Assessing advanced life support (ALS) competence: Victorian practices

Advanced life support (ALS) assessments are performed to assess nurses’ abilities to recognize cardiac arrest events, and appropriately manage patients according to resuscitation guidelines. Although there is evidence for conducting assessments after initial ALS education, there is little evidence to guide educators about ongoing assessments in terms of methods, format and frequency.

The aim of this study was to determine methods used by educators to assess ALS skills and knowledge for nurses in Victorian intensive care units. This descriptive study used telephone interviews to collect data. Data were analysed using content analysis. Twenty intensive care educators participated in this study. Thirteen educators (65%) were employed in public hospitals, and 7 educators (35%) worked in private hospitals across 12 Level 3 (60%) and 8 Level 2 (40%) intensive care units.

Results showed all educators used scenarios to assess ALS skills, with 12 educators (60%) including an additional theoretical test. There was variability in ALS assessment frequency, assessment timing in relation to initial/ongoing education, person performing the assessment, and the assessor/participant ratio. Nineteen educators (95%) reported ALS skill competency assessments occurred annually; 1 educator (5%) reported assessments occurred every 2 years. Assessments were conducted during a designated month (n = 10), numerous times throughout the year (n = 8), or on nurses’ employment anniversaries (n = 2). All educators reported many nurses avoided undertaking assessments.

Variability in ongoing ALS assessment methods was evident in Victorian intensive care units with some units applying evidence-based practices. Consideration should be given to the purposes and methods of conducting annual ALS assessments to ensure resources and strategies are directed appropriately. To encourage nurses to retain ALS skills and knowledge, regular practices are recommended as an alternative to assessments. However, further research is required to support this notion.

The politics of developing reference standards for nutrient intakes : the case of Australia and New Zealand

Objective Nutrient Reference Values (NRV) are evidence-based benchmarks for assessing the dietary adequacy of individuals and population groups as well as informing public health nutrition policies and programmes. The present paper presents the findings of an analysis of the views of submitters to a draft document associated with the development of the 2006 NRV for Australia and New Zealand. The aim of the study was to explore how these views were reflected in the policy-making process and final policy document.

Design The information necessary to fulfil this aim required access to stakeholder submissions to the NRV development process and this necessitated exploiting the provisions of the Commonwealth of Australia’s Freedom of Information (FOI) Act 1982. We understand that the present research represents the first time that an FOI request seeking information about a National Health and Medical Research Council food and nutrition policy process has been made and therefore is novel in its approach to public health nutrition policy analysis.

Results The analysis of stakeholder submissions identified that stakeholders had particular concerns about the conduct of the review process and the future application of the nutrient values to policy and programmes. There is a lack of evidence that the majority of stakeholder comments were addressed in the final NRV document.

Conclusion Although these findings cannot be interpreted to assess the validity or otherwise of the set nutrient values, they do raise questions about the process for their development and the adequacy of the final document to reflect the views of key stakeholders.

Principals, politics and change : confronting school resilience to radical renewal

Governments expect school principals to lead and manage significant change to implement school improvement agendas. Research evidence suggests, however, that schools are slow to change (Evans, 1996; Duignan, 2006), that many teachers resist change (Marzano, Waters & McNulty, 2005), and that change is often cursory or short lived – not disrupting dominant cultures and existing arrangements (Johnson, 2004). This paper discusses the resistance to major change encountered by Australian principals, and their perceptions of its causes. Emergent themes demonstrate that the success or otherwise of change rests heavily on the political astuteness of principals, which suggests the need for ongoing professional learning and leadership support around the issue of leading and managing change.

Memory, photography, and the politics of abuse : the ambiguous nature of photography

Critical commentary on Australian artist Bill Henson’s work including the series Untitled 1994-1995 which represented Australia at the Venice Biennale is frequently framed within the discourse of the ‘white cube’. Its contextualisation in predominantly art historical and formalist perspectives tends to operate as a mechanism that denies affective and embodied dimensions of meaning making. Much the same could be said of the work of Marian Drew who uses road kill in her photographic still life works. However, the ‘distancing’ in these works is also achieved through historical allusion, which at the same time reactivates the fl ow of emotional empathy and desire. In this paper, I ask the question: “What distinguishes the work of these two artists with media images of torture?”

My attempt to address this question will involve a narrative re-reading of selected works of Henson and Drew incorporating notions of affect, identification, memory and desire as processes which operate non-discursively, but which are inseparable from memory and lived experiences. This will permit a double exposure of the work of these artists. Within a psychoanalytical context, my re-reading will be used to extend an understanding of the now familiar press and Internet images of the torture of Iraqi prisoners.

As a metaphor for desire and ideology, photography operates within manifest and latent registers. I will argue that certain forms of photographic practice may be understood in terms of a politics of abuse — instantiating an uneven differentiation of power between actants, the winning (forcefully or otherwise) of consent or complicity, the silencing of refusal of resistance and/or the incriminating of the ‘victim’ — whilst at the same time upholding the claim of verisimilitude and aesthetic or ethical intent. Critical engagement with such practices is crucial to an understanding of the relationship between institutional discourses, trauma and abuse in contemporary society.