Public health messaging during disasters: A qualitative study of emergency department key informants.

BACKGROUND: Patient education is a professional obligation for all nurses. Public health messaging in emergency departments during disasters can help prevent further risk or illness for affected communities. In this study, Australian emergency nurse Key Informants share their perceptions and experiences of preventative messaging provided in their departments during disasters and the governance and processes in place to support this practice. METHODS: The qualitative phase of a mixed methods study, where semi structured interviews were utilised, and data analysed using a six step Thematic analysis. RESULTS: Three themes were identified: (1) Part of the Job; (2) It's all in the delivery; and (3) Preparation is the key. These themes include concepts involving the confidence and competence of nurses providing messages, what, when and how messages are being given and how prepared both the department and staff are regarding patient education during disaster events. CONCLUSIONS: Nurse confidence is a key factor in the delivery of preventative messages during disasters, potentially resulting from a lack of exposure, a junior workforce and minimal training. Leaders agree that departments are not preparing or supporting messaging practice, with an absence of specific training, formal guidelines, and patient education resources; and that improvement is needed.

Public health messaging during disasters: Practice and attitudes of Australian emergency nurses.

BACKGROUND: The growing frequency of disasters increases health system demands, increasing the need for emergency departments to provide public health messaging to prevent illness and reduce risk. This study aims to explore emergency nurse practice and attitudes in providing public health messages from the emergency department during disasters in Australia. METHODS: Quantitative phase of a mixed methods study, using an explanatory sequential design. Australian emergency nurses were surveyed using a validated online questionnaire. Data was analysed using descriptive and inferential statistics, an enumerative content analysis, participant profiling and a factor analysis. RESULTS: Disaster experience varied in 143 nurse participants. The perception of the emergency nurse's role in providing public health messages is influencing practice. Embracing teachable moments and health promotion responsibilities, attributes to positive attitudes and practice. In contrast, negative attitudes, lack of confidence, time, policy, and training, are barriers to public health messages being provided in the emergency setting. CONCLUSIONS: These barriers suggest that Australian emergency nurses may not have the capability, the opportunity, nor the motivation, to provide preventative messages to their patients during disasters. Intrinsic and extrinsic factors need to be addressed, ensuring nurses are confident and supported in their public health messaging practice during disasters.

Student-led pop-up health check clinics: innovative health prevention strategy for a low socioeconomic community.

BACKGROUND: To improve preventative health screening in regional Victoria, Australia, a collaborative student-led health prevention strategy was initiated. The aim of this study is to evaluate the impact of four health check clinics using a free 'pop-up' format within community settings. METHODS: A mixed methods, explanatory sequential design was used to explore community health data and participant experiences in utilising the free health check clinics. The clinics were delivered over 6months and located in three different communities within the regional government area. Descriptive statistics were used to analyse participant health data and a thematic analysis was utilised to determine themes from participant feedback and health outcomes. RESULTS: The clinics were attended by 188 community members, largely impacted by government lockdowns during the coronavirus disease 2019 (COVID-19) pandemic. Health check results indicate the population is overweight and at high risk of diabetes. Participants enjoyed the free and convenient nature of the health check program and the location of the venues. Feedback from participants indicate the health education provided was useful and advocated for changes in current behaviours. Many embraced the new information and community connections and made changes to improve their future health. Others claimed to enjoy the clinic experience but reported no action from the recommendations. CONCLUSIONS: Evaluation of the health check clinics indicate they had a minor, yet positive impact on the local community in increasing engagement with preventative screening strategies. COVID-19 restrictions impacted participant numbers and thus more research is needed in a time where community movement is not limited.

Public health education by emergency nurses: A scoping review and narrative synthesis.

OBJECTIVE: To identify the extent, range, and nature of the evidence on public health education provided by emergency nurses. METHODS: A scoping review, using the methodological guidance of Joanna Briggs Institute, was conducted to scope and map the literature and research activity. Using predetermined criteria, databases, grey literature, and reference lists were searched for eligible sources. At least two authors reviewed each article. A narrative synthesis methodology was utilised to analyse and report the findings. RESULTS: There was significant methodological heterogeneity between sources (n = 6). Three themes were identified: 1) Benefits of the system: An opportunity to inform the public, 2) The barriers: Time pressures and being prepared and 3) The strategies: Plan for structured and created teachable moments CONCLUSION: Limited research is being conducted in this area. Further research is needed to understand emergency nurse's practice and attitudes towards providing public health messages. PRACTICE IMPLICATIONS: Emergency nurses need to utilise the 'teachable moment' for every emergency admission, providing opportunistic preventative education to improve health outcomes and reduce demand on the healthcare system.

Beyond simulation - Extracurricular volunteering in nursing education: A focus group.

BACKGROUND: A reduction in clinical placement hours has seen alternative teaching methods being explored in nursing education in Australia. The use of simulated patients in academic laboratories is highly utilised, however, may still be limiting learning opportunities. OBJECTIVE: The objective of this research was to describe the learning experiences of nursing students who participated in supervised extracurricular, volunteering opportunities during their nursing studies. DESIGN: A descriptive qualitative design was used to discover and understand learning experiences of a volunteering encounter, described from the nursing student perspective. SETTING: The Pit Stop men's health check program is a collaboration of local health organisations, volunteering their time to provide free health checks at a farming Field Day event in regional Victoria, Australia. PARTICIPANTS: Twelve second year undergraduate nursing students volunteered at the 2019 Pit Stop event, over a four day period and outside their normal study requirements. Seven volunteers then participated in post event research, sharing experiences and providing feedback. METHODS: One semi-structured focus group interview was conducted at University campus, using reflective and open ended questioning. Interviews were audio recorded and transcribed. Thematic analysis identified common themes. RESULTS: Students unanimously recommended the real life learning experiences and reported an increased confidence and competence in basic communication and clinical skills, not always provided in the simulated environment of the academic laboratory. Their motivation to attend was driven by wanting more real life contact with patients, having time to practice skills and experience diversity within their practice. Students also recommended future volunteering ideas that would potentially provide additional learning opportunities. CONCLUSIONS: Experiential learning such as simulation is highly valued in current nursing education, however, students still crave the real life learning experiences from working with human patients. With limited clinical exposure currently offered to students within nursing education programs, additional opportunities such as supervised volunteering may be worth considering when preparing confident and competent nurse graduates.

ED-HOME: Improving educator confidence and patient education in the Emergency Department.

BACKGROUND: Barriers to effective patient communication in the emergency department (ED) are well recognised; time, resources and staff and consumer expectations. This project aimed to improve the quality of health education provided in the ED by increasing nurses' confidence as educators. METHOD: By providing a staff information package including the introduction of a new structured education tool; ED-HOME, and by assessing the confidence and self-efficacy of the nurses in the process, we hoped to determine if an improvement in practice and confidence was achieved. A quantitative, pre and post-test questionnaire comparison study was undertaken before and after a four week implementation period. The project examined the attitudes and practices of registered emergency nurses and was conducted in one metropolitan emergency department. RESULTS: Results indicated that nurse confidence and self-efficacy improved by using the new structured ED-HOME format and both staff satisfaction and education competence increased. Participants positively responded to the new tool and recommended future use in the ED. CONCLUSION: This project demonstrates that if emergency nurses feel more confident with their educating practices and by using a structured format, patients will benefit from better quality patient education provided in the ED.