Collegian最新文献_第10页

Nurses’ perception of missed nursing care in a Western Australian teaching hospital: A cross-sectional study 西澳大利亚教学医院护士对护理缺失的感知:一项横断面研究

IF 1.5 4区医学 Q2 NURSING

Collegian

Pub Date : 2023-08-01 DOI: 10.1016/j.colegn.2023.05.005

Afia Achiaa Sarpong , Diana Arabiat , Lucy Gent , Ebenezer Afrifa-Yamoah , Amanda Towell-Barnard

Background

Missed nursing care (MNC) has gained increasing emphasis in nursing literature because of its association with nurse and patient outcomes in healthcare settings. While missed care has been widely studied, little evidence is available on the types and frequency of missed care, reasons for its occurrence, and predictors of missed care in Western Australia.

Aims

To determine nurses’ perceptions of the types of MNC, reasons for missed care and to identify factors predicting missed care occurrence in Western Australian acute care settings.

Methods

A cross-sectional study in medical and surgical wards was performed. The nurse MISSCARE survey tool was used to capture self-reported types and reasons for missed care and level of nurse job satisfaction from a sample of 204 nurses working in 16 acute care wards. Data analyses were carried out in International Business Machines Corperation located in Armonk, New York United States (IBM SPSS Statistics) (v 29).

Findings

The most common perceived missed activities included ambulation (87%), patient teaching (79%), interdisciplinary conference attendance (78%), mouth care (78%), intake and output (77%), and patient turning (75%). Labour resources ranked highest for reasons for missed care followed by material resources and communication. Significant relationships were observed between missed care and job satisfaction, role satisfaction, and teamwork.

Discussion

Working overtime, job dissatisfaction, inadequate staffing, and heavy admissions and discharges were related to increased likelihood for missed care occurrence.

Conclusion

Although further studies examining the link between MNC and staffing methodologies are needed, this study provides evidence on nurse-reported missed care and the impact of missed care in Western Australia.

护理遗漏(MNC)在护理文献中越来越受到重视，因为它与医疗保健环境中护士和患者的预后有关。虽然错过护理已被广泛研究，但很少有证据表明错过护理的类型和频率，其发生的原因，以及在西澳大利亚错过护理的预测因素。目的确定护士对MNC类型的认知，漏护理的原因，并确定预测漏护理发生的因素在西澳大利亚州的急性护理设置。方法对内科和外科病房进行横断面研究。使用护士MISSCARE调查工具，从16个急症病房的204名护士中获取自我报告的错过护理的类型和原因以及护士工作满意度水平。数据分析是在美国纽约阿蒙克的国际商业机器公司进行的(IBM SPSS统计)(v . 29)。最常见的被认为错过的活动包括走动(87%)、病人教学(79%)、参加跨学科会议(78%)、口腔护理(78%)、摄入和输出(77%)和病人翻身(75%)。错过护理的原因中，劳动力资源排名最高，其次是物质资源和沟通。缺勤护理与工作满意度、角色满意度和团队合作有显著关系。加班、对工作不满意、人员配备不足、大量入院和出院与漏诊发生的可能性增加有关。结论:虽然需要进一步研究跨国公司和人员配置方法之间的联系，但本研究提供了西澳大利亚州护士报告的遗漏护理和遗漏护理影响的证据。

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引用次数: 0

Hospital service use in the last year of life by Indigenous Australians who died of heart failure or cardiomyopathy: A linked data study 死于心力衰竭或心肌病的澳大利亚土著居民生命最后一年的医院服务使用情况:一项相关数据研究

IF 1.5 4区医学 Q2 NURSING

Collegian

Pub Date : 2023-08-01 DOI: 10.1016/j.colegn.2023.03.002

Gursharan K. Singh , Alison P. Bowers , Caleb Ferguson , Julee McDonagh , Serra E. Ivynian , Shirley Chambers , Louise D. Hickman

Background

Aboriginal and Torres Strait Islander peoples experience disproportionate rates of heart failure. However, information regarding their use of hospital services in the last year of life is poorly delineated to inform culturally appropriate end-of-life health services.

Objectives

To quantify hospital service use in the last year of life of Aboriginal and Torres Strait Islander peoples who died of heart failure or cardiomyopathy in Queensland, Australia.

Methods

A subgroup analysis of a larger retrospective linkage study using administrative health data in Queensland, Australia. Individuals that identified as an Aboriginal and Torres Strait Islander person from their first hospital admission in the last year of life, who died of heart failure or cardiomyopathy from 2008 to 2018, were included.

Results

There were 99 individuals, with emergency department presentation/s recorded for 85 individuals. Over 50% of individuals presenting to the Emergency Department were from regional areas (n = 43, 51%). The 99 individuals had a total of 472 hospital admissions, excluding same day admissions for haemodialysis, and 70% (n = 70) died in hospital. Most admissions were coded as acute care (n = 442, 94%), and fewer were coded as palliative care (n = 19, 4%). Median comorbidities or factors that led to hospital contact = 5 (interquartile range 3–9).

Conclusion

Acute care hospital admissions in the last year of life by this population are common for those who died of heart failure or cardiomyopathy. Multimorbidity is prevalent in the last year of life, underscoring the importance of primary health care, provided by nurses and Indigenous health workers.

原住民和托雷斯海峡岛民患心力衰竭的比例不成比例。然而，关于他们在生命的最后一年使用医院服务的信息描述得很差，无法为文化上适当的临终保健服务提供信息。目的量化澳大利亚昆士兰州原住民和托雷斯海峡岛民死于心力衰竭或心肌病的最后一年的医院服务使用情况。方法对澳大利亚昆士兰州一项大型回顾性关联研究进行亚组分析。包括在2008年至2018年期间死于心力衰竭或心肌病的土著人和托雷斯海峡岛民，他们在生命的最后一年首次入院。结果99例患者，其中85例有急诊科就诊记录。到急诊科就诊的患者中，超过50%来自地区(n = 43,51 %)。99名患者共入院472次(不包括同一天入院的血液透析)，70% (n = 70)在医院死亡。大多数入院被编码为急性护理(n = 442, 94%)，较少被编码为姑息治疗(n = 19.4%)。导致医院接触的合并症或因素中位数= 5(四分位数范围3-9)。结论该人群在生命最后一年因心力衰竭或心肌病死亡的患者中，急症住院较为常见。多病在生命的最后一年很普遍，强调了由护士和土著卫生工作者提供的初级卫生保健的重要性。

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引用次数: 0

Nurses’ perceptions on the skills, knowledge, and attributes required to provide healthcare to people experiencing homelessness in Australia: A qualitative study 护士对向澳大利亚无家可归者提供医疗保健所需的技能、知识和属性的看法:一项定性研究

IF 1.5 4区医学 Q2 NURSING

Collegian

Pub Date : 2023-08-01 DOI: 10.1016/j.colegn.2023.03.006

Jane Currie , Lucy McWilliams , Vijeta Venkataraman , Martha Paisi , Jill Shawe , Anna Thornton , Matthew Larkin , Joanne Taylor , Sandy Middleton

Background

People experiencing homelessness have unmet healthcare needs often related to chronic health conditions and injury. Nurses are often the first and only point of contact for people experiencing homelessness accessing healthcare. However, education that prepares them to meet the needs of this vulnerable population is limited.

Aim

To qualitatively explore nurses’ perceptions on the skills, knowledge, and attributes required to provide healthcare to people experiencing homelessness in Australia that could underpin an educational pathway.

Design

Semi-structured interviews with registered nurses and nurse practitioners.

Methods

Participants of a national survey were invited to undertake an interview. Interview data were analysed thematically and reported here in accordance with the Consolidated Criteria for Reporting Qualitative Research guidelines.

Findings

The registered nurses (n = 11) and nurse practitioners (n = 6) had varying levels of experience providing care for homeless Australians. Overarching themes that arose from the registered nurse and nurse practitioner participants included equitable access to care, knowledge around homelessness, contribution of nursing, and nurses’ role. However, nurse practitioners had a greater sense of agency and empowerment to enact care, while registered nurses perceived being underprepared and overwhelmed by the unmet needs of people experiencing homelessness.

Conclusions

The findings suggest that nursing practice holds opportunities to improve access and care provision for people experiencing homelessness. Capitalising on these opportunities requires that nurses are educationally prepared with the skills, knowledge, and attributes to meet the needs of this vulnerable population without necessarily becoming nurse practitioners. These findings will be used to underpin the development of an educational pathway for nurses to enhance their response to homeless populations.

背景无家可归者的保健需求得不到满足，往往与慢性健康状况和伤害有关。护士往往是无家可归者获得医疗保健的第一个也是唯一的联系人。然而，使他们能够满足这一弱势群体需求的教育是有限的。目的定性地探讨护士对为澳大利亚无家可归者提供医疗保健所需的技能、知识和属性的看法，这可能是教育途径的基础。设计对注册护士和执业护士进行半结构化访谈。方法邀请全国调查对象进行访谈。访谈数据按主题进行分析，并根据报告定性研究准则的综合标准在此报告。研究结果注册护士(n = 11)和执业护士(n = 6)在为无家可归的澳大利亚人提供护理方面有不同程度的经验。从注册护士和执业护士参与者中产生的总体主题包括公平获得护理，关于无家可归的知识，护理的贡献和护士的角色。然而，执业护士在制定护理方面有更大的能动性和赋权感，而注册护士则被认为准备不足，被无家可归者的未满足需求所压倒。结论:研究结果表明，护理实践有机会改善无家可归者的接触和护理服务。利用这些机会需要护士在教育上具备技能、知识和属性，以满足这一弱势群体的需求，而不必成为护士从业人员。这些发现将用于支持护士教育途径的发展，以加强他们对无家可归者的反应。

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引用次数: 0

Nurses’ perceptions of the skills, knowledge and attributes required to optimise scope of practice and improve access to care for people experiencing homelessness in Australia: A cross-sectional study 护士对优化执业范围和改善澳大利亚无家可归者获得护理所需技能、知识和属性的看法：一项横断面研究

IF 1.5 4区医学 Q2 NURSING

Collegian

Pub Date : 2023-08-01 DOI: 10.1016/j.colegn.2023.02.002

Jane Currie , Lucy McWilliams , Martha Paisi , Jill Shawe , Anna Thornton , Matthew Larkin , Joanne Taylor , Sandy Middleton

Background

People experiencing homelessness are less likely to access healthcare, particularly primary and preventive care. Nurses are well placed to improve access to healthcare for this vulnerable population.

Aim

To explore nurses’ perceptions of the skills, knowledge and attributes required to optimise scope of practice and improve access to healthcare for people experiencing homelessness, to underpin an education framework.

Design

A cross-sectional national survey of nurses in Australia.

Methods

Part of a larger study, a 222-item electronic survey was disseminated via social media and nursing colleges and associations. Participants rated the level of priority of specific skills knowledge and attributes to optimise nurses’ scope of practice and improve access to care for people experiencing homelessness. Quantitative data were analysed descriptively and qualitative data thematically.

Findings

The final analysis comprised n = 67 surveys. Participants were registered nurses (n = 54), nurse practitioners (n = 12) and one enrolled nurse. Items rated as highest priority and used in practice to optimise access to care were interpersonal attributes (n = 66.5, 99%), diagnosing presenting complaints (n = 64, 95%) and interpreting diagnostic test results (n = 63, 93%). Organisationally, support from colleagues (n = 58, 87%), managers (n = 57, 85%) and clear clinical guidelines (n = 46, 69%) are reportedly important. Most participants stated willingness to undertake further education in the care of people experiencing homelessness (93%, n = 62).

Conclusion

In developing a nursing education framework to optimise nurses’ scope of practice and improve access to care for people experiencing homelessness, the findings suggest that interpersonal skills, diagnosis and treatment are priority topics.

背景无家可归者获得保健的可能性较小，特别是初级保健和预防性保健。护士完全有能力改善这一弱势群体获得医疗保健的机会。目的探讨护士对优化实践范围和改善无家可归者获得医疗保健机会所需的技能、知识和属性的看法，以巩固教育框架。设计对澳大利亚护士进行横断面全国调查。方法通过社交媒体和护理学院及协会进行222项电子调查，这是一项更大规模研究的一部分。参与者评估了特定技能知识和属性的优先级，以优化护士的实践范围，并改善无家可归者获得护理的机会。定量数据进行描述性分析，定性数据进行主题性分析。最后的分析包括n = 67个调查。参与者为注册护士(n = 54)、执业护士(n = 12)和1名注册护士。被评为最高优先级并在实践中用于优化获得护理的项目是人际属性(n = 66.5, 99%)、诊断主诉(n = 64, 95%)和解释诊断测试结果(n = 63, 93%)。在组织层面，来自同事(n = 58, 87%)、经理(n = 57, 85%)和明确的临床指南(n = 46, 69%)的支持据称很重要。大多数参与者表示愿意在照顾无家可归者方面接受进一步的教育(93%，n = 62)。研究结果表明，在制定护理教育框架以优化护士的实践范围并改善无家可归者获得护理的机会时，人际交往技能、诊断和治疗是优先考虑的主题。

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引用次数: 0

Long-acting reversible contraception prescribing coverage by nurse practitioners and midwives in Australia 澳大利亚执业护士和助产士的长效可逆避孕处方覆盖率

IF 1.5 4区医学 Q2 NURSING

Collegian

Pub Date : 2023-08-01 DOI: 10.1016/j.colegn.2023.04.004

Sharon James , Aline Kunnel , Jane Tomnay , Danielle Mazza , Luke Grzeskowiak

Background

Expanded patient access to long-acting reversible contraception (LARC) is needed to support patient choice and access to efficacious forms of contraception. Little is known about nurse practitioner (NP) and midwife LARC prescribing.

Aims

To examine LARC prescribing by NPs and midwives in Australia.

Methods

A cross-sectional study of Australian Pharmaceutical Benefits Scheme dispensing data from 2018 to 2021 for females aged 15–54. Age‐standardised rates were calculated by state, remoteness area, and level 3 statistical areas (SA3s).

Findings

Despite a 1.6 fold increase since 2018, NPs and midwives accounted for 0.82 % (n = 2184) of prescriptions for LARC dispensed in 2021. The percentage of services in 2021 was greater in outer regional (2.21 %) and lowest in major cities (0.68 %) and was higher for the implant (0.92 %) compared with the hormonal intrauterine device (0.76 %). The proportion of total SA3s where a NP/midwife prescribed LARC increased from 23.35 % in 2018 to 29.94 % in 2021. NP/midwife LARC prescribing was highest in outer regional (42.6 %) and lowest in remote areas (18.8 %). When stratified by state/territory, coverage of SA3s was highest in Australian Capital Territory (50.0 %) and lowest in the Northern Territory (11.1 %).

Discussion and conclusion

Our findings suggest that whilst there has been an increase in NP and midwife LARC prescribing, the overall rate remains low and coverage across Australia appears fragmented. NPs and midwives are well placed to enhance women’s access to efficacious forms of contraception, but this requires future efforts to identify and address critical barriers (e.g. legislative, funding, training) to service provision.

背景:需要扩大患者获得长效可逆避孕(LARC)的途径，以支持患者选择和获得有效的避孕方式。对执业护士(NP)和助产士LARC处方知之甚少。目的调查澳大利亚护士和助产士的LARC处方。方法对澳大利亚药品福利计划2018年至2021年15-54岁女性配药数据进行横断面研究。年龄标准化率按州、偏远地区和3级统计区(SA3s)计算。尽管自2018年以来增加了1.6倍，但NPs和助产士在2021年分配的LARC处方中占0.82% (n = 2184)。2021年的服务比例在外围地区最高(2.21%)，在主要城市最低(0.68%)，植入物的服务比例(0.92%)高于激素宫内节育器(0.76%)。NP/助产士开具LARC处方的所有sa3的比例从2018年的23.35%上升到2021年的29.94%。NP/助产士LARC处方在外围地区最高(42.6%)，在偏远地区最低(18.8%)。按州/地区分层时，澳大利亚首都地区的sa3覆盖率最高(50.0%)，北领地最低(11.1%)。讨论和结论我们的研究结果表明，虽然NP和助产士LARC处方有所增加，但总体比率仍然很低，整个澳大利亚的覆盖范围似乎很分散。国家计划生育人员和助产士完全有能力提高妇女获得有效避孕方式的机会，但这需要今后努力确定和解决服务提供方面的关键障碍(例如立法、资金、培训)。

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引用次数: 0

Exploring assessment policies for clinical practice: A scoping review of the literature 探索临床实践的评估政策:文献的范围综述

IF 1.5 4区医学 Q2 NURSING

Collegian

Pub Date : 2023-08-01 DOI: 10.1016/j.colegn.2023.03.007

Lynda J. Hughes , Amy N.B. Johnston , Jacqueline H. Byrne , Debbie Massey

Background

Assessment of pre-registration nursing students in clinical practice is an essential process, ensuring students who graduate meet standards for practice and competently and safely care for patients under their care. However, such assessment remains challenging for individuals and organisations.

Aim

We aimed to investigate what is known about the application of clinical placement assessment policies guiding pre-registration nursing programmes.

Methods

Arskey and O’Malley’s five-stage method for scoping reviews was employed. Health and education databases were searched in July 2020 and December 2021. Identified papers were screened. The Joanna Briggs Institute’s critical appraisal tools were used to appraise the quality of the included articles. The Invitational Theory domains of people, processes, programmes, places, and policies were utilised to aid meaningful analysis of the findings.

Findings

Nineteen articles were appraised: eleven primary data studies, two that psychometrically tested a survey instrument, four discussion articles, and two literature reviews. Article quality varied widely. Three themes were identified: lack of processes around clinical practice, people and clinical practice, and policies and clinical practice.

Discussion

Assessment within placement is complex and unique. Uncertainty permeates the literature around assessment of pre-registration students in clinical practice. There is a clear need to promote policies that highlight differences between theoretical and practice assessment, ensuring all stakeholders can access relevant governance processes that support patient safety.

Conclusion

More empirical evidence is needed to develop policies and processes that reduce uncertainty and improve patient safety associated with student assessment within clinical placements.

在临床实践中对预注册护理学生进行评估是一个必要的过程，以确保毕业的学生达到实践标准，并能胜任和安全地照顾他们所照顾的病人。然而，这种评估对个人和组织来说仍然具有挑战性。AimWe旨在调查临床安置评估政策指导预注册护理计划的应用情况。方法采用sarskey和O 'Malley的五阶段法进行范围评价。在2020年7月和2021年12月检索了卫生和教育数据库。识别的文件进行了筛选。乔安娜布里格斯研究所的关键评估工具被用来评估纳入文章的质量。人员、流程、方案、地点和政策的邀请理论领域被用来帮助对研究结果进行有意义的分析。19篇文章被评估:11篇主要数据研究，2篇心理测量测试了一种调查工具，4篇讨论文章和2篇文献综述。商品质量参差不齐。确定了三个主题:缺乏临床实践过程，人与临床实践，政策与临床实践。讨论安置中的评估是复杂和独特的。在临床实践中，不确定性弥漫在对预注册学生评估的文献中。显然有必要促进强调理论评估和实践评估之间差异的政策，确保所有利益攸关方都能获得支持患者安全的相关治理流程。结论:需要更多的经验证据来制定政策和流程，以减少不确定性，提高临床实习中与学生评估相关的患者安全。

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引用次数: 0

A survey of nurse practitioner’s views on registered nurse prescribing in Australia — Conflicted perspectives 澳大利亚执业护士对注册护士处方的看法调查——观点冲突

IF 1.5 4区医学 Q2 NURSING

Collegian

Pub Date : 2023-08-01 DOI: 10.1016/j.colegn.2023.04.005

Amanda Fox , Raymond Javan Chan , Fiona Crawford-Williams , Suzanne Williams , Jane Currie , Carla Thamm

Background

The Nursing and Midwifery Board of Australia has proposed a standard of practice that enables registered nurses (RNs) to prescribe under a partnership model. This requires extensive input and support from authorised prescribers including nurse practitioners. Understanding nurse practitioners’ views and preparedness to support partnership nurse prescribing is imperative to its successful adoption.

Aim

To report Australian nurse practitioners’ views on the RN-prescribing standard.

Methods

This cross-sectional study surveyed a convenience sample of nurse practitioners using multiple-choice, Likert Scale and open-text responses. Quantitative data were analysed using descriptive statistics; short answer responses were explored thematically.

Findings

The majority of the 229 participants (n = 183, 76.2%) agreed that prescribing would optimise RN knowledge, skills, and capability. Mentorship was the highest-rated enabling factor (n = 205, 89.5%). Three themes were identified: the lived experience of nurse practitioners, perceived impact on nurse practitioner roles, and patient safety.

Discussion

Participant views were conflicted. While the potential advantages for patients, RNs, and the healthcare system were acknowledged, there was equal concern for the implementation of nurse prescribing, role ambiguity, and erosion and patient safety. Nurse practitioners’ support for RN prescribing will be an important component of implementation.

Conclusion

RN prescribing is an opportunity to potentially improve consumer access to medicines and enhance healthcare system efficiency. It is also an opportunity for the nursing profession to contribute to improved systems of care while embedding succession planning for advanced practice nursing roles.

澳大利亚护理和助产委员会提出了一项实践标准，使注册护士(RNs)能够在合作模式下开处方。这需要包括执业护士在内的授权开处方者的广泛投入和支持。了解护士从业人员的意见和准备支持合作护士处方是必要的，其成功采用。目的报告澳洲执业护士对rn处方标准的看法。方法采用多项选择、李克特量表和开放文本问卷对执业护士进行抽样调查。定量资料采用描述性统计分析;简短的回答是按主题进行探讨的。研究结果229名参与者中的大多数(n = 183, 76.2%)同意处方会优化注册护士的知识、技能和能力。师徒关系是评价最高的使能因素(n = 205, 89.5%)。确定了三个主题:执业护士的生活经验，对执业护士角色的感知影响和患者安全。与会者的意见是相互矛盾的。虽然对患者、注册护士和医疗保健系统的潜在优势得到了承认，但对护士处方的实施、角色模糊、侵蚀和患者安全也存在同样的担忧。执业护士对注册护士处方的支持将是实施的重要组成部分。结论注册护士处方是改善消费者药品可及性和提高医疗保健系统效率的一个潜在机会。这也是护理专业为改进护理系统做出贡献的机会，同时为高级实践护理角色嵌入继任计划。

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引用次数: 0

Practice standards for Australian cardiovascular nurses: An electronic Delphi study 澳大利亚心血管护士执业标准:电子德尔福研究

IF 1.5 4区医学 Q2 NURSING

Collegian

Pub Date : 2023-08-01 DOI: 10.1016/j.colegn.2023.03.003

Jacqueline Colgan , Patricia Irene Bromley , Dawn McIvor , Ross Proctor , Melanie Greenwood

Background

Professional standards for nurse practice protect the public and define the scope of nursing broadly and in specialty areas. Nurses encounter patients with cardiovascular disease in a variety of clinical contexts, and specialty practice standards have the potential to articulate the scope and role expectations for nurses caring for this population. Practice standards and role expectations for nurses caring for cardiovascular patients in Australia were developed through electronic Delphi (eDelphi) technique.

Aim

To present the development of practice standards and role expectations for Australian cardiovascular nurses.

Methods

Three-round eDelphi survey with experts from a broad range of contexts who identified as cardiovascular nurses to reach a consensus on the Practice Standards for Australian Cardiovascular Nurses. External stakeholder agreement was also sought on the final version prior to publication.

Findings

Three domains were identified: Clinical Care, Cultural Safety, and Person-Centred Care, and Leadership and Teamwork, and their supporting elements. Role expectations reflected the varied context and scope of practice.

Discussion

These standards describe the scope of cardiovascular nursing practice regardless of context. Underpinning the standards is the recognition of person-centred care and cultural safety. The standards provide a framework for professional recognition, support the delivery of patient care, and may be used to aid curriculum development in cardiovascular nursing education.

Conclusion

The eDelphi technique and external stakeholder agreement validated the expected capability of nurses involved in the assessment, management, and evaluation of care for the cardiovascular patient. The standards and role expectations reflect the various contexts where care for the cardiovascular patient occurs.

护士执业的专业标准保护公众，并在专业领域广泛界定护理的范围。护士在各种临床环境中遇到心血管疾病患者，专业实践标准有可能阐明护理这一人群的护士的范围和角色期望。通过电子德尔菲(eDelphi)技术制定了澳大利亚护理心血管患者的护士的实践标准和角色期望。目的介绍澳大利亚心血管护士执业标准的发展和角色期望。方法与来自广泛背景的心血管护士专家进行三轮eDelphi调查，以就澳大利亚心血管护士的实践标准达成共识。在出版之前，还就最终版本征求了外部利益相关者的同意。研究结果确定了三个领域:临床护理、文化安全和以人为本的护理、领导和团队合作及其支持要素。角色期望反映了实践的不同背景和范围。这些标准描述了心血管护理实践的范围，无论背景如何。这些标准的基础是对以人为本的护理和文化安全的认可。这些标准提供了一个专业认可的框架，支持病人护理的交付，并可用于帮助心血管护理教育的课程开发。结论eDelphi技术和外部利益相关者协议验证了护士参与心血管患者护理评估、管理和评价的预期能力。标准和角色期望反映了对心血管患者进行护理的各种情况。

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引用次数: 0

The sleeping giant - Nurses’ professional principal practice in managing sleep health and sleep disorders in Australia and New Zealand: A cross-sectional study 睡眠巨人——澳大利亚和新西兰护士管理睡眠健康和睡眠障碍的专业主要实践:一项横断面研究

IF 1.5 4区医学 Q2 NURSING

Collegian

Pub Date : 2023-08-01 DOI: 10.1016/j.colegn.2023.03.004

Catherine Buchan , Sally Powell , Nicole Grivell , Darren O’Brien , Christopher J. Gordon

Background

The current practices and roles of nurses working extensively in sleep health that manage people with sleep health problems are poorly described and unclear. To our knowledge, there is no global data, and as nurses are the largest healthcare workforce, it is important to understand the roles and practices of nurses involved in sleep health. The aim of this study was to understand the roles, practices, and educational credentials of nurses involved in sleep health in Australia and New Zealand.

Methods

A sleep nursing workforce survey was developed, consisting of 35 questions. The survey was distributed through the Australasian Sleep Association, the peak scientific and professional association of sleep health in Australia and New Zealand. Data were analysed using descriptive statistics.

Results

In total, 100 participants (Australia, 72%; New Zealand, 28%) completed the survey. The majority of the participants were aged between 40 and 69 years and 79% had a Bachelor’s degree education or higher, had approximately 7 years’ experience in sleep health, and most worked in hospital settings (55%). Nurses spent considerable time involved in direct patient care; undertaking a range of sleep-specific clinical, scientific, and research roles. The more experienced nurses had higher levels of sleep-related education (p = 0.034).

Conclusions

This study is the first to characterise the sleep nurse workforce engaged in sleep health in Australia and New Zealand. Our findings show that the nurses working principally in clinical sleep practice have high experience levels and intend remaining in these positions. We propose that educational programs, creating clinical standards for sleep nurses and forging professional practice domains, would be beneficial.

目前，护士在睡眠健康方面广泛工作，管理有睡眠健康问题的人，其实践和角色描述很差，也不清楚。据我们所知，目前还没有全球数据，而且由于护士是最大的医疗保健劳动力，了解护士在睡眠健康方面的作用和做法非常重要。本研究的目的是了解澳大利亚和新西兰参与睡眠健康的护士的角色、实践和教育证书。方法对睡眠护理人员进行问卷调查，共35个问题。这项调查是通过澳大利亚睡眠协会进行的，该协会是澳大利亚和新西兰睡眠健康的最高科学和专业协会。数据分析采用描述性统计。结果共100名受试者(澳大利亚72%;新西兰(28%)完成了调查。大多数参与者的年龄在40到69岁之间，79%的人拥有学士学位或更高的学历，在睡眠健康方面有大约7年的经验，大多数在医院工作(55%)。护士花费大量时间直接护理病人;承担一系列睡眠相关的临床、科学和研究工作。经验越丰富的护士睡眠相关教育水平越高(p = 0.034)。这项研究首次描述了澳大利亚和新西兰从事睡眠健康的睡眠护士队伍。我们的研究结果表明，主要从事临床睡眠实践的护士具有较高的经验水平，并打算留在这些岗位上。我们建议教育项目，为睡眠护士制定临床标准和建立专业实践领域，将是有益的。

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引用次数: 0

Eating and drinking-related care for persons with advanced dementia in long-term care 长期护理中晚期痴呆患者的饮食相关护理

IF 1.5 4区医学 Q2 NURSING

Collegian

Pub Date : 2023-08-01 DOI: 10.1016/j.colegn.2023.03.005

Tim Luckett , Dimity Pond , Geoffrey Mitchell , Lynnette Chenoweth , Ingrid Amgarth-Duff , Domenica Disalvo , Jane Louise Phillips , Elizabeth Beattie , Patricia Mary Davidson , Georgina Luscombe , Stephen Goodall , Meera Agar

Background

Advanced dementia is a life-limiting illness that requires a palliative approach to care. Decline in eating/drinking represents a milestone in progression that warrants decision-making and planning of care. In long-term care (LTC), this is best conducted via family case conferences.

Aim

To explore decision-making and planning regarding eating/drinking-related care in case conferences for persons with advanced dementia in LTC to inform future practice.

Methods

A qualitative approach was taken, using observation of audio-recorded case conferences. Case conferences were conducted in 6 LTC facilities within the intervention arm of a cluster randomized controlled trial. Participants were LTC personnel, doctors, and families of persons with advanced dementia. Content was analysed for eating/drinking-related goals of care and the degree to which decision-making was shared.

Findings

Thirty-two case conferences considered eating/drinking-related care. The goals included nutrition, hydration, weight gain and maintenance, food enjoyment, social interaction, and independence. Key considerations included secondary health issues impacting comfort, and tensions between food enjoyment versus nutrition and risk of aspiration. While families contributed essential information about eating/drinking history, sometimes decision-making was dominated by professionals and overlooked overall goals of care.

Discussion

Shared decision-making regarding eating/drinking-related care for persons with advanced dementia in LTC should start with consensus on overall goals of care and include contributions to quality of life as well as risks. Family involvement should be supported beyond information-giving.

Conclusion

Future studies are needed to identify the most sensitive and understandable ways for families of discussing eating/drinking-related decline in dementia.

背景:晚期痴呆是一种限制生命的疾病，需要姑息治疗。饮食减少是进展中的一个里程碑，有必要对护理进行决策和规划。在长期护理(LTC)中，这最好通过家庭病例会议进行。目的探讨LTC晚期痴呆患者病例会议中饮食相关护理的决策和规划，为今后的实践提供参考。方法采用定性方法，对病例会议录音进行观察。病例会议在干预组的6个LTC设施中进行。参与者是LTC工作人员、医生和晚期痴呆患者的家属。分析了与饮食有关的护理目标的内容以及决策共享的程度。研究结果:32个病例会议考虑了饮食相关护理。这些目标包括营养、水合作用、体重增加和维持、食物享受、社会互动和独立性。主要考虑因素包括影响舒适度的次要健康问题、食物享受与营养之间的紧张关系以及吸入风险。虽然家庭提供了有关饮食史的重要信息，但有时决策由专业人员主导，忽视了护理的总体目标。讨论LTC晚期痴呆患者饮食相关护理的共同决策应始于对护理总体目标的共识，并包括对生活质量和风险的贡献。除了提供信息外，还应支持家庭参与。结论未来的研究需要确定最敏感和可理解的方式，让家庭讨论与饮食有关的痴呆下降。

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引用次数: 0