Academic literature on the topic 'Pediatric nursing Victoria Melbourne'

Background: Nurses played a critical role in providing care for patients throughout the COVID-19 pandemic. Aim: This study aimed to explore perspectives of Australian palliative care nurses regarding the impact of COVID-19 on the provision of care for patients with advanced illness, or at the end of life. Methods: The authors conducted a survey of palliative care nurses in ward- and consultation-based roles at a metropolitan health service in Victoria, Australia. Findings: A total of 24 out of 39 nurses completed the survey. Responses included strong themes of fear of COVID-19 and sadness about separating dying patients from their families. Conclusion: Delivery of palliative care changed at an individual and service level. Importantly, there were strong themes of adapting to change and ‘soldiering on’ with the core business of palliative care.

Background Invasive group A streptococcal disease (IGAS) carries significant morbidity and mortality in children. Fluctuations in disease incidence are well documented. However, the modulating factors that contribute to these changes remain unclear. Prospective monitoring of IGAS cases in Victoria, Australia, showed an increased number of cases in 2017, coinciding with a peak of influenza illness. Methods Children identified to have IGAS are prospectively monitored in Melbourne through a disease surveillance network. Data on their presentation, investigations, and clinical course are collected. An increased number of cases identified between June 1, 2017, and October 31, 2017, have been retrospectively analyzed. Results We identified 22 cases of pediatric IGAS during the study period. Increased case detection occurred during a period of increased influenza disease. Of 11 children in our cohort who underwent respiratory viral testing, 4 were confirmed to have concurrent respiratory tract illnesses, and 2 were confirmed to have influenza.

The care of people living with HIV/AIDS in the home and community can be complex and challenging, requiring high levels of knowledge, skill, preparedness and, importantly, the ability to engage with people belonging to marginalised groups. In 2003, the Royal District Nursing Service (RDNS) HIV/AIDS Team in Victoria, Australia, developed the new role of HIV Resource Nurse at two RDNS centres in Melbourne serving high numbers of people living with HIV/AIDS. Drawing from two case studies and interviews with two HIV Resource Nurses from one of the centres, this paper describes this practice innovation. Benefits (including a positive impact on client engagement with services, client care, relationships with other health care workers and job satisfaction) are outlined, along with challenges in the implementation and evolution of the role. Strategies to sustain and develop the HIV Resource Nurse role are proposed.

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.

Background Responsibilities of critical care nurses for management of mechanical ventilation may differ among countries. Organizational interventions, including weaning protocols, may have a variable impact in settings that differ in nursing autonomy and interdisciplinary collaboration. Objective To characterize the role of Australian critical care nurses in the management of mechanical ventilation. Methods A 3-month, prospective cohort study was performed. All clinical decisions related to mechanical ventilation in a 24-bed, combined medical-surgical adult intensive care unit at the Royal Melbourne Hospital, a university-affiliated teaching hospital in Melbourne, Victoria, Australia, were determined. Results Of 474 patients admitted during the 81-day study period, 319 (67%) received mechanical ventilation. Death occurred in 12.5% (40/319) of patients. Median durations of mechanical ventilation and intensive care stay were 0.9 and 1.9 days, respectively. A total of 3986 ventilation and weaning decisions (defined as any adjustment to ventilator settings, including mode change; rate or pressure support adjustment; and titration of tidal volume, positive end-expiratory pressure, or fraction of inspired oxygen) were made. Of these, 2538 decisions (64%) were made by nurses alone, 693 (17%) by medical staff, and 755 (19%) by nurses and staff in collaboration. Decisions made exclusively by nurses were less common for patients with predominantly respiratory disease or multiple organ dysfunction than for other patients. Conclusions In this unit, critical care nurses have high levels of responsibility for, and autonomy in, the management of mechanical ventilation and weaning. Revalidation of protocols for ventilation practices in other clinical contexts may be needed.

ObjectiveThe aim of this study was to identify the challenges anticipated by clinical staff in two Melbourne health services in relation to the legalisation of voluntary assisted dying in Victoria, Australia. MethodsA qualitative approach was used to investigate perceived challenges for clinicians. Data were collected after the law had passed but before the start date for voluntary assisted dying in Victoria. This work is part of a larger mixed-methods anonymous online survey about Victorian clinicians’ views on voluntary assisted dying. Five open-ended questions were included in order to gather text data from a large number of clinicians in diverse roles. Participants included medical, nursing and allied health staff from two services, one a metropolitan tertiary referral health service (Service 1) and the other a major metropolitan health service (Service 2). The data were analysed thematically using qualitative description. ResultsIn all, 1086 staff provided responses to one or more qualitative questions: 774 from Service 1 and 312 from Service 2. Clinicians anticipated a range of challenges, which included burdens for staff, such as emotional toll, workload and increased conflict with colleagues, patients and families. Challenges regarding organisational culture, the logistics of delivering voluntary assisted dying under the specific Victorian law and how voluntary assisted dying would fit within the hospital’s overall work were also raised. ConclusionsThe legalisation of voluntary assisted dying is anticipated to create a range of challenges for all types of clinicians in the hospital setting. Clinicians identified challenges both at the individual and system levels. What is known about the topic?Voluntary assisted dying became legal in Victoria on 19 June 2019 under the Voluntary Assisted Dying Act 2017. However there has been little Victorian data to inform implementation. What does this paper add?Victorian hospital clinicians anticipate challenges at the individual and system levels, and across all clinical disciplines. These challenges include increased conflict, emotional burden and workload. Clinicians report concerns about organisational culture, the logistics of delivering voluntary assisted dying under the specific Victorian law and effects on hospitals’ overall work. What are the implications for practitioners?Careful attention to the breadth of staff affected, alongside appropriate resourcing, will be needed to support clinicians in the context of this legislative change.

Aim. Receiving professional help early can reduce long-term harms associated with substance use. However, little is known about the factors that influence help-seeking for substance use problems during early-mid adolescence, prior to the emergence of disorder. Given that beliefs regarding help-seeking are likely to develop early, understanding adolescent views of help-seeking during this period is likely to provide important information for prevention and intervention efforts. The current study identifies perceptions that would facilitate or prevent adolescents from seeking support for substance use problems from formal and informal help sources. Method. Thirty-four 12- to 16-year-olds from two schools in Melbourne, Victoria, Australia, were recruited. A qualitative interpretative design was used, incorporating semistructured, audio-recorded interviews. Results. Three overlapping themes that reflected barriers or enablers to help-seeking were identified: approachability, confidentiality and trustworthiness, and expertise. Help-seeking was facilitated when adolescents believed that the help source would be supportive and understanding, would keep information confidential, and had expertise in the alcohol and drug field. Conversely, adolescents were reluctant to seek help from sources they believed would be judgmental, lacked expertise, or would inform their parents. Conclusions. These findings highlight perceptions that may influence help-seeking for alcohol and drug problems during adolescence. Further research is needed to determine if help-seeking can be facilitated by improving parents’ and peers’ knowledge and promoting health professionals’ expertise in working with young people’s alcohol and drug issues.

Abstract Background Electronic medical task management systems (ETMs) have been adopted in health care institutions to improve health care provider communication. ETMs allow for the requesting and resolution of nonurgent tasks between clinicians of all craft groups. Visibility, ability to provide close-loop feedback, and a digital trail of all decisions and responsible clinicians are key features of ETMs. An embedded ETM within an integrated electronic health record (EHR) was introduced to the Royal Children's Hospital Melbourne on April 30, 2016. The ETM is used hospital-wide for nonurgent tasks 24 hours a day. It facilitates communication of nonurgent tasks between clinical staff, with an associated designated timeframe in which the task needs to be completed (2, 4, and 8 hours). Objective This study aims to examine the usage of the ETM at our institution since its inception. Methods ETM usage data from the first 3 years of use (April 2016 to April 2019) were extracted from the EHR. Data collected included age of patient, date and time of task request, ward, unit, type of task, urgency of task, requestor role, and time to completion. Results A total of 136,481 tasks were placed via the ETM in the study period. There were approximately 125 tasks placed each day (24-hour period). The most common time of task placement was around 6:00 p.m. Task placement peaked at approximately 8 a.m., 2 p.m., and 9 p.m.—consistent with nursing shift change times. In total, 63.16% of tasks were placed outside business hours, indicating predominant usage for after-hours task communication. The ETM was most highly utilized by surgical units. The majority of tasks were ordered by nurses for medical staff to complete (97.01%). A significant proportion (98.79%) of tasks was marked as complete on the ETM, indicating closed-loop feedback after tasks were requested. Conclusion An ETM function embedded in our EHR has been highly utilized in our institution since its introduction. It has multiple benefits for the clinician in the form of efficiencies in workflow and improvement in communication and also workflow management. By allowing collection, tracking, audit, and prioritization of tasks, it also provides a stream of actionable data for quality-improvement activities.

Objective: To determine the frequency, nature and consequence of adverse events sustained by children admitted to a combined general and cardiac paediatric intensive care unit (PICU). Design: Retrospective analysis of data collected between January 1st 2008 and December 31st 2017 from PICU. Setting: The Royal Children’s Hospital, a paediatric tertiary referral centre in Melbourne, Victoria, Australia. The PICU has thirty beds. Results: During the study period, PICU received 15208 admissions, of which 73% sustained at least one adverse event with a frequency of 67 adverse events per 100 PICU-days and 3 per admission. One adverse event was sustained for every 35 hours of care. The risk of an adverse event was highest in children less than a month of age, or if mechanically ventilated, a high Pediatric Index of Mortality (PIM2) score, longer PICU length of stay, had a pre-existing disability or a high risk adjustment for congenital heart surgery (RACHS) score. Those patients who sustained an adverse event, as compared to those who did not, were mechanically ventilated for longer (80 hrs Vs. 7 hrs, p=<0.001), had a longer PICU length of stay (131 hrs Vs. 35 hrs, p=<0.001), had a longer hospital length of stay (484 hrs Vs. 206 hrs, p=<0.001) and had a higher mortality rate (3% vs. 0.1%, p=<0.001). Conclusion: Whilst admission to PICU is an essential aspect of care for many patients, the risk of adverse events is high and is associated with significant clinical consequences. Monitoring of adverse events as part of quality improvement enables targeted intervention to improve patient safety.

Objective: Virtual reality (VR), a novel and highly immersive technology, offers promise in addressing potential psychological impacts of cancer treatments and hospitalization. The primary aim of this study was to examine multiple key user perspectives on the acceptability and feasibility of an Immersive VR therapeutic intervention for use with hospitalized patients with cancer. Secondary aims were to identify issues and opportunities related to the adoption and clinical implementation of VR in pediatric oncology settings. Method: The study was conducted at The Royal Children’s Hospital (RCH), Melbourne, Australia. Thirty multidisciplinary oncology health care professionals participated in an initial test of VR intervention usability (Stage 1). Ninety oncology inpatients (7-19 years) and their parent caregivers participated in a pilot randomized controlled study to examine the effectiveness of an Immersive VR therapeutic intervention (Stage 2). This mixed methods study reports Stages 1 and 2 quantitative and qualitative data related to VR feasibility and acceptability. Results: Results indicate favorable perceptions from health care professionals with respect to ease of use and usefulness of VR, and had positive intentions to use it in the future. Parent caregivers reported high acceptability of VR for their hospitalized child. Patients reported high satisfaction of the VR intervention within minimal adverse effects. Barriers and facilitators to VR use with seriously ill children and specific recommendations for content development were elicited. Conclusion: This study shows that there are several potential clinical uses for Immersive VR intervention, beyond medical procedural distraction, to support psychological adjustment to hospitalization and patient quality of life.

This study attempted to identifj and explore the role the building plays in the organisation culture of nursing homes. To do this a research plan was formulated in which the central plank was a case-study of a seventy-five bed high care nursing home. As part of the case-study, interviews were conducted at the nursing home with ten members of staff, two residents and a daughter of a resident. The study was also informed by interviews with two architects, who specialise in the design of nursing homes and aged care facilities. A theoretical model entitled the 'Conceptual Framework' was developed prior to the case-study. It was tested by applying it to findings related to the physical context and the organisation culture of the case-study venue. The hypothesis that the building does influence the culture of the nursing home environment was explored by studying the manner in which the building influenced the lives of those who work in the nursing home and those who live there. This challenge was met with the use of theoretical contributions from organisation theory and psychodynamics, which together provided a vehicle for analysis of the culture and the building's role in it.

This study investigated childbirth education programs in Victoria from the perspective of the educators themselves. Prior to the study the Ministerial Review of Birthing Services in Victoria (1990) entitled “Having a Baby in Victoria” identified shortcomings in the childbirth education programs offered to expectant women and their partners. The study sought to interpret the experiences of the childbirth educators with regard to the development, implementation, delivery and evaluation of their programs.

First time parent couples are more likely to be a dual income family now than ever before. In Australia, 65% of employed women in couple families have dependant children, and in couple families with children under five years of age, 52% of mothers are in paid employment. Research consistently shows that women still take on responsibility for family chores, those unpaid jobs which are essential for maintenance of society. The aim of this study was to examine the experience of first-time parent couples when the mother returned to the paid workforce. An Australian community based sample of 141 participants (69 couples plus 3 women whose partners failed to return questionnaire booklets) were recruited into this longitudinal study for the purpose of comparing single and two-income first-time parent couples. Recruitment occurred prior to the two-income mother returning to paid work and participants were followed for ten months to determine how men and women negotiated the transition from single to two-income status. A number of variables were measured on four occasions over a ten-month period to examine the effects of the transition on each partner and compare the results between the two groups of parents. These variables included marital satisfaction, worker spillover, stress levels, parenting satisfaction, division of household labour and emotional status.

The purpose of this study was to enhance the clinical experience of undergraduate nursing students through an investigation into a Flexible Clinical Education Model offered at Victoria University. Clinical education is a vital component of the undergraduate nursing curriculum that provides students with the opportunity to develop the knowledge, attitudes and skills needed to function effectively as a qualified nurse. Despite the commitment of universities to produce competent graduates, there is continued debate regarding models of clinical education that provide best practice in the clinical learning environment.

The Australian Catholic University (ACU National at www.acu.edu.au) is a public university funded by the Australian Government. There are six campuses across the country, located in Brisbane, Queensland; North Sydney, New South Wales; Strathfield, New South Wales; Canberra, Australian Capital Territory (ACT); Ballarat, Victoria; and Melbourne, Victoria. The university serves a total of approximately 27,000 students, including both full- and part-time students, and those enrolled in undergraduate and postgraduate studies. Through fostering and advancing knowledge in education, health, commerce, the humanities, science and technology, and the creative arts, ACU National seeks to make specific and targeted contributions to its local, national, and international communities. The university explicitly engages the social, ethical, and religious dimensions of the questions it faces in teaching, research, and service. In its endeavors, it is guided by a fundamental concern for social justice, equity, and inclusivity. The university is open to all, irrespective of religious belief or background. ACU National opened its doors in 1991 following the amalgamation of four Catholic tertiary institutions in eastern Australia. The institutions that merged to form the university had their origins in the mid-17th century when religious orders and institutes became involved in the preparation of teachers for Catholic schools and, later, nurses for Catholic hospitals. As a result of a series of amalgamations, relocations, transfers of responsibilities, and diocesan initiatives, more than twenty historical entities have contributed to the creation of ACU National. Today, ACU National operates within a rapidly changing educational and industrial context. Student numbers are increasing, areas of teaching and learning have changed and expanded, e-learning plays an important role, and there is greater emphasis on research. In its 2005–2009 Strategic Plan, the university commits to the adoption of quality teaching, an internationalized curriculum, as well as the cultivation of generic skills in students, to meet the challenges of the dynamic university and information environment (ACU National, 2008). The Graduate Diploma of Education (Secondary) Program at ACU Canberra Situated in Australia’s capital city, the Canberra campus is one of the smallest campuses of ACU National, where there are approximately 800 undergraduate and 200 postgraduate students studying to be primary or secondary school teachers through the School of Education (ACT). Other programs offered at this campus include nursing, theology, social work, arts, and religious education. A new model of pre-service secondary teacher education commenced with the introduction of the Graduate Diploma of Education (Secondary) program at this campus in 2005. It marked an innovative collaboration between the university and a cohort of experienced secondary school teachers in the ACT and its surrounding region. This partnership was forged to allow student teachers undertaking the program to be inducted into the teaching profession with the cooperation of leading practitioners from schools in and around the ACT. In the preparation of novices for the teaching profession, an enduring challenge is to create learning experiences capable of transforming practice, and to instill in the novices an array of professional skills, attributes, and competencies (Putnam & Borko, 2000). Another dimension of the beginning teacher experience is the need to bridge theory and practice, and to apply pedagogical content knowledge in real-life classroom practice. During the one-year Graduate Diploma program, the student teachers undertake two four-week block practicum placements, during which they have the opportunity to observe exemplary lessons, as well as to commence teaching. The goals of the practicum include improving participants’ access to innovative pedagogy and educational theory, helping them situate their own prior knowledge regarding pedagogy, and assisting them in reflecting on and evaluating their own practice. Each student teacher is paired with a more experienced teacher based at the school where he/she is placed, who serves as a supervisor and mentor. In 2007, a new dimension to the teaching practicum was added to facilitate online peer mentoring among the pre-service teachers at the Canberra campus of ACU National, and provide them with opportunities to reflect on teaching prior to entering full-time employment at a school. The creation of an online community to facilitate this mentorship and professional development process forms the context for the present case study. While on their practicum, students used social software in the form of collaborative web logging (blogging) and threaded voice discussion tools that were integrated into the university’s course management system (CMS), to share and reflect on their experiences, identify critical incidents, and invite comment on their responses and reactions from peers.