Intensive care nurses' knowledge of enteral nutrition: a descriptive questionnaire

BACKGROUND: Nurses have an important role in the delivery and management of enteral nutrition in critically ill patients, to prevent iatrogenic malnutrition. It is not clear how nurses source enteral nutrition information. 

Constipation and diet in a community sample of older Australians

Objective: To estimate the prevalence of constipation and laxative use in a sample of people 65 years and over and examine relationships between usual diet and constipation.
Design: A mailed survey using validated instruments to measure bowel habit and laxative use with follow-up interviews to collect dietary data.
Subjects and setting: Three hundred and thirty people aged 65 years and over living at home in Melbourne were randomly selected from the electoral roll of a federal electorate.
Statistical analysis: Descriptive statistics, frequencies and two sample t-tests were used.
Results: Seventy-nine people responded to the mailed bowel survey and 61 were interviewed to collect food intake data. The proportion of constipated people was approximately one quarter (n = 18). Laxative use in the previous 12 months was reported by a fifth of respondents and in these subjects one in four was not constipated. Analysis of the dietary data revealed that the average number of cereal and vegetable serves consumed per day was similar to the national average but less than recommended by nutrition bodies although fruit intake met these recommendations. Constipated subjects consumed fewer serves from the cereals food group than those who were not constipated (2.9 and 3.5 serves respectively, P = 0.03).
Conclusion: Constipation and laxative use appears to be as common in older Australians as in similar populations overseas. Low intake of cereal foods may be a contributing factor.

Access and attitude of rural allied health professionals to CPD and training

Continuing professional development (CPD) activities for allied health professionals are becoming mandatory as a means for professionals to maintain accreditation or skills. To access CPD activities, rural allied health professionals have the added costs of travel, accommodation and information technology access. It is assumed that health professionals in rural areas want access to training and CPD. In 2003, a survey of allied health professionals was carried out in Southwest Victoria, Australia, with the aim of identifying access and attitudes to CPD. Results showed that allied health professionals in Southwest Victoria were highly qualified, wished to access CPD more than four times a year and were prepared to spend a mean rate of $1000 (1300) per annum on CPD activities.

Clinical research 5: quantitative data collection and analysis

This six-part research series is aimed at clinicians who wish to develop research skills, or who have a particular clinical problem that they think could be addressed through research. The series aims to provide insight into the decisions that researchers make in the course of their work, and to also provide a foundation for decisions that nurses may make in applying the findings of a study to practice in their own Unit or Department. The series emphasises the practical issues encountered when undertaking research in critical care settings; readers are encouraged to source research methodology textbooks for more detailed guidance on specific aspects of the research process.

A couple of points:

1. It is artificial to describe research as qualitative or quantitative. Studies often include both dimensions. However, for the purposes of this paper/series, this distinction is drawn for clarity of writing.

2. It is common practice for quantitative studies to refer to study ‘subjects’ and qualitative studies to refer to study ‘participants’. For ease of reading, the latter term will be used throughout this series.

Post-migration food habits of sub-Saharan migrants in Victoria: a cross-sectional study

Objective: (i) To describe sub-Saharan African (SSA) post-migration food habits and eating patterns; and (ii) to examine how the food habits of SSA households in Victoria reflect post-migration acculturation.
Design: A cross-sectional survey using a snowball sampling technique. Data on food habits and eating patterns were obtained using semi-structured, face-to-face interviews from November 2001 to April 2002.
Subjects: A total of 139 households of demographically diverse recent migrants from across sub-Saharan Africa.
Setting: Melbourne metropolitan and Melbourne fringes.
Analysis: Data were summarised using descriptive statistics.
Results: SSA migrants and refugees indicated dietary acculturation characterised by three processes: substitution, supplementation and modification of recipes. They experienced difficulty locating their traditional foods, in particular, African vegetables (34.2%), unprocessed maize meal (29.1%), camel milk (23.1%) and maize grain (13.7%). The new foods adopted since arrival were pizza, breakfast cereals and fast foods, but also included new fruits and vegetables. Takeaway food such as Pizza Hut or McDonalds featured prominently in the SSA post-migration diet. Reasons for eating out were favourite food (48.3%), routine family outing (38.3%), special occasion (33.3%) and no time to cook (25%). A significant change in meal pattern was the inclusion of breakfast, although 21% reported skipping breakfast.
Conclusion: Many of the observed dietary changes were not consistent with good health and may predispose this population to rapid weight gain and chronic disease. Rapid modernisation and the Anglo-Australian culture interact in a complex way with traditional eating and socialisation practices of SSA migrants. Understanding these forces can allow effective health promotion and community development strategies to be developed for the future health of SSA migrants and their communities.

Critical care nurses' beliefs about discharge planning process: a questionnaire survey

Aim: To report on the beliefs of critical care nurses with regard to the discharge planning process, in Victoria, Australia.

Methods: An exploratory descriptive design was used. A total of 502 Victorian critical care nurses were approached to take part in the study. A total of 218 eligible participants completed the survey, which represented a nett response rate of 43.4%. The data were analysed using descriptive statistics.

Results: The current discharge planning processes are ad hoc and influenced by patient acuity. Critical care nurses believe that workload issues, unplanned discharges and inadequate communication contribute to difficulties implementing the discharge plan.

The development and validation of the impact of multiple sclerosis scale and the symptoms of multiple sclerosis scale

Objective

To develop and validate the Impact of Multiple Sclerosis Scale (IMSS) and the Symptoms of Multiple Sclerosis Scale (SMSS) using the Extended Disability Status Scale (EDSS) for construct validity.
Design

Panel design involving test-retest over 4 months.
Setting

A mailed survey.
Participants

Volunteers with a diagnosis of multiple sclerosis (MS) recruited from an MS support service in Australia: 193 people (mean age, 39y) and 150 people participated at time 1 and time 2, respectively.
Interventions

Not applicable.
Main Outcome Measures

Principal components analyses, the Cronbach α, and descriptive statistics for the 2 scales; correlations for construct validity with the EDSS and retest; and confirmatory factor analysis to test the stability of IMSS and SMSS components over time.
Results

The IMSS yielded 5 independent and reliable components; the SMSS yielded 3 components; both component structures were stable over time. These scales showed convergent validity with the EDSS.
Conclusions

The IMSS and SMSS are psychometrically sound scales suitable for clinical and research purposes to assess the symptoms and impact of MS.

The characteristics of property trust IPOs in Australia

This paper follows Ling and Ryngaert (1997) and Brounen and Eichholtz (2001) who investigate the underpricing of REIT initial public offerings (lPOs) in the United States and Europe respectively. This study adds to the international literature by investigating Australian property trusts. It reports a variety of descriptive statistics on 37 Australian property trust IPOs from 1994 to 1999. What it also contributes is the finding that some IPOs have extremely low volumes of shares traded on the first day so the simple use of a closing price at the end of the first day to determine underpricing returns (without reference to the volume of trading) may not always be the optimum method of calculating these returns.

Co-ordination of the discharge planning process in critical care

Aim and objectives: This article reports on the current discharge planning beliefs in relation to the co-ordination of the discharge planning process in the critical care environment in the health care system in the state of Victoria, Australia. As there is a paucity of previous studies examining discharge planning in critical care nursing knowledge about the phenomena is consequently limited. Background: The study reported here is part of a larger study exploring critical care nurses' perceptions and understanding of the discharge planning process in the health care system in the state of Victoria, Australia. While a number of different discharge planning models are reported in the literature there is no agreement on the most effective or the most efficient model. Design: An exploratory descriptive research design was used for this study. Methods: A total of 502 Victorian critical care nurses were approached to take part in the study. A total of 218 participants completed the survey, which represented a nett response rate of 43·4%. The data from the questionnaire were entered into the Statistical Package for Social Sciences (SPSS) Base 10.0. This allowed calculation of descriptive statistics and statistical analysis using chi-square test for goodness-of-fit.  Results: While just over half the participants reported that the discharge planning process in their unit was co-ordinated by a combination of personnel that included a nurse, just under half the participants believed that this was an appropriate model. Another key finding was of those participants who worked in critical care units using primary nursing, just over half responded that the bedside nurse/primary nurse co-ordinated the discharge planning process while just under half responded that a combination of health care team members, including a nurse, co-ordinated the process. Overall there was little support for the designated discharge planning nurse to co-ordinate the process. Conclusions: The findings presented here suggest critical care nurses need to examine who has the ultimate responsibility of co-ordinating the critical care patient's discharge plan irrespective of the nursing model employed within the critical care ward. There is the need to ensure that when discharge planning becomes everybody's responsibility it ultimately does not become no-one's responsibility. Relevance to clinical practice: If discharge planning practices are to be changed with the introduction of new discharge planning models in the critical care environment then it is important not only to know current practice but also the perceptions of critical care nurses in terms of who they believe should co-ordinate the discharge planning process.

Vice chancellors for the 21st century? A study of contemporary recruitment and selection practices in Australian universities

This article is based on recent Ph.D research. The practices for appointing Vice Chancellors (VC's) in Australian Universities were examined, together with the changing role of the VC and new demographic patterns in VC backgrounds. A number of other issues were also examined, including the training and preparation of VC's, mentoring and the changing skill base required to be effective in the role. In addition, the paradox was investigated of appointing academics from the ranks of individuals with non-business backgrounds, to run large enterprises which are being compelled to adopt an increasingly business-oriented focus. The methodology employed involved the use of a survey instrument administered to present and former VC's, Chancellors and members of selection panels, supplemented by interviews. Representatives of the Australian Vice Chancellors Committee (AVCC) and consultants operating in the academic field were also interviewed. In addition, extensive use was made of public domain material. The research was mainly qualitative in nature. However, use was also made of descriptive statistics to provide an insight into how higher education in Australia is changing and to analyse survey findings. Some key results of the research are reported, including the importance of informal processes such as networking in the selection of VC's, the key role played by Chancellors, and the continued practice of appointing VC's from within academia rather than the private sector. This is in spite of evidence that the role of the VC has changed to one of strategic planner and business manager rather than the more traditional role, in the context of a rapidly changing external environment. Suggestions are also made for ongoing research in the area.

The creation of effective learners using an autarchic study method

The aim of this study is to assess whether universities are meeting the needs of marketing students and consequently the needs of the corporate marketing sector. A comparison is made between marketing classes using a specific technology of study called an autarchic system, and those classes not using this method. As part of this analysis the study investigates the application of self-determination theory and psychological needs  satisfaction. The basic needs scale, comprising two constructs; Control and Caring was adapted and used to evaluate students' perception of subjects using autarchic study system and those not utilising this methodology. The study used a multi-method approach consisting of a literature review, a qualitative phase involving in-depth interviews with marketing teaching staff and focus groups with marketing students and a survey of students. An adapted version of the basic psychological needs scale was included in a questionnaire that was administered to a convenience sample of 441 students. ANOVAlMANOVA and descriptive statistics were used to analyse the data. The pedagogy used in a conventional university setting is detailed and contrasted with the autarchic learning system. Findings strongly indicate students become far more able as learners when they have the knowledge of the types of learning barriers, they are coached to recognise the barrier when it occurs and apply the appropriate remedy as researched in this paper. These findings are of interest to educators, students, and industry as all sectors face significant social and financial losses because individuals are unable to duplicate instructions, maintain currency and plan tactically and strategically.

Self-determination theory and needs satisfaction in marketing education : are we meeting the needs of students in large marketing classes?

The aim of this study is to assess whether universities are meeting the needs of students in large marketing classes. In so doing the study investigates the application of self determination theory and psychological needs satisfaction. The basic needs scale, comprising of three constructs; Control, Competence and Caring was adapted and used to evaluate students’ perception of an introductory marketing subject. The study used a multi-method approach consisting of a literature review, a qualitative phase involving in-depth interviews with marketing teaching staff and focus groups with marketing students and a survey of students about introductory level marketing. An adapted version of the basic psychological needs scale was included in a questionnaire that was administered to a convenience sample of 366 students. MANOVA, ANOVA and descriptive statistics were used to analyse the data. The results show that the psychological needs satisfaction of many students are not being fully realised. It was also found that marketing degree students enjoyed the challenges and were more stimulated by the subject. The higher achieving students enjoyed the challenge of the subject more than the lower achieving students. As a result of this study, there are three suggestions for further research. Firstly, further study should compare subjects, with relatively small enrolments, to those with large enrolments to corroborate the value of this method of assessing student satisfaction. Secondly, the use of a larger sample across other universities would confirm whether these findings hold for other institutions. Finally, it is suggested that a structural model should be developed to extend this investigation of student satisfaction and the constructs used in the study.

The career development year : responding to the emergency nursing shortage in Australia

Background: The Career Development Year (CDY) is a 12 month supported entry program at one health care service in Victoria, Australia. The program targets Division One Registered Nurses with little or no emergency nursing experience. The intent of CDY is to improve recruitment to, and retention in, emergency nursing by educational and experiential preparation for emergency nursing practice.

Method: This study used a retrospective exploratory design to examine recruitment and retention of emergency nurses recruited via CDY (n = 72) and compare these findings with recruitment and retention data for a cohort of non-CDY participants (n = 15). CDY data was collected by self-report questionnaires. Descriptive statistics, correlations and inferential statistics were calculated using SPSS.

Results: CDY was found to promote recruitment of novice nurses to emergency nursing, with almost half the respondents (n = 25, 48.1%) reporting they would not have entered emergency nursing were it not for the supported entry program. Further, comparison with non-CDY participants revealed that CDY promoted retention within emergency nursing, with both short-term (n = 47, 90.4% vs. n = 8, 53.4%) and long-term retention doubling (n = 50, 96.1% vs. n = 7, 46.6%) following the introduction of CDY.

Conclusion: CDY was a valuable recruitment tool and successful retention strategy in the ED. Future research using a larger sample may demonstrate potential applicability to other clinical areas.

Patient outcomes in the acute revovery phase following robotic-assisted prostate surgery : a prospective study

Background: Robotic-assisted minimally invasive urologic surgery was developed to minimise surgical trauma resulting in quicker recovery. It has many potential benefits for patients with localised prostate cancer over traditional surgical techniques without taking a risk with the oncological result.

Objectives: To report the specific surgical outcomes for the first Australian cohort of patients with localised prostate cancer that had undergone robotic-assisted radical prostatectomy (RARP) surgery. The outcomes represent the acute (in-hospital) recovery phase and include pain, length of stay (LOS), urinary catheter management and wound management.

Methods: Prospective descriptive survey of 214 consecutive patients admitted to a large metropolitan private hospital in Melbourne, Australia between December 2003 and June 2005. Patients had undergone RARP surgery for localised prostate cancer. Data were collected from the medical records and through interview at the time of discharge. Descriptive statistics were used to describe the frequency and proportion of outcomes. Patient characteristics were tabulated using cross tabulation frequency distribution and measures of central tendency.

Results: The findings from this study are highly encouraging when compared to outcomes associated with traditional surgical techniques. Transurethral catheter duration (median 7 days (IQ range 2)) and LOS (median 3 days (IQ range 2)) were considerably reduced. While operation time (median 3.30 h (IQ range 1.07)) was marginally reduced we would expect a further reduction as the surgical team becomes more skilled.

Conclusion: The findings from this study contribute to building a comprehensive picture of patient outcomes in the acute (in-hospital) recovery phase for a cohort of Australian patients who have undergone RARP surgery for localised prostate cancer. As such, these findings will provide valuable information with which to plan care for patients’ who undergo robotic-assisted surgery.

The impact of patient sex on paramedic pain management in the prehospital setting

Objective: The aim of this study was to establish the impact of patient sex on the provision of analgesia by paramedics for patients reporting pain in the prehospital setting.
Methods: This retrospective cohort study of paramedic patient care records included all adult patients with a Glasgow Coma Score higher than 12 transported to hospital by ambulance in a major metropolitan area over a 7-day period in 2005. Data collected included demographics, patient report of pain and its type and severity, provision of analgesia by paramedics, and type of analgesia provided. The outcomes of interest were sex differences in the provision of analgesia. Data analysis was by descriptive statistics, χ2 test, and logistic regression.
Results: Of the 3357 patients transported in the study period, 1766 (53%) reported pain; this forms the study sample. Fifty-two percent were female, median age was 61 years, and median initial pain score (on a 0-10 verbal numeric rating scale) was 6. Forty-five percent of patients reporting pain did not receive analgesia (791/1766) (95% confidence interval [CI], 43%-47%), with no significant difference between sexes (P = .93). There were, however, significant sex differences in the type of analgesia administered, with males more likely to receive morphine (17%; 95% CI, 15%-20%) than females (13%; 95% CI, 11%-15%) (P = .01). The difference remains significant when controlled for type of pain, age, and pain severity (odds ratio, 0.61, 95% CI, 0.44-0.84).
Conclusion: Sex is not associated with the rate of paramedic-initiated analgesia, but is associated with differences in the type of analgesia administered.