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

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