Block learning: Evaluation of a new teaching approach for nursing and midwifery education.

AIM: The aim is to present outcome and engagement data from the initial years of the implementation of a new teaching approach in entry to practice nursing and midwifery education. BACKGROUND: The Block Model (TBM) is a teaching approach that involves studying one unit of study at a time over a four-week period, as opposed to the traditional semester model. This paper presents data revealing the impact of TBM on student engagement and overall experience in entry to practice Bachelor of Nursing and Midwifery programs. DESIGN: The evaluation retrospectively compared key indicators pre- Block Model implementation with outcomes for nursing and midwifery students using TBM approach using standard data sets and external comparators such as the Student Experience Survey and National Employability Survey. METHODS: The study presents a comparative analysis of key indicators and graduate outcomes for students. We use reportable data and two external comparators, the Student Experience Survey and the National Employability Survey, to gauge student learning and graduate employability. The evaluation was conducted in a tertiary institution in Australia with for nursing and midwifery students who completed their studies using TBM approach at the university. RESULTS: The implementation of TBM in nursing and midwifery programs resulted in improvements in learner engagement, retention rates and pass rates. Improvements were also noted graduate outcomes, with an increase in full-time graduate employment. CONCLUSIONS: The results suggest the Block Model is a promising new teaching approach in nursing and midwifery education, with potential benefits for learner engagement, retention and pass rates.

Oral nutritional supplements for preventing surgical site infections: protocol for a systematic review and meta-analysis.

BACKGROUND: Surgical site infections (SSIs) are among the most common healthcare-associated infections. Under-nutrition is an important risk factor for SSIs and can lead to delayed wound healing and longer hospital stays. Oral nutritional supplements are prescribed to reduce the risk of infection and improve health status, but data from randomised controlled trials (RCTs) have shown mixed results. Thus, the objective of our planned systematic review is to evaluate oral nutritional supplements on preventing SSIs in adult surgical patients METHODS: RCTs conducted in adult surgical patients who receive oral nutritional support will be included. The primary outcome will be the incidence of SSIs (within 30 days of surgery or within 90 days for joint replacement surgery). Secondary outcomes will be changes in nutritional status, mortality, health-related quality of life and costs. Literature searches will be conducted in several electronic databases (from inception onwards): MEDLINE, Embase, CINAHL and The Cochrane Central Register of Controlled Trials (CENTRAL). Grey literature will be identified through searching clinical trial registers and dissertation databases. Two reviewers will independently screen all citations, full-text articles and abstract data. The study methodological quality (or bias) will be appraised using the Cochrane risk of bias tool. If feasible, we will conduct random effects meta-analysis where appropriate. DISCUSSION: This systematic review will evaluate the evidence for pre- and post-surgical intervention with oral nutritional supplements in adults. Findings from this planned review may inform subsequent nutritional interventions for hospitalised patients who undergo surgery. SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD42020140954.

The influence of hospital location and 'level of care' on continuing professional development.

Healthcare workers core skills are reinforced and knowledge of latest developments ensured by undertaking systematic continuing professional development. The current study explored the impact of health facility location and level of care provided on the continuing professional development offered to maternity services healthcare workers in Victoria, Australia. An online survey of middle to senior management staff of 71 public and private health services as well as 7 professional bodies was conducted, yielding 114 participants. Analysis was by location (metropolitan or regional/rural) and level of care provided. The findings revealed Australian Health Practitioner Regulation Agency registration is the predominant requirement to provide continuing professional development to staff. Dedicated education departments or educators are significantly underrepresented in Level 1&2 facilities, while Level 5&6 facilities are more likely to provide breastfeeding continuing professional development. Metropolitan locations provided more wide-ranging programmes compared with rural/regional locations. Key enablers are the capacity to share resources, have access to external courses and simulation equipment/centres, and the provision of relevant and timely continuing professional development programmes, indicating that 'Educational hubs' with credentialed staff working from better resourced regional facilities could deliver a complete array of CPD programmes to lower level facilities.

Competencies and skill development in maternity care services in Victoria - A qualitative study.

In healthcare, continuing professional development is provided to ensure professional standards are maintained and for clinicians to remain fit to practice. The purpose of the study was to identify potential gaps or issues with continuing professional development in maternity services through consultations with key stakeholders and, in addition, to generate possible solutions or recommendations towards the development of a state wide continuing professional development program. The data was collected through semi-structured interviews of a purposive sample between June and August 2018. A thematic analysis was undertaken. Participants included a practicing midwife, allied health practitioner (physiotherapist), manager, healthcare educator, and an outlier service worker (maternal and child health nurse). Following the thematic analysis, four main themes (education, practitioner standards, programme monitoring and resources) were identified along with nine sub-themes. The results suggest organisations need to offer explicit support for staff to access to continuing professional development. In addition, the qualifications of facilitators of continuing professional development and/or consumer education are recommended to go beyond education levels required for registration. In this respect, some organisations credentialed their educators locally in a 'train the trainer' manner however, most participants supported professional preparation for the role of educator.

Emergency department nurse's attitudes towards patients who self-harm: A meta-analysis.

Self-harm is a major challenge to public health. Emergency department (ED) nurses treat significant proportions of patients with self-harm injuries, and positive therapeutic patient-nurse interactions are imperative to the physical and psychological outcome of this vulnerable patient group. Research, both nationally and internationally, suggests that treating those with self-harm injuries is emotionally challenging, and ambivalence, powerlessness, and ineffectiveness are commonly manifested in negative attitudes towards these patients. Following the PRISMA guidelines, this systematic review with meta-analyses examined the attitudes of ED nurses towards patients who self-harm, based on currently available evidence. The following databases were searched: CINAHL complete; Medline complete; PsycARTICLES; PsycINFO; The Allied and Complementary Medicine Database; Health Source: Nursing/Academic Edition; PsycEXTRA; and Psychology and Behavioural Sciences Collection. Clinical trials registries for ongoing and unpublished studies, and scanned reference lists of relevant reports to identify additional studies, were also searched. Five studies were included in the meta-analysis. The Self-Harm Antipathy Scale (SHAS) was used as an outcome in two studies appropriate for meta-analysis. The Attitudes Towards Deliberate Self-Harm Questionnaire (ADSHQ) scale was used as an outcome in three studies appropriate for meta-analysis. Results demonstrated limited empathy and negativity towards patients who self-harm, indicating a requirement for education and supervision of ED staff, where the SHAS or the ADSHQ can be used to monitor attitude change. Self-harm educational content for ED staff should include areas of knowledge building including explanations and causes of self-harm; range, forms, and functions of self-harm; staff responses to self-harm; assessment, management, and interventions; professional practice issues.

Challenges in acute care of people with co-morbid mental illness.

Acute secondary care settings are complex environments that offer a range of challenges for healthcare staff. These challenges can be exacerbated when patients present with a co-morbid mental illness. This article is a systematic review of the literature that has investigated the challenges imposed on health professionals working in acute secondary care settings where they care for patients who experience co-morbid physical and mental illnesses. A systematic search of the bibliographic databases was conducted and a total of 25 articles were included in this review. A number of challenges were identified including experience of fear, negative attitudes, poor mental health literacy, being positive and optimistic in providing care as a profession and environmental factors. Health professionals working in acute secondary care settings require organisational support and training in mental health care. Acute secondary care environments conducive to providing holistic care to patients experiencing mental illness co-morbidity are required.

Service integration for the dually diagnosed.

The needs of dually diagnosed clients in mental health services have been and remain a focus for service development and improvement in Australia. The Council of Australian Governments committed to a five-year National Action Plan on Mental Health with a $1.8 billion injection into mental health services. In Australia there have been great advances in the service initiatives and service deliverables to those clients who experience a dual diagnosis. These advances include that dual diagnosis is systematically identified and responded to in a timely, evidence-based manner as a core business in mental health and alcohol and other drug services. These advances are brought to life by specialist mental health and alcohol and other drug services that establish effective partnerships and agreed mechanisms to support integrated care and collaborative practice. Here, four case studies are offered as a means of illustrating the ways in which projects undertaken in local community health services have approached dual diagnosis treatment for clients. These case studies reflect how cooperation and cross-referral between services, as well as effective management of dual diagnosis clients by suitably qualified staff can produce benefits to clients who use the service.

Care: what nurses say and what nurses do.

Caring is neither simply a set of attitudes or theories, nor does it comprise all that nurses do. Nursing care is determined by the way nurses use knowledge and skills to appreciate the uniqueness of the person they are caring for (changing the care noun into a caring verb). The purpose of this article is to present a range of contemporary nurse theorists' ideas on caring and to examine these ideas using the backdrop of nursing as practiced in both Australia and Canada to demonstrate a range of national and international similarities and theoretical beliefs. Caring relationships set up the conditions of trust that enable the one receiving the care to accept the help offered, underpinning the nurse-patient relationship or the therapeutic relationship. Caring is always specific and relational such as that found in the nurse-patient relationship. We believe that caring theory has much to offer nursing practice worldwide. Caring must be considered in the caring context because the nature of the caring relationship is central to most nursing interventions. Nurses need to be able to actually practice caring rather than just theorize about it-using caring theories to inform their practice.

A theoretical discussion about the clinical value of phenomenology for nurses.

This article develops a theoretical discussion related to the value of a phenomenological framework in contributing to contemporary nursing knowledge. Nursing is based on the understanding of patients' personal experiences and their responses to their illness. Phenomenological methodology utilizes the patient's own language to reflect meanings embedded in their health experience.