The experiences of undergraduate Assistants in Nursing (AIN)

Background: University academic timelines and a shortage of clinical placements available for students have created challenges for universities to provide maximum clinical exposure and preparation for practise. A State-run health system in Australia developed an incentive whereby students are actively recruited to work as Assistants in Nursing (AINs) whilst completing their undergraduate nursing programme, enabling them to enhance clinical skills learned during university. There have been no previous studies that reflect their experiences. Aim: This study aimed to explore and describe experiences of undergraduate AINs in the nursing workforce. Method: Semi-structured interviews were used to obtain in-depth accounts of the undergraduate AIN experience. Six participants who were employed at various healthcare facilities around the Sydney metropolitan area comprised the sample. Interviews were digitally recorded and transcribed verbatim. Data were thematically analysed. Findings: Three main themes emerged from the data: becoming part of the team, understanding the scope of the AIN role, and working outside your comfort zone. Conclusion: Findings can add to international discussions in the literature related to the training and education of ancillary nursing staff. Furthermore findings provide insights into some of the challenges faced by tertiary institutions in preparing students for the clinical work environment. Whilst the employment of undergraduate AIN's can be an effective strategy, the lack of formalised guidelines to inform those working with undergraduate AINs may hinder the full potential of their employment

Nurse practitioner (NP) led care : cervical screening practices and experiences of women attending a women's health centre

Background: Cervical cancer is the second most prevalent carcinoma among women. Stringent screening is the most effective strategy of reducing the morbidity and mortality associated with cervical cancer, however barriers to such screening exist. South West Sydney is primarily populated by ethnic minority groups and those with lower socioeconomic status. Thus, women from this area of Sydney represent some of the most disadvantaged women and face many barriers when accessing healthcare, including cervical cancer screening. Previous research has found that gender can influence attitudes and practices regarding women's health screening. While women's health nurse practitioners are becoming more involved in preventative healthcare including cervical cancer screening, the experiences of women who access their services have not been explored. Aim: The aim of this study was to determine the demographic characteristics of the women accessing the Liverpool Women's Health Centre and to explore their experiences of the service. Methods: Demographic data were collected over a one-year period and reflected the diversity of the women who access the WHC in the Liverpool local government area. Ten women who were first time users of the service, aged over the age of 18 years and fluent in English language were then interviewed to explore in-depth their experiences of service. Findings: Study findings illustrated the benefits of providing free women-centred care. In addition to being accessible in terms of location and cost, women conveyed their appreciation for the continuity of care provided. Further, women who accessed the service reported the nurse practitioner provided a professional environment that facilitated the development of trust. Conclusion: Providing a service that is accessible and comforting can increase the participation of vulnerable women in routine cervical cancer screening practices as well as reduce the morbidity and mortality rate of cervical cancer that often results from under-screening

Undergraduate nursing assistant employment in aged care has benefits for new graduates

Aims: To determine how undergraduate assistant in nursing employment in aged care helps to prepare new graduates for clinical work as a registered nurse. Background: The amount and quality of clinical experience afforded by university programs has been the subject of constant debate in the nursing profession. New graduate nurses are often deemed inadequately prepared for clinical practice and so many nursing students seek employment as assistants in nursing whilst studying to increase their clinical experience. Design: This paper presents the first phase of a larger mixed‐methods study to explore whether undergraduate assistant in nursing employment in aged care prepares new graduate nurses for the clinical work environment. The first phase involved the collection of quantitative data from a modified Preparation for Clinical Practice survey, which contained 50‐scaled items relating to nursing practice. Methods: Ethics approval was obtained prior to commencing data collection. New graduate nurses who were previously employed as assistants in nursing in aged care and had at least 3 months’ experience as a registered nurse, were invited to complete the survey. Social media and professional networks were used to distribute the survey between March 2015 and May 2016 and again in January 2017 ‐ February 2017. Purposeful and snowballing sampling methods using social media and nursing networks were used to collect survey responses. Data were analysed using principal components analysis. Results: 110 completed surveys were returned. Principal components analysis revealed four underlying constructs (components) of undergraduate assistant in nursing employment in aged care. These were emotional literacy (component 1), clinical skills (component 2), managing complex patient care (component 3) and health promotion (component 4). Conclusion: The 4 extracted components reflect the development of core nursing skills that transcend that of technical skills and includes the ability to situate oneself as a nurse in the care of an individual and in a healthcare team

Adaptation and validation of a survey instrument measuring perceived preparedness of nursing graduates

Background In Australia, a significant percentage of bachelor of nursing students are employed in the aged care sector, or in aged care settings, as assistants in nursing (AINs) or personal care assistants. However the value of aged care in nursing education is often overlooked. Aim To outline the adaptation and validation of a survey, originally developed for medical graduates, for use with nursing graduates. Discussion Adaptation of the instrument was undertaken as part of a doctoral study that aimed to explore whether employment as an undergraduate assistant in nursing (AIN) in aged care prepares new graduates for clinical work. Conclusion Outlining each step of the modification process can help nurse researchers who want to adapt existing instruments to meet their research objectives. Implications for practice Undergraduate AIN employment has the potential to supplement clinical learning without the restrictions inherent in the student role. Furthermore, it has the potential to enhance recruitment and retention in the aged care sector

An exploration of undergraduate nursing assistant employment in aged care and its value to undergraduate nursing education

Aims: To explore the types of nursing skills that are learnt through work as nursing assistants in aged care; and determine how these skills help to prepare novice nurses for new graduate practice as a Registered Nurse. Background: Issues surrounding patient care currently plague the aged care sector in Australia. Undergraduate Assistants in Nursing are undergraduate nursing students who work in a variety of clinical settings, including aged care facilities. The employment of nursing students in aged care is not well explored. Design: This paper presents the findings from an open-response question in the Preparation for Clinical Practice survey. The survey represented the first stage of a larger sequential mixed-methods study that explored how undergraduate Assistant in Nursing employment in aged care contributed to the preparation of new graduate Registered Nurses for clinical practice. Setting: Data were predominantly collected online via an online survey platform. Social media and snowball sampling methods were utilised to distribute the survey nation-wide. Participants: New graduate nurses (n = 108) who were previously employed as undergraduate Assistants in Nursing in an aged care facility during their Bachelor of Nursing program. Methods: Thematic analysis was used to analyse data from the open-response question in the survey. Findings: Three main themes were created: developing communication skills, prioritising patient care, and professional growth through immersion. Conclusions: Undergraduate Assistant in Nursing employment in aged care prepared novice nurses for new graduate practice, developing higher-order nursing skills in communication, time management, understanding various aspects of care from the patient's unique experiences, and understanding the structure of the healthcare organisation

Barriers to breast and cervical cancer screening for women with physical disability : a review

This review critically examined the barriers to breast and cervical cancer screening services for women with physical disability and discussed ways forward to change practice. When compared to the rest of the community, women with disability were less likely to use preventive health screening services for multiple reasons. Moreover, women with disability live longer than in previous years, and as age is linked to an increased risk of developing cancer, it is imperative that the barriers to screening for these women become a focus of discussion. We designed an integrative literature review to investigate this. Multiple databases were systematically searched for literature published between 2001 and 2013. Search terms used were a combination (AND/OR) of key terms. After excluding duplicates and articles not meeting the eligibility criteria, twenty-five articles were systematically and critically reviewed. Sociodemographic factors were associated with less access to preventive health screening for women with disability. The literature reviewed indicated that this was complicated further by three prominent barriers: health insurance, health care workers, and physical barriers. Sociodemographic, health insurance, health workers, and physical barriers impair access for disabled women to breast and cervical cancer screening, which are vital measures in the timely detection of breast and cervical cancers and preventable morbidity and mortality. Measures are needed to address these limiting factors for women with disability so that they can be active participants in health care, rather than being marginalized because of their disability

Chlorhexidine bathing and health care-associated infections among adult intensive care patients : a systematic review and meta-analysis

Background: Health care-associated infections (HAI) have been shown to increase length of stay, the cost of care, and rates of hospital deaths (Kaye and Marchaim, J Am Geriatr Soc 62(2):306–11, 2014; Roberts and Scott, Med Care 48(11):1026–35, 2010; Warren and Quadir, Crit Care Med 34(8):2084–9, 2006; Zimlichman and Henderson, JAMA Intern Med 173(22):2039–46, 2013). Importantly, infections acquired during a hospital stay have been shown to be preventable (Loveday and Wilson, J Hosp Infect 86:S1–70, 2014). In particular, due to more invasive procedures, mechanical ventilation, and critical illness, patients cared for in the intensive care unit (ICU) are at greater risk of HAI and associated poor outcomes. This meta-analysis aims to summarise the effectiveness of chlorhexidine (CHG) bathing, in adult intensive care patients, to reduce infection. Methods: A systematic literature search was undertaken to identify trials assessing the effectiveness of CHG bathing to reduce risk of infection, among adult intensive care patients. Infections included were: bloodstream infections; central line-associated bloodstream infections (CLABSI); catheter-associated urinary tract infections; ventilator-associated pneumonia; methicillin-resistant Staphylococcus aureus (MRSA); vancomycin-resistant Enterococcus; and Clostridium difficile. Summary estimates were calculated as incidence rate ratios (IRRs) and 95% confidence/credible intervals. Variation in study designs was addressed using hierarchical Bayesian random-effects models. Results: Seventeen trials were included in our final analysis: seven of the studies were cluster-randomised crossover trials, and the remaining studies were before-and-after trials. CHG bathing was estimated to reduce the risk of CLABSI by 56% (Bayesian random effects IRR = 0.44 (95% credible interval (CrI), 0.26, 0.75)), and MRSA colonisation and bacteraemia in the ICU by 41% and 36%, respectively (IRR = 0.59 (95% CrI, 0.36, 0.94); and IRR = 0.64 (95% CrI, 0.43, 0.91)). The numbers needed to treat for these specific ICU infections ranged from 360 (CLABSI) to 2780 (MRSA bacteraemia). Conclusion: This meta-analysis of the effectiveness of CHG bathing to reduce infections among adults in the ICU has found evidence for the benefit of daily bathing with CHG to reduce CLABSI and MRSA infections. However, the effectiveness may be dependent on the underlying baseline risk of these events among the given ICU population. Therefore, CHG bathing appears to be of the most clinical benefit when infection rates are high for a given ICU population