and sleep variables. 2) Nap proximity Groups (< 7hrs, >7hrs)x (kRA) and sleep variables. Pearson ... more and sleep variables. 2) Nap proximity Groups (< 7hrs, >7hrs)x (kRA) and sleep variables. Pearson correlations were performed between the kRA and sleep variables. Results: ANOVAs revealed a significant group effect on kRA (p< 0.01). Posthoc Tukey HSD comparison indicated that frequent nappers (M±SD 0.0589±0.01) had a significantly higher kRA than moderate nappers (0.0484±0.01, p< 0.01, d¼0.96) and non-nappers (0.0497±.01, p< 0.02, d¼0.83). Moderate nappers did not significantly differ from non-nappers (p¼0.96). We failed to find a significant difference on the sleep variables (TST, WASO, SE, SOL, AWK, ActivL), p's>0.05. Nap duration did not result in significant differences in the sleep variables or kRA metric (t-tests p's>0.10). Late evening naps with a proximity of < 7hrs vs. >7hrs to the bedtime, significantly increased TST, WASO, SOL, and AWK (t-tests p's0.02) but not SE or kRA (p's>0.15). ActivL did not result in differences in sleep variables or kRA (p's>0.14). Pearson correlations revealed negative associations between kRA and TST (r ¼-0.32, p¼0.01), SE (r ¼-0.32, p¼0.01). As awakenings and WASO increased there was an increase in kRA (r¼0.53, r¼036 p's < 0.01, respectively). Conclusion: Frequent napping may result in increased sleep fragmentation. Evening naps closer to bedtime resulted in longer sleep durations and poorer quality sleep reflected in longer sleep onsets, increased awakenings without a change in sleep efficiency. The length of a nap did not appear to affect sleep in our analysis. Acknowledgements: This study was supported by AASM (mm; tdv); NSERC, CIHR and CFI (tdv).
Background: After their attempts to have patient safety concerns addressed internally were ignore... more Background: After their attempts to have patient safety concerns addressed internally were ignored by wilfully blind managers, nurses from Bundaberg Base Hospital and Macarthur Health Service felt compelled to 'blow the whistle'. Wilful blindness is the human desire to prefer ignorance to knowledge; the responsibility to be informed is shirked. Objective: To provide an account of instances of wilful blindness identified in two high-profile cases of nurse whistleblowing in Australia. Research design: Critical case study methodology using Fay's Critical Social Theory to examine, analyse and interpret existing data generated by the Commissions of Inquiry held into Bundaberg Base Hospital and Macarthur Health Service patient safety breaches. All data was publicly available and assessed according to the requirements of unobtrusive research methods and secondary data analysis. Ethical considerations: Data collection for the case studies relied entirely on publicly available documentary sources recounting and detailing past events. Findings: Data from both cases reveal managers demonstrating wilful blindness towards patient safety concerns. Concerns were unaddressed; nurses, instead, experienced retaliatory responses leading to a 'social crisis' in the organisation and to whistleblowing. Conclusion: Managers tasked with clinical governance must be aware of mechanisms with the potential to blind them. The human tendency to favour positive news and avoid conflict is powerful. Understanding wilful blindness can assist managers' awareness of the competing emotions occurring in response to ethical challenges, such as whistleblowing.
Background Patient engagement is a patient's capacity and willingness to participate and collabor... more Background Patient engagement is a patient's capacity and willingness to participate and collaborate in their own health care. This scoping review aimed to identify tools used to measure engagement among surgical patients, the levels of engagement and the association between engagement and surgical outcomes. We hypothesise that highly engaged patients are more likely to achieve better surgical outcomes. Review methods MEDLINE/PubMed, CINAHL, SCOPUS and Embase were searched for studies that assessed adult perioperative patients for engagement. Analysis from charting the data identified the measurement tools, levels of capacity to engage and relationships between engagement and surgical outcomes. Results Twelve studies were selected out of 3975 identified; three valid and reliable tools to measure surgical patient engagement-Patient activation measure (PAM®), Patient health engagement scale (PHE-s) and Hopkins rehabilitation engagement rating scale (HRERS)-were identified, as well as levels of engagement. The capacity to engage was categorised into two, three or four levels. High levels of engagement were associated with enhanced patient satisfaction, better adherence to physical therapy, and decreased pain and disability. Conclusion There are valid and reliable tools to measure the capacity of surgical patients to engage in their post-operative recovery; PAM® is the most frequently used tool. Patients with higher engagement are more likely to report better physical health and greater satisfaction with their surgery. Using these tools could assist health care providers in the early identification of patients at risk of poor recovery and provide tailored support.
International Journal of Evidence-Based Healthcare, 2019
BACKGROUND AND AIMS Postoperative nausea and vomiting (PONV) is a common surgical complication, a... more BACKGROUND AND AIMS Postoperative nausea and vomiting (PONV) is a common surgical complication, affecting 30-50% of patients and 80% in high risk populations. Successful prevention and management of PONV relies on accurately assessing individual risk prior to surgery. A valid and reliable Apfel score is commonly used to assess patients' risk. It is however challenging to translate this evidence into clinical practice. This evidence-based project aimed to identify the current practice of assessing and documenting the risk factors of PONV prior to surgery, and to develop strategies to improve the practice. METHODS The project had three phrases, including forming a team and conducting the baseline audit; identifying problems and developing strategies; and conducting a follow-up tool to assess the impact on compliance with best practice. A research team was formed. A baseline audit was conducted at a public hospital in Victoria in June 2016 to examine PONV risk assessment practice t...
Getting undergraduate Bachelor of Nursing students to understand and to apply procedures accurate... more Getting undergraduate Bachelor of Nursing students to understand and to apply procedures accurately for calculating medication doses in the clinical setting has always been an educational challenge for nursing academics. The experience at Central ...
Between 2002 and 2005, two high-profile Australian cases of nurse whistleblowing received widespr... more Between 2002 and 2005, two high-profile Australian cases of nurse whistleblowing received widespread media attention. Little is known about the processes that influence nurse whistleblowing. This study investigated the nurse actions and highlighted the need to take seriously matters reported that pose a threat to patient safety and quality care.
The Bachelor of Nursing (BN) program at Central Queensland University requires students to comple... more The Bachelor of Nursing (BN) program at Central Queensland University requires students to complete industry based clinical practicum in each of the 3 years of their program. Students spend 40– 60% of their week off campus in clinical practicum. The Bachelor of Nursing Program Gateway (BNPG) is the application of the traditional Blackboard course management system from a single course to a whole program. It has pushed the boundaries of online course management creating an online learning community that consists of students, lecturers, clinical laboratory managers, administration staff, program advisors and industry clinical staff from three Central Queensland University campuses (Rockhampton, Mackay and Bundaberg), one hub (Noosa) and Flexible delivery. This paper will adopt Wenger, McDermott, and Synder’s (2002) seven principles of communities of practice to discuss development strategies that have proved successful, as well as some of the pitfalls experienced and lessons learned t...
Supervision and delegation are important leadership skills that nurses require when practising wi... more Supervision and delegation are important leadership skills that nurses require when practising within the multi-tiered nursing team. In response to increasing demands globally on healthcare systems, Nursing Assistants are becoming more prevalent members of the nursing workforce in the acute care setting. An exploratory descriptive research design was used to examine supervision and delegation of Nursing Assistants in an acute hospital setting in Victoria, Australia. It was found that supervision and delegation in the context of a multi-tier nursing team required a complex assessment and decision-making process which was influenced by multiple factors. This research promotes developing transparent nursing practices and mutual understanding in the multi-tier nursing team to facilitate effective supervision and delegation based on informed decision-making and culture of openness and trust. Pre-registration education and continuing education and support for nurses are important to build transparent supervision and delegation practices and teamwork, empowering the nursing team to practice to their full scope of practice to provide high-quality patient care.
Background: Indigenous people make up approximately 3% of the total Australian population and sco... more Background: Indigenous people make up approximately 3% of the total Australian population and score poorer on all health indices, including back pain. Chiropractors are well placed to alleviate back pain, yet there is no research that considers chiropractors' readiness to treat Indigenous patients. This study explores chiropractors`experience working with Indigenous Australians, describes perceived barriers and facilitators to chiropractors' participation in Indigenous Healthcare and their willingness to engage in cultural competency training. Methods: This study used a non-representative cross-sectional design and a convenience sample. Participants were recruited via email invitation to complete an online survey and encouraged to send the invitation on to colleagues. A 17-item online-survey measured demographic data, perceived barriers and facilitators related to caring for Indigenous Australians, participants`level of comfort when working in Indigenous health, and their willingness to participate in cultural competency programs to enhance their skills, knowledge and cultural capacity when engaging with Indigenous Australians. Analysis of the data included descriptive statistics as well as thematic analysis of qualitative free text.
International Journal of Evidence-Based Healthcare, 2017
To explore and qualitatively review &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;... more To explore and qualitatively review &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;end-of-shift&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; verbal communication practices and processes; and to further develop a core theoretical construction of nurses&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; perspectives on handover in contemporary Australian clinical settings. The following study will report the results from phase 1 of a two-phase study examining the Australian nurse&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s perspective of verbal handover. The data were gathered over a 2-month period in 2013 for phase 1 of the study.Phase 1 of the research was undertaken using Strauss and Corbin&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s Grounded Theory methodology, to explore the perceptions of verbal handover by acute care nurses. The participants included 41 registered nurses purposively sampled from acute care surgical and medical backgrounds in a metropolitan hospital in Melbourne, Australia.Data were collected using intensive interviewing techniques in six focus groups with an average of seven members in each group. The data were then coded and analyzed concurrently allowing the categorization of core concepts. Communication proved to be the underlying core concept with linked themes such as mode of handover, relevance of information, professional roles of nursing, duty of care, timeliness and scope of practice. Communication during handover time must be tailored to support the oncoming nurse in preparing for the shift ahead. To do this effectively, information shared must be relevant and fashioned in such a way that the oncoming nurse can prioritize patient care needs while ensuring adherence to their scope of practice. This Grounded Theory has helped toward the reconceptualization of verbal handover, one that attempts to enhance current end-of-shift communication practices and processes, thereby optimizing clinical outcomes.
The clinical placement learning environment is a critical component of nursing education where Au... more The clinical placement learning environment is a critical component of nursing education where Australian nursing students spend a minimum of 800h. Identifying components of successful clinical placements for undergraduate nursing students is therefore paramount. To assess nursing students&amp;amp;amp;amp;#39; views of the learning environment during clinical placement with an emphasis on the pedagogical atmosphere, leadership style of the ward manager, and premises of nursing on the unit or ward. The study used Clinical Learning Environment, Supervision and nurse teacher (CLES+T) questionnaire to examine 150 final year undergraduate students&amp;amp;amp;amp;#39; perceptions of the clinical placement learning environment. The questionnaire was anonymous and completed by the students at the end of their clinical placement. The statistical program SPSS v22 was used. Principal components analysis (PCA) for data reduction was run on the 42-question section of the first dimension (&amp;amp;amp;amp;#39;pedagogical atmosphere on the ward&amp;amp;amp;amp;#39;) of the questionnaire that measured the perceptions of the learning environment of the clinical placement of the 150 final-year undergraduate nursing students. The comments sections of the factors were subjected to interpretive content analysis to create the themes for the two components. Principle Component Analysis revealed two components that had eigenvalues greater than one: &amp;amp;amp;amp;#39;Happy to Help&amp;amp;amp;amp;#39; Component 1 and &amp;amp;amp;amp;#39;Happy to be Here&amp;amp;amp;amp;#39; Component 2. These components were statistically significant (p&amp;amp;amp;amp;lt;0.0005), using Bartlett&amp;amp;amp;amp;#39;s Test of Sphericity indicating that the data was likely factorizable. These components scored higher than any other related factors. Student nurses value a welcoming workplace where staff and educators are happy to help and have a positive attitude to student presence on the wards. More than any other factors these ward-based factors appear to have the strongest influence on student satisfaction.
International Journal of Health Policy and Management, 2015
Whistleblowing by health professionals is an infrequent and extraordinary event and need not occu... more Whistleblowing by health professionals is an infrequent and extraordinary event and need not occur if internal voices are heard. Mannion and Davies' editorial on "Cultures of Silence and Cultures of Voice: The Role of Whistleblowing in Healthcare Organisations" asks the question whether whistleblowing ameliorates or exacerbates the 'deaf effect' prevalent in healthcare organisations. This commentary argues that the focus should remain on internal processes and hearer courage. Citation: Cleary SR, Doyle KE. Whistleblowing need not occur if internal voices are heard: From deaf effect to hearer courage: Comment on "Cultures of silence and cultures of voice: the role of whistleblowing in healthcare organisations.
The Bachelor of Nursing (BN) program at Central Queensland University requires students to comple... more The Bachelor of Nursing (BN) program at Central Queensland University requires students to complete industry based clinical practicum in each of the 3 years of their program. Students spend 40– 60% of their week off campus in clinical practicum. The Bachelor of Nursing Program Gateway (BNPG) is the application of the traditional Blackboard course management system from a single course to a whole program. It has pushed the boundaries of online course management creating an online learning community that consists of students, lecturers, clinical laboratory managers, administration staff, program advisors and industry clinical staff from three Central Queensland University campuses (Rockhampton, Mackay and Bundaberg), one hub (Noosa) and Flexible delivery. This paper will adopt Wenger, McDermott, and Synder's (2002) seven principles of communities of practice to discuss development strategies that have proved successful, as well as some of the pitfalls experienced and lessons learn...
Objective The purpose of this paper is to describe the Practice‑Based Simulation Model (PBSM) as ... more Objective The purpose of this paper is to describe the Practice‑Based Simulation Model (PBSM) as a pedagogical framework that enables the integration of simulation in a way that ensures critical thinking skills are explicitly taught as part of the processes and outcomes of students’ learning. Setting The PBSM is an innovative pedagogical strategy that offers greater flexibility; one that can be applied to various types of educational contexts and delivery modes, while simultaneously ensuring desired learning outcomes. Primary argument The use of simulation has been gaining popularity because of its capacity to provide effective experiential learning as a method of enhancing learners’ critical thinking skills. Despite ample literature that highlights the need for the integration of simulation into nursing curricula, there are few papers demonstrating simulated learning experiences that are underpinned by sound pedagogy. This paper asserts that simulated learning experiences need to b...
This study reports a comparative survey of mature students undertaking pre-registration undergrad... more This study reports a comparative survey of mature students undertaking pre-registration undergraduate nursing education in Australia and Scotland. The study aimed to explore comparisons between the course-related and course-related financial difficulties faced by mature students in two very different educational and funding systems. Financial stress is a predictor of both physical and mental health problems. A similar pattern of course-related problems were reported by both Australian and Scottish students with the exception that Scottish students experienced more problems with childcare and caring for elderly relatives. Course-related problems may be inherent in the nature of undergraduate nursing education although the relatively time-intensive nature of Scottish curricula may explain the childcare and elderly relatives difference. Scottish students reported higher overall financial-related problems but Australian students reported more problems with funding placements. These find...
Australia has witnessed a policy-led drive to widen access gates to undergraduate nurse education... more Australia has witnessed a policy-led drive to widen access gates to undergraduate nurse education. In nursing education this has meant a move from recruiting primarily young female school-leavers to increased numbers of older women and to a lesser extent older men entering nurse education. Mature women generally choose to enter nursing because of the ease of entry into less restrictive
and sleep variables. 2) Nap proximity Groups (< 7hrs, >7hrs)x (kRA) and sleep variables. Pearson ... more and sleep variables. 2) Nap proximity Groups (< 7hrs, >7hrs)x (kRA) and sleep variables. Pearson correlations were performed between the kRA and sleep variables. Results: ANOVAs revealed a significant group effect on kRA (p< 0.01). Posthoc Tukey HSD comparison indicated that frequent nappers (M±SD 0.0589±0.01) had a significantly higher kRA than moderate nappers (0.0484±0.01, p< 0.01, d¼0.96) and non-nappers (0.0497±.01, p< 0.02, d¼0.83). Moderate nappers did not significantly differ from non-nappers (p¼0.96). We failed to find a significant difference on the sleep variables (TST, WASO, SE, SOL, AWK, ActivL), p's>0.05. Nap duration did not result in significant differences in the sleep variables or kRA metric (t-tests p's>0.10). Late evening naps with a proximity of < 7hrs vs. >7hrs to the bedtime, significantly increased TST, WASO, SOL, and AWK (t-tests p's0.02) but not SE or kRA (p's>0.15). ActivL did not result in differences in sleep variables or kRA (p's>0.14). Pearson correlations revealed negative associations between kRA and TST (r ¼-0.32, p¼0.01), SE (r ¼-0.32, p¼0.01). As awakenings and WASO increased there was an increase in kRA (r¼0.53, r¼036 p's < 0.01, respectively). Conclusion: Frequent napping may result in increased sleep fragmentation. Evening naps closer to bedtime resulted in longer sleep durations and poorer quality sleep reflected in longer sleep onsets, increased awakenings without a change in sleep efficiency. The length of a nap did not appear to affect sleep in our analysis. Acknowledgements: This study was supported by AASM (mm; tdv); NSERC, CIHR and CFI (tdv).
Background: After their attempts to have patient safety concerns addressed internally were ignore... more Background: After their attempts to have patient safety concerns addressed internally were ignored by wilfully blind managers, nurses from Bundaberg Base Hospital and Macarthur Health Service felt compelled to 'blow the whistle'. Wilful blindness is the human desire to prefer ignorance to knowledge; the responsibility to be informed is shirked. Objective: To provide an account of instances of wilful blindness identified in two high-profile cases of nurse whistleblowing in Australia. Research design: Critical case study methodology using Fay's Critical Social Theory to examine, analyse and interpret existing data generated by the Commissions of Inquiry held into Bundaberg Base Hospital and Macarthur Health Service patient safety breaches. All data was publicly available and assessed according to the requirements of unobtrusive research methods and secondary data analysis. Ethical considerations: Data collection for the case studies relied entirely on publicly available documentary sources recounting and detailing past events. Findings: Data from both cases reveal managers demonstrating wilful blindness towards patient safety concerns. Concerns were unaddressed; nurses, instead, experienced retaliatory responses leading to a 'social crisis' in the organisation and to whistleblowing. Conclusion: Managers tasked with clinical governance must be aware of mechanisms with the potential to blind them. The human tendency to favour positive news and avoid conflict is powerful. Understanding wilful blindness can assist managers' awareness of the competing emotions occurring in response to ethical challenges, such as whistleblowing.
Background Patient engagement is a patient's capacity and willingness to participate and collabor... more Background Patient engagement is a patient's capacity and willingness to participate and collaborate in their own health care. This scoping review aimed to identify tools used to measure engagement among surgical patients, the levels of engagement and the association between engagement and surgical outcomes. We hypothesise that highly engaged patients are more likely to achieve better surgical outcomes. Review methods MEDLINE/PubMed, CINAHL, SCOPUS and Embase were searched for studies that assessed adult perioperative patients for engagement. Analysis from charting the data identified the measurement tools, levels of capacity to engage and relationships between engagement and surgical outcomes. Results Twelve studies were selected out of 3975 identified; three valid and reliable tools to measure surgical patient engagement-Patient activation measure (PAM®), Patient health engagement scale (PHE-s) and Hopkins rehabilitation engagement rating scale (HRERS)-were identified, as well as levels of engagement. The capacity to engage was categorised into two, three or four levels. High levels of engagement were associated with enhanced patient satisfaction, better adherence to physical therapy, and decreased pain and disability. Conclusion There are valid and reliable tools to measure the capacity of surgical patients to engage in their post-operative recovery; PAM® is the most frequently used tool. Patients with higher engagement are more likely to report better physical health and greater satisfaction with their surgery. Using these tools could assist health care providers in the early identification of patients at risk of poor recovery and provide tailored support.
International Journal of Evidence-Based Healthcare, 2019
BACKGROUND AND AIMS Postoperative nausea and vomiting (PONV) is a common surgical complication, a... more BACKGROUND AND AIMS Postoperative nausea and vomiting (PONV) is a common surgical complication, affecting 30-50% of patients and 80% in high risk populations. Successful prevention and management of PONV relies on accurately assessing individual risk prior to surgery. A valid and reliable Apfel score is commonly used to assess patients' risk. It is however challenging to translate this evidence into clinical practice. This evidence-based project aimed to identify the current practice of assessing and documenting the risk factors of PONV prior to surgery, and to develop strategies to improve the practice. METHODS The project had three phrases, including forming a team and conducting the baseline audit; identifying problems and developing strategies; and conducting a follow-up tool to assess the impact on compliance with best practice. A research team was formed. A baseline audit was conducted at a public hospital in Victoria in June 2016 to examine PONV risk assessment practice t...
Getting undergraduate Bachelor of Nursing students to understand and to apply procedures accurate... more Getting undergraduate Bachelor of Nursing students to understand and to apply procedures accurately for calculating medication doses in the clinical setting has always been an educational challenge for nursing academics. The experience at Central ...
Between 2002 and 2005, two high-profile Australian cases of nurse whistleblowing received widespr... more Between 2002 and 2005, two high-profile Australian cases of nurse whistleblowing received widespread media attention. Little is known about the processes that influence nurse whistleblowing. This study investigated the nurse actions and highlighted the need to take seriously matters reported that pose a threat to patient safety and quality care.
The Bachelor of Nursing (BN) program at Central Queensland University requires students to comple... more The Bachelor of Nursing (BN) program at Central Queensland University requires students to complete industry based clinical practicum in each of the 3 years of their program. Students spend 40– 60% of their week off campus in clinical practicum. The Bachelor of Nursing Program Gateway (BNPG) is the application of the traditional Blackboard course management system from a single course to a whole program. It has pushed the boundaries of online course management creating an online learning community that consists of students, lecturers, clinical laboratory managers, administration staff, program advisors and industry clinical staff from three Central Queensland University campuses (Rockhampton, Mackay and Bundaberg), one hub (Noosa) and Flexible delivery. This paper will adopt Wenger, McDermott, and Synder’s (2002) seven principles of communities of practice to discuss development strategies that have proved successful, as well as some of the pitfalls experienced and lessons learned t...
Supervision and delegation are important leadership skills that nurses require when practising wi... more Supervision and delegation are important leadership skills that nurses require when practising within the multi-tiered nursing team. In response to increasing demands globally on healthcare systems, Nursing Assistants are becoming more prevalent members of the nursing workforce in the acute care setting. An exploratory descriptive research design was used to examine supervision and delegation of Nursing Assistants in an acute hospital setting in Victoria, Australia. It was found that supervision and delegation in the context of a multi-tier nursing team required a complex assessment and decision-making process which was influenced by multiple factors. This research promotes developing transparent nursing practices and mutual understanding in the multi-tier nursing team to facilitate effective supervision and delegation based on informed decision-making and culture of openness and trust. Pre-registration education and continuing education and support for nurses are important to build transparent supervision and delegation practices and teamwork, empowering the nursing team to practice to their full scope of practice to provide high-quality patient care.
Background: Indigenous people make up approximately 3% of the total Australian population and sco... more Background: Indigenous people make up approximately 3% of the total Australian population and score poorer on all health indices, including back pain. Chiropractors are well placed to alleviate back pain, yet there is no research that considers chiropractors' readiness to treat Indigenous patients. This study explores chiropractors`experience working with Indigenous Australians, describes perceived barriers and facilitators to chiropractors' participation in Indigenous Healthcare and their willingness to engage in cultural competency training. Methods: This study used a non-representative cross-sectional design and a convenience sample. Participants were recruited via email invitation to complete an online survey and encouraged to send the invitation on to colleagues. A 17-item online-survey measured demographic data, perceived barriers and facilitators related to caring for Indigenous Australians, participants`level of comfort when working in Indigenous health, and their willingness to participate in cultural competency programs to enhance their skills, knowledge and cultural capacity when engaging with Indigenous Australians. Analysis of the data included descriptive statistics as well as thematic analysis of qualitative free text.
International Journal of Evidence-Based Healthcare, 2017
To explore and qualitatively review &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;... more To explore and qualitatively review &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;end-of-shift&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; verbal communication practices and processes; and to further develop a core theoretical construction of nurses&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; perspectives on handover in contemporary Australian clinical settings. The following study will report the results from phase 1 of a two-phase study examining the Australian nurse&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s perspective of verbal handover. The data were gathered over a 2-month period in 2013 for phase 1 of the study.Phase 1 of the research was undertaken using Strauss and Corbin&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s Grounded Theory methodology, to explore the perceptions of verbal handover by acute care nurses. The participants included 41 registered nurses purposively sampled from acute care surgical and medical backgrounds in a metropolitan hospital in Melbourne, Australia.Data were collected using intensive interviewing techniques in six focus groups with an average of seven members in each group. The data were then coded and analyzed concurrently allowing the categorization of core concepts. Communication proved to be the underlying core concept with linked themes such as mode of handover, relevance of information, professional roles of nursing, duty of care, timeliness and scope of practice. Communication during handover time must be tailored to support the oncoming nurse in preparing for the shift ahead. To do this effectively, information shared must be relevant and fashioned in such a way that the oncoming nurse can prioritize patient care needs while ensuring adherence to their scope of practice. This Grounded Theory has helped toward the reconceptualization of verbal handover, one that attempts to enhance current end-of-shift communication practices and processes, thereby optimizing clinical outcomes.
The clinical placement learning environment is a critical component of nursing education where Au... more The clinical placement learning environment is a critical component of nursing education where Australian nursing students spend a minimum of 800h. Identifying components of successful clinical placements for undergraduate nursing students is therefore paramount. To assess nursing students&amp;amp;amp;amp;#39; views of the learning environment during clinical placement with an emphasis on the pedagogical atmosphere, leadership style of the ward manager, and premises of nursing on the unit or ward. The study used Clinical Learning Environment, Supervision and nurse teacher (CLES+T) questionnaire to examine 150 final year undergraduate students&amp;amp;amp;amp;#39; perceptions of the clinical placement learning environment. The questionnaire was anonymous and completed by the students at the end of their clinical placement. The statistical program SPSS v22 was used. Principal components analysis (PCA) for data reduction was run on the 42-question section of the first dimension (&amp;amp;amp;amp;#39;pedagogical atmosphere on the ward&amp;amp;amp;amp;#39;) of the questionnaire that measured the perceptions of the learning environment of the clinical placement of the 150 final-year undergraduate nursing students. The comments sections of the factors were subjected to interpretive content analysis to create the themes for the two components. Principle Component Analysis revealed two components that had eigenvalues greater than one: &amp;amp;amp;amp;#39;Happy to Help&amp;amp;amp;amp;#39; Component 1 and &amp;amp;amp;amp;#39;Happy to be Here&amp;amp;amp;amp;#39; Component 2. These components were statistically significant (p&amp;amp;amp;amp;lt;0.0005), using Bartlett&amp;amp;amp;amp;#39;s Test of Sphericity indicating that the data was likely factorizable. These components scored higher than any other related factors. Student nurses value a welcoming workplace where staff and educators are happy to help and have a positive attitude to student presence on the wards. More than any other factors these ward-based factors appear to have the strongest influence on student satisfaction.
International Journal of Health Policy and Management, 2015
Whistleblowing by health professionals is an infrequent and extraordinary event and need not occu... more Whistleblowing by health professionals is an infrequent and extraordinary event and need not occur if internal voices are heard. Mannion and Davies' editorial on "Cultures of Silence and Cultures of Voice: The Role of Whistleblowing in Healthcare Organisations" asks the question whether whistleblowing ameliorates or exacerbates the 'deaf effect' prevalent in healthcare organisations. This commentary argues that the focus should remain on internal processes and hearer courage. Citation: Cleary SR, Doyle KE. Whistleblowing need not occur if internal voices are heard: From deaf effect to hearer courage: Comment on "Cultures of silence and cultures of voice: the role of whistleblowing in healthcare organisations.
The Bachelor of Nursing (BN) program at Central Queensland University requires students to comple... more The Bachelor of Nursing (BN) program at Central Queensland University requires students to complete industry based clinical practicum in each of the 3 years of their program. Students spend 40– 60% of their week off campus in clinical practicum. The Bachelor of Nursing Program Gateway (BNPG) is the application of the traditional Blackboard course management system from a single course to a whole program. It has pushed the boundaries of online course management creating an online learning community that consists of students, lecturers, clinical laboratory managers, administration staff, program advisors and industry clinical staff from three Central Queensland University campuses (Rockhampton, Mackay and Bundaberg), one hub (Noosa) and Flexible delivery. This paper will adopt Wenger, McDermott, and Synder's (2002) seven principles of communities of practice to discuss development strategies that have proved successful, as well as some of the pitfalls experienced and lessons learn...
Objective The purpose of this paper is to describe the Practice‑Based Simulation Model (PBSM) as ... more Objective The purpose of this paper is to describe the Practice‑Based Simulation Model (PBSM) as a pedagogical framework that enables the integration of simulation in a way that ensures critical thinking skills are explicitly taught as part of the processes and outcomes of students’ learning. Setting The PBSM is an innovative pedagogical strategy that offers greater flexibility; one that can be applied to various types of educational contexts and delivery modes, while simultaneously ensuring desired learning outcomes. Primary argument The use of simulation has been gaining popularity because of its capacity to provide effective experiential learning as a method of enhancing learners’ critical thinking skills. Despite ample literature that highlights the need for the integration of simulation into nursing curricula, there are few papers demonstrating simulated learning experiences that are underpinned by sound pedagogy. This paper asserts that simulated learning experiences need to b...
This study reports a comparative survey of mature students undertaking pre-registration undergrad... more This study reports a comparative survey of mature students undertaking pre-registration undergraduate nursing education in Australia and Scotland. The study aimed to explore comparisons between the course-related and course-related financial difficulties faced by mature students in two very different educational and funding systems. Financial stress is a predictor of both physical and mental health problems. A similar pattern of course-related problems were reported by both Australian and Scottish students with the exception that Scottish students experienced more problems with childcare and caring for elderly relatives. Course-related problems may be inherent in the nature of undergraduate nursing education although the relatively time-intensive nature of Scottish curricula may explain the childcare and elderly relatives difference. Scottish students reported higher overall financial-related problems but Australian students reported more problems with funding placements. These find...
Australia has witnessed a policy-led drive to widen access gates to undergraduate nurse education... more Australia has witnessed a policy-led drive to widen access gates to undergraduate nurse education. In nursing education this has meant a move from recruiting primarily young female school-leavers to increased numbers of older women and to a lesser extent older men entering nurse education. Mature women generally choose to enter nursing because of the ease of entry into less restrictive
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Papers by Sonja Cleary