Transforming nursing assessment in acute hospitals: A cluster randomised controlled trial of an evidence-based nursing core assessment (the ENCORE trial).

Background: Patient safety is threatened when early signs of clinical deterioration are missed or not acted upon. This research began as a clinical-academic partnership established around a shared concern of nursing physical assessment practices on general wards and delayed recognition of clinical deterioration. The outcome was the development of a complex intervention facilitated at the ward level for proactive nursing surveillance.

Using Talanoa in Community-Based Research with Australian Pacific Islander Women with Type 2 Diabetes.

Background: Type 2 diabetes is a significant public health problem and Australian Pacific Islander (API) women and their communities are experiencing a higher burden of morbidity and mortality from the disease. Despite this higher burden there are few initiatives that are culturally tailored to improve prevention and management.

Objectives: We used talanoa, a community-based research methodology to build capacity with API women living in Queensland and to develop culturally relevant methods of information sharing and knowledge building.

The Concepts of Social Space and Social Value: An Interpretation of Clinical Nursing Practice in Vietnam Các khái niệm về không gian xã hội và giá trị xã hội: diễn giải về thực hành điều dưỡng lâm sàng ở Việt Nam.

This research draws on broader inquiry that explores the construction of the spatial positioning of nurses in Vietnam and how power structures sustained that positioning. Observations and individual interviews were undertaken with 32 registered nurses. Analysis of participant data and relevant policy documents moved beyond coding to theorising and thus to the abstraction of key concepts.

The phenomenon of caring for older patients who are dying from traumatic injuries in the emergency department: An interpretive phenomenological study.

Purpose: To gain greater understanding of what it means to care for older patients dying from traumatic injuries in the emergency department.

Design: A Heideggerian phenomenological design using the methods of Van Manen.

Methods: In-depth, face-to-face interviews were conducted with five emergency nurses who worked in an emergency department in Australia.

Deconstructing type 2 diabetes self-management of Australian Pacific Islander women: Using a community participatory research and talanoa approach.

Community-based participatory research using culturally appropriate talanoa approaches provided the framework to explore diabetes self-management of Australian Pacific Islander (API) women living with type 2 diabetes in South-East Queensland. Data collection included interviews with key informants (21), in-depth interviews with API women with diabetes (10), talanoa group discussions (7) and monthly steering committee meetings. Using an interpretive-constructionist lens and the interpretations of community members, four cultural constructs in diabetes self-management emerged: self-identity, spirituality, stigma and denial, and structural factors.

Effects of nurse-to-patient ratio legislation on nurse staffing and patient mortality, readmissions, and length of stay: a prospective study in a panel of hospitals.

Background: Substantial evidence indicates that patient outcomes are more favourable in hospitals with better nurse staffing. One policy designed to achieve better staffing is minimum nurse-to-patient ratio mandates, but such policies have rarely been implemented or evaluated. In 2016, Queensland (Australia) implemented minimum nurse-to-patient ratios in selected hospitals.

A Scoping Review of End-of-Life Communication in International Palliative Care Guidelines for Acute Care Settings.

Context: End-of-life communication in acute care settings can be challenging and many patients and families have reported low satisfaction with those conversations.

Objective: To explore existing guidelines around palliative care to increase current understanding of end-of-life communication processes applicable to the acute care setting.

Methods: A scoping review following the method of Arksey and O'Malley was undertaken to identify eligible documents and thematically summarize findings.

Case for hospital nurse-to-patient ratio legislation in Queensland, Australia, hospitals: an observational study.

Objectives: To determine whether there was variation in nurse staffing across hospitals in Queensland prior to implementation of nurse-to-patient ratio legislation targeting medical-surgical wards, and if so, the extent to which nurse staffing variation was associated with poor outcomes for patients and nurses.

Design: Analysis of cross-sectional data derived from nurse surveys linked with admitted patient outcomes data.

Setting: Public hospitals in Queensland.

The constitution of space in intensive care: Power, knowledge and the othering of people experiencing mental illness.

A sociological conceptualisation of space moves beyond the material to the relational, to consider space as a social process. This paper draws on research that explored the reproduction of legitimated knowledge and power structures in intensive care units during encounters, between patients, who were experiencing mental illness, and their nurses. Semi-structured telephone interviews with 17 intensive care nurses from eight Australian intensive care units were conducted in 2017.

Exploring the Use of Complementary and Alternative Medicine in Cancer Patients.

In Australia, it is estimated that around 17% to 87% of cancer patients have used one form of complementary therapy during their cancer treatment. There are numerous reasons and contributing factors for cancer patients to consider using complementary and alternative medicine (CAM). CAM information and products are readily available.

Exploring the Use of Complementary and Alternative Medicine in Cancer Patients.

In Australia, it is estimated that around 17% to 87% of cancer patients have used one form of complementary therapy during their cancer treatment. There are numerous reasons and contributing factors for cancer patients to consider using complementary and alternative medicine (CAM). CAM information and products are readily available.

Evaluation frameworks in health services: An integrative review of use, attributes and elements.

Aims And Objective: To synthesise the evidence on the use of evaluation frameworks by nurses and midwives in research designed to improve healthcare services and practice. A secondary aim was to identify the attributes and elements of evaluation frameworks.

Background: Evaluation is an integral component of any initiative to improve outcomes or change clinical practice.

Expanding knowledge and roles for authority and practice boundaries of Emergency Department nurses: a grounded theory study.

Purpose: While emergency department nurses in Indonesia are critical to quality care, the role lacks recognition and standard practices and regulation of scope of practice are absent. This research explored the role of nurses in Indonesian EDs.

Method: The conceptual lens applied in the research was grounded theory.

Factors influencing variation in investigations after a negative CT brain scan in suspected subarachnoid haemorrhage: a qualitative study.

Introduction: Variation in the approach to the patient with a possible subarachnoid haemorrhage (SAH) has been previously documented. The purpose of this study was to identify factors that influence emergency physicians' decisions about diagnostic testing after a normal CT brain scan for ED patients with a headache suspicious of a SAH.

Methods: We conducted an interview-based qualitative study informed by social constructionist theory.

Perceptions of nursing workloads and contributing factors, and their impact on implicit care rationing: A Queensland, Australia study.

Aims: To explore nurses' perceptions of factors affecting workloads and their impact on patient care.

Background: Fiscal restraints and unpredictable patient illness trajectories challenge the provision of care. Cost containment affects the number of staff employed and the skill-mix for care provision.

Centralizing Temporality in Adolescent and Young Adult Cancer Survivorship.

Drawing on Gadamer's hermeneutic philosophy, this article presents a key outcome of broader research into the phenomenon of adolescent and young adult cancer survivorship. Data were generated through semi-structured interviews with 45 participants from Australia, England, and the United States. The participants received a cancer diagnosis between the ages of 15 and 29 years and were aged 18 to 40 years at the time of interview.

Engaging students in a community of learning: Renegotiating the learning environment.

Promoting student engagement in a student led environment can be challenging. This article reports on the process of design, implementation and evaluation of a student led learning approach in a small group tutorial environment in a three year Bachelor of Nursing program at an Australian university. The research employed three phases of data collection.

Nurse practitioner led pain management the day after caesarean section: A randomised controlled trial and follow-up study.

Background: Pain on the day after caesarean section is often treated with controlled-release oxycodone to supplement the decline in analgesia from intrathecal opioids. Evidence suggests that caesarean birth is a biopsychosocial experience where a comprehensive approach is needed that promotes control and participation in pain management.

Objectives: This study compared immediate-release oxycodone integrated with supportive educational strategies to controlled-release oxycodone.

Collaboration: A critical exploration of the care continuum.

The purpose of this research was to explore the concept of collaboration within a specific healthcare context and to include the perspectives of healthcare users, a position largely lacking in previous studies. In applying a critical theoretical approach, the focus was on, as an exemplar, mothers with newborn babies who had spent more than 48 hr in a special care nursery. Semistructured interviews were undertaken with child health nurses, midwives and mothers.

Evaluating a Web-Based Self-Management Intervention in Heart Failure Patients: A Pilot Study.

Background: Web-based interventions may have the potential to support self-care in patients with chronic disease, yet little is known about the feasibility of Web-based interventions in patients with heart failure (HF).

Objective: The objective of our study was to develop and pilot a Web-based self-care intervention for patients with HF.

Methods: Following development and pretesting, we pilot tested a Web-based self-care intervention using a randomized controlled design.

Nursing physical assessment for patient safety in general wards: reaching consensus on core skills.

Aims And Objectives: To determine consensus across acute care specialty areas on core physical assessment skills necessary for early recognition of changes in patient status in general wards.

Background: Current approaches to physical assessment are inconsistent and have not evolved to meet increased patient and system demands. New models of nursing assessment are needed in general wards that ensure a proactive and patient safety approach.

The Trajectory of Tolerance for Wandering-related Boundary Transgression: An Exploration of Care Staff and Family Perceptions.

Purpose Of The Study: This study aimed to explore the experience of living with and caring for a person with dementia who wanders and transgresses boundaries into out-of-bounds and potentially hazardous areas (wandering-related boundary transgression [BT]), from the perspective of family members and care staff.

Design And Methods: This descriptive qualitative study utilized four focus groups with care staff (n = 28), one with family members (n = 4), and individual interviews (n = 8) with family members. Content analysis generated key concepts that formed the basis of the development of a theoretical understanding of the experience.

The positioning of palliative care in acute care: A multiperspective qualitative study in the context of metastatic melanoma.

Objective: The positioning and meaning of palliative care within the healthcare system lacks clarity which adds a level of complexity to the process of transition to palliative care. This study explores the transition to the palliative care process in the acute care context of metastatic melanoma.

Method: A theoretical framework drawing on interpretive and critical traditions informs this research.

Too much knowledge for a nurse? Use of physical assessment by final-semester nursing students.

There is debate around the scope of physical assessment skills that should be taught in undergraduate nursing programs. Yet this debate is largely uninformed by evidence on what is learned and practiced by nursing students. This study examined the pattern and correlates of physical assessment skill utilization by 208 graduating nursing students at an Australian university, including measures of knowledge, frequency of use, and perceived barriers to physical assessment skills during clinical practice.

Nursing and Medical Perceptions of a Hospital Rapid Response System: New Process But Same Old Game?

Perhaps no other patient safety intervention depends so acutely on effective interprofessional teamwork for patient survival than the hospital rapid response system. Yet, little is known about nurse-physician relationships when rescuing at-risk patients. This study compared nursing and medical staff perceptions of a mature rapid response system at a large tertiary hospital.