Medicine and Health Sciences Commons^™

Woman-Centred Ethics: A Feminist Participatory Action Research, Katherine A. Buchanan

Theses: Doctorates and Masters

Background: The maternity system has a complexity of everyday ethical issues. The bioethical principles: non maleficence, beneficence justice and autonomy, that govern health care practice have been criticised as abstract, patriarchal and even rhetorical in maternity care practice (MacLellan, 2014) and consequently may be insufficient in guiding care of childbearing women. Midwifery-led care is guided by the International Confederation of Midwives International Code of Ethics, which considers more than the bioethical principles, such as the importance of relationship. Care ethics is a relational based feminist ethics first described by Gilligan (1983) and has been theorised as an alternate paradigm for …

The Adherence To Group B Streptococcus Screening Guidelines Amongst Pregnant Women In Western Australia – A Quantitative Descriptive Analysis, Sabine Pangerl

Theses: Doctorates and Masters

Colonisation with Group B Streptococci (GBS) is a major risk factor for neonatal infection acquired via vertical transmission during pregnancy, labour, or birth, potentially resulting in significant morbidity and mortality. Universal screening at 35 – 37 weeks gestation for maternal GBS colonisation and the use of intrapartum antibiotic prophylaxis has resulted in substantial reductions in the burden of neonatal Early-Onset GBS Disease (EOGBSD). Women in Western Australia (WA) are offered GBS screening in pregnancy and intrapartum antibiotic prophylaxis. Anecdotal evidence suggests variations in viewpoints and thus low adherence to relevant clinical guidelines amongst midwives and pregnant women in the midwifery …

Delegation Practices Between The Registered Nurse And The Assistant In Nursing In The Acute Care Setting In Western Australia, Carol Crevacore

Theses: Doctorates and Masters

Background:

Delegation is an essential skill that allows the Registered Nurse (RN) to allocate aspects of patient care to other team members including the unregulated Assistant in Nursing (AIN). Concerns have been raised about the activities delegated to AINs in the acute care environment.

Aim:

The aim of this research was to explore the practice of delegation between the RN and the AIN in the acute care environment. This delegation practice was examined through the lens of both the RN and the AIN.

Methodology:

This study used a mixed method explanatory sequential design. The participants were RNs and AINs working …

Barriers To Ghanaian Midwives’ Ability To Provide Quality Care: A Glaserian Grounded Theory Study, Yakubu Ismaila

Theses: Doctorates and Masters

The midwifery model of care that promotes the employment of trained and regulated midwives for the provision of maternal and neonatal care has been found to be beneficial, especially in Low and Middle-Income Countries that have high maternal and neonatal mortalities. Midwives in those setting are however, facing a myriad of barriers which negatively affect their ability to provide optimal care. Although Ghana is implementing the midwifery model of care, maternal and neonatal mortality remains high in the country. Little is known from the point of view of midwives, who are the primary providers of maternal and neonatal care, about …

Improving Processes For Implementing Evidence-Based Practice In Midwifery: Development Of An Etool(Kit) For Midwives, Annemarie June De Leo

Theses: Doctorates and Masters

Evidence-based practice (EBP) is well-established as the gold standard for service delivery of quality healthcare around the world, yet there remains a significant gap between best available evidence and its everyday use in maternity services. The numerous benefits of EBP are therefore never realised and although a considerable body of knowledge has evolved on how to promote the uptake of new EBPs, little is known about midwives’ experience of implementing EBP or leading practice change projects in clinical areas.

The aim of this study was to work collaboratively with midwives towards the co-development of an evidence implementation resource, designed to …

Exploring Leadership And Research In Nurse Practitioner Roles Across Australia And Ireland: A Mixed-Methods Study, Mary Ryder

Theses: Doctorates and Masters

Introduction

The Nurse Practitioner role is recognised as the highest level of clinical nursing. Leadership and research are identified as core attributes for Nurse Practitioners in the regulatory frameworks. There is an expectation that as clinical leaders, Nurse Practitioners have the ability to transform healthcare delivery within their specialist area of practice.

Background

The voice of Nurse Practitioners is limited in the current literature related to how they view their leadership contribution to Nursing. There has been some criticism in the evidence to date related to volume, consistency and transferability of Nurse Practitioner research. However, there is a shortage of …

The Ward-Based Nurse Clinical Educator: Impact On Student Learning Outcomes And Student And Preceptor Experiences, Karen Ann Mccarthy

Theses: Doctorates and Masters

Aim

This study aimed to determine the impact of the implementation of a ward based Nurse Clinical Educator (NCE) role on students and staff at one health service whilst students were on clinical practicum at a Western Australian regional health care facility.

Question

The research question was: “What impact does the NCE support intervention have on students and clinical staff during clinical practicum?” Background Clinical experience for undergraduate student nurses (students) undertaking their bachelor’s degree is of utmost importance for gaining both competence and registration. Students encounter difficulties in obtaining opportunities to practice their skills and develop competence when on …

A Qualitative Study Into The Communication Surrounding The Initiation And Withdrawal Of Non-Invasive Ventilation (Niv) In People With Motor Neurone Disease, Charlotte Chapman

Theses: Doctorates and Masters

Introduction

Motor neurone disease (MND) is a degenerative disease that adversely affects the nervous system and muscular control. Eventually respiratory muscles weaken, causing breathing, communication and swallowing difficulties, and ultimately, respiratory failure and death. Improved quality of life and potentially a short extension of life can be provided with non-invasive ventilation (NIV), which is offered to people with MND when symptoms of respiratory distress become evident.

It is recommended that end-of-life communication, encompassing the benefits and burdens of symptom-relieving interventions (NIV and percutaneous gastrostomy tube to assist with nutrition), NIV withdrawal (proposed when continued use is considered futile) and other …

A Public Health Perspective Of The Higher Education Experiences Of Women Studying Nursing: A Hermeneutic Inquiry Into Commencement And Progression, Lesley Jane Andrew

Theses: Doctorates and Masters

While student retention is a central goal across higher education, the projected shortage in the Australian health workforce has intensified its importance to undergraduate nursing.

Nursing degrees attract a higher proportion of mature-age women students than ever before. More are therefore beginning university at life stage characterised by marriage (or co-habitation) and traditional family structures. Nursing retention strategies require an understanding of the unique university experiences of these women, however, this is missing in the nursing literature. This study is the first to explore the experiences of these women students, doing so from the perspective of Bachelor of Science (Nursing) …

Moving On After Critical Incidents In Health Care. Second Victims: A Qualitative Study Of The Experiences Of Nurses And Midwives, Melanie Buhlmann

Theses: Doctorates and Masters

Aims: The aims of this study were to gain a deeper understanding of the experiences of nurses and midwives who have been involved in a critical incident in a non-critical care area and to explore how they have ‘moved-on’ from the event.

Background: It is irrefutable that health care is intrinsically risk-laden and perceived to be personally and professionally demanding for those who are employed within it. The term ‘second victim’ has been assigned to health care professionals who experienced emotional distress as a result of their involvement in critical incidents. Despite the recognition that critical incidents contribute to workrelated …

Linking Patient Safety To Clinical Practice: The Insight Of New Graduate Registered Nurses, Melanie Murray

Theses: Doctorates and Masters

New graduate registered nurses’ (NGRNs) transition to practice with limited clinical experiences and skills. The related anxiety and stress predispose new graduate nurses to increased risk of contributing to preventable errors or adverse events. This risk, together with the new graduate’s fledgling ability to manage clinical deterioration, potentially compromises quality and safety of patient outcomes.

A longitudinal mixed methods design was used to develop an understanding of new graduate registered nurses’ patient safety knowledge and actions within the first year of nursing registration and offer important insights into NGRNs’ transition with a patient safety focus. New graduate registered nurses employed …

Exploring The Preparedness Of Novice (Student) Paramedics For The Mental Health Challenges Of The Paramedic Profession: Using The Wisdom Of The Elders, Lisa Holmes

Theses: Doctorates and Masters

This study investigates the preparedness of novice (student) paramedics for the mental health challenges of the paramedic profession and identifies the coping strategies used by veteran paramedics to successfully meet these challenges. The lived experience of veteran paramedics is utilised to provide this important assistance.

Initially, two surveys were developed and administered to 16 course coordinators and 302 students of the 16 accredited undergraduate degree paramedicine courses across Australia and New Zealand, to identify the perceived need (for preparation) within the curriculum. In addition, the anticipations, confidence and fears of novice (student) paramedics, course coordinators and veteran paramedics were also …

Ultrasound Measurements On The Inferior Vena Cava By Renal Nursing Staff For Assessment And Management Of Intravascular Volume Status In Haemodialysis Patients, Ulrich Steinwandel

Theses: Doctorates and Masters

Title: Ultrasound measurements on the inferior vena cava (IVC-US) by renal nursing staff for assessment and management of intravascular volume status in haemodialysis patients.

Aims: The primary aim of this thesis was to provide evidence that renal nurses could safely and efficiently perform IVC-US on haemodialysis patients to obtain objective assessment of intravascular volume status and potentially reduce adverse events and morbidity. The secondary aims for this study were: (1) conduct a systematic literature review to identify evidence if renal nurses have previously used this method for intravascular volume assessment; (2) teach a renal nurse through a staged educational programme, …

The Delivery Of Primary Health Care In Remote Australian Communities: A Grounded Theory Study Of The Perspective Of Nurses, Kylie Mccullough

Theses: Doctorates and Masters

Around 85% of Australia’s landmass is remote and sparsely populated. Across these vast areas of desert, wilderness and tropical islands, nurses provide the majority of health care services. The residents of Australia’s remote communities have poorer health status than their metropolitan counterparts. The proportion of Indigenous people is high and health and social disadvantage is widespread. The characteristics of each remote community are unique and often reflect challenges associated with distance to tertiary health services and limited health resources. As a result, nursing practice within this context is very different to other nursing contexts. Despite recognition of Primary Health Care …

Ghanaian Parents’ Experiences Of Caring For Their Preterm Infants After Discharge From The Neonatal Unit - A Narrative Inquiry Study, Esther Abena Adama

Theses: Doctorates and Masters

The care of preterm infants is associated with stress. In the busy neonatal unit where highly skilled healthcare workers are always present, parents have reported being stressed when caring for their preterm infants in the neonatal unit. In Ghana, preterm birth is the highest cause of neonatal mortality with 70% of these morbidities and mortalities occurring in the community. Yet to date, no study in Ghana has explored how parents experience their care giving role after discharge from the neonatal unit into the community.

This study explored the experiences of caring for preterm infants in the neonatal unit and after …

Chinese Nursing Students At Australian Universities: A Narrative Inquiry Into Their Motivation, Learning Experience, And Future Career Planning, Carol Chungfeng Wang

Theses: Doctorates and Masters

This study presents a narrative inquiry of Chinese nursing students at Australian universities in order to examine these students’ motivations, learning experiences and future career planning. Australia seeks to attract international nursing students from China to maintain its economic advantage and alleviate its projected nursing shortage. In contrast, China desperately needs its best and brightest citizens who have trained abroad as nurses to return to China in order to cope with its current challenges in the healthcare system and nursing education. Little is known about the underlying factors that motivate Chinese nursing students to study in Australia, these students’ learning …

‘Fighting A Losing Battle’: A Glaserian Grounded Theory Of Midwives’ Workplace Stress, Sadie Margaret Geraghty

Theses: Doctorates and Masters

The development of the midwifery profession and the culture of childbirth are inevitably entwined from an historical perspective through to current day practice. Early written accounts describe the fifteenth century midwife as dealing with high maternal and child mortality rates, the invention of forceps, the rise of male obstetric practitioners, and the complex social and cultural changes of that era. The twenty-first century midwife faces challenges in Australia and worldwide, which are not dissimilar to our midwifery predecessors.

Midwifery clinical practice has become more complex due to the medicalisation of childbirth and 21st century lifestyles, which have contributed to a …

Nurse Staffing, Patient Falls And Medication Errors In Western Australian Hospitals: Is There A Relationship?, Ahmad Mousa

Theses: Doctorates and Masters

Background: According to the Australian Bureau of Statistics (2013) falls and medication errors in hospitals are among the first twenty leading causes of death. Research on the relationship between nurse staffing, patient falls, and medication errors are limited. Even scarcer are studies that examine this relationship on a nursing shift by shift and ward by ward basis, and no research exists on shift overlap periods and adverse patient outcomes.

Objective: This study examined whether there was a relationship between hospital inpatient falls and medication errors and nurse staffing on a shift by shift and ward by ward basis, including an …

The Impact Of Communication Satisfaction On Paediatric Nurses’ Job Satisfaction And Intention To Stay, Gemma Doleman

Theses: Doctorates and Masters

Effective communication is the most central process within an organisation and is essential to organisational values, norms and expectations. There is a documented connection between job satisfaction, work commitment and organisational communication. However, nurses’ and nursing middle managers’ satisfaction with organisational communication has not been extensively studied in recent years and not at all among paediatric nurses. Therefore, the purpose of this study was to develop and test a theoretical model that examined paediatric nurses’ and middle managers’ satisfaction with organisational communication and the effect this has on paediatric nurses’ job satisfaction and intention to stay in their job.

Employing …

An Assessment Of Nurses’ Experiences Of Work Related Stress Through Self-Reporting And Hair Cortisol Analysis, In A Metropolitan Hospital In Western Australia, Kim Oliver

Theses: Doctorates and Masters

The aim of this study was to assess how years of experience and practice area influence work related stress amongst 1,200 nurses employed in a metropolitan hospital environment in Western Australia. A combination of self-administered questionnaires and hair cortisol, an objective stress biomarker, was utilised to measure stress levels and to relate these to practice area, age and experience. Questionnaire results indicated that there was a higher level of perceived stress for 40% of this cohort of nurses; the study methodology was able to unearth noteworthy factors within a local WA nursing population that impacted on their perceived stress. These …

Living After Confronting Death; Story Telling During The Recovery Trajectory Of Intensive Care Unit Survivors: An Interpretive Biographical Approach, Beverley Anne Ewens

Theses: Doctorates and Masters

Aim: To create new meaning of the experiences of intensive care survivors during early recovery and the meaning of “self” during this time. To add to the understanding of how support should be focussed for survivors during recovery.

Background: Survival from a critical event/illness and intensive care unit experience is increasing, as is associated physical and psychological complications. Complications are due to the severity of illness, the intensive care experience itself and the nature of the treatments which promote survival. If complications remain untreated increased health care service uptake and reduced quality of life can ensue. Despite the …

The Impact Of Nursing A Significant Other In The Course Of Employment, Tania Arnold

Theses: Doctorates and Masters

This thesis describes the experiences of nurses and midwives working in metropolitan hospitals who cared for a significant other in their role of employment.

The absence of research directly related to this topic guided the exploration of individuals’ experiences to establish base line knowledge relating to this phenomenon.

This study used descriptive research to provide information relating to the personal and professional effects on nurses who were required to, chose to or had no choice but to care for a significant other in their role of employment. An on-line survey gathered demographic, Likert scale responses to evaluate impact on care, …

Antenatal Clinic: Using Ethnographic Methods To Listen To The Voices Of Pregnant Adolescents, Deborah Ireson

Theses: Doctorates and Masters

Aim: This research aims to explore the motivating reasons and external influences that affect pregnant adolescents’ reasons for attending an antenatal clinic. Background: Pregnancy during adolescence has been researched from perceived ‘poor’ decision making during pregnancy and postnatal perspectives involving high-risk outcomes for mother and baby. Antenatal clinic attendance by pregnant adolescents is often characterised by late and infrequent attendance, limiting midwifery contact with this inexperienced group. Gaps in the literature exist where the real-time voices of pregnant adolescents offer their current experiences of antenatal clinic as a relevant means to inform midwifery practice.

Research design: Using ethnographic methods, this …

De Concentv Amisso Qvaerendo: An Investigation Into The Relative Benefits Of Three Different Types Of Ambient Music On The Observed Agitated Behaviour And Quality Of Life Of Dementia Sufferers In Residential Aged Care Facilities, Peter Wilkinson

Theses: Doctorates and Masters

There is an increasing body of research evidence to support the use of music as a therapeutic modality in reducing the agitated behaviour frequently associated with late-stage dementia. Although much of this evidence suggests that music interventions are most effective when they are “individualized”, this type of intervention is often difficult to implement in large, busy, aged care facilities where residents may be located together in communal areas during the day. The challenge therefore is to try and identify a particular musical genre which, when played as “ambient” or “background” music, demonstrates a consistent capacity to reduce agitated behaviour in …

Migration Matters : The Experience Of United Kingdom Registered Nurses Migrating To Western Australia, Caroline J. Vafeas

Theses: Doctorates and Masters

This qualitative study uses heuristic inquiry to investigate the unique journey of 21 registered nurses (RN) who migrated from the United Kingdom (UK) to Perth in Western Australia (WA) between 2003 and 2008. The study explores the reasons for migration as well as the professional, social and psychological impact on each participant and their accompanying family during the first two years of settling in a new country.

In the contemporary climate of international nurse mobility, many employers are attempting to attract new employees, often with tantalising offers of an immediate visa and the enticement of a better climate and standard …

Covert Violence In Nursing: A Western Australian Experience, Susette Bakker

Theses: Doctorates and Masters

Covert violence in the workplace has been extensively theorized amongst social scientists as having negative effects on the worker’s self esteem, job satisfaction and stress, resulting in increased absenteeism and a reduction in productivity, and yet it continues to fester in nursing. The purpose of this research was twofold. The first was to answer the question, ‘What are the characteristics of covert violence experienced by Western Australian nurses?’ and through the description of Western Australian nurses’ experience of covert violence and describe the characteristics related to this to form a definition of covert violence. The second question was ‘What are …

The Experiences Of Cancer Survivors As They Transition From Chemotherapy Treatment To Life After Cancer, Violet Platt

Theses: Doctorates and Masters

This study explored and described the experience of people with a diagnosis of cancer, as they transitioned from life as a chemotherapy patient to life after treatment as a cancer survivor. The purpose of this study was to ultimately improve the care of people as they transitioned into life after completion of chemotherapy treatment. There is minimal information related to this phase of the cancer trajectory, therefore this study was intentionally exploratory and descriptive. To achieve the proposed outcome a two-phased approach was undertaken. In Phase One a qualitative approach was followed using Grounded Theory to the descriptive level of …

Paediatric Nursing : An Investigation Of The Effect Of Specialist Paediatric Nurse Education On The Quality Of Children’S Nursing Care In Western Australia, Jonathan Mark Mould

Theses: Doctorates and Masters

In Australia, specialist education in paediatrics is not a requirement for nurses caring for hospitalised children. Thus, nurses can work in paediatrics without any prior knowledge of the unique needs of children such as developmental stages or separation anxiety. As a consequence, there are some clinicians and authors who advocate that when children require health care, they should be cared for by nurses who are educated in, and understand the specific physical, psychological and social needs of children. Despite this, the evidence is lacking as to whether specialist nurse education affects the quality of care in paediatrics. This study investigates …

Portraits Of Nursing Resilience: Listening For A Story, Vicki Cope

Theses: Doctorates and Masters

The nursing workforce in Australia is a workforce under pressure. Within in-patient settings, rapidly increasing turnover of more acutely ill or co-morbid patients, and staff retention issues, place those staff that remain under extra pressure to maintain a quality service. In nurse education settings the increasing imperative to recruit more students into the profession combined with financial cutbacks leading to staff retention issues creates a similar tension. Yet many Registered Nurses (RNs) do remain in their chosen work setting displaying tenacity and resilience despite well documented trials and tribulations.

A qualitative approach, Portraiture, was used to construct a collection of …

Violence Towards Remote Area Nurses: A Delphi Study To Develop A Risk Management Approach, Kylie M. Mccullough

Theses : Honours

Incidents of occupational violence against nurses are unacceptably high. Remote Area
Nurses in Australia frequently encounter violence in the work place and have limited
resources to deal with the problem. Adopting a risk management approach, and
utilising the Delphi method, a panel of expert Remote Area Nurses (n=10) from
geographically diverse communities, identified and prioritised hazards that increase the
risk of violence and made suggestions for controlling those hazards.
Priority hazards included; building maintenance and design, attending call-outs away
from the clinic, staff inexperience and lack of knowledge about the community, as well
as intoxicated clients, communication difficulties and a …