Nursing

The devastation of New Orleans after Hurricane Katrina increased the awareness of persons who were unable to self-evacuate because of physical and/or mental disabilities. From that awareness, plans emerged to provide a safe haven for those who had special needs. In this article, we describe our efforts as a school of nursing to shelter medical special needs (MSN) evacuees in the wake of a hurricane. After the shelter closed, faculty and students involved in the shelter answered a short survey that included both open- and close-ended questions. The responses are summarized to encourage other schools of nursing to consider caring for MSN evacuees and to share our successes, our failures, and our plans for the future.

... Therapet volunteer; the Trinity Mother Frances Health System; the nurses in the step-down open-heart-recovery unit at Mother Frances Hospital; the volunteers and therapy animals from Therapet Animal Assisted Therapy Foundation; Sue Ellen Thompson; and Debbie Waldrop. ...

BACKGROUND Nurses transitioning into the specialty of orthopaedics gradually develop the skills required to provide care for patients with musculoskeletal conditions or injuries, but during the early stages this can be challenging and lead to a lack of confidence. Strategies aimed at developing confidence in these nurses to make sound decisions and clinical judgements in their professional practice will assist in strengthening their practice and delivery of quality care. AIMS This study aimed to investigat if the delivery of an orthopaedic workshop improved the ongoing confidence of advanced beginner nurses, as recognised in Benner's exploration of skill acquisition, to undertake skills required to assess and manage patients with musculoskeletal injuries or conditions and assist in their decision making to achieve optimal patient outcomes. METHODOLOGY A quasi experimental pre-test, post-test study was chosen to measure nurses' confidence to undertake the scope of practice in orthopaedics at the advanced beginner level of expertise. METHODS A questionnaire was designed and administered to measure the level of confidence pre-intervention, immediately post intervention and twelve weeks following participation at an orthopaedic workshop. The workshop was designed specifically for nurses transitioning into the specialty of orthopaedics. FINDINGS The intervention had a positive impact on the confidence of advanced beginner nurses. The measurement prior to participation at the workshop indicated confidence levels were generally low. Immediately post participation the level of confidence had increased for all participants. When measured again at twelve weeks' post intervention the level of confidence had been maintained or continued to increase in the majority of orthopaedic practice areas. The overall level of confidence between pre-interven tion to twelve weeks post intervention demonstrated a clear improvement in all areas of practice. CONCLUSION It was evident that nurses transitioning into the speciality of orthopaedics had lower confidence levels in relation to specialty-specific skills and knowledge. The use of an education workshop improved the confidence of nurses, not only immediately post intervention, but also in the longer term. Supporting a pathway to transition in the specialty which includes specific education delivered at key times is recommended as it could beneficial to advanced beginner nurses, the specialty, patients and the profession.

Little empirical research exists on how best to teach fundamentals of care to prelicensure nursing students. This pilot aims to develop this evidence base. A 6-week intervention embedded fundamentals of care explicitly, focusing on the integrated nature of such care, within a first-year prelicensure nursing curriculum at an Australian university. The intervention involved two components: (a) using the fundamentals of care framework to structure and guide teaching and shape students' conceptual understanding of the fundamentals of care, and (b) restructuring clinical skills sessions to reinforce this conceptual understanding. Preliminary observations show that the intervention offers a practical and effective way to teach the fundamentals of care to prelicensure students, helping them to see the value of the fundamentals of care and to provide quality care for patients' fundamental needs. Explicitly embedding the fundamentals of care within accredited nursing curricula is fea...

A major goal of care for orthopaedic surgical patients is the achievement of their pre-morbid functional level or at least an improvement of their functional ability. However, patients with altered mental status can significantly impact this and other outcomes and influence the delivery of care. Patient mobilisation is a role shared by both nurses and physiotherapists. To enhance the understanding of nurses and physiotherapists' experience in mobilising postoperative orthopaedic patients with altered mental status. Three nurses and three physiotherapists were recruited using purposive sampling. Data was collected through interviews and analysed using Burnard's 14 stages of thematic content analysis. Four main categories emerged from the study: altruism, interprofessional specialist practice, patient dynamics and challenges. Nurses and physiotherapists' experience have more similarities than differences under the four categories. Nurses and physiotherapists experience num...

This paper reports on workplace violence, self-reported as part of a survey among members of the Queensland Nurses' Union (QNU) in October 2001. The aim of the overall study was to ascertain how nurses perceived their work and their working conditions and to use the ...

The overall objective of this study was to document the nature of the chemotherapy nursing practice of rural and remote area nurses in Queensland. A questionnaire survey that elicited descriptive quantitative and qualitative data. Forty-seven rural and remote area health facilities in Queensland involved in the administration of chemotherapy. Sixty-seven Queensland rural and remote area nurses involved in the administration of cytotoxic drugs. Characteristics of chemotherapy practice including context of practice, amount and type of chemotherapy administered, logistical problems, level of support from referral centres, policies and procedures, safety issues. The results indicate that the risks to nursing staff and the potential for poor patient outcomes are higher than in specialist chemotherapy facilities. This is largely due to the human and material resource constraints characteristic of rural practice. These include a lack of understanding on the part of metropolitan-based health departments and the specialist cancer centres that refer patients to rural areas of the constraints that may adversely influence patient outcomes. It is essential that steps are taken to ensure that rural and remote area cancer patients have equitable access to safe and competent chemotherapy care delivered in their choice of context, and the results of this study provide guidance on ways that this can be achieved.

Background  Residents of aged care facilities usually have a large number of oral health problems. Residents who suffer from dementia are at particular risk. A systematic review of the best available evidence with regard to maintaining the oral health of older people with dementia in residential aged care facilities provided a number of recommendations. Objectives  The aim of the implementation project was to introduce evidence-based oral hygiene practices for patients with dementia in two publicly funded residential aged care facilities and monitor for changes in nursing awareness, knowledge, documentation and practice to improve patient outcomes and ensure appropriate accreditation standards were met. An additional aim was to identify barriers and strategies to overcome barriers to implementation of evidence-based recommendations. Methods  Two facilities, a 40-bed facility and a 71-bed facility in the health service district of the regional Australian city of Toowoomba, provided the setting. A quality improvement approach was taken, using a number of strategies from the National Health and Medical Research Council guidelines for implementation studies. The implementation involved a number of stages, including project development, interactive oral health education, oral audits of residents, changes to oral hygiene practice via care plans and critical reflection. Results  The multidisciplinary approach to improving oral healthcare appeared to improve knowledge and awareness and move oral health practices in facilities closer to best practice. Specialised training in oral health was provided to a Clinical Nurse Consultant. Regular oral audits were introduced and facility staff were trained in the use of the oral audit tool. Care plans at one facility were of better quality and more comprehensive than before the intervention. Comments made during critical reflection suggested improvements in the oral health of residents, increased use of oral swabs and saliva substitutes, improved care of dentures and mention of the use of mouth props in resident care plans. There was also some evidence that changes brought about by the implementation are sustainable. Conclusion  The majority of recommendations provided in the systematic review of oral healthcare for dementia patients were applicable to the applied context. The importance of day-to-day leaders was highlighted by the apparently varied outcomes across target facilities. The quality improvement approach would appear to have considerable advantages when applied to improving practice in residential aged care.