Contemporary Nurse最新文献

The purpose of this paper is to provide discourse regarding awareness of institutional racism, from a non-Indigenous, Australian nursing student's perspective. The discussion has a focus on the presence of institutional racism in the Australian healthcare system, its impact on the health of First Nation Peoples and a commitment to ensuring culturally safe practice. It will be argued that institutional racism is pervasive in healthcare as a consequence of three factors: exclusion of First Nations Peoples from governance roles, inherent racism impacting on socio-cultural treatment bias, and institutional racism influencing key relationships in healthcare delivery.

Background: Healthcare work is one of the most accident-prone occupations globally. Nurses, especially those who work in Intensive Care Units (ICU), are very likely to experience mishaps on the job due to the complicated duties they perform. Safety performance through compliance and participation in safety is a proactive approach and a critical tool to measure the protection of employees, like these, in the workplace. Although interest in this tool has increased among hospital administrators and managers, scientific research has been limited in this area.

Aims: The study's purposes were twofold: (1) to explore the effect of perceived respect safety on the safety performance of ICU nurses and (2) to explore the mediation effect of Management Commitment to Safety (MCS) between the relationship of perceived respect safety and safety performance.

Methods: Eight public hospitals from the Jordanian Ministry of Health (JMoH) were selected randomly using cluster sampling, and their ICU nurses were surveyed. A total of 285 nurses completed questionnaires. The SmartPLS3 bootstrapping technique was used to analyse data.

Results: The results established that the perceived respect for the safety of nurses has a significant and positive effect on their safety compliance (β = .39, p < .01) and safety participation (β = .34, p < .01), and that MCS mediated these associations.

Conclusion: The findings support the importance of developing and maintaining a culture of respect between management and employees, especially in terms of perceived respect for safety issues, and that culture will improve safety performance. The study explains the role of an active MCS, which contributes to understanding the research model fully. Practical implications for improving workplace safety also are added.

Impact statement: Recognition of the study's findings by healthcare organisation managers would improve ICU nurses' safety and ultimately decrease undesirable outcomes.

Background: Misconceptions about men in nursing may influence recruitment and retention, further perpetuating the gender diversity imbalance in the nursing workforce. Identifying misconceptions and implementing early intervention strategies to address these deep-rooted stereotypes remain challenging but is considered critical to support students who are commencing a nursing career.

Objective: To develop and evaluate the psychometric properties of the 'Gender Misconceptions of meN in nursIng (GEMINI) Scale.

Design: Cross-sectional survey.

Methods: Pre-registration nursing students enrolled in undergraduate nursing programmes across 16 nursing institutions in Australia were surveyed from July to September 2021. The 17-item self-report GEMINI Scale measured the gender misconceptions of men in nursing.

Results: Of the 1410 completed surveys, data from 683 (45%) women were used for exploratory factor analysis showing a one factor structure, while data from 727 men (47%) were used for confirmatory factor analysis of the 17-item GEMINI Scale, which showed a good model fit. The scale demonstrated high internal consistency (Cronbach's alpha of 0.892). Men were found to have higher gender misconceptions (p < 0.001) while respondents who: (a) identified nursing as their first career choice (p = 0.002); (b) were in their final year of programme enrolment (p = 0.016); and (c) engaged in health-related paid work (p = 0.002) had lower gender misconceptions.

Conclusion: The GEMINI Scale is a robust, valid, reliable, and easy to administer tool to assess misconceptions about men in nursing, which may potentially influence academic performance and retention. Identifying and addressing specific elements of misconceptions could inform targeted strategies to support retention and decrease attrition among these students.

Impact statement: Genderism harms nursing, as well as the men and women working in the profession. Recruitment and retention of men into nursing is needed to cultivate male role models and diversify the workforce, however this is impeded by negative portrayals in popular culture and misconceptions entrenched in society.

Aim: To evaluate the relationship between nursing assessment findings at discharge and acute ischaemic stroke (AIS) patient prognosis after mechanical thrombectomy (MT).

Methods: We analysed the characteristics of 144 AIS patients with MT treatment admitted to a university affiliated teaching hospital in Chengdu, Sichuan Province China, from January 2020 to December 2020. The modified Rankin Scale (mRS) score was used to assess outcomes 90-days after discharge. Exploratory analyses were undertaken using IBM SPSS Statistics (Version 26.0).

Results: At 90-days, 47.9% (n = 69) had a good prognosis (mRS ≤ 2) including 22.2% (n = 32) fully recovered patients. There were 5 (3.5%) deceased patients and 48.6% (n  = 70) of patients had a poor prognosis (mRS ≥ 3). In univariate analysis, clinical prognosis correlated with the need for inpatient endotracheal intubation (p = 0.02), nasogastric tube (p < 0.001), indwelling urinary catheter (p < 0.001), central venous catheter (p = 0.03), health knowledge needs of pressure injury prevention (p = 0.03), National Institute of Health Stroke Scale (NIHSS) score (p < 0.001) and Activities of Daily Living (ADL) score (p < 0.001) at the time of discharge from hospital. The average hospitalization time of the 144 patients was 12[IQR, 9-25] days, and the average cost of hospitalization was $Y$21291.93 (SD 9165.01).

Conclusion: Almost half of the surviving patients had a poor prognosis. In our country, this surgery and rehabilitation impose a significant financial burden that needs to be addressed. However, the longer length of hospital stay and higher costs at discharge may be contributing factors to worse outcomes. The outcomes of comprehensive nursing assessment of the patients, including nursing needs, activities of daily living, and neurological function, can predict their outcome.

Impact statement: We recommend a comprehensive nursing assessment at discharge that predicts patient outcomes and can be used for subsequent targeted interventions. The prognosis of patients with acute ischaemic stroke after mechanical thrombectomy is poor, and the financial burden needs to be considered.

Objectives: Vital signs assessment is a critical component of acute clinical care. Despite this, research has consistently found that the assessment of these signs is often neglected in clinical practice. This paper highlights three recent cases reported in the media where the neglect of vital signs assessment resulted in patient mortality.Results: Recent media reports highlighted the potentially devastating consequences of vital signs not being rigorously assessed, including avoidable death. The public needs to be confident they will receive safe, quality health care when they are admitted to hospital.Conclusion: The neglect of vital signs assessment places patients at risk of poor outcomes. Early detection of clinical deterioration via the assessment of vital signs facilitates prompt medical intervention. Factors contributing to the neglect of vital signs assessment need to be identified and corrective action is taken to improve the safety of clinical care.

Background: In the transitional period following registration, newly qualified nurses may feel socially isolated and easily overwhelmed by increases in accountability, workplace pressures and the psychological demands of the role. Such experiences place them at risk of burnout and leaving the profession.

Aims: To explore newly qualified nurses' support needs and their experiences of an online peer support intervention.

Method: Eighteen newly qualified nurses participated in online peer support groups. After 3 months participants took part in interviews exploring their support needs and experiences of the groups. Eight one-to one interviews were conducted between October 2019 and January 2020. Qualitative thematic analysis was used.

Findings: Two themes identified were; "The Support needs of newly qualified nurses" with two subthemes, "The role of the newly qualified nurse" and "Unmet support needs"; "The online experience" with three subthemes, "Barriers to participation", "Anticipated benefits" and "Unmet expectations".

Conclusion: Our findings suggested that there is insufficient support for newly qualified nurses. The newly qualified nurses wanted to use online support to help manage their stress. However, the organisation of online peer support needs careful consideration to ensure participation can be beneficial.

Impact statement: Online support requires careful design and clear support from employing organisations to promote improved transition experiences. Further research should focus on evaluating adjusted online support interventions.

Purpose: To validate a vision-screening tool for use by nurses and other non-eye care health practitioners (NECHP) to aid identification of visual deficits and ocular conditions in stroke survivors.Material and Methods: Stroke survivors were recruited from two metropolitan Sydney public hospitals who had no access to on-site eye care professionals. Those admitted for 3 days and who were able to provide clear responses were randomly allocated into two groups. All were assessed by a NECHP using a purposely designed bedside vision-screening tool to assess their visual function. In Group 1, the orthoptist repeated the assessment with the same vision-screening tool, in Group 2 they performed a comprehensive orthoptic assessment. Levels of agreement and sensitivity and specificity for key outcomes were assessed.Findings: Levels of agreement for most items analyzed for Group 1 reached 80%. Comparison of the screening tool to a comprehensive orthoptist assessment (Group 2), demonstrated high (88.57-91.12%) sensitivity and specificity for detecting pre-existing and acquired visual problems.Conclusion: The vision-screening tool is a valid instrument for use by NECHP, for the detection of vision defects in stroke survivors. Improved detection of eye conditions may facilitate timely identification and management of visual conditions in stroke survivors, potentially improving patient care and rehabilitation outcomes.

Background: The enrolled nurse is the second-level regulated nursing role in Australia and internationally. Reports and research indicate that the nursing profession requires greater understanding of the role, so it can be utilised to its potential.

Aim: To explore issues that may impact the EN role in the Australian nursing workforce.

Design: An integrative review.

Methods: A seven-step framework was used to review scholarly papers, government documents, and grey literature.

Results: Three themes from 24 documents were identified: understanding the EN's scope of practice, standardised practice, and career development.

Discussion: A lack of understanding of their scope of practice creates role confusion and a lack of standardised practice, with an expected progression to become a registered nurse. These factors contribute to ENs' not feeling valued.

Conclusion: The nursing profession do not understand the enrolled nurse role, and further work is required to value its place in the Australian nursing workforce.

Background: Introduction of mental health service users and their family within undergraduate health profession courses has become routine in many curriculums. Few studies have explored the expectations and perceptions of such presenters.

Objectives: This study reports the perceptions of nine carers and consumers in a regional Australian University.

Design: A descriptive design was utilised. Participants were recruited via a consumer and carer support group. A semi-structured interview and thematic analysis of the data were used to generate themes.

Findings: The analysis identified six common themes that addressed personal benefits, an imperative to increase the awareness of others, a desire to do something worthwhile, personal changing of perspectives, expectations of the presentation role and characteristics of the presenter. Several points of difference between presenters and non-presenters and issues relating to rural and regional settings were identified.

Conclusions: These findings suggest that in rural and regional areas participation is more likely when life circumstances exhibit employment stability as some feel threatened by stigma. The theme of 'expectations' adds to current knowledge, with presenter's expectations often being exceeded in terms of student attitudes across different study programs.