Improving nursing management of patients with diabetes using an action research approach.

Nurses in an acute hospital implemented an action research process supporting changes to the assessment and management of acutely ill patients admitted with diabetes and other co-morbidities. An audit of practice identified inaccurate documentation and uncoordinated care that included inflexible protocols for blood glucose level (BGL) assessment and administration of insulin, unrelated to patients' meals and snacks, that in some instances resulted in hypoglycemic episodes. Specialist nurses and ward staff collaborated to improve practice by increasing nurses' knowledge of insulin and by designing and trialing a blood glucose monitoring form that enabled a more individualised approach to patient care.

Measuring the impact of a team model of nursing practice using work sampling.

The increasing number of inexperienced graduates, as well as other levels of nurse such as the enrolled nurse and assistant-in-nursing, requires health service and nursing managers in the acute care sector to rethink the long-preferred "patient allocation" model of care provision. As well, the escalating shortage of registered nurses and subsequent low morale among those remaining in the workforce require hospitals to re-examine skills mix and staffing ratios. This paper presents the results of two work-sampling studies conducted in a major metropolitan private hospital, the first of which was to provide a rationale for changing from the patient allocation model to a team model of care.

A volunteer companion-observer intervention reduces falls on an acute aged care ward.

Purpose: Falls are the most frequently reported adverse event in hospitalised patients and carry a risk of great harm for the frail elderly. This intervention aimed to prevent high-risk in-patients on an acute aged care ward from falling.

Design/methodology/approach: Patients assessed at high falls risk were accommodated in a room staffed by volunteer companion-observers.

Who, where and why: situational and environmental factors contributing to patient falls in the hospital setting.

Falls are a significant burden on the Australian healthcare budget and can result in loss of personal independence, injury or death. A sustained high rate of inpatient falls at St George Hospital has made it imperative for nurses to identify those patients at highest risk in order to implement preventive interventions. Ninety-one inpatients fell over a ten-week period, with a total of 118 falls.

Evaluating key dimensions of the breast care nurse role in Australia.

A survey of women who had surgery for breast cancer during 1997-1998 at The St George Public and St George Private Hospitals identified substantial deficits in information provision, perceived support, and use of available services. Consequently, a breast care nurse (BCN) was appointed for a 12-month trial to assess women's needs and provide emotional support, education, and referral to appropriate services from diagnosis through to completion of treatment, according to evidence-based guidelines set out by the Australian National Breast Cancer Centre. A questionnaire regarding the role of the BCN was sent to 63 women who had surgery at either hospital from September 1999 to January 2000.

A retrospective comparative study of patients with chest pain and intra-ward transfers.

This retrospective, comparative survey examined patients who had a discharge diagnosis of chest pain and were admitted to The St. George Hospital between July 1999 to June 2000. The aim was to identify the clinical wards/units to which patients were admitted and the number of intra-ward transfers' patients experienced during their hospitalisation.

Australian implantable cardiac defibrillator recipients: quality-of-life issues.

Implantable cardioverter defibrillators (ICDs) have become a well-established therapy for people experiencing potentially lethal dysrhythmias. Australian recipients' quality of life and adjustment to the device over time, device-related complications, shock and associated sensations, and potential sequelae have not been widely explored. This paper reports a longitudinal prospective study of Australian ICD recipients (n = 74) to determine their responses to the device, health-related quality of life over time and shock experiences.