Putting People First: The Importance of Recommending Minimum Staffing Levels and Skills Mix.

Australia's Royal Commission into Aged Care Quality and Safety has concluded. The Commission's final report described a sector failing to deliver care that older Australians deserve despite the best efforts of many staff. Throughout the Commission, staffing was a frequent concern, with the size and composition of the direct care workforce a prominent focus. Throughout the Commission, many stakeholders campaigned for mandated staffing levels in skills mix in nursing homes and the Commission's report and Commonwealth Government response included recommendations for these. While this is a necessary step toward wider reform, the Royal Commission's recommendation and the Australian Government's response must support the delivery of best practice care more strongly. This column argues that the minimum standard for nursing home staff care time must be higher, and that higher minimum staffing levels and more clearly defined skills mix are critical to the delivery of safe, respectful, dignified person-centred care.

Recency of Practice and the Maintenance of Professional Competence for Nurses and Midwives: A Scoping Review Protocol.

Australian and international nursing regulators have specific requirements for continuing competence and the professional, safe practice of nurses and midwives. Requirements can dictate duration of practice, time away from/recency of practice, revalidation policies, and time between study program completion and practice commencement. Requirements vary between contexts and are periodically updated. To identify and examine Australian and international evidence for best regulatory practices relating to recency and the maintenance of professional competence among nurses and midwives, a scoping review based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews will be undertaken. This protocol details the scope, inclusion criteria, and methodology that will guide the scoping review, which will inform an update to the Nursing and Midwifery Board of Australia's Registration Standard: Recency of Practice.

Extent, range, and nature of studies examining sleep in nurses: a scoping review protocol.

OBJECTIVE: This scoping review aims to comprehensively map the extent, range, and nature of studies that examine the various dimensions of nurses' sleep across all health care settings or countries. INTRODUCTION: Over the past 2 decades, the importance of sleep for nurses has gained increasing attention from health care administrators, researchers, and policymakers. Despite growing research in the area, it remains unclear as to how research on sleep in nurses aligns with emerging concepts in sleep medicine more broadly, particularly in terms of how outcomes and predictors are associated with different dimensions of sleep. INCLUSION CRITERIA: This review will include primary studies that examine nurses' sleep. All dimensions of sleep (eg, duration, timing, variability, quality, and common disorders) and all nurses, irrespective of career stage, will be considered for inclusion. METHODS: This review will utilize the JBI methodology for scoping reviews and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRIMSA-ScR). Databases to be searched include MEDLINE (Ovid), Emcare, Embase, PsycINFO, and Scopus. A 3-step search strategy will be undertaken to identify primary studies published in English with no date limit. The data extracted will include specific details about the nursing population, sleep dimension, outcome measures, methodology, and key findings. Figurative, tabular, and accompanying narrative synthesis will be used to present the results in line with the review questions. REVIEW REGISTRATION: Open Science Framework https://osf.io/rzc4m.

Experiences of undergraduate nursing students and new graduate nurses in paid employment models and health-related work influencing the transition to practice: a qualitative systematic review protocol.

OBJECTIVE: This review aims to synthesize qualitative literature exploring the experiences of undergraduate nursing students and newly graduated nurses who are employed for less than 1 year in clinical settings after graduation. It will focus on those who had paid employment and health-related work experience during their undergraduate studies, examining the influence of these experiences on the transition to practice. INTRODUCTION: Nursing professionals undergo a transformative journey, starting from envisioning themselves as nurses, to developing professional identity and competence. However, the initial transition to nursing practice often poses challenges for undergraduates and newly graduated nurses. To ease this transition, gaining additional clinical experience through paid employment or health-related work during undergraduate studies can be beneficial. INCLUSION CRITERIA: This review will include qualitative studies on the experiences of undergraduate nursing students and newly graduated nurses in paid employment models and health-related work. No restrictions on the publication date or country will be applied; however, only English-language publications will be included. METHODS: The JBI methodology for qualitative systematic reviews will be employed. Searches will be conducted in MEDLINE, Embase, Emcare (Ovid); CINAHL Complete (EBSCOhost); and ERIC (ProQuest), along with gray literature in ProQuest Dissertations and Theses and Google Scholar. Study selection, quality assessment, and data extraction will be conducted as per the JBI methodology. Findings will be synthesized using meta-aggregation, and a ConQual Summary of Findings will be created. REVIEW REGISTRATION NUMBER: PROSPERO CRD42024520724.

International nursing students' perceptions and experiences of transition to the nursing workforce - A cross-sectional survey.

OBJECTIVE: To investigate international nursing students' perceptions about their preparedness and experiences of transition from the educational settings to the host country's nursing workforce. BACKGROUND: Transition from a student to a registered nurse is a challenging phase for undergraduate nursing students. Undergraduate nursing students have reported concerns about their clinical preparedness and felt inadequately prepared as new graduates. One under-researched area is international nursing students' preparedness and experiences of transition from their undergraduate nursing program to the host country's nursing workforce. DESIGN: A descriptive cross-sectional study. SETTING: Online survey active from 26 October 2020-31 January 2021 in Australia. PARTICIPANTS: 110 eligible international nursing students (Mean age = 25.10 ± 3.32; 57.8% female) in the final year of their undergraduate nursing program Australian universities took part in the survey in 2020. METHODS: The survey used the Casey-Fink Readiness for Practice Survey as well as newly added questions to measure transition preparedness, clinical preparedness, facilitators and barriers that may affect transition and the impact of Coronavirus disease of 2019 on transition. Both descriptive and inferential statistics were used for data analysis. RESULTS: Over 90% of the respondents planned to transition to the Australian nursing workforce, with over 50% feeling prepared to transition as registered nurses. However, over 50% of the respondents did not feel ready to find nursing employment in Australia. When assessing clinical preparedness, participants reported their discomfort and lack of confidence in dealing with dying patients, delegating tasks to nursing assistants and communicating and interacting with physicians and interdisciplinary team members in the clinical area. They also reported clinical simulation activities helpful in clinical preparation, being comfortable in taking actions to solve problems and being confident in identifying actual or potential safety risks for patients. The major barriers for transition included temporary visa status, financial challenges, duration of clinical placements during the nursing program, inability to comprehend local colloquialism and knowledge of the Australian healthcare system. The main facilitators were clinical simulation experiences, the ability to speak languages other than English and interactions with people from diverse cultures. CONCLUSIONS: International nursing students had unique challenges related to their temporary visa status, knowledge of the Australian healthcare system and comprehension of colloquialism. Clinical simulation experiences, the ability to interact with diverse cultures and speak different languages contributed positively to their transition preparedness. They expressed their desire to have extended clinical placements in more acute care settings to improve their clinical experiences.

Conducting high quality scoping reviews-challenges and solutions.

OBJECTIVES: Scoping reviews are being increasingly used by researchers. The objective of this article was to outline some challenges and potential solutions to improve the conduct and reporting of scoping reviews. STUDY DESIGN AND SETTING: The JBI scoping review methodology group consists of 9 experts in the field of scoping reviews. This article summarizes the key issues facing reviewers who conduct scoping reviews and those who use the results from scoping reviews and may engage in consultations during their development. RESULTS: Several key issues have been identified for reviewers as challenges in conducting scoping reviews. Challenges may be faced throughout the conduct of the review, from developing the a priori protocol to finalizing the review report for publication and developing implications or recommendations for research, policy, and practice from the results of the review. Challenges to publishing scoping reviews may stem from a lack of understanding of scoping reviews by journal editors, authors, and peer reviewers to extending the conclusion drawn from these reviews to generate recommendations for practice and policy. CONCLUSION: By identifying and overcoming challenges to the conduct and reporting of scoping reviews, reviewers may better ensure that scoping reviews are effective in meeting the objectives of scoping reviews.

Speaking the same language: Development of a Nutrition Minimum Data Set for healthcare professionals in primary healthcare.

Providing the best possible nutritional care requires accurate and precise communication between healthcare professionals. Developing a Nutrition Minimum Data Set will inform professionals in primary healthcare of which core elements should be documented and facilitate a standardized approach to the documentation of nutritional care. A two-step methodological approach was utilized in this study: (1) a systematic scoping review was conducted to map evidence underpinning the development of a Minimum Data Set and (2) the datasources were categorized using the inductive content analysis approach. A total of 32 items were identified in the datasources. Five categories were inductively derived from the data: (1) physiologic measurements, (2) ability to eat, (3) intake, (4) stress factors and (5) factors which indirectly affect intake and needs. Organizing the documentation following the structure presented in this Minimum Data Set will contribute to a standardized terminology, which may lead to increased quality of documentation, increased continuity of care and improved health outcomes.

Mixed methods study on the use of and attitudes towards safety checklists in interventional radiology.

INTRODUCTION: The use of safety checklists in interventional radiology is an intervention aimed at reducing mortality and morbidity. Currently there is little known about their practical use in Australian radiology departments. The primary aim of this mixed methods study was to evaluate how safety checklists (SC) are used and completed in radiology departments within Australian hospitals, and attitudes towards their use as described by Australian radiologists. METHODS: A mixed methods approach employing both quantitative and qualitative techniques was used for this study. Direct observations of checklist use during radiological procedures were performed to determine compliance. Medical records were also audited to investigate whether there was any discrepancy between practice (actual care measured by direct observation) and documentation (documented care measured by an audit of records). A focus group with Australian radiologists was conducted to determine attitudes towards the use of checklists. RESULTS: Among the four participating radiology departments, overall observed mean completion of the components of the checklist was 38%. The checklist items most commonly observed to be addressed by the operating theatre staff as noted during observations were correct patient (80%) and procedure (60%). Findings from the direct observations conflicted with the medical record audit, where there was a higher percentage of completion (64% completion) in comparison to the 38% observed. The focus group participants spoke of barriers to the use of checklists, including the culture of radiology departments. CONCLUSION: This is the first study of safety checklist use in radiology within Australia. Overall completion was low across the sites included in this study. Compliance data collected from observations differed markedly from reported compliance in medical records. There remain significant barriers to the proper use of safety checklists in Australian radiology departments.

Fluoropyrimidine and platinum toxicity pharmacogenetics: an umbrella review of systematic reviews and meta-analyses.

Fluoropyrimidine (FU) and platinum-based chemotherapies are greatly complicated by their associated toxicities. This umbrella systematic review synthesized all systematic reviews that investigated associations between germline variations and toxicity, with the aim of informing personalized medicine. Systematic reviews are important in pharmacogenetics where false positives are common. Four systematic reviews were identified for FU-induced toxicity and three for platinum. Polymorphisms of DPYD and TYMS, but not MTHFR, were statistically significantly associated with FU-induced toxicity (although only DPYD had clinical significance). For platinum, GSTP1 was found to not be associated with toxicity. This umbrella systematic review has synthesized the best available evidence on the pharmacogenetics of FU and platinum toxicity. It provides a useful reference for clinicians and identifies important research gaps.