2,764 research outputs found

    The causes and consequences of nursing shortages: a helicopter view of the research.

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    In Australia, as in most industrialised countries, there is an acute shortage of registered nurses. While there are numerous research reports emanating from Canada, the United States and Great Britain that provide insight into reasons for this shortage, little comparable work has been undertaken in Australia. This paper presents an overview of the complex interlinking set of factors which cause or are the consequences of nursing shortages including lifestyle preferences, workforce composition, quality of work life and workload and the impact of organisational change and altered management practices. It is important that managers in Australian health care settings understand these issues in order to work towards developing sustainable solutions for retention

    The health and health behaviours of Australian metropolitan nurses: An exploratory study

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    Background: Nurses make up the largest component of the health workforce and provide the majority of patient care. Most health education is delivered by nurses, who also serve as healthy living and behavioural role models. Anything that diminishes their health status can impact their credibility as role models, their availability and ability to deliver quality care, and is potentially disadvantageous for the health of the population. Study aims were to investigate nurses\u27 overall health and the presence of chronic disease; to describe nurses\u27 health-related behaviours and to compare them to those of the general population, with both groups matched by age and gender. Methods: Cross-sectional descriptive paper-based survey of nurses from two Sydney metropolitan hospitals using established instruments and questions and measurements taken with standardised methods. Results: This nursing sample (n = 381) had a mean age of 39.9 (SD 11.7, range 20-67) years, Most (n = 315; 82.7 %) were female, worked full-time (80.0 %), and were shift workers (93.0 %). The majority (94.0 %) indicated good, very good or excellent health, despite 42.8 % indicating they had chronic disease. The most common risk factors for chronic disease were inadequate vegetable (92.6 %) and fruit intake (80.1 %), overweight and obesity (44.0 %) and risky alcohol intake (34.7 %); health screening behaviours were not ideal. Aside from overweight and obesity, these risk factors were more prevalent in nurses than the equivalent group of the New South Wales population, particularly for risky alcohol intake which was much more common in female nurses and most marked in those aged under 35 years. However, 80 % met the guidelines for physical activity, more than the equivalent group of the New South Wales population. Conclusion: There are early \u27warning signs\u27 concerning the health status of nurses. Despite perceiving current good health, support is required for nurses to prevent future chronic disease, particularly in the areas of nutrition and alcohol intake. With these concerns, the nursing workforce ageing and demands for care increasing, it is now time to implement health enhancing strategies for nurses

    Acceptable ungrammaticality in sentence matching

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    This paper presents results from a new set of experiments using the sentence matching paradigm (Forster, Kenneth (1979), Freedman & Forster (1985), also Bley-Vroman & Masterson (1989), investigating native-speakers’ and L2 learners’ knowledge of constraints on clitic placement in French.1 Our purpose is three-fold: (i) to shed more light on the contrasts between native-speakers and L2 learners observed in previous experiments, especially Duffield & White (1999), and Duffield, White, Bruhn de Garavito, Montrul & PrĂ©vost (2002); (ii), to address specific criticisms of the sentence-matching paradigm leveled by Gass (2001); (iii), to provide a firm empirical basis for follow-up experiments with L2 learner

    Shifts in Global Security Policies: Why They Matter for the South

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    The global security order has been evolving since 1989, led initially by the USA to expand its post?1945 order in Europe to the rest of the world but propelled as well by competition and debates within that post?Second World War alliance, as collective victors in the Cold War, about how to define a new international order. This article identifies three US policies that began this restructuring; their parallel redefinitions of security, and the tensions provoked by this agenda and its consequences, both within the ‘North’, replacing the ‘West’, between North and ‘South’, replacing the‘East’and the resulting multiple opportunities for alternative political coalitions, North against South, between North and South, and within the South, that have yet to play themselves out fully. The resulting fluidity has not yet stabilised into a new international security order

    Integrative review : Factors impacting effective delegation practices by registered nurses to assistants in nursing

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    Aim To identify the evidence on factors that impact delegation practices by Registered Nurses to Assistants in Nursing in acute care hospitals. Design An integrative review. Data Sources Database searches were conducted between July 2011 and July 2021. Review Methods We used the 12-step approach by Kable and colleagues to document the search strategy. The (Whittemore & Knafl. 2005. Journal of Advanced Nursing, 52(5), 546–553) integrative review framework method was adopted and the methodological quality of the studies was assessed using Joanna Briggs critical appraisal instruments. Results Nine studies were included. Delegation between the Registered Nurse and the Assistant in Nursing is a complex but critical leadership skill which is impacted by the Registered Nurse's understanding of the Assistant in Nursing's role, scope of practice and job description. Newly qualified nurses lacked the necessary leadership skills to delegate. Further education on delegation is required in pre-registration studies and during nurses' careers to ensure Registered Nurses are equipped with the skills and knowledge to delegate effectively. Conclusion With increasing numbers of Assistants in Nursing working in the acute care environment, it is essential that Registered Nurses are equipped with the appropriate leadership skills to ensure safe delegation practice

    Harnessing ward-level administrative data and expert knowledge to improve staffing decisions: A multi-method case study

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    © 2019 John Wiley & Sons Ltd Aim: The aim of this study was to investigate the impact of changes to bed configuration and patient mix on nurses’ workload in a single ward. Design: Multi-method case study. Method: The study was undertaken in an acute 28-bed ward in a tertiary referral public hospital in Queensland, Australia. Ward-level administrative data were obtained for a 2-year period, 12 months before bed configuration changes in October 2015 and 12 months after. These data included patient activity (bed occupancy, transfers, length of stay and casemix) and nurse staffing (budgeted and actual staffing levels, employment status and skillmix). Semi-structured interviews were conducted with ward nurses (N = 17) to explore the impact of the bed configuration changes on their workload. Results: Administrative data showed that the bed configuration changes resulted in more complex and dependent patients, increased patient transfers and greater variability in casemix. The interview data found these changes to patient complexity and activity intensified workloads, which were further increased by staffing decisions that resulted in greater reliance on temporary staff. Conclusion: Hospitals already possess the data and expert knowledge needed to improve staffing and bed management decisions without the need for additional, costly workload systems. Impact: Determining appropriate nurse staffing in light of the complexities and variation of patient needs at the ward level remains a challenge. This study identified increases in patient complexity, dependency, variability and churn that increased workload. Staffing grew but hidden factors associated with temporary staffing and skillmix further intensified nurses’ workload. Harnessing existing data and the expertise and experience of nursing unit managers (NUMs) would help staff wards more efficiently and effectively, providing reasonable workloads and appropriate skillmix that can enhance the safety and quality of patient care. To facilitate this, NUMs need access to accurate, timely, data and authority in staffing and bed management decisions

    Integrative review: Factors impacting effective delegation practices by registered nurses to assistants in nursing

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    Aim To identify the evidence on factors that impact delegation practices by Registered Nurses to Assistants in Nursing in acute care hospitals. Design An integrative review. Data Sources Database searches were conducted between July 2011 and July 2021. Review Methods We used the 12-step approach by Kable and colleagues to document the search strategy. The (Whittemore & Knafl. 2005. Journal of Advanced Nursing, 52(5), 546–553) integrative review framework method was adopted and the methodological quality of the studies was assessed using Joanna Briggs critical appraisal instruments. Results Nine studies were included. Delegation between the Registered Nurse and the Assistant in Nursing is a complex but critical leadership skill which is impacted by the Registered Nurse\u27s understanding of the Assistant in Nursing\u27s role, scope of practice and job description. Newly qualified nurses lacked the necessary leadership skills to delegate. Further education on delegation is required in pre-registration studies and during nurses\u27 careers to ensure Registered Nurses are equipped with the skills and knowledge to delegate effectively. Conclusion With increasing numbers of Assistants in Nursing working in the acute care environment, it is essential that Registered Nurses are equipped with the appropriate leadership skills to ensure safe delegation practice
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