Contemporary nurse最新文献

Background: Hypokalemia is a frequently occurring electrolyte disorder in hospital patients and is often treated with intravenous (IV) potassium replacement. In Australia, most hospital departments use IV potassium replacement therapies, which are known anecdotally to cause pain. To our knowledge, there have been no studies on Australian clinicians' practices in managing IV potassium replacement.

Aims: To investigate the management of IV potassium infusions by clinical staff in a regional Local Health District in New South Wales, Australia.

Methods: An interprofessional team of clinicians was formed and utilised the Plan-Do-Study-Act (PDSA) cycle. An online case-based survey was created to collect infusion management issues from clinicians' perspectives. The survey utilised a fictional case study with multiple-choice questions. It aimed to investigate clinicians' self-reported clinical practice behaviours when managing potassium infusions, which were analysed descriptively. Data from open-ended questions about managing potassium infusion pain were analysed using inductive content analysis.

Results: The study found that clinicians (n = 177) manage IV replacement, with two-thirds reporting multiple weekly instances. Clinicians observed that patients report pain during infusions. Factors such as potassium concentration (n = 130), patient anxiety (n = 118), peripheral administration (n = 109) and cannula sites in the lower arm (n = 102) were reported as pain risk factors. Clinicians reported using various strategies to manage infusion pain, including slowing the infusion, simple pain relievers, and topical applications. Severe potassium deficiency was a barrier to managing pain. Clinicians felt the management of pain to be challenging both clinically and ethically. Survey comments also suggest that IV potassium may be overused, presenting an opportunity for future improvement.

Conclusion: The PDSA cycle structured the quality improvement initiative. This research explores how clinicians manage IV potassium infusions. Our findings uncover how frequently clinicians manage pain caused by IV potassium infusions, an area that is not well-documented. Further research is needed for pain management strategies.

Background: The COVID-19 pandemic has abruptly enforced the adoption of online learning approaches in nursing education, which have placed both students and educators under various challenges such as student academic achievement, reduced curricular completion, reduced teacher-student interaction, and decreased information retention.

Aim: This study aimed to explore the engagement, satisfaction, and motivation in online and hybrid learning environments among Lebanese and Turkish nursing students.

Methods: A sample of 650 Lebanese and 654 Turkish nursing students took part in this study. A quantitative cross-sectional research design was adopted.

Results: The results of independent T-tests showed that Lebanese students scored significantly higher on the level of self-efficacy (5.49 ± .098), yet Turkish students scored higher on the level of distance learning satisfaction with connectivity (3.40 ± 0.72). The regression analysis showed that higher motivation (p < 0.001), lower satisfaction (p < 0.001), and the type of education (p = 0.001) were predictors of higher engagement. The effect of nationality on these outcomes needs to be further investigated, as the comparison showed association only in two subscales.

Conclusion: This implies that nurse educators are encouraged to investigate the factors that increase nursing student satisfaction thus to increase their engagement. This research encourages further educational and psychological research among nursing students to explore the factors and predictors of academic achievement in online and hybrid learning environments.

Background: Continuity of Care Experience is a mandated inclusion in all Australian degrees leading to registration as a midwife.

Aim: Translating the objectives and learning outcomes of the midwifery student Continuity of Care Experience learning model into practice via an infographic.

Design: Underpinned by an Appreciative Inquiry approach, this process used a strengths-based approach to engage participants to develop the design of an infographic.

Method: Participants were Australian midwives working in a healthcare clinical or academic setting and were invited to provide feedback via an online survey on the design elements to inform the development of an infographic.

Results: An expert midwifery panel included 11 participants representing midwives in clinical practice and academic positions. Content analysis of the survey identified strengths such as flow and visual appeal and what design elements needed improvement to enhance the sense-making of the infographic.

Discussion: This study describes a process that engages participants meaningfully to contribute to how research findings are communicated. The process used in this study engaged participants meaningfully to develop an infographic for the midwifery student Continuity of Care Experience. This infographic provides a visual representation of learning objectives and outcomes for this learning model to aid translation into practice.

Conclusion: Infographics are an effective tool in education and healthcare settings. Engaging participants in how an infographic is depicted can enhance the translation of learning outcomes and objectives of the midwifery student Continuity of Care Experience in education settings.

Background: The development of First Nations nurses and midwives is crucial to addressing health inequities stemming from systemic injustices. However, this workforce is significantly underrepresented globally. Understanding the reasons for this underrepresentation and identifying key challenges and opportunities for leadership is necessary.

Aim: This scoping review aimed to explore the challenges and opportunities in leadership development of First Nations nursing and midwifery professionals internationally.

Design: A scoping review was conducted following the framework developed by Arksey and O'Malley (2005).

Data sources: Six databases including PubMed, CINAHL, Scopus, PsychInfo, Proquest and Australian Indigenous HealthInfoNet were searched.

Methods: The search was performed on 30 January 2024. Items were included if the research focus was on First Nations nursing and midwifery leadership. Full texts were then thematically analysed for overarching themes, and extracted data was charted. After charting, key findings were reviewed, and emerging themes were grouped into common categories.

Results: The scoping review identified a paucity in the contemporary literature, with only ten articles retrieved. Analysis revealed five main theses: (1) systemic injustices impacting leadership opportunities, (2) complex responsibilities beyond typical roles, (3) underrepresentation in leadership positions, (4) shifting from colonial leadership models and (5) effective methods for leadership development. Opportunities identified included promoting equitable leadership, fostering integrated relationships, building cultural resilience and emphasising community-orientated leadership approaches.

Conclusion: Promoting adequate representation and developing culturally safe leadership models are essential steps towards empowering First Nations nurses and midwives in their leadership development. The study highlights the need for targeted leadership development strategies for First Nations nurses and midwives to enhance representation and impact within healthcare systems globally.

Background: Climate-fuelled disasters are increasing in frequency and duration, with impacts known to disproportionately affect vulnerable populations, such as perinatal women and young families. Local healthcare workforce engagement into planning responses is required to ensure improved healthcare for these populations. One important component of perinatal care in Australia occurs through the maternal and child health nurses (MCHN). Attempted research engagement with the maternal child health nurse sector regarding the impact of disasters on the care of perinatal women during times of disaster has encountered structural barriers.

Aim: To understand the structural barriers that impact the research engagement of rural MCHN particularly during times of disasters.

Methods: A facilitated focus group with semi-structured questions was conducted with five participant-researchers. The focus group discussion underwent reflexive thematic analysis.

Results: Identified themes were Rationale for Research into Care of Families in the Perinatal Period, Perinatal Health and Service Provision and The Overlay of Disasters. An overarching fourth theme Implications for future Research identified elements that may improve the research engagement of primary healthcare staff, including MCHN.

Conclusion: There is a need to overcome structural challenges to MCHN engagement in meaningful research around the impacts of multiple disasters. Appropriate research design, including utilising co-design, adequate resourcing, and planned and considered participant communication may help to improve participant engagement for this important research. With improved sector engagement, the ongoing care of perinatal women in the current environment of multiple and compounding climate-fuelled disasters will be improved.

Nurses' important role in cancer treatment shows the need to explore their experiences caring for older adults with cancer, an area where previous research has identified a research gap.

This review aimed to synthesize the existing qualitative findings on nurses' experiences of caring for older adults with cancer.

Meta-synthesis.

A systematic search of four electronic databases was conducted using relevant keywords, from January 2000 to April 2024, with an update in July 2024.

A meta-synthesis using thematic analysis was employed to integrate the primary qualitative findings. The reporting of this review adhered to the ENTREQ guidelines.

Four analytical themes emerged: (1) unpacking the emotional and psychological toll, (2) facilitating effective connections with patients, (3) addressing practical and logistical challenges, and (4) navigating role dynamics in cancer care.

This meta-synthesis identified the need of prioritizing nurses' emotional, psychological, and practical well-being in cancer care, particularly when caring for older adults. By acknowledging and addressing the emotional and psychological strain, fostering meaningful patient connections, managing practical challenges, and navigating role dynamics, healthcare systems can enhance the quality of care for older cancer patients and support the well-being of nurses in this critical role.

Background: The rapid growth of artificial intelligence in healthcare is transforming how nurses deliver care and make clinical decisions. From supporting diagnostics to providing virtual health assistants, artificial intelligence offers new ways to enhance patient outcomes and streamline healthcare processes. However, these advancements also bring challenges, particularly around ethics, potential biases, and ensuring technology complements rather than replaces human expertise.

Methods: A discussion paper designed to break down key artificial intelligence terms and demonstrate real-world applications to guide nurses to develop the skills needed to navigate this evolving technological landscape.

Findings: This discussion emphasises the importance of maintaining the critical role of human clinical judgment, highlighting that artificial intelligence should support nurses' expertise rather than diminish it. The need for continuous education to keep nurses equipped with the knowledge to effectively integrate artificial intelligence into their practice is argued. With an inclusive approach, artificial intelligence has the potential to become a powerful tool that supports nurses in improving patient care while preserving the essential human touch in healthcare.

Background: Our understanding of how nursing and midwifery students in Australia are prepared to support people in unintended pregnancy prevention and care is currently limited.

Objective: This study examined Australian nursing and midwifery students and recent graduates' perspectives on their preparation and confidence in providing unintended pregnancy prevention and care.

Methods: A descriptive, cross-sectional online survey of nursing and midwifery students and graduates was undertaken. An invitation email with information sheet and link to the survey was sent to heads of departments at Australian universities for distribution to nursing and midwifery students. Social media platforms of professional organisations were used to promote the study to nurses and midwives within two years of graduation. The survey instrument was based on US educational competencies for unintended pregnancy prevention and care, adapted for the Australian context.

Results: Participants (N = 109) from 14 institutions completed the survey. The majority of (92%) expressed that nursing and midwifery graduates should possess unintended pregnancy prevention and care knowledge and skills. Five competencies, out of 29, were identified as taught as core curriculum by 50% or more of participants; reproductive anatomy and physiology (72%); effective communication skills encompassing culture, sexual orientation, and gender identity (58%), understanding how contraceptives work (54%), obtaining a sexual/reproductive history (53%), and identifying preconception health risks (50%). Students felt well prepared to provide independent care related to pregnancy testing (44%), pregnancy prevention (26%), sexual history taking (23%), ethical/legal considerations around abortion (9%), options counseling/referral (5%), and pre/post-abortion care (5%).

Conclusion: With the decriminalization of abortion care, the Australian nursing and midwifery workforce must prepare students to care for people in all aspects of pregnancy prevention, early pregnancy decision-making, and abortion services. Our data show students are interested in this preparation but the entry-to-practice curricula has not yet been standardized to enable this.

Background: Indigenous Australians are disproportionately affected by diabetes, with a diagnosis rate nearly four times higher than people from a non-Indigenous background. This health disparity highlights the urgent need for healthcare providers to develop cultural empathy - a critical competency for delivering culturally safe and person-centered care. Cultural empathy is essential for building trust and effective communication in diabetes education and management within Indigenous people. However, there is a significant gap in targeted interventions to enhance this skill among healthcare providers.Aims: The aim of this study was to evaluate the effectiveness of a digital storytelling intervention for enhancing cultural empathy levels of postgraduate diabetes education students.Design: This study has a pre-post survey design to measure changes in participants' cultural empathy levels after exposure to a digital story.Methods: Students enrolled in a postgraduate diabetes education course at an Australian university were eligible to participate. The intervention included a first-person digital story about an Indigenous man with type 2 diabetes, accompanied by group-based discussions and self-reflection. The Comprehensive State Empathy Scale was utilised to assess empathy levels.Results: A total of 98 students completed both pre- and post-intervention surveys. There was a statistically significant increase in mean Comprehensive State Empathy Scale scores post-intervention (p < 0.001), indicating higher empathy levels. Improvements were observed across all six Comprehensive State Empathy Scale subscales, suggesting a multidimensional impact of the intervention.Conclusions: The digital story intervention significantly enhanced the cultural empathy levels of postgraduate diabetes education students. This study contributes to the evidence base for narrative-based pedagogies in cultivating empathy among healthcare providers. The findings highlight the potential of digital storytelling as a tool for improving cultural competency in healthcare education and practice, ultimately contributing to more empathic care for Indigenous people with diabetes.