Choosing work and care : four Australian women negotiating return to paid work in the first year of motherhood

Australian women make decisions about return to paid work and care for their child within a policy environment that presents mixed messages about maternal employment and child care standards. Against this background an investigation of first-time mothers’ decision-making about workforce participation and child care was undertaken. Four women were studied from pregnancy through the first postnatal year using interview and diary methods. Inductive analyses identified three themes, all focused on dimensions of family security: financial security relating to family income, emotional security relating to child care quality, and pragmatic security relating to child care access. The current policy changes that aim to increase child care quality standards in Australia present a positive step toward alleviating family insecurities but are insufficient to alleviate the evidently high levels of tension between workforce participation and family life experienced by women transitioning back into the workforce in Australia.

The lived experience of post-traumatic stress disorder as described by motor vehicle accident victims in Jordan

Aim: To explore the lived experience of post-traumatic stress disorder (PTSD) as described by individuals who have been involved in a motor vehicle accident (MVA) in Jordan. Background: Motor vehicle accident (MVA) survivors who develop post-traumatic stress disorder (PTSD) have become an important health issue. The World Health Organisation (WHO) states that trauma resulting from MVAs is a phenomenon of increasing concern, with death from injuries projected to rise from 5.1 million in 1990 to 8.4 million in 2020 particularly in developing countries such as Jordan (WHO, 2002). The impact of trauma from MVAs inevitably compromises the victim’s quality of life (WHO, 2002; Blanchard & Hickling, 2007) resulting in psychological and emotional distress, occupational disability, family disintegration, and socio-economic difficulty (Jordan Ministry of Health, 2005). The development of PTSD as a result of an MVA is not limited to the individual, but also extends to the family, friends, and the health care team involved in the person's care and rehabilitation. Design: A descriptive phenomenological approach was used for this study. Method: This study was conducted in an orthopaedic unit in Amera Basma Hospital in Irbid Jordan. Fifteen (15) participants were voluntary recruited through the process of purposeful sampling. Data was collected by face-to-face in depth-interviews. Interviews were digitally recorded and transcribed verbatim. The process of analysis was undertaken using Colaizzi’s (1978) eight step approach with the addition of two extra steps. Findings: The process of analysis identified seven themes explicated from the participants’ transcripts of interview. The seven themes were: 1. Feeling frustrated at a diminishing health status 2. Struggling to maintain a sense of independence 3. Harbouring feelings of not being able to recover 4. Feeling discriminated against and marginalised by society 5. Feeling ignored and neglected by health care professionals 6. Feeling abandoned by family, and 7. Moving toward acceptance through having faith in Allah. Conclusion: The findings of this study have the potential to make a significant contribution to extant knowledge on the topic which can inform future nursing practice, education, policy development, and research initiatives in Jordan and internationally.

Job satisfaction and intention to leave among critical care nurses in Saudi Arabia

Aim The purpose of this study was to examine the relationship between registered nurses’ (RN) job satisfaction and their intention to leave critical care nursing in Saudi Arabia. Background Many studies have identified critical care areas as stressful work environments for nurses and have identified factors contributing to job satisfaction and staff retention. However, very little research has examined these relationships in the Saudi context. Design and Methods This study utilised an exploratory, cross-sectional survey design to examine the relationship between RN job satisfaction and intention to leave at King Abdul-Aziz University Hospital, Saudi Arabia. Respondents completed a self-administered survey including demographic items and validated measures of job satisfaction and intention to leave. A convenience sample of 182 RNs working in critical care areas during the data collection period were included. Results Regression analysis predicting RN intention to leave found that demographic variables including age, parental status and length of ICU experience, and three of the job satisfaction subscales including perceived workload, professional support and pay and prospects for promotion, were significantly associated with the outcome variable. Conclusion This study adds to the existing literature on the relationship between job satisfaction and intention to leave critical care areas among RNs working in Saudi Arabia. These findings point to the need for management and policy interventions targeting nurses’ workloads, professional support and pay and promotion in order to improve nurse retention.

Patients’ satisfaction with acute care hospital foodservice: does age matter?

In an aging population, healthcare providers should understand the foodservice preferences of the elderly to reduce the risk of malnutrition through adequate nutrition. Conflicting reports exist for elderly patient satisfaction regarding foodservice.1 This study aimed to investigate the relationship between age and foodservice satisfaction within the acute care hospital setting. Patient satisfaction was assessed using the Acute Care Hospital Foodservice Patient Satisfaction Questionnaire with data collected over three years (2008–2010, n = 785) at The Wesley Hospital, Brisbane. Age was grouped into three categories; <50, 51–70 and >70 years. ANOVA was used to measure age related differences in patients’ overall foodservice satisfaction, four foodservice dimensions and two independent statements (meal size and hot food temperature). Results showed that older patients were more satisfied than younger patients and indicated increasing satisfaction with increasing age regarding food quality (F2,767 = 15.787, p < 0.001), staff/service issues (F2,768 = 12.243, p < 0.001), physical environment (F2,765 = 5.454, p = 0.004), meal size (F2,730 = 10.646, p < 0.001) and hot food temperature (F2,730 = 10.646, p < 0.001). While patients aged >70 years also reported greater satisfaction with meal service quality, those aged 51–70 years indicated the lowest (F2,762 = 9.988, p < 0.001). Overall patient satisfaction across all age groups was high (4.26–4.43/5) and a trend of increasing satisfaction with increasing age was evident (F2,752 = 2.900, p = 0.056). These findings suggest patients’ satisfaction with hospital foodservice increases with age and can assist foodservices to meet the varying generational expectations of their clients.

Role of ubiquitous sensor network in patient care

Efficient caring for the patient's information is an important aspect of caring for the patient. If these processes are possible to monitor anytime anywhere as per the patients' and doctors desecrations the cost of patient care could be minimised. In this connection, Ubiquitous Sensor Network is playing a key role on communication between physicians and patients as well as information sharing among health care providers with rapid access to medical information through reliable and trusted computer network systems. This paper argues possibilities of such scenarios by introducing a ubiquitous sensor network in patient care for 21st century's requirements and standards.

A case study examination of the influence of cultural diversity in the multicultural nursing workforce on the quality of care and patient safety in a Saudi Arabian hospital

The purpose of the study: The purpose of this study is to investigate the influence of cultural diversity, in a multicultural nursing workforce, on the quality and safety of patient care and the work environment at King Abdul-Aziz Medical City, Riyadh region. Study background: Due to global migration and workforce mobility, to varying degrees, cultural diversity exists in most health services around the world, particularly occurring where the health care workforce is multicultural or where the domestic population comprises minority groups from different cultures speaking different languages. Further complexities occur when countries have a multicultural workforce which is different from the population for whom they care, in addition to the workers being from culturally diverse countries and with different languages. In Saudi Arabia the health system is mainly staffed by expatriate nurses who comprise 67.7% of the total number of nurses. Study design: This research utilised a case study design which incorporated multiple methods including survey, qualitative interviews and document review. Methods: The participant nurses were selected for the survey via a population sampling strategy; 319 nurses returned their completed Safety Climate Survey questionnaires. Descriptive and inferential statistics (Kruskal–Wallis test) were used to analyse survey data. For the qualitative component of the study, a purposive sampling strategy was used; 24 nurses were interviewed using a semi-structured interview technique. The documentary review included KAMC-R policy documents that met the inclusion criteria using a predetermined data abstraction instrument. Content analysis was used to analyse the policy documents data. Results: The data revealed the nurses‘ perceptions of the clinical climate in this multicultural environment is that it was unsafe, with a mean score of 3.9 out of 5. No significant difference was detected between the age groups or years of experience of the nurses and the perception of safety climate in this context; the study did reveal a statistically significant difference between the cultural background categories and the perception of safety climate. The qualitative phase indicated that the nurses within this environment were struggling to achieve cultural competence; consequently, they were having difficulties in meeting the patients‘ cultural and spiritual needs as well as maintaining a high standard of care. The results also indicated that nurses were disempowered in this context. Importantly, there was inadequate support by the organisation to manage the cultural diversity issue and to protect patients from any associated risks, as demonstrated by the policy documents and supported by the nurses‘ experiences. The study also illustrated the limitations of the conceptual framework of cultural competence when tested in this multicultural workforce context. Therefore, this study generated amendments to the model that is suitable to be used in the context of a multicultural nursing workforce. Conclusion: The multicultural nature of this nursing work environment is inherently risky due to the conflicts that arise from the different cultural norms, beliefs, behaviours and languages. Further, there was uncertainty within the multicultural nursing workforce about the clinical and cultural safety of the patient care environment and about the cultural safety of the nursing workforce. The findings of the study contribute important new knowledge to the area of patient and nurse safety in a multicultural environment and contribute theoretical development to the field of cultural competence. Specifically, the findings will inform policy and practice related to patient care in the context of cultural diversity.

Practice and Procedure: Worker's Compensation and Rehabilitation Act 2003 (Qld) s275

In Australian Meat Holdings Pty Ltd v Sayers [2007] QSC 390 Daubney J considered the obligation imposed on a claimant under s 275 of the Workers’ Compensation and Rehabilitation Act 2003 (Qld) to provide the insurer with an authority to obtain information and documents. The decision leads to practical results.

Is language a barrier for quality care in hospitals? A case series from an Emergency Department of a teaching hospital in Brisbane

Aim: The aim of this pilot study is to describe the use of an Emergency Department (ED) at a large metropolitan teaching hospital by patients who speak English or other languages at home. Methods: All data were retrieved from the Emergency Department Information System (EDIS) of this tertiary teaching hospital in Brisbane. Patients were divided into two groups based on the language spoken at home: patients who speak English only at home (SEO) and patients who do not speak English only or speak other language at home (NSEO). Modes of arrival, length of ED stay and the proportion of hospital admission were compared among the two groups of patients by using SPSS V18 software. Results: A total of 69,494 patients visited this hospital ED in 2009 with 67,727 (97.5%) being in the SEO group and 1,281 (1.80%) in the NSEO group. The proportion of ambulance utilisation in arrival mode was significantly higher among SEO 23,172 (34.2%) than NSEO 397 (31.0%), p <0.05. The NSEO patients had longer length of stay in the ED (M = 337.21, SD = 285.9) compared to SEO patients (M= 290.9, SD = 266.8), with 46.3 minutes (95%CI 62.1, 30.5, p <0.001) difference. The admission to the hospital among NSEO was 402 (31.9%) higher than SEO 17,652 (26.6%), p <0.001. Conclusion: The lower utilisation rates of ambulance services, longer length of ED stay and higher hospital admission rates in NSEO patients compared to SEO patients are consistent with other international studies and may be due to the language barriers.