Medication management by graduate nurses: before, during and following medication administration

The purpose of the present study was to explore graduate nurses' perceptions of their medication management activities in the acute care context. A qualitative research design with a semistructured interview schedule was used to elicit information from participants. The sampling population consisted of graduate nurses involved in direct patient care in medical and surgical wards of a Melbourne metropolitan teaching hospital, completing a graduate nurse program. Twelve graduate nurses participated in the interviews. Two major themes emerged: (i) monitoring medications and (ii) interventions for patient care. The findings indicate that graduate nurses are required to address several facets of the medication management role in their daily practice. It is pertinent to examine ward dynamics to ensure that graduate nurses have ready access to experienced health care professionals. Through collegial support, graduate nurses should also be encouraged to critically examine the different possibilities when making clinical judgments about monitoring patient medications.

Graduate nurses communication with health professionals when managing patients medications

Aim and objectives. The aim was to examine how graduate nurses communicated with other health professionals about their medication management activities in the acute care context. The objectives were to determine the types of information communicated about patients' medications and the communication processes used during interactions with other nurses, doctors and pharmacists.

Background. Graduate nurses are challenged with enormous responsibilities and their competence is constantly tested in an ever-changing arena. One of their responsibilities involves communicating with other health professionals about patients' medications.

Design. A qualitative exploratory research design was used for this study.

Methods. Participant observation and semi-structured interviews were conducted to elicit information from 12 graduate nurses with university degrees employed in a metropolitan public hospital, in Melbourne, Australia. Graduate nurses were observed once for two hours and interviewed on the same day of the observation at a mutually convenient time. The purpose of these interviews was to clarify activities observed and to obtain further information.

Results. The results highlighted how work dynamics of the clinical setting had an impact on the ability of graduate nurses to communicate effectively with other nurses, doctors and pharmacists. These work dynamics included the availability of doctors and the structure of ward rounds. The results also demonstrated the value graduate nurses placed on communicating particular information such as evaluating the effect of medication changes and organizing discharge medication.

Conclusions. Graduate nurses were effective in communicating about medication management activities when they initiated or were prepared for such interactions. When graduate nurses were not prepared, such as during impromptu ward rounds, they did not participate effectively and important information was not communicated.

Relevance to clinical practice. It is important to understand how collegial communication facilitates accurate exchange of information and effective decision-making to achieve optimal health care outcomes for patients.

Evaluating the impact of financial literacy programs on the retirement savings of superannuation fund members

Currently, in Australia, the age pension, paid for out of Commonwealth government taxes, forms the basis of Australia’s retirement income system, however, given the reality of an ageing population has compelled the government to undertake a number of measures to shift the responsibility for saving to the individual, forcing them to accept an increasing level of responsibility for their financial decision-making. In the light of the changing retirement environment, it would be expected that Australians’ would ensure that they became financially literate, however, despite the amount of information and advice available in the market place, this is not the case, and they do not appear to be appropriately prepared for their retirement. Recognising the importance of financial literacy, an increasing number of government agencies, employers, superannuation funds and schools are implementing financial literacy programs in Australia. This article provides an overview of the impact that attending a financial education seminar has on the retirement decisions and settings of participants. Evidence is provided from this research that in the short term, providing financial education programs make a difference to an individual’s intended retirement settings. However, the impact of these education programs in changing investment behaviour is less conclusive.

Professional accounting qualifications of audit committee membership : implications for curriculum and learning

A useful attribute of the audit committee is to have accounting financial experts on that committee of the Board. Defond, Haan and Hu (2005) argue there is a positive market reaction to the appointment of such experts. This study analyses how many qualified accountants there are on the Boards of Australia’s largest companies. The study finds that, while many Boards have at least one qualified financial accountant on their audit committee, the great majority of members are not qualified accountants. The paper considers whether this paucity of professionally qualified accountants on audit committees has any implications for the curriculum development and learning objectives of corporate governance and related topic areas within the disciplines of accounting and auditing in undergraduate and graduate professional accounting programs within the international tertiary education sector?

Drop out from behavioral management training programs for ADHD: a prospective study

To investigate dropout from parenting programs for disruptive behavior disorders, we followed 18 clients prospectively from the beginning of a manualized treatment program to three month follow-up. Using qualitative and quantitative methods, we then compared those who dropped out of the program with those who completed it. We found that in general, those participants who dropped out of the program were parents of children with more disturbed behavior, who perceived their children to be more difficult than others, and who experienced more subjective parenting stress. Those who dropped out were also not convinced that the strategies proposed in the program to help manage their children were useful. On the other hand, those who completed the program reported a determination to persevere with the strategies which they saw as assisting them to re-establish positive relationships with their adolescent children. The findings are discussed in the context of how manualized programs might be modified to increase retention.

Key stakeholders' expectations of educational outcomes from Australian critical care nursing courses: a Delphi study

Background
Educational preparation for critical care nursing in Australia varies considerably in terms of the level of qualification resulting in a lack of clarity for key stakeholders about student outcomes.

Objectives
The study aim was to identify and reach consensus regarding the desired learning outcomes from Australian post-registration critical care education programs as demonstrated through the graduate's knowledge, skills and attitudes.

Design
A Delphi technique was used to establish consensus between educators, managers, clinicians and students regarding learning outcomes expected of graduates with a Graduate Certificate, Graduate Diploma and Master level qualification in critical care nursing.

Participants
A total of 164 critical care nurses (66 clinicians, 48 educators, 32 managers and 18 students) participated and 99 questionnaires were returned in the first round (response rate 60%). Fifty-seven questionnaires were returned for Round 2 (response rate 58%).

Methods
Learning outcomes were obtained from the Australian College of Critical Care Nurses Competency Standards for Specialist Critical Care Nurses. Some statements included more than one characteristic, and these were split to create learning outcomes with one characteristic per item. A survey of Australian higher education providers of critical care education provided additional learning outcomes, for a total of 73 learning outcomes for the first Delphi round.

Results
Findings suggest that patient comfort, safety, professional responsibility and ethical conduct are deemed most important for all three levels of educational preparation. There was a lack of emphasis on clinical practice issues for all levels. Participants placed higher emphasis on learning outcomes related to complex decision-making, leadership, supervision, policy development and research for Graduate Diploma and Master level programs.

Conclusion
The findings have implications for curriculum development and the profession with regards to the level of educational preparation required of critical care nurses and suggest that further work is required before clear recommendations can be made for desired educational outcomes from critical care nursing programs in Australia.

Effectiveness of staff training programs to manage behavioural problems of dementia

Purpose : Behavioural problems among older people with dementia are a major concern in nursing homes. This study was designed to evaluate the effectiveness of staff training programs on both staff and residents.
Methodology : Two programs (standard dementia care, individualised behaviour therapy) were compared to a control condition. A total of 90 staff and 113 aged care residents participated in the study.
Findings: The results demonstrated an improvement in the self-efficacy of staff who received either training program at post-intervention, and at three- and six-month follow-up. Facility managers also rated an improvement in the performance of staff who received behaviour therapy at post-intervention and at follow-up. There were no changes in behaviours or quality of life for residents in any group.
Implications: Staff education programs may not assist in the management of behavioural symptoms of dementia, but can improve staff attitudes. Other explanations and suggestions for future research are discussed.

Effectiveness of staff training programs for behavioral problems among older people with dementia

This paper reviewed studies on staff training programs to address the behavioral problems associated with dementia among older people in residential care. The papers were classified according to whether or not the studies included a control group in the research design. The results of the review demonstrate that there has been a wide range of psychosocial and educational interventions to reduce behavioral problems among older people with dementia, with inconsistent results being obtained. However, many of these studies suffer from problems in their research design that make it difficult to evaluate their effectiveness. Problems in conducting research in the nursing home setting are highlighted, and suggestions for future research in this area are discussed.

Should personality traits be considered when refining substance misuse treatment programs?

The interplay between stable personality characteristics and environmental factors is emphasised in most contemporary approaches to individual differences. This interaction appears to be important in understanding the development of substance use and misuse. Impulsivity related personality traits such as sensation-seeking, novelty seeking, reward-sensitivity and behavioural disinhibition, are strongly linked to adolescent and adult substance use and misuse. The role of anxiety-related traits, in the development of substance misuse is less clear. Nonetheless, anxiety disorders are very common amongst adult substance misusers and almost certainly play a critical role in the maintenance of a substance use disorder and influence treatment effectiveness. The data suggest that personality influences treatment outcomes and yet these individual differences are generally not addressed in treatment. We argue in this review that interventions which are matched to these relevant personality traits may improve treatment outcomes for substance misusers. [Staiger PK, Kambouropoulos N, Dawe S. Should personality traits be considered when refining substance misuse treatment programs?

Obesity prevention programs demand high-quality evaluations

Obesity prevention programs are at last underway or being planned in Australia and New Zealand. However, it is imperative that they are well-evaluated so that they can contribute to continuous program improvement and add much-needed evidence to the international literature on what works and does not work to prevent obesity. Three critical components of program evaluation are especially at risk when the funding comes from service delivery rather than research sources. These are: the need for comparison groups; the need for measured height and weight; and the need for sufficient process and context information. There is an important opportunity to build collaborative mechanisms across community-based obesity prevention sites to enhance the program and evaluation quality and to accelerate knowledge translation into practice and policy.

On the pathogenicity of culture : questioning the rationality of "development" programs for perpetually dysfunctional aboriginal groups

All Australian Aborigines have experienced the impact of Western culture to some extent which has resulted in the traditional cultures being irrevocably decimated. The reaction to the disintegration of traditional culture has been marked by a variety of outcomes. While some Aborigines have either accepted or reached a level of accommodation to the new order, others have responded in maladaptive ways. For some Aborigines, the disintegration of traditional culture and society has generated conflict, confusion and the disintegration of personality, which is conducive to the evolution of a dysfunctional group. It is the circumstances of and policy responses to dysfunctional Aboriginal groups, therefore, that is the concern of this article.

`Silly, soft and otherwise suspect`: doctoral education as risky business

This article investigates how certain doctoral practices come to count as scandalous and with what effects on universities. To do so, it engages with a number of recent media allegations that relate to doctoral practice in Australia and elsewhere. The analysis of these allegations is developed in terms of three broad categories, namely allegations of silliness in relation to thesis content, allegations of softness in relation to entry, rigour and assessment, and allegations of suspect conduct and/or credentials. The impact of such allegations on university governance is then addressed.

Print versus website physical activity programs: a randomized trial.

Background: Mediated physical activity interventions can reach large numbers of people at low cost. Programs delivered through the mail that target the stage of motivational readiness have been shown to increase activity. Communication technology (websites and e-mail) might provide a means for delivering similar programs. Methods: Randomized trial conducted between August and October 2001. Participants included staff at an Australian university (n=655; mean AGE=43, standard deviation, 10 years). Participants were randomized to either an 8-week, stage-targeted print program (Print) or 8-week, stage-targeted website (Web) program. The main outcome was change in self-reported physical activity. Results: There was no significant increase in total reported physical activity within or between groups when analyzed by intention to treat (F [1,653]=0.41, p=0.52). There was a significant increase in total physical activity reported by the Print participants who were inactive at baseline (t [1,173]=−2.21, p=0.04), and a significant decrease in the average time spent sitting on a weekday in the Web group (t [1,326]=2.2, p=0.03). Conclusions: There were no differences between the Print and Web program effects on reported physical activity. The Print group demonstrated slightly larger effects and a higher level of recognition of program materials.