Exploring Nursing Staff's Experiences and Perspectives of COVID-19 Lockdown in a Residential Aged Care Setting in Australia.

An exploratory qualitative study was performed to evaluate the experiences of nursing staff (N = 10) working in a residential aged care facility (RACF) during the coronavirus disease 2019 (COVID-19) pandemic lockdown. Semi-structured, in-person interviews were performed, and thematic analysis was used to analyze the data. Care staff had little or no knowledge of how to cope with a lockdown necessitated by a pandemic. However, management developed proactive plans as they aligned with the changing care circumstances and ongoing government directives. Five major themes were identified: Prolonged Use and Shortage of Personal Protective Equipment; "Blind Leading the Blind"; Communication and Teamwork; Lack of Education; and Resident Response. RACF staff described working under stressful conditions during the initial COVID-19 pandemic lockdown; yet with experience, care staff and the management team adapted to pandemic requirements to meet the needs of residents in their care. RACFs should be prepared for the impact of pandemics on staff and ensure care resources and support are available for the continuity of safe and quality care of residents. [Journal of Gerontological Nursing, 49(3), 34-39.].

Nursing in a different world: Remote area nursing as a specialist-generalist practice area.

OBJECTIVE: Remote area nurses provide primary health care services to isolated communities across Australia. They manage acute health issues, chronic illness, health promotion and emergency responses. This article discusses why their generalist scope of practice should be formally recognised as a specialist nursing practice area. DESIGN: Constructivist grounded theory, using telephone interviews (n = 24) with registered nurses and nurse practitioners. SETTING: Primary health care clinics, in communities of 150-1500 residents across Australia. PARTICIPANTS: A total of 24 nurses participated in this study. RESULTS: Nurses' perceived their clinical knowledge and skill as insufficient for the advanced, generalist, scope of practice in the remote context, especially when working alone. Experience in other settings was inadequate preparation for working in remote areas. Knowledge and skill developed on the job, with formal learning, such as nurse practitioner studies, extending the individual nurse's scope of practice to meet the expectations of the role, including health promotion. CONCLUSION: Remote area nursing requires different knowledge and skills from those found in any other nursing practice setting. This study supports the claim that remote area nursing is a specialist-generalist role and presents a compelling case for further examination of the generalist education and support needs of these nurses. Combined with multidisciplinary collaboration, developing clinical knowledge and skill across the primary health care spectrum increased the availability of health resources and subsequently improved access to care for remote communities. Further research is required to articulate the contemporary scope of practice of remote area nurses to differentiate their role from that of nurse practitioners.

Common components of nurse manager development programmes: A literature review.

AIMS: To critically appraise contemporary literature and synthesize common components of nurse manager development programmes. BACKGROUND: Although the need for nurse manager development programmes has been well documented, minimal recent research exists which identifies and evaluates the common components in these programmes. Furthermore, nurse managers continue to be poorly prepared and supported in role transition, contributing to poor organisational and role performance and decreased retention. METHOD: A structured literature review saw 14 original research publications appraised for quality, analysed and included in the review. RESULTS: The common components identified in nurse manager development programmes include curriculum, method of delivery, support, and funding components. Various subthemes were also identified. CONCLUSION: The components identified within existing nurse manager development programmes are varied. Although there are common components within nurse manager development programmes, these individual components have not been evaluated for effectiveness. There is a clear need for further development of nurse manager development programmes and evaluation of the specific components within. IMPLICATIONS FOR NURSING MANAGEMENT: An understanding of the common components in NM development programmes is useful for designing and implementing robust evidence-based programmes. Inclusion of these components may facilitate a smoother role transition, enhance performance and improve recruitment and retention of nurse managers.

Qualitative perspectives of nurse managers on mixed-gender accommodation in a regional hospital in Australia.

AIMS: To explore and analyse the current bed management processes and understand the perspectives of nurse managers on mixed-gender accommodation in a regional hospital in Australia. BACKGROUND: Mixed-gender accommodation was introduced to help manage the increasing demand for hospital beds. Yet, some health services identify same-gender accommodation better aligns with patient-centredness. METHOD: This qualitative research was conducted at a public hospital in regional Australia and focused on the experience in the general wards. Eight nurse managers were selected using purposeful sampling. Data were collected through face-to-face semi-structured interviews and thematically analysed. RESULTS: Three main themes were identified: current admission processes-managing admissions, bed allocation considerations, patient involvement and managing mixed-gender rooms; impacts on patients-participant views, patient experience and bathrooms; and barriers and facilitators-capacity, infrastructure, safety and risk, bed swapping and organisational factors. CONCLUSIONS: The study demonstrates a lack of structure and patient-centredness with mixed-gender allocation processes. Local organisational guidelines are suggested to support improvement in patient-centred inpatient hospital accommodation. IMPLICATIONS FOR NURSING MANAGEMENT: The findings of this study will help nursing leaders drive positive change concerning bed allocations and support advocacy for patient rights. Future studies should explore the patient perspective of mixed-gender accommodation.

A Mixed-Methods Study on Patient Safety Insights of New Graduate Registered Nurses.

BACKGROUND: New graduate nurses transition with limited experience, and with anxiety and stress. They present an increased risk of contributing to preventable errors or adverse events. PURPOSE: The purpose was to develop an understanding of new graduate registered nurses' (RNs) patient safety knowledge and actions within the first year of registration. METHODS: The longitudinal mixed-methods study was conducted using a questionnaire delivered at 3 time points (n = 68). Qualitative data were collected by semistructured interviews (n = 11). RESULTS: Self-reported knowledge of medical error decreased over the 3 time points. Themes emerging from qualitative data include patient safety and insights, time management, making a mistake, experiential learning, and transition. CONCLUSIONS: Medical errors and time management persist during transition to the RN role. New graduates reported moderate knowledge of safety and quality issues; however, questioning their own abilities overshadowed growth in their involvement in patient safety.

New graduate nurses' understanding and attitudes about patient safety upon transition to practice.

AIMS: To explore the transition experiences of newly graduated registered nurses with particular attention to patient safety. BACKGROUND: New graduate registered nurses' transition is accompanied by a degree of shock which may be in tune with the described theory-practice gap. The limited exposure to clinical settings and experiences leaves these nurses at risk of making errors and not recognising deterioration, prioritising time management and task completion over patient safety and care. DESIGN: Qualitative descriptive approach using semi-structured interviews. METHODS: Data were collected during 2017-18 from 11 participants consenting to face-to-face or telephone semi-structured interviews. Interviews were transcribed verbatim, and data were analysed using thematic analysis techniques assisted by Nvivo coding software. The study follows the COREQ guidelines for qualitative studies (see Supplementary File 1). RESULTS: Key themes isolated from the interview transcripts were as follows: patient safety and insights; time management; making a mistake; experiential learning; and transition. Medication administration was a significant cause of stress that adds to time management anguish. Although the new graduate registered nurses' clinical acumen was improving, they still felt they were moving two steps forward, one step back with regards to their understanding of patient care and safety. CONCLUSION: Transition shock leaves new graduate registered nurses' focused on time management and task completion over patient safety and holistic care. Encouragement and support needed to foster a safety culture that foster safe practices in our new nurses. RELEVANCE TO PRACTICE: Having an understanding of the new graduate registered nurses' experiences and understanding of practice will assist Graduate Nurse Program coordinators, and senior nurses, to plan and provide the relevant information and education during these initial months of transition to help mitigate the risk of errors occurring during this time.

Nurse absenteeism: An analysis of trends and perceptions of nurse unit managers.

AIM: To explore absenteeism trends and absenteeism management from the perspective of nurse unit managers. BACKGROUND: Unscheduled absenteeism among nurses appears to be a multi-factorial phenomenon and is a source of concern due to the effect absenteeism has on the daily management of human resources, ultimately affecting delivery of safe care. Identifying absenteeism trends among nurses may inform the development of targeted strategies to minimize unscheduled absenteeism. METHODS: A mixed-methods approach was used with the quantitative phase retrospectively reviewing and analysing nurse absenteeism data, whilst the qualitative phase involved semi-structured interviews with nurse unit managers, exploring their perceptions pertaining to the absenteeism trends. RESULTS: Data analysis revealed that absenteeism in hospitals follows various trends, amongst them seasonal, daily, and demographic trends. A heavy workload, which takes its toll on the nurses' physical and mental health, also contributes to nurse absenteeism. CONCLUSION: This study reveals absenteeism trends from nurse managers' perspectives, with authentication from official statistics. Any prescriptive measures for absenteeism should take into account absenteeism trend analysis and the work environment. IMPLICATIONS FOR NURSING MANAGEMENT: An analysis of absenteeism trends will assist management in initiating tailor-made intervention measures.

Change fatigue: The frontline nursing experience of large-scale organisational change and the influence of teamwork.

AIM: To evaluate the experience of change fatigue in frontline nursing staff following large-scale organisational change and determine whether improved teamwork perception scores can mitigate the experience of change fatigue in this population. BACKGROUND: There is limited published research pertaining to the experience of change fatigue in nursing, despite the rapid rate and volume of change within health care organisations. METHOD: An online questionnaire was used to survey a cross section of frontline nurses from two distinct cohorts; those that transitioned to a new build hospital in an established team (n = 225), and those who transitioned into a newly reconfigured team (n = 521). RESULTS: Frontline nurses who transitioned in an established team reported higher levels of change fatigue following large-scale change, compared with those that commenced in a new, reconfigured team (p = 0.013). There is a small significant negative correlation between perception of teamwork and change fatigue scores. CONCLUSION(S): Regardless of team type, high levels of change fatigue are reported by frontline nursing staff following large-scale organisational change. Established teams have a higher perceived level of teamwork in all domains when compared with a new team in the same change conditions. It is unlikely that the perception of teamwork has any real-world impact upon the experience of change fatigue. IMPLICATIONS FOR NURSING MANAGEMENT: Change fatigue is a real phenomena experienced by frontline nursing staff during large-scale organisational change conditions. Investing in teamwork training prior to or during large-scale organisational change does not affect the experience of change fatigue.

New graduate nurses' clinical safety knowledge by the numbers.

AIM: To explore new graduate registered nurses' knowledge and attitudes concerning medical error and patient safety, during their first 6 months of professional practice. BACKGROUND: New graduate registered nurses demonstrate basic skills and levels of performance due to limited exposure and experience in actual situations. There is a concern held for their clinical reasoning skills required to recognize patient deterioration, posing a threat to patient safety. METHODS: An online questionnaire was used to survey new graduate registered nurses at three time points during graduate nurse programmes between August 2016 and February 2018. RESULTS: A decrease in self-reported knowledge and attitudes regarding medical errors was noted over the three time points. These results indicate initial confidence in theoretical knowledge and attitudes upon completion of undergraduate education, and prior to commencing professional practice. CONCLUSION: Results suggest that a theory practice gap persists with respect to medical error for transitioning new nurses. IMPACT FOR NURSING MANAGEMENT: New nurses lack confidence around compromised patient safety situations and a knowledge gap around actions related to medical error. Nurse managers and educators should be made aware of this gap to implement strategies to decrease risk during novice nurse transition.

The nexus of nursing leadership and a culture of safer patient care.

AIMS AND OBJECTIVES: To explore the connection between +6 nursing leadership and enhanced patient safety. BACKGROUND: Critical reports from the Institute of Medicine in 1999 and Francis QC report of 2013 indicate that healthcare organisations, inclusive of nursing leadership, were remiss or inconsistent in fostering a culture of safety. The factors required to foster organisational safety culture include supportive leadership, effective communication, an orientation programme and ongoing training, appropriate staffing, open communication regarding errors, compliance to policy and procedure, and environmental safety and security. As nurses have the highest patient interaction, and leadership is discernible at all levels of nursing, nurse leaders are the nexus to influencing organisational culture towards safer practices. DESIGN: The position of this article was to explore the need to form a nexus between safety culture and leadership for the provision of safe care. CONCLUSIONS: Safety is crucial in health care for patient safety and patient outcomes. A culture of safety has been exposed as a major influence on patient safety practices, heavily influenced by leadership behaviours. The relationship between leadership and safety plays a pivotal role in creating positive safety outcomes for patient care. A safe culture is one nurtured by effective leadership. RELEVANCE TO PRACTICE: Patient safety is the responsibility of all healthcare workers, from the highest executive to the bedside nurse, thus effective leadership throughout all levels is essential in engaging staff to provide high quality care for the best possible patient outcomes.

New graduate registered nurses' knowledge of patient safety and practice: A literature review.

AIMS AND OBJECTIVES: To critically appraise available literature and summarise evidence pertaining to the patient safety knowledge and practices of new graduate registered nurses. BACKGROUND: Responsibility for patient safety should not be limited to the practice of the bedside nurses, rather the responsibility of all in the healthcare system. Previous research identified lapses in safety across the health care, more specifically with new practitioners. Understanding these gaps and what may be employed to counteract them is vital to ensuring patient safety. DESIGN: A focused review of research literature. METHODS: The review used key terms and Boolean operators across a 5-year time frame in CINAHL, Medline, psycINFO and Google Scholar for research articles pertaining to the area of enquiry. Eighty-four articles met the inclusion criteria, 39 discarded due to irrelevant material and 45 articles were included in the literature review. RESULTS: This review acknowledges that nursing has different stages of knowledge and practice capabilities. A theory-practice gap for new graduate registered nurses exists, and transition to practice is a key learning period setting new nurses on the path to becoming expert practitioners. Within the literature, there was little to no acknowledgement of patient safety knowledge of the newly registered nurse. CONCLUSIONS: Issues raised in the 1970s remain a concern for today's new graduate registered nurses. Research has recognised several factors affecting transition from nursing student to new graduate registered nurse. These factors are leaving new practitioners open to potential errors and risking patient safety. RELEVANCE TO CLINICAL PRACTICE: Understanding the knowledge of a new graduate registered nurse upon entering clinical practice may assist in organisations providing appropriate clinical and theoretical support to these nurses during their transition.

Resilience as resistance to the new managerialism: portraits that reframe nursing through quotes from the field.

AIM: This paper acknowledges the relationship between resilience and the new managerialism of contemporary nursing. METHODS: Qualitative portraiture methodology. DISCUSSION: The new managerialism in hospital settings results in a rapidly increasing turnover of acutely ill or comorbid patients, which directly relates to retention and quality service. In education settings, the management imperative to recruit more students into the profession combined with financial cutbacks leads to similar tensions. In aged care the trend equates care directly with funding, with the same effect. Yet despite this, many registered nurses remain working. Portraiture explored 'why' nurses remain in workplaces often described as awful. The resilience of nurses is seen through their stories and reframed to highlight resilience as a form of resistance to the new managerialism inherent in contemporary healthcare. CONCLUSION: This paper describes some of the hallmarks of new managerialism where workforce pressures force practices that do not value the 'human resource'. IMPLICATIONS FOR NURSING MANAGEMENT: The quotes from the field give insight into the nurse's world view and have implications for managers, educators and employers, as well as for consumers of nursing care.

Variation of Kozinets' framework and application to nursing research.

BACKGROUND: Online communities are new sites for undertaking research, with their textual interactions providing a rich source of data in real time. 'Ethnonetnography' is a research methodology based on ethnography that can be used in these online communities. In this study, the researcher and a specialist breast care nurse (SBCN) were immersed in the online community, adding to patients' breast cancer care and providing a nursing research component to the community. AIM: To examine Kozinets' ( 2010 ) framework for ethnonetnography and how it may be varied for use in a purpose-built, disease-specific, online support community. DISCUSSION: The online community provided an area where members could communicate with each other. Kozinets' ( 2010 ) framework was varied in that the research was carried out in a purpose-built community opf which an SBCN was a member who could provide support and advice. The application of the ethnonetnographic methodology has wide implications for clinical nursing practice and research. CONCLUSION: Ethnonetnography can be used to study disease-specific communities in a focused manner and can provide immediate benefits through the inclusion of an expert nurse and contemporaneous application of research findings to patient care. IMPLICATIONS FOR PRACTICE: With ethical permission and the permission of online community members, nurse researchers can enter already established online communities. Ethnonetnography is ideally suited to nursing research as it provides the immediacy of evidence-based interaction with an expert nurse. These real-time responses improve support for those experiencing a critical life event.

Why nurses chose to remain in the workforce: Portraits of resilience.

AIM: This study explored why nurses chose to remain in the Western Australian workforce and to develop insights into the role of resilience of nurses and to identify the key characteristics of resilience displayed by these nurses. BACKGROUND: Nursing is a stressful profession. Prolific quantitative research which measures job stress and resilience has been implemented; however, there is a dearth of qualitative studies which hear the personal narratives as to why nurses remain and thrive in a stressful workplace. DESIGN/METHODS: Vignettes of nursing resilience reveal underlying themes of resilience where personal stories and events are presented as narrative. Portraiture recognises the inherent value of the nurses' stories giving attention to the nature of their resilience. Interpretation illuminates the portraits or verbal canvasses of the told experience, reflecting success and positivity despite disarray in healthcare settings. RESULTS/FINDINGS: Eight themes were identified. The portraits highlight a sometimes imperceptible theme of resilience within nursing. Nurses are resilient; they rely on the social support of colleagues, family and friends to continue to bear their mantle of responsibility. They take pride in their work and accomplishments and give to others altruistically. They laugh, they love nursing and they keep the needs of their patients, clients, residents or students foremost. CONCLUSION: This paper describes the hallmarks of resilience demonstrated by nurses. Resilience and its relationship to coping in times of adversity are captured within the portraits presented.

Portraiture: a methodology through which success and positivity can be explored and reflected.

AIM: To present an overview of portraiture. BACKGROUND: Nursing is increasingly embracing more arts-based approaches as research methodologies. Portraiture has an underlying philosophy and process that enables the illumination of real people in real settings through the 'painting' of their stories. It is a complex methodology in which the researcher attempts to illuminate meaning of personal stories and events presented as narrative. DATA SOURCES: Interview data were collected from nine participants from three nursing settings. Nurses were invited to participate in an interview or conversation designed to elicit data to address the research questions; the aim was to gain insight into the nurses' common shared meanings and shared contemplations of their feelings about resilience. Criteria for inclusion in this study required that all nurse participants were English speaking, registered with the Nurses and Midwives Board of Western Australia and that each had over five years' experience in the Western Australian healthcare environment. This was to enable reflection on significant and ongoing changes within the workplace as a possible source of resilient behaviours. REVIEW METHODS: This is a methodological paper. DISCUSSION: Portraiture blends aesthetics and empiricism while drawing on features of narrative, case study, phenomenology and ethnography. The portraits stand as individual vignettes revealing recognisable themes and enabling patterns of experience to emerge from each topic being studied. Each portrait requires the researcher to constantly reflect on the participant's experiences by incorporating ethnographic observations, interview responses, impressionistic records, the interpretation of context, and the researcher's experiences and insights. It is a methodology that concentrates on success and positivity to immerse the reader in carefully painted and perceptive stories of success and positivity in times of adversity. CONCLUSION: This paper describes some of the hallmarks of the portraiture method, one of which is to portray success and positivity, and points to the relationship this approach may have with contemporary social science and positive psychology research. IMPLICATIONS FOR RESEARCH/PRACTICE: The illumination of resilience as a strategy to be learned and fostered in nurses in times of adversity has implications for managers and nursing practice. Resilience education engenders a more resilient workforce and has implications for nurses choosing to or being able to stay in nursing during times of stress and adversity.

Generational diversity: what nurse managers need to know.

AIM: This article presents a discussion of generational differences and their impact on the nursing workforce and how this impact affects the work environment. BACKGROUND: The global nursing workforce represents four generations of nurses. This generational diversity frames attitudes, beliefs, work habits and expectations associated with the role of the nurse in the provision of care and in the way the nurse manages their day-to-day activities. DATA SOURCES: An electronic search of MEDLINE, PubMed and Cinahl databases was performed using the words generational diversity, nurse managers and workforce. The search was limited to 2000-2012. DISCUSSION: Generational differences present challenges to contemporary nurse managers working in a healthcare environment which is complex and dynamic, in terms of managing nurses who think and behave in a different way because of disparate core personal and generational values, namely, the three Cs of communication, commitment and compensation. IMPLICATIONS FOR NURSING: An acceptance of generational diversity in the workplace allows a richer scope for practice as the experiences and knowledge of each generation in the nursing environment creates an environment of acceptance and harmony facilitating retention of nurses. CONCLUSION: Acknowledgement of generational characteristics provides the nurse manager with strategies which focus on mentoring and motivation; communication, the increased use of technology and the ethics of nursing, to bridge the gap between generations of nurses and to increase nursing workforce cohesion.

Left behind: Exploring the concerns of emergency department staff when personnel are utilised for inter-hospital transfer.

BACKGROUND: Inter-Hospital Transfer (IHT) may require an escort from the referring hospital, either a Registered Nurse (RN), physician or both, leading to a sudden drop in staffing levels within the referring department potentially increasing risk to patients and staff. AIMS: To explore the perspectives of RNs and physicians of differing experience levels when left behind due to an escorted IHT, and the decision-making protocols for IHT. METHOD: A qualitative exploratory approach of 5 RNs and 4 physicians selected using purposeful sampling. Data were collected through semi-structured interviews and thematically analysed. FINDINGS: Five themes were identified: the impact of being left behind; the burden of transfer; missed care; a triangulation of competing needs upon the decision-making process; and the effect of inter-hospital transfers on staff with different experience levels. CONCLUSION: IHT is described differently by less experienced RNs compared to their more experienced counterparts especially concerning safety and risk. Physicians described the department as vulnerable with ad-hoc decision-making protocols surrounding IHT the norm.

The impact of pregnancy on women with adolescent idiopathic scoliosis: a scoping review.

INTRODUCTION: Adolescent idiopathic scoliosis is the most common spinal deformity encountered in adolescents and larger curves are more prevalent in girls. For females with scoliosis, women's health issues are of particular concern, especially pregnancy. The aim of this review was to summarise the best available evidence to determine the influence of pregnancy on scoliosis-related outcomes in women with scoliosis and whether scoliosis affects maternal-health outcomes, differentiating between patients who have been managed conservatively and/or surgically. EVIDENCE ACQUISITION: A search was conducted using CINAHL, Scopus, Cochrane Database, MEDLINE, and EMBASE from inception to May 2023 to identify relevant articles in any language. The scoping review followed the PRISMA-ScR guidelines. Studies were eligible if they included pregnant women (primiparous or multiparous) with a diagnosis of scoliosis of unknown aetiology. The results were summarized by outcomes, including pregnancy and scoliosis-related outcomes and type of management. EVIDENCE SYNTHESIS: Our comprehensive search strategy identified 6872 articles, of which 50 articles were eligible for this review. Back pain appears to be more prevalent in this population during pregnancy and associated with the major curve and the decrease of lumbar lordosis. There have been reports of failed attempted spinal anaesthesia among patients with instrumented scoliosis correction and minor complications related to epidural anaesthesia at a higher rate compared to non-instrumented patients and healthy controls, however successful spinal analgesia can be achieved in patients with instrumented scoliosis correction. Overall, the caesarean section rate was similar in scoliosis patients compared to controls without scoliosis and to national averages. Curve progression occurs in some but not all patients during pregnancy, and this phenomenon occurs irrespective of the treatment received. CONCLUSIONS: Higher-quality prospective longitudinal research is needed to understand the relationship between pregnancy and adolescent idiopathic scoliosis. Further, the patient's perspective, concerns and fears surrounding pregnancy with scoliosis are yet to be explored. Exploring the impact of pregnancy on women with adolescent idiopathic scoliosis would have clinically relevant outcomes and could help provide pertinent answers to patients and healthcare workers and help guide future research.

Coping with COVID-19. Work life experiences of nursing, midwifery and paramedic academics: An international interview study.

BACKGROUND: The COVID-19 global pandemic was declared in March 2020. By June 2022, the total deaths worldwide attributed to COVID-19 numbered over 6.3 million. Health professionals have been significantly impacted worldwide primarily those working on the frontline but also those working in other areas including nursing, midwifery, and paramedic higher education. Studies of occupational stress have focused on the clinical health professional roles but scant attention has been drawn to the pressures on university-based academic staff supporting and preparing professionals for frontline health work. DESIGN AND OBJECTIVES: This qualitative study sought to explore the challenges experienced by health academics (nurses, midwives and paramedics), during COVID-19 and identify strategies enlisted. SETTING AND PARTICIPANTS: Six Australian and two United Kingdom universities collaborated, from which 34 health academics were individually interviewed via video or teleconference, using six broad questions. Ethical approval was obtained from the lead site and each participating University. DATA ANALYSIS: Thematic analysis of the data was employed collaboratively across institutions, using Braun and Clarke's method. RESULTS: Data analysis generated four major themes describing academics': Experiences of change; perceptions of organisational responses; professional and personal impacts; and strategies to support wellbeing. Stress, anxiety and uncertainty of working from home and teaching in a different way were reported. Strategies included setting workday routine, establishing physical boundaries for home-working and regular online contact with colleagues. CONCLUSIONS: The ability of nursing, midwifery and, paramedic academic staff to adapt to a sudden increase in workload, change in teaching practices and technology, while being removed from their work environment, and collegial, academic and technological supports is highlighted. It was recognised that these changes will continue post-COVID and that the way academics deliver education is forever altered.

The Intensive Care Unit Liaison Nurse and their value in averting clinical deterioration: A qualitative descriptive study.

OBJECTIVES: Intensive Care Unit Liaison Nurse roles are associated with improved clinical outcomes for patients and financial benefits for healthcare providers. However, there is little academic exploration of the ward nurses' perspectives of the role and whether it can affect ward nurses' confidence in identifying and managing the deteriorating patient. This study addresses this gap by examining both those perspectives. RESEARCH DESIGN: A qualitative descriptive approach was used, utilising semi-structured interviews to garner the perspectives of ward nurses.Interviewswere conducted with ward nurses who had been involved in a MedicalEmergencyTeam/Code Blue call;sought technical or clinical support;or had been at the bedside during a post intensive care unit discharge review. Data were analysed using thematic analysis. SETTING: A private, not-for-profit, metropolitan acute care hospital. FINDINGS: The participants identified four areas that contributed to improved patient care: reduced Medical Emergency Team/Code calls; improved ward based critical care knowledge through education; improved ward nurses' confidence in dealing with the deteriorating patient and provision of technical support. CONCLUSION: The Intensive Care Unit Liaison Nurse role not only contributes to improved clinical patient outcomes; it also influences confidence levels of the ward nurses in managing deteriorating patients.