Melanie Murray

Background
Standardised Nursing Terminologies (SNTs) provide a set of agreed terms that are aligned to nurses’ assessments, interventions, and nurse-sensitive patient care outcomes. The use of such a terminology allows for improved visibility of nursing care and comparisons of interventions and outcomes to support and assess evidence-based practice. Whilst SNTs have been in use internationally for decades, there is a gap in practice and literature related to SNTs throughout Australia.

Purpose
The objectives of this review were to explore recent literature to identify and understand (i) the benefits of SNTs, (ii) the limitations of SNTs, and (iii) the potential scope of SNTs for the Australian context.

Methods
A scoping review was undertaken to search relevant literature in CINAHL, Cochrane Review, EMBASE, IEEE Xplore, Medline Complete, and Scopus databases using a date range of 2015–2023.

Findings
A total of 36 studies were reviewed, none of which were Australian. Main benefits associated with integrating SNTs into health records include improved nursing documentation quality, facilitate visibility of nursing care, and enable nursing practice quality improvement. Key limitations identified were the lack of evidence about correlation between nurses’ knowledge level and the use of SNT in practice, lack of strong evidence related to benefits in terms of patient outcomes, workflow efficiencies or enhanced communication, poor representation of nursing practice in SNTs, and mapping limitations to achieve interoperability.

Conclusions
In order to support SNT implementation and adoption throughout Australia, there is a need for Australian research as well as a national strategy for the adoption of an SNT taxonomy in Australia. This requires stakeholder policy development, government support to ensure standardisation, and broad education at academic and local level to enable comprehensive systems’ integration.

The health inequities experienced by Aboriginal and Torres Strait Islander peoples, rooted in the historical and ongoing negative impacts of colonisation and disrupted traditional lifestyles, sees higher rates of illness and hospitalisations, increased morbidity and higher premature death rates than other Australians. Nurses represent the majority of Australia’s health workforce and nursing students must have knowledge to provide culturally safe care to Australia’s Aboriginal and Torres Strait Islander peoples. An Aboriginal and Torres Strait Islander Peoples’ Health and Wellbeing unit was developed and introduced into an undergraduate nursing curriculum. This project aimed to determine the effectiveness of the unit content in changing the attitude of nursing students towards care of First Nations peoples. A quasi-experimental design was used and included all undergraduate nursing students commencing this unit in 2020 at one university in Western Australia. Students completed a validated questionnaire prior to engaging with unit learning materials and again at completion of the unit. Complete paired data was available for 339 participants. Results demonstrated statistically significant change in attitude following completion of the unit. Embedding targeted education concerning Aboriginal and Torres Strait Islander peoples’ health and wellbeing positively influences attitudes in caring for this population of patients.

Aim

To understand the practice readiness of the early career registered nurse in their first five years of practice within very remote hospital healthcare provision.

Background

The practice readiness of early career registered nurses is often questioned; this is particularly true of nurses in rural and remote settings where, due to a transitory workforce, adequate support may not be forthcoming.

Method

Qualitative descriptive design using semi-structured interviews involving early career (n = 4) and later career (n = 3) registered nurses in very remote hospitals. Data were analysed using Creswell's six-step approach to thematic analysis.

Findings

Practice readiness includes both professional and personal readiness. Early career registered nurse participants felt not ready for remote area employment. Later career registered nurses suggest that critical care placements in an emergency department or intensive care unit are necessary for preparedness to work in rural and remote areas. Key to supporting and developing practice readiness is organisational support, adequate, consistent staffing, and structured orientation across all departments.

Discussion

Early career registered nurses understand their limitations; however, organisational support through appropriate orientation, supernumerary time, and adequate education is often not available.

Conclusion

To support early career registered nurses to be practice ready, it is the organisation's responsibility to provide the adequate support, information, and preparatory education to ensure an effective transition to practice for future proofing of the rural and remote nurse workforce.

Background Transition to practice can be exceedingly stressful for newly qualified nurses as they grapple with the “reality shock” of everyday practice as an RN. Transition to practice programs were implemented as a support strategy to ease the transition from student to RN and are designed to increase graduates' confidence and competence, improve their professional adjustment, and increase their retention. Method This rapid review was framed by the Cochrane Methods Rapid Review, supported by the PRISMA statement checklist, aiming to identify and describe the benefits of transition to practice programs for newly graduated RNs and their impact on workforce retention. Results The literature revealed that mixed evidence exists regarding the value and benefits of graduate nurse transition programs to both the graduate and the health service. Conclusion There are multiple inconsistencies across clinical settings, organizations, and preceptor-ship/mentoring training, among others, particularly in relation to duration of the program and the amount of formalized contact/study days.

Aims To critically appraise contemporary literature and synthesize common components of nurse manager development programmes. Background Although the need for nurse manager development programmes has been well documented, minimal recent research exists which identifies and evaluates the common components in these programmes. Furthermore, nurse managers continue to be poorly prepared and supported in role transition, contributing to poor organisational and role performance and decreased retention. Method A structured literature review saw 14 original research publications appraised for quality, analysed and included in the review. Results The common components identified in nurse manager development programmes include curriculum, method of delivery, support, and funding components. Various subthemes were also identified. Conclusion The components identified within existing nurse manager development programmes are varied. Although there are common components within nurse manager development programmes, these individual components have not been evaluated for effectiveness. There is a clear need for further development of nurse manager development programmes and evaluation of the specific components within. Implications for Nursing Management An understanding of the common components in NM development programmes is useful for designing and implementing robust evidence‐based programmes. Inclusion of these components may facilitate a smoother role transition, enhance performance and improve recruitment and retention of nurse managers.

Aims To explore and analyse the current bed management processes and understand the perspectives of nurse managers on mixed‐gender accommodation in a regional hospital in Australia. Background Mixed‐gender accommodation was introduced to help manage the increasing demand for hospital beds. Yet, some health services identify same‐gender accommodation better aligns with patient‐centredness. Method This qualitative research was conducted at a public hospital in regional Australia and focused on the experience in the general wards. Eight nurse managers were selected using purposeful sampling. Data were collected through face‐to‐face semi‐structured interviews and thematically analysed. Results Three main themes were identified: current admission processes—managing admissions, bed allocation considerations, patient involvement and managing mixed‐gender rooms; impacts on patients—participant views, patient experience and bathrooms; and barriers and facilitators—capacity, infrastructure, safety and risk, bed swapping and organisational factors. Conclusions The study demonstrates a lack of structure and patient‐centredness with mixed‐gender allocation processes. Local organisational guidelines are suggested to support improvement in patient‐centred inpatient hospital accommodation.

Background Safety leadership in healthcare is required and should be encouraged from the bedside through to the executive and is essential for the safety of the patients in our care. Major health inquiries have highlighted failure of leadership as a cause of poor patient outcomes. Aim To highlight issues and initiatives raised within discussion forums by postgraduate health care management students asked to reflect upon leadership, quality and safety, and human factors in today's healthcare environment Methods A qualitative approach by way of retrospective review of compulsory discussion forum posts from online postgraduate quality and safety and human factors in health care units. Findings Authority gradients persist in contemporary healthcare settings, influenced to a certain degree by the multi-generational workforce, and ultimately compromising communication and teamwork. Human factors effects on care provision emphasised fatigue as a significant issue that needs to be addressed by appropriate workforce management. Discussion The ability for healthcare professionals to challenge decisions and directives that may compromise safety is hampered by the persistence of both intra- and interprofessional authority gradients. Students reported hesitancy to challenge or seek assistance from those who hold ‘leadership’, or senior positions, due to distrust and fear of ridicule. Students could, however, see the bigger picture and sought to translate their learning into quality improvements in the workplace. Conclusion Challenging perceived authority is necessary and open communication should be encouraged through effective leadership. Effective leadership leads to efficient teamwork and ultimately safe and efficient care for patients.

Introduction Promotion from paramedic to manager is common in ambulance services, yet there is limited research concerning paramedics’ experience of this role transition. The purpose of this qualitative study was to explore the experiences of paramedics who have transitioned from clinician to manager. Methods A qualitative approach was used for this study. Through purposive sampling, semi-structured interviews were conducted with paramedics who had made the transition to manager. The participants were asked to describe how they felt and what their experiences were concerning this transition. Thematic analysis was undertaken identifying themes within participant responses. Results Six key themes emerged during the data analysis. Participants described feelings of isolation on moving from the frontline, a lack of feeling part of the team ‘in green’; however, they also reported that previously being a paramedic in some instances gave credibility in their new manager roles. Challenges reported concerned no formal training before transitioning into the role, and the lack of essential managerial experience. Conclusion This research provided insight into how paramedics feel and perceive the transition from clinician to management roles. A review of the organisational approach to role transition is of benefit to paramedics. Such a review may help identify what changes could be made in support of paramedics transitioning to management roles. Further research is required across other ambulance services to determine the efficacy of these results in the broader ambulance service environment.