The impact of low socioeconomic status and primary health care access on emergency department presentations in young children in regional Queensland.

AIM: The purpose of this study was to empirically evaluate if children from low socio-economic status (SES) families in regional southeast Queensland utilise acute care services for low acuity health care rather than utilising primary health services. METHODS: A retrospective audit of children under the age of 5 years presented at a regional hospital emergency department (ED) over a 12-month period. Medical records were examined for presenting problem, Australasian triage category, care outcomes, whether the child's parent/guardian held an Australian concession/health care card (AC/HCC) and accessed child health services or a general medical practitioner (GP). RESULTS: Eight hundred and eighty-eight children who had not reached their fifth birthday presented to ED between 1 June 2019 and 31 May 2020, with a total of 1691 presentations. Most children were bought to the ED by their parents with semi-urgent health concerns and were discharged home following medical review. Holding an AC/HCC was a significant predictor for hospital presentation. Holding an AC/HCC was not associated with access to child health services. However, accessing child health services resulted in a small but significant increase in hospital presentations. CONCLUSIONS: The AC/HCC may be an important proxy to identify low SES individuals. These card holders tended to use acute services more frequently than those who did not qualify for an AC/HCC. Furthermore, families that engage with primary care services such as child health also accessed acute care services more frequently. The results indicate accessing primary health-care services does not ameliorate the use of acute care services.

Importance of attachment to place in growing a sustainable Australian Rural Health Workforce: A rapid review.

INTRODUCTION: Personal, community, and environmental factors can influence the attraction and retention of regional, rural, and remote health workers. However, the concept of place attachment needs further attention as a factor affecting the sustainability of the rural health workforce. OBJECTIVE: The purpose of this rapid review was to explore the influence of a sense of place in attracting and retaining health professionals in rural and remote areas. DESIGN: A systematic rapid review was conducted based on an empirical model using four dimensions: place dependence, place identity, social bonding and nature bonding. English-language publications between 2011 and 2021 were sought from academic databases, including studies relevant to Australian health professionals. FINDINGS: A total of 348 articles were screened and 52 included in the review. Place attachment factors varied across disciplines and included (a) intrinsic place-based personal factors; (b) learning experiences enhancing self-efficacy and rural health work interest; (c) relational, social and community integration; and (d) connection to place with lifestyle aspirations. DISCUSSION: This rapid review provides insight into the role of relational connections in building a health workforce and suggests that community factors are important in building attachment through social bonding and place identity. Results indicate that future health workforce research should focus on career decision-making and psychological appraisals including place attachment. CONCLUSION: An attachment to place might develop through placement experiences or from a strong rural upbringing. The importance of the relational interactions within a work community and the broader community is seen as an important factor in attracting, recruiting, and sustaining a rural health workforce.

Cognitive mental workload of emergency nursing: A scoping review.

AIM: Emergency nurses work in an environment of high cognitive mental workload. Excessive cognitive mental workload may result in patient harm and nurses' burnout. Therefore, it is necessary to understand nurses' subjective experience of cognitive workload. This scoping review aimed to curate literature about the subjective experience of cognitive mental workload reported by nurses and psychometric measures of the phenomenon. DESIGN: The scoping review was conducted in accordance with JBI methodology and reported using PRISMA extension for scoping review checklist. METHODS: A priori protocol was created with Peer Review of Electronic Search Strategies checklist and registered in the OSF registry. Databases including PubMed, CINAHL, ProQuest, Scopus, Science Direct, Web of Science and Google Scholar were searched. Published reports were reviewed against the eligibility criteria by performing Title and Abstract screening, followed by Full-text screening. The initial search yielded 1373 studies. Of these, 57 studies met the criteria for inclusion in this study. RESULTS: The search revealed five general measures of cognitive mental workload and their variations. Only one customised measure specifically for medical-surgical nurses was found in the study. Identified measures were collated and categorised into a framework for conceptual clarity. NASA Task Load Index and its variations were the most popular subjective measure of cognitive mental workload in nursing. However, no measure or self-report scale customised for emergency nurses was identified. PATIENT OR PUBLIC CONTRIBUTION: The findings of this scoping review can inform future research into the cognitive mental workload of nurses. The findings have implications for workplace health and safety for nurses and patients.

Nursing students' interprofessional socialisation and readiness for interprofessional learning: A cross-sectional research study.

BACKGROUND: Interprofessional education programs in university settings have facilitated the development of student attributes needed to become a team-player, understand roles and responsibilities of other health disciplines, and acquire knowledge to deliver patient-centred care. Although the benefits of interprofessional education are widely acknowledged, there is limited research on interprofessional socialisation within university contexts. OBJECTIVES: To examine readiness of undergraduate nursing students for interprofessional learning and interprofessional socialisation. DESIGN: A cross-sectional design was used to examine the correlation between interprofessional learning and socialisation, and group differences between mode of study, year level, and prior healthcare experience. SETTING: A large Australian regional university, across two campuses. PARTICIPANTS: A total of 103 undergraduate nursing students across year levels, including 58 enrolled on-campus, and 45 studying externally. METHOD: Students completed an online survey using the Readiness for Interprofessional Learning Scale and the Interprofessional Socialisation and Valuing Scale. Data analyses included independent t-tests, and a one-way between subjects ANOVA. RESULTS: No significant differences in student readiness for interprofessional learning or interprofessional socialisation were found between on-campus and external modes of study and between healthcare experience and no prior healthcare experience. Participants with previous healthcare experience had significantly higher scores for interprofessional socialisation than those with no previous healthcare experience. CONCLUSIONS: Readiness for interprofessional learning and interprofessional socialisation and were not impacted by the students' mode of study; however, previous experience in the healthcare industry and duration of study significantly improved interprofessional socialisation skills. As nursing students advance through their study, they may experience interprofessional education opportunities that influence their perceived socialisation skills.

A Confirmatory Factor Analysis of the Student Evidence-Based Practice Questionnaire (S-EBPQ) in an Australian sample.

BACKGROUND: It is crucial that nursing students develop skills and confidence in using Evidence-Based Practice principles early in their education. This should be assessed with valid tools however, to date, few measures have been developed and applied to the student population. OBJECTIVE: To examine the structural validity of the Student Evidence-Based Practice Questionnaire (S-EBPQ), with an Australian online nursing student cohort. DESIGN: A cross-sectional study for constructing validity. PARTICIPANTS AND METHOD: Three hundred and forty-five undergraduate nursing students from an Australian regional university were recruited across two semesters. Confirmatory Factor Analysis was used to examine the structural validity. RESULTS: Confirmatory Factor Analysis was applied which resulted in a good fitting model, based on a revised 20-item tool. CONCLUSIONS: The S-EBPQ tool remains a psychometrically robust measure of evidence-based practice use, attitudes, and knowledge and skills and can be applied in an online Australian student context. The findings of this study provided further evidence of the reliability and four factor structure of the S-EBPQ. Opportunities for further refinement of the tool may result in improvements in structural validity.

Exploring nursing educators' use of theory and methods in search for evidence based credibility in nursing education.

OBJECTIVES: In this paper, a review of nursing education literature is employed to ascertain the extent to which nursing educators apply theory to their research, as well as the types of theory they employ. In addition, the use of research methodologies in the nursing education literature is explored. DESIGN: An integrative review. METHODS: A systematic search was conducted for English-language, peer reviewed publications of any research design via Academic Search Complete, Science Direct, CINAHL, and Health Source: Nursing/Academic Edition databases from 2001 to 2016, of which 140 were reviewed. FINDINGS: The findings suggest that within current nursing education literature the scholarship of discovery, and the exploration of epistemologies other than nursing, in particular as they relate to teaching and learning, shows significant potential for expansion and diversification. CONCLUSIONS: The analysis highlights opportunities for nursing educators to incorporate broader theoretical, pedagogical, methodological and philosophical perspectives within teaching and the scholarship of teaching.

The interrelationships between student approaches to learning and group work.

BACKGROUND AND AIM: As part of the process of nursing students becoming 'work ready' within future health care teams, students need the skills to work collaboratively. In higher education, establishing group work assignments is a teaching method to develop group work skills. Not only is group work an important teaching method to develop effective group work skills but it is also used to activate deep learning. However, to date, there has been a lack of research on the impact of group work on student approaches to learning. This study aimed to examine the interrelationships between students, group work characteristics, and their approaches to learning. DESIGN AND PARTICIPANTS: A survey design was used, before and after a targeted academic skills development intervention, which had a specific focus on the development of group work skills. The sample involved first year undergraduate nursing students undertaking a Bachelor of Nursing programme at a regional university in Australia. A total of 92 students completed the pre-survey, and 102 students completed the post-survey. METHOD: Data were collected using quantitative surveys. RESULTS: Metacognitive awareness was found to best predict a deep approach to learning. Young age and experiencing discomfort in group work were two predictors of a surface approach to learning. CONCLUSION: Findings indicate that nurse educators should develop strategies that support students' metacognitive awareness in relation to group work, and also support those students who feel less comfortable in working with others.

Nursing student's perceptions and understanding of intimate partner violence.

Intimate partner violence (IPV) is a significant health issue in the Australian population and nurses have a role in assessment, intervention and support of families. World Health Organization Statistics indicate that as many as 61% of women, under the age of 50 have been physically abused by their partners. As nurses are in a unique position to identify, assist and support women living with IPV a greater understanding of student nurse's knowledge and attitudes may assist undergraduate programs to ensure better preparation of nurses for this role. A nurse's readiness to manage IPV may be influenced by their knowledge, attitudes, beliefs and behaviors, largely related to their self-efficacy in identifying these women (i.e. via screening procedures) and providing effective interventions. Students from all levels of the undergraduate program of an Australian regional university were invited to participate in focus groups and a subsequent survey that explored their perceptions, attitudes and knowledge of IPV. The results showed students had limited and stereotypical beliefs regarding what constitutes IPV and who perpetrates it. They indicated that they were under prepared to deal with IPV situations in clinical practice but did identify communication as a core skill required. Nursing students may not understand the significance of the issues of IPV nor fully understand the social, economic and health impacts at an individual and societal level. This may result in further under detection of the problem. The results of this study indicate a number of important implications for undergraduate nursing education curricula.