Nursing Commons^™

The Use Of Naltrexone In Pregnancy In Opiate-Dependent Mothers, Sadie Geraghty, Carly Dixon

Research outputs 2012

There is an absence of sufficient evidence regarding naltrexone use in pregnancy due to the limited range of human studies. Naltrexone implants are being used in Western Australia as a treatment for opioid dependency, and although contraindicated for insertion during pregnancy, there are a number of women who conceive while undergoing treatment. A review of the available data revealed that naltrexone is associated with improved maternal and fetal outcomes. Extensive research into this area in the form of large, multicentre trials is required to confirm the results of the current research.

The Development Of An Interdisciplinary Research Agenda At Ngala: An Innovative Case Study, E Bennett, Y Hauck, S Bindahneem, Vicki Banham, M Owens, L E Priddis, G Wells, W Sinclair, L Shields

Research outputs 2012

Background Ngala is an early parenting, not-for-profit organisation in Western Australia (WA). Research academics from three universities in Perth had been involved in separate research activities over recent years at Ngala. During 2007, a strategic decision was made to forge formal links and articulate an interdisciplinary research framework to promote a research culture amongst Ngala practitioners. Aim To describe an organisational case study of the development of an interdisciplinary research agenda within Ngala. Methods Collaborative methods were used. An action learning project was undertaken over a two-year period with the involvement of researchers, managers and practitioners across the five disciplines …

Ginger And Osteoarthritis, Tessa Therkleson

Research outputs 2012

Ginger has been used for 1000s of years as a food and medicine; it is likely one of the most ancient remedies valued by humans. Ancient Indian and Chinese cultures reportedly used ginger for a wide variety of conditions and modern day research has found it effective as an anti-emetic and anti-inflammatory agent, when taken internally. Random controlled trials using ginger extract have been found effective in relieving symptoms of osteoarthritis. Osteoarthritis is the primary cause of musculoskeletal pain and disability in Western cultures. Current management is primarily through the use of anti-inflammatory and analgesic medication, with cortisone injections and …

Systematic Review Of Predictive Performance Of Injury Severity Scoring Tools, Hideo Tohira, Ian Jacobs, David Mountain, Nicholas Gibson, Allen Yeo

Research outputs 2012

Many injury severity scoring tools have been developed over the past few decades. These tools include the Injury Severity Score (ISS), New ISS (NISS), Trauma and Injury Severity Score (TRISS) and International Classification of Diseases (ICD)-based Injury Severity Score (ICISS). Although many studies have endeavored to determine the ability of these tools to predict the mortality of injured patients, their results have been inconsistent. We conducted a systematic review to summarize the predictive performances of these tools and explore the heterogeneity among studies. We defined a relevant article as any research article that reported the area under the Receiver Operating …

Psycho-Educational Group Intervention For Family Caregivers Of Hospitalized Palliative Care Patients: Pilot Study, Peter Hudson, Elizabeth Lobb, Kristina Thomas, Rachel Zorden, Tom Trauer, Karen Quinn, Anne Williams, Michael Summers

Research outputs 2012

Background: Family caregivers of patients requiring palliative care commonly experience physical, social, and psychological burdens. Although family caregivers are acknowledged as valid service recipients of palliative care, many have unmet needs, and systematic reviews have shown there are limited evidence-based supportive interventions. Objectives: This study aimed to develop and pilot test a psycho-educational group education program delivered in the inpatient specialist palliative care setting and designed to prepare primary family caregivers for the role of supporting a relative receiving hospital-based palliative care. Methods: (1) Development of education session and delivery protocol by the research team and expert panel; (2) pilot …

Paramed Home: A Protocol For A Randomised Controlled Trial Of Paramedic Assessment And Referral To Access Medical Care At Home, Glenn Arendts, Moira Sim, Steven Johnston, Richard Brightwell

Research outputs 2011

Background: In Australia approximately 25% of Emergency Department (ED) attendances are via ambulance. ED overcrowding in Australia, as in many countries, is common. Measures to reduce overcrowding include the provision of enhanced timely primary care in the community for appropriate low risk injury and illness. Therefore paramedic assessment and referral to a community home hospital service, in preference to transfer to ED, may confer clinical and cost benefit.

Methods/Design: A randomised controlled trial. Consenting adult patients that call an ambulance and are assessed by paramedics as having an eligible low risk problem will be randomised to referral to …

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 …

Culturally And Linguistically Diverse Carers' Perceptions Of The Cultural Appropriateness Of Carer Support Services: An Exploratory Study, Andrea Creado

Theses : Honours

Research on service utilisation by primary family carers has highlighted that carers from culturally and linguistically diverse (CALD) backgrounds face specific barriers in accessing services, such as lack of culturally appropriate services, communication issues, prejudice, feelings of failure and misunderstanding of mental illness. However, little is known about how to best overcome these factors from the carers' perspective. The aim of this study was to investigate the perceptions CALD carers had of the cultural appropriateness of carers' support services available in Perth. Ten primary family carers from CALD backgrounds participated in a semi-structured interview to explore their perceptions of existing …

The Palliative Care Interdisciplinary Team: Where Is The Community Pharmacist?, Moira O'Connor, Judith Pugh, Moyez Jiwa, Jeff Hughes, Colleen Fisher

Research outputs 2011

Palliative care emphasizes an interdisciplinary approach to care to improve quality of life and relieve symptoms. Palliative care is provided in many ways; in hospices, hospital units, and the community. However, the greatest proportion of palliative care is in the community. In hospice and palliative care units in hospitals, clinical pharmacists are part of the interdisciplinary team and work closely with other health care professionals. Their expertise in the therapeutic use ofmedications is highly regarded, particularly as many palliative care patients have complex medication regimens, involving off-label or off-license prescribing that increases their risk for drug-related problems. However, this active …

The Decision Making Process Involved When Changing Career: A Qualitative Study Of Registered Nurses Who Have Left The Profession, Katherine S. Gallager

Theses : Honours

Career choice is an important decision an individual has to make during their lifetime. Personal, environmental and organisational factors all assist this decision process as individuals strive for a work-life balance within careers that meet their needs and realise their potential. This research study investigated which factors contributed to the decision process of Registered Nurses (RNs) who have left the profession for a career change. There is currently a global shortage of RNs, which is of major concern to healthcare policy makers in most countries, including Australia. This qualitative study examined the narrative interviews often females over the age of25 …

The Impact Of Nurses On Patient Morbidity And Mortality: The Need For A Policy Change In Response To The Nursing Shortage, Diane Twigg, Christine Duffield, Peter L. Thompson, Pat Rapley

Research outputs pre 2011

Context. Workforce projections indicate that by 2012 there will be a shortfall of 61 000 registered nurses in Australia. There is a growing body of evidence that links registered nurse staffing to better patient outcomes. Purpose. This article provides a comprehensive review of the research linking nurse staffing to patient outcomes at a time of growing shortages, highlighting that a policy response based on substituting registered nurses with lower skilled workers may have adverse effects on patient outcomes. Method. An electronic search of articles published in English using the Cumulative Index to Nursing and Allied Health Literature (CINAHL), Journals @ …

The Impact Of The Nursing Hours Per Patient Day (Nhppd) Staffing Method On Patient Outcomes: A Retrospective Analysis Of Patient And Staffing Data, Diane Twigg, Christine Duffield, Alex Bremner, Pat Rapley, Judith Finn

Research outputs pre 2011

In March 2002 the Australian Industrial Relations Commission ordered the introduction of a new staffing method – nursing hours per patient day (NHPPD) – for implementation in Western Australia public hospitals. This method used a ‘‘bottom up’’ approach to classify each hospital ward into one of seven categories using characteristics such as patient complexity, intervention levels, the presence of high dependency beds, the emergency/elective patient mix and patient turnover. Once classified, NHPPD were allocated for each ward. The objective of this study was to determine the impact of implementing the NHPPD staffing method on 14 nursing-sensitive outcomes: central nervous system …

A Leadership Program In An Undergraduate Nursing Course In Western Australia: Building Leaders In Our Midst, Joyce M. Hendricks, Vicki C. Cope, Maureen Harris

Research outputs pre 2011

This paper discusses a leadership program implemented in the School of Nursing at Edith Cowan University to develop leadership in fourth semester nursing students enrolled in a three year undergraduate nursing degree to prepare them for the dynamic ‘changing world’ environment of healthcare. Students were invited to apply to undertake the program in extracurricular time. Nineteen students applied to the program and ten were chosen to participate in the program. The numbers were limited to ten to equal selected industry leader mentors. The leadership program is based on the belief that leadership is a function of knowing oneself, having a …

A Study Of Clinical Behaviour In Intensive Care Unit, Vivienne-Marie Smith

Research outputs pre 2011

In order to support the needs of the staff working in discrete areas of nursing, the attitudes, behaviors and needs of the group must first be articulated. Unfortunately, there has been little research conducted to understand the culture of what it is that health care workers think and feel and why they make the choices they do in their working environment and also why they chose to leave the environment. Specifically, what do intensive care clinicians think about the work they do when managing end-of-life care in this technical, highly skilled environment. The focus of an ethnographic study conducted in …

The Leadership Characteristics Registered Nurses Perceive As Important In Their Clinical Nurses, Linda May Aitken

Theses : Honours

Limited research exists about the leadership attributes registered nurses (RNs) want from their clinical nurses (CNs). This study explored the leadership attributes Western Australian RNs considered important in CNs and determine if there were differences in the choice of preferred CN attributes according to RNs years of experience; types of nursing education; level of seniority and nursing specialty. A modified version of the Emerging Workforce's Preference Survey was distributed to 403 RNs with a 30% response rate. The respondents ranked their top three preferences from 4 clusters of traits. S.P.S.S. 15.0 was used to summarise demographic data and then analyse …

The Effect Of Nurse Initiated Paracetamol On Emergency Department Patients With Pain From Low Acuity Injury, Joanne G. Wilson

Theses: Doctorates and Masters

Early identification and management of pain was identified at the commencement of this study as a key area requiring research in emergency departments. Prolonged waiting times for analgesia especially, was highlighted in the National Institute of Clinical Studies emergency department collaborative in 2003. Many barriers exist for a patient to receive analgesia. In Western Australia this is compounded by the legislation which restricts prescribing rights for nurses. Three considerations guided the development of the research project. Firstly, the patient has initial contact with the emergency department from the nurse at triage. Secondly, paracetamol was recognised as a potentially effective analgesic …

The Lived Experience Of Self-Intermittent Catheterisation In People With Spinal Cord Injury, Brendan J. Bakes

Theses: Doctorates and Masters

Self-intermittent catheterisation (SIMC) is one of the most common and safest methods of bladder emptying in people with spinal cord injury (SCI). There is a large amount of literature relating to the biomedical aspects of SIMC, such as infection rates and renal complications. There is however, very little information about how people actually experience SIMC and its effect on their daily lives. Through a series of semi-structured interviews this study describes the lived experience of eight men with spinal cord injuries who perform self-intermittent catheterisation to empty their bladder. The study uses Husserlian phenomenology and Colaizzi's method to analyse data …

Academic - Practice Bridges: Implications For Lecturers When The Complexities Of Change Meets The Higher Education And Nurse Education Systems, Adrianne Jones

Theses : Honours

Government, industry, enterprises and the community expect the Vocational and Educational Training (VET) system to provide up-to-date educational programs that provide pathways from school-based learning to the higher education facilities such as universities and to employment opportunities. Reforms in the VET sector over the past ten years have had a significant impact on the work of staff employed in the area. Educators now operate in more competitive markets and face increased demands for higher quality and more relevant training programs from clients. Understanding and keeping up with the changes and working in new and more flexible ways have been major …

A Descriptive Survey Of Undergraduate Nursing Students' Perceptions Of Desirable Leadership Qualities Of Nurse Preceptors, Melanie Zilembo

Theses : Honours

Leadership in the nursing profession has gained much attention over the previous decade. However, there is a paucity of literature examining the context of leadership within the clinical preceptor/undergraduate nursing student relationship and the relevance of this to the clinical learning environment. Globally, the nursing profession is experiencing a climbing attrition rate, an accelerating ageing workforce and a trend toward part-time employment. Practical experience is based upon a preceptored model of supervision creating a potential for inconsistencies for student supervision and assessment within this mode of education. The purpose of this study was to explore, from the perspective of the …

Understanding Personal Carers' Experiences Of Caring For Older People In Pain, Kristi Holloway

Theses : Honours

Pain is a complex phenomenon that can be challenging for staff working in residential aged care facilities (RACFs) (Fisher et al., 2002; Twycross, 2002). A high prevalence of pain reported by older individuals has been reported and suggests that further study in this area is warranted (Higgins, Madjar & Walton, 2004). Research suggests that a significant barrier to effective pain management in the elderly is the provision of primary care by care staff who have little or no education about pain, pain assessment or pain management (Allcock, McGarry & Elkan, 2002). Studies have identified personal carers as being in a …

Why Undergraduate Nurses Choose Not To Pursue Mental Health Nursing As A Career In Western Australia : A Descriptive Study, Therese Howell

Theses : Honours

Not only are fewer undergraduate nursing students opting to pursue a career in mental health nursing (Arnswald, 1987; Clinton & Hazelton, 2000; Happell, 1998; Lam, McMaster & Troup, 1993), but nursing students continue to rank mental health nursing as their lowest preference of career choice. Instead, nursing undergraduates appear to be opting for positions within the surgical or critical care specialties (Durkin, 2002; Happell, 1999; Happell1999; Happell, 2001). The aim of this descriptive study was to investigate and identify the potential reasons why undergraduate nursing students do not take up mental health nursing as a career. This descriptive study implemented …

Enrolled Nurses' Attitudes, Subjective Norms, Intentions And Behaviour Related To Independent Medication Administration, Donna Sayers

Theses : Honours

The purpose of this quantitative descriptive research study was to investigate Enrolled Nurses' attitudes, intentions and behaviour in relation to independent medication administration (IMA). This research was necessary as a significant number of Enrolled Nurses (ENs) are now able to administer medications up to Schedule Four level, without supervision when they have completed a medication administration programme (MAP). This change in the scope of practice for the EN will eventually be introduced nationally as recommended by the National Review of Nursing Education (2002). Anecdotal reports suggest that IMA is causing concern for the EN but little or no research has …

Nurses' Decision Making Processes Regarding Indwelling Catheter Insertion And Removal, Helen Hull

Theses : Honours

Urinary catheterisation remains a common procedure conducted by nurses often as a result of autonomous decision making. This research aimed to identify and describe the lived experience of nurses' decision making processes regarding the insertion and removal of urinary catheters. The research was believed to be important as there is a myriad of literature on what is best practice but very little on what is actually taking place in nursing practice. A qualitative phenomenological study design was chosen, where nurse participants were interviewed using open-ended questions. Descriptive phenomenology was the chosen method which follows in Heidegerr's tradition that allowed nurses …

Controlling Involvement To Promote Confidence In Palliative Care Decisions - A Grounded Theory From The Patient's Perspective, Susan F. Lee

Theses: Doctorates and Masters

Decision making in the context of palliative care is particularly complex given the unpredictable illness trajectories experienced by patients and the number of individuals who may be part of the decision making process. This grounded theory study explored and described from the perspective of patients with advanced illness, their experiences of making care decisions. A review of literature at the commencement of the study indicated that there was a lack of evidence to support the best way of ascertaining patient's preferences for involvement in decisions in a palliative care context and almost no research to guide clinicians about the involvement …

Other People's Country: A Memoir; And, Developing A Trustworthy Narrator: An Essay, Maureen Helen

Theses: Doctorates and Masters

This thesis comprises two interrelated sections. The first section is a substantial piece of creative writing, which l have cailed 'Other People's Country: A Memoir, in the genre of travel memoir, and an essay. The memoir borrows techniques from fiction, drama and poetry to tell a story of a middle-aged, middle-class city nurse, who travels to a remote settlement at the edge of the Western Desert of Western Australia to provide health care for a fluctuating population of around 400 people, for whom English is a third or fourth language.

Writing that includes stories about vulnerable people from another culture, …

A Comparison Of Nurses' Clinical Judgement And The Short Form-Mini Nutritional Assessment Tool In Assessing The Nutritional Status Of Older Patients In An Acute Clinical Setting, Roger Shreeve

Theses : Honours

Decreased nutritional status of older hospitalised patients has been identified as a significant problem. The prevalence of malnutrition in older people has been reported to be between 17% and 65% in acute hospital settings. This has led to the recognition of a need for a valid instrument to adequately assess nutritional status. Tools developed to date still require much time and expertise to implement, limiting their use within the practical setting. Nurses are in an ideal position to conduct nutritional assessments. They possess clinical knowledge which can be utilised to provide individualised and timely assessment. To. date, the literature does …

Nurses' Perceptions Of The Pharmacological Management Of Acute Pain Experienced By Patients Hospitalised In The General Ward Setting, Susan Slatyer

Theses : Honours

This study explored and described the experiences and perceptions of nurses managing acute pain in a Western Australian public hospital. The focus was nurses practising in the general ward setting and using current prescribing guidelines. The aim of this research was to explore nurses' attitudes, beliefs and knowledge about pain and pain pharmacology and how this practice setting influences efficient pain management. Qualitative methodology was selected for its ability to explore complex issues in order to build nursing knowledge and guide nursing practice. This study used a descriptive, exploratory design based on a phenomenological approach. The sample comprised ten Registered …

The Lived Experience Of Rural Mental Health Nurses, Vicki Drury, Karen Francis, Geoffery Dulhunty

Research outputs pre 2011

The lived experiences of five registered mental health nurses employed in community settings in the southwest region of Western Australia were examined in this study. The study was generated in response to concerns of clinicians working in the area about their scope of practice. Study participants were interviewed concerning their everyday “lived experience.” Interviews were audio taped, transcribed and coded numerically to ensure participant confidentiality. Data was analysed using van Manen’s hermeneutic phenomenological approach. Five essential themes were identified. They were holistic care of clients; isolation, autonomy and advanced practice; professional development and status recognition; educational support; and caseload numbers …

Understanding Palliative Care: An Ethnographic Study Of Three Australian Palliative Care Services, Judith M. Greaves

Theses: Doctorates and Masters

Palliative care commenced in Australia in the early 1980s. Although the value of palliative care has become more widely recognised by the public and other health care professionals, there is still a lack of understanding about what palliative care is and the depth and scope of this specialty area of health care. The research that I present in this thesis is based on examination of palliative care practice in a selection of Australian services, undertaken with the aim of enhancing understanding of Palliative Care. The significance of the research arises from the notion that members of the Australian community should …

Palliative Care Nurses' Perceptions Of Their Management Of The Psychosocial And Spiritual Pain Experienced By Their Clients In The Home Hospice Setting, Laurence Vogler

Theses : Honours

Pain, in palliative care clients, consists of more than just a physical manifestation of their condition. Pain can be experienced on a psychological or emotional level, a psychosocial level or even at a spiritual level. It is widely accepted that nurses in the palliative care setting manage well the physical issues that their clients have, but perceptions can vary on their management of the "non - physical" pain experienced by their clients. This study provided an opportunity for palliative care nurses to describe their perceptions of their management of the psychosocial and spiritual pain experienced by their clients in the …