adherence interventions“…the people you often most want in your sample are the people who are non-adherent and often the people who are non-adherent are the people who are hardest to recruit.”“Long term the issue has been about measurements because people confuse and conflate various aspects of medication adherence.Theme 2: Current outcomes in adherence intervention studies and their relevance“you have a whole range of outcomes…psychological outcomes…there’s measures of health care utilization and things like attendance at hospital, nurse appointments and duration, things like times off work,, and also all the relevant clinical outcomes.”Theme 3: Implementing a core domain set of outcomes for adherence intervention studies“…will make trials more comparable and increase the likelihood that you’d be able to combine efforts internationally”Disclosure of Interests:Shahrzad Salmasi: None declared, Ayano Kelly: None declared, Susan J. Bartlett Consultant of: Pfizer, UCB, Lilly, Novartis, Merck, Janssen, Abbvie, Speakers bureau: Pfizer, UCB, Lilly, Novartis, Merck, Janssen, Abbvie, Maarten de Wit Grant/research support from: Dr. de Wit reports personal fees from Ely Lilly, 2019, personal fees from Celgene, 2019, personal fees from Pfizer, 2019, personal fees from Janssen-Cilag, 2017, outside the submitted work., Consultant of: Dr. de Wit reports personal fees from Ely Lilly, 2019, personal fees from Celgene, 2019, personal fees from Pfizer, 2019, personal fees from Janssen-Cilag, 2017, outside the submitted work., Speakers bureau: Dr. de Wit reports personal fees from Ely Lilly, 2019, personal fees from Celgene, 2019, personal fees from Pfizer, 2019, personal fees from Janssen-Cilag, 2017, outside the submitted work., Lyn March: None declared, Allison Tong: None declared, Peter Tugwell: None declared, Kathleen Tymms: None declared, Suzanne Verstappen Grant/research support from: BMS, Consultant of: Celltrion, Speakers bureau: Pfizer, Mary De Vera: None declared
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Talbot, Benjamin, Sara Farnbach, Allison Tong, Steve Chadban, Shaundeep Sen, Vincent Garvey, Martin Gallagher, and John Knight. "Patient and Clinician Perspectives on the use of Remote Patient Monitoring in Peritoneal Dialysis." Canadian Journal of Kidney Health and Disease 9 (January 2022): 205435812210844. http://dx.doi.org/10.1177/20543581221084499.
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Background: Numerous factors influence patient recruitment to, and retention on, peritoneal dialysis (PD), but a major challenge is a perceived “inaccessibility” to treating clinicians. It has been suggested that remote patient monitoring (RPM) could be a means of improving such oversight and, thereby, uptake of PD. Objective: To describe patient and clinician perspectives toward RPM and the use of applications (Apps) suitable for mobiles, tablets, or computers to support the provision of PD care. Design: Qualitative design using semi-structured interviews. Setting: All patient participants perform PD treatment at home under the oversight of an urban PD unit in Sydney, Australia. Patient and clinician interviews were conducted within the PD unit. Participants: 14 participants (5 clinicians [2 nephrologists, 3 PD nurses] and 9 patients treated with PD). Methods: Semi-structured interviews were conducted using interview guides tailored for clinician and patient participants. Transcripts were coded and analyzed by a single researcher using thematic analysis. Results: Six themes were identified: perceived benefits of RPM implementation (offering convenience and efficiency, patient assurance through increased surveillance, more complete data and monitoring adherence), uncertainty regarding data governance (protection of personal data, data reliability), reduced patient engagement (transfer of responsibility leading to complacency), changing patient-clinician relationships (reduced patient-initiated communication, the need to maintain patient independence), increased patient and clinician burden (inadequate technological literacy, overmanagement leading to frequent treatment changes), and clinician preference influencing patient behavior. Limitations: The interviews were conducted in English only and with participants from a single urban dialysis unit, which may limit generalizability. Conclusions: For patients and clinicians, advantages from the use of RPM in PD may include increased patient confidence and assurance, improved treatment oversight, more complete data capture, and overcoming barriers to data documentation. Careful patient selection and patient and clinician education may help to optimize the benefits of RPM, maintain patient independence, and reduce the risks of patient disengagement. The use of an App may support RPM; however, participants expressed concerns about increasing the burden on some patients through the use of unfamiliar technology. Human Research Ethics Committee Approval Number: CH62/6/2019-028
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Cardoso, Fatima, Julie Rihani, Dawn Aubel, Adam Moore, Victoria Harmer, Nadia Harbeck, Ana Casas, Sina Haftchenary, Purnima Pathak, and Eva Schumacher-Wulf. "Abstract P4-12-03: Assessment of quality of life (QoL) in patients with metastatic breast cancer (MBC) in clinical practice: A real-world multi-country survey." Cancer Research 82, no. 4_Supplement (February 15, 2022): P4–12–03—P4–12–03. http://dx.doi.org/10.1158/1538-7445.sabcs21-p4-12-03.
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Abstract Background: Patient (pt) QoL is a key factor in the treatment (tx) of ABC. There are gaps in real-world evidence of how QoL is assessed in clinical practice. We examined the importance of QoL, its influence on tx decisions, and how it is discussed in a clinical setting from pts’ and healthcare professionals’ (HCPs) perspectives. Methods: The survey was designed by a steering committee of medical oncologists and patients and ethically approved to survey HCPs and patients. Data were collected from July 2020 to May 2021 via a cross-sectional online survey of HCPs (oncologists [Onc] and oncology nurses [OncNu]) and pts with HR+/HER2- ABC in Australia, Brazil, Egypt, Germany, Italy, South Korea, and USA. HCPs were recruited via a 3rd party and surveyed on the management of ABC including the importance of QoL and its assessment in clinical practice. Pts were recruited via HCPs and advocacy groups and surveyed on the importance of QoL, how tx impacts QoL, daily activities, and work, and the frequency of QoL discussions with HCPs. All observations were assessed using a 4-point Likert scale; data were analysed descriptively. Results: 277 Onc, 225 OncNu, and 467 pts with ABC took part in the survey. 221 pts had stage III advanced (locoregionally recurrent not amenable to curative therapy) and 229 had stage IV metastatic disease. 142 pts were receiving first line (1L), 116 second line (2L), and 209 third or later line (3L+) tx. Most HCPs, 88% of Onc and 96% of OncNu, reported asking about QoL at follow-up appointments, where fewer pts report being asked about QoL by Onc (64%) and OncNu (43%). Pts at later line of therapy (LoT) less frequently reported QoL discussions with Onc; 43% of pts at 1L (n=140) reported they were always asked about QoL at follow-up appointments vs 21% at 2L (n=113) and 16% at 3L+ (n=206). Among Onc, importance of QoL for tx decisions increased with LoT; 48% reported that QoL was very important at 1L, 57% at 2L, 79% at 3L, and 85% at 4th line. In contrast, importance of QoL among pts decreased with LoT; while only 39% were comfortable discussing QoL with Onc, 73% at 1L agreed that QoL was important vs 45% at 2L and 40% at 3L+. Among pts who experienced a side effect (SE) that was not discussed with their HCP (n=96), 40% agreed this was because HCPs did not ask about it, and 28% at least moderately agreed they do not report SE as they do not want their Onc to change their tx. 81% of HCPs did not completely agree with the statement “I have enough time to discuss QoL with my pts”. Among those who reported asking pts about their QoL, 93% of HCPs (n=481) reported using questions of their own, while 11% of Onc and 30% of OncNu reported using QoL questionnaires. Only 11% of HCPs agreed that available QoL tools were specific enough to customise for their pts, and only 12% agreed they had access to QoL tools that were integrated with electronic health record systems. Among HCPs (n=341) who were familiar with QoL tools used in clinical trials for ABC, only 10% agreed that these tools were able to accurately reflect QoL, and only 11% agreed that the tools were able to capture improvements in QoL when tx delayed disease progression. Conclusion: We found disconnects between pts with ABC and HCPs around the importance of discussions around QoL; pts report a lower frequency of these discussions in later LoT than HCPs. QoL assessment tools were infrequently used by HCPs, as those currently available were not considered adequate for ABC. QoL should be formally assessed regularly using an ABC-specific QoL assessment tool. This would allow HCPs to address pt issues around QoL through focused discussions to help inform tx decisions. To ensure clinical value, a tool should be quick and easy to use, be able to be completed outside of an appointment setting, yield results that are easy to interpret and compare, and be integrated into medical records. Citation Format: Fatima Cardoso, Julie Rihani, Dawn Aubel, Adam Moore, Victoria Harmer, Nadia Harbeck, Ana Casas, Sina Haftchenary, Purnima Pathak, Eva Schumacher-Wulf. Assessment of quality of life (QoL) in patients with metastatic breast cancer (MBC) in clinical practice: A real-world multi-country survey [abstract]. In: Proceedings of the 2021 San Antonio Breast Cancer Symposium; 2021 Dec 7-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2022;82(4 Suppl):Abstract nr P4-12-03.
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Lowane, Mygirl P., and Rachel T. Lebese. "Missing appointments by patients on antiretroviral therapy: Professional nurses’ perspective." Curationis 45, no. 1 (January 1, 2022). http://dx.doi.org/10.4102/curationis.v45i1.2213.
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Background: Missed appointments for medicine pick-ups are regarded as a predictor of poor adherence, and should trigger immediate questions about issues that may affect follow-up visits to healthcare settings.Objectives: The study explored and described professional nurses’ perspectives about the factors that contribute to missing appointments by people living with Human Immunodeficiency Virus (PLWHIV) on antiretroviral therapy (ART) at Mopani and Vhembe district in Limpopo Province.Method: A qualitative explorative contextual approach was used for the study. Non-probability, purposive sampling was used to select 14 professional nurses who met the inclusion criteria. Data were collected through face-to-face unstructured interviews. One central question was asked and probing questions were based on the participants’ responses to the central question. Thematic analysis of the findings was carried out. Trustworthiness was ensured through intercoder agreement, audio recording, triangulation, bracketing, and member checking. Required permission, approval, and ethical clearance were also ensured.Results: Organisational health system and management of the healthcare facility were found to be the barriers that negatively impacted on the ability of the PLWHIV on ART to maintain clinic visits appointments. Lack of patient involvement, stereotyped appointment dates selection, poor patient-provider relationships, errors of recording appointment dates and long waiting times came up as sub-themes derived from the main theme.Conclusion: The results suggest that there is a need to increase and improve mutual trust in patient-provider relationships, improve nurses working conditions, develop proper booking systems and reduce clinic waiting hours.
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Jooste, Karien, and Carine Prinsloo. "Factors that guide nurse managers regarding the staffing of agency nurses in intensive care units at private hospitals in Pretoria." Curationis 36, no. 1 (January 8, 2013). http://dx.doi.org/10.4102/curationis.v36i1.115.
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Staffing needs affect the nursing department’s budget, staff productivity, the quality of care provided to patients and even the retention of nurses. It is unclear how the role players (the nursing agency manager, the nurse manager and the agency nurse) perceive the staffing of agency nurses in intensive care units (ICUs). The purpose of this study was to explore and describe the factors that guide nurse managers regarding the staffing of agency nurses in ICUs at private hospitals in Pretoria. A quantitative exploratory and descriptive design was used. A survey by means of a structured questionnaire was carried out. Probability sampling was implemented to obtain a study sample (n = 124). One similar self-administered 5-point scale instrument was completed by the participants. Data was analysed by means of descriptive and inferential statistics. The principles of validity and reliability were adhered to and ethical considerations were also taken into account. The results indicated limitations in the determining of posts, recruitment and advertising, as well as the selection and appointment of agency nurses in ICUs at private hospitals in Pretoria. Recommendations on staffing are made to nurse managers in ICUs.
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Engel, Marijanne, Lia van Zuylen, Andrée van der Ark, and Agnes van der Heide. "Palliative care nurse champions’ views on their role and impact: a qualitative interview study among hospital and home care nurses." BMC Palliative Care 20, no. 1 (February 18, 2021). http://dx.doi.org/10.1186/s12904-021-00726-1.
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Abstract Background One of the strategies to promote the quality of palliative care in non-specialised settings is the appointment of palliative care nurse champions. It is unclear what the most effective model to implement the concept of nurse champions is and little is known about palliative care nurse champions’ own views on their role and responsibilities. This paper aims to describe views of palliative care nurse champions in hospitals and home care on their role, responsibilities and added value. Methods In 2018, a qualitative interview study was conducted with 16 palliative care nurse champions in two hospitals and four home care organisations in the southwest of the Netherlands. The framework approach was used to analyse the data. Results Most palliative care nurse champions described their role by explaining concrete tasks or activities. Most nurse champions perceive their main task as disseminating information about palliative care to colleagues. A few nurses mentioned activities aimed at raising awareness of palliative care among colleagues. Most nurses were to a limited extent involved in collaboration with the palliative care expert team. Hospital nurse champions suggested that more support from the palliative care expert team would be helpful. Most nurse champions feel little responsibility for organisational tasks and inter-organisational collaboration. Especially hospital nurses found it difficult to describe their role. Conclusion The role of palliative care nurse champions in hospital and home care varies a lot and nurses have diverging views on palliative care in these settings. Comprehensively fulfilling the role of palliative care nurse champion is a challenge. Careful selection, training, support and task descriptions for nurse champions are needed to make the concept of nurse champions work in palliative care.
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May, Josephine. "Revisiting the life of Lucy Garvin, first principal of Sydney Girls High School: expanded biography and use of digital sources." History of Education Review ahead-of-print, ahead-of-print (March 5, 2021). http://dx.doi.org/10.1108/her-10-2020-0053.
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PurposeThe article sets out primarily to fill in some of the gaps in the biography of Lucy Arabella Stocks Garvin (1851–1938), first principal of Sydney Girls High School. As a reflexive exercise stimulated by this biographical research, the second aim is to explore the transformative work of digital sources on the researcher's research processes that in turn generate possibilities for expanded biographical studies in the history of education.Design/methodology/approachThis article encompasses two approaches: the first uses traditional historical methods in the digital sources to provide an expanded biography of Lucy Garvin. The second is a reflexive investigation of the effects of digitisation of sources on the historian's research processes.FindingsThe advent of digital technologies has opened up more evidence on the life of Lucy Garvin which enables a fuller account both within and beyond the school gate. Digital sources have helped to address important gaps in her life story that challenge current historiographical understandings about her: for example, regarding her initial travel to Australia; her previous career as a teacher in Australia and the circumstances of her appointment as principal; her private and family life; and her involvement in extra school activities. In the process of exploring Garvin's life, the researcher reflected on the work of digital sources and argues that such sources transform the research process by speeding up and de-situating the collection and selection of evidence, while at the same time expanding and slowing the scrutiny of evidence. The ever-expanding array of digital sources, despite its patchiness, can lead to finer grained expanded biographical studies while increasing the provisionality of historical accounts.Originality/valueThe article presents new biographical information about an important early female educational leader in Australia and discusses the impact of digital sources on archival and research processes in the history of women's education.
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Naranjo, A., S. Ojeda, M. Giner, M. Balcells-Oliver, L. Canals, J. M. Cancio, E. Duaso, et al. "Best Practice Framework of Fracture Liaison Services in Spain and their coordination with Primary Care." Archives of Osteoporosis 15, no. 1 (April 25, 2020). http://dx.doi.org/10.1007/s11657-020-0693-z.
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Abstract Summary The coordination of Fracture Liaison Services (FLS) with Primary Care (PC) is necessary for the continuity of care of patients with fragility fractures. This study proposes a Best Practice Framework (BPF) and performance indicators for the implementation and follow-up of FLS-PC coordination in clinical practice in Spain. Purpose To develop a BPF for the coordination of FLS with PC in Spain and to improve the continuity of care for patients with fragility fractures. Methods A Steering Committee selected experts from seven Spanish FLS and related PC doctors and nurses to participate in a best practice workshop. Selection criteria were an active FLS with an identified champion and prior contact with PC centres linked to the hospital. The main aim of the workshop was to review current FLS practices in Spain and their integration with PC. A BPF document with processes, tools, roles, and metrics was then generated. Results Spanish FLS consists of a multidisciplinary team of physicians/nurses but with low participation of other professionals and PC staff. Evaluation and treatment strategies are widely variable. Four desired standards were agreed upon: (1) Effective channels for FLS-PC communication; (2) minimum contents of an FLS clinical report and its delivery to PC; (3) adherence monitoring 3 months after FLS baseline visit; and (4) follow-up by PC. Proposed key performance indicators are (a) number of FLS-PC communications, including consensus protocols; (b) confirmation FLS report received by PC; (c) medical/nursing PC appointment after FLS report received; and (d) number of training sessions in PC. Conclusions The BPF provides a comprehensive approach for FLS-PC coordination in Spain, to promote the continuity of care in patients with fragility fractures and improve secondary prevention. The implementation of BPF recommendations and performance indicator tracking will benchmark best FLS practices in the future.
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Rae, Louise, Natalie MacNab, Sarah Bidner, Cameron Davidson, and Phillip McDonagh. "Attitudes and practices of veterinarians in Australia to acute pain management in cats." Journal of Feline Medicine and Surgery, September 20, 2021, 1098612X2110430. http://dx.doi.org/10.1177/1098612x211043086.
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Objectives Up-to-date information on the current practices and attitudes of veterinarians in Australia to acute pain management in cats was sought in 2017–2018 in the first nationwide survey in over 20 years. Methods An online survey was created, consisting of 54 questions in four sections, with 18 feline-specific questions. Veterinarians throughout Australia were invited to participate in the survey through advertisements in the veterinary press, electronic and regular mail, and through in-clinic visits and promotional materials. Results A total of 614 veterinarians completed the survey, with 513 (83.6%) completing the feline-specific section. The demographics of the respondents of this survey were an accurate representation of the registered veterinarians in Australia at the time. Multiple different opioids and non-steroidal anti-inflammatory drugs (NSAIDs) were widely available in practices to manage pain, with analgesic efficacy reported as the primary factor influencing drug selection. Opioids were most commonly used in the preoperative period and NSAIDs were most commonly used postoperatively. Despite the wide availability in clinic (>99%), only 55% of respondents reported regularly using local anaesthetic techniques in cats. Pain assessment of hospitalised patients was primarily performed by veterinarians (91.1%); however, 84.7% of respondents did not routinely use a validated pain scale. Conclusions and relevance Veterinary practitioners in Australia are adequately equipped with analgesic medication to treat pain in their patients. In the management of acute pain in cats, they frequently use a multimodal approach and practice a variety of analgesic protocols. Based on the results of this survey, potential areas for improvement in feline pain management include an increase in duration of postoperative analgesia and more routine use of validated pain scales, performed by nurses and veterinarians alike, to assess individual analgesic needs.
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Khoo, Thomas, Navkiran Sidhu, Franca Marine, Susan Lester, Alannah Quinlivan, Debra Rowett, Rachelle Buchbinder, and Catherine L. Hill. "Perceptions towards biologic and biosimilar therapy of patients with rheumatic and gastroenterological conditions." BMC Rheumatology 6, no. 1 (December 23, 2022). http://dx.doi.org/10.1186/s41927-022-00309-4.
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Abstract Background Biologic and targeted synthetic disease modifying agents (b/tsDMARDs) have broadened the treatment landscape for autoimmune diseases particularly in patients refractory to conventional DMARDs. More recently, the introduction of biosimilars has reduced the price of bDMARDs, potentially improving accessibility. Though efficacy and safety have been described, patient attitudes to b/tsDMARDs are not well-understood. We aim to investigate patients’ beliefs about biologic and biosimilar therapy, and the factors influencing their perceptions. Methods Patient consumer groups (Arthritis Australia, Crohn’s and Colitis Australia) assisted in advertising an online questionnaire for people with a self-reported diagnosis of inflammatory arthritis (IA) or inflammatory bowel disease (IBD). The questionnaire incorporated the Belief about Medicines Questionnaire (BMQ) and the single-item literacy screener (SILS). Sources and favourability of biologic/biosimilar information were analysed, using the chi-square and a non-parametric trend test for unordered and ordered categorical variables respectively, comparing respondents with IA and IBD. Results Eight hundred and thirty eight people (686–IA, 144–IBD, 8 both) responded. 658 (79%) used b/tsDMARDs. The BMQ demonstrated high necessity belief (median 4.2) with moderate concerns (median 2.8) about biologics. 95% of respondents obtained medication information from specialists though most used multiple sources (median 4). The most positive resources were specialists and specialist nurses. 73/141 (52%) respondents with IBD obtained information from specialist nurses compared with 202/685 (29%) with IA (p = 0.012). Respondents with limited reading ability on SILS were more likely to discuss information with a general practitioner or pharmacist. Younger respondents and those with higher BMQ concern scores more frequently consulted less reliable sources (e.g. social media). 502 respondents (60%) answered the biosimilar questions. Only 23 (4.6%) reported currently using a biosimilar and 336 (66.9%) were unsure if biosimilars were available in Australia. Specialist recommendation was the most frequent factor that would influence a patient to change from originator to biosimilar (352/495, 71.1%). Conclusions There is a high level of trust in specialists’ recommendations about b/tsDMARDs, although most people also utilise additional information sources. Contextual factors influencing resource selection include age, reading ability and degree of concern about medicines. People with IA and IBD have similar attitudes though those with IBD more frequently access specialist nurse advice.
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Danielis, Matteo, Domenico Regano, Anna Castaldo, Maria Mongardi, and Tania Buttiron Webber. "What are the nursing competencies related to antimicrobial stewardship and how they have been assessed? Results from an integrative rapid review." Antimicrobial Resistance & Infection Control 11, no. 1 (December 6, 2022). http://dx.doi.org/10.1186/s13756-022-01189-6.
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Abstract Background Antimicrobial resistance issues, and the consequent demand for antimicrobial stewardship (AMS) programs, need to be investigated urgently and clearly. Considering the large amount of time nurses spend at patients’ bedside, the aim of the present study was to examine recent literature on nursing competency in AMS. Methods Drawing from Tricco and colleagues’ seven-stage process, a rapid review was performed. MEDLINE, CINAHL and EMBASE databased were searched from December 1st, 2019 until December 31st, 2021. Article screening and study selection were conducted independently by three reviewers. Data were analyzed narratively and categorized adopting an inductive thematic coding. Results Sixteen studies met the inclusion criteria and were included. Publications were mainly authored in USA (n = 4), Australia and New Zealand (n = 4) and Asia (n = 4), followed by Europe (n = 2) and Africa (n = 2). Ten studies were quantitative in design, followed by qualitative (n = 4) and mixed-methods studies (n = 2). Nursing competency in AMS seems to be influenced by a two-dimensional model: on the one hand, internal factors which consisted in knowledge, attitudes and practices and, on the other hand, external aspects which are at environmental level in terms of structures and processes. Conclusion This study provided a map of dimensions for researchers and practitioners to consider when planning clinical governance, educational activities, and research programs. Significant opportunities exist for nurses to contribute to practice, education, research, and policy efforts aimed at reducing antimicrobial resistance.
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Ambagtsheer, Rachel C., Mavourneen G. Casey, Michael Lawless, Mandy M. Archibald, Solomon Yu, Alison Kitson, and Justin J. Beilby. "Practitioner perceptions of the feasibility of common frailty screening instruments within general practice settings: a mixed methods study." BMC Primary Care 23, no. 1 (June 27, 2022). http://dx.doi.org/10.1186/s12875-022-01778-9.
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Abstract Background Frailty is a highly prevalent clinical syndrome increasing older people’s vulnerability to risk of adverse outcomes. Better frailty identification through expanded screening implementation has been advocated within general practice settings, both internationally and within Australia. However, little is known about practitioner perceptions of the feasibility of specific instruments, and the underlying motivations behind those perceptions. Consequently, the purpose of this study was to explore the attitudes and perceptions of a convenience and volunteer sample of Australian general practitioners (GPs) and practice nurses (PNs) towards common frailty screening instruments. Methods The feasibility of several frailty screening instruments (PRISMA-7 [P7], Edmonton Frail Scale [EFS], FRAIL Questionnaire [FQ], Gait Speed Test [GST], Groningen Frailty Indicator [GFI], Kihon Checklist [KC] and Timed Up and Go [TUG]) to 43 Australian GPs and PNs was assessed. The study adopted a concurrent embedded mixed-methods design incorporating quantitative (ranking exercise) and qualitative (content analysis) data collection integrated during the analysis phase. Results Practitioners assessed multi-dimensional instruments (EFS, GFI, KC) as having relatively higher clinical utility, better integration into existing assessment processes and stronger links to intervention over uni-dimensional (GST, TUG) and simple (FQ, P7) instruments. Conclusions While existing frailty screening instruments show promise as an initial step in supporting better care for older people, all the included instruments were associated with perceived advantages and disadvantages. Ultimately, clinicians will need to weigh several factors in their selection of the optimal screening instrument. Further translational research, with a focus on contextual fit, is needed to support clinical decision-making on the selection of instruments for frailty screening.
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Kneebone-Hopkins, C., A. Artemiou, and CA Demetriou. "Determinants of excess mortality during the COVID-19 pandemic in 18 countries of the CMOR consortium." European Journal of Public Health 32, Supplement_3 (October 1, 2022). http://dx.doi.org/10.1093/eurpub/ckac129.278.
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Abstract Many countries suffered excess all-cause mortality during the COVID-19 pandemic. This study aims to identify factors associated with excess mortality rates (EMR) in partaking countries during 2020. Weekly all-cause death counts for 2015-2020 were extracted from national databases for Australia, Austria, Brazil, Cyprus, Denmark, Estonia, France, Georgia, Israel, Italy, Mauritius, Norway, Peru, Slovenia, Sweden, USA, Ukraine and UK. EMR per 100,000 population were gauged using a 5-year mean baseline. Separate OLS multiple linear regressions explored pre-pandemic country profiles including healthcare system, geographic, socio-economic and population factors. Feature selection methods detected the main factors contributing to 2020 EMR. The health system model showed that an extra nurse per 1,000 and a 1% increase in Healthcare Access and Quality Index reduces EMR by 41.7% (p = 0.019) and 0.48% (p = 0.034). The model was statistically significant (R^2=0.415,p=0.018). Although the geographical model suggested that a 1% increase in neighbouring countries increased EMR by 0.42% (p = 0.078), population density and the model itself were statistically insignificant (p > 0.05). The socio-economic and population model indicated a 1% increase in service employed (% of employed) and investment (% GDP) was linked with a 43.4% (p = 0.01) and 43.7% (p = 0.01) fall in EMR. The model was significant (R^2=0.488, p = 0.007). Death registration quality and population share over 70 years, improved model performance (R^2=0.632), but neither approached nominal significance. EMR during the COVID-19 pandemic benefited from higher ratios of nurses to population and able and prompt healthcare. The geographic traits were trivial in explaining EMR variation. Higher ratios of service employed, and investment (% of GDP) were linked to lower EMR. These results help to inform policies now and in future pandemics to strengthen resilience against EMR. Key messages • This study identified which pre-pandemic factors affected EMR in partaking countries, adding to a growing body of work on the COVID-19 pandemic. • Higher ratios of nurses to population, able and prompt healthcare, higher % employed, and investment (% of GDP) were linked to lower EMR.
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Crawford, Gregory Brian, Katherine Hodgetts, Teresa Burgess, and Jaklin Eliott. "Documenting plans for care: advance care directives and the 7-step pathway in the acute care context." BMC Palliative Care 20, no. 1 (September 9, 2021). http://dx.doi.org/10.1186/s12904-021-00838-8.
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Abstract Background Advance care planning involves the discussion and documentation of an individual’s values and preferences to guide their future healthcare should they lose capacity to make or communicate treatment decisions. Advance care planning can involve the individual’s completion of an Advance Care Directive (ACD), a legislated and common-law instrument which may include appointment of a substitute decision-maker and binding refusals of treatment. In South Australia, ACDs intersect in the acute-care context with the Resuscitation Plan 7-Step Pathway (7-SP), an integrated care plan written for and by clinicians, designed to organise and improve patients’ end-of-life care through the use of structured documentation. Here, we examine the perspectives of healthcare professionals (HCPs) within a hospital setting on the practical integration of ACDs and the 7-SP, exploring the perceived role, function, and value of each as they intersect to guide end-of-life care in an Australian hospital setting. Methods Qualitative data were collected via eight focus groups with a total of 74 HCPs (acute care, and oncology specialists; medical intern; general and emergency nurses; social workers) across two hospitals. Audio recordings were transcribed and thematically analysed. Results HCPs viewed ACDs as a potentially valuable means of promoting patient autonomy, but as rarely completed and poorly integrated into hospital systems. Conversely, the process and documentation of the 7-SP was perceived as providing clarity about clinicians’ responsibilities, and as a well-understood, integrated resource. Participants sometimes exhibited uncertainty around which document takes precedence if both were present. Sometimes, the routinisation of the 7-SP meant it was understood as the ‘only way’ to determine patient wishes and provide optimal end-of-life care. When this occurs, the perceived authority of ACDs, or of patients’ choice not to participate in end-of-life discussions, may be undermined. Conclusions The intersection of ACDs and the 7-SP appears problematic within acute care. Clinicians’ uncertainty as to whether an ACD or 7-SP takes precedence, and when it should do so, suggests a need for further clarity and training on the roles of these documents in guiding clinical practice, the legislative context within which specific documentation is embedded, and the dynamics associated with collaborative decision-making in end-of-life care.
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Holm, Doreen, Se Ok Ohr, and Michelle Giles. "The experiences of new graduate nurses and midwives going through a virtual interview recruitment process during the COVID-19 crisis: a cross-sectional study." Human Resources for Health 19, no. 1 (October 2, 2021). http://dx.doi.org/10.1186/s12960-021-00658-0.
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Abstract Background The annual recruitment of new graduate nurses and midwives is key to recruiting large numbers of staff with the right attitude, skills and knowledge who are the best fit for the organisation. Virtual interviews were undertaken in 2020 due to the surge worldwide in the COVID-19 crisis. This study evaluates those virtual interviews and explores the sustainability of the model. Methods A cross-sectional study was conducted at a large health organisation in New South Wales, Australia. Data were collected over 3 weeks using two online surveys, one for interviewees (n = 512) and the other for interviewers (n = 68). Quantitative data were analysed using descriptive statistics and frequency distributions, and additional free-text comments were analysed using content analysis. Results Response rates were 55% (n = 280) interviewees and 54% (n = 37) for interviewers. The majority of interviewees (58%, n = 184) and interviewers (78%, n = 29) stated the interview was seamless or very seamless and 55% (n = 156) of interviewees and 73% (n = 27) of interviewers agreed interviewees conveyed themselves well during interviews. Over half of interviewees (65%, n = 182) and interviewers (51%, n = 18) agreed the virtual interview was fair or very fair for interviewee performance, regardless of age, race, or socio-economic status. However, many expressed a need for better internet access, equipment, and support, and a longer interview time to personally connect. Both new graduate interviewees (60%) and interviewers (75%) agreed virtual interviews are a suitable model for future use. However, some respondents indicated they preferred face-to-face interviews. Conclusions The use of virtual interviews to select new graduates is considered acceptable, cost-effective and sustainable, as well as fair by the majority of participants. Study findings inform policy development, future planning, support the use of flexible selection practices and provide other health care professionals with a virtual recruitment model to consider when developing strategies to grow their future health workforce.
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Hoang, Kevin Thien Anh, Richard W. Morris, Diana Nicole Naehrig, and Nick Glozier. "The comparative mental health of Australian doctors before and during COVID-19: A population-based approach." Australian & New Zealand Journal of Psychiatry, June 25, 2022, 000486742211066. http://dx.doi.org/10.1177/00048674221106677.
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Objective: Occupational surveys of doctors consistently show higher rates of depression and anxiety than reported in general population surveys, findings replicated in all other occupational groups, suggesting potential selection bias. We evaluated the comparative mental health of different occupations in Australia from the same sampling frame over the past 6 years and assessed whether COVID-19 differentially affected different occupational groups. Methods: We analysed six annual data waves (2015–2020) from the nationally representative ‘Household, Income, and Labour Dynamics in Australia’ study. Mental health (Mental Health Inventory–5 from the 36-Item Short Form Survey) and life satisfaction scores of doctors over this period were compared with five other professions and all other employees. Regression models were adjusted for age, gender, income and work hours. Two-way analysis of variance examined the comparative changes in mental health among occupations between 2019 and after exposure to the COVID-19 pandemic in late 2020. Results: The sample of 15,174 employed respondents included 106 doctors. The 5-year mean mental health score for doctors (M = 78.7; SD = 13.1) was significantly higher than that for teachers ( M = 75.6; SD = 14.9), nurses and midwives (M = 76.6; SD = 15.9), lawyers (M = 74.2; SD = 16.1), accountants (M = 74.2; SD = 16.5) and all other employed respondents (M = 73.1, SD = 16.7) ( p < 0.001). Cognitive wellbeing comparisons were similar. There were no significant changes in professionals’ mental health over this period except for an improvement in engineers and a decline for teachers. From 2019 to 2020, all occupations suffered mental health declines without any significant inter-occupational differences. Conclusion: Australian doctors identified from a population-based sample rather than occupational surveys reported better levels of mental health and greater life satisfaction than most professions prior to COVID-19 without experiencing the worsening seen in the general employed population over the past 5 years. From 2020, there was a mental health decline in all of the employed population, not disproportionately affecting doctors. Although over-representing Australian trained general practitioners, the results from both this sample and other tentative findings challenge the discourse in medical advocacy, but need more formal comparative studies to confirm.
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Jeong, Sarah, Peter Cleasby, Se Ok Ohr, Tomiko Barrett, Ryan Davey, and Christopher Oldmeadow. "Efficacy of Normalisation of Advance Care Planning (NACP) for people with chronic diseases in hospital and community settings: a quasi-experimental study." BMC Health Services Research 21, no. 1 (September 1, 2021). http://dx.doi.org/10.1186/s12913-021-06928-w.
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Abstract Background Advance Care Planning (ACP) has emerged to improve end-of-life processes and experiences. However, the available evidence presents the gloomy picture of increasing number of older people living with chronic diseases and the mismatch between their preferences for and the actual place of death. The study aimed to investigate the efficacy of normalisation of an Advance Care Planning (NACP) service delivered by specially trained Registered Nurses (RNs) in hospital and community settings. Methods A quasi-experimental study was conducted involving 16 sites (eight hospital and eight community sites) in Australia. Patients who were aged ≥18 years, who had at least one of nine chronic conditions, and who did not have an Advance Care Directive (ACD) were offered the NACP service. ACP was normalised as part of routine service on admission. The intervention, NACP, was a series of facilitated conversations about the components of ACP. The primary outcomes which included the completion of ACDs, and/or appointment of an Enduring Guardian (EG), were assessed in both intervention and control sites at pre and post intervention stages. Numbers of patients who completed an ACD or appointed an EG were described by count (percentage). ACD completion was compared between intervention and control sites using a logistic mixed effects regression model. The model includes fixed effects for treatment group, period, and their interaction, as well as random site level intercepts. Secondary model included potentially confounding variables as covariates, including age, sex and chronic diseases. Results The prevalence of legally binding ACDs in intervention sites has increased from five to 85 (from 0.85% in pre to 17.6% in post), whereas it has slightly decreased from five to 2 (from 1.2% in pre and to 0.49% in post) in control sites (the difference in these changes being statistically significant p < 0.001). ACD completion rate was 3.6% (n = 4) in LHD1 and 1.2% (n = 3) in LHD2 in hospital whereas it was 53% (n = 26) in LHD1 and 80% (n = 52) in LHD2 in community. Conclusions The study demonstrated that NACP service delivered by ACP RNs was effective in increasing completion of ACDs (interaction odds ratio = 50) and was more effective in community than hospital settings. Involvement of various healthcare professionals are warranted to ensure concordance of care. Trial registration The study was retrospectively registered with the Australian New Zealand Clinical Trials Registry (Trial ID: ACTRN12618001627246) on 03/10/2018. The URL of the trial registry record http://www.anzctr.org.au/trial/MyTrial.aspx