Empowering Parents of Australian Infants and Children in Hospital

Objectives: To translate, culturally adapt, and psychometrically test the EMpowerment of PArents in The Intensive Care-30 questionnaire in Australian pediatric critical care, neonatal, and pediatric ward settings. Design: Cross-sectional, descriptive, multicenter study conducted in two phases; 1) translation and cultural adaptation and 2) validation of the EMpowerment of PArents in The Intensive Care-30 questionnaire. Settings: Two Western Australian sites, the PICU and two pediatric wards of a children's hospital and the neonatal unit of a women's and newborn hospital. Participants: Parents whose baby or child was admitted to the participating wards or units with a length of hospital stay greater than 24 hours. Intervention: None. Measurements and Main Results: Phase 1: A structured 10-step translation process adhered to international principles of good practice for translation and cultural adaptation of patient-reported outcomes. Thirty parents participated in cognitive debriefing. Phase 2: A total of 328 parents responded to the EMpowerment of PArents in The Intensive Care-30-AUS questionnaire. Reliability was sufficient (Cronbach á at domain level 0.70 -0.82, for each clinical area 0.56-0.86). Congruent validity was adequate between the domains and three general satisfaction items (rs 0.38-0.69). Nondifferential validity showed no significant effect size between three patient or parent demographic characteristics and the domains (Cohen's d < 0.36). Between the different clinical areas, significant differences in responses were found in all domains. Conclusions: The translated and culturally adapted EMpowerment of PArents in The Intensive Care-30-AUS is a reliable and valid questionnaire to measure parent-reported outc omes in pediatric critical care, pediatric ward, and neonatal hospital settings. Using this questionnaire can provide a framework for a standardized quality improvement approach and identification of best practices across specialties, hospital services and for benchmarking similar health services worldwide

Exploring modifiable risk factors for premature birth in the context of COVID-19 mitigation measures: A discussion paper

© 2020 Elsevier Ltd. All rights reserved. This manuscript is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International Licence http://creativecommons.org/licenses/by-nc-nd/4.0/.During the COVID-19 pandemic, parents with sick or premature babies have faced challenges following admission to a neonatal unit due to the imposed lock-down restrictions on social contact, hospital visitation and the wearing of personal protective equipment. The negative short-term impact on neonatal care in relation to the prevention of close proximity, contact and bonding between parents and babies is potentially significant. However, an interesting finding has been reported of a reduction in premature birth admissions to the neonatal intensive care unit during the pandemic, raising important questions. Why was this? Was it related to the effect of the modifiable risk-factors for premature birth? This discussion paper focuses on an exploration of these factors in the light of the potential impact of COVID-19 restrictions on neonatal care. After contextualising both the effect of premature birth and the pandemic on neonatal and parental short-term outcomes, the discussion turns to the modifiable risk-factors for premature birth and makes recommendations relevant to the education, advice and care given to expectant mothers.Peer reviewe

Stakeholder and ethical perspectives on performance management : a critical evaluation of contemporary issues

EThOS - Electronic Theses Online ServiceGBUnited Kingdo

Developing a culture of nursing research in neonatal clinical care in Western Australia

Aim: The purpose of our study was to develop a culture of nursing research in neonatal clinical care in Western Australia (WA) by developing a neonatal research agenda. Background: Nursing research provides nurses with evidence for practice, informing them of relevant best practice. Many nurses view their role as providing nursing care but not actually conducting research. However, the evidence to inform nursing care must be provided by nursing-led research. Methods: A three-round Delphi approach was conducted over a nine-month period (April to December 2012) with data collection lasting four weeks for each round. During round one, neonatal nurses were asked to suggest research topics they felt were relevant to nursing within a neonatal clinical area. In round two, nurses were asked to rank 37 topics in six themes from lowest to highest priority. Round three asked the nurses to prioritise the 15 highest ranking topics. Results: The final results were derived from round three after the nurses listed the highest ranking topics from round two. Nurses identified the top two topics as: (1) Medication safety and nurses' confidence to question prescribed orders; and (2) The effect that a series of failed extubations may have on the extremely low birth weight (ELBW) infant. Conclusion: The findings have highlighted research topics considered most important to Western Australian nurses employed in neonatal clinical care. The Delphi approach encourages ownership of the research process which can then be used to foster a culture of nursing research

Factors influencing a nurse's decision to question medication administration in a neonatal clinical care unit

Aims and objectives: The aim of this study was to identify factors that influence nurse's decisions to question concerning aspects of medication administration within the context of a neonatal clinical care unit. Background: Medication error in the neonatal setting can be high with this particularly vulnerable population. As the care giver responsible for medication administration, nurses are deemed accountable for most errors. However, they are recognised as the forefront of prevention. Minimal evidence is available around reasoning, decision making and questioning around medication administration. Therefore, this study focuses upon addressing the gap in knowledge around what nurses believe influences their decision to question. Design: A critical incident design was employed where nurses were asked to describe clinical incidents around their decision to question a medication issue. Nurses were recruited from a neonatal clinical care unit and participated in an individual digitally recorded interview. Results: One hundred and three nurses participated between December 2013-August 2014. Use of the constant comparative method revealed commonalities within transcripts. Thirty-six categories were grouped into three major themes: 'Working environment', 'Doing the right thing' and 'Knowledge about medications'. Conclusions: Findings highlight factors that influence nurses' decision to question issues around medication administration. Nurses feel it is their responsibility to do the right thing and speak up for their vulnerable patients to enhance patient safety. Negative dimensions within the themes will inform planning of educational strategies to improve patient safety, whereas positive dimensions must be reinforced within the multidisciplinary team. Relevance to clinical practice: The working environment must support nurses to question and ultimately provide safe patient care. Clear and up to date policies, formal and informal education, role modelling by senior nurses, effective use of communication skills and a team approach can facilitate nurses to appropriately question aspects around medication administration