A scoping review to inform an auditing framework evaluating healthcare environments for inclusion of people with intellectual disability and/or autism.

People with intellectual disability and/or autism are likely to be in hospital more often, for longer, and have poorer health outcomes. Few audit tools exist to identify their barriers in mainstream healthcare environments. This study aimed to identify evidence of audit characteristics of healthcare contexts specifically for people with intellectual disability and/or autism, for conceptual development of an auditing framework. A scoping review of evaluations of healthcare environments was completed in January 2023. Findings were presented using the PAGER framework. Of the sixteen studies identified, most originated in the UK, nine focused on intellectual disability, four on autism, and three were concerned with mixed diagnosis. Six domains for auditing healthcare environments were identified: care imperatives, communication to individuals, understanding communication from individuals, providing supportive environments of care, supporting positive behaviour, and actions to make things go well. Further research is recommended to refine an audit framework.

Registered nurses' awareness and implementation of reasonable adjustments for people with intellectual disability and/or autism.

AIM: To describe Australian registered nurses' awareness, and implementation of reasonable adjustments within their practice when caring for people with intellectual disability and/or autism. Additionally, the association between key demographic, workforce, and respondent variables and familiarity of the term and regularity of use was explored. DESIGN: Cross-sectional survey. METHODS: Survey data were collected between August and October 2020 using an online survey tool. Data were analysed using descriptive and inferential statistics. RESULTS: Familiarity of the concept of reasonable adjustments was relatively low, compared to respondents who report applying adjustments when caring for people with intellectual disability and/or autism. Higher levels of confidence, comfort, and knowledge when caring for this cohort were associated with greater awareness and application of reasonable adjustments. CONCLUSION: A higher volume, and diversity in type of, nursing education related to care for people with intellectual disability and/or autism is indicated.

A cross-practice context exploration of nursing preparedness and comfort to care for people with intellectual disability and autism.

AIMS AND OBJECTIVES: To compare the self-perceived preparedness, knowledge, comfort and confidence of Australian Registered Nurses when caring for people with ID and/or ASD across contexts of practice: primary care and community, intensive care, acute hospital, emergency department, paediatrics and ID/ASD. BACKGROUND: There is limited research comparing nursing preparedness and competency when caring for people with intellectual disability (ID) and/or autism (ASD) across nursing contexts of practice. A greater understanding of the differed educational preparedness, confidence and comfort across contexts of practice can aid the development of tailored educational programmes to improve nursing capacity to care for this cohort. DESIGN: Cross-sectional descriptive study. METHODS: A descriptive survey tool of registered nurses (n = 69.3). Comparative inferential analysis was undertaken between the independent categorical variable of six nursing contexts of practice across several dependent variables including age, years since registration, educational content and exposure, knowledge, comfort and confidence. This cross-sectional study was undertaken according to the STROBE Statement checklist of items. RESULTS: Occupying an ID/ASD nursing role was significantly associated with higher reported levels of educational preparedness, professional development and postgraduate education relevant to caring for people with ID and/or ASD. Levels of self-reported knowledge of care issues, confidence and comfort when undertaking healthcare tasks was significantly associated with the context of practice, with nurses working in ID/ASD settings reporting the highest levels across all variables. CONCLUSION: The findings of the study highlight an association between greater educational exposure to content relevant to working with people with ID/ASD and subsequently working in that field. RELEVANCE TO CLINICAL PRACTICE: This study has highlighted that professional development programmes aiming to improve nursing capacity to care for people with ID and/or ASD, should be informed by and address differing gaps in confidence, comfort and educational preparedness across nursing contexts of practice.

Informing the development midwifery standards for practice: A literature review for policy development.

AIM: To critically appraise and synthesise the literature regarding the role and scope of midwifery practice, specifically to inform the evidence based development of standards for practice for all midwives in Australia. DESIGN: A structured scoping review of the literature DATA SOURCES: CINAHL Complete, MEDLINE Complete and Cochrane Libraries databases, online and grey literature databases REVIEW METHODS: Comprehensive searches of databases used key words and controlled vocabulary for each database to search for publications 2006-2016. Studies were not restricted by research method. FINDINGS: There is no substantive body of literature on midwifery competency standards or standards for practice. From 1648 papers screened, twenty-eight papers were identified to inform this review. Eight studies including systematic reviews were annotated with three research papers further assessed as having direct application to this review. To inform the development of Midwife standards for practice, the comprehensive role of the midwife across multiple settings was seen to include: woman centred and primary health care; safe supportive and collaborative practice; clinical knowledge and skills with interpersonal and cultural competence. KEY CONCLUSIONS: Midwifery practice is not restricted to the provision of direct clinical care and extends to any role where the midwife uses midwifery skills and knowledge. This practice includes working in clinical and non-clinical relationships with the woman and other clients as well as working in management, administration, education, research, advisory, regulatory, and policy development roles. IMPLICATIONS FOR PRACTICE: This review articulates the definition, role and scope of midwifery practice to inform the development of contemporary standards for practice for the Australian midwife.

EARLY CAREER NURSES AND MIDWIVES NEED JOBS.

One of the many important roles the ANMF undertakes, as the national professional and industrial organisation for nurses and midwives in Australia, is monitoring and promoting employment opportunities for early career nurses and midwives (previously referred to as graduates).

SAFETY AND SECURITY IS EVERYONE'S BUSINESS.

Workplace safety and security should be a given but as we all know this is not always the case.

The development of professional practice standards for Australian general practice nurses.

AIMS: The aim of this study was to explore the current role of general practice nurses and the scope of nursing practice to inform the development of national professional practice standards for Australian general practice nurses. BACKGROUND: Increasing numbers of nurses have been employed in Australian general practice to meet the growing demand for primary care services. This has brought significant changes to the nursing role. Competency standards for nurses working in general practice were first developed in Australia in 2005, but limited attention has been placed on articulating the contemporary scope of practice for nurses in this setting. DESIGN: Concurrent mixed methods design. METHODS: Data collection was conducted during 2013-2014 and involved two online surveys of Registered and Enrolled Nurses currently working in general practice, a series of 14 focus groups across Australia and a series of consultations with key experts. FINDINGS: Data collection enabled the development of 22 Practice Standards separated into four domains: (i) Professional Practice; (ii) Nursing Care; (iii) General Practice Environment and (iv) Collaborative Practice. To differentiate the variations in enacting these Standards, performance indicators for the Enrolled Nurse, Registered Nurse and Registered Nurse Advanced Practice are provided under each Standard. CONCLUSION: The development of national professional practice standards for nurses working in Australian general practice will support ongoing workforce development. These Standards are also an important means of articulating the role and scope of the nurses' practice for both consumers and other health professionals, as well as being a guide for curriculum development and measurement of performance.

The complexities of defining nurse practitioner scope of practice in the Australian context.

AIMS: To explore the legislative and regulatory constraints that defines nurse practitioner scope of practice within the Australian context. BACKGROUND: Nurse practitioners have been endorsed to practice in Australia for over 13 years. However, despite this lengthy period, there still remains confusion amongst newly endorsed nurse practitioners and their employers as to what determines the scope of their practice in Australia. DESIGN: A review of available policy and regulatory documents related to the Australian operational requirements for nurse practitioner scope of practice cited within or referred to by the Nursing and Midwifery Board of Australia. DATA SOURCES: Data were collected over a 2-month period in 2013. This utilized the current standards, codes and guidelines cited by the Nursing and Midwifery Board of Australia related to scope of practice and nurse practitioner, as well as legislation and regulation referred to in relation to nurse practitioner practice. Information was also obtained through government health and professional organization websites. All information in the literature regarding current and past status, and nomenclature of advanced practice nursing was considered relevant. Implications for nursing: Providing a means of interpreting the determinants of nurse practitioner scope of practice within Australia. CONCLUSIONS: The factors that determine nurse practitioner scope of practice, education, clinical experience, and competence leading to endorsement, are straightforward. However, the context of clinical practice, including jurisdictional restrictions, is major barriers to the expression of nurse practitioner scope of practice. These restrictions, although not insurmountable, continue to hinder nurse practitioners from practicing to their full scope of practice.

Nursing competency standards in primary health care: an integrative review.

AIMS AND OBJECTIVES: This paper reports an integrative review of the literature on nursing competency standards for nurses working in primary health care and, in particular, general practice. BACKGROUND: Internationally, there is growing emphasis on building a strong primary health care nursing workforce to meet the challenges of rising chronic and complex disease. However, there has been limited emphasis on examining the nursing workforce in this setting. DESIGN: Integrative review. METHODS: A comprehensive search of relevant electronic databases using keywords (e.g. 'competencies', 'competen*' and 'primary health care', 'general practice' and 'nurs*') was combined with searching of the Internet using the Google scholar search engine. Experts were approached to identify relevant grey literature. Key websites were also searched and the reference lists of retrieved sources were followed up. The search focussed on English language literature published since 2000. RESULTS: Limited published literature reports on competency standards for nurses working in general practice and primary health care. Of the literature that is available, there are differences in the reporting of how the competency standards were developed. A number of common themes were identified across the included competency standards, including clinical practice, communication, professionalism and health promotion. Many competency standards also included teamwork, education, research/evaluation, information technology and the primary health care environment. CONCLUSION: Given the potential value of competency standards, further work is required to develop and test robust standards that can communicate the skills and knowledge required of nurses working in primary health care settings to policy makers, employers, other health professionals and consumers. RELEVANCE TO CLINICAL PRACTICE: Competency standards are important tools for communicating the role of nurses to consumers and other health professionals, as well as defining this role for employers, policy makers and educators. Understanding the content of competency standards internationally is an important step to understanding this growing workforce.

WE MAKE A DIFFERENCE.

Back in 2009 Julianne used this column to raise the issue of the importance of language 'in the way we describe ourselves as nurses and midwives, what it is that we do and what that means to both ourselves and others'. Her assertion was that when attempting to define nursing or midwifery, or the role of a nurse or a midwife, the definition never seems to adequately address all that a nurse or midwife is, or does. We are not 'just a nurse' or 'just a midwife'.

NURSE PRACTITIONERS -- THE ANSWER FOR AGED CARE.

The nurse practitioner role is now well established in Australia, with these nurses driving clinical leadership and innovation, across a diversity of care settings. The aged care sector, however, was slower than other areas to create positions for nurse practitioners.

Development of the Nurse Practitioner Standards for Practice Australia.

This article describes the context and development of the new Nurse Practitioner Standards for Practice in Australia, which went into effect in January 2014. The researchers used a mixed-methods design to engage a broad range of stakeholders who brought both political and practice knowledge to the development of the new standards. Methods included interviews, focus groups, surveys, and work-based observation of nurse practitioner practice. Stakeholders varied in terms of their need for detail in the standards. Nonetheless, they invariably agreed that the standards should be clinically focussed attributes. The pillars common in many advanced practice nursing standards, such as practice, research, education, and leadership, were combined and expressed in a new and unique clinical attribute.