Medicine and Health Sciences Commons^™

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 …

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 …

Investigating The Molecular Pathology Of Dupuytren’S Disease, Robert Pearce

Theses

The eponymous progressive palmar fibromatosis described by Guillaume Dupuytren in 1831 is a common and debilitating disease with limited treatment options and high rates of recurrence after intervention. Dupuytren’s disease has been generally accepted as predominantly affecting Northern European individuals; Dupuytren’s disease is sometimes referred to as “Vikings Disease” as an attribution to this ethnic origin. Its familial occurrence in all communities is suggestive of Mendelian inheritance as an autosomal dominant disease with incomplete penetrance. The genetic and molecular basis of Dupuytren’s disease (DD) has been the focus of many studies, with increasingly sophisticated approaches since the sequencing of the …

Parent Rated Importance Of Active Play And Organised Physical Activity For Young Children, Casey Murphy

Theses

Background: Children participate in less daily physical activity, both organised and informal, often referred to as active play (AP), than in the past. For young children, parents are primarily responsible for planning their child’s day including their engagement in physical activity.

Purpose: As there has been little research in this area, the purpose of this study was to examine how parents rated the importance of their child’s level of AP and organised physical activity (OPA), how this affected the amount of time their child participated in these activities, and whether their child’s physical activity (PA) related to their own level …

The Who.I.Am Study : Identity Formation And Motor Competence In Adolescents, Amanda Timler

Theses

Our sense of identity is an emergent concept that develops over the lifespan in response to many factors, however the adolescent phase is the most critical. During adolescence, some factors that influence identity are level of parent and peer support, environmental stresses and the ability to form personal interests and goals. These factors influence the health of one’s identity in both positive and negative ways, which may differ between males and females. Therefore, identity health refers to an individual’s capacity to develop a positive sense of self and to integrate their self within a number of valuable social settings. One …

Open Versus Endovascular Thoracic Aneurysm Repairs In Australia, Timothy Shiraev

Theses

Objectives: Thoracic aortic aneurysms (TAAs) affect 10 per 100,000 people, and are responsible for significant mortality. Open surgical repair carries substantial risks of both morbidity and mortality. Endovascular TAA repair is a relatively new technology, with numerous proposed benefits over open repair. However, data is yet to demonstrate whether endovascular TAA repairs outperform open repair. We sought to observe trends and outcomes of TAA repairs over the previous decade in order to identify the optimal method of management of thoracic and thoracoabdominal aneurysm repairs, as well as predictors of poor outcome.

Methods: We conducted a retrospective analysis of all patients …

Modelling Spatial Heterogeneity In The Haemodynamic Response With Implications For Neuroimaging, Russell Gore

Theses

Background: A foundational assumption of neuroimaging is the central volume principle (CVP): the mean transit time of oxygen particles in the brain equals the ratio of blood vessel volume to blood flow. Changes in mean transit time are expected to cause detectable changes in images produced by functional magnetic resonance imaging (fMRI). The CVP assumes a uniform distribution of transit times, but in fact blood vessel volumes are spatially heterogeneous. This thesis examines the implications of spatial heterogeneity for fMRI research.

Methods: An amended form of the CVP that accounts for spatial heterogeneity is developed and parameterised using empirical data. …

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 …

Promoting Student Belongingness: The Development, Implementation And Evaluation Of A Toolkit For Nurses, Christine King

Theses

The literature suggests that the need to belong to a community influences health and wellbeing, which in turn affects behavioural, and cognitive responses. However, student nurses are often in a vulnerable position of being excluded intentionally or otherwise from ward/unit activities. This can lead to feelings of isolation and poor achievement.

The aim of this project was to design and develop a toolkit for nurses in an e-learning format using reflective learning to promote a sense of belonging and inclusion of student nurses in the clinical team. Upon completion of the development of the e-learning program, distribution commenced to selected …

Assessment Of The Neuroprotective Efficacy Of Poly-Arginine-18 (R18) Peptides In A Pre-Clinical Model Of Perinatal Hypoxic-Ischaemic Encephalopathy (Hie), Adam Edwards

Theses

Hypoxic-ischaemic encephalopathy (HIE) is one of the leading causes of mortality and morbidity in infants, globally. This disorder eventuates following a reduction in oxygenated cerebral blood flow to the foetus in utero, leading to excitotoxic-mediated brain cell (e.g. neuron, glia and glial progenitor cell) death. Currently, there is no clinically appropriate neuroprotective treatment to reduce acute brain injury following HIE. Recent studies have demonstrated that poly-arginine and cationic arginine-rich peptides (CARPs; e.g. R18: R = arginine residues) exhibit potent neuroprotective properties in both in vitro and adult animal models of ischaemia, and therefore have the potential to be developed into …

Diagnosing Pulmonary Hypertension Due To Left Heart Disease Using Diastolic Echo Markers: The National Echo Database Of Australia (Neda) Ph-Lhd Predictive Formula, Kevin Chung

Theses

Aims: Pulmonary hypertension (PH) is commonly due to left heart disease caused by ischaemic heart disease, hypertension and valvular heart disease. It is under diagnosed and associated with a high mortality. PH diagnosed using echo requires a measurable tricuspid regurgitation velocity (TRV) to estimate the pulmonary artery systolic pressure (PH = PASP >40mmHg). However, up to 40% of studies have insufficient TRV to calculate a PASP. This can lead to significant delays in the diagnosis of pulmonary hypertension, increased morbidity and delays in the initiation of treatment.

This thesis seeks to determine the prevalence of PH and the diastolic echo …

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 …