Medicine and Health Sciences Commons^™

An Investigation Of Registered Nurses’ Knowledge And Decision-Making Processes In Relation To The Management Of Adults With Diabetic Ketoacidosis, Megan Alice Westphalen

Theses

Introduction: Diabetic ketoacidosis (DKA) is an acute complication of diabetes. Registered nurses (RNs) knowledge with regard to DKA has never been investigated in any depth, nor has their decision making ever been examined in this specific context.

Research Significance: Nursing research literature acknowledges that nurses have an important role in the management of patient with DKA. However, there is very little empirical evidence available to support this claim. The purpose of this study is to provide evidence of the level of knowledge, the decision-making processes and the factors that influence nurses’ decision making whilst managing patients with DKA.

Methodology: A …

‘Burnt Out Lamps’: Exploring The Impact Of Occupational Stress And Burnout On The Wellbeing Of Intensive Care Nurses In A Tertiary Hospital, Swapna Mathew

Theses

Occupational stress and burnout are commonly experienced by nurses in the intensive care unit and contribute to poor nursing practice. A study in the United Kingdom revealed that approximately one-third of the intensive care unit team members were at a ‘high risk’ for burnout syndrome. Research suggests that multiple factors contribute to occupational stress and burnout, including nursing shortages, staff turnover, high workloads, workplace conflicts, and bullying. Research suggests that the wellbeing of nurses is imperative in ensuring the best delivery of care to patients, which further results in positive health outcomes for patients.

This study was conducted in a …

Participation Of Tanzanian Nurses And Midwives In The Implementation Of Millennium Development Goals 4 (Reduction Of Child Mortality) And 5 (Improvement Of Maternal Health): A Case Study, Peter Taratara

Theses

In 2000, the United Nations (UN) developed the Millennium Development Goals (MDGs) as an international framework to address poverty, promote sustainable development, and improve global health. The framework was translated into 8 goals with goals 4 and 5 targeting the reduction of child mortality and the improvement of maternal health. The UN and the World Health Organization (WHO) encouraged nurses and midwives to participate in the implementation process of the MDGs, and each country had the responsibility of formulating its own implementation policies and plans. The encouragement to participate was from the understanding that nurses and midwives are the backbone …

Journeying Through Uncharted Territory: The Role Of Humour In Adaption Of Undergraduate Nursing Students In Their First Year Of Study, Marie-Josée Boulianne

Theses

Newly graduated nurses adapting to their professional role have been studied, mainly in their first year of practice. The development of coping strategies, acculturation and other adaptations to the nursing world begin at the onset of the educational journey. Understanding how these manifest early in the formative years can enable educators to tailor nursing programs to assist the future nurse to develop positive coping mechanisms and help pave the way to a successful transition into practice. This research aimed to identify elements conducive to positive adaptation and wellbeing of nursing students during their first year of nursing studies, including the …

Cancer Education Framework For Australian Medical Schools, Darren Starmer

Theses

The incidence, mortality, survival, and impact of cancer on the Australian health system and community highlight the need for Australian medical schools to adequately prepare medical student to care for patients with cancer. Several studies have shown that Australian medical students are ill-prepared to care for cancer patients upon graduation. At a national level, oncology and palliative care curricula have been developed. However, it is unclear as to the level of uptake of either curricula within Australian medical schools. There remains a lack of consensus on what content to include in a cancer curriculum and how best to deliver such …

Nurse Escorts’ Perceptions Of Their Ability To Manage Patient Clinical Deterioration During Nurse-Led Inter-Hospital Ambulance Transfer In The Wheatbelt Region Of Western Australia: A Mixed Methods Study, Sinqobizitha Mndebele

Theses

The Western Australia (WA) Country Health Service (WACHS) requires a ward or emergency department registered nurse (RN) to assume the responsibility of conducting inter-hospital nurse-led patient ambulance transfers. In WACHS, these nurses are usually generalist nurses with no specialised training. WACHS has various escalation policies, guidelines and support systems for nurses when they are located within the hospital and wards. However, despite these escalation protocols being clear in this setting, their relevance and practicality during patient transport is uncertain. This research explores how well equipped WACHS RNs in the Wheatbelt region of WA are in managing clinical deterioration of patients …

Perceptions, Impact And Scope Of Medication Errors With Opioids In Australian Specialist Palliative Care Inpatient Services: A Mixed Methods Study (The Periscope Project), Nicole Heneka

Theses

Background: Opioids are a high-risk medicine, and one of the most frequently reported drug classes causing patient harm. In specialist palliative care inpatient services opioids are widely used to manage cancer pain and other symptoms. Palliative care inpatients are vulnerable to both exposure to, and harm from, opioid errors due to a combination of their: advanced age, comorbidities which affect drug metabolism, polypharmacy, and the seriousness of their illness. Despite this potential for harm, and the frequency of opioid administration in this specialist setting, little is known about opioid errors in palliative care. Better understanding the prevalence, patient impact and …

Using Digital Health Technology To Optimise Older People’S Pain Self-Management Capabilities: A Mixed Methods Study (The Digitech Pain Project), Priyanka Bhattarai

Theses

Background

Arthritic pain is a major cause of illness and disability among older people. As the use of smartphones and apps increases in the lives of older people, there is an opportunity to explore the role of these apps in helping older people better manage their arthritic pain.

Aim

To explore the feasibility and acceptability of older people using an arthritic pain selfmanagement app to improve their pain symptoms.

Methods

A parallel convergent, mixed methods design underpinned by Bandura’s Self-Efficacy Theory and the Technology Acceptance Model 2; comprising of the following five studies:

(i) Study 1a: an integrative review;

(ii) …

A Qualitative Descriptive Study About The Experiences And Views Of Undergraduate And Postgraduate Nursing Students: What Influenced Them To Choose The Mental Health Specialty, Kaile Moon

Theses

Nurses perform a vital role in the mental health (MH) speciality. The mental health nurse (MHN) role is complex with expectations to manage a safe milieu, practice person-centred care, crisis management, and therapeutic skills, teach coping skills, provide emotional support, and set professional boundaries. However, MHN recruitment and retention continues to be a global struggle. Nursing students typically have low interest in choosing the MH speciality. Strategies to reduce stigma and improve attitudes and beliefs about MH nursing and mental illness have been successful among nursing students, globally and in Australia. However, these successful strategies have not extended to an …

Moral Competence In Nursing: An Exploration Of The Giving Voice To Values Curriculum, Catherine Costa

Theses

The development of moral competence is central to the profession of nursing and its practice. Nurses engage in moral decision making that impacts the health of people, families, and communities. It is important, then, to ensure that nursing graduates possess the necessary moral development for engaging in professional practice. To this end, research was conducted, the principle premise of which was to explore the use of the introduction of the Giving Voice to Values curriculum (Gentile, 2010) and its contribution to the development of moral competence in nursing. The Giving Voice to Values curriculum is a values-based methodology enabling students …

Being On Track: A Phenomenological Study Of The Lived Experience Of Staff Development Nurses’ Transition From A Ward-Based Role To The Role Of Staff Development Nurse In A Hospital In Western Australia, Penny Keogh

Theses

Continuing education is widely accepted as a means to remain competent in nursing and knowledgeable about the numerous changes in health care and the health care environments in which nurses work. The ward-based staff development nurse (SDN) role is considered a vital support for clinical staff (Armstrong & Laschinger, 2006; Conway & Elwin, 2007), with the role responsible for organising orientation and continuing education for nursing staff in their respective area of specialty. There is a dearth of research on the lived experience of the hospital-based SDN, most of whom have no formal training or preparation for their role. Newly …

"Taming The Beast": Exploring The Lived Experience Of Relapsing Remitting Multiple Sclerosis Using A Life History Approach, Therese Burke

Theses

Multiple Sclerosis (MS) is a complex neurological disease affecting the central nervous system and is driven by a complex autoimmune cascade. The peak age of onset is between the ages of 20 and 40 years and shows a female preponderance of 3:1. The most common form of the disease affecting 85% of people living with the illness is called relapsing remitting MS (RRMS), and is characterised by unpredictable relapses or exacerbations which usually last a few weeks before returning to baseline function. There is the possibility of disease progression and non-reversible disability after many years. RRMS is also characterised by …

"Bridging Two Worlds?”: Towards Cultural Safety Within Schools Of Nursing In Australian Universities, Samantha Petric

Theses

Cultural safety has been a developing movement within the nursing profession in Australia over the past decade, led by the Congress of Aboriginal and Torres Strait Islander Nurses and Midwives. This thesis explores this progress towards cultural safety; with a focus upon the Schools of Nursing in Australia. The philosophical and educational shifts from cultural awareness and competence, towards cultural safety are required within these very Schools that prepare nurses for their profession and its practice.

This thesis utilises a descriptive survey method, derived from the Aboriginal and Torres Strait Islander Health Framework, to gather information about the Schools of …

Perceptions Of Parental Awareness, Knowledge And Anxiety Levels Regarding Infant Cardiopulmonary Resuscitation Training Amongst Parents Residing In Southern Tasmania, Nakita Stephens

Theses

Prenatal and postnatal education help to prepare parents to care appropriately for their newborn child. This education however, rarely includes learning infant cardiopulmonary resuscitation or CPR. CPR for Infants differs from both adult and paediatric resuscitation techniques, and most people who do learn CPR usually only learn adult techniques. Research shows that bystander intervention with CPR improves the chances of both survival and survival without sequelae in out of hospital arrests. Including Infant CPR education as part of the general parent education could assist in scenarios of Sudden Infant Death Syndrome (SIDS) or other emergency situations. Some concern has been …

The Steering Towards Readiness Framework : The Lived Experience Of Clinical Facilitators In Identifying, Assessing And Managing Students At Risk Of Not Being Ready To Practice As Beginning Practitioners Within Western Australian Health Settings, Rosealie Southwell

Theses

Clinical facilitators (CFs) are a fundamental resource for student registered nurses (RNs) as they facilitate the consolidation of theory and practice in preparation for registration with the Nursing and Midwifery Board of Australia (NMBA). Health service providers (HSPs) and higher education providers (HEPs) require CFs to identify, assess and manage (I, A & M) the risks of final placement nursing students and, in doing so, protect risk to patient safety. This research aimed to explore the lived experience of CFs in Western Australia in identifying, assessing and managing risk of a student progressing to be a RN. The study used …

The Identification Of The Role And Competencies Of The Graduate Nurse In Recognising And Responding To The Deteriorating Patient In An Acute Ward Environment: A Mixed Methods Study, Steven Hardman

Theses

The identification of the role and competencies of the graduate nurse in recognising and responding to the deteriorating patient in an acute ward environment: A mixed method study. Patients’ physiological condition can be unstable for prolonged periods before transfer to critical care units. Thus, it is imperative that ward based nurses are able to recognise, respond and initially manage patients with a deteriorating condition. Unfortunately, warning signs of physiological decline are often missed, or ignored by both experienced and newly graduated registered nurses. Complex systems and processes to recognise and respond to clinical deterioration have been developed to try to …

The Factors Influencing Nurse Graduates Use Of Mobile Technology In Clinical Settings In Perth Western Australia: A Mixed Method Study, Benjamin Hay

Theses

The ubiquitous use of mobile technology in today’s society extends to the learning and teaching environment. Most academics in universities encourage its use, aided by libraries offering online resources. Whilst the literature highlights benefits of using mobile technology in learning, particularly for nurses to keep up-to-date, there is limited evidence on such use in clinical settings by graduate nurses in Western Australia (WA). Additionally, there is a lack of information and clarification on the use of such technology in WA hospitals. The purpose of this study was to identify and explore factors influencing the use of mobile technology by newly …

The Role Of The Public Health Nurse In Rural Areas Of Kerry And Cork, Hannah Healy

Theses

Aim of Research: To understand and gain insight into the role of the Public Health nurse in rural communities in Kerry and Cork.

Background: Public health nursing is the single largest group in community care, current figure employed by the HSE stands at 1,438. Demographic, changes such as the increase in population coupled with the shift in care from the acute sector to primary care has provided many challenges to the PHN service .

Objective: Whilst there have been substantial reviews on the role and workload of the PHN in Ireland, there is limited qualitative research available on what the …

Effect Of A Nurse-Led Lymphoma Survivorship Model Of Care: A Pragmatic Phase Ii Pilot Randomised Controlled Trial, Karen Taylor

Theses

Background: Cancer survivorship is recognised as an integral component of the cancer continuum. Robust evidence on how best to deliver tailored survivorship care is limited, particularly for individuals affected by rarer cancers such as lymphoma, a potentially curable haematological cancer. These survivors may face long-term and late effects affecting quality of life due to the aggressiveness of the disease and treatment that may not be adequately addressed in current follow-up models of care.

Aim: To develop and pilot test a nurse-led model of survivorship care intervention that utilises an individualised survivorship care plan and treatment summary (SCPTS), motivational interviewing, tailored …

A Mixed Methods Sequential Explanatory Study Of Male Farmers' Health Beliefs, Attitudes And Practices In Rural Kerry, Chrystal O'Brien

Theses

Aim/Background: Beliefs and attitudes about health directly and indirectly influence concomitant behaviours, practices and health outcomes. In Ireland, male farmers are experiencing a disproportionate burden of ill health in preventable lifestyle diseases, yet there is a lack of behavioural research in relation to male farmers and their health. Therefore, the purpose of this study was to examine the health beliefs, attitudes and practices of male farmers in rural Kerry, and to explore healthcare professionals' insights of male farmers' health beliefs, attitudes and practices.

Methodology: The study adopted a mixed methods design. Phase one of the study involved structured interviews with …

Readiness For Assisted Decision-Making: An Exploratory Qualitative Study, Kay Cronin

Theses

Background: Ireland has recently enacted the Assisted Decision-Making (Capacity) Act 2015. The enactment of the legislation has allowed Ireland to ratify the United Nations Convention on the Rights of People with Disabilities (2008). The convention obliges all member states to assist people with disabilities to make their own decisions, with their will and preference taking precedence over what others deem to be in their best interests. Implementation of this legislation requires a change in working practice among health and social care providers to promote autonomy and decision-making among service users. To date, this topic has not been researched in Ireland. …

Evaluation Of An E-Learning Training Package By Nurses For Various Designations For Developing Clinical Skills And Knowledge., Nitasha A. Narayan

Theses

An essential component of nurses delivering good healthcare is continuous education. However, nurses’ [participation in continuing education can be hampered by lack of time, limited access to educational resources and cost concerns. Globally, electronic learning has emerged in the last decade as a flexible mechanism to provide education for nurses.

The purpose of this research is to evaluate an e-learning training package used by nurses of various designations for developing clinical skills and knowledge at a private hospital in Perth, Western Australia (‘The Hospital’). This study employs descriptive correlational design – a non-experimental quantitative approach. Data was collected via a …

Intensive Care Nurses’ Attitudes, Beliefs And Reported Practices Relating To Patient Sleep: A Descriptive Study, Rebecca Hahn

Theses

Empirical evidence suggests that patients treated in the intensive care unit (ICU) experience chronic sleep disturbance, leading to sleep deprivation. Multiple intrinsic and external factors contribute to poor quantity and quality of sleep among critically ill patients. Noise, light and clinical interventions are some of the external factors most disruptive to patient sleep in the ICU. Given that nurses are the gatekeepers to the ICU, understanding their perceptions and practices relating to patient sleep is necessary to elicit change. However, ICU nurses’ attitudes, beliefs and practices relating to sleep are poorly understood.

Using a descriptive survey method, this study investigated …

Development Of A Professional Practice Competency For Undergraduate Nursing Students At A Private Catholic University In Western Australia: A Mixed-Method Study, Christine Adams

Theses

This research investigating professional student nursing practice occurred at a private Catholic university in Western Australia. The objects of this university articulate the provision of education in the context of Catholic faith and values. The objects are further expressed through the university’s 10 graduate attributes, which every student should have achieved by graduation. These attributes aim to foster and grow the qualities of ethical practice, interpersonal skills, professionalism, specialist knowledge and skills to support local and global communities. Suggested university strategies for attaining these attributes include undertaking high-quality work-integrated learning and building strong and mutually beneficial relationships with industry partners …

Psychometric Testing Of The Endotracheal Suction Assessment Tool© (Esat©): An Exploratory Sequential Mixed Methods Study, Kylie Davies

Theses

Background: Endotracheal tube (ETT) suction is a common nursing procedure performed in paediatric intensive care settings. Significant side effects of this procedure can dramatically affect the stability of the critically ill ventilated paediatric patient. The lack of clear standards for determining when the procedure is warranted, especially in paediatrics, can present challenges for the inexperienced paediatric intensive care nurse when assessing a patient’s need for ETT suction. Previous research underpinned the development of an Endotracheal Suction Assessment Tool© (ESAT©) to guide inexperienced nurses through the decision making process to determine suction requirements. The aim of the ESAT© is to improve …

Narratives Of Experience: Senior Registered Nurses Working With New Graduate Nurses In The Intensive Care Unit, Susan Whittam

Theses

The experiences and perceptions of New Graduate Nurses as they transition into professional practice and into intensive care units abounds in the literature. However, there is a dearth of literature exploring the experiences of Senior Registered Nurses who work with New Graduate Nurses in intensive care units.

The aim of this inquiry was to contribute to nursing knowledge by examining Senior Registered Nurses’ stories of experience around the complexity of enabling development of New Graduate Nurses whilst working in clinical or team leading roles in the intensive care unit. Thus, allowing the Senior Registered Nurses’ voice to be heard in …

Aboriginal Women Yarning About Experiences As Undergraduate Nursing Students In Western Australian Universities, Melanie Robinson

Theses

The inequities and poor health outcomes experience by Aboriginal people in Western Australia are well documented. It has been suggested that such issues could be better addressed if more Aboriginal nurses are employed, as there appears to be a link between improved health outcomes and the inclusion of Aboriginal health professionals in practice. In recent years the number Aboriginal nursing students undertaking tertiary studies has increased, but their completion rates could be improved. Aboriginal nursing students continue to struggle to achieve success.

The aim of this study was to investigate factors that enabled (supported) or inhibited (prevented) the progress of …

The Influence Of The Supernumerary Clinical Nurse Educator Role On Advancing Graduate Nurses’ Quality Of Patient Care: A Mixed-Methods Study In A Private Western Australian Health Service, Tracey Coventry

Theses

Theoretical and anecdotal evidence suggests that the presence of the supernumerary clinical nurse educator (CNE) in the acute care hospital clinical environment will positively affect patient quality outcomes. However, the supernumerary role suffers from scrutiny in response to the financial constraints of healthcare organisations, and is questioned regarding sustainability. The lack of empirical research diminishes the CNE role and its benefit for patient quality of care. This research focuses on newly qualified graduate registered nurses (GRNs) employed in a graduate programme and supported by the CNE in the clinical environment in order to articulate the effect of the supernumerary CNE …

The Modification Of Two Tools To Measure Emotional Intelligence In Undergraduate Student Nurses: A Mixed Method Pilot Study, Laurel Collin

Theses

Nurses need a range of strategies to manage their clinical practice while helping patients to cope with their health problems. Stress and inefficient coping skills of student nurses have been shown to lead to attrition within the university and later, on graduation, in the workplace. Student nurses can learn some of these strategies as they are expected to cope with issues associated with the practical nature of nursing, university demands and home life. One strategy offered is the use of emotional intelligence (EI). An ability to monitor and regulate emotions may contribute to an increase in the repertoire of coping …

Integrating A Code Of Professional Conduct And Ethics: An Action Research Approach, Ciara Kissane

Theses

A new version of the Code of Professional Conduct and Ethics for Registered Nurses and Registered Midwives (NMBI, 2014a) was published in 2014. A nurse’s fitness to practice, and the associated patient experience, is determined by the extent to which the nurse accords with the duties outlined in the Code. Professional misconduct among members of the nursing profession has been highlighted within recent reports and enquiries. The failure to act on unethical care is also a feature. The literature suggests that Codes are poorly understood and can be problematic to integrate in practice. This study sought to; explore the impact …