The provision of emergency healthcare for women who experience intimate partner violence: Part 2: Strategies to address knowledge deficits and negative attitudes

Background The first article in this two-part series evaluated healthcare professionals’ approaches to the care of women who present to the emergency department (ED) with injuries related to intimate partner violence (IPV). It identified barriers to appropriate care provision, which included a lack of healthcare professional knowledge and negative professional attitudes. Aim To delineate and evaluate strategies that aim to address the knowledge deficits and negative attitudes affecting the care of women presenting to the ED with IPV-related injuries. Method A rapid review of three databases was undertaken with strict inclusion and exclusion criteria. The literature was analysed using three-step thematic analysis. Findings Eleven articles were included in the review. Two main strategies to address ED healthcare professionals’ knowledge deficits and negative attitudes about IPV were identified. These were developed into the themes of IPV/domestic violence specialists, and education and training. Conclusion An IPV healthcare specialist in the ED and a focused IPV education and training programme may improve emergency healthcare professionals’ knowledge, attitudes and ability to respond appropriately to women presenting with IPV-related injuries

Hypocalcaemia-induced tetany secondary to total thyroidectomy: A nursing case review

Presentations to the emergency department with a diagnosis of hypocalcaemia-induced tetany secondary to total thyroidectomy are rare. A patient presented to the emergency department of a regional Australian hospital with hypocalcaemia-induced tetany. A case study was employed to reflect on the care provided and identify knowledge practice deficits within this unusual patient presentation. Calcium plays a central role within the nervous system and is vital for both cardiac and muscular contraction. The clinical manifestations of electrolyte disturbances such as hypocalcaemia can be life threatening, and therefore, appropriate assessment, monitoring and management are essential to ensure positive patient outcomes. Understanding the importance of calcium imbalance for the emergency and critical care nurse is paramount in preventing complications associated with cardiac conduction and muscle tone, especially the potential for airway compromise. Education is central to this and may include clinical case reviews, the application of pathophysiological presentations of electrolyte imbalance and a review of electrolyte administration guidelines. Understanding the role of calcium within the body will assist emergency and critical care nurses to assess, monitor and intervene appropriately, thereby preventing the life-threatening manifestations of hypocalcaemia

Nurse-initiated and criteria-led discharge from hospital for children and young people

The readiness of a child or young person for discharge includes patient safety, the family's ability to care for the child at home and the ongoing treatment they will need, which has a direct influence on their health outcomes and future readmissions to hospital. There are no standard criteria for discharge practice and registered nurses have reported concerns about their ability to provide education and discharge planning to meet the needs of the patient and their family. A literature review was carried out to ascertain the current discharge principles adhered to in practice and the implemented tools used. The problems faced by registered nurses include ineffective communication, poorly defined role in discharge planning and lack of agreement with the multidisciplinary team. The standardisation of discharge procedures may reduce the risk of readmission and health deterioration of the patient and ensure positive health outcomes, improve family health literacy and continuity of care

The provision of emergency healthcare for women who experience intimate partner violence: Part 1. An integrative review

This integrative review is the first of a two-part series about intimate partner violence (IPV). Part 2 will explore strategies to address barriers to the care of women who experience IPV in the emergency department (ED). IPV has become a major concern globally and specifically in Australia. Healthcare professionals in the ED are often the first point of contact for women experiencing IPV and therefore the provision of a comprehensive healthcare response to these vulnerable patients remains a priority. The review evaluated healthcare professionals' approaches to the care of women who present to the ED with injuries related to IPV. A systematic search of studies was undertaken using four databases. After the selection process, a total of 24 articles was identified. Six themes emerged: IPV care protocols, physical care provision, psychosocial care provision, provision of safety, role of referrals and barriers to appropriate care provision. There is a lack of evidence supporting healthcare approaches in the ED to address IPV. ED healthcare professionals experience numerous barriers that hinder their ability to provide patient-centred care, which suggests that patients presenting with IPV-related concerns may not be receiving adequate or appropriate healthcare in ED settings. © RCN Publishing Company Limited 2019

Can active learning principles be applied to the bioscience assessments of nursing students? A review of the literature

Objectives: To explore if active learning principles be applied to nursing bioscience assessments and will this influence student perception of confidence in applying theory to practice? Design and Data Sources: A review of the literature utilising searches of various databases including CINAHL, PUBMED, Google Scholar and Mosby's Journal Index. Methods: The literature search identified research from twenty-six original articles, two electronic books, one published book and one conference proceedings paper. Results: Bioscience has been identified as an area that nurses struggle to learn in tertiary institutions and then apply to clinical practice. A number of problems have been identified and explored that may contribute to this poor understanding and retention. University academics need to be knowledgeable of innovative teaching and assessing modalities that focus on enhancing student learning and address the integration issues associated with the theory practice gap. Increased bioscience education is associated with improved patient outcomes therefore by addressing this "bioscience problem" and improving the integration of bioscience in clinical practice there will subsequently be an improvement in health care outcomes. Conclusion: From the literature several themes were identified. First there are many problems with teaching nursing students bioscience education. These include class sizes, motivation, concentration, delivery mode, lecturer perspectives, student's previous knowledge, anxiety, and a lack of confidence. Among these influences the type of assessment employed by the educator has not been explored or identified as a contributor to student learning specifically in nursing bioscience instruction. Second that educating could be achieved more effectively if active learning principles were applied and the needs and expectations of the student were met. Lastly, assessment influences student retention and the student experience and as such assessment should be congruent with the subject content, align with the learning objectives and be used as a stimulus tool for learning

An integrative review of graduate transition programmes: Developmental considerations for nursing management

Graduate transition programmes have been developed to recruit new nursing staff and facilitate an effective transition from nursing student to Registered Nurse within the clinical environment. Therefore the aim of this paper was to explore the various elements included in nursing graduate transition programmes. An integrative review was undertaken incorporating a strict inclusion criterion, critical appraisal, and thematic analysis of 30 studies. There are numerous transition programmes available yet there remains a lack of transparency regarding their aims/objectives, course content, support timeframe and the type of support provided. This inconsistency has resulted in a lack of clarity regarding efficacy or superiority of any one programme over another. Innovative multifaceted programs may assist in supporting the graduate registered nurse to transition effectively into the clinical environment. Providing these support programmes may allow nurse managers to recruit new graduates and therefore decrease the staff budget expenditure. Implications for nursing management: No graduate programme was shown to be superior to others yet graduate programmes appear to positively influence the experience of the graduate and increase staff recruitment. Comparative research is needed to ascertain the integral components of these programmes

Using Colaizzi's method of data analysis to explore the experiences of nurse academics teaching on satellite campuses

Background Phenomenology is a useful methodological approach in qualitative nursing research. It enables researchers to put aside their perceptions of a phenomenon and give meaning to a participant's experiences. Exploring the experiences of others enables previously unavailable insights to be discovered. Aim To delineate the implementation of Colaizzi's (1978) method of data analysis in descriptive phenomenological nursing research. Discussion The use of Colaizzi's method of data analysis enabled new knowledge to be revealed and provided insights into the experiences of nurse academics teaching on satellite campuses. Local adaptation of the nursing curriculum and additional unnoticed responsibilities had not been identified previously and warrant further research. Conclusion Colaizzi's (1978) method of data analysis is rigorous and robust, and therefore a qualitative method that ensures the credibility and reliability of its results. It allows researchers to reveal emergent themes and their interwoven relationships. Researchers using a descriptive phenomenological approach should consider using this method as a clear and logical process through which the fundamental structure of an experience can be explored. Implications for research Colaizzi's phenomenological methodology can be used reliably to understand people's experiences. This may prove beneficial in the development of therapeutic policy and the provision of patient-centred care. © 2018 RCN Publishing Company Ltd. All rights reserved

Understanding registered nurse decision-making, communication and care delivery between emergency departments and residential aged care facilities: A research protocol

Objectives: Nursing staff in residential aged care facilities (RACF)s often make decisions about the transfer of residents to the emergency department (ED). This paper describes the protocol of a study that aims to understand decision-making process utilised by RACF registered nurses (RNs) and to explore the perceptions of RNs about the decision and communication process between RACF and ED. Methods: The proposed mixed-method study will survey and interview RACF RNs to understand their decision to transfer a resident and collect information about older people referred to the ED. Data collection will involve telephone survey, ED information system (EDIS) data and semistructured interviews. Results: The project outcomes will provide an understanding of existing ED service provision, communication between facilities and the reasons for transfer of older person to ED. This may inform redesign in communication processes between the ED and local RACFs and outreach care from the ED to RACFs