Introduction: Northern Thailand has a distinct culture and set of health beliefs. Nurses’ beliefs... more Introduction: Northern Thailand has a distinct culture and set of health beliefs. Nurses’ beliefs influence approaches to care affecting health care outcomes. This study explored the content, origin, and sociocultural influences on health beliefs of Northern Thai nurses and how they influence clinical practice and education. Method: Q-methodology was used in this study. Data were collected with interviews using Q-cards, Q-sort distribution board, and a semistructured interview guide. Results: Data were collected from 30 clinical nurses and 30 nurses working in academia. Q-factor analysis produced three factors accounting for 48% of variance: personal experience, Thai and Buddhist beliefs, and contemporary beliefs. Discussion: Participants who felt strongly rooted in their culture and beliefs were homogeneous in recognizing the need for evidence-based practice. Nurses aware of the nature and sources of their beliefs and those of patients are well-placed to balance maintenance of cult...
Background: Older people who present to the Emergency Department (ED) experience high rates of pr... more Background: Older people who present to the Emergency Department (ED) experience high rates of prevalent and incident delirium. This study aimed to determine whether an assistant workforce in the ED could effectively conduct screening to inform assessment and care planning for older people as well as enhance supportive care activities for prevention of delirium. Methods: Using a pre-post design, data was collected before and after the introduction of Older Person Technical Assistants (OPTAs) in the ED. OPTA activity was recorded during the intervention period and a medical record audit undertaken prior to and 9 months after implementation. Data were analysed using descriptive statistics for OPTA activities. Weighted Kappa scores were calculated comparing concordance in screening scores between OPTAs and Aged Services Emergency Team Registered Nurses. Changes in the rates of documented screening and supportive care were analysed using Chi-square tests. Focus groups were conducted to explore clinicians' experiences of the OPTA role. Results: Three thousand five hundred fourty two people were seen by OPTAs in 4563 ED Presentations between 1st July 2011 and 2012. The reproducibility of all screening tools were found to be high between the OPTAs and the RNs, with Kappas and ICCs generally all above 0.9. The medical record audit showed significant improvement in the rates of documented screening, including cognition from 1.5 to 38% (p < 0.001) and review of pain from 29 to 75% (p < 0.001). Supportive care such as being given fluids or food also improved from 13 to 49% (p < 0.001) and pressure care from 4.8 to 30% (p < 0.001). This was accomplished with no increase in ED length of stay among this age group. Focus group interviews described mixed responses and support for the OPTA role. Conclusions: An assistant workforce in an ED setting was found to provide comparable screening results and improve the rates of documented screening and supportive care provided to older people with or at risk of developing delirium in the ED. There is a need for a shared philosophy to the care of older people in the ED.
The purpose of this research was to replicate a study undertaken with different cohorts of client... more The purpose of this research was to replicate a study undertaken with different cohorts of clients and their caregivers in both Australia and the United States of America (USA). The researcher wanted to establish better local information, through the use of a survey, about the needs of informal caregivers who provide physical and emotional care, rehabilitation and supervision of treatments for patients with Chronic Obstructive Pulmonary Disease (COPD), at home. Contemporary feedback about what caregivers perceive as critical to their ability to provide care in the home environment was identified. Health services, particularly professionals such as nurses within those services, need to respond appropriately to these needs.
The human ability to make inferences about the minds of conspecifics is remarkable. The majority ... more The human ability to make inferences about the minds of conspecifics is remarkable. The majority of work in this area focuses on mental state representation (‘theory of mind’), but has had limited success in explaining individual differences in this ability, and is characterized by the lack of a theoretical framework that can account for variability in the population of minds to which individuals are exposed. We draw analogies between faces and minds as complex social stimuli, and suggest that theoretical and empirical progress on understanding the mechanisms underlying mind representation can be achieved by adopting a ‘Mind-space’ framework; that minds, like faces, are represented as vectors in a multidimensional psychological space. This Mind-space framework can accommodate the representation of whole cognitive systems, and may help to explain individual differences in the consistency and accuracy with which the mental states of others are inferred. Mind-space may also have releva...
An observational study was conducted to examine the use of sun protective hats, clothing, and sun... more An observational study was conducted to examine the use of sun protective hats, clothing, and sunglasses of people attending an outdoor entertainment event in an area of high-to-extreme ultraviolet radiation in New South Wales, Australia. Armidale is unique, as it is a highly-elevated area, almost 1000 m above sea level, and temperatures are often mild with very high-to-extreme levels of ultraviolet radiation. Four trained data collectors observed attendees as they entered the event, and recorded their use of sun protective hats, clothing, and sunglasses. While more than half of the attendees wore sun protective hats, only 14% wore sun protective clothing. Broad-brimmed hats were considered sun protective, while sun protective clothing was defined by shirts with at least three-quarter-length sleeves. Females were more likely to wear both a sun protective hat and clothing than males, and children were less protected than adults. Legislative changes are required to ensure that organiz...
Clinical Leaders drive healthcare performance in the provision of safe high quality patient care ... more Clinical Leaders drive healthcare performance in the provision of safe high quality patient care by influencing others and augmenting change. Clinical leadership features strongly in Nurse Consultant (NC) roles and holds potential to strengthen the NC's place in healthcare teams, making their contribution as clinical leaders more recognisable. This study explores how clinical leadership is enacted through the NC role, providing understanding of the elements that influence their effectiveness as clinical leaders. This paper presents qualitative findings from a larger sequential mixed method study conducted in a large Local Health District in New South Wales, Australia. Focus groups were held with NCs, managers and other stakeholders from a variety of context including acute, primary and community care settings across metropolitan and rural locations. An online discussion forum was provided for NCs unable to attend focus groups. Transcript data were analysed using iterative themin...
Australian health review : a publication of the Australian Hospital Association, 2018
To compare annual costs of an intervention for acutely unwell older residents in residential age ... more To compare annual costs of an intervention for acutely unwell older residents in residential age care facilities (RACFs) with usual care. The intervention, the Aged Care Emergency (ACE) program, includes telephone clinical support aimed to reduce avoidable emergency department (ED) presentations by RACF residents.This costing of the ACE intervention examines the perspective of service providers: RACFs, Hunter Medicare Local, the Ambulance Service of New South Wales, and EDs in the Hunter New England Local Health District. ACE was implemented in 69 RACFs in the Hunter region of NSW, Australia. Analysis used 14 weeks of ACE and ED service data (June-September 2014). The main outcome measure was the net cost and saving from ACE compared with usual care. It is based on the opportunity cost of implementing ACE and the opportunity savings of ED presentations avoided.Our analysis estimated that 981 avoided ED presentations could be attributed to ACE annually. Compared with usual care, ACE ...
Aim: This study aimed to explore the work roles, major tasks and core activities of advanced prac... more Aim: This study aimed to explore the work roles, major tasks and core activities of advanced practice dietitians in Australia to define the Competency Standards for advanced practice. Methods: A qualitative approach was used to review advanced dietetic practice in Australia involving experienced professionals, mostly dietitians. Four focus groups were conducted with a total of 17 participants and an average of 20 years experience: 15 dietitian practitioners plus 2 employers (1 dietitian and 1 non-dietitian). The focus groups explored the key purpose, roles and outcomes of these practitioners. Data from the focus groups were confirmed with in-depth interviews about their core activities with a purposive sample of 10 individuals recently recognised as Advanced Accredited Practising Dietitians. Data from both focus groups and interviews were analysed adductively to identify key themes. Results: The key theme that emerged to define advanced dietetics practice was leadership, with four subthemes that described in more detail the major work roles and outcomes of advanced practice. These subthemes identified that advanced practitioners were (i) outcome-focused, having impact; (ii) influence others and advocate; (iii) innovate and embrace change; and (iv) inspire others and are recognised for their practice. These outcomes were conceptualised within a broad generalist framework to generate revised Competency Standards. Conclusions: This study confirmed that leadership rather than specialist practice skills is the key determinant of advanced practice.
Background: There is a direct link between job satisfaction, nurses' job performance and improved... more Background: There is a direct link between job satisfaction, nurses' job performance and improved patient outcomes. Understanding what job characteristics influence job satisfaction is vital if health organizations are to optimize individual employee satisfaction and performance. This is particularly necessary in the Nurse Consultant role, which is a multifaceted role that has evolved to meet the dynamic and changing needs of health services. This study aims to examine how job characteristics influence Nurse Consultant job satisfaction and identify differences across metropolitan and rural contexts. Methods: This paper presents quantitative findings that are part of a larger prospective cross sectional mixed method study. An online survey consisting of a variety of job characteristic factors was administered to all NCs working in a large Local Health District in New South Wales, Australia over an 8-week period in 2010. Descriptive analysis identified NC's perceptions of job satisfaction and job characteristics in their current role and factor and regression analysis identified relationships between these factors. Results: Job satisfaction was identified as high (mean 4.3) and is strongly correlated with job autonomy, role clarity, role conflict and job support. A high level of role clarity has a moderating effect on the relationship between job autonomy and job satisfaction. Conclusions: Study findings inform how we prepare nurses for the NC role and how managers engage with and support NCs in their role taking into account context. Understanding the factors that influence job satisfaction and role effectiveness gives managers valuable information to assist in positioning and supporting these roles to maximize effectiveness across integrated and contemporary models of health care delivery.
Older people living in Residential Aged Care Facilities (RACF) are a vulnerable, frail and comple... more Older people living in Residential Aged Care Facilities (RACF) are a vulnerable, frail and complex population. They are more likely than people who reside in the community to become acutely unwell, present to the Emergency Department (ED) and require admission to hospital. For many, hospitalisation carries with it risks. Importantly, evidence suggests that some admissions are avoidable. A new collaborative model of care, the Aged Care Emergency Service (ACE), was developed to provide clinical support to nurses in the RACFs, allowing residents to be managed in place and avoid transfer to the ED. This paper examines the effects of the ACE service on RACF residents' transfer to hospital using a controlled pre-post design. Four intervention RACFs were matched with eight control RACFs based on number of total beds, dementia specific beds, and ratio of high to low care beds in Newcastle, Australia, between March and November 2011. The intervention consisted of a clinical care manual t...
This study aimed to establish the scale of alcohol-related injuries originating in the home. Desp... more This study aimed to establish the scale of alcohol-related injuries originating in the home. Despite recent media and public attention on alcohol-related injuries occurring at licensed venues, many occur in other locations including the home. A retrospective observational study. Emergency department surveillance data sourced from the Queensland Injury Surveillance Unit were interrogated for alcohol-related emergency department presentations from 2003-2012 (n = 12,296). Descriptive analysis was undertaken to assess alcohol involvement in injury, and analysis of variance was used to determine the differences among group means and their associated presentations. The relationship between demographic variables and injury location was assessed using p value of &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;0·05 as statistically significant. Of all injuries that were positively identified as being alcohol related, 41·07% occurred at the &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;other&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; location, 36·14% &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;at home&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;, 13·00% on the street and 9·78% at licensed premises. Of these, males (n = 2635; 59%) represented a higher proportion than females (n = 1807; 41%). Of injuries identified as domestic violence by spouse or partner (n = 510), 59·5% occurred &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;at home&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;. This is the first study to investigate alcohol-related injuries occurring at home. The home accounts for a greater proportion of injuries than the frequently assessed licensed premises location. Further research is required to validate these findings in a wider setting. A public health campaign is required to minimise harm associated with alcohol-related injuries in the home, and nurses are positioned to inform health policy makers around this issue. Furthermore, emergency department nurses are in a unique position to provide brief interventions around safe alcohol consumption and injury prevention.
Contemporary Nurse a Journal For the Australian Nursing Profession, Oct 1, 2007
... Conway J and Kearin M (2007) The contribution of the Patient Support Assistant to direct pati... more ... Conway J and Kearin M (2007) The contribution of the Patient Support Assistant to direct patient care: An exploration of nursing and PSA role perceptions ... Addressing the needs of children of parents with a mental illness Kim Foster, Louise O'Brien, Margaret McAllister. ...
Competency standards document the knowledge, skills, and attitudes required for competent perform... more Competency standards document the knowledge, skills, and attitudes required for competent performance. This study develops competency standards for dietitians in order to substantiate an approach to competency standard development. Focus groups explored the current and emerging purpose, role, and function of the profession, which were used to draft competency standards. Consensus was then sought using two rounds of a Delphi survey. Seven focus groups were conducted with 28 participants (15 employers/practitioners, 5 academics, 8 new graduates). Eighty-two of 110 invited experts participated in round one and 67 experts completed round two. Four major functions of dietitians were identified: being a professional, influencing the health of individuals, groups, communities, and populations through evidence-based nutrition practice, and working collaboratively in teams. Overall there was a high level of consensus on the standards: 93% achieved agreement by participants in round one and all revised standards achieved consensus on round 2. The methodology provides a framework for other professions wishing to embark on competency standard review or development.
Contemporary Nurse a Journal For the Australian Nursing Profession, Apr 1, 2007
Effective promotion of nursing as a career to high school students can potentially have a positiv... more Effective promotion of nursing as a career to high school students can potentially have a positive impact on the shortage of nurses. This study identified the perceptions of high school careers advisers of the Bachelor of Nursing program as a career choice, their perceptions of the attributes and characteristics necessary for nurses, and their perceptions of nurses&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; roles and responsibilities. These perceptions have not been previously identified in Australia and may not have been adequately considered in the planning of recruitment and retention strategies for nursing. The study findings suggest that careers advisers recognise the complexity of nursing practice in providing direct patient care and the range of attributes required for the registered nurse who provides this care. Careers advisers recognised that nursing had changed over the past ten years, although few perceived the roles and responsibilities of nurses to extend beyond activities related to patient care. There were few requests for information about nursing as a career from careers advisers and the findings indicates that they do not actively promote nursing as a career. This suggests that despite a range of initiatives to promote registered nursing as a career choice, careers advisers are not influencing significant numbers of school students to consider registered nursing as career.
This dissertation presents an evaluation of a funded consultancy that was intended to bring about... more This dissertation presents an evaluation of a funded consultancy that was intended to bring about change in the education and training of police in Australia in response to illicit drugs. Sponsored by what was at the time known as the Commonwealth Department of Health and Aged Care, the ultimate goal of the consultancy was a national framework for police education and training to enhance frontline police response to illicit drug problems. The research used a case study design. Guba and Stufflebeam's (1970) Context, Input, Process, and Product (CIPP) model was used to organise the presentation of a rich description of the design, development and implementation of the consultancy. Application of this framework enabled illumination of a number of issues related to social policy, change and innovation, and quality improvement processes. The study explores the role of education and training in organisational change and concludes that the potential of external consultancy activity to effect meaningful change in police education, training and practice is limited by a number of factors. Key findings of the study are that while a number of consultancy processes could have been enhanced, the primary determinants of the extent to which a change in police education and training will enhance frontline practice are contextual and conceptual factors. The study reveals that the response of frontline police to illicit drug use is influenced by multivariate factors. The findings of this study suggest that while frontline police are keen to provide solutions to a range of practice issues in response to illicit drug problems, they desire concrete strategies that are well defined and supported by management, consistent with policy and within the law.
Introduction: Northern Thailand has a distinct culture and set of health beliefs. Nurses’ beliefs... more Introduction: Northern Thailand has a distinct culture and set of health beliefs. Nurses’ beliefs influence approaches to care affecting health care outcomes. This study explored the content, origin, and sociocultural influences on health beliefs of Northern Thai nurses and how they influence clinical practice and education. Method: Q-methodology was used in this study. Data were collected with interviews using Q-cards, Q-sort distribution board, and a semistructured interview guide. Results: Data were collected from 30 clinical nurses and 30 nurses working in academia. Q-factor analysis produced three factors accounting for 48% of variance: personal experience, Thai and Buddhist beliefs, and contemporary beliefs. Discussion: Participants who felt strongly rooted in their culture and beliefs were homogeneous in recognizing the need for evidence-based practice. Nurses aware of the nature and sources of their beliefs and those of patients are well-placed to balance maintenance of cult...
Background: Older people who present to the Emergency Department (ED) experience high rates of pr... more Background: Older people who present to the Emergency Department (ED) experience high rates of prevalent and incident delirium. This study aimed to determine whether an assistant workforce in the ED could effectively conduct screening to inform assessment and care planning for older people as well as enhance supportive care activities for prevention of delirium. Methods: Using a pre-post design, data was collected before and after the introduction of Older Person Technical Assistants (OPTAs) in the ED. OPTA activity was recorded during the intervention period and a medical record audit undertaken prior to and 9 months after implementation. Data were analysed using descriptive statistics for OPTA activities. Weighted Kappa scores were calculated comparing concordance in screening scores between OPTAs and Aged Services Emergency Team Registered Nurses. Changes in the rates of documented screening and supportive care were analysed using Chi-square tests. Focus groups were conducted to explore clinicians' experiences of the OPTA role. Results: Three thousand five hundred fourty two people were seen by OPTAs in 4563 ED Presentations between 1st July 2011 and 2012. The reproducibility of all screening tools were found to be high between the OPTAs and the RNs, with Kappas and ICCs generally all above 0.9. The medical record audit showed significant improvement in the rates of documented screening, including cognition from 1.5 to 38% (p < 0.001) and review of pain from 29 to 75% (p < 0.001). Supportive care such as being given fluids or food also improved from 13 to 49% (p < 0.001) and pressure care from 4.8 to 30% (p < 0.001). This was accomplished with no increase in ED length of stay among this age group. Focus group interviews described mixed responses and support for the OPTA role. Conclusions: An assistant workforce in an ED setting was found to provide comparable screening results and improve the rates of documented screening and supportive care provided to older people with or at risk of developing delirium in the ED. There is a need for a shared philosophy to the care of older people in the ED.
The purpose of this research was to replicate a study undertaken with different cohorts of client... more The purpose of this research was to replicate a study undertaken with different cohorts of clients and their caregivers in both Australia and the United States of America (USA). The researcher wanted to establish better local information, through the use of a survey, about the needs of informal caregivers who provide physical and emotional care, rehabilitation and supervision of treatments for patients with Chronic Obstructive Pulmonary Disease (COPD), at home. Contemporary feedback about what caregivers perceive as critical to their ability to provide care in the home environment was identified. Health services, particularly professionals such as nurses within those services, need to respond appropriately to these needs.
The human ability to make inferences about the minds of conspecifics is remarkable. The majority ... more The human ability to make inferences about the minds of conspecifics is remarkable. The majority of work in this area focuses on mental state representation (‘theory of mind’), but has had limited success in explaining individual differences in this ability, and is characterized by the lack of a theoretical framework that can account for variability in the population of minds to which individuals are exposed. We draw analogies between faces and minds as complex social stimuli, and suggest that theoretical and empirical progress on understanding the mechanisms underlying mind representation can be achieved by adopting a ‘Mind-space’ framework; that minds, like faces, are represented as vectors in a multidimensional psychological space. This Mind-space framework can accommodate the representation of whole cognitive systems, and may help to explain individual differences in the consistency and accuracy with which the mental states of others are inferred. Mind-space may also have releva...
An observational study was conducted to examine the use of sun protective hats, clothing, and sun... more An observational study was conducted to examine the use of sun protective hats, clothing, and sunglasses of people attending an outdoor entertainment event in an area of high-to-extreme ultraviolet radiation in New South Wales, Australia. Armidale is unique, as it is a highly-elevated area, almost 1000 m above sea level, and temperatures are often mild with very high-to-extreme levels of ultraviolet radiation. Four trained data collectors observed attendees as they entered the event, and recorded their use of sun protective hats, clothing, and sunglasses. While more than half of the attendees wore sun protective hats, only 14% wore sun protective clothing. Broad-brimmed hats were considered sun protective, while sun protective clothing was defined by shirts with at least three-quarter-length sleeves. Females were more likely to wear both a sun protective hat and clothing than males, and children were less protected than adults. Legislative changes are required to ensure that organiz...
Clinical Leaders drive healthcare performance in the provision of safe high quality patient care ... more Clinical Leaders drive healthcare performance in the provision of safe high quality patient care by influencing others and augmenting change. Clinical leadership features strongly in Nurse Consultant (NC) roles and holds potential to strengthen the NC's place in healthcare teams, making their contribution as clinical leaders more recognisable. This study explores how clinical leadership is enacted through the NC role, providing understanding of the elements that influence their effectiveness as clinical leaders. This paper presents qualitative findings from a larger sequential mixed method study conducted in a large Local Health District in New South Wales, Australia. Focus groups were held with NCs, managers and other stakeholders from a variety of context including acute, primary and community care settings across metropolitan and rural locations. An online discussion forum was provided for NCs unable to attend focus groups. Transcript data were analysed using iterative themin...
Australian health review : a publication of the Australian Hospital Association, 2018
To compare annual costs of an intervention for acutely unwell older residents in residential age ... more To compare annual costs of an intervention for acutely unwell older residents in residential age care facilities (RACFs) with usual care. The intervention, the Aged Care Emergency (ACE) program, includes telephone clinical support aimed to reduce avoidable emergency department (ED) presentations by RACF residents.This costing of the ACE intervention examines the perspective of service providers: RACFs, Hunter Medicare Local, the Ambulance Service of New South Wales, and EDs in the Hunter New England Local Health District. ACE was implemented in 69 RACFs in the Hunter region of NSW, Australia. Analysis used 14 weeks of ACE and ED service data (June-September 2014). The main outcome measure was the net cost and saving from ACE compared with usual care. It is based on the opportunity cost of implementing ACE and the opportunity savings of ED presentations avoided.Our analysis estimated that 981 avoided ED presentations could be attributed to ACE annually. Compared with usual care, ACE ...
Aim: This study aimed to explore the work roles, major tasks and core activities of advanced prac... more Aim: This study aimed to explore the work roles, major tasks and core activities of advanced practice dietitians in Australia to define the Competency Standards for advanced practice. Methods: A qualitative approach was used to review advanced dietetic practice in Australia involving experienced professionals, mostly dietitians. Four focus groups were conducted with a total of 17 participants and an average of 20 years experience: 15 dietitian practitioners plus 2 employers (1 dietitian and 1 non-dietitian). The focus groups explored the key purpose, roles and outcomes of these practitioners. Data from the focus groups were confirmed with in-depth interviews about their core activities with a purposive sample of 10 individuals recently recognised as Advanced Accredited Practising Dietitians. Data from both focus groups and interviews were analysed adductively to identify key themes. Results: The key theme that emerged to define advanced dietetics practice was leadership, with four subthemes that described in more detail the major work roles and outcomes of advanced practice. These subthemes identified that advanced practitioners were (i) outcome-focused, having impact; (ii) influence others and advocate; (iii) innovate and embrace change; and (iv) inspire others and are recognised for their practice. These outcomes were conceptualised within a broad generalist framework to generate revised Competency Standards. Conclusions: This study confirmed that leadership rather than specialist practice skills is the key determinant of advanced practice.
Background: There is a direct link between job satisfaction, nurses' job performance and improved... more Background: There is a direct link between job satisfaction, nurses' job performance and improved patient outcomes. Understanding what job characteristics influence job satisfaction is vital if health organizations are to optimize individual employee satisfaction and performance. This is particularly necessary in the Nurse Consultant role, which is a multifaceted role that has evolved to meet the dynamic and changing needs of health services. This study aims to examine how job characteristics influence Nurse Consultant job satisfaction and identify differences across metropolitan and rural contexts. Methods: This paper presents quantitative findings that are part of a larger prospective cross sectional mixed method study. An online survey consisting of a variety of job characteristic factors was administered to all NCs working in a large Local Health District in New South Wales, Australia over an 8-week period in 2010. Descriptive analysis identified NC's perceptions of job satisfaction and job characteristics in their current role and factor and regression analysis identified relationships between these factors. Results: Job satisfaction was identified as high (mean 4.3) and is strongly correlated with job autonomy, role clarity, role conflict and job support. A high level of role clarity has a moderating effect on the relationship between job autonomy and job satisfaction. Conclusions: Study findings inform how we prepare nurses for the NC role and how managers engage with and support NCs in their role taking into account context. Understanding the factors that influence job satisfaction and role effectiveness gives managers valuable information to assist in positioning and supporting these roles to maximize effectiveness across integrated and contemporary models of health care delivery.
Older people living in Residential Aged Care Facilities (RACF) are a vulnerable, frail and comple... more Older people living in Residential Aged Care Facilities (RACF) are a vulnerable, frail and complex population. They are more likely than people who reside in the community to become acutely unwell, present to the Emergency Department (ED) and require admission to hospital. For many, hospitalisation carries with it risks. Importantly, evidence suggests that some admissions are avoidable. A new collaborative model of care, the Aged Care Emergency Service (ACE), was developed to provide clinical support to nurses in the RACFs, allowing residents to be managed in place and avoid transfer to the ED. This paper examines the effects of the ACE service on RACF residents' transfer to hospital using a controlled pre-post design. Four intervention RACFs were matched with eight control RACFs based on number of total beds, dementia specific beds, and ratio of high to low care beds in Newcastle, Australia, between March and November 2011. The intervention consisted of a clinical care manual t...
This study aimed to establish the scale of alcohol-related injuries originating in the home. Desp... more This study aimed to establish the scale of alcohol-related injuries originating in the home. Despite recent media and public attention on alcohol-related injuries occurring at licensed venues, many occur in other locations including the home. A retrospective observational study. Emergency department surveillance data sourced from the Queensland Injury Surveillance Unit were interrogated for alcohol-related emergency department presentations from 2003-2012 (n = 12,296). Descriptive analysis was undertaken to assess alcohol involvement in injury, and analysis of variance was used to determine the differences among group means and their associated presentations. The relationship between demographic variables and injury location was assessed using p value of &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;0·05 as statistically significant. Of all injuries that were positively identified as being alcohol related, 41·07% occurred at the &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;other&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; location, 36·14% &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;at home&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;, 13·00% on the street and 9·78% at licensed premises. Of these, males (n = 2635; 59%) represented a higher proportion than females (n = 1807; 41%). Of injuries identified as domestic violence by spouse or partner (n = 510), 59·5% occurred &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;at home&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;. This is the first study to investigate alcohol-related injuries occurring at home. The home accounts for a greater proportion of injuries than the frequently assessed licensed premises location. Further research is required to validate these findings in a wider setting. A public health campaign is required to minimise harm associated with alcohol-related injuries in the home, and nurses are positioned to inform health policy makers around this issue. Furthermore, emergency department nurses are in a unique position to provide brief interventions around safe alcohol consumption and injury prevention.
Contemporary Nurse a Journal For the Australian Nursing Profession, Oct 1, 2007
... Conway J and Kearin M (2007) The contribution of the Patient Support Assistant to direct pati... more ... Conway J and Kearin M (2007) The contribution of the Patient Support Assistant to direct patient care: An exploration of nursing and PSA role perceptions ... Addressing the needs of children of parents with a mental illness Kim Foster, Louise O'Brien, Margaret McAllister. ...
Competency standards document the knowledge, skills, and attitudes required for competent perform... more Competency standards document the knowledge, skills, and attitudes required for competent performance. This study develops competency standards for dietitians in order to substantiate an approach to competency standard development. Focus groups explored the current and emerging purpose, role, and function of the profession, which were used to draft competency standards. Consensus was then sought using two rounds of a Delphi survey. Seven focus groups were conducted with 28 participants (15 employers/practitioners, 5 academics, 8 new graduates). Eighty-two of 110 invited experts participated in round one and 67 experts completed round two. Four major functions of dietitians were identified: being a professional, influencing the health of individuals, groups, communities, and populations through evidence-based nutrition practice, and working collaboratively in teams. Overall there was a high level of consensus on the standards: 93% achieved agreement by participants in round one and all revised standards achieved consensus on round 2. The methodology provides a framework for other professions wishing to embark on competency standard review or development.
Contemporary Nurse a Journal For the Australian Nursing Profession, Apr 1, 2007
Effective promotion of nursing as a career to high school students can potentially have a positiv... more Effective promotion of nursing as a career to high school students can potentially have a positive impact on the shortage of nurses. This study identified the perceptions of high school careers advisers of the Bachelor of Nursing program as a career choice, their perceptions of the attributes and characteristics necessary for nurses, and their perceptions of nurses&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; roles and responsibilities. These perceptions have not been previously identified in Australia and may not have been adequately considered in the planning of recruitment and retention strategies for nursing. The study findings suggest that careers advisers recognise the complexity of nursing practice in providing direct patient care and the range of attributes required for the registered nurse who provides this care. Careers advisers recognised that nursing had changed over the past ten years, although few perceived the roles and responsibilities of nurses to extend beyond activities related to patient care. There were few requests for information about nursing as a career from careers advisers and the findings indicates that they do not actively promote nursing as a career. This suggests that despite a range of initiatives to promote registered nursing as a career choice, careers advisers are not influencing significant numbers of school students to consider registered nursing as career.
This dissertation presents an evaluation of a funded consultancy that was intended to bring about... more This dissertation presents an evaluation of a funded consultancy that was intended to bring about change in the education and training of police in Australia in response to illicit drugs. Sponsored by what was at the time known as the Commonwealth Department of Health and Aged Care, the ultimate goal of the consultancy was a national framework for police education and training to enhance frontline police response to illicit drug problems. The research used a case study design. Guba and Stufflebeam's (1970) Context, Input, Process, and Product (CIPP) model was used to organise the presentation of a rich description of the design, development and implementation of the consultancy. Application of this framework enabled illumination of a number of issues related to social policy, change and innovation, and quality improvement processes. The study explores the role of education and training in organisational change and concludes that the potential of external consultancy activity to effect meaningful change in police education, training and practice is limited by a number of factors. Key findings of the study are that while a number of consultancy processes could have been enhanced, the primary determinants of the extent to which a change in police education and training will enhance frontline practice are contextual and conceptual factors. The study reveals that the response of frontline police to illicit drug use is influenced by multivariate factors. The findings of this study suggest that while frontline police are keen to provide solutions to a range of practice issues in response to illicit drug problems, they desire concrete strategies that are well defined and supported by management, consistent with policy and within the law.
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Papers by jane conway