The content, format and timing of a preparation for childhood hospitalization booklet: An action research project.

The experience of childhood hospitalization may be improved by appropriate preparation. As part of a larger project to improve preparation practices for children and their families, a group of health-care professionals investigated the content, format and timing of a pre-existing preparation booklet for a particular procedure. This article analyses the evaluation of the preparation booklet that led to a finding that collaboration among health-care professionals enables improved practice and shared professional power and responsibility.

The management of type 1 diabetes in Australian primary schools.

Aim: The aim of this study was to explore the management of type 1 diabetes in Australian primary schools: kindergarten-Year 2, from the parent's perspective. The study questions were: What diabetes treatment is being delivered? Who is providing the treatment? Where is the treatment given?

Methods: A cross sectional, descriptive approach was used to collect data from parents (66) of children with type 1 diabetes attending an Australian primary school (kindergarten-Year 2). An online self-administered questionnaire was designed in Survey Monkey and was available via a dedicated Facebook page.

Enhancing the resilience of nurses and midwives: pilot of a mindfulness-based program for increased health, sense of coherence and decreased depression, anxiety and stress.

Health workers in general, and midwives and nurses in particular, experience high levels of stress/distress due to the nature of their work and workplaces; and, their socialization into ways of working that minimizes the likelihood of self-care. Increasing interest in the development of resilient workers has meant an enormous growth in interest in the role of holistic practices such as mindfulness meditation. Kabat-Zinn's mindfulness-based stress reduction (MBSR) is one of the most commonly used by those seeking to practise, theorize or research mindfulness across multiple contexts.

Enhancing transformational facilitation skills for nurses seeking to support practice innovation.

Aims: To provide an overview of the development, implementation and process evaluation of a programme for nurses seeking to develop the knowledge and skills required to facilitate practice innovation.

Method: The 12 month facilitation in clinical practice programme was underpinned by transformational practice development (tPD) methodology. The programme included a series of workshops, active learning groups and was supported by experienced facilitators, using a co-facilitation model.

The management of type 1 diabetes in primary school: review of the literature.

Type 1 diabetes is one of the most common chronic health conditions in childhood. The introduction of intensive insulin therapy and the rising prevalence of diabetes in younger children has increased the need for involvement of diabetes educators and school personnel in school diabetes care. School encompasses a significant proportion of a child's day, therefore diabetes treatment at school needs to be optimal or the child will have poor metabolic control.

Modification and testing of the chronic disease compliance instrument to measure treatment compliance in adolescents with asthma.

Compliance is a key challenge for adolescents with asthma, and valid and reliable measures of compliance behaviour and explanatory factors remain elusive, particularly in an Australian setting. This study aimed to examine the factor structure and internal consistency of the chronic disease compliance instrument - asthma in an Australian sample of adolescents with asthma, as well as the relationship between compliance behaviour and explanatory factors. Participants were 132 adolescents (12-17 years) diagnosed with asthma, who voluntarily completed the self-report instrument.

Peer-led education for adolescents with asthma in Jordan: a cluster-randomized controlled trial.

Objectives: To determine the impact of a peer-led education program, developed in Australia, on health-related outcomes in high school students with asthma in Jordan.

Methods: In this cluster-randomized controlled trial, 4 high schools in Irbid, Jordan, were randomly assigned to receive the Adolescent Asthma Action program or standard practice. Bilingual health workers trained 24 peer leaders from Year 11 to deliver asthma education to younger peers from Year 10 (n = 92), who in turn presented brief asthma skits to students in Years 8 and 9 (n = 148) and to other members of the school community in the intervention schools.

Barriers and enablers to implementation of a New Zealand-wide guideline for assessment and management of cardiovascular risk in primary health care: a template analysis.

Aim: The aim of this study was to identify the enablers and barriers to guideline implementation in a primary healthcare setting by employing the Promoting Action on Research Implementation in Health Services (PARIHS) framework as a template for data analysis and interpretation.

Background: The use of clinical practice guidelines is pivotal to improving health outcomes. However, the implementation of guidelines into practice is complex, unpredictable, and, in spite of much investigation, remains resistant to explanation of what works and why.

Practice guidelines need to address the 'how' and the 'what' of implementation.

Aim: The aim of this study was to explore the realities of everyday nursing practice associated with the implementation of a guideline for the assessment and management of cardiovascular risk.

Background: The use of clinical practice guidelines is pivotal to improving health outcomes. However, the implementation of guidelines into practice is complex, unpredictable and, in spite of much investigation, remains resistant to explanation of what works and why.

Modification and testing of the chronic disease compliance instrument to measure treatment compliance in adolescents with diabetes.

Aims And Objectives: To examine the factor structure and internal consistency of the Chronic Disease Compliance Instrument-Diabetes in an Australian sample of adolescents with diabetes, to modify the instrument and re-examine factor structure and internal consistency of subsequent scales and to examine the relationship between compliance behaviour and theoretically relevant explanatory factors.

Background: Compliance is a key challenge for adolescents with a chronic disease; however, valid and reliable self-report measures of compliance behaviour and explanatory factors for diabetes remain elusive, particularly applied in an Australian setting.

Design: Correlational design.

How do facilitators of practice development gain the expertise required to support vital transformation of practice and workplace cultures?

Background: Skilled facilitation is at the heart of transformational practice development, and facilitators carry the hopes and expectations of those eager to see the promises of practice development come to fruition.

Aim: The aim of this paper is to present a framework that assists facilitators to understand their progress in relation to the development of specific expertise, identify their ongoing needs and make the most of all opportunities for development.

Conclusion: We argue that insight into several stages of development, and finding appropriate forms of challenge and support, are likely to enhance the experiences of facilitators, their rate of development and the level of expertise achieved.

Variability in incubator humidity practices in the management of preterm infants.

Aim: To determine current practice and opinion in relation to incubator humidity use in the management of preterm infants in neonatal intensive care units (NICU's) within the Australian and New Zealand Neonatal Network (ANZNN).

Methods: A survey was conducted in 26 NICU's in the ANZNN. A senior clinical nurse in each perinatal centre participated in a telephone survey that focused on local humidification practices and on the clinicians' views and experiences of humidity use.

The Australian experience of nurses' preparedness for evidence-based practice.

Aim: This study aimed to determine current knowledge and attitudes towards evidence-based practice (EBP) among pre- and post-registration nurses in New South Wales (NSW), Australia.

Background: Educational and clinical strategies for EBP in nursing assume a readiness to interpret and integrate evidence into clinical care despite continued reports of low levels of understanding and skill in this area.

Method: Perceptions of EBP were examined through a self-complete, anonymous postal survey distributed to 677 (post-registration) clinical nurses and to 1134 final year (pre-registration) nursing students during 2002 and 2003.

Views on evidence from nursing and midwifery opinion leaders.

National registration standards in Australia require nurses and midwives to be educationally prepared to use an evidence-based framework for their practice. These standards assume a shared professional understanding of evidence and, an agreed approach towards educational preparation for evidence implementation. In this study, a qualitative phenomenographic approach is used to explore the ways in which nursing opinion leaders understand 'evidence' within the context of evidence-based practice (EBP).

The role of specialist nurses in improving treatment adherence in children with a chronic illness.

Adherence to medical treatment is an ongoing challenge for families and young people with chronic medical conditions. One factor that is likely to influence treatment success is the quality of professional relationships both within the health care team and between the family, child and professionals. This paper explores the topic of professional relationships and adherence and provides an example of how a multidisciplinary team can improve the health and quality of life of paediatric patients.

Development of children's assent documents using a child-centred approach.

The call for researchers to obtain children's informed assent, prior to their participation in medical procedures and research, has increased over recent years and parallels moves to implement child-centred approaches to health care. This article describes the processes used to include children in developing a research information sheet and assent form for use in future research into children's understandings of their surgery and hospital experiences. The process involved primary school children aged between six and 12 years.

Handwashing practice and policy variability when caring for central venous catheters in paediatric intensive care.

It has been estimated that there may be as many as 150,000 healthcare associated infections (HCAI) in Australia each year, contributing to 7,000 deaths, many of which could be prevented through the implementation of appropriate infection control practices. Contact with contaminated hands is a primary source of HCAI. Intensive care staff have been identified as one of the least adherent groups of health care professionals with handwashing; they are less likely to practise hand antisepsis before invasive procedures than staff working in other patient care specialties.

Quantitative evaluation of regular morning meetings aimed at improving work practices associated with effective interdisciplinary communication.

In 2000, an interdisciplinary surgical morning meeting (SMM) was introduced into the infants' and toddlers' ward of a major paediatric hospital to help overcome a number of communication and work process problems among the health professionals providing care to children/families. The objective of this study was to evaluate the impact of the SMM on a range of work practices. Comparative design including pre- and postintervention data collection was used.

Qualitative evaluation of regular morning meetings aimed at improving interdisciplinary communication and patient outcomes.

Effective interdisciplinary communication is at the heart of clinical decision-making in contemporary health-care environments. Efforts to enhance communication and work processes among nurses and doctors in an infants-and-toddler ward of a specialist paediatric hospital led to the establishment of Surgical Morning Meetings (SMMs). To evaluate the experiences of nursing and medical team members and their perceptions of the changes brought about by the SMM, qualitative evaluation of the SMM was undertaken through semistructured interviews.

Central venous access and handwashing: variability in policies and practices.

This study examined variability in handwashing policy between hospitals, variability in handwashing practices in nurses and how practice differed from policy in tertiary paediatric hospitals in Australia and New Zealand. Eight of the possible nine major paediatric hospitals provided a copy of their handwashing and/or central venous access device (CVAD) policies, and 67 nurses completed a survey on their handwashing practices associated with CVAD management. A high degree of variability was found in relation to all the questions posed in the study.

Treatment adherence of youth and young adults with and without a chronic illness.

The present study was undertaken to explore the psychosocial functioning of young people with chronic illness, their beliefs about treatment adherence, difficulties with adherence and concerns about living with their illness. A small correlational study was undertaken to compare the psychosocial functioning of young people, with and without chronic illness, aged between 12 and 24 years. Subjects were recruited from a metropolitan teaching hospital.