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Ryan C, Cant R, Ossenberg C, Ahchay D, Hughes L, Bogossian F. Competency domains for registered nurse preceptor professional development: Evidence from a modified e-Delphi study. Nurse Educ Pract 2024; 77:103952. [PMID: 38598885 DOI: 10.1016/j.nepr.2024.103952] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Revised: 03/07/2024] [Accepted: 03/25/2024] [Indexed: 04/12/2024]
Abstract
AIM To develop an evidence-based framework of nurse preceptor competency domains and competency descriptors for use in nurse preceptor professional development. BACKGROUND Nurse preceptors are registered nurses who coach, support and assess nursing students while simultaneously caring for patients. Working as both clinician and educator requires preceptors to develop additional skills. However, preceptor preparation is often overlooked and may not be evidence based. DESIGN A modified e-Delphi study. METHODS A three-phase e-Delphi method informed the study that was conducted between March and September 2023. In the first preparatory phase an expert group distilled the results of a previous literature review identifying seven preceptor competency domains and more than 200 competency descriptors. Two e-Delphi rounds followed. A 70% rater agreement response threshold was chosen as appropriate in this study. The CREDES reporting framework was followed. RESULTS In the preparatory phase, the expert group (n=6) reached consensus on six preceptor domains and 57 preceptor descriptors. In Round 1, nurse preceptors (n= 89) rated the domains and descriptors using a four-point Likert scale; from not important to very important. Six domains and 34 competency descriptors were ranked as very important'. Round 2 participants (n=30) who opted in from Round 1 indicated their 100% agreement with the Round 1 results. The results reveal that preceptors resonate intuitively with the six domains Role model, Facilitator, Leader, Evaluator, Teacher and Coach and the related descriptors. CONCLUSION The preceptor evidence-based competency framework offers registered nurse preceptors and their employers the opportunity to focus efforts in developing a nurse preceptor workforce. The framework can be used to design preceptor professional development and offers registered nurses a self-assessment tool to identify their preceptorship skills strengths and areas for development. If implemented in these ways the framework may benefit healthcare organisations to provide quality nurse preceptorship, thus enhancing the clinical learning experiences of nursing preceptees.
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Affiliation(s)
- Colleen Ryan
- School of Nursing Midwifery and Social Sciences, Central, Queensland University, 160 Ann St, Brisbane, Queensland, Australia.
| | - Robyn Cant
- Health Innovation and Transformation Centre, Federation University Australia, Berwick, VIC, Australia.
| | - Christine Ossenberg
- School of Nursing Midwifery and Social Sciences, Central, Queensland University, 160 Ann St, Brisbane, Queensland, Australia; Nursing Practice Development Unit, Princess Alexandra Hospital, 199 Ipswich Road, Woolloongabba, Brisbane, Queensland, Australia.
| | - Darelle Ahchay
- Nursing Clinical Placements, The Prince Charles Hospital, 627 Rode Road, Chermside, QLD 4032, Australia.
| | - Lynda Hughes
- School of Nursing and Midwifery Griffith University, 170 Kessels Rd, Nathan 4111, Australia.
| | - Fiona Bogossian
- School of Health University of the Sunshine Coast, 1 Moreton Pde, Petrie 4502, Australia.
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Brady S, Gibbons KS, Bogossian F. Defining woman-centred care: A concept analysis. Midwifery 2024; 131:103954. [PMID: 38364459 DOI: 10.1016/j.midw.2024.103954] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Revised: 12/01/2023] [Accepted: 02/10/2024] [Indexed: 02/18/2024]
Abstract
PROBLEM In midwifery a shared definition of woman-centred care is lacking, and this remains an identified gap in the evidence underpinning midwifery practice. BACKGROUND Woman-centred care is an underpinning philosophy used in midwifery practice both nationally and internationally. AIM To analyse the practice of woman-centred care to clarify its meaning and comprehension and subsequently advance an evidence-based definition of the concept. METHODS Using an adapted theoretical and colloquial evolutionary model a three-stage concept analysis was conducted to identify attributes, antecedents, and consequences of woman-centred care and subsequently construct an evidence-based, internationally informed definition. FINDINGS Antecedents of woman-centred care are education, models of care and midwife characteristics. Attributes are choice and control, empowerment, and relationships. Consequences are shared and informed decision making which supports the woman in navigating complex health systems, and improved health outcomes. Whilst important to midwifery practice and midwifery-led models of care, continuity of care is not a core essential element of woman-centred care. DISCUSSION Analysis, synthesis, and re-examination of the data on woman-centred care facilitated deep immersion, exploration and clarification of this concept that underpins midwifery philosophy and practice. The constructed definition can be used to inform health policy, midwifery research, education, and clinical practice. CONCLUSION An evidence-based definition of woman-centred care is necessary for conversion of this essential concept to practice. Regardless of model of care all women should receive woman-centre care improving the health outcomes of both the woman and neonate.
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Affiliation(s)
- Susannah Brady
- School of Nursing, Midwifery & Social Work, The University of Queensland, Level 3, Building 35, St Lucia, Brisbane, Queensland 4067, Australia.
| | - Kristen S Gibbons
- Child Health Research Centre, Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia
| | - Fiona Bogossian
- School of Nursing, Midwifery & Social Work, The University of Queensland, Level 3, Building 35, St Lucia, Brisbane, Queensland 4067, Australia; School of Health, University of the Sunshine Coast, Sippy Downs, Queensland, Australia
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Kearney L, Nugent R, Maher J, Shipstone R, Thompson JM, Boulton R, George K, Robins A, Bogossian F. Factors associated with spontaneous vaginal birth in nulliparous women: A descriptive systematic review. Women Birth 2024; 37:63-78. [PMID: 37704535 DOI: 10.1016/j.wombi.2023.08.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Revised: 08/25/2023] [Accepted: 08/26/2023] [Indexed: 09/15/2023]
Abstract
PROBLEM Spontaneous vaginal birth (SVB) rates for nulliparous women are declining internationally. BACKGROUND There is inadequate understanding of factors affecting this trend overall and limited large-scale responses to improve women's opportunity to birth spontaneously. AIM To undertake a descriptive systematic review identifying factors associated with spontaneous vaginal birth at term, in nulliparous women with a singleton pregnancy. METHODS Quantitative studies of all designs, of nulliparous women with a singleton pregnancy and cephalic presentation, who experienced a SVB at term were included. Nine databases were searched (inception to October 2022). Two reviewers undertook quality appraisal; Randomised Controlled Trials (RCTs) with high risk of bias (ROB 2.0) and other designs with (QATSDD) scoring ≤ 50% were excluded. FINDINGS Data were abstracted from 90 studies (32 RCTs, 39 cohort, 9 cross-sectional, 4 prevalence, 5 case control, 1 quasi-experimental). SVB rates varied (13%-99%). Modifiable factors associated with SVB included addressing fear of childbirth, low impact antenatal exercise, maternal positioning during second-stage labour and midwifery led care. Complexities arising during pregnancy and regional analgesia were shown to decrease SVB and other interventions, such as routine induction of labour were equivocal. DISCUSSION Antenatal preparation (low impact exercise, childbirth education, addressing fear of childbirth) may increase SVB, as does midwifery continuity-of-care. Intrapartum strategies to optimise labour progression emerged as promising areas for further research. CONCLUSION Declining SVB rates may be improved through multi-factorial approaches inclusive of maternal, fetal and clinical care domains. However, the variability of SVB rates testifies to the complexity of the issue.
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Affiliation(s)
- Lauren Kearney
- School of Nursing, Midwifery and Social Work, University of Queensland, Australia; Women's and Newborn Services, Royal Brisbane and Women's Hospital, Metro North Health, Australia.
| | - Rachael Nugent
- Department of Obstetrics and Gynaecology, Sunshine Coast Hospital and Health Service, Australia
| | - Jane Maher
- Department of Obstetrics and Gynaecology, Sunshine Coast Hospital and Health Service, Australia
| | | | - John Md Thompson
- School of Health, University of the Sunshine Coast, Australia; Faculty of Medicine, University of Auckland, New Zealand
| | - Rachel Boulton
- Department of Obstetrics and Gynaecology, Sunshine Coast Hospital and Health Service, Australia
| | - Kendall George
- Women's and Newborn Services, Townsville Hospital and Health Service, Australia
| | - Anna Robins
- School of Health, University of the Sunshine Coast, Australia
| | - Fiona Bogossian
- School of Health, University of the Sunshine Coast, Australia
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Brady S, Bogossian F, Gibbons KS. Achieving international consensus on the concept of woman-centred care: A Delphi study. Women Birth 2023; 36:e631-e640. [PMID: 37308353 DOI: 10.1016/j.wombi.2023.06.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Revised: 05/31/2023] [Accepted: 06/01/2023] [Indexed: 06/14/2023]
Abstract
PROBLEM There is no internationally-informed understanding of how midwives perceive woman-centred care and use it in practice. BACKGROUND Woman-centred care is integral to the role of the midwife and to determining standards of practice. Few empirical studies have explored the meaning of woman-centred care, and those that have are limited to country specific research. AIM To gain an in-depth understanding and consensus on the concept of woman-centred care from an international perspective. METHODS A three round Delphi study was conducted, with surveys distributed online to a group of international expert midwives to draw consensus on the topic of woman-centred care. FINDINGS A panel of 59 expert midwives representing 22 countries participated. Fifty-nine statements about woman-centred care, of which 63% of statements reached the 75% a priori agreement level, were developed and categorised under four emergent themes: defining characteristics of woman-centred care (n = 17), the role of the midwife in woman-centred care (n = 19), woman-centred care and systems of care (n = 18), woman-centred care in education and research (n = 5). DISCUSSION Participants agreed that woman-centred care should be provided by any health care professional in any health care setting. Systems of maternity care should provide holistic care tailored for the individual woman rather than subject her to routine practices and policies. Although continuity of care is important to midwifery practice, it was not reported as a core characteristic of woman-centred care. CONCLUSION This is the first study to investigate the concept of woman-centred care as it is experienced globally by midwives. The findings of this study will be used to contribute to the development of an internationally informed evidence-based definition of woman-centred care.
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Affiliation(s)
- Susannah Brady
- School of Nursing, Midwifery & Social Work, The University of Queensland, St Lucia, Australia.
| | - Fiona Bogossian
- School of Nursing, Midwifery & Social Work, The University of Queensland, St Lucia, Australia; School of Health, University of the Sunshine Coast, Sippy Downs, Australia
| | - Kristen S Gibbons
- Child Health Research Centre, Faculty of Medicine, The University of Queensland, Brisbane, Australia
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Baba A, Webbe J, Butcher NJ, Rodrigues C, Stallwood E, Goren K, Monsour A, Chang ASM, Trivedi A, Manley BJ, McCall E, Bogossian F, Namba F, Schmölzer GM, Harding J, Nguyen KA, Doyle LW, Jardine L, Rysavy MA, Konstantinidis M, Meyer M, Helmi MAM, Lai NM, Hay S, Onland W, Choo YM, Gale C, Soll RF, Offringa M. Heterogeneity and Gaps in Reporting Primary Outcomes From Neonatal Trials. Pediatrics 2023; 152:e2022060751. [PMID: 37641881 DOI: 10.1542/peds.2022-060751] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/26/2023] [Indexed: 08/31/2023] Open
Abstract
OBJECTIVES Clear outcome reporting in clinical trials facilitates accurate interpretation and application of findings and improves evidence-informed decision-making. Standardized core outcomes for reporting neonatal trials have been developed, but little is known about how primary outcomes are reported in neonatal trials. Our aim was to identify strengths and weaknesses of primary outcome reporting in recent neonatal trials. METHODS Neonatal trials including ≥100 participants/arm published between 2015 and 2020 with at least 1 primary outcome from a neonatal core outcome set were eligible. Raters recruited from Cochrane Neonatal were trained to evaluate the trials' primary outcome reporting completeness using relevant items from Consolidated Standards of Reporting Trials 2010 and Consolidated Standards of Reporting Trials-Outcomes 2022 pertaining to the reporting of the definition, selection, measurement, analysis, and interpretation of primary trial outcomes. All trial reports were assessed by 3 raters. Assessments and discrepancies between raters were analyzed. RESULTS Outcome-reporting evaluations were completed for 36 included neonatal trials by 39 raters. Levels of outcome reporting completeness were highly variable. All trials fully reported the primary outcome measurement domain, statistical methods used to compare treatment groups, and participant flow. Yet, only 28% of trials fully reported on minimal important difference, 24% on outcome data missingness, 66% on blinding of the outcome assessor, and 42% on handling of outcome multiplicity. CONCLUSIONS Primary outcome reporting in neonatal trials often lacks key information needed for interpretability of results, knowledge synthesis, and evidence-informed decision-making in neonatology. Use of existing outcome-reporting guidelines by trialists, journals, and peer reviewers will enhance transparent reporting of neonatal trials.
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Affiliation(s)
- Ami Baba
- Child Health Evaluative Sciences, The Hospital for Sick Children Research Institute, Toronto, Ontario, Canada
| | - James Webbe
- Neonatal Medicine, School of Public Health, Imperial College London, London, United Kingdom
| | - Nancy J Butcher
- Child Health Evaluative Sciences, The Hospital for Sick Children Research Institute, Toronto, Ontario, Canada
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Craig Rodrigues
- Child Health Evaluative Sciences, The Hospital for Sick Children Research Institute, Toronto, Ontario, Canada
| | - Emma Stallwood
- Child Health Evaluative Sciences, The Hospital for Sick Children Research Institute, Toronto, Ontario, Canada
| | - Katherine Goren
- Child Health Evaluative Sciences, The Hospital for Sick Children Research Institute, Toronto, Ontario, Canada
| | - Andrea Monsour
- Child Health Evaluative Sciences, The Hospital for Sick Children Research Institute, Toronto, Ontario, Canada
| | - Alvin S M Chang
- Quality, Safety and Risk Management, and Department of Neonatology, KK Women's and Children's Hospital, Singapore
- DUKE-NUS Medical School, Singapore
| | - Amit Trivedi
- The Children's Hospital at Westmead, New South Wales, Australia
| | | | - Emma McCall
- School of Nursing and Midwifery, Queen's University of Belfast, Belfast, Northern Ireland
| | | | - Fumihiko Namba
- Department of Pediatrics, Saitama Medical Center, Saitama Medical University, Saitama, Japan
| | - Georg M Schmölzer
- Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada
| | - Jane Harding
- Liggins Institute, University of Auckland, Auckland, New Zealand
| | - Kim An Nguyen
- Claude Bernard University Lyon, Villeurbanne, France
| | - Lex W Doyle
- Department of Obstetrics and Gynaecology, The Royal Women's Hospital, University of Melbourne, Parkville, Victoria, Australia
| | - Luke Jardine
- Department of Neonatology, Mater Mothers' Hospital, South Brisbane, Queensland, Australia
- University of Queensland, Brisbane, Australia
| | - Matthew A Rysavy
- University of Texas Health Science Centre at Houston, Houston, Texas
| | - Menelaos Konstantinidis
- Institute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, Ontario, Canada
- Li Ka Shing Knowledge Institute, St Michael's Hospital, Unity Health Toronto, Toronto, Ontario, Canada
| | | | | | - Nai Ming Lai
- School of Medicine, Taylor's University, Malaysia
| | - Susanne Hay
- Department of Neonatology, Beth Israel Deaconess Medical Center, Boston, Massachusetts
- Harvard Medical School, Boston, Massachusetts
| | - Wes Onland
- Department of Neonatology, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
- Amsterdam Reproduction and Development Research Institute, Amsterdam, Netherlands
| | - Yao Mun Choo
- Department of Paediatrics, University Malaya, Malaysia
| | - Chris Gale
- Neonatal Medicine, School of Public Health, Imperial College London, London, United Kingdom
| | - Roger F Soll
- Cochrane Neonatal, Burlington, VT
- Division of Neonatal-Perinatal Medicine, University of Vermont Larner College of Medicine, Burlington, Vermont
| | - Martin Offringa
- Child Health Evaluative Sciences, The Hospital for Sick Children Research Institute, Toronto, Ontario, Canada
- Institute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, Ontario, Canada
- Division of Neonatology, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
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Webbe J, Baba A, Butcher NJ, Rodrigues C, Stallwood E, Goren K, Monsour A, Chang ASM, Trivedi A, Manley BJ, McCall E, Bogossian F, Namba F, Schmölzer GM, Popat H, Nguyen KA, Doyle LW, Jardine L, Rysavy MA, Konstantinidis M, Muhd Helmi MA, Lai NM, Hay S, Onland W, Choo YM, Gale C, Soll RF, Offringa M. Strengthening Reporting of Neonatal Trials. Pediatrics 2023; 152:e2022060765. [PMID: 37641894 DOI: 10.1542/peds.2022-060765] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/26/2023] [Indexed: 08/31/2023] Open
Abstract
BACKGROUND AND OBJECTIVES There is variability in the selection and reporting of outcomes in neonatal trials with key information frequently omitted. This can impact applicability of trial findings to clinicians, families, and caregivers, and impair evidence synthesis. The Neonatal Core Outcomes Set describes outcomes agreed as clinically important that should be assessed in all neonatal trials, and Consolidated Standards of Reporting Trials (CONSORT)-Outcomes 2022 is a new, harmonized, evidence-based reporting guideline for trial outcomes. We reviewed published trials using CONSORT-Outcomes 2022 guidance to identify exemplars of neonatal core outcome reporting to strengthen description of outcomes in future trial publications. METHODS Neonatal trials including >100 participants per arm published between 2015 to 2020 with a primary outcome included in the Neonatal Core Outcome Set were identified. Primary outcome reporting was reviewed using CONSORT 2010 and CONSORT-Outcomes 2022 guidelines by assessors recruited from Cochrane Neonatal. Examples of clear and complete outcome reporting were identified with verbatim text extracted from trial reports. RESULTS Thirty-six trials were reviewed by 39 assessors. Examples of good reporting for CONSORT 2010 and CONSORT-Outcomes 2022 criteria were identified and subdivided into 3 outcome categories: "survival," "short-term neonatal complications," and "long-term developmental outcomes" depending on the core outcomes to which they relate. These examples are presented to strengthen future research reporting. CONCLUSIONS We have identified examples of good trial outcome reporting. These illustrate how important neonatal outcomes should be reported to meet the CONSORT 2010 and CONSORT-Outcomes 2022 guidelines. Emulating these examples will improve the transmission of information relating to outcomes and reduce associated research waste.
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Affiliation(s)
- James Webbe
- Neonatal Medicine, School of Public Health, Imperial College London, United Kingdom
| | - Ami Baba
- Child Health Evaluative Sciences, The Hospital for Sick Children Research Institute, Toronto, Ontario, Canada
| | - Nancy J Butcher
- Child Health Evaluative Sciences, The Hospital for Sick Children Research Institute, Toronto, Ontario, Canada
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Craig Rodrigues
- Child Health Evaluative Sciences, The Hospital for Sick Children Research Institute, Toronto, Ontario, Canada
| | - Emma Stallwood
- Child Health Evaluative Sciences, The Hospital for Sick Children Research Institute, Toronto, Ontario, Canada
| | - Katherine Goren
- Child Health Evaluative Sciences, The Hospital for Sick Children Research Institute, Toronto, Ontario, Canada
| | - Andrea Monsour
- Child Health Evaluative Sciences, The Hospital for Sick Children Research Institute, Toronto, Ontario, Canada
| | - Alvin S M Chang
- Quality, Safety and Risk Management (QSRM) and Department of Neonatology, KK Women's and Children's Hospital, Singapore
- DUKE-NUS Medical School, Singapore
| | - Amit Trivedi
- The Children's Hospital at Westmead, New South Wales, Australia
| | | | - Emma McCall
- School of Nursing and Midwifery, Queen's University Belfast, Northern Ireland
| | | | - Fumihiko Namba
- Department of Pediatrics, Saitama Medical Center, Saitama Medical University, Saitama, Japan
| | | | - Himanshu Popat
- The Children's Hospital at Westmead, New South Wales, Australia
| | | | - Lex W Doyle
- Department of Obstetrics and Gynaecology, The Royal Women's Hospital, University of Melbourne, Parkville, Victoria, Australia
| | - Luke Jardine
- Department of Neonatology, Mater Mothers' Hospital, South Brisbane, Queensland, Australia
- University of Queensland, Brisbane, Australia
| | - Matthew A Rysavy
- University of Texas Health Science Centre at Houston, Houston, Texas
| | - Menelaos Konstantinidis
- Li Ka Shing Knowledge Institute, St Michael's Hospital, Unity Health Toronto, Toronto, Ontario, Canada
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
| | - Muhd Alwi Muhd Helmi
- Department of Paediatrics, International Islamic University, Kuala Lumpur, Malaysia
| | - Nai Ming Lai
- School of Medicine, Faculty of Health and Medical Sciences, Taylor's University, Selangor, Malaysia
| | - Susanne Hay
- Department of Neonatology, Beth Israel Deaconess Medical Center, Boston, Massachusetts
- Harvard Medical School, Boston, Massachusetts
| | - Wes Onland
- Department of Neonatology, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
- Amsterdam Reproduction and Development Research Institute, Amsterdam, Netherlands
| | - Yao Mun Choo
- Neonatal Medicine, School of Public Health, Imperial College London, United Kingdom
| | - Chris Gale
- Neonatal Medicine, School of Public Health, Imperial College London, United Kingdom
| | - Roger F Soll
- Child Health Evaluative Sciences, The Hospital for Sick Children Research Institute, Toronto, Ontario, Canada
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Martin Offringa
- Child Health Evaluative Sciences, The Hospital for Sick Children Research Institute, Toronto, Ontario, Canada
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
- Division of Neonatology, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
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Dopper A, Steele M, Bogossian F, Hough J. High flow nasal cannula for respiratory support in term infants. Cochrane Database Syst Rev 2023; 8:CD011010. [PMID: 37542728 PMCID: PMC10401649 DOI: 10.1002/14651858.cd011010.pub2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/07/2023]
Abstract
BACKGROUND Respiratory failure or respiratory distress in infants is the most common reason for non-elective admission to hospitals and neonatal intensive care units. Non-invasive methods of respiratory support have become the preferred mode of treating respiratory problems as they avoid some of the complications associated with intubation and mechanical ventilation. High flow nasal cannula (HFNC) therapy is increasingly being used as a method of non-invasive respiratory support. However, the evidence pertaining to its use in term infants (defined as infants ≥ 37 weeks gestational age to the end of the neonatal period (up to one month postnatal age)) is limited and there is no consensus of opinion regarding the safety and efficacy HFNC in this population. OBJECTIVES To assess the safety and efficacy of high flow nasal cannula oxygen therapy for respiratory support in term infants when compared with other forms of non-invasive respiratory support. SEARCH METHODS We searched the following databases in December 2022: Cochrane CENTRAL; PubMed; Embase; CINAHL; LILACS; Web of Science; Scopus. We also searched the reference lists of retrieved studies and performed a supplementary search of Google Scholar. SELECTION CRITERIA We included randomised controlled trials (RCTs) that investigated the use of high flow nasal cannula oxygen therapy in infants ≥ 37 weeks gestational age up to one month postnatal age (the end of the neonatal period). DATA COLLECTION AND ANALYSIS Two review authors independently assessed trial eligibility, performed data extraction, and assessed risk of bias in the included studies. Where studies were sufficiently similar, we performed a meta-analysis using mean differences (MD) for continuous data and risk ratios (RR) for dichotomous data, with their respective 95% confidence intervals (CIs). For statistically significant RRs, we calculated the number needed to treat for an additional beneficial outcome (NNTB). We used the GRADE approach to evaluate the certainty of the evidence for clinically important outcomes. MAIN RESULTS We included eight studies (654 participants) in this review. Six of these studies (625 participants) contributed data to our primary analyses. Four studies contributed to our comparison of high flow nasal cannula (HFNC) oxygen therapy versus continuous positive airway pressure (CPAP) for respiratory support in term infants. The outcome of death was reported in two studies (439 infants) but there were no events in either group. HFNC may have little to no effect on treatment failure, but the evidence is very uncertain (RR 0.98, 95% CI 0.47 to 2.04; 3 trials, 452 infants; very low-certainty evidence). The outcome of chronic lung disease (need for supplemental oxygen at 28 days of life) was reported in one study (375 participants) but there were no events in either group. HFNC may have little to no effect on the duration of respiratory support (any form of non-invasive respiratory support with or without supplemental oxygen), but the evidence is very uncertain (MD 0.17 days, 95% CI -0.28 to 0.61; 4 trials, 530 infants; very low-certainty evidence). HFNC likely results in little to no difference in the length of stay at the intensive care unit (ICU) (MD 0.90 days, 95% CI -0.31 to 2.12; 3 trials, 452 infants; moderate-certainty evidence). HFNC may reduce the incidence of nasal trauma (RR 0.16, 95% CI 0.04 to 0.66; 1 trial, 78 infants; very low-certainty evidence) and abdominal overdistension (RR 0.22, 95% CI 0.07 to 0.71; 1 trial, 78 infants; very low-certainty evidence), but the evidence is very uncertain. Two studies contributed to our analysis of HFNC versus low flow nasal cannula oxygen therapy (LFNC) (supplemental oxygen up to a maximum flow rate of 2 L/min). The outcome of death was reported in both studies (95 infants) but there were no events in either group. The evidence suggests that HFNC may reduce treatment failure slightly (RR 0.44, 95% CI 0.21 to 0.92; 2 trials, 95 infants; low-certainty evidence). Neither study reported results for the outcome of chronic lung disease (need for supplemental oxygen at 28 days of life). HFNC may have little to no effect on the duration of respiratory support (MD -0.07 days, 95% CI -0.83 to 0.69; 1 trial, 74 infants; very low-certainty evidence), length of stay at the ICU (MD 0.49 days, 95% CI -0.83 to 1.81; 1 trial, 74 infants; very low-certainty evidence), or hospital length of stay (MD -0.60 days, 95% CI -2.07 to 0.86; 2 trials, 95 infants; very low-certainty evidence), but the evidence is very uncertain. Adverse events was an outcome reported in both studies (95 infants) but there were no events in either group. The risk of bias across outcomes was generally low, although there were some concerns of bias. The certainty of evidence across outcomes ranged from moderate to very low, downgraded due to risk of bias, imprecision, indirectness, and inconsistency. AUTHORS' CONCLUSIONS When compared with CPAP, HFNC may result in little to no difference in treatment failure. HFNC may have little to no effect on the duration of respiratory support, but the evidence is very uncertain. HFNC likely results in little to no difference in the length of stay at the intensive care unit. HFNC may reduce the incidence of nasal trauma and abdominal overdistension, but the evidence is very uncertain. When compared with LFNC, HFNC may reduce treatment failure slightly. HFNC may have little to no effect on the duration of respiratory support, length of stay at the ICU, or hospital length of stay, but the evidence is very uncertain. There is insufficient evidence to enable the formulation of evidence-based guidelines on the use of HFNC for respiratory support in term infants. Larger, methodologically robust trials are required to further evaluate the possible health benefits or harms of HFNC in this patient population.
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Affiliation(s)
- Alex Dopper
- School of Allied Health, Australian Catholic University, Brisbane, Australia
| | - Michael Steele
- School of Allied Health, Australian Catholic University, Brisbane, Australia
- Nursing Research and Practice Development Centre, The Prince Charles Hospital, Brisbane, Australia
| | - Fiona Bogossian
- School of Nursing, Midwifery and Social Work, The University of Queensland, St Lucia, Australia
- Sunshine Coast Health Institute, Birtinya, Australia
- School of Health, University of the Sunshine Coast, Petrie, Australia
| | - Judith Hough
- School of Allied Health, Australian Catholic University, Brisbane, Australia
- Department of Physiotherapy, Mater Health, South Brisbane, Australia
- Centre for Children's Health Research, The University of Queensland, South Brisbane, Australia
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Jans C, Bogossian F, Andersen P, Levett-Jones T. Examining the impact of virtual reality on clinical decision making - An integrative review. Nurse Educ Today 2023; 125:105767. [PMID: 36906980 DOI: 10.1016/j.nedt.2023.105767] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Revised: 02/01/2023] [Accepted: 02/20/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND Clinical decision making is an essential cognitive skill in nursing. It is a process undertaken daily by nurses as they make judgements about patient care and manage complex issues as they arise. Virtual reality is an emerging technology that is increasingly being used pedagogically to teach non-technical skills including CDM, communication, situational awareness, stress management, leadership, and teamwork. OBJECTIVE The objective of this integrative review are to synthesise the research findings regarding the impact of virtual reality on clinical decision making in undergraduate nurses. DESIGN An integrative review using Whittemore and Knafl's framework for integrated reviews. DATA SOURCES An extensive search was conducted of healthcare databases including CINAHL, Medline and Web of Science between 2010 and 2021 using the terms virtual reality, clinical decision and undergraduate nursing. REVIEW METHODS The initial search located 98 articles. After screening and checking for eligibility, 70 articles were critically reviewed. Eighteen studies were included in the review and were critically appraised using the Critical Appraisal Skills Program checklist for qualitative papers and McMaster's Critical appraisal form for quantitative papers. RESULTS Research in the use of VR has demonstrated its potential to improve undergraduate nurses' critical thinking, clinical reasoning, clinical judgement and clinical decision-making skills. Students perceive these teaching modalities to be beneficial to the development of their clinical decision-making ability. There is lack of research related to the use of immersive virtual reality in developing and enhancing undergraduate nursing students' clinical decision-making skills. CONCLUSION Current research on the impact of virtual reality on the development of nursing CDM has demonstrated positive results. VR is one pedagogical approach that could further assist, however, there are no identified studies that focus on its impact in developing CDM, therefore further studies are required to address this gap in the literature.
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Affiliation(s)
- Carley Jans
- School of Nursing, University of Wollongong, Faculty of Science, Medicine and Health, Australia.
| | - Fiona Bogossian
- School of Health, University of the Sunshine Coast, 1 Moreton Parade, Petrie QLD, 4502, Australia.
| | - Patrea Andersen
- Centre for Health and Social Practice, Waikato Institute of Technology, Private Bag 3036, Waikato Mail Centre, Hamilton 3240, New Zealand.
| | - Tracy Levett-Jones
- School of Nursing & Midwifery, University of Technology Sydney, Faculty of Health, 235 Jones St, Ultimo, NSW 2007, Australia.
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Bogossian F, New K, George K, Barr N, Dodd N, Hamilton AL, Nash G, Masters N, Pelly F, Reid C, Shakhovskoy R, Taylor J. The implementation of interprofessional education: a scoping review. Adv Health Sci Educ Theory Pract 2023; 28:243-277. [PMID: 35689133 PMCID: PMC9186481 DOI: 10.1007/s10459-022-10128-4] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/13/2022] [Accepted: 05/08/2022] [Indexed: 06/15/2023]
Abstract
INTRODUCTION Implementation of interprofessional education (IPE) is recognised as challenging, and well-designed programs can have differing levels of success depending on implementation quality. The aim of this review was to summarise the evidence for implementation of IPE, and identify challenges and key lessons to guide faculty in IPE implementation. METHODS Five stage scoping review of methodological characteristics, implementation components, challenges and key lessons in primary studies in IPE. Thematic analysis using a framework of micro (teaching), meso (institutional), and macro (systemic) level education factors was used to synthesise challenges and key lessons. RESULTS Twenty-seven primary studies were included in this review. Studies were predominantly descriptive in design and implementation components inconsistently reported. IPE was mostly integrated into curricula, optional, involved group learning, and used combinations of interactive and didactic approaches. Micro level implementation factors (socialisation issues, learning context, and faculty development), meso level implementation factors (leadership and resources, administrative processes), and macro level implementation factors (education system, government policies, social and cultural values) were extrapolated. Sustainability was identified as an additional factor in IPE implementation. CONCLUSION Lack of complete detailed reporting limits evidence of IPE implementation, however, this review highlighted challenges and yielded key lessons to guide faculty in the implementation of IPE.
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Affiliation(s)
- Fiona Bogossian
- School of Nursing, Midwifery and Paramedicine, University of the Sunshine Coast, Sippy Downs, Australia.
- Sunshine Coast Health Institute, 6 Doherty Street, Birtinya, QLD, 4575, Australia.
- School of Health and Behavioural Sciences, University of the Sunshine Coast, Sippy Downs, Australia.
| | - Karen New
- School of Health and Behavioural Sciences, University of the Sunshine Coast, Sippy Downs, Australia
- Consultant, Healthcare Evidence and Research, Brisbane, Australia
| | - Kendall George
- School of Nursing, Midwifery and Paramedicine, University of the Sunshine Coast, Sippy Downs, Australia
| | - Nigel Barr
- School of Nursing, Midwifery and Paramedicine, University of the Sunshine Coast, Sippy Downs, Australia
| | - Natalie Dodd
- School of Nursing, Midwifery and Paramedicine, University of the Sunshine Coast, Sippy Downs, Australia
- Sunshine Coast Health Institute, 6 Doherty Street, Birtinya, QLD, 4575, Australia
- School of Health and Behavioural Sciences, University of the Sunshine Coast, Sippy Downs, Australia
- School of Medicine and Dentistry, Griffith University, Sunshine Coast, Birtinya, Australia
| | - Anita L Hamilton
- School of Health and Behavioural Sciences, University of the Sunshine Coast, Sippy Downs, Australia
| | - Gregory Nash
- School of Preparation Pathways, University of the Sunshine Coast, Sippy Downs, Australia
| | - Nicole Masters
- School of Health and Behavioural Sciences, University of the Sunshine Coast, Sippy Downs, Australia
| | - Fiona Pelly
- School of Health and Behavioural Sciences, University of the Sunshine Coast, Sippy Downs, Australia
| | - Carol Reid
- School of Nursing, Midwifery and Paramedicine, University of the Sunshine Coast, Sippy Downs, Australia
| | - Rebekah Shakhovskoy
- Sunshine Coast Health Institute, 6 Doherty Street, Birtinya, QLD, 4575, Australia
- School of Health and Behavioural Sciences, University of the Sunshine Coast, Sippy Downs, Australia
- Sunshine Coast Hospital and Health Service, Birtinya, Australia
| | - Jane Taylor
- School of Health and Behavioural Sciences, University of the Sunshine Coast, Sippy Downs, Australia
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Ratsch A, Bogossian F, Burmeister EA, Ryu B, Steadman KJ. Higher blood nicotine concentrations following smokeless tobacco (pituri) and cigarette use linked to adverse pregnancy outcomes for Central Australian Aboriginal pregnancies. BMC Public Health 2022; 22:2157. [DOI: 10.1186/s12889-022-14609-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Accepted: 11/14/2022] [Indexed: 11/25/2022] Open
Abstract
Abstract
Background
In central Australia, Aboriginal women use wild tobacco plants, Nicotiana spp. (locally known as pituri) as a chewed smokeless tobacco, with this use continuing throughout pregnancy and lactation. Our aim was to describe the biological concentrations of nicotine and metabolites in samples from mothers and neonates and examine the relationships between maternal self-reported tobacco use and maternal and neonatal outcomes.
Methods
Central Australian Aboriginal mothers (and their neonates) who planned to birth at the Alice Springs Hospital (Northern Territory, Australia) provided biological samples: maternal blood, arterial and venous cord blood, amniotic fluid, maternal and neonatal urine, and breast milk. These were analysed for concentrations of nicotine and five metabolites.
Results
A sample of 73 women were enrolled who self-reported: no-tobacco use (n = 31), tobacco chewing (n = 19), or smoking (n = 23). Not all biological samples were obtained from all mothers and neonates. In those where samples were available, higher total concentrations of nicotine and metabolites were found in the maternal plasma, urine, breast milk, cord bloods and Day 1 neonatal urine of chewers compared with smokers and no-tobacco users. Tobacco-exposed mothers (chewers and smokers) with elevated blood glucose had higher nicotine and metabolite concentrations than tobacco-exposed mothers without elevated glucose, and this was associated with increased neonatal birthweight. Neonates exposed to higher maternal nicotine levels were more likely to be admitted to Special Care Nursery. By Day 3, urinary concentrations in tobacco-exposed neonates had reduced from Day 1, although these remained higher than concentrations from neonates in the no-tobacco group.
Conclusions
This research provides the first evidence that maternal pituri chewing results in high nicotine concentrations in a wide range of maternal and neonatal biological samples and that exposure may be associated with adverse maternal and neonatal outcomes. Screening for the use of all tobacco and nicotine products during pregnancy rather than focusing solely on smoking would provide a more comprehensive assessment and contribute to a more accurate determination of tobacco and nicotine exposure. This knowledge will better inform maternal and foetal care, direct attention to targeted cessation strategies and ultimately improve long-term clinical outcomes, not only in this vulnerable population, but also for the wider population.
Note to readers
In this research, the central Australian Aboriginal women chose the term ‘Aboriginal’ to refer to themselves, and ‘Indigenous’ to refer to the broader group of Australian First Peoples. That choice has been maintained in the reporting of the research findings.
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Ratsch A, Bogossian F, Burmeister EA, Steadman K. Central Australian Aboriginal women's placental and neonatal outcomes following maternal smokeless tobacco, cigarette or no tobacco use. Aust N Z J Public Health 2021; 46:186-195. [PMID: 34821425 DOI: 10.1111/1753-6405.13186] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2021] [Revised: 09/01/2021] [Accepted: 10/01/2021] [Indexed: 12/24/2022] Open
Abstract
OBJECTIVE To describe the placental characteristics and neonatal outcomes of Central Australian Aboriginal women based on maternal self-report of tobacco use. METHODS Placental and neonatal variables were collected from a prospective maternal cohort of 19 smokeless tobacco chewers, 23 smokers and 31 no-tobacco users. RESULTS Chewers had the lowest placental weight (460 g) while the no-tobacco group had the heaviest placental weight (565 g). Chewers and the no-tobacco group had placental areas of similar size (285 cm2 and 288 cm2 , respectively) while the placentas of smokers were at least 13 cm2 smaller (272 cm2 ). There were two stillbirths in the study and more than one-third (36%) of neonates (newborns) were admitted to the Special Care Nursery, with the chewers' neonates having a higher admission rate compared with smokers' neonates (44% vs. 23%). The cohort mean birthweight (3348 g) was not significantly different between the groups. When stratified for elevated maternal glucose, the chewers' neonates had the lowest mean birthweight (2906 g) compared to the neonates of the no-tobacco group (3242 g) and smokers (3398 g). CONCLUSIONS This research is the first to demonstrate that the maternal use of Australian Nicotiana spp. (pituri) as smokeless tobacco may negatively impact placental and neonatal outcomes. Implications for public health: Maternal smokeless tobacco use is a potential source of placental and foetal nicotine exposure. Maternal antenatal screening should be expanded to capture a broader range of tobacco and nicotine products, and appropriate cessation support is required.
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Affiliation(s)
- Angela Ratsch
- Wide Bay Hospital and Health Services, Queensland.,Rural Clinical School, The University of Queensland, Queensland
| | - Fiona Bogossian
- School of Health and Behavioural Sciences, University of the Sunshine Coast, Queensland.,School of Nursing, Midwifery and Social Work, The University of Queensland, Queensland
| | - Elizabeth A Burmeister
- Wide Bay Hospital and Health Services, Queensland.,School of Nursing, Midwifery and Social Work, The University of Queensland, Queensland
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12
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Paliwoda M, New K, Bogossian F, Ballard E. Physiological vital sign reference ranges for well late preterm newborns calculated during a typical two-hour newborn period between 2 hours and 7 days of life. Physiol Meas 2021; 42. [PMID: 34271562 DOI: 10.1088/1361-6579/ac155b] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Accepted: 07/16/2021] [Indexed: 11/12/2022]
Abstract
Objectives To calculate 95% reference ranges for heart rate, respiratory rate, oxygen saturation, temperature and blood pressure for well late preterm newborns between 34+0/7 and 36+6/7 weeks of gestation during typical neonatal behaviour. Approach A single site, prospective cohort study in a major Australian quaternary hospital between February and September 2019. A total of 120 late preterm newborns had their heart rate, respiratory rate and oxygen saturation measurements recorded every two seconds for up to two hours with unconditional 95% reference ranges determined using a linear mixed model with random intercept for total standard deviation calculation including repeated measures. Temperature and blood pressure measurements were collected twice - at the start and conclusion of the data recording period, with weighted 2.5th and 97.5th percentiles calculated using the mean value. Main results A total of 364,577 heart rate, 365,208 respiratory rate, 360,494 peripheral oxygen saturation, and 240 temperature and blood pressure values were obtained. The 95% reference ranges were: heart rate 102 - 164 bpm; respiratory rate 15 - 67 rpm; oxygen saturation 94 - 100%; temperature 36.4 - 37.6°C; systolic blood pressure 51 - 86 mmHg; diastolic blood pressure 28 - 61 mmHg; mean arterial pressure 35 - 68 mmHg. Significance Seven vital sign references ranges were reported for the late preterm population during a typical newborn period (such as crying, sleeping, feeding, awake and alert, and during nappy hygiene cares); internal and external validation should be completed prior to clinical use. Cut off points for escalation of care have previously been generalised to all newborns irrespective of gestational age which may result in over-treatment or a delay in recognising subtle signs of deterioration.
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Affiliation(s)
- Michelle Paliwoda
- School of Nursing, Midwifery, and Social Work, The University of Queensland, Saint Lucia, Queensland, 4072, AUSTRALIA
| | - Karen New
- The University of Queensland, Saint Lucia, Queensland, AUSTRALIA
| | - Fiona Bogossian
- University of the Sunshine Coast, Maroochydore DC, Queensland, AUSTRALIA
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Jenkinson B, Kearney L, Kynn M, Reed R, Nugent R, Toohill J, Bogossian F. Validating a scale to measure respectful maternity care in Australia: Challenges and recommendations. Midwifery 2021; 103:103090. [PMID: 34332313 DOI: 10.1016/j.midw.2021.103090] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Revised: 06/27/2021] [Accepted: 07/03/2021] [Indexed: 10/20/2022]
Abstract
OBJECTIVE Respectful maternity care is a pervasive human rights issue, but little is known about its realisation in Australia. Two scales, developed in North America, measure key aspects of respectful maternity care: the Mothers on Respect Index and Mothers Autonomy in Decision Making scale. This study aimed to validate these two scales in Queensland, Australia, and to determine the extent to which women currently experience respectful maternity care and autonomy in decision making. DESIGN A sequential two-phase study. A focus group reviewed the scales, made adaptations to scale items and completed a Content Validation Survey. The Respectful Maternity Care in Queensland survey, comprising the validated Australian scales and demographic questions was distributed online in early 2020. SETTING Queensland, Australia. PARTICIPANTS Focus group involved women (n=10) who were aged over 18, English-speaking, and had given birth during the preceding two years. All women who had birthed in Queensland between September 2019 and February 2020, were eligible to participate in the cross-sectional survey. 161 women participated in the survey. MEASUREMENTS AND FINDINGS Item content validity (>0.78) was established for all but one item. Scale content validity was established for both scales (0.92 and 0.99 respectively). Survey participants (n= 161) were mostly married/partnered (95%), heterosexual (93%), tertiary educated (47%), Caucasian (88%), and had experienced a range of maternity models of care. Median scores on each scale (74 and 26 respectively) indicated that participants felt well respected and highly autonomous. Free-text comments highlighted the importance of relationship-based care. KEY CONCLUSIONS Both scales appear valid for use in Australia. Although most participants reported high levels of respect and autonomy, the proportion of participants who had experienced continuity of midwifery care was also high. IMPLICATIONS FOR PRACTICE Both scales could be routinely deployed as patient reported experience measures in Australia, broadening the data that informs maternity service planning and delivery.
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Affiliation(s)
- Bec Jenkinson
- University of the Sunshine Coast, Sippy Downs, Queensland, Australia; The University of Queensland, Australia
| | - Lauren Kearney
- University of the Sunshine Coast, Sippy Downs, Queensland, Australia; Sunshine Coast Health Institute, Australia.
| | - Mary Kynn
- University of Aberdeen, United Kingdom
| | - Rachel Reed
- University of the Sunshine Coast, Sippy Downs, Queensland, Australia
| | - Rachael Nugent
- Sunshine Coast Health Institute, Australia; The Sunshine Coast University Hospital, Queensland, Australia
| | - Jocelyn Toohill
- Office of the Chief Nursing and Midwifery Officer, Department of Health, Queensland, Australia
| | - Fiona Bogossian
- University of the Sunshine Coast, Sippy Downs, Queensland, Australia; The University of Queensland, Australia; Sunshine Coast Health Institute, Australia
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14
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Ratsch A, Bogossian F, Steadman K. Central Australian Aboriginal women's pregnancy, labour and birth outcomes following maternal smokeless tobacco (pituri) use, cigarette use or no-tobacco use: a prospective cohort study. BMC Public Health 2021; 21:814. [PMID: 33910555 PMCID: PMC8082654 DOI: 10.1186/s12889-021-10872-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2021] [Accepted: 04/15/2021] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Outcomes related to maternal smoked tobacco (cigarette) use have been substantially examined over the past 50 years with resultant public health education targeted towards the reduction of use during pregnancy. However, worldwide the effects of maternal smokeless tobacco use have been less well explored and in Australia, there has been no examination of maternal outcomes in relation to the use of Australian Nicotiana spp. (tobacco plant) as a smokeless tobacco, colloquially known as pituri. The aim of this study is to describe the maternal outcomes of a group of central Australian Aboriginal women in relation to their self-reported tobacco use. METHODS Eligible participants were > 18 years of age, with a singleton pregnancy, > 28 weeks gestation, and who planned to birth at the Alice Springs Hospital (the major regional hospital for central Australia, in the Northern Territory, Australia). The sample consisted of 73 conveniently recruited women categorized by tobacco-use status as no-tobacco users (n = 31), pituri chewers (n = 19), and smokers (n = 23). RESULTS There were differences in the groups in relation to teenage pregnancies; 35% of no-tobacco users, compared with 5% of pituri users, and 13% of smokers were < 20 years of age. The chewers had a higher rate (48%) of combined pre-existing and pregnancy-related elevated glucose concentrations compared with smokers (22%) and no-tobacco users (16%).The pituri chewers had the lowest rate (14%) of clinically significant post-partum hemorrhage (> 1000 ml) compared with 22% of smokers and 36% of the no-tobacco users. CONCLUSIONS This is the first research to examine pituri use in pregnancy and the findings indicate possible associations with a range of adverse maternal outcomes. The use of smokeless tobacco needs to be considered in maternal healthcare assessment to inform antenatal, intrapartum and postpartum care planning. IMPLICATIONS FOR PUBLIC HEALTH Female smokeless tobacco use is a global phenomenon and is particularly prevalent in low and middle income countries and in Indigenous populations. The findings contribute to the developing knowledge around maternal smokeless tobacco use and maternal outcomes. Maternal screening for a broader range of tobacco and nicotine products is required. NOTE TO READERS In this research, the central Australian Aboriginal women chose the term 'Aboriginal' to refer to themselves, and 'Indigenous' to refer to the broader First Peoples. That choice has been maintained in the reporting of the research findings.
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Affiliation(s)
- Angela Ratsch
- Wide Bay Hospital and Health Services, Hervey Bay, Queensland 4655 Australia
| | - Fiona Bogossian
- Professor of Practice Education in Health at the University of the Sunshine Coast (USC) and USC Academic Lead at the Sunshine Coast Health Institute (SCHI), Birtinya, Queensland 4575 Australia
| | - Kathryn Steadman
- Associate Professor School of Pharmacy, The University of Queensland, Brisbane, Queensland 4102 Australia
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Blazek EV, East CE, Jauncey-Cooke J, Bogossian F, Grant CA, Hough J. Lung recruitment manoeuvres for reducing mortality and respiratory morbidity in mechanically ventilated neonates. Cochrane Database Syst Rev 2021; 3:CD009969. [PMID: 33781001 PMCID: PMC8094588 DOI: 10.1002/14651858.cd009969.pub2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
BACKGROUND Preterm infants and neonates with respiratory conditions commonly require intubation and conventional mechanical ventilation (CMV) to maintain airway patency and support their respiration. Whilst this therapy is often lifesaving, it simultaneously carries the risk of lung injury. The use of lung recruitment manoeuvres (LRMs) has been found to reduce the incidence of lung injury, and improve oxygenation and lung compliance in ventilated adults. However, evidence pertaining to their use in neonates is limited, and there is no consensus of opinion as to whether LRMs are appropriate or effective in this population. OBJECTIVES To determine the effects of LRMs on mortality and respiratory outcomes in mechanically ventilated neonates, when compared to no recruitment (routine care). SEARCH METHODS: We used the standard search strategy of Cochrane Neonatal to search the Cochrane Central Register of Controlled Trials (CENTRAL 2020, Issue 4) in the Cochrane Library, MEDLINE via Ovid (1946 to 13 April 2020), and CINAHL via EBSCOhost (1989 to 13 April 2020). We also handsearched the reference lists of retrieved studies to source additional articles. SELECTION CRITERIA: We included randomised controlled trials (RCTs), quasi-RCTs and randomised cross-over studies that compared the effect of LRMs to no recruitment (routine care) in mechanically ventilated neonates. DATA COLLECTION AND ANALYSIS Two review authors independently assessed trial eligibility, extracted data and evaluated risk of bias in the included studies. When studies were sufficiently similar, we performed a meta-analysis using mean difference (MD) for continuous data and risk ratio (RR) for dichotomous data, with their respective 95% confidence intervals (CIs). We used the GRADE approach to assess the certainty of the evidence for key (clinically important) outcomes. MAIN RESULTS We included four studies (152 participants in total) in this review. Three of these studies, enrolling 56 participants, contributed data to our prespecified outcomes. Two studies enrolling 44 participants on CMV for respiratory distress syndrome compared a stepwise LRM with positive end-expiratory pressure (PEEP) to routine care. Meta-analysis demonstrated no evidence of a difference between the LRM and routine care on mortality by hospital discharge (RR 1.00, 95% CI 0.17 to 5.77; low-certainty evidence), incidence of bronchopulmonary dysplasia (RR 0.25, 95% CI 0.03 to 2.07; low-certainty evidence), duration of supplemental oxygen (MD -7.52 days, 95% CI -20.83 to 5.78; very low-certainty evidence), and duration of ventilatory support (MD -3.59 days, 95% CI -12.97 to 5.79; very low-certainty evidence). The certainty of the evidence for these outcomes was downgraded due to risk of bias, imprecision, and inconsistency. Whilst these studies contributed data to four of our primary outcomes, we were unable to identify any studies that reported our other primary outcomes: duration of continuous positive airway pressure therapy, duration of neonatal intensive care unit stay, and duration of hospital stay. The third study that contributed data to the review enrolled 12 participants on CMV for respiratory and non-respiratory causes, and compared two different LRMs applied after endotracheal tube suctioning to routine care. It was determined that both LRMs may slightly improve end-expiratory lung volume at 120 minutes' post-suctioning, when compared to routine care (incremental PEEP LRM versus routine care: MD -0.21, 95% CI -0.37 to -0.06; double PEEP LRM versus routine care: MD -0.18, 95% CI -0.35 to -0.02). It was also demonstrated that a double PEEP LRM may slightly reduce mean arterial pressure at 30 minutes' post-suctioning, when compared with routine care (MD -16.00, 95% CI -29.35 to -2.65). AUTHORS' CONCLUSIONS: There is insufficient evidence to guide the use of LRMs in mechanically ventilated neonates. Well-designed randomised trials with larger sample sizes are needed to further evaluate the potential benefits and risks of LRM application in this population.
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Affiliation(s)
- Elizabeth V Blazek
- School of Allied Health, Australian Catholic University, Brisbane, Australia
| | - Christine E East
- School of Nursing & Midwifery, Judith Lumley Centre, La Trobe University, Melbourne, Australia
| | | | - Fiona Bogossian
- School of Health & Behavioural Sciences & School of Nursing, Midwifery & Paramedicine, University of the Sunshine Coast, Sippy Downs, Australia
| | - Caroline A Grant
- Institute of Health and Biomedical Innovation at The Centre for Children's Health Research, Queensland University of Technology, Brisbane, Australia
| | - Judith Hough
- School of Allied Health, Australian Catholic University, Brisbane, Australia
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Bogossian F, Craven D. A review of the requirements for interprofessional education and interprofessional collaboration in accreditation and practice standards for health professionals in Australia. J Interprof Care 2020; 35:691-700. [PMID: 32935599 DOI: 10.1080/13561820.2020.1808601] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
In Australia, a national approach to accreditation of programs and regulation of health professions was adopted a decade ago. Accreditation standards and regulatory frameworks can drive change and provide support for interprofessional education and collaborative practice. There is a commonly held belief among Australian academics involved in health professional education, that accreditation and practice standards provide system-level support for interprofessional education and interprofessional collaborative practice. Using a purpose-designed analysis framework and scoring scheme, we analyzed standards of accreditation and practice for 29 regulated, self-regulated and member health professions in Australia to determine the extent and accountability of statements related to interprofessional education and interprofessional collaborative practice. Currently, in Australia, there is a fragmented and inconsistent approach to interprofessional education and interprofessional collaboration evident in accreditation and practice standards and, in general, there are more explicit requirements in standards of the regulated health professions. However, overall the concepts of interprofessional education and interprofessional practice are ill-defined and statements lack accountability and/or outcome measures. Our analysis provides a foundation for reform of Australian standards and an approach for analysis of accreditation and practice standards which may be useful in other jurisdictions.
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Affiliation(s)
- Fiona Bogossian
- School of health and Sports Sciences, University of the Sunshine Coast, Sippy Downs, Australia.,Sunshine Coast Health Institute, Birtinya, Australia.,School of Nursing, Midwifery and Social Work, The University of Queensland, St Lucia, Australia
| | - Dana Craven
- School of health and Sports Sciences, University of the Sunshine Coast, Sippy Downs, Australia
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Alexander C, Bogossian F, New K. Australian midwives and clinical investigation: Exploration of the personal and professional impact. Women Birth 2020; 34:38-47. [PMID: 32948468 DOI: 10.1016/j.wombi.2020.09.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2019] [Revised: 08/11/2020] [Accepted: 09/02/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND The purpose of regulation of health professionals is public protection. Concerns regarding professional conduct or midwifery care can lead to clinical investigation. Midwifery literature reveals midwives feel ill-equipped and unprepared for clinical investigation and experience stress and abreaction. AIM To explore the lived experience of clinical investigation and identify the personal and professional impact on Australian midwives. METHOD Semi-structured interviews of a purposive sample of Australian midwives. Data analysis was informed by a phenomenological conceptual framework derived from Husserl, Heidegger and Merleau-Ponty. FINDINGS Twelve midwives were interviewed, with seven under current investigation. Discussion involved personal and professional experiences of three or more investigations each, over a period of three to five years. Most investigations were instigated by hospitals with two complaints from women. Seven participants were alleged negligent following adverse neonatal outcomes and five had misconduct allegations. Midwives were employed or in private practice and half provided homebirth services. Themes included being safe, being connected, time and being, perception and well-being. DISCUSSION The investigative process involves different health services, state and national bodies using varying powers and processes over protracted time periods. Participants discussed aspects such as disrespect, inequity, powerlessness, silence and ostracization. Midwives who successfully navigated clinical investigation developed resilience through reflection on clinical practice in a culture of safety. CONCLUSION The process of regulating midwives, designed to protect the Australian public, may be harming investigated midwives. Understanding the personal and professional impact of clinical investigation needs to underpin midwifery education, clinical practice, inform policy and regulatory reform.
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Affiliation(s)
- Catherine Alexander
- The University of Queensland, School of Nursing, Midwifery and Social Work Level 3, Chamberlain Building (35), St Lucia, Qld 4072, Australia.
| | - Fiona Bogossian
- The University of Queensland, School of Nursing, Midwifery and Social Work Level 3, Chamberlain Building (35), St Lucia, Qld 4072, Australia; University of the Sunshine Coast, Sippy Downs, Qld 4558, Australia
| | - Karen New
- The University of Queensland, School of Nursing, Midwifery and Social Work Level 3, Chamberlain Building (35), St Lucia, Qld 4072, Australia
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Levett-Jones T, Bogossian F, Cooper S, Kelly M, McKenna L, Seaton P. Progress in the Quest to Improve Patient Safety through Simulation. Clin Simul Nurs 2020; 44:1-2. [PMID: 32550937 PMCID: PMC7292603 DOI: 10.1016/j.ecns.2020.05.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- Tracy Levett-Jones
- Professor of Nursing Education, Head of School, University of Technology Sydney, School of Nursing & Midwifery, Ultimo, New South Wales 2007, Australia
| | - Fiona Bogossian
- Churchill Fellow, Professor of Practice Education in Health, University of the Sunshine Coast, School of Nursing, Midwifery and Paramedicine, Queensland 4556, Australia
| | - Simon Cooper
- Associate Dean Research, Federation University Australia, School of Nursing and Health Professions, Gippsland Campus, Churchill, Victoria, Australia
| | - Michelle Kelly
- Simulation Lead - School of Nursing, Midwifery & Paramedicine, Curtin University
| | - Lisa McKenna
- Professor and Head, School of Nursing and Midwifery, La Trobe University, Bundoora, Victoria 3086, Australia
| | - Philippa Seaton
- Associate Professor and Director, Centre for Postgraduate Nursing Studies, University of Otago, Christchurch 8140, New Zealand
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Affiliation(s)
- Fiona Bogossian
- University of the Sunshine Coast, Sippy Downs, QLD, Australia
| | - Lisa McKenna
- School of Nursing and Midwifery, La Trobe University, Bundoora, VIC, Australia
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Levett-Jones T, Andersen P, Bogossian F, Cooper S, Guinea S, Hopmans R, McKenna L, Pich J, Reid-Searl K, Seaton P. A cross-sectional survey of nursing students' patient safety knowledge. Nurse Educ Today 2020; 88:104372. [PMID: 32143174 DOI: 10.1016/j.nedt.2020.104372] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/10/2019] [Revised: 12/11/2019] [Accepted: 02/15/2020] [Indexed: 06/10/2023]
Abstract
BACKGROUND Knowledge provides a foundation for safe and effective nursing practice. However, most previous studies have focused on exploring nursing students' self-reported perceptions of, or confidence in, their level of patient safety knowledge, rather than examining their actual levels of knowledge. OBJECTIVE The overarching objective of this study was to examine final year nursing students' levels of knowledge about key patient safety concepts. DESIGN A cross-sectional design was used for this study. Data collection was undertaken during 2018 using a web-based patient safety quiz with 45 multiple choice questions informed by the Patient Safety Competency Framework for Nursing Students. A Modified Angoff approach was used to establish a pass mark or 'cut score' for the quiz. SETTING AND PARTICIPANTS Nursing students enrolled in the final year of a pre-registration nursing program in Australia or New Zealand were invited to participate in the study. RESULTS In total, 2011 final year nursing students from 23 educational institutions completed the quiz. Mean quiz scores were 29.35/45 or 65.23% (SD 5.63). Participants achieved highest scores in the domains of person-centred care and therapeutic communication, and lowest scores for infection prevention and control and medication safety. Based on the pass mark of 67.3% determined by the Modified Angoff procedure, 44.7% of students (n = 899) demonstrated passing performance on the quiz. For eight of the institutions, less than half of their students achieved a passing mark. CONCLUSIONS Given the pivotal role that nurses play in maintaining patient safety, the results from this quiz raise important questions about the preparation of nursing students for safe and effective clinical practice. The institutional results also suggest the need for increased curricula attention to patient safety.
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Affiliation(s)
- Tracy Levett-Jones
- University of Technology Sydney, Faculty of Health, 235 Jones St, Ultimo, NSW 2007, Australia.
| | - Patrea Andersen
- University of the Sunshine Coast, School of Nursing, Midwifery and Paramedicine, 90 Sippy Downs Drive, QLD 4556, Australia.
| | - Fiona Bogossian
- University of the Sunshine Coast, School of Nursing, Midwifery and Paramedicine, 90 Sippy Downs Drive, QLD 4556, Australia.
| | - Simon Cooper
- School of Nursing and Health Professions, Federation University Australia, Room 2W-249, Gippsland Campus, Churchill, Victoria, Australia.
| | - Stephen Guinea
- Australian Catholic University, Faculty of Health Sciences, 14-18 Brunswick Street, Fitzroy, VIC 3065, Australia.
| | - Ruben Hopmans
- Monash University, Faculty of Medicine, Nursing and Health Sciences, Building B, McMahons Road, Frankston, Victoria 3199, Australia.
| | - Lisa McKenna
- La Trobe University, Kingsbury Drive, Bundoora, VIC 3086, Australia.
| | - Jacqui Pich
- University of Technology Sydney, 235 Jones St, Ultimo, NSW 2007, Australia.
| | - Kerry Reid-Searl
- CQUniversity, Building 18, Yaamba Road, Rockhampton, QLD 4703, Australia.
| | - Philippa Seaton
- University of Otago, 72 Oxford Terrace, Christchurch 8140, New Zealand.
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McKenna L, Cant R, Bogossian F, Cooper S, Levett-Jones T, Seaton P. Clinical placements in contemporary nursing education: Where is the evidence? Nurse Educ Today 2019; 83:104202. [PMID: 31655308 DOI: 10.1016/j.nedt.2019.104202] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/27/2019] [Accepted: 08/31/2019] [Indexed: 06/10/2023]
Affiliation(s)
- Lisa McKenna
- La Trobe University, Bundoora, Victoria, Australia.
| | - Robyn Cant
- School of Nursing and Health Professions, Federation University Australia, Victoria, Australia
| | - Fiona Bogossian
- School of Health & Sports Sciences, School of Nursing, Midwifery & Paramedicine, University of the Sunshine Coast, Sippy Downs, Australia
| | - Simon Cooper
- School of Nursing and Health Professions, Federation University Australia, Victoria, Australia
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Brady S, Lee N, Gibbons K, Bogossian F. The contribution of midwifery education to the provision of woman-centred care: outcomes and implications of an integrative review. Women Birth 2019. [DOI: 10.1016/j.wombi.2019.07.198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Bogossian F, McLelland G. Editorial: Peer review deliberations. Women Birth 2019; 32:289-290. [DOI: 10.1016/j.wombi.2019.04.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Ratsch A, Steadman K, Ryu B, Bogossian F. Tobacco and Pituri Use in Pregnancy: A Protocol for Measuring Maternal and Perinatal Exposure and Outcomes in Central Australian Aboriginal Women. Methods Protoc 2019; 2:E47. [PMID: 31181680 PMCID: PMC6632177 DOI: 10.3390/mps2020047] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2019] [Revised: 06/04/2019] [Accepted: 06/04/2019] [Indexed: 01/17/2023] Open
Abstract
Maternal tobacco smoking is a recognized risk behavior that has adverse impacts onmaternal and fetal health. However, in some populations, the use of smokeless tobacco exceeds theuse of smoked tobacco. In central Australia, Aboriginal populations utilize wild tobacco plants(Nicotiana spp.) as a smokeless product. These plants are known by a variety of names, one of whichis pituri. The plants are masticated and retained in the oral cavity for extended periods of time andtheir use continues throughout pregnancy, birth, and lactation. In contrast to the evidence related tocombusted tobacco use, there is no evidence as to the effects of pituri use in pregnancy. CentralAustralian Aboriginal women who were at least 28 weeks pregnant were stratified into three tobaccoexposure groups: (a) Pituri chewers, (b) smokers, and (c) non-tobacco users. Routine antenatal andbirth information, pre-existing and pregnancy-related maternal characteristics, fetal characteristics,and biological samples were collected and compared. The biological samples were analysed fortobacco and nicotine metabolite concentrations. Samples from the mother included venous blood,urine, hair and colostrum and/or breast milk. From the neonate, this included Day 1 and Day 3 urineand meconium, and from the placenta, arterial and venous cord blood following delivery. This is thefirst study to correlate the pregnancy outcomes of central Australian Aboriginal women with differenttobacco exposures. The findings will provide the foundation for epidemiological data collection inrelated studies. Note to readers: In this article, the term "Aboriginal" was chosen by central Australianwomen to refer to both themselves and the Aboriginal people in their communities. "Indigenous" waschosen to refer to the wider Australian Aboriginal and Torres Strait Islander people.
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Affiliation(s)
- Angela Ratsch
- Research Education, Development and Support, Wide Bay Hospital and Health Service,Hervey Bay 4655, Australia.
| | - Kathryn Steadman
- School of Pharmacy, The University of Queensland, Brisbane 4072, Australia.
| | - BoMi Ryu
- School of Pharmacy, The University of Queensland, Brisbane 4072, Australia.
| | - Fiona Bogossian
- School of Health & Sports Science and School of Nursing, Midwifery and Paramedicine, University of the Sunshine Coast, Maroochydore 4558, Australia.
- School of Nursing, Midwifery and Social Work, The University of Queensland, Brisbane 4072, Australia.
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Brady S, Lee N, Gibbons K, Bogossian F. Woman-centred care: An integrative review of the empirical literature. Int J Nurs Stud 2019; 94:107-119. [DOI: 10.1016/j.ijnurstu.2019.01.001] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2018] [Revised: 12/31/2018] [Accepted: 01/01/2019] [Indexed: 10/27/2022]
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Cooper S, Cant R, Kelly M, Levett-Jones T, McKenna L, Seaton P, Bogossian F. An Evidence-Based Checklist for Improving Scoping Review Quality. Clin Nurs Res 2019; 30:230-240. [PMID: 31088144 DOI: 10.1177/1054773819846024] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
A scoping review aims to systematically explore and map the research available from a wide range of sources. The objective of this study was to produce a scoping review checklist to guide future scoping studies to enable rigorous review and critique of phenomena of interest. The methods used included a review of literature, expert consensus group meetings, a modified Delphi survey and, finally, verification against recent scoping study examples. Results showed that the checklist was able to identify key elements of scoping reviews. The 22-item Scoping Review Checklist (SRC), which includes two optional stakeholder consultation items, has been developed using rigorous recommended approaches. The checklist can be used to guide the conduct and critique of scoping studies.
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Affiliation(s)
- Simon Cooper
- Federation University Australia, Churchill, Victoria, Australia
| | - Robyn Cant
- Federation University Australia, Churchill, Victoria, Australia
| | | | | | - Lisa McKenna
- La Trobe University, Bundoora, Victoria, Australia
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Kilgour C, Bogossian F, Callaway L, Gallois C. Experiences of women, hospital clinicians and general practitioners with gestational diabetes mellitus postnatal follow-up: A mixed methods approach. Diabetes Res Clin Pract 2019; 148:32-42. [PMID: 30579804 DOI: 10.1016/j.diabres.2018.12.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2018] [Revised: 11/09/2018] [Accepted: 12/12/2018] [Indexed: 12/17/2022]
Abstract
PROBLEM Postnatal screening rates to detect type two diabetes following gestational diabetes are low. The quality of communication is an important element to consider in developing targeted strategies that support women in completing recommended follow-up care. AIMS To explore the communication perspectives, practices and preferences of women, hospital clinicians and general practitioners, to determine strategies that may promote completion of recommended postnatal GDM follow-up, in Queensland Australia. METHOD We used an exploratory, three-phase, mixed-methods approach, interpreted through intergroup communication theory. Phase one: convergent interviews explored perspectives of the communication experience in GDM care among new mothers (n = 13), hospital clinicians (n = 13) and general practitioners (n = 16). Phase two: a retrospective chart audit assessed current practice in postnatal discharge summaries of women (n = 86). Phase three: an online survey identified the preferences of general practitioners and hospital clinicians who provide maternity care in Queensland. Triangulation of the findings from the interviews, audit and surveys was used to clarify results and increase the robustness of the findings. RESULTS Three themes: Seeking information, Written hospital discharge summary (discharge summary) and Clarity of follow-up requirements, provide direction for pragmatic strategies to promote follow-up. Practical recommendations include continued discussion about care with women from the point of GDM diagnosis into the postnatal period; discharge summaries that give primacy to diagnosis and ongoing treatment; and provision of explicit directions for recommended testing and timing. IMPLICATIONS This research informs seven practical recommendations to help promote completion of recommended postnatal GDM follow-up.
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Affiliation(s)
- Catherine Kilgour
- The University of Queensland, Level 3, Chamberlain (Building 35), St Lucia 4072, Australia.
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Best K, Bogossian F, New K. Sensory exposure of neonates in single-room environments (SENSE): an observational study of light. Arch Dis Child Fetal Neonatal Ed 2018; 103:F436-F440. [PMID: 28970325 DOI: 10.1136/archdischild-2017-312977] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2017] [Revised: 09/07/2017] [Accepted: 09/08/2017] [Indexed: 11/04/2022]
Abstract
OBJECTIVES To measure the internal and external light exposure of incubators and open cots in an Australian single-room configured neonatal unit and compare findings to current recommendations. METHODS Light meters were placed in the internal and external environment of incubators and open cots within occupied single rooms in a tertiary-level neonatal unit between 15 September and 28 October 2015. Data were recorded in one-second increments over a minimum of 48 hours per room. RESULTS Internal median light in incubators and open cots predominantly fell below 50 lux, with low amplitude diurnal cycling. Incubator covers substantially reduced external light exposure, contributing to very low light conditions (<10 lux). Periodically, light inside incubators peaked six times greater than the maximum recommendation of 600 lux. Overall, internal incubator and open cot lighting in the neonatal unit met American Academy of Pediatrics and American College of Obstetricians and Gynecologists recommendations for 65.1% of the time during the day and 25.6% overnight. Australasian Health Infrastructure Alliance recommendations were met for 6.7% of the time during the day and 2.4% overnight. CONCLUSIONS Overall, light levels fell predominantly below 50 lux with peak periods of extreme light exposure. Low amplitude cyclic light was evident, but it remains unknown if this is sufficient to produce an effect on circadian entrainment, especially in preterm neonates. Current guidelines do not stipulate optimal cyclic light levels in neonatal units to promote circadian rhythms in the newborn population. Further research to determine well-defined lighting parameters for neonates of different gestations is paramount.
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Affiliation(s)
- Kobi Best
- School of Nursing, Midwifery and Social Work, The University of Queensland, Brisbane, QLD, Australia.,Newborn Care Unit, Gold Coast University Hospital, Southport, QLD, Australia
| | - Fiona Bogossian
- School of Nursing, Midwifery and Social Work, The University of Queensland, Brisbane, QLD, Australia
| | - Karen New
- School of Nursing, Midwifery and Social Work, The University of Queensland, Brisbane, QLD, Australia
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Bogossian F, Cooper S, Kelly M, Levett-Jones T, McKenna L, Slark J, Seaton P. Best practice in clinical simulation education − are we there yet? A cross-sectional survey of simulation in Australian and New Zealand pre-registration nursing education. Collegian 2018. [DOI: 10.1016/j.colegn.2017.09.003] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Cooper S, Seaton P, Absalom I, Cant R, Bogossian F, Kelly M, Levett-Jones T, McKenna L. Can scholarship in nursing/midwifery education result in a successful research career? J Adv Nurs 2018; 74:2703-2705. [PMID: 29733436 DOI: 10.1111/jan.13698] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/25/2018] [Indexed: 11/26/2022]
Affiliation(s)
- Simon Cooper
- Federation University Australia, Churchill, Vic., Australia
| | | | | | - Robyn Cant
- Federation University Australia, Churchill, Vic., Australia
| | - Fiona Bogossian
- University of the Sunshine Coast, Maroochydore, QLD, Australia
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Paliwoda M, New K, Davies M, Bogossian F. Physiological vital sign ranges in newborns from 34 weeks gestation: A systematic review. Int J Nurs Stud 2018; 77:81-90. [DOI: 10.1016/j.ijnurstu.2017.10.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2017] [Revised: 09/07/2017] [Accepted: 10/08/2017] [Indexed: 01/24/2023]
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Best K, Bogossian F, New K. Language Exposure of Preterm Infants in the Neonatal Unit: A Systematic Review. Neonatology 2018; 114:261-276. [PMID: 29975954 DOI: 10.1159/000489600] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2018] [Accepted: 04/24/2018] [Indexed: 11/19/2022]
Abstract
BACKGROUND Elevated sound levels and low language exposures of preterm infants (< 37 weeks) cared for in the neonatal unit contribute to poorer growth, cognition, language and motor outcomes. These delays can have lasting effects on childhood development and continue throughout adult life. Whilst recommendations have been established for appropriate sound exposure levels in neonatal units, very little is known about the optimal level of language exposure. OBJECTIVES To examine the evidence regarding language exposure, both measured (observational) and prescribed (interventional), in preterm infants (< 37 weeks) cared for in neonatal units and to identify optimal exposure levels to promote neurodevelopment. SEARCH METHODS An electronic search of English-language articles with an open date range was conducted in the PubMed, MEDLINE, Joanna Briggs, CINAHL and Cochrane databases and in Google Scholar. The criteria were limited to original research studies of preterm infants (< 37 weeks) in which language was either measured as it naturally occurred in the neonatal unit environment or through a language intervention. RESULTS The search produced a total of 2,367 articles, 49 of which were related to language. A full-text review of these articles identified 10 eligible studies and 6 studies from reference searches. CONCLUSIONS Preterm infants experience low levels of language exposure and high sound exposures in neonatal units. There is a lack of conclusive evidence to recommend an optimal level of language exposure to support improved neurodevelopmental outcomes in preterm infants. Further research from large, good-quality clinical trials is required before clear direction can be provided to inform clinical practice.
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Affiliation(s)
- Kobi Best
- The University of Queensland, St. Lucia, Queensland, Australia.,Newborn Care Unit, Gold Coast University Hospital, Southport, Queensland, Australia
| | - Fiona Bogossian
- The University of Queensland, St. Lucia, Queensland, Australia.,The University of the Sunshine Coast, Sippy Downs, Queensland, Australia
| | - Karen New
- The University of Queensland, St. Lucia, Queensland, Australia
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Cooper SJ, Hopmans R, Cant RP, Bogossian F, Giannis A, King R. Deteriorating Patients: Global Reach and Impact of an E-Simulation Program. Clin Simul Nurs 2017. [DOI: 10.1016/j.ecns.2017.06.004] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Affiliation(s)
- Lisa McKenna
- School of Nursing and Midwifery; La Trobe University; Bundoora Victoria Australia
- School of Nursing and Midwifery; University of Queensland; Australia
- School of Nursing and Midwifery; Monash University; Australia
| | - Simon J. Cooper
- School of Nursing Midwifery and Healthcare; Federation University Australia; Churchill Victoria 3842 Australia
| | - Robyn Cant
- School of Nursing Midwifery and Healthcare; Federation University Australia; Churchill Victoria 3842 Australia
| | - Fiona Bogossian
- School of Nursing and Midwifery; Monash University; Australia
- School of Nursing, Midwifery and Social Work; The University of Queensland; St Lucia Queensland 4065 Australia
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Staneva AA, Bogossian F, Morawska A, Wittkowski A. "I just feel like I am broken. I am the worst pregnant woman ever": A qualitative exploration of the "at odds" experience of women's antenatal distress. Health Care Women Int 2017; 38:658-686. [PMID: 28278018 DOI: 10.1080/07399332.2017.1297448] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Advances in perinatal mental health research have provided valuable insights around risk factors for the overall development of maternal distress. However, there is still a limited understanding of the experience of women struggling emotionally during pregnancy. We explored how women view, experience, and interpret psychological distress antenatally. Eighteen Australian women participated in in-depth interviews that were analyzed thematically within a critical realist theoretical framework. We present and situate the current findings within the dominant discourse of the good mother, which arguably promotes guilt and stigma and results in women self-labeling as bad mothers.
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Affiliation(s)
- Aleksandra A Staneva
- a School of Psychology , The University of Queensland , Brisbane , Queensland , Australia
| | - Fiona Bogossian
- b School of Nursing , Midwifery and Social Work, The University of Queensland , Brisbane , Queensland , Australia
| | - Alina Morawska
- a School of Psychology , The University of Queensland , Brisbane , Queensland , Australia
| | - Anja Wittkowski
- c Division of Clinical Psychology, Department of Psychology , University of Manchester , Manchester , UK
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Bogossian F, Brodribb W, Farley R, Goodwin H, Tin A, Young J. A feasibility study to improve practice nurses' competence and confidence in providing care for mothers and infants. Contemp Nurse 2017; 53:503-514. [PMID: 28093945 DOI: 10.1080/10376178.2017.1281087] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
BACKGROUND Postnatal care is best provided in primary health care settings, yet Practice Nurses (PNs) lack relevant training and report difficulty in providing postnatal care. AIM To evaluate the feasibility of a pilot educational intervention in improving PN competence and confidence to care for mothers and infants in the first postnatal year. DESIGN A feasibility study. METHODS PNs were recruited from selected general practices Queensland, Australia to undertake the pilot educational intervention that included a pre-intervention survey, two-day education program, program evaluation and completion of a practice journal. RESULTS Thirteen PNs from three general practices participated, with 31% completing all study components. Evaluation of the intervention was positive and all participants reported increased confidence and competence in providing postnatal care. Following detailed consideration of feasibility (process, resource, management and scientific assessment) we propose that changes to intervention delivery and data collection should be incorporated into a larger trial.
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Affiliation(s)
- Fiona Bogossian
- a School of Nursing, Midwifery & Social Work, The Faculty of Health & Behavioural Sciences , The University of Queensland , St Lucia Campus , QLD 4072 , Australia
| | - Wendy Brodribb
- b Discipline of General Practice, School of Medicine , The University of Queensland, The Faculty of Medicine & Biomedical Sciences , Herston Campus , QLD 4006 , Australia
| | - Rebecca Farley
- b Discipline of General Practice, School of Medicine , The University of Queensland, The Faculty of Medicine & Biomedical Sciences , Herston Campus , QLD 4006 , Australia
| | - Helen Goodwin
- a School of Nursing, Midwifery & Social Work, The Faculty of Health & Behavioural Sciences , The University of Queensland , St Lucia Campus , QLD 4072 , Australia
| | - Anne Tin
- a School of Nursing, Midwifery & Social Work, The Faculty of Health & Behavioural Sciences , The University of Queensland , St Lucia Campus , QLD 4072 , Australia
| | - Jacqui Young
- a School of Nursing, Midwifery & Social Work, The Faculty of Health & Behavioural Sciences , The University of Queensland , St Lucia Campus , QLD 4072 , Australia
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Staneva AA, Morawska A, Bogossian F, Wittkowski A. Maternal psychological distress during pregnancy does not increase the risk for adverse birth outcomes. Women Health 2017; 58:92-111. [DOI: 10.1080/03630242.2017.1282395] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Aleksandra A. Staneva
- The School of Psychology, The University of Queensland, Brisbane, Queensland, Australia
| | - Alina Morawska
- The School of Psychology, The University of Queensland, Brisbane, Queensland, Australia
| | - Fiona Bogossian
- The School of Nursing, Midwifery and Social Work, The University of Queensland, Brisbane, Queensland, Australia
| | - Anja Wittkowski
- Department of Psychology, University of Manchester, Manchester, UK
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Brady S, Bogossian F, Gibbons K. Development and piloting the Woman Centred Care Scale (WCCS). Women Birth 2016; 30:220-226. [PMID: 27865817 DOI: 10.1016/j.wombi.2016.10.010] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2016] [Revised: 10/17/2016] [Accepted: 10/21/2016] [Indexed: 11/18/2022]
Abstract
PROBLEM/BACKGROUND In midwifery we espouse a woman centred care approach to practice, yet in midwifery education no valid instrument exists with which to measure the performance of these behaviours in midwifery students. AIM To develop and validate an instrument to measure woman centred care behaviours in midwifery students. METHOD We identified four core concepts; woman's sphere, holism, self-determination and the shared power relationship. We mapped 18 individual descriptive care behaviours (from the Australian National Competency Standards for the Midwife) to these concepts to create an instrument to articulate and measure care behaviours that are specifically woman centred. Review by expert midwifery clinicians ensured face, content and construct validity of the scale and predictive validity and reliability were tested in a simulated learning environment. Midwifery students were video recorded performing a clinical skill and the videos were reviewed and rated by two expert clinicians who assessed the woman centred care behaviours demonstrated by the students (n=69). FINDINGS/DISCUSSION Test and re-test reliability of the instrument was high for each of the individual raters (Kappa 0.946 and 0.849 respectively p<0.001). However, when raters were compared there were differences between their scores suggesting variation in their expectations of woman centred care behaviours (Kappa 0.470, p<0.001). Midwifery students who had repeated exposures to higher levels of simulation fidelity demonstrated higher levels of woman centred care behaviours. CONCLUSION The WCCS has implications for education and the wider midwifery profession in recognising and maintaining practice consistent with the underlying philosophy of woman centred care.
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Affiliation(s)
- Susannah Brady
- The University of Queensland, School of Nursing, Midwifery & Social Work, St. Lucia Campus, Level 3, Building 35, St. Lucia, QLD 4067, Australia.
| | - Fiona Bogossian
- The University of Queensland, School of Nursing, Midwifery & Social Work, St. Lucia Campus, Level 3, Building 35, St. Lucia, QLD 4067, Australia.
| | - Kristen Gibbons
- The University of Queensland, School of Nursing, Midwifery & Social Work, St. Lucia Campus, Level 3, Building 35, St. Lucia, QLD 4067, Australia; Mater Research Office, Rm 255, Level 2, Aubigny Place, South Brisbane, QLD 4101, Australia.
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Paliwoda M, New K, Bogossian F. Neonatal Early Warning Tools for recognising and responding to clinical deterioration in neonates cared for in the maternity setting: A retrospective case-control study. Int J Nurs Stud 2016; 61:125-35. [PMID: 27348358 DOI: 10.1016/j.ijnurstu.2016.06.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2015] [Revised: 06/09/2016] [Accepted: 06/14/2016] [Indexed: 02/07/2023]
Abstract
BACKGROUND All newborns are at risk of deterioration as a result of failing to make the transition to extra uterine life. Signs of deterioration can be subtle and easily missed. It has been postulated that the use of an Early Warning Tool may assist clinicians in recognising and responding to signs of deterioration earlier in neonates, thereby preventing a serious adverse event. OBJECTIVE To examine whether observations from a Standard Observation Tool, applied to three neonatal Early Warning Tools, would hypothetically trigger an escalation of care more frequently than actual escalation of care using the Standard Observation Tool. DESIGN A retrospective case-control study. SETTING A maternity unit in a tertiary public hospital in Australia. METHODS Neonates born in 2013 of greater than or equal to 34(+0) weeks gestation, admitted directly to the maternity ward from their birthing location and whose subsequent deterioration required admission to the neonatal unit, were identified as cases from databases of the study hospital. Each case was matched with three controls, inborn during the same period and who did not experience deterioration and neonatal unit admission. Clinical and physiological data recorded on a Standard Observation Tool, from time of admission to the maternity ward, for cases and controls were charted onto each of three Early Warning Tools. The primary outcome was whether the tool 'triggered an escalation of care'. Descriptive statistics (n, %, Mean and SD) were employed. RESULTS Cases (n=26) comprised late preterm, early term and post-term neonates and matched by gestational age group with 3 controls (n=78). Overall, the Standard Observation Tool triggered an escalation of care for 92.3% of cases compared to the Early Warning Tools; New South Wales Health 80.8%, United Kingdom Newborn Early Warning Chart 57.7% and The Australian Capital Territory Neonatal Early Warning Score 11.5%. Subgroup analysis by gestational age found differences between the tools in hypothetically triggering an escalation of care. CONCLUSIONS The Standard Observation Tool triggered an escalation of care more frequently than the Early Warning Tools, which may be as a result of behavioural data captured on the Standard Observation Tool and escalated, which could not be on the Early Warning Tools. Findings demonstrate that a single tool applied to all gestational age ranges may not be effective in identifying early deterioration or may over trigger an escalation of care. Further research is required into the sensitivity and specificity of Early Warning Tools in neonatal sub-populations.
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Affiliation(s)
- Michelle Paliwoda
- The University of Queensland, School of Nursing and Midwifery, UQ, Australia; The Royal Brisbane & Women's Hospital, Australia.
| | - Karen New
- The University of Queensland, School of Nursing and Midwifery, UQ, Australia; The Royal Brisbane & Women's Hospital, Australia; The University of Queensland, Centre for Clinical Research, Australia.
| | - Fiona Bogossian
- The University of Queensland, School of Nursing and Midwifery, UQ, Australia.
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Thistlethwaite J, Dallest K, Moran M, Dunston R, Roberts C, Eley D, Bogossian F, Forman D, Bainbridge L, Drynan D, Fyfe S. Introducing the individual Teamwork Observation and Feedback Tool (iTOFT): Development and description of a new interprofessional teamwork measure. J Interprof Care 2016; 30:526-8. [DOI: 10.3109/13561820.2016.1169262] [Citation(s) in RCA: 43] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Bucknall TK, Forbes H, Phillips NM, Hewitt NA, Cooper S, Bogossian F. An analysis of nursing students' decision-making in teams during simulations of acute patient deterioration. J Adv Nurs 2016; 72:2482-94. [PMID: 27265550 DOI: 10.1111/jan.13009] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/01/2016] [Indexed: 11/29/2022]
Abstract
AIM The aim of this study was to examine the decision-making of nursing students during team based simulations on patient deterioration to determine the sources of information, the types of decisions made and the influences underpinning their decisions. BACKGROUND Missed, misinterpreted or mismanaged physiological signs of deterioration in hospitalized patients lead to costly serious adverse events. Not surprisingly, an increased focus on clinical education and graduate nurse work readiness has resulted. DESIGN A descriptive exploratory design. METHODS Clinical simulation laboratories in three Australian universities were used to run team based simulations with a patient actor. A convenience sample of 97 final-year nursing students completed simulations, with three students forming a team. Four teams from each university were randomly selected for detailed analysis. Cued recall during video review of team based simulation exercises to elicit descriptions of individual and team based decision-making and reflections on performance were audio-recorded post simulation (2012) and transcribed. RESULTS Students recalled 11 types of decisions, including: information seeking; patient assessment; diagnostic; intervention/treatment; evaluation; escalation; prediction; planning; collaboration; communication and reflective. Patient distress, uncertainty and a lack of knowledge were frequently recalled influences on decisions. CONCLUSIONS Incomplete information, premature diagnosis and a failure to consider alternatives when caring for patients is likely to lead to poor quality decisions. All health professionals have a responsibility in recognizing and responding to clinical deterioration within their scope of practice. A typology of nursing students' decision-making in teams, in this context, highlights the importance of individual knowledge, leadership and communication.
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Affiliation(s)
- Tracey K Bucknall
- Deakin University Centre for Quality and Patient Safety, School of Nursing and Midwifery, Geelong, Victoria, Australia.,Alfred Health, Victoria, Australia
| | - Helen Forbes
- Deakin University Centre for Quality and Patient Safety, School of Nursing and Midwifery, Geelong, Victoria, Australia
| | - Nicole M Phillips
- Deakin University Centre for Quality and Patient Safety, School of Nursing and Midwifery, Geelong, Victoria, Australia
| | | | - Simon Cooper
- School of Nursing, Midwifery and Paramedicine, Federation University Australia, Victoria, Australia
| | - Fiona Bogossian
- School of Nursing, Midwifery and Social Work, The University of Queensland, Queensland, Australia
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Browning M, Cooper S, Cant R, Sparkes L, Bogossian F, Williams B, O'Meara P, Ross L, Munro G, Black B. The use and limits of eye-tracking in high-fidelity clinical scenarios: A pilot study. Int Emerg Nurs 2016; 25:43-7. [DOI: 10.1016/j.ienj.2015.08.002] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2015] [Revised: 07/30/2015] [Accepted: 08/04/2015] [Indexed: 11/16/2022]
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Jauncey-Cooke J, Schibler A, Bogossian F, Gibbons K, Grant CA, East CE. Lung recruitment manoeuvres in mechanically ventilated children for reducing respiratory morbidity. Hippokratia 2016. [DOI: 10.1002/14651858.cd008866.pub2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
| | - Andreas Schibler
- Mater Children’s Hospital; Paediatric Critical Care Research Group; South Brisbane Queensland Australia 4101
| | - Fiona Bogossian
- School of Nursing and Midwifery; The University of Queensland; Herston Australia
| | - Kristen Gibbons
- Mater Research Institute; South Brisbane Queensland Australia 4101
| | - Caroline A Grant
- Mater Children's Hospital; Paediatric Intensive Care Unit; Raymond Terrace South Brisbane Queensland Australia 4001
| | - Christine E East
- Monash University/Monash Health; School of Nursing and Midwifery/Maternity Services; 246 Clayton Road Clayton Victoria Australia 3168
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Pritchard MA, de Dassel T, Beller E, Bogossian F, Johnston L, Paynter J, Russo S, Scott J. Autism in Toddlers Born Very Preterm. Pediatrics 2016; 137:e20151949. [PMID: 26798043 DOI: 10.1542/peds.2015-1949] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/16/2015] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE This study aimed to determine the prevalence of autism spectrum disorder (ASD) by using the Autism Diagnostic Observation Schedule-Generic (ADOS-G) classifications in children born very preterm during their toddler years. METHODS Two birth cohorts of toddlers (2 and 4 years old) each recruited over 12 months and born at <29 weeks' gestation were administered the Modified Checklist of Autism in Toddlers-Follow-up Interview (M-CHAT-FI) screen, the ADOS-G, and developmental assessments. The ADOS-G was conducted on toddlers with M-CHAT-FI-positive screens. RESULTS Data were available on 88% (169/192) of children. In total, 22 (13%) toddlers screened positive and 3 (1.8%) were confirmed diagnostically with ASD. These 3 cases reached the highest ADOS-G threshold classification of autism. All but 1 child who scored below the ADOS-G thresholds (11/12) demonstrated some difficulty with social communication. Risk was significantly increased for co-occurring neurodevelopmental problems in 21 of the 22 positive-screen ASD cases. Adaptive behavior (P < .001) was the only co-occurring factor independently predictive of ASD in toddlers. CONCLUSIONS Children born very preterm are at increased risk of ASD. By using the ADOS-G, we found a lower incidence of ASD in children born at <29 weeks' gestation compared with previous studies. Children who screened positive for ASD on the M-CHAT-FI had developmental delays consistent with subthreshold communication impairment.
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Affiliation(s)
| | - Therese de Dassel
- Royal Brisbane Women's Hospital, Brisbane, Queensland, Australia; Bond University, Robina, Queensland, Australia
| | - Elaine Beller
- The University of Queensland, Brisbane, Queensland, Australia
| | | | | | - Jessica Paynter
- Autism Early Intervention and Ootcome Unit Foundation, Brisbane, Queensland, Australia
| | - Santo Russo
- Better Life Psychology, Brisbane, Queensland, Australia
| | - James Scott
- Australian Catholic University, Brisbane, Queensland, Australia; Bond University, Robina, Queensland, Australia
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Heron-Delaney M, Kenardy JA, Brown EA, Jardine C, Bogossian F, Neuman L, de Dassel T, Pritchard M. Early Maternal Reflective Functioning and Infant Emotional Regulation in a Preterm Infant Sample at 6 Months Corrected Age. J Pediatr Psychol 2016; 41:906-14. [PMID: 26811019 DOI: 10.1093/jpepsy/jsv169] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2015] [Accepted: 12/18/2015] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVE This study investigated the influence of maternal reflective functioning (RF) on 6-month-old infants' emotional self-regulating abilities in preterm infant-mother dyads. METHODS 25 preterm (gestational age 28-34.5 weeks) infants' affect, gaze toward mother, and self-soothing behaviors (thumb-sucking and playing with clothing) were measured during the still-face procedure at 6 months corrected age. Maternal RF was measured at 7-15 days post-delivery using the Parent Development Interview. RESULTS Infants with high RF mothers showed the most negative affect during the still-face episode (M = 21.33s, SE = 5.44), whereas infants with low RF mothers showed the most negative affect in the reunion episode (M = 18.14s, SE = 3.69). Infants with high RF mothers showed significantly more self-soothing behaviors when distressed (Ms > 14.5s) than infants with low RF mothers (Ms < 1s), p's < .01. CONCLUSION Maternal RF was associated with infants' self-regulating behavior, providing preliminary evidence for the regulatory role of maternal RF in preterm infants' emotion regulation capacity.
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Affiliation(s)
| | | | - Erin A Brown
- Recover Injury Research Centre, University of Queensland
| | | | | | | | | | - Margo Pritchard
- School of Nursing, Midwifery and Paramedicine, Australian Catholic University
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Bogossian F, Cooper S, Cant R, Beauchamp A, Porter J, Kain V, Bucknall T, Phillips NM. Corrigendum to "Undergraduate nursing students' performance in recognising and responding to sudden patient deterioration in high psychological fidelity simulated environments: An Australian multi-centre study" [Nurse Educ. Today 34(5) (May 2014) 691-696]. Nurse Educ Today 2015; 38:S0260-6917(15)00522-5. [PMID: 26758210 DOI: 10.1016/j.nedt.2015.12.016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Affiliation(s)
- Fiona Bogossian
- The School of Nursing & Midwifery, The University of Queensland, Herston Campus, QLD, Australia.
| | - Simon Cooper
- The School of Nursing & Midwifery, Monash University, Berwick Campus, VIC, Australia
| | - Robyn Cant
- The School of Nursing & Midwifery, Monash University, Berwick Campus, VIC, Australia
| | - Alison Beauchamp
- The School of Nursing & Midwifery, Monash University, Berwick Campus, VIC, Australia; Population Health Strategic Research Centre, Deakin University, Burwood Campus, VIC, Australia
| | - Joanne Porter
- The School of Nursing & Midwifery, Monash University, Gippsland Campus, VIC, Australia
| | - Victoria Kain
- The School of Nursing & Midwifery, The University of Queensland, Herston Campus, QLD, Australia
| | - Tracey Bucknall
- School of Nursing and Midwifery, Deakin University, Burwood Campus, VIC, Australia
| | - Nicole M Phillips
- School of Nursing and Midwifery, Deakin University, Burwood Campus, VIC, Australia
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Staneva A, Morawska A, Bogossian F, Wittkowski A. Pregnancy-specific distress: the role of maternal sense of coherence and antenatal mothering orientations. J Ment Health 2015; 25:387-394. [PMID: 26652295 DOI: 10.3109/09638237.2015.1101425] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Maternal mental health during pregnancy has been identified as a key factor in the future physiological, emotional and social development of both the mother and her baby. Yet little is known about the factors that contribute to increased levels of pregnancy-specific distress. The present study investigated the role of two psychosocial and personality-based constructs, namely women's sense of coherence (SoC) and their mothering orientations, on their pregnancy-specific distress. DESIGN During their second trimester of pregnancy, 293 Australian and New Zealand women participated in an online study. Hierarchical multiple regression analysis was used to determine the unique contribution of women's SoC (Sense of Coherence Scale, SoC 13) and their antenatal mothering orientation (Antenatal Mothering Orientation Measure-Revised, AMOM-R) to pregnancy-specific distress (Revised Prenatal Distress Questionnaire, NuPDQ). RESULTS Low SoC was the best determinant of women's pregnancy-specific distress, accounting for over 45% of the variance (β = -0.33, p < 0.001, 95% CI [-0.43, -0.23]). A Regulator mothering orientation was correlated with distress but did not have a unique contribution in the final model. CONCLUSIONS This study further highlights the importance of better understanding women's perceptions of emotional health and their mothering role while taking into consideration their wider social context.
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Affiliation(s)
| | - Alina Morawska
- a The School of Psychology, The University of Queensland , Australia
| | - Fiona Bogossian
- b The School of Nursing, Midwifery and Social Work, The University of Queensland , Brisbane , Australia , and
| | - Anja Wittkowski
- c Department of Psychology, Division of Clinical Psychology , University of Manchester , Manchester , UK
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Staneva A, Bogossian F, Pritchard M, Wittkowski A. The effects of maternal depression, anxiety, and perceived stress during pregnancy on preterm birth: A systematic review. Women Birth 2015; 28:179-93. [DOI: 10.1016/j.wombi.2015.02.003] [Citation(s) in RCA: 244] [Impact Index Per Article: 27.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2014] [Revised: 02/09/2015] [Accepted: 02/12/2015] [Indexed: 10/23/2022]
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Staneva AA, Bogossian F, Wittkowski A. The experience of psychological distress, depression, and anxiety during pregnancy: A meta-synthesis of qualitative research. Midwifery 2015; 31:563-73. [DOI: 10.1016/j.midw.2015.03.015] [Citation(s) in RCA: 61] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2014] [Revised: 03/22/2015] [Accepted: 03/29/2015] [Indexed: 11/29/2022]
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