1
|
Nguyen VNB, Brand G, Gardiner S, Moses S, Collison L, Griffin K, Morphet J. A snapshot of Australian primary health care nursing workforce characteristics and reasons they work in these settings: A longitudinal retrospective study. Nurs Open 2023. [PMID: 37141515 DOI: 10.1002/nop2.1785] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Accepted: 04/17/2023] [Indexed: 05/06/2023] Open
Abstract
AIM This article aimed to provide a snapshot of demographics and professional characteristics of nursing and midwifery workforce in Australian primary health care (PHC) settings during 2015-2019 and factors that influenced their decisions to work in PHC. DESIGN Longitudinal retrospective survey. METHODS Longitudinal data that were collected from a descriptive workforce survey were retrieved retrospectively. After collation and cleaning, data from 7066 participants were analysed using descriptive and inferential statistics in SPSS version 27.0. RESULTS The majority of the participants were female, aged between 45 and 64 years old and working in general practice. There was a small yet steady increase in the number of participants in the 25-34 age group and a downward trend in the percentage of postgraduate study completion among participants. While factors perceived most/least important to their decision to work in PHC were consistent during 2015-2019, these factors differed among different age groups and postgraduate qualification holders. This study's findings are both novel and supported by previous research. It is necessary to tailor recruitment and retention strategies to nurses/midwives' age groups and qualifications to attract and retain highly skilled and qualified nursing and midwifery workforce in PHC settings.
Collapse
Affiliation(s)
- Van N B Nguyen
- Monash School of Nursing and Midwifery, Monash University, Clayton, Victoria, Australia
| | - Gabrielle Brand
- Monash School of Nursing and Midwifery, Monash University, Clayton, Victoria, Australia
| | - Shanthi Gardiner
- Australian Primary Health Care Nurse Association, Melbourne, Victoria, Australia
| | - Samantha Moses
- Australian Primary Health Care Nurse Association, Melbourne, Victoria, Australia
| | - Lisa Collison
- Australian Primary Health Care Nurse Association, Melbourne, Victoria, Australia
| | - Ken Griffin
- Australian Primary Health Care Nurse Association, Melbourne, Victoria, Australia
| | - Julia Morphet
- Monash School of Nursing and Midwifery, Monash University, Clayton, Victoria, Australia
| |
Collapse
|
2
|
Rosli SN, Soh KL, Ong SL, Halain AA, Abdul Raman R, Soh KG. Physical assessment skills practised by critical care nurses: A cross-sectional study. Nurs Crit Care 2023; 28:109-119. [PMID: 35023244 DOI: 10.1111/nicc.12748] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Revised: 12/03/2021] [Accepted: 12/11/2021] [Indexed: 02/03/2023]
Abstract
BACKGROUND Physical assessment skills are essential to clinical decision-making in nursing as they help nurses to identify and respond to patients' deterioration. Nurses develop confidence and can detect any out-of-range parameters in diagnosing and treating patients. Prior studies surveyed 120 skills but did not explicitly assess critical care. AIM To determine the range of physical assessment skills practised by critical care nurses and their adoption factors. STUDY DESIGN This study uses a cross-sectional survey design. A self-administered questionnaire evaluating 40 physical assessment skills was conducted with 133 staff nurses (response rate: 96.4%) in three critical care units at a Malaysian government hospital between November 2019 and January 2020. RESULTS Most nurses applied 32 (80%) skills during every working shift, involving the vital signs and all body systems except the gastrointestinal system. Five skills (12.5%) were occasionally applied, while three skills (7.5%) were rarely applied or not part of most nurses' clinical practice. About 20% of the nurses did not routinely check the respiration rate. Medical and surgical intensive care unit nurses (U = 1129, p < .001) and nurses who had served over 10 years (H (2) = 9.60, p = .008) used more physical assessment skills than others. Nurses felt that continuing nursing education, participating in relevant courses and implementing standardised forms to record physical assessments would improve the application of such skills. CONCLUSION Clinical practice in these critical care settings challenges the assertion that physical assessment is vital to critical care nursing roles. Concerns highlighted by the nurses should be addressed by nursing management so that the application of physical assessment skills can be enhanced, especially in critical care settings. RELEVANCE TO CLINICAL PRACTICE The findings indicated that physical assessment skills in critical care need to be improved. Education and training should emphasise these skills.
Collapse
Affiliation(s)
- Syeril Nadia Rosli
- Department of Nursing and Rehabilitation, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Malaysia
| | - Kim Lam Soh
- Department of Nursing and Rehabilitation, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Malaysia
| | - Swee Leong Ong
- School of Nursing Science, Faculty of Medicine, Universiti Sultan Zainal Abidin Malaysia, Terengganu, Malaysia
| | - Azura Abdul Halain
- Department of Nursing and Rehabilitation, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Malaysia
| | - Rosna Abdul Raman
- Department of Nursing and Rehabilitation, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Malaysia
| | - Kim Geok Soh
- Department of Sport Studies, Faculty of Educational Studies, University Putra Malaysia, Seri Kembangan, Malaysia
| |
Collapse
|
3
|
Varga S, Ryan T, Moore T, Seymour J. What are the perceptions of intensive care staff about their sedation practices when caring for a mechanically ventilated patient?: A systematic mixed-methods review. INTERNATIONAL JOURNAL OF NURSING STUDIES ADVANCES 2022; 4:100060. [PMID: 38745639 PMCID: PMC11080319 DOI: 10.1016/j.ijnsa.2021.100060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Revised: 12/22/2021] [Accepted: 12/31/2021] [Indexed: 11/15/2022] Open
Abstract
Background Sedation is used alongside mechanical ventilation for patients in intensive care units internationally; its use is complex and multifaceted. Existing evidence shows that the ways health care professionals use sedation significantly impacts patient outcomes, including how long someone spends on a ventilator, length of stay in intensive care and recovery. Objective Our study aimed to systematically review and synthesize qualitative and quantitative evidence about how intensive care staff perceive sedation practices when looking after sedated and mechanically ventilated patients. Design We performed a systematic integrated mixed-methods literature review collecting qualitative and quantitative studies according to inclusion and exclusion criteria. Studies were included if they were published from 2009 and focused on perceptions of staff working in general adult intensive care units and caring for mechanically ventilated patients. Settings General adult intensive care units. Participants Health care professionals working in adult intensive care units. Methods Screening, data extraction and quality appraisal was undertaken by SV. Screening for inclusion and quality issues were reviewed by TR, TM and JS. The following databases: Embase, BNI, PubMed, Scopus, AMED, CINAHL, ASSIA, The Cochrane Library and Google Scholar. We used an assessment tool called the Mixed Methods Appraisal Tool. The studies were assessed and analysed by transforming the qualitative and quantitative data into 'text-in-context' statements. The statements were then synthesized using thematic analysis. Results Eighteen studies were included from ten countries, fourteen quantitative and four qualitative. Three overarching themes were identified: 'Variation in Decision Making', 'Challenges in Decision Making' and 'Thinking Outside the Box'. Existing studies revealed that there is considerable variation in most aspects of perceived sedation practice. Staff face challenges with interprofessional collaboration and sedation practice, and there are barriers to using sedation protocols and light sedation. There is also evidence that there is a need for health care professionals to develop coping strategies to help them facilitate lighter sedation. Conclusions A review of a decade of evidence shows that variation in decision making and challenges in decision making should be addressed to improve the care of the sedated and ventilated patient, and improve the caregiving experience for staff. Staff continue to require support with sedation practice, especially in light sedation. Research should now focus on how to help staff cope with looking after lightly sedated patients. In addition, future studies should focus on exploring sedation practices using qualitative methods as there is a dearth of qualitative evidence. Tweetable abstract Staff perceive a range of complex challenges that explain some of the variability in sedation practice for the ventilated patient in ICU.
Collapse
Affiliation(s)
- Sarah Varga
- Division of Nursing and Midwifery, Health Sciences School, Sheffield S10 2HQ, United Kingdom
| | - Tony Ryan
- Division of Nursing and Midwifery, Health Sciences School, Sheffield S10 2HQ, United Kingdom
| | - Tracey Moore
- Division of Nursing and Midwifery, Health Sciences School, Sheffield S10 2HQ, United Kingdom
| | - Jane Seymour
- Division of Nursing and Midwifery, Health Sciences School, Sheffield S10 2HQ, United Kingdom
| |
Collapse
|
4
|
Santana-Padilla YG, Bernat-Adell MD, Santana-Cabrera L. Nurses’ perception on competency requirement and training demand for intensive care nurses. Int J Nurs Sci 2022; 9:350-356. [PMID: 35891902 PMCID: PMC9305005 DOI: 10.1016/j.ijnss.2022.06.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Revised: 05/29/2022] [Accepted: 06/13/2022] [Indexed: 11/19/2022] Open
Affiliation(s)
- Yeray Gabriel Santana-Padilla
- Complejo Hospitalario Universitario Insular Materno Infantil, Las Palmas de Gran Canaria, Canary Islands, Spain
- Corresponding author.
| | | | - Luciano Santana-Cabrera
- Complejo Hospitalario Universitario Insular Materno Infantil, Las Palmas de Gran Canaria, Canary Islands, Spain
| |
Collapse
|
5
|
Huang J, Lu H, Li J, Zhou N, Zang Y, Ren L, Wang J. Comparison of midwives' self-perceived essential competencies between low and high maternal mortality ratio provinces in China. J Clin Nurs 2020; 29:4733-4747. [PMID: 32979861 DOI: 10.1111/jocn.15514] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Revised: 09/12/2020] [Accepted: 09/16/2020] [Indexed: 11/30/2022]
Abstract
AIMS AND OBJECTIVES To present and compare midwives' self-perceived essential competencies in regions with different maternal mortality ratios, and explore possible competency-related factors. BACKGROUND In China, there is an urgent need for high-quality maternal health care with equal access, as the regional disparity in the maternal mortality ratio remains a big challenge. Midwives' essential competencies refer to the minimum knowledge, skills, and professional behaviours required by midwives, and directly affect the quality of maternal care they provide. However, there is very limited literature evaluating Chinese midwives' essential competencies, especially for midwives working in regions with high maternal mortality ratios. DESIGN A cross-sectional survey design. METHODS The national cross-sectional study using an online questionnaire was conducted with a convenience sample of 2,022 midwives working in regions with different maternal mortality ratios. The STROBE guideline for cross-sectional studies was used in this study. RESULTS Midwives rated themselves higher on their essential competencies in intrapartum care and lower on their essential competencies in assisting or performing the operative vaginal delivery. Specifically, when compared to those from regions of low maternal mortality ratios, midwives from regions with high maternal mortality ratios reported comparatively poor self-perceived essential competencies, especially in the area of detecting and treating pregnancy and childbirth-related complications. The factors influencing midwives' self-perceived essential competencies included majors, education levels, years of experience as a midwife, participation in teaching, and access to in-service training. CONCLUSION In regions with high maternal mortality ratios, improving midwives' essential competencies is a key priority. Furthermore, it is recommended that midwifery education could be conducted in universities, and relevant regulations could be developed to enable midwives to provide a wider scope of care, thereby promoting the development of the midwifery workforce in China. RELEVANCE TO CLINICAL PRACTICE Understanding self-perceived essential competencies of Chinese midwives working in regions with different maternal mortality ratios could guide the midwifery workforce, management, especially midwives' capability building.
Collapse
Affiliation(s)
- Jing Huang
- School of Nursing, Peking University, Beijing, China
| | - Hong Lu
- School of Nursing, Peking University, Beijing, China
| | - Jie Li
- School of Nursing, Peking University, Beijing, China
| | - Nan Zhou
- School of Nursing, Peking University, Beijing, China
| | - Yu Zang
- School of Nursing, Peking University, Beijing, China.,School of Nursing, Hebei Medical University, Shijiazhuang, China
| | - Lihua Ren
- School of Nursing, Peking University, Beijing, China
| | - Jianying Wang
- Delivery Room, The Xibei Hospital for Women and Children, Xian, China
| |
Collapse
|
6
|
Ilangakoon C, Jones T, Innes K, Morphet J. Caring for deteriorating paediatric patients in the emergency department: A mixed method study. Australas Emerg Care 2020; 23:252-258. [PMID: 32814686 DOI: 10.1016/j.auec.2020.07.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2020] [Revised: 07/11/2020] [Accepted: 07/14/2020] [Indexed: 12/17/2022]
Abstract
BACKGROUND Paediatric presentations to emergency departments are common for a range of conditions with varying severity. Children can compensate well and early signs of deterioration may not be obvious. Nurses working in emergency departments (ED) should not only have the knowledge and skill to recognise the unwell child, but also be confident and competent to provide care. AIM To explore the self-reported preparedness, confidence and competence of emergency nurses in caring for deteriorating paediatric patients, and to identify how their confidence and competence could be improved. METHODS An exploratory sequential mixed methods study with two phases was used. In Phase One, qualitative data were collected via focus group and thematically analysed. The findings from Phase One informed Phase Two survey development, with quantitative data collected and analysed. RESULTS Findings from both phases identified that emergency nurses' confidence and competence when caring for deteriorating paediatric patients did not correlate with their level of qualification. In contrast, increased years of experience in caring for this cohort did increase level of confidence. Availability of human resources further impacted nurses' confidence when caring for deteriorating paediatric patients and emergency nurses showed an interest and enthusiasm for further education in caring for the deteriorating paediatric patient. CONCLUSIONS Regular exposure to paediatrics was key to nurses having confidence and competence to care for deteriorating patients, irrespective of educational qualifications. A focus on interprofessional insitu simulation could address human resource challenges to enhance skill development.
Collapse
Affiliation(s)
- Chanika Ilangakoon
- Nursing and Midwifery, Monash University, 47-49 Moorooduc Highway, Frankston, Victoria, Australia.
| | - Tamsin Jones
- Nursing and Midwifery, Monash University, 47-49 Moorooduc Highway, Frankston, Victoria, Australia
| | - Kelli Innes
- Nursing and Midwifery, Monash University, 47-49 Moorooduc Highway, Frankston, Victoria, Australia
| | - Julia Morphet
- Nursing and Midwifery, Monash University, 47-49 Moorooduc Highway, Frankston, Victoria, Australia; Monash Centre for Scholarship in Health Education (MCSHE), Monash University, Australia
| |
Collapse
|
7
|
Ozga D, Gutysz-Wojnicka A, Lewandowski B, Dobrowolska B. The clinical learning environment, supervision and nurse teacher scale (CLES+T): psychometric properties measured in the context of postgraduate nursing education. BMC Nurs 2020; 19:61. [PMID: 32655316 PMCID: PMC7339495 DOI: 10.1186/s12912-020-00455-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2019] [Accepted: 06/30/2020] [Indexed: 12/31/2022] Open
Abstract
Background The Clinical Learning Environment, Supervision and Nurse Teacher Scale (CLES+T) instrument is internationally used for the evaluation of clinical learning environment in undergraduate nursing education. However, no evidence is available on the possible applications of this instrument in the context of postgraduate nursing education. Purpose To examine the basic psychometric properties of CLES+T in the context of clinical postgraduate nursing education in Poland. Methods Study among a sample of 417 nurses participating in the clinical postgraduate training in Poland. Results Cronbach's alpha for the total scale was 0.97. A five-factor structure was confirmed in accordance with the assumptions adopted by the authors of the original version of the scale. Cronbach's alpha coefficient for the Polish version of the CLES+T subscales ranged from 0.83 (Nursing care on the ward) to 0.95 (The content of supervisory relationship). The mean results for individual subscales ranged from 4.52 ± 0.63 for nursing care on the ward to 4.73 ± 0.45 for role of the nurse teacher. Conclusions Having shown satisfactory psychometric properties, CLES+T can be considered a useful instrument to assess those elements of clinical learning environment which are important for the assurance of education quality at the postgraduate level.
Collapse
Affiliation(s)
- Dorota Ozga
- Department of Emergency Medicine, Faculty of Medicine, University of Rzeszów, Pigonia 6 Street, 35-310 Rzeszów, Poland
| | - Aleksandra Gutysz-Wojnicka
- Department of Nursing, Faculty of Health Sciences, Collegium Medicum, University of Warmia and Mazury in Olsztyn, Zolnierska 14c Street, 10-561 Olsztyn, Poland
| | - Bogumił Lewandowski
- Department of Emergency Medicine, Faculty of Medicine, University of Rzeszów, Pigonia 6 Street, 35-310 Rzeszów, Poland
| | - Beata Dobrowolska
- Department of Development in Nursing, Faculty of Health Sciences, Medical University of Lublin, Staszica Street 4-6, 20-081 Lublin, Poland
| |
Collapse
|
8
|
Competence perceptions of veterinary nursing students and registered veterinary nurses in Ireland: a mixed methods explanatory study. Ir Vet J 2020; 73:10. [PMID: 32566129 PMCID: PMC7301512 DOI: 10.1186/s13620-020-00162-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2019] [Accepted: 05/21/2020] [Indexed: 12/03/2022] Open
Abstract
Background Veterinary regulators require veterinary nursing students to demonstrate clinical competence prior to registration and practice as a veterinary nurse. However, in common with other medical professions, there is no one broadly accepted definition of competence. Studies in nursing have revealed that practicing nurses may view newly qualified colleagues as lacking competence, leading to disillusionment with nursing training programmes. Similar studies are lacking in veterinary nursing, despite the profession having recently undergone a similar transition from workplace-based training to undergraduate education. Methods A mixed methods explanatory study surveyed 66 Irish registered veterinary nurses and 31 first year veterinary nursing students at two Irish third level institutions to obtain their views on what constitutes veterinary nursing competence and when veterinary nurses develop it. The surveys were followed by student focus groups and semi-structured one-on-one interviews with registered veterinary nurses. Content analysis was employed to analyse the surveys, while the focus groups and interview transcripts underwent thematic analysis. Results Students perceived competence primarily as the ability to provide patient care, and they expected it to develop close to the time of graduation. RVNs held a broader definition of competence, incorporating leadership skills and confidence as well as patient care provision. RVNs expected it to take approximately two years of workplace-based experience post-graduation for a veterinary nurse to develop competence. In addition, RVNs recognised that anxiety felt by many newly qualified veterinary nurses during this period could be attenuated by mentorship from more experienced colleagues. Conclusions Irish RVNs and veterinary nursing students perceive competence differently, similar to previous findings from the nursing profession. Educators and regulators should provide explicit descriptions of terms such as ‘competence’ to avoid confusion and possible disillusionment amongst veterinary nursing stakeholders.
Collapse
|
9
|
Jones T, Curtis K, Shaban RZ. Academic and professional characteristics of Australian graduate emergency nursing programs: A national study. Australas Emerg Care 2020; 23:173-180. [PMID: 32115399 DOI: 10.1016/j.auec.2020.02.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2019] [Revised: 02/11/2020] [Accepted: 02/16/2020] [Indexed: 11/19/2022]
Abstract
BACKGROUND Specialist graduate emergency nursing education programs are essential to the delivery of high quality and safe healthcare to patients with complex needs in emergency care. Little is known about tertiary emergency nursing programs in Australia. This study aimed to determine the academic and professional characteristics of Australian emergency programs. METHOD This embedded mixed-method study examined the academic and professional characteristics of Australian emergency programs in two interdependent phases: (1) document and content analysis of Australian graduate emergency nursing program websites; and (2) semi-structured interviews with the associated convenors. The data underwent framework analysis using eight pre-identified categories of (i) course entry, (ii) fee arrangement, (iii) mode of delivery, (iv) volume of learning, (v) clinical assessment, (vi) employment requirements, (vii) graduate expectations, and (viii) influence of healthcare employers and professional engagement. RESULTS Prior clinical experience and the requirement for concurrent practising in an emergency care environment influenced were common, however fee arrangements were not clearly articulated. The College of Emergency Nursing Australasia Practice Standards for the Emergency Nursing Specialist featured in part within 12 programs, principally to guide development of clinical assessments. CONCLUSION Establishment of emergency nursing graduate practice standards could better inform the design and delivery of emergency nurse programs, and yield benefits in terms of graduate expectations and satisfaction and improved patient care.
Collapse
Affiliation(s)
- Tamsin Jones
- Faculty of Medicine and Health, Susan Wakil School of Nursing and Midwifery, University of Sydney, Camperdown, NSW, Australia; Nursing and Midwifery, Monash University, 47-49 Moorooduc Highway, Frankston, Victoria, Australia.
| | - Kate Curtis
- Faculty of Medicine and Health, Susan Wakil School of Nursing and Midwifery, University of Sydney, Camperdown, NSW, Australia; Emergency Services, Illawarra Shoalhaven Local Health District, NSW, Australia
| | - Ramon Z Shaban
- Faculty of Medicine and Health, Susan Wakil School of Nursing and Midwifery, University of Sydney, Camperdown, NSW, Australia; Marie Bashir Institute for Infectious Diseases and Biosecurity, University of Sydney, Camperdown, NSW, Australia; Department of Infection Prevention and Control, Division of Infectious Diseases and Sexual Health, Westmead Hospital and the Directorate of Nursing, Midwifery and Clinical Governance, Western Sydney Local Health District, Westmead, NSW, Australia
| |
Collapse
|