Papers by Virginia Plummer
Psychiatry Research-neuroimaging, Sep 1, 2020
Nurses are acknowledged for their care and expertise on the front line of pandemics over the last... more Nurses are acknowledged for their care and expertise on the front line of pandemics over the last century. The recent global impact of COVID-19 has been unprecedented and a parallel battle has also been fought by increasing numbers of nurses for their workplace mental health. Factors associated with nurses mental stress and consequence of suicide were identified from a retrospective analysis of six non-representative media case-reports in high and low resource countries. The need for a structured model of nursing workforce mental health preparation, monitoring, support and health care is essential to inform advocacy and timely intervention in pandemic response.
Prehospital and Disaster Medicine, May 1, 2023
International Nursing Review, Aug 3, 2023
AimTo identify nurses’ perspectives of their core competencies for emergency care in the context ... more AimTo identify nurses’ perspectives of their core competencies for emergency care in the context of armed conflict.IntroductionEmergency department's (ED) capacity is frequently overwhelmed by a sudden surge of patients when located near armed conflict. Although emergency nurses are key frontline responders, evidence detailing core competencies needed to work in these areas remains limited.MethodThe study used a cross‐sectional survey design and is reported using STROBE guidelines. A validated questionnaire was administered in hospitals near the southern Kingdom of Saudi Arabia and Yemen border, where emergency nurses regularly manage large numbers of patients from armed conflict.ResultA total of 163 questionnaires were returned (68% response rate). Most participants were female and had more than six years of ED experience. The core competencies for emergency nurses working near armed conflict were identified and highly rated by participants: the highest mean value was 9.47/10 and the lowest was 8.89/10. Analysis revealed regular education, training and drills were needed to provide quality emergency nursing care for victims of armed conflict.Conclusion and implications for nursing and health policyThis study provides new evidence regarding core competencies in emergency nursing care in the context of armed conflict. The identified competencies should be incorporated into future education, curricula, training programmes and evaluations to enable emergency nurses to function effectively in the context of armed conflict. The findings will assist decision‐makers to develop plans and strategies for mitigating risk and improving the future nursing response in similar contexts.
Nursing management, May 1, 2013
There is evidence of support for nurse practitioner (NP) roles in national and international lite... more There is evidence of support for nurse practitioner (NP) roles in national and international literature. However, despite this, and numerous Australian government feasibility and evaluation studies, barriers to implementing NP roles in mainstream health care and developing them to their full potential remain. A study was undertaken to explore nurse practitioners', managers' and nurse policymakers' perceptions of the roles in general, and this article reports on the findings from the initial survey phase. The article also discusses barriers to full integration and development of NPs.
PubMed, Jan 26, 2013
Coding, costing, and accounting for nursing care requirements in Australian public and private ho... more Coding, costing, and accounting for nursing care requirements in Australian public and private hospitals lacks systematic research. Nurse costing for two nurse staffing allocation methods--nurse patient ratios and a computerized nurse dependency management system--were compared. Retrospective nursing workload management data were obtained from hospital information systems in 21 acute care public and private hospitals in Australia and New Zealand. Descriptive statistics, cost analysis, and cost modeling were conducted for 103,269 shifts of nursing care. The comparison of costs for nursing staff by nurse-patient ratios and by a computerized nurse dependency management system demonstrated differences. The provision of nursing care using the computerized nurse dependency management system was, overall, lower in cost than for nurse-patient ratios.
International Journal of Mental Health Nursing, Jun 23, 2017
Journal of Clinical Nursing, Nov 7, 2016
To explore and evaluate perioperative nurses&... more To explore and evaluate perioperative nurses' experience of organ procurement. Organ procurement is part of the organ donation process, and is typically performed in the perioperative setting. This experience may contribute to perioperative nurses' feelings of distress and negative attitudes toward organ donation. Systematic review of the literature. Primary research studies, published in the English language between 1990-2014 were identified screened and appraised using Joanna Briggs Institute (JBI) appraisal tools. Data extraction and analysis followed. The quality assessment resulted in seven qualitative and three quantitative research studies. The main findings were, 1: Perioperative nurses reported feeling emotionally distressed, challenged, lonely and physically drained throughout the entire organ procurement procedure. 2: Perioperative nurses reported finding their own unique self-coping strategies and ways of eliciting support. 3: Perioperative nurses' had positive and negative attitudes toward organ donation. Perioperative nurses reported feelings of sadness, feeling challenged and physically drained through the entire organ procurement procedure, which were influenced by differing factors in the preoperative, intraoperative and postoperative stages. It is acknowledged that personal coping strategies and support are important to help perioperative nurses improve their psychological wellbeing, and their experiences and attitudes toward organ procurement and donation. The meaningfulness of these findings for practice policy and research is described. This article is protected by copyright. All rights reserved.
Psychological Trauma: Theory, Research, Practice, and Policy, May 19, 2022
Nurse Education in Practice, May 1, 2021
High-fidelity simulation has become an essential educational approach in nurse education globally... more High-fidelity simulation has become an essential educational approach in nurse education globally. Several studies have explored the experience of undergraduate nursing students and educators with high-fidelity simulation; however, none have explored the experience of students in the vocational educational sector. The aim of the study was to explore nurse educators' knowledge, attitude and skills toward using high-fidelity simulation in the setting of vocational education. An anonymous on-line survey design was conducted at three campuses of a major Australian Technical and Further Education vocational education setting. Forty-eight nurse educators teaching into Diploma of Nursing program for at least six months were invited to participate, 29 participated in the study, a response rate of 60%. Participants expressed lack of knowledge in managing technological issues, simulation facilitation procedures and conducting scenarios. Most participants had positive attitude towards high-fidelity simulation and rated their skills as 'novice'. An urgent need for nurse educator training was identified to enhance knowledge and skills in technical and scenario management of high-fidelity simulation. A program of supportive mentoring by nurse educator mentors experienced in high-fidelity simulation, engaging with existing simulation associations, will enhance and sustain nurse educator knowledge, attitude and skills in a protected environment further, so that they can optimise training they provide to students for safe quality care of patients in the future.
Australian Nursing Journal, Mar 1, 2010
A function of the TrendCare system: the direct care nurse reviews and updates the indicators. The... more A function of the TrendCare system: the direct care nurse reviews and updates the indicators. The 'hours predicted for nursing care' are then automatically adjusted to reflect actual nursing hours currently being worked. An update in the categorizing of patients also automatically follows. Actualization facilitates a variance measurement. This variance in the actual hours worked by the nurse that are above or below the hours predicted for nursing care and is recorded as 'Total Variance by hh: mm' in TrendCare reporting. The process of actualizing does not replace the predicted hours, they remain in the reporting formats as 'Hours required by hh: mm'. All discharges, deaths, transfers and admissions are accounted for in the actualization process. Acuity A term used in slightly different ways throughout the literature and used in this thesis to describe the relative requirements for nursing care for patients with a given medical condition or conditions. See also dependency. Acute care hospital A hospital which may provide medical, surgical, obstetric, nursing and other health care services to inpatients, most of whom have acute or temporary conditions and whose average stay is relatively short. (PSCU, 1997:14) xxii AN-DRG Australian National Diagnosis Related Group. Versions 1-3 of the Australian system were developed to classify Australian acute in-patients. AR-DRG AR-DRG-Australian Refined Diagnosis Related Group-Diagnoses classified according to relative values for distribution of costs for hospital budgets and coded alphanumerically. They include significant complication or co-morbidity severity measurements and are used for reporting casemix to Government Health Departments, Health Insurers and other funding bodies. AR-DRG Version 4.1 has been implemented in both the public and private acute hospital care sectors in Australia and New Zealand. The AR-DRG code is for an entire episode, after discharge and is unlikely to change. See Patient type. Known also as DRG in the literature and in TrendCare Reporting. Average skill mix The mix of staff by title, qualifications and grade or years of experience. The competency that comprises an overall clinical team, capable of managing a workload of 8 hours per full time equivalent across the shift. (TrendCare 2003). Benchmarks Benchmarks are used for comparison for measurement of performance and quality improvement both internal and external to the organisation. TrendCare users have provided data to the vendor for the derivation of 2001 Average Clinical Benchmarks in HPPD. The benchmark is a range of hours calculated as average, (or mean). For example, a general surgical benchmark of 4.5-4.9 HPPD in Thailand and 3.8-4.3 HPPD in Australia xxiii Care model Care models are how work is organised, delegated and evaluated. Care models are the nursing work systems in place in a ward/unit setting. Common systems include for example, team nursing, task allocation, patient allocation, case management, or nursepatient ratios. Some systems work well for a mix of junior and senior staff and others work better where the team is expert. A Nurse Unit Manager will manage the nursing resources well by selecting an appropriate care model. Further, the experienced team leader can act as a mentor or role model to the more junior team member. TrendCare allocates patients to either individuals or teams as required. Case mix The mix of different patient types in a specific ward/unit or hospital. Casemix funding A method of funding health services which is similar to output based funding. The method involves funding of health care products which are categorized using casemix classifications. Output based funding usually includes teaching and research in addition to casemix classifications (PSCU, 1997). Categorising A function of the TrendCare system: The process begins after selection of the patient type relevant to a patient's diagnosis, treatment and response to treatment, then selection of the appropriate indicators and variables within the indicators for the relevant patient type. (TrendCare 2003). The TrendCare system allocates a category. The category may change at any time throughout the shift or the episode of care. xxiv Clinical hours Clinical hours are recorded in TrendCare. Nursing care is one component of clinical care which is recorded and it includes direct and indirect nursing care. Other clinical care may be recorded such as physiotherapy, or nutrition services but non-nursing clinical hours were not recorded by hospitals in the sample for this thesis. Clinical pathways A document describing the usual method of care provision for a particular type of patient and allowing for annotation of deviations from the norm (PSCU, 1997:3). Comorbidity A secondary condition existing at the time of admission which, because of its presence with a specific principal diagnosis, causes an increase in length of stay. In the AN-DRG classification, comorbidity is expected to result in an increased length of stay of at least one day in 75% of patients (PSCU, 1997:9). Complication A secondary condition arising during the hospital stay which, when present in association with one or more specific principal diagnosis causes and increase in length of stay (PSCU, 1997:9). Convalescent days An episode of care involving the provision of maintenance nursing while the patient achieves functional gain through his or her own resources (PSCU, 1997:9). xxv Cost centre An accounting entity where all costs associated with a particular type of activity can be recorded (PSCU, 1997:9). For example, the cost of training, occupational health and safety or agency nursing hours can be recorded. Cost weight In general, the cost of one item of production relative to other items. (PSCU, 1997:9). DRG Diagnosis related groups. See AR-DRG. De-identified All information which indicates the source of the data has been removed. For example the source could be name, address, date of birth, Unit record (UR) Number or Bed number. Dependency Nurse dependency, patient dependency, nursing acuity and patient acuity are terms xxix Mandated nurse patient ratios Nurse patient ratios which are legally enforceable. Medical Illness Severity Grouping System (MedisGroups) A scoring system which involves the extraction of approximately 250 types of clinical data items and computation of a weighted measure of severity of illness. The results can be used for many purposes, including assessment of quality of care and study of variations in casemix within DRGs (PSCU, 1997:9). Medicus The Rush Medicus Patient Classification System. It contains 37 indicators that determine patient dependency. It was developed in the USA in 1976. Minimum safe staffing levels Minimum safe staffing levels are rostering strategies which may be established as 'policy' by individual hospitals. These policies override all acuity measures. For example, night duty may predict 12 hours of direct care time, based on acuity, but policy requires a minimum of 2 nurses to work in each ward or unit on night shift. Two nurses on night shift would equal, for example, 18 hours. Therefore, the night shift would have 12 hours of care time and 6 hours of safety time, to maintain minimum safe staffing levels. Night duty unproductive time The TrendCare system takes into consideration the 'down time' during the early hours of the morning on the night shift when the patient activity is low and recognises that this minimizes a nurse's opportunity to attend to patient care during this time. The unproductive value selected when setting up ward maintenance should be reflective of xxx ward activity during this time. Refer to the TrendCare Training Booklet-Clinical.
Journal of Clinical Nursing, Aug 29, 2021
Aims and objectivesThe aim of this integrative review was to assess how emergency nurses cope and... more Aims and objectivesThe aim of this integrative review was to assess how emergency nurses cope and motivate themselves to sustain their caring work.BackgroundThe need to enhance sustainability of the workforce creates a demand to consolidate contemporary evidence related to emergency nurses’ motivations, how they cope and sustain themselves for caring work.Design and methodsThe integrative literature review informed by Whittemore and Knafl involved searching four databases, which yielded 977 published research papers (2008–2021). A total of 33 studies met the inclusion and quality assessment criteria. The PRISMA checklist for review was followed.ResultsNo studies addressing all three areas (motivations, coping and caring sustainability) together were identified. Integration of evidence from quantitative and qualitative research was achieved in three categories: (1) emergency nurses’ motivations to sustain their work, (2) emergency nurses’ coping strategies and (3) sustaining care as emergency nurses.ConclusionTo sustain themselves in caring work, emergency nurses need to be intrinsically and extrinsically motivated and know how to cope effectively with stressors and work demands. There is need for research examining the relationships between these aspects of emergency nursing work.Relevance to clinical practiceTo ensure the sustainability of emergency nurses’ work and careers understanding of the factors that influence and sustain their motivations and coping strategies is important for nurses and their clinical leaders and managers.
Journal of Clinical Nursing, Sep 4, 2017
To investigate the prevalence and extent of burnout on nurses and its association with personal r... more To investigate the prevalence and extent of burnout on nurses and its association with personal resilience. Background: With the worldwide shortage of nurses, nurse burnout is considered one of the main contributing factors and has been the focus of studies in recent years. Given the well-documented high level of burnout among nurses, resilience is expected to be a significant predictor of nurse burnout. The association between burnout and resilience has not previously been investigated extensively. Design: A cross-sectional survey design was selected. Methods: A total of 1,061 nurses from six separate three-level hospitals in Hunan Province, China, returned self-reported questionnaires from March-June 2015. Data were collected using a socio-demographic sheet, Maslach Burnout Inventory-General Survey and the Connor-Davidson Resilience Scale. Results: Nurses experienced severe burnout symptoms and showed a moderate level of resilience. Three metrics of burnout had significantly negative correlations with the total score and following variables of resilience. Linear regression analysis showed resilience, especially strength, demographic characteristics (exercise, alcohol use and marital status) and job characteristics (income per month, ratio of patients to nurses, shift work and professional rank) were the main predictors of the three metrics of burnout. Conclusion: The findings of this study may help nurse managers and hospital administrators to have a better understanding of nurse burnout and resilience. The significantly negative relationship between burnout symptoms and resilience has been demonstrated, and this informs the role of resilience in influencing burnout. Relevance to clinical practice: Adaptable and effective interventions for improving resilience are needed to relieve nurses' burnout and reduce workplace stress. Moreover, nurse managers and hospital administrators should establish an effective management system to cultivate a healthy workplace and adopt positive attitudes and harmonious relationships.
International Emergency Nursing, Jul 1, 2023
Journal of Nursing Management, Sep 11, 2022
AIM To investigate the associations between perceived overqualification, organizational commitmen... more AIM To investigate the associations between perceived overqualification, organizational commitment and work passion of nurses. BACKGROUND Few studies have considered the effects of perceived overqualification and organizational commitment on work passion of nurses, especially in developing countries. METHODS A multicentre cross-sectional study. A total of 4511 nurses from eight tertiary hospitals were recruited. The Scale of Perceived OverQalification (SPOQ), the Organizational Commitment Scale (OCS) and the Work Passion Scale (WPS) were used to collect the data. Hierarchical multiple regression were employed. RESULTS Perceived overqualification and organizational commitment were the main predictors for both harmonious and obsessive passions (each p < 0.001). The unique effect of organizational commitment (βharmonious = 0.608, βobsessive = 0.556) on work passion were six to eight times larger than these of perceived overqualification (βharmonious = -0.079, βobsessive = 0.085). CONCLUSION Our findings indicate that high perceived overqualification clearly reduces nurses' harmonious passion and increases their obsessive passion, while high organizational commitment significantly promotes nurses' harmonious and obsessive passions. IMPLICATIONS FOR NURSING MANAGERS Nurse managers should distinguish the different effects of perceived overqualification and organizational commitment on work passion. Effective intervention should be developed to release nurses' potential abilities and improve their organizational commitment and work passion.
International Journal of Epidemiology, Sep 1, 2021
Uploads
Papers by Virginia Plummer