A brief intervention to standardize postanesthetic clinical handoff.

This naturalistic, pre- and post-design study explored the feasibility and acceptability of a brief patient safety intervention to introduce a tool to standardize interdisciplinary communication processes at patient handoff between anesthetists and postanesthesia nurses in the postanesthetic care unit. Observation and interview data were collected pre- and post-intervention from a convenience sample of 27 nurses and 23 anesthetists in a large tertiary hospital in Melbourne, Australia. Following the intervention, significant improvement was observed in nurses' performance of several patient safety behaviors, but trends in nurses' interdisciplinary communication behaviors such as asking questions and escalation of care were nonsignificant. This research provides evidence that tools to standardize clinical handoff communication may empower nurses to perform desired patient safety behaviors during interprofessional handoff. It underpins future research to explore strategies to empower nurses to advocate for patient safety during interdisciplinary communication, and provides a foundation for patient handoff improvement, education, and further research.

The Impact of Social Support Networks on Family Resilience in an Australian Intensive Care Unit: A Constructivist Grounded Theory.

PURPOSE: This article discusses the findings of a grounded theory of family resilience in an Australian intensive care unit (ICU) with a specific focus on families' experiences of their interactions with other members within their own family, and the families of other patients in the ICU. DESIGN: A constructivist grounded theory methodology was adopted. Data were collected using in-depth interviews with 25 family members of 21 critically ill patients admitted to a tertiary-level ICU in Australia. FINDINGS: The core category regaining control represents the families' journey toward resilience when in ICU. The major categories represent facilitators for, and barriers to, regaining control. One of the main facilitators is drawing strength, and it explains the manner with which families receive social support from their own and other family members to help them cope. CONCLUSIONS: This study offers a framework to improve patient- and family-centered care in the ICU by facilitating families' ability to manage their situation more effectively. Social support offered by family members facilitates the families' ability to regain control. An ICU family resilience theoretical framework, situated within the context of the Australian healthcare system, adds to what is currently known about the families' experiences in the ICU. CLINICAL RELEVANCE: The relationships that develop between families in the ICU may provide a source of social support; however, not all families welcome interactions with other ICU families, and it may cause further emotional distress. Further research is warranted to determine whether families suffer a secondary stress reaction from incidental interactions with other patients' families in the ICU. Furthermore, when family members pull together and offer social support to each other, they are better able to regain control. This process contributes to an ICU family resilience framework.

Nurses' and personal care assistants' role in improving the relocation of older people into nursing homes.

AIMS AND OBJECTIVES: This article presents findings from a study that explored nurses' and personal care assistants' role in improving the relocation of older people into a nursing home. BACKGROUND: Suggestions for improving the relocation process for older people moving into a nursing home have been the outcomes of studies that have interviewed residents and their families. However, the views of nurses and personal care assistants working in nursing homes have not been previously explored. DESIGN: An exploratory, descriptive qualitative research design. METHODS: Individual interviews were conducted with 20 care staff (seven registered nurses, five enrolled nurses and eight personal care assistants) employed at four nursing homes. FINDINGS: Using thematic analysis, two key themes were identified: 'What it's like for them' - highlighted staffs' awareness of the advantages, disadvantages and meaning of relocation, and focused on staffing and nursing care; other services provided and the environment. The second theme - 'We can make it better', revealed suggestions for improving the relocation process, and included spending time with new residents and the importance of a person-centred approach to care. CONCLUSION: Care staff have an important role in improving the relocation process of older people into a nursing home, as well as contributing to the discussion on this important clinical topic. RELEVANCE TO CLINICAL PRACTICE: Challenging care staff to acknowledge the importance of their role in helping older people settle into a nursing home is a key requirement of nursing practice in aged care. Nursing practice guidelines, with a focus on person-centred care, on how to manage the relocation process for an older person and their family are required for this aspect of nursing home care. Education of staff on relocation policies and procedures is essential to ensure that residents and their families are supported through this process.

Practical infection control training for Victoria's aged care workforce at the time of COVID-19 pandemic: a community case study.

The need to improve career development and training for residential aged care workers in Australia to achieve required essential competencies, including infection prevention and control competencies, has been repeatedly highlighted. In Australia long-term care settings for older adults are known as residential aged care facilities (RACFs). The COVID-19 pandemic has brought to light the lack of preparedness of the aged care sector to respond to emergencies, and the urgent need to improve the infection prevention and control training in residential aged care facilities. The government in the Australian State of Victoria allocated funds to support older Australians in RACFs, including funds toward infection prevention and control training of RACF staff. The School of Nursing and Midwifery at Monash University addressed some of these challenges in delivering an education program on effective infection prevention and control practices to the RACF workforce in Victoria, Australia. This was the largest state-funded program delivered to RACF workers to date in the State of Victoria. The aim of this paper is to provide a community case study, where we share our experience of program planning and implementation during early stages of the COVID-19 pandemic and lessons learned.

Feasibility of implementing an innovative manual handling risk assessment training program for staff working in long-term care.

BACKGROUND: The Risk Assessment for moving Individuals SafEly (RAISE) program is a hospital-based manual handling nursing training program. RAISE involves upskilling on continual risk assessment during patient-assisted movements. RAISE aims to optimise staff and patient safety while providing the patient with movement and rehabilitation opportunities. Implementation of RAISE in the hospital setting has been established. The aim of this study was to explore the feasibility of implementing RAISE in the long-term care setting. METHODS: We examined three feasibility domains: acceptability, practicality, and limited efficacy (observed nursing behaviour change which has the potential to reduce nursing injuries), using a prospective pilot pre-post design in the long-term care setting. Staff completed a 4-hour training session on RAISE delivered by two physiotherapists, followed by 8 h of supported behaviour change in the workplace. Staff acceptability and practicality of incorporating risk assessment strategies into manual handling approaches were explored through pre- and post-training staff surveys and a semi-structured interview. Resident acceptability of manual handling practices was explored via survey data collected after the RAISE training. Pre to post-training changes in staff knowledge and behaviour were examined through the pre- and post-training staff survey, and observation of staff assisting resident movement. RESULTS: Two enrolled nurses and five residents participated. Staff reported the RAISE program was acceptable and practical to implement in the long-term care setting. There were no adverse events or safety concerns. Staff reported the RAISE program provided guidance and enhanced staff empowerment to make decisions during assisted resident movement. There were 26 observed resident-staff manual handling interactions recorded, with 13 pre-training and 13 post-training. Post-training, RAISE skills had improved and were completed 100% of the time, except for completing a physical risk assessment which improved from 46 to 85%, demonstrating limited efficacy. Residents reported it's important for staff to be trained on how to assist them to mobilise and they found the concept of the RAISE program acceptable. CONCLUSIONS: This pilot study supports the feasibility of long-term care facilities participating in future studies testing the effectiveness and cost-effectiveness of the Risk Assessment for moving Individuals SafEly (RAISE) patient and resident manual handling program.

Behavioural drivers influencing emergency department attendance in Victoria during the 2020 COVID-19 pandemic: A mixed methods investigation.

OBJECTIVE: To identify behavioural drivers and barriers that may have contributed to changes in ED attendance during the first 10 months of the coronavirus disease 2019 (COVID-19) pandemic in Victoria. METHODS: We conducted a mixed methods analysis of patients who attended one of eight participating EDs between 1 November 2019 and 31 December 2020. A random sample of patients were chosen after their visit and invited to participate in an online survey assessing behavioural drivers and barriers to attendance. The study timespan was divided into four periods based on local and world events to assess changes in attitudes and behaviours over this period. RESULTS: A total of 5600 patients were invited to complete the survey and 606 (11%) submitted sufficient information for analysis. There were significant differences in participants' attitudes towards healthcare and EDs, levels of concern about contracting and spreading COVID-19 and the influence of mask wearing. Patients expressed more concern about the safety of an ED during the largest outbreak of COVID-19 infections than they did pre-COVID, but this difference was not sustained once community infection numbers dropped. General concerns about hospital attendance were higher after COVID than they were pre-COVID. A total of 27% of patients specifically stated that they had delayed their ED attendance. CONCLUSION: Patients expressed increased concerns around attending ED during the first 10 months of the 2020 COVID-19 pandemic and frequently cited COVID-19 as a reason for delaying their presentation. These factors would be amenable to mitigation via focussed public health messaging.

Assessing mental health literacy of primary health care workers in Kenya: a cross-sectional survey.

AIM: To assess mental health literacy of health workers in primary health care services in Kenya. BACKGROUND: Mental illness is common in Kenya, yet there are fewer than 500 specialist mental health workers to serve Kenya's population of over 50 million. The World Health Organization recommends the integration of mental health care into primary health care services to improve access to and equity of this care, especially in low and middle-income countries. An important step to integrating mental health care into primary health care services is to determine mental health literacy levels of the primary health care workforce. METHOD: A cross-sectional survey using Jorm's Mental Health Literacy Instrument (adapted for the Kenyan context) was administered to 310 primary health care workers in four counties of Kenya. RESULTS: Of the 310 questionnaires distributed, 212 (68.3%) were returned. Of the respondents, 13% had a formal mental health qualification, while only 8.7% had received relevant continuing professional development in the five years preceding the survey. Just over one third (35.6%) of primary health care workers could correctly identify depression, with even fewer recognising schizophrenia (15.7%). CONCLUSIONS: This study provides preliminary information about mental health literacy among primary health care workers in Kenya. The majority of respondents had low mental health literacy as indicated by their inability to identify common mental disorders. While identifying gaps in primary health care workers' mental health knowledge, these data highlight opportunities for capacity building that can enhance mental health care in Kenya and similar low and middle-income countries.

Engaging patients and families in communication across transitions of care: An integrative review.

OBJECTIVE: To determine the current evidence about patient and family engagement in communication with health professionals during transitions of care to, within and from acute care settings. METHODS: An integrative review using seven international databases was conducted for 2003-2017. Forty eligible studies were analysed and synthesised using framework synthesis. RESULTS: Four themes: 1) Partnering in care: patients and families should be partners in decision-making and care; 2) Augmenting communication during transitions: intrinsic and extrinsic factors supported transition communication between patients, families and health professionals; 3) Impeding information exchange: the difficulties faced by patients and families taking an active role in transition; and 4) Outcomes of communication during transitions: reported experiences for patients, families and health professionals. CONCLUSION: While attitudes towards engaging patients and family in transition communication in acute settings are generally positive, current practices are variable. Structural supports for practice are not always present. PRACTICE IMPLICATIONS: Organisational strategies to improve communication must incorporate an understanding of patient needs. A structured approach which considers timing, privacy, location and appropriateness for patients and families is needed. Communication training is required for patients, families and health professionals. Health professionals must respect a patient's right to be informed by regularly communicating.

Influence of traditional Vietnamese culture on the utilisation of mainstream health services for sexual health issues by second-generation Vietnamese Australian young women.

BACKGROUND: The present paper discusses the impact the traditional Vietnamese culture has on the uptake of mainstream health services for sexual health matters by Vietnamese Australian young women. It is part of a wider qualitative study that explored the factors that shaped the sexual behaviour of Vietnamese Australian young women living in Australia. METHODS: A Grounded Theory methodology was used, involving in-depth interviews with 15 Vietnamese Australian young women aged 18 to 25 years who reside in Victoria, Australia. RESULTS: The findings demonstrated that the ethnicity of the general practitioner had a clear impact on the women utilising the health service. They perceived that a Vietnamese doctor would hold the traditional view of sex as held by their parents' generation. They rationalised that due to cultural mores, optimum sexual health care could only be achieved with a non-Vietnamese health professional. CONCLUSION: It is evident from the present study that cultural influences can impact on the sexual health of young people from culturally diverse backgrounds and in Australia's multicultural society, provision of sexual health services must acknowledge the specific needs of ethnically diverse young people.