The influence of personal characteristics on perioperative nurses' perceived competence: Implications for workforce planning

Objective: To examine the influence of personal characteristics on perioperative nurses' perceived competence. Design: A cross-sectional survey design was used. Setting: A census of 3,209 operating room nurses who were members of the Australian College of Operating Room Nurses across all Australian states and territories was invited to participate. Primary Outcome Measure: The Perceived Perioperative Competence Scale-Revised, a 40-item survey consisting of six subscales measuring the dimensions of perioperative competence was used. Results: A total of 1,044 usable surveys were analysed representing 32.5% of the accessible population. Across the six subscales, demographic predictors accounted for 5% to 33% of the variance in nurses' perceived perioperative competence. Conclusions: These results may inform workforce planning initiatives designed to address the needs of this diverse specialty group. Efforts to retain older nurses need to be centered on redesigning workplaces, increased remuneration and professional recognition, and integrating technology to promote efficiency and safety. Workforce planning should include strategies such as creating academic partnerships with universities, to provide perioperative nurses access to specialty education and advanced skills programs

Hospice nurses’ views on single nurse administration of controlled drugs

noBackground: The involvement of two nurses to dispense and administer controlled drugs is routine practice in most clinical areas despite there being no legal or evidence-based rationale. Indeed, evidence suggests this practice enhances neither safety nor care. Registered nurses at two hospices agreed to change practice to single nurse dispensing and administration of controlled drugs (SNAD). Participants’ views on SNAD were evaluated before and after implementation. The aim of this study was to explore the views and experiences of nurses who had implemented SNAD and to identify the views and concerns of those who had not yet experienced SNAD. Method: Data was obtained through semi-structured interviews. Results: Qualitative thematic analysis of interview transcripts identified three key themes: practice to enhance patient benefit and care; practice to enhance nursing care and satisfaction; and practice to enhance organisational safety. Conclusion: The findings have implications for the understanding of influences on medicines safety in clinical practice and for hospice policy makers

Psychometric evaluation of the German version of a social support scale of FAFHES (family functioning, family health and social support)

This is the peer reviewed version which has been published in final form at https://doi.org/10.1111/scs.12700. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions.BACKGROUND: Family members often need to be supported in informal care of the elderly and desire to be involved into care planning and decision-making. Valid and reliable instruments are needed to measure how family members perceive the care and support they receive from nurses for older family members living at home. AIM: The purpose of this study was to translate the 20-item social support scale of the Family Functioning, Family Health and Social Support (FAFHES) questionnaire from English to German and test the validity and reliability of the scale among Swiss-German-speaking family caregivers of home-dwelling elderly people who receive home healthcare services. METHODS: A cross-sectional study was conducted to test the empirical and psychometric properties of the translated and culturally adapted version of the social support questionnaire. A factor analysis with the principal component analysis PCA was used to test construct validity. The internal consistency of items was measured with the Cronbach`s alpha coefficient. RESULTS: After a rigorous translation process the original 20-item questionnaire was adapted into a 19-item version and tested with family caregivers (n = 207) of home-dwelling elderly. Psychometric testing of the German version of the social support questionnaire revealed that the three factors - affirmation, affect and concrete aid - were congruent with the original questionnaire. The accounted variance was 79.5% and the internal consistency determined by the Cronbach's alpha was 0.973. CONCLUSION: The German version of the social support scale of the FAFHES questionnaire is a valid and reliable instrument to assess family perceived support on three dimensions - affirmation, affect and concrete aid - received from nursing professionals. The questionnaire should be tested further in other German-speaking population

Transvaginal ultrasound simulation and its effect on trainee confidence levels: A replacement for initial clinical training?

Introduction: The ScanTrainer transvaginal ultrasound simulator has been developed to facilitate initial training of transvaginal ultrasound skills without patient contact. Due to the intimate nature of the examination and in some cases, limited training opportunities, the need for simulation-based education in ultrasound has gained momentum. Currently, research into the effectiveness of the ScanTrainer is limited. Methods: A mixed method study was conducted in a single institution between October 2011 and January 2012. Participants were recruited using convenience sampling and allocated to the control (clinical training) or experimental (simulation training) group following a pre-test. After 10 hours of their allocated transvaginal ultrasound training method a post-test assessment was conducted and the results statistically analysed. Participants then experienced the alternative method of training and completed questionnaires. The results were used to inform semi-structured interviews for each group. Interview transcripts were interpreted using theme analysis. Results: A small number of doctors completed the study, nine (82%) out of the 11 recruited. The majority of participants (89%) felt that practice on the ScanTrainer can increase confidence prior to attempting a real transvaginal ultrasound scan. Average scores showed that the simulation training group outperformed the clinical training group on overall score and each of the five post-test components. No statistically significant differences were demonstrated for overall score (U = 13, P = 0.556) or the five components (P = 0.190–1). Conclusions: Transvaginal ultrasound training on the ScanTrainer has the potential to replace initial clinical training; however, further larger trials are required to evaluate. Clinically significant outcomes exist if the ScanTrainer training is proven to be more effective than initial clinical training. The ScanTrainer prepares a trainee and builds confidence to progress to clinical scanning, which has the potential to improve the patient experience

The relationship between attitudes, beliefs and physical activity in older adults with knee pain: secondary analysis of a randomised controlled trial

Objective To investigate how attitudes and beliefs about exercise relate to physical activity behavior in older adults with knee pain attributable to osteoarthritis (OA). Methods We conducted secondary data analyses of a randomized controlled trial of exercise interventions (ISRCTN: 93634563). Participants were adults ≥45 years old with knee pain attributable to OA (n = 514). Crude and adjusted cross‐sectional and longitudinal associations between baseline Self‐Efficacy for Exercise (SEE), Positive Outcome Expectations for Exercise (POEE), Negative Outcome Expectations for Exercise scores, and physical activity level, at baseline, 3 months, and 6 months (measured by self‐report using the Physical Activity Scale for the Elderly [PASE]), and important increases in physical activity level (from baseline to 6‐month followup) were investigated using multiple linear and logistic regression. Results Cross‐sectional associations were found between SEE and PASE scores (β = 4.14 [95% confidence interval (95% CI) 0.26, 8.03]) and POEE and PASE scores (β = 16.71 [95% CI 1.87, 31.55]), adjusted for sociodemographic and clinical covariates. Longitudinal associations were found between baseline SEE and PASE scores at 3 months (β = 4.95 [95% CI 1.02, 8.87]) and 6 months β = 3.71 (0.26, 7.16), and baseline POEE and PASE at 3 months (β = 34.55 [95% CI 20.13, 48.97]) and 6 months (β = 25.74 [95% CI 11.99, 39.49]), adjusted for baseline PASE score and intervention arm. However, no significant associations with important increases in physical activity level were found. Conclusion Greater exercise self‐efficacy and more positive exercise outcome expectations were associated with higher current and future physical activity levels. These may be targets for interventions aimed at increasing physical activity

Researching the lived experiences of cancer patients with malignant fungating wounds

Background: Researching the experiences of terminally ill patients with disfiguring wounds is likely to be a challenge anywhere, and this investigation came face-to-face with different attitudes on the part of both patients and nurses and doctors in England (the South-East) and Italy (Tuscany). Aim: To highlight the complexity of researching sensitive subjects and the difficulties encountered from the perspective of the researcher(s). Methods: Fourteen patients were interviewed. In England access was relatively straightforward, with nurses linked to the hospice doing most of the recruitment. Access was more difficult in Italy, with some doctors expressing opposition. Discussion: How ethical is it to treat dying patients as subjects for research? How does research of this kind vary from one culture to another? Conclusions: Interviewees can find it therapeutic to talk about their experiences to a sympathetic listener—although the listening does pose a considerable strain on the researcher

Assessing the vulnerability of women to sexually transmitted diseases STDS/ HIV: construction and validation of markers

Objective To construct and validate markers of vulnerability of women to STDs/HIV, taking into consideration the importance of STDs/HIV. Method Methodological study carried out in three stages: 1) systematic review and identification of elements of vulnerability in the scientific production; 2) selection of elements of vulnerability, and development of markers; 3) establishment of the expert group and validation of the markers (content validity). Results Five markers were validated: no openness in the relationship to discuss aspects related to prevention of STDs/HIV; no perception of vulnerability to STDs/HIV; disregard of vulnerability to STDs/ HIV; not recognizing herself as the subject of sexual and reproductive rights; actions of health professionals that limit women’s access to prevention of STDs/HIV. Each marker contains three to eleven components. Conclusion The construction of such markers constituted an instrument, presented in another publication, which can contribute to support the identification of vulnerabilities of women in relation to STDs/HIV in the context of primary health care services. The markers constitute an important tool for the operationalization of the concept of vulnerability in primary health care and to promote inter/multidisciplinary and inter/multi-sectoral work processes