Hospital readmission among older adults with congestive heart failure.

Introduction: To examine the factors associated with unplanned readmission among older adults with congestive heart failure (CHF) within 28 days of discharge from an index admission, within a large Australian health service.

Methods: Using a comparative cohort design, a multivariate logistic regression model was used to compare readmitted patients with non-readmitted patients and identify risk factors associated with readmission.

Results: Significant risk factors identified were male gender, numerous diagnoses, length of stay 3 days or longer and patients being admitted from acute, subacute or aged-care facilities.

The role of informal caregivers during cancer patients' recovery from chemotherapy.

Aims: (i) To investigate the availability, perceived importance and roles of informal caregivers in the recovery of patients treated at day oncology centres and (ii) identify differences between patients with and without informal caregivers in the extent to which they experienced symptoms, and the level of bother symptoms caused.

Method: Patients from three Australian hospitals (n = 122) were recruited during cycles 1 or 2 of adjuvant chemotherapy. Participants completed a modified version of the Rotterdam Symptom Checklist (RSCL) each day for 5 days after chemotherapy.

Team clinical supervision in acute hospital wards: a feasibility study.

Clinical supervision provides a strategy to mitigate nurses' workplace stress and enhance retention, but the literature provides little guidance about its implementation beyond mental health nursing. This study explored the feasibility of implementing and evaluating ward-based team clinical supervision for general nurses on two separate wards at one public and one private hospital. Nurses completed the Work Environment Questionnaire pre- (n = 36) and postintervention (n = 27), and focus groups (n = 20) explored their perceptions of supervision.

Frequency of migraine and the risk of cardiovascular disease for women: limited evidence of an association.

Evaluation of: Kurth T, Schurks M, Logroscino G et al. Migraine frequency and risk of cardiovascular disease in women. Neurology 73, 581-588 (2009).

Incontinence: managed or mismanaged in hospital settings?

This paper reports the results of a survey of inpatients to determine the prevalence of their continence status and the overall management of their incontinence. A survey of 447 hospitalized adults was conducted and an audit of their medical records. Twenty-two per cent of patients reported urinary incontinence, 10% faecal incontinence, 78% nocturia, 23% urinary urgency and 11% trouble passing urine.

The Tri-focal model of care: advancing the teaching-nursing home concept.

Providing residential aged care is challenging because of the complexity of residents' health status, difficulties recruiting and retaining skilled staff, and financial and regulatory constraints. This paper discusses some of these challenges and describes an innovative model of care, termed 'The Tri-focal model of care'. This model was developed based on the concepts of 'partnership-centred care', 'positive work environment' and the need for evidence-based practice to underpin all aspects of care.

Nursing handover: it's time for a change.

Nursing handover is a common part of nursing practice that is fundamental to safe patient care. Despite this, the literature provides little direction on the best way to conduct handover. This project aimed to examine nurses' perceptions of handover and to determine the strengths and imitations of the handover process.

Nurses' attitudes to single checking medications: before and after its use.

We report nurses' attitudes towards the single checking of medications before and after the implementation of this procedure in an acute health-care setting. Data from a pre-implementation survey confirmed that some nurses held strong views against single checking. Following this survey, the hospital's medication administration policy was revised, a single checking resource manual was developed, 1-2 h nurse education sessions were held, the competencies of nurses to single check and to administer medications were assessed, and single checking was successfully piloted before hospital-wide implementation.

Clinical usefulness and feasibility of using Reality Orientation with patients who have dementia in acute care settings.

Reality Orientation (RO) was developed as a strategy to assist people with dementia to improve their orientation and everyday function. Although its efficacy has been extensively studied in long-term care facilities, its effectiveness has rarely been examined in acute care settings. The aim of this review was to examine the studies cited in systematic reviews of RO to determine the potential clinical usefulness and the feasibility of using RO in acute care settings.

Risk items associated with patient falls in oncology and medical settings.

The aim of this study was to determine whether items on a falls risk-assessment tool, made up of brief cognitive and physical measures that nurses use in practice, differentiated fallers and nonfallers in oncology and medical settings. A measure of leg muscle strength clearly distinguished between fallers and nonfallers, with the latter having stronger leg muscles. For nursing practice, the assessment of patients' muscle strength seems to be the most useful scale for identifying potential fallers.