The intra-aortic balloon pump in heart failure management : implications for nursing practice

Management of acute heart failure is an important consideration in critical care. Mechanical support of the failing heart is crucial for improving health outcomes. The most common Australasian application of intraaortic balloon counterpulsation (IABP) is in the setting of cardiogenic shock. High end users of IABP (>37/annum) demonstrate significantly lower mortality for cardiogenic shock managed with IABP (p <0.001) in contrast to hospitals which employ limited IABP (<4/annum). This underscores the importance of proficiency in managing patient receiving IABP support. Nurses play a crucial role in carding for patients with acute heart failure. This paper summarises care considerations for management of the IABP.

Psychosocial predictors of the use of enhanced podcasting in student learning

The current study examined the influence of psychosocial constructs, from a theory of planned behavior (TPB) perspective, to predict university students’ (N = 159) use of a newly offered on-line learning tool, enhanced podcasts. Pre-semester, students completed questionnaires assessing the TPB predictors (attitude, subjective norm, perceived behavioral control) related to intended enhanced podcast use until the middle of semester. Mid-semester, students completed similar items relating to podcast use until the end of semester. Self-report measures of podcast use were obtained at the middle and end of semester. At both time points, students’ attitudes predicted their intentions and, at the initial time point, subjective norm also predicted intended podcast use. An examination of the beliefs underlying attitudes, the only construct to predict intentions at both time points, revealed differences between those students higher, rather than lower on intentions to use the podcasts, especially for the perceived educational benefits of podcast use later in the semester. Intentions to use enhanced podcasting only predicted self-reported use in the second half of the semester. Overall, this study identified some of the determinants which should be considered by those aiming to encourage student use of novel on-line educational tools.

Students’ conceptual knowledge about workplace pedagogies and applications to learning in the workplace

The development of effective workplace pedagogies is integral to work-integrated and work-based learning. The workplace pedagogies that facilitate and support learning include: activities in which individuals engage such as daily work practices, questioning; observing, and listening; interactions with more experienced workers through coaching and modelling; and referencing documented procedures. Each of these dimensions is significant in enhancing processes of workplace learning. Learning can be optimised when these pedagogies are appropriately embedded in the context of and process of participating in normal work activities. Yet learners need to understand the nature of these pedagogies, and how and for what purposes to use these to achieve a range of learning outcomes. This is because it is the worker-learners who play the key roles in the process and outcomes of learning through work. A pilot study was conducted on students’ conceptions of how each of these dimensions of workplace pedagogy help their learning, by providing examples of learning from these sources; and stating their preferences for learning in the workplace. A sample of seventeen students, enrolled in the second year of a Diploma in Nursing course at a Technical and Further Education institution, participated in a survey intended to capture these conceptions and the importance attached to each of them. The findings indicate that these students have basic understanding of how each of seven workplace pedagogic practices can contribute to their learning. They reported relying mostly on daily practices, observing and listening to others, modelling, coaching, and other workers. Their selection of these contributions emphasise significant opportunities for guided learning by others, yet suggest fewer student-initiated interactions, less intensity in interactions, and likelihood that learning is more passive. The data also suggests that these students rely mostly on using academic learning skill, and limited workplace learning skills. It is proposed, therefore, that the knowledge and understandings about workplace learning and pedagogies might be best embedded in the full curriculum and not become add-on shortly before students go on work placement. This approach will allow students to appreciate the significance and use of workplace pedagogies for learning.

Australian nursing informatics competency project

A study of Australian nurses on their use of information technology in the workplace was undertaken by the Australian Nursing Federation (ANF) in 2007. This study of over 4000 nurses highlighted that nurses recognise benefits to adopting more information technology in the workplace although there are significant barriers to their use. It also identified gross deficits in the capacity of the nursing workforce to engage in the digital processing of information. Following the release of the study last year, the ANF commenced work on a number of key recommendations from the report in order to overcome identified barriers and provide opportunities for nurses to better utilise information technology and information management systems. One of these recommendations was to seek research funding to develop national information technology and information management competency standards for nurses. This project has now received Federal Government funding to undertake this development. This project is being developed in collaboration with the ANF and the Queensland University of Technology. This paper will discuss the methodology, development and publication of the Australian Nursing Informatics Competency Standards Project which is currently underway and due for completion in May 2009. The Australian Nursing Informatics Competencies will be presented at the conference.

Taiwanese nursing students' attitudes toward older people

The aim of this research was to establish Taiwanese undergraduate nursing students’ attitudes toward older people. This study involved a cross-sectional survey of 362 nursing students in a university in southern Taiwan. Overall, the results showed that nursing students had positive attitudes toward older people. Moreover, the findings suggested that nursing students’ intention to work with older people and gender were important factors influencing their attitudes toward older people. The findings of this study indicate that efforts are required to maintain these positive attitudes. In addition, provision of nursing courses related to older people that place greater emphasis on attitudes about aging and that take into account students’ working experience and career intention will lead to higher quality of care for older people.

Student perceptions of the impact of online discussion forum participation on learning outcomes

Choosing the “right” type of technology, either synchronous or asynchronous, to facilitate learning outcomes is a new challenge as the pace of emerging technologies increases and diversifies. Teachers are encouraged to design courses that require collaboration in online learning communities to facilitate the development of higher order thinking skills for life long learning. It is therefore important to gather evidence of the kinds of opportunities afforded to students and whether the students themselves endorse collaborative online tools as a legitimate method of assisting in their learning. This paper outlines the way in which one secondary school has used an online discussion forum to support students in the International Baccalaureate (IB) Diploma Program in enhancing research skills and skills for lifelong learning. The paper considers whether online collaborative tools are perceived by students as a positive way to improve learning outcomes.

The meaning of cancer for Australian Aboriginal women : changing the focus of cancer nursing

Aim: The purpose of the study was to explore why Aboriginal women participate in cancer screening programs but appear reluctant to following-up results, or accept medical advice about treatment. Methods: Interpretive ethnography, a qualitative methodology, was used to explore Aboriginal women’s perception of cancer, and the cultural context in which meaning was constructed and influenced treatment decision. Data collection, which occurred over two years, involved fieldwork, participant-observation, face-to-face interviews and focus groups, in two rural Aboriginal communities. Forty eight interviews were recorded from a cross section of the communities, including cancer survivors and patients, family members, health care providers and other women from the community. Results: Key findings were that Aboriginal women’s had a fearful and fatalistic attitude toward cancer, doubted the efficacy of treatment and carried an enduring ambivalence toward the authority of whiteman’s medicine. The women faced a dilemma of wanting access to cancer treatment options but feared entering hospital or clinics not attuned to their cultural needs. Conclusion: The findings highlight the need for a culture-centred approach that decentres the authority of conventional services and instead gives prominence to Aboriginal cultural values as a focal point in cancer control. It should be the responsibility of cancer nurses and others to engage with their local Aboriginal communities to build relationships that foster an exchange of learning about cultural differences that make a difference to how cancer control is practiced.

Building research capacity in the nursing workforce : the design and evaluation of the nurse researcher role

Objectives: The Nurse Researcher Project (NRP) was initiated to support development of a nursing research and evidence based practice culture in Cancer Care Services (CCS) in a large tertiary hospital in Australia. The position was established and evaluated to inform future directions in the organisation.---------- Background: The demand for quality cancer care has been expanding over the past decades. Nurses are well placed to make an impact on improving health outcomes of people affected by cancer. At the same time, there is a robust body of literature documenting the barriers to undertaking and utilising research by and for nurses and nursing. A number of strategies have been implemented to address these barriers including a range of staff researcher positions but there is scant attention to evaluating the outcomes of these strategies. The role of nurse researcher has been documented in the literature with the aim to provide support to nurses in the clinical setting. There is, to date, little information in relation to the design, implementation and evaluation of this role.---------- Design: The Donabedian’s model of program evaluation was used to implement and evaluate this initiative.---------- Methods: The ‘NRP’ outlined the steps needed to implement the nurse researcher role in a clinical setting. The steps involved the design of the role, planning for the support system for the role, and evaluation of outcomes of the role over two years.---------- Discussion: This paper proposes an innovative and feasible model to support clinical nursing research which would be relevant to a range of service areas.---------- Conclusion: Nurse researchers are able to play a crucial role in advancing nursing knowledge and facilitating evidence based practice, especially when placed to support a specialised team of nurses at a service level. This role can be implemented through appropriate planning of the position, building a support system and incorporating an evaluation plan.

Cochrane review summary for cancer nursing : influenza vaccination in children having chemotherapy for cancer

Background: Children having chemotherapy for cancer are prone to developing influenza infections. Influenza virus infection may lead to hospitalization/prolonged hospitalization, interruption of treatment, and other severe adverse outcomes such as death. Although clinical guidelines recommend children who are being treated for cancer be vaccinated against influenza, evidence supporting this recommendation is unclear.--------- Objectives: The objectives of this review were to (1) assess the efficacy of influenza vaccination in stimulating immunologic response in children with cancer receiving chemotherapy, compared with other control groups; (2) assess the efficacy of influenza vaccination in preventing influenza infection; and (3) establish any adverse effects associated with influenza vaccines in children with cancer.

An economic case for systematic student monitoring and intervention in the first year in higher education

Previous work has established the effectiveness of systematically monitoring first year higher education students and intervening with those identified as at-risk of attrition. This nuts-and-bolts paper establishes an economic case for a systematic monitoring and intervention program, identifying the visible costs and benefits of such a program at a major Australian university. The benefit of such a program is measured in savings to the institution which would otherwise be lost revenue, in the form of retained equivalent full-time student load (EFTSL). The session will present an economic model based on a number of assumptions. These assumptions are explored along with the applicability of the model to other institutions.