Corrigendum to "Undergraduate nursing students' performance in recognising and responding to sudden patient deterioration in high psychological fidelity simulated environments: An Australian multi-centre study" [Nurse Educ. Today 34(5) (May 2014

The authors regret that the original text: The SAGAT instrument has been previously validated (Bell et al., 2006) is incorrect and should read: The SAGAT technique has been demonstrated as valid, sensitive and reliable measure of situation awareness in diverse applications (Endsley, 2000).

Endsley, M. R. (2000) Direct measurement of situation awareness: Validity and use of SAGAT. In Endsley, M.R. & Garland, D.J. (Eds.), Situation awareness analysis and measurement (pp 147–173). New Jersey: Lawrence Erlbaum Associates.

The authors would like to apologise for any inconvenience caused.

Impact of nurse-mediated management on achieving blood pressure goal levels in primary care: insights from the Valsartan intensified primary carE reduction of blood pressure study

BACKGROUND: Blood pressure targets in individuals treated for hypertension in primary care remain difficult to attain.

AIMS: To assess the role of practice nurses in facilitating intensive and structured management to achieve ideal BP levels.

METHODS: We analysed outcome data from the Valsartan Intensified Primary carE Reduction of Blood Pressure Study. Patients were randomly allocated (2:1) to the study intervention or usual care. Within both groups, a practice nurse mediated the management of blood pressure for 439 patients with endpoint blood pressure data (n=1492). Patient management was categorised as: standard usual care (n=348, 23.3%); practice nurse-mediated usual care (n=156, 10.5%); standard intervention (n=705, 47.3%) and practice nurse-mediated intervention (n=283, 19.0%). Blood pressure goal attainment at 26-week follow-up was then compared.

RESULTS: Mean age was 59.3±12.0 years and 62% were men. Baseline blood pressure was similar in practice nurse-mediated (usual care or intervention) and standard care management patients (150 ± 16/88 ± 11 vs. 150 ± 17/89 ± 11 mmHg, respectively). Practice nurse-mediated patients had a stricter blood pressure goal of ⩽125/75 mmHg (33.7% vs. 27.3%, p=0.026). Practice nurse-mediated intervention patients achieved the greatest blood pressure falls and the highest level of blood pressure goal attainment (39.2%) compared with standard intervention (35.0%), practice nurse-mediated usual care (32.1%) and standard usual care (25.3%; p<0.001). Practice nurse-mediated intervention patients were almost two-fold more likely to achieve their blood pressure goal compared with standard usual care patients (adjusted odds ratio 1.92, 95% confidence interval 1.32 to 2.78; p=0.001).

CONCLUSION: There is greater potential to achieve blood pressure targets in primary care with practice nurse-mediated hypertension management.

Nurse academics perceptions of the efficacy of the OSCA tool

The use of Objective Structured Clinical Examination/Objective Structured Clinical Assessment (OSCE/OSCA) has been well documented. How assessors currently view the process, and if the OSCA tool still fulfils the assessment requirements, is unclear. In this study, the beliefs and expectations of assessors towards the assessment tool used in an undergraduate nursing degree to assess clinical skills was investigated. A cross-sectional study used semi-structured interviews and focus groups with 16 lecturers in nursing from a rural Australian university. This represents 65% of the total nurse academic staff employed there. The key issues that the academic staff raised reflect those from previous studies, such as the use of OSCA as formative assessment or a quality check process before the clinical practice. The OSCAs were seen as a good assessment tool, which gave students the opportunity to receive feedback on their performance in relation to clinical skills. The drawbacks identified in relation to the use of OSCAs were that the OSCA was seen as stressful to students. This drawback was thought to be further compounded if there was a lack of congruence regarding essential criteria between assessors. If not adequately addressed these drawbacks will erode the potential the OSCA tool has to foster uniformity, which was one of the main reasons for its implementation. .

Providing end-of-life care in the intensive care unit : issues that impact on nurse professionalism

With death a frequent event in intensive care units how, people die and the impact on family and staffs is becoming increasingly recognised as an issue requiring significant attention. Caring for a dying patient in these environments challenges the dominant ethos of seeking to cure critically ill patients. Family members require particular care as they keep vigil with their loved one and this forms a major area of work and concern for nurses. Mortality rates are higher in intensive care units than in most other settings and this impacts on staff. This paper builds on a qualitative exploratory study utilising focus groups that was undertaken to describe how nurses support family members during and after a death in the intensive care unit. This study identified issues that challenged the nurses' ability to maintain professionalism and the ways in which nurses ensured self-care. They highlighted organisational constraints, support for families and for their nursing colleagues as important issues for discussion.

The role of religious leaders on digital piracy attitude and intention

This study examines the role of religious leaders and individual's religiousness in affecting attitude towards digital piracy and behavior intention. The data analysis of 400 usable responses from a religious organisations provided several significant relationships. Attitude towards digital piracy and subjective norms has a negative relationship with digital piracy intention. There are also significant differences between highly religious and less religious respondents in terms of their attitude towards digital piracy, motivation to comply with their religious leaders, and intention to engage in digital piracy behavior.

Assessment of an established dialysis nurse practitioner model of care using mixed methods research

AIMS AND OBJECTIVES: To assess a dialysis nurse practitioner (NP) model of care by examining satisfaction, quality of life (QOL) and clinical outcomes of haemodialysis patients and explore experiences of dialysis nurses.

DESIGN: Mixed methods.

METHODS: Database analyses of dialysis indices amongst a sample (n = 45) of haemodialysis patients; a survey (n = 27) examining patient experience, satisfaction and QOL; and in-depth interviews with a sample (n = 10) of nurses.

RESULTS: Nurses commended the NP role, with five themes emerging: "managing and co-ordinating", "streamlining and alleviating", "developing capability", "supporting innovation and quality" and "connecting rurally". Patients' average age was 66 years and 71% were male. Patients' satisfaction with the care they received was rated 3.5/4 or higher across seven parameters and the average QOL score was 7.9/10.

CONCLUSION: The NP model of care is effective in enhancing patient care within a collaborative framework. The challenge is to sustain, and enhance the model, through mentorship programs for potential candidates.

A randomized controlled trial of a nurse-led supportive care package (SurvivorCare) for survivors of colorectal cancer

INTRODUCTION: Colorectal cancer (CRC) and its treatments can cause distressing sequelae. We conducted a multicenter randomized controlled trial aiming to improve psychological distress, supportive care needs (SCNs), and quality of life (QOL) of patients with CRC. The intervention, called SurvivorCare (SC), comprised educational materials, needs assessment, survivorship care plan, end-of-treatment session, and three follow-up telephone calls.

METHODS: At the end of treatment for stage I-III CRC, eligible patients were randomized 1:1 to usual care (UC) or to UC plus SC. Distress (Brief Symptom Inventory 18), SCNs (Cancer Survivors' Unmet Needs measure), and QOL (European Organization for Research and Treatment of Cancer [EORTC] QOL questionnaires C30 and EORTC CRC module CR29) were assessed at baseline and at 2 and 6 months (follow-up 1 [FU1] and FU2, respectively). The primary hypothesis was that SC would have a beneficial effect on distress at FU1. The secondary hypotheses were that SC would have a beneficial effect on (a) SCN and QOL at FU1 and on (b) distress, SCNs, and QOL at FU2. A total of 15 items assessed experience of care.

RESULTS: Of 221 patients randomly assigned, 4 were ineligible for the study and 1 was lost to FU, leaving 110 in the UC group and 106 in the SC group. Patients' characteristics included the following: median age, 64 years; men, 52%; colon cancer, 56%; rectal cancer, 35%; overlapping sites of disease, 10%; stage I disease, 7%; stage II, 22%; stage III, 71%. Baseline distress and QOL scores were similar to population norms. Between-group differences in distress at FU1 (primary outcome) and at FU2, and SCNs and QOL at FU1 and FU2 were small and nonsignificant. Patients in the SC group were more satisfied with survivorship care than those in the UC group (significant differences on 10 of 15 items).

CONCLUSION: The addition of SC to UC did not have a beneficial effect on distress, SCNs, or QOL outcomes, but patients in the SC group were more satisfied with care.

IMPLICATIONS FOR PRACTICE: Some survivors of colorectal cancer report distressing effects after completing treatment. Strategies to identify and respond to survivors' issues are needed. In a randomized controlled trial, the addition of a nurse-led supportive care package (SurvivorCare) to usual posttreatment care did not impact survivors' distress, quality of life, or unmet needs. However, patients receiving the SurvivorCare intervention were more satisfied with survivorship care. Factors for consideration in the design of subsequent studies are discussed.

Graduate nurse experiences of support : a review

UNLABELLED: The first year of practice as a nurse is recognized as stressful. Graduate nurses (GNs) report gaps in their education, reality shock, burnout and other negative experiences that influence their intentions to remain in nursing. OBJECTIVES: The aim of this literature review was to gain a greater understanding of the experiences of GNs. REVIEW METHODS: It included thirty-six articles that focused on GNs and their transition to nursing, as part of a graduate nurse program (GNP), from 2005 to present. RESULT: The review identified three main themes that influence the transition from student to registered nurse. These themes included, 1) feeling stressed and overwhelmed by nursing responsibilities, 2) the amount of support from senior nurses and 3) the importance of feedback on their performance as nurses. CONCLUSIONS: Further research that is focused on the support and feedback provided to new nurses is needed.

Nurse-led group consultation intervention reduces depressive symptoms in men with localised prostate cancer: a cluster randomised controlled trial

BACKGROUND: Radiotherapy for localised prostate cancer has many known and distressing side effects. The efficacy of group interventions for reducing psychological morbidity is lacking. This study investigated the relative benefits of a group nurse-led intervention on psychological morbidity, unmet needs, treatment-related concerns and prostate cancer-specific quality of life in men receiving curative intent radiotherapy for prostate cancer.

METHODS: This phase III, two-arm cluster randomised controlled trial included 331 men (consent rate: 72 %; attrition: 5 %) randomised to the intervention (n = 166) or usual care (n = 165). The intervention comprised four group and one individual consultation all delivered by specialist uro-oncology nurses. Primary outcomes were anxious and depressive symptoms as assessed by the Hospital Anxiety and Depression Scale. Unmet needs were assessed with the Supportive Care Needs Survey-SF34 Revised, treatment-related concerns with the Cancer Treatment Scale and quality of life with the Expanded Prostate Cancer Index -26. Assessments occurred before, at the end of and 6 months post-radiotherapy. Primary outcome analysis was by intention-to-treat and performed by fitting a linear mixed model to each outcome separately using all observed data.

RESULTS: Mixed models analysis indicated that group consultations had a significant beneficial effect on one of two primary endpoints, depressive symptoms (p = 0.009), and one of twelve secondary endpoints, procedural concerns related to cancer treatment (p = 0.049). Group consultations did not have a significant beneficial effect on generalised anxiety, unmet needs and prostate cancer-specific quality of life.

CONCLUSIONS: Compared with individual consultations offered as part of usual care, the intervention provides a means of delivering patient education and is associated with modest reductions in depressive symptoms and procedural concerns. Future work should seek to confirm the clinical feasibility and cost-effectiveness of group interventions.

An evaluation of a nurse-led rehabilitation programme (the ProBalance Programme) to improve balance and reduce fall risk of community-dwelling older people: a randomised controlled trial

info:eu-repo/semantics/publishedVersion

When theories become practice—a metaphorical analysis of adult-education school-leaders’ talk

Marketization has changed the education system. If we say that education is a market, this transforms the understanding of education and influences how people act. In this paper, adult-education school-leaders’ talk is analysed and seven metaphors for education are found: education as administration, market, matching, democracy, policy work, integration and learning. Exploring empirical metaphors provides a rich illustration of coinciding meanings. In line with studies on policy texts, economic metaphors are found to dominate. This should be understood not only as representing liberal ideology, as is often discussed in analyses of policy papers, but also as representing economic theory. In other words, contemporary adult education can be understood as driven by economic theories. The difference and relation between ideology and theory should be further examined since they have an impact on our society and on our everyday lives.

Is it time to stop researching nurse to patient ratios?

Determining nurse to patient ratios in haemodialysis units has been debated in many forums. Ratios to ensure safe and quality care vary globally, nationally, statewide, servicewide, clinic-wide and from nurse to nurse. Given the research complexities, this editorial asks, “How do we go about exploring ratios?”, “What is the optimal ratio?” and “Is nurse to patient ratio research a worthy pursuit?”

Academisation, school collaboration and the primary school sector in England: a story of six school leaders

This paper presents data from a study of five English primary schools. It examines some of the challenges associated with school autonomy and collaboration for state primary schools amid the uncertainty and complexity of governance in the present English education context. The paper features the voices of six leaders gathered from interviews that explored their thoughts about the academies movement. It highlights their fears that academisation, and particularly the imperative to join a large academy chain, will undermine their autonomy as individual schools. Accepting of the inevitability of academisation and the forms of network governance this reform offers, it highlights the head teachers’ moves to ensure their autonomy in terms of determining the timing and type of conversion. In relation to these moves, the paper reiterates the significance within effective collaboratives of member schools experiencing a sense of ownership, a common purpose, shared responsibility for students and their learning and relations of trust. The paper considers some of the tensions arising in this space in relation to competition, collaboration and school vulnerability.

The Citadel blueprint : the strategic plan for educating principled leaders

The Citadel conducted a campus-wide planning process that engaged the campus community in a discussion of the institution’s strategic goals and future vision, culminating in The Citadel’s 2009-2012 Strategic Plan. This planning document communicates The Citadel’s priorities and lays the foundation for a successful capital campaign that will take the institution to new heights of academic and leadership excellence. Building upon previous strategic planning processes, our mission, and core values, eight strategic initiatives will continue to form the foundation of the institution’s planning efforts and help define the college’s planning priorities.

Data, Software, and Advanced Computational Usage of University of Washington Research Leaders

Scientific research is increasingly data-intensive, relying more and more upon advanced computational resources to be able to answer the questions most pressing to our society at large. This report presents findings from a brief descriptive survey sent to a sample of 342 leading researchers at the University of Washington (UW), Seattle, Washington in 2010 and 2011 as the first stage of the larger National Science Foundation project “Interacting with Cyberinfrastructure in the Face of Changing Science.” This survey assesses these researcher’s use of advanced computational resources, data, and software in their research. We present high-level findings that describe UW researchers’: demographics, interdisciplinarity, research groups, data use, software and computational use—including software development and use, data storage and transfer activities, and collaboration tools, and computing resources. These findings offer insights into the state of computational resources in use during this time period as well as offering a look at the data intensiveness of UW researchers.