Perspectives on global nursing leadership: International experiences from the field

AIM Nursing leaders from six countries engaged in a year-long discussion on global leadership development. The purpose of these dialogues was to strengthen individual and collective capacity as nursing leaders in a global society. Field experiences in practice and education were shared. Perspectives on global leadership can strengthen nurses' contributions to practice, workplace and policy issues worldwide. BACKGROUND Transformational leadership empowers nurses' increasing confidence. Mentoring is needed to stimulate leadership development but this is lacking in many settings where nurses practice, teach and influence policy. Organizations with global mission provide opportunity for nurses' professional growth in leadership through international dialogues. PROCEDURES Dialogues among participants were held monthly by conference calls or videoconferences. Example stories from each participant illustrated nursing leadership in action. From these exemplars, concepts were chosen to create a framework. Emerging perspectives and leadership themes represented all contexts of practice, education, research and policy. The cultural context of each country was reflected in the examples. RESULTS Themes emerged that crossed global regions and countries. Themes were creativity, change, collaboration, community, context and courage. IMPLICATIONS FOR NURSING AND HEALTH POLICY Relationships initially formed in professional organizations can be extended to intentionally facilitate global nursing leadership development. Exemplars from the dialogues demonstrated nursing leadership in health policy development within each cultural context. Recommendations are given for infrastructure development in organizations to enhance future collaborations.

Collecting in an urban context: Relationships between collections and space in the home

Collecting has become a popular hobby within Western society, with collectables including anything from ‘bottle tops’ to ‘skyscrapers’. As the nature and size of these collections can impact upon the use of space in the home, the purpose of this study is to explore the relationship between the collections, space in the home and the impacts on others. This qualitative study explores the experiences of 11 Australian collectors, investigating the motivations, practices and adaption techniques used within their urban home environment. The themes of sentimentality, sociability and spatial tensions, including physical, personal and use of space are discussed within the context of their home and family environments. Overall the practice of collecting objects is a complex, varied, sentimental and sociable activity, providing enjoyment, knowledge and friendships. Space can be a central consideration to the practice of collecting as collections shape and are shaped by the available space in a household.

Fixing the alignment: An exploration of budgeting practices in the home

Budgeting is an important means of controlling ones finances and reducing debt. This paper outlines our work towards designing more user centred technology for individual and household budgeting. Based on an ethnographically informed study with 15 participants, we highlight a misalignment between people's actual budgeting practices and those supported by off-the-shelf budgeting aids. In addressing this misalignment we outline three tenets that may be incorporated into future work in this area. These include (1) catering for the different phases of engagement with technology; (2) catering for the practices of hiding and limiting access to money, and; (3) integrating materiality into technical solutions.

Barriers to entering affordable home ownership for young people: A preliminary study from university students’ perspectives

Over the last two decades, housing affordability has been a problem for young people, and identified as factor leading to youth homelessness. The National Youth Commission Inquiry into Youth Homelessness developed a roadmap for preventing this problem (National Youth Commission, 2008). The roadmap recommends increasing the supply of affordable housing for young people as an important strategy to reduce the risk of homelessness problems. In addition, understanding the barriers and the needs of young people is a significant part of the development of a national affordable housing strategy. This paper explores issues encountered by young people when they enter the housing market as first home buyers. A short survey was conducted to review the barriers to entry, classified by income levels, housing cost and availability of affordable housing. In the current competitive job market, young people have minimal work experience, relatively low job security and low income. In addition to these barriers, participants also suggested other barriers towards the purchase of their first home, such as lack of knowledge of legal issues and lack of government funding. This study suggests the need for both government and educational support for young people around housing choices and the development of financial strategies to manage barriers towards owning their first home.

Beyond energy savings: Exploring how design can extend the scope of eco-feedback for users in the home

As energy use information is becoming increasingly visible and sharable, this research aimed to inform the design of eco-feedback systems for the home. It involved observation and analysis of people's practices, which involve energy use, and their use of a domestic eco-feedback system. The question was asked: how can design best engage people with energy consumption information- making feedback more relevant to home occupants? In addressing this, a specifically bottom-up approach was employed, studying what people actually do with eco-feedback, rather than what technologists imagine eco-feedback will do to people.

Too much knowledge for a nurse? Use of physical assessment by final-semester nursing students

There is debate around the scope of physical assessment skills that should be taught in undergraduate nursing programs. Yet this debate is largely uninformed by evidence on what is learned and practiced by nursing students. This study examined the pattern and correlates of physical assessment skill utilization by 208 graduating nursing students at an Australian university, including measures of knowledge, frequency of use and perceived barriers to physical assessment skills during clinical practice. Of the 126 skills surveyed, on average only five were used every time students practiced. Core skills reflected inspection or general observation of the patient; none involved complex palpation, percussion or auscultation. Skill utilization was also shaped by specialty area. Most skills (70%) were, on average, never performed or learned and students perceived nursing physical assessment was marginalized in both university and workplace contexts. Lack of confidence was thus a significant barrier to use of skills. Based on these findings we argue that the current debate must shift to how we might best support students to integrate comprehensive physical assessment into nursing practice.

Nursing and medical perceptions of a hospital rapid response system: New process but same old game?

Perhaps no other patient safety intervention depends so acutely on effective interprofessional teamwork for patient survival than the hospital rapid response system (RRS). Yet little is known about nurse-physician relationships when rescuing at-risk patients. This study compared nursing and medical staff perceptions of a mature RRS at a large tertiary hospital. Findings indicate the RRS may be failing to address a hierarchical culture and systems-level barriers to early recognition and response to patient deterioration.

Feasibility and acceptability of wrist actigraph in assessing sleep quality and sleep quantity: A home-based pilot study in healthy volunteers

Purpose This study aimed to determine the feasibility and acceptability of actigraphy to monitor sleep quality and quantity in healthy self-rated good sleeper adults at home-based settings. Method Sixteen healthy volunteers (age > 18) were invited to participate. Each participant was provided with a wrist actigraph device to be worn for 24-hour/day for seven consecutive days to monitor their sleep-wake patterns. Actigraphy data were downloaded using-proprietary software to generate an individual-sleep report. Participants also completed a set of self-reported Health Related Quality of Life (HRQOL) using WHO (five) Well Being Index (WBI) questionnaires. Results Actigraphy was well accepted by all participants. Only 43.8% of the participants achieved normal total sleep time (TST) and 62.5% had a mean sleep efficiency value below the normal range. Despite a reduced quality of sleep among the participants, the self-reported HRQOL scores produced by the WHO-5 WBI showed a “fair” to “good” among the participants. Conclusions To maintain healthy well-being, it is vital to have efficient and quality sleep. Insufficient and poor sleep may contribute to various health problems and hazardous outcomes. People often believe they have normal and efficient sleep, not realising they may be developing poor sleep habits. This study found that actigraphy can be easily utilized to monitor sleep-wake patterns at home-based settings. We proposed that actigraphy could be adapted for use in the primary care settings (e.g. community pharmacy) to improve the sleep health management in the community.

Lewis's medical-surgical nursing: Assessment and management of clinical problems [ANZ Edition, 4th Ed.]

"Using the nursing process as a framework for practice, the fourth edition has been extensively revised to reflect the rapid changing nature of nursing practice and the increasing focus on key nursing care priorities. Building on the strengths of the third Australian and New Zealand edition and incorporating relevant global nursing research and practice from the prominent US title Medical-Surgical Nursing, 9Th Edition, Lewis’s Medical-Surgical Nursing, 4th Edition is an essential resource for students seeking to understand the role of the professional nurse in the contemporary health environment."--Publisher website

Inappropriate formulation choices in the administration of medication to elderly patients with dysphagia in nursing homes

Inappropriate food or medication texture in patients with dysphagia is the most significant risk factor for pneumonia. Dysphagia is prevalent within care homes for the older person as it is largely found in conditions associated with ageing. This study was designed to determine the appropriateness of medication formulation choices in elderly patients with dysphagia in care homes.

Continuity and change in family engagement in home learning activities across the early years

This research utilised data from The Longitudinal Study of Australian Children and explored continuity and change in parental engagement in home learning activities with young children. The findings indicated a decrease over time in parental engagement with children, from age to 2-3 years to 6-7 years. Rate of decrease impacted negatively on learning outcomes for language and literacy, and mathematical thinking, in the early years of school, when children were aged 6-7 years. Shared reading with children and interactions around everyday home activities and play, in which children and parents participate together, impact on children's later development.

Active aging: Exploration into self-ratings of "being active," out-of-home physical activity, and participation among older Australian adults living in four different settings

We examined whether self-ratings of “being active” among older people living in four different settings (major city high and lower density suburbs, a regional city, and a rural area) were associated with out-of-home participation and outdoor physical activity. A mixed-methods approach (survey, travel diary, and GPS tracking over a one-week period) was used to gather data from 48 individuals aged over 55 years. Self-ratings of “being active” were found to be positively correlated with the number of days older people spent time away from home but unrelated to time traveled by active means (walking and biking). No significant differences in active travel were found between the four study locations, despite differences in their respective built environments.The findings suggest that additional strategies to the creation of “age-friendly” environments are needed if older people are to increase their levels of outdoor physical activity. “Active aging” promotion campaigns may need to explicitly identify the benefits of walking outdoors to ambulatory older people as a means of maintaining their overall health, functional ability, and participation within society in the long-term and also encourage the development of community-based programs in order to facilitate regular walking for this group.

Patients' outcomes related to person-centred nursing care in radiation oncology: A case study

Abstract Purpose The aim of this case study is to describe patients' responses to nursing care following the implementation of a person-centred model in a radiation oncology department. Method An instrumental case study design utilised surveys to collect data on a range of key patient outcomes: patient satisfaction (PSS), informational issues (RSEP), quality of life (FACT_G), comfort (RTCQ), and emotional status (HADS). This occurred at the beginning of, and twelve months following, the implementation of the new model of care. Results This study demonstrated that, although adverse effects of radiotherapy continue to affect patient well-being in the latter part of their course of radiation therapy, patients continue to be satisfied with nursing care. There were significant differences between groups in perceptions of the care environment and the use of the nurse as an acknowledged source of information are noteworthy, since these variables were key targets of the new model of care. The finding that nurses were seen by the post-implementation cohort as more likely to be a source of information is an important indicator that the nurses' presence was noted by patients, and they generally reported high levels of functioning despite undergoing a curative course of radiotherapy. Conclusion The person-centred nursing approach in the radiotherapy setting has contributed to some improvements in the provision of patient care. Aspects of this study may assist in planning further nursing interventions for patients undergoing radiotherapy for cancer, and continue to enhance the contribution of the radiation oncology nurse to improved patient outcomes.

Home is where the stuff is: Framing life-worlds in domestic space

This PhD playfully employs visual arts as a means through which to explore concepts of gender, normative behaviour, play, humour, collecting and an intimate and idiosyncratic relationship with domestic space. This PhD seeks to: represent certain complexities of individual experience through theoretical frameworks of Gaston Bachelard, Michel de Certeau, Pierre Bourdieu and selected visual artists; use my art to elucidate the humour that exists in the mundane; and illustrate the construction of particular life-worlds using auto-ethnography and visual documentation. This is represented in a 50,000 word exegesis (50%) and a practice comprising of eight artist books (50%).