Are new nurses work ready – the impact of preceptorship. An integrative systematic review

The aim of this integrative systematic review was to systematically search, critically appraise, and summarise reported research related to readiness to practice and types of clinical support offered to newly registered nurses and preregistration nurses (such as, mentoring, preceptorship, or clinical facilitation). The review was undertaken in February 2017. The databases of Medline, CINAHL, Academic Search Complete, and Cochrane Library were searched. The search returned 137 articles. The final number of papers (after screening and exclusions) was 15 articles related to the topic. Key findings that influence work readiness for newly registered nurses were - Importance of Preceptors for Facilitating Work Readiness with the sub themes of Positive relationships between the preceptors and the student or newly registered nurse, Preparing and supporting the preceptor for the role and Using a model to guide preceptorship of students, the second theme was related to Clincal Exposure, including a sub theme of Adequate clinical exposure and clinical competence. Work readiness has been attributed to many factors and this review has revealed a number of key factors that contribute to newly registered nurses’ work readiness such as preparation of the preceptor, positive relationships and adequate clinical exposure.

General Hospital Health Professionals' Attitudes and Perceived Dangerousness Towards Patients with co-Morbid Mental and Physical Health Conditions: Systematic Review and Meta-Analysis

The stigmatisation of mental health is present in general hospital settings impacting quality of care. We hypothesised that health professionals in these areas would elicit negative attitudes and a perceived level of dangerousness across a range of mental health disorders. We aimed to conduct a systematic review and meta-analysis to examine these attitudes and perceptions. We searched the bibliographic databases of CINAHL Complete, MEDLINE Complete, PsycINFO and Psychology and Behavioral Sciences Collection in May 2017 (no date parameters were set). Quantitative studies investigating generalist health professionals’ attitudes towards mental health conditions were selected. Initially prevalence meta-analyses were conducted to assess the extent of perceived danger, followed by a series of comparative meta-analyses in which the perceived dangerousness of mental health conditions were compared. Of the 653 citations retrieved, eight studies met the inclusion criteria. The overall sample included 2548 health professionals. A majority of health professionals perceived patients with substance use disorder as dangerous 0.60 (95% CI: 0.32 to 0.88) when compared with patients who had an alcohol-related disorder, schizophrenia and depression. The results also indicated that a large proportion of staff perceived patients with a diagnosis of schizophrenia as dangerous 0.42 (95% CI: 0.33 to 0.52). Negative attitudes towards people experiencing mental illness in general hospital settings may be attributed to poor mental health literacy, skills and limited exposure, and social and cultural beliefs about mental illness. Ongoing professional development targeting mental health knowledge is recommended for health professionals working in general hospital settings

Cardiac outcomes 12 months post percutaneous coronary intervention

Cardiovascular disease (CVD) has over the last decade emerged as the single most important cause for death worldwide [1]. Percutaneous coronary intervention (PCI) is a very common revascularisation procedure for coronary artery disease (CAD). Despite advancement in surgical technology, PCI is associated with a range of post-procedural complications, including physical [2] and psychological morbidity [3]. Research findings are inconclusive as to the impact of PCI on quality of life post-procedure. There also appears to be no studies that have examined the notion of personal resilience in this group of patients. The aim of this longitudinal prognostic study was to evaluate cardiac outcomes including - health related quality of life (HRQoL), personal resilience, mental health and adherence behaviours in patients who have had undergone a PCI measured at two time points (6 months and 12 months) post-intervention

Effect of a thermal care bundle on the prevention, detection and treatment of perioperative inadvertent hypothermia

Aims and Objectives: To improve the prevention, detection, and treatment of perioperative inadvertent hypothermia (PIH) in adult surgical patients by implementing a Thermal Care Bundle. Background: Keeping patients normothermic perioperatively prevents adverse surgical outcomes. Hypothermia leads to serious complications including increased risk of surgical bleeding, surgical site infections, and morbid cardiac events. The Thermal Care Bundle consists of three elements: 1) assess risk; 2) record temperature; and (3) actively warm. Design: A pre-post implementation study was conducted to determine the impact of the Thermal Care Bundle on the prevention, detection and treatment of PIH. Methods: The Thermal Care Bundle was implemented using an adapted version of the Institute of Healthcare Improvement's Breakthrough Series Collaborative Model. Data were collected from auditing medical records. Results: Data from 729 patients (pre-implementation: n=351; post-implementation: n=378) at four sites were collected between December 2014 to January 2016. Improvements were recorded in the percentage of patients with a risk assessment; at least one documented temperature recording per perioperative stage; and appropriate active warming. Despite this, the overall incidence of PIH increased post-implementation. Conclusion: The Thermal Care Bundle facilitated improved management of PIH through increased risk assessment, temperature recording, and active warming but did not impact on PIH incidence. Increased temperature recording may have more accurately revealed the true extent of PIH in this population

Using self-management to control seizures

The aim of this study was to develop, deliver and evaluate the impact of an education intervention regarding lifestyle self-management in the control of seizures, health related quality of life (HRQoL), satisfaction with life and resilience for adults with epilepsy

An Australian longitudinal pilot study examining health determinants of cardiac outcomes 12 months post percutaneous coronary intervention

Background Percutaneous coronary intervention (PCI) is a very common revascularisation procedure for coronary artery disease (CAD). The purpose of this study was to evaluate cardiac outcomes, health related quality of life (HRQoL), resilience and adherence behaviours in patients who have undergone a PCI at two time points (6 and 12 months) following their procedure. Methods A longitudinal pilot study was conducted to observe the cardiac outcomes across a cohort of patients who had undergone a percutaneous coronary intervention (PCI). Participants who had undergone PCI 6 months prior were invited. Those participants who met the inclusion criteria and provided consent then completed a telephone survey (time point 1). These participants were then contacted 6 months later (i.e. 12 months post-intervention, time point 2) and the measures were repeated. Results All patients (n = 51) were recorded as being alive at time point 1. The multiple model indicated that controlling for other factors, gender was significantly associated with a linear combination of outcome measures (p = 0.004). The effect was moderate in magnitude (partial-η2 = 0.303), where males performed significantly better than females 6 months after the PCI procedure physically and with mood. Follow-up univariate ANOVAs indicated that gender differences were grounded in the scale measuring depression (PHQ9) (p = 0.005) and the physical component score of the short form measuring HRQoL (SF12-PCS) (p = 0.003). Thirteen patients were lost to follow-up between time points 1 and 2. One patient was confirmed to have passed away. The pattern of correlations between outcome measures at time point 2 revealed statistically significant negative correlation between the PHQ instrument and the resilience scale (CD-RISC) (r = -0.611; p < 0.001); and the physical component score of the SF-12 instrument (r = -0.437; p = 0.054). Conclusions Men were performing better than women in the 6 months post-PCI, particularly in the areas of mood (depression) and physical health. This pilot results indicate gender-sensitive practices are recommended particularly up to 6 months post-PCI. Any gender differences observed at 6 month appear to disappear at 12 months post-PCI. Further research into the management of mood particularly for women post-PCI is warranted. A more detailed inquiry related to access/attendance to secondary prevention is also warranted

The experience of mental health literacy in health professionals in non-mental health areas

Some literature suggests that health professionals in acute medical care settings find the complex care of patients who experience mental and physical co-morbidities challenging and consequently the patient experience of care can be poor. A number of studies have investigated health professional's attitudes and perceptions however there is limited research that investigates the lived experience in a current healthcare context. The aim of this research was to explicate an in-depth description of the health professional's experience when caring for patients experiencing co-morbid physical and mental illness in acute medical care settings. A phenomenological design was undertaken with six participants representing nursing and medical disciplines. One-on-one semi-structured interviews were used and the data collected underwent thematic analysis using an extended version of Colaizzi's phenomenological inquiry. The areas that emerged were: managing challenging behaviours, optimising environmental factors, mental health skills and knowledge, and managing negative attitudes. These areas can be considered for extending mental health literacy of general health professional

The phenomenon of co-morbid physical and mental illness in acute medical care: The lived experience of Australian health professionals

Background An estimated 30–50% of patients admitted to acute medical care settings experience co-morbid physical and mental illness. Research suggests that health professionals in these settings find managing this patient group challenging. A number of studies have investigated health professional’s attitudes and perceptions however there is limited research that investigates the lived experience in a current Australian healthcare context. The aim of this study was to explicate an in-depth description of the health professional’s experience when caring for patients experiencing co-morbid physical and mental illness in Australian acute medical care settings. Methods A phenomenological design was undertaken with six participants representing nursing and medical disciplines. In 2013–2014 one-on-one semi-structured interviews were used and the data collected underwent thematic analysis using an extended version of Colaizzi’s phenomenological inquiry. Results Six themes emerged including—challenging behaviours, environmental and organisational factors, lack of skills, knowledge and experience, hyper-vigilance and anxiety, duty of care and negative attitudes with an overarching theme of fear of the unknown. Conclusions Staff in acute medical care settings were unsure of patients with mental illness and described them as unpredictable, identifying that they lacked requisite mental health literacy. Regular training is advocated