Pressure injury prevalence in critical care settings: An observational pre-post intervention study.

AIM: To explore pressure injury prevention practices and evaluate the impact of an educational intervention on PI prevalence before and after an educational intervention. DESIGN: A multi-centre observational study. METHOD: Data were collected at two time points in May 2021 and April 2022 using a Qualtrics® online form. Two Registered Nurses at each site collected observational data at each time point by diagnosing and staging any identified pressure injuries as part of a prevalence study. Patients admitted to participating units were included. RESULTS: A total of 181 patients in critical care units were included at the two-time points. Pressure injury prevalence was 60.9% at the outset, with 52.9% hospital-acquired, 37.9% unit-acquired and 23.0% medical device-related. Post-intervention prevalence decreased significantly to 28.7%, including 21.3% hospital-acquired, 14.9% unit-acquired, and 8.5% medical device-related. Pressure injuries were prominent in the sacral region, head area, and heels. Stages I and II pressure injuries were the most common. Increased age and longer ICU stays are linked to a heightened risk of pressure injury development in critically ill patients, whereas higher haemoglobin levels show an inverse relationship with the development of both pressure injury and severe stages in the univariate analysis. The predictive models revealed that increased age and longer ICU stays are predictors for both pressure injury development and progression to severe stages, while Braden scores predict the likelihood of developing severe stages of pressure injuries. CONCLUSIONS: This study has identified a benchmark for pressure injury prevalence in critical care units in Saudi Arabia. The results demonstrate that pressure injuries can be prevented in critically ill patients when evidence-based education strategies are implemented. PATIENT CARE IMPACT: Pressure injuries are an important issue for critically ill patients and can be prevented with proper investments. Strategies to prevent pressure injuries from admission will result in fewer pressure injuries. REPORTING METHOD: Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines and the Template for Intervention Description and Replication (TIDieR) checklist. PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution.

Examining the roles of rural nurses in resuscitation care: An ethnographic study.

INTRODUCTION: Rural nurses play a vital role in the provision of resuscitation care, as first responders and often the sole healthcare professionals delivering timely interventions with greater role autonomy and extended scope of practice. Whilst there is a developing body of literature describing the 'generalist' roles of rural nurses when providing care in acute care settings, little is known about the roles rural nurses assume during a resuscitation. AIM: The aim of this study was to explore the role/s that rural nurses enact when delivering resuscitative care to their rural community. DESIGN/METHODS: An ethnographic methodology was used across two rural hospital sites in Australia, involving non-participant observation and interviews. RESULTS: Reflexive thematic analysis led to three themes that described the resuscitative roles of rural nurses: Senior and junior nurse, formal and informal leadership roles, multiple roles. CONCLUSION: This study has placed a spotlight on rural nurse's capacity to be adaptive in a dynamic and highly variable resuscitative environment. Building leadership capacity should be a rural nursing workforce strategy, aimed at supporting the unique roles that rural nurses undertake when working with various external teams during resuscitations.

Understanding the processes, practices and influences of calibration on feedback literacy in higher education marking: A qualitative study.

BACKGROUND: In the University setting, striving for consistency and reliability of assessment evaluation is essential to reducing the impact of marking variations. Marking processes such as consensus calibration have the potential to reduce issues which arise from the influence of markers professional knowledge and experience, as well as fixed and acquired marking habits. Furthermore, the influence of marker feedback which supports learning development is associated with the feedback literacy of both the teacher and the student. A gap is currently present in the literature as these practices are not discussed together. OBJECTIVES: To explore how nursing academics perceive and understand calibration practices and associated feedback literacy. DESIGN: Theoretical underpinnings in participatory and person-centred research methodology supported the critical ontological perspective of this study where the intent of the research was to explore the reality that exists within the context where the research was conducted. SETTING: A single School of Nursing in an Australian University with six campuses spanning metropolitan, regional and rural sites. PARTICIPANTS: Nursing academics and casual tutors with various levels of experience in assessment marking and feedback. METHODS: Semi-structured group interviews that were analysed using reflexive thematic analysis. RESULTS: Four overarching themes were identified; rubrics, calibration, feedback and justice. CONCLUSION: Calibration improves staff cohesion, fosters better practices and consistency, and permits nuanced interpretation of assessments while maintaining uniformity. Enhanced feedback literacy that integrates principles of equity, justice, and learner-centeredness is required. Fundamentally calibration guides educators toward holistic approaches that foster consistency, equity, and thorough feedback practices.

Using data from mHealth apps to inform person-centred practice: A discussion paper.

BACKGROUND: mHealth applications (apps) are tools that can enhance research by efficiently collecting and storing large amounts of data. However, data collection alone does not lead to change. Innovation and practice change occur through utilisation of evidence. The volume of data collected raises questions regarding utilisation of data by nurses and midwives, and how data from mHealth apps can be used to improve person-centred practice. There is limited empirical evidence and a lack of direction from global health authorities to guide nurses and midwives in this area. AIM: To describe strategies for nurses and midwives that could enhance the effective use of data generated by mHealth apps to inform person-centred practice. The purpose of this paper is to stimulate reflection and generate actions for data utilisation when using mHealth apps in nursing research and practice. METHODS: This discussion paper has been informed by current evidence, the integrated-Promoting Action on Research Implementation in Health Services (i-PARIHS) framework, and research experience as part of doctoral study. FINDINGS: Before engaging in data collection using mHealth apps, nurses and midwives would benefit from considering the nature of the evidence collected, available technological infrastructure, and staff skill levels. When collecting data and interpreting results, use of a team approach supported by engaged leadership and external facilitation is invaluable. This provides support to operate apps, and more importantly use the data collected to inform person-centred practice. CONCLUSIONS: This paper addresses the limited available evidence to guide nurses and midwives when using mHealth apps to collect and use data to inform practice change. It highlights the need for appropriate technology, external facilitative support, engaged leadership, and a team approach to collect meaningful evidence using mHealth apps. Clinicians, leaders, and researchers can apply the strategies provided to enhance the use of mHealth apps and ensure translation of evidence into practice.

Critical care nurses' knowledge and attitudes toward pressure injury prevention: A pre and post intervention study.

OBJECTIVE: To explore nurses' knowledge and attitudes towards pressure injury prevention before and after implementing an educational intervention. DESIGN/METHOD: A pre-and post-intervention study. Pre-intervention data collection involved administering an instrument, including demographic information, the Pressure Ulcer Knowledge Assessment Tool version 2, and the Attitudes towards Pressure Ulcer Prevention instruments. Following the analysis of pre-intervention data, an educational intervention was implemented. Post-intervention data were collected using the same instrument. SETTING: Intensive care units at three Saudi Arabian hospitals. MAIN OUTCOME MEASURES: Nurses' knowledge and attitudes towards pressure injury prevention. RESULTS: The pre-intervention phase included 190 participants, and the post-intervention phase included 195 participants. Participants completed a paper-based survey at two different time points between June 2021 and March 2022. The mean pre-intervention scores for nurses' knowledge and attitudes towards pressure injury prevention were 43.22% and 74.77%, respectively. Following the educational intervention, the knowledge and attitude scores increased significantly to 51.22% and 79.02%, respectively. Higher knowledge of pressure injury prevention was positively associated with positive attitudes towards prevention practices. Age, clinical nursing experience, and experience in intensive care units were identified as factors correlated with knowledge of pressure injury prevention. A Bachelor's qualification or higher predicted better knowledge and attitudes towards pressure injury prevention. CONCLUSIONS: Nurses' knowledge and attitudes towards pressure injury prevention greatly improved following tailored, evidence-based education. The educational intervention featured multiple on-site bedside discussions, case studies, small-group presentations, and the provision of printed resources. IMPLICATIONS FOR CLINICAL PRACTICE: Nurses' knowledge and attitudes towards pressure injury prevention should be examined, and education provided to ensure evidence-based prevention practices are implemented. Tailored small-group education sessions delivered conveniently could be an effective approach. Efforts should focus on attracting and retaining experienced, highly qualified nurses to ensure the adoption of evidence-based prevention practices.

Career optimism and job-related well-being of Australian nurses during COVID-19: A cross-sectional study.

BACKGROUND: Australia has been confronted with a severe nursing deficit, making it difficult to maintain a strong healthcare workforce capable of meeting the mounting demands of healthcare organizations. AIMS: This study aimed to understand how personal and organizational resources influence career optimism and job-related affective well-being of Australian nurses during a pandemic using the Conservation of Resource Theory. METHODS: A cross-sectional online survey was emailed to 123 Australian nurses from January to February 2021. The survey consisted of self-reported measures, including mindfulness, career optimism, job-related affective well-being, personal and job resources measures, and the Dirty Dozen scale. Correlations, independent sample t-test, and a series of hierarchical regressions were conducted on the cross-sectional data with SPSS Version 27. The STROBE checklist was used to report the results. RESULTS: Findings suggested that mindfulness, perceived supervisor support, and job autonomy were significant predictors of job-related well-being, whereas mindfulness, perceived supervisor support, and opportunities for professional growth contributed more to career optimism of nurses during a health crisis. Male nurses in this study reported significantly higher mindfulness, career optimism, and job-related well-being levels than female nurses. LINKING EVIDENCE TO ACTION: Developing mindfulness among nurses, allocating organizational resources to facilitate more supervisor support, and providing job autonomy may enhance career optimism and job-related well-being of nursing staff who work in disruptive and high-demand work environments such as those experienced during the COVID-19 health crisis. Supervisors should also facilitate and encourage nurses to reflect and be mindful of their behaviors with their peers and patients which can help to reduce exploitative or arrogant behaviors in the workplace.

The engagement of older people living with chronic lung disease in a peer support community-based exercise programme: A qualitative study.

BACKGROUND: Chronic lung disease is a common and complex condition. Pulmonary rehabilitation programmes-either hospital-based or in the community are recommended in evidence-based clinical practice guidelines. AIM: To explore the experience of older people with chronic lung disease involved in a peer support community-based exercise maintenance programme. DESIGN AND METHOD: Participants were a part of the Lungs in Action programme run in a local community leisure centre through Lung Foundation Australia. All the programme participants (n = 25) were invited by an independent person through email and/or letter to participate in the study and provided with a participant information and consent form. Participants who returned consent forms were scheduled for group interviews. Participants were recruited over a 2-week period between 30 August and 13 September 2022. We conducted qualitative group interviews using a semi-structured interview guide to explore the experiences of older people living with chronic lung disease. Data were analysed using reflexive thematic analysis. RESULTS: A total of 14 participants (eight female and six male) aged between 64 and 86 years were interviewed. Three themes emerged from the data: motivation, authentic social engagement, and sustainable achievement. Motivation stemmed from the participants' perceived health benefits, and from the trainers' motivation and encouragement. Participants discussed how sharing experiences created an environment of trust and understanding, fun and friendship. Social engagement and creating authentic relationships were key aspects raised by participants. Feeling more confident in themselves and being able to accomplish physical tasks, making activities of daily living more manageable featured highly in participants' responses. DISCUSSION AND CONCLUSION: Community-based peer support exercise groups enable environments for people with chronic lung disease to maintain physical fitness, and to connect with others to form friendships and have fun.

Observing resuscitative practice. A novice researcher's experience of obtaining ethics approval.

Undertaking research involving vulnerable groups, such as those requiring resuscitation involves careful analysis during the ethical review process. When a person lacks the capacity to make an informed choice about their participation in a research study, a waiver of consent offers an alternative. This paper is based on a doctoral research study using ethnography to explore the resuscitative practices and experiences of rural nurses through observation and interviews. This paper aims to explore the ethical issues raised by the Human Research Ethics Committee relating to consent of vulnerable patients requiring resuscitation within a rural context. In particular, the challenges of addressing risk (privacy) vs benefit (public) associated with a waiver of consent. This paper will consider why the rural context should be championed during the ethical review process, when decisions about public benefit are being deliberated. Utilising a communitarianism approach that advocates for greater rural representation during the ethical review processes will ensure that rural research involving vulnerable groups can be addressed safely and benefit not only the experiences and practices of rural nurses but also the wider rural communities they serve.

Exploring leadership in health professionals following an industry-based leadership program: A cross-sectional survey.

AIM: To evaluate the self-reported leadership practices and behaviours of health professionals following a leadership program and explore factors that impacted leadership style. DESIGN: An online cross-sectional survey was conducted from August to October 2022. METHODS: The survey was disseminated via email to leadership program graduates. The Multifactor Leadership Questionnaire Form-6S was used to measure leadership style. RESULTS: Eighty completed surveys were included in the analysis. Participants scored highest on transformational leadership and lowest on passive/avoidant leadership style. Participants with higher qualifications scored significantly higher in the inspirational motivation scores (p = 0.03). As years in their profession increased, there was a significant decrease in contingent reward scores (p = 0.04). The younger participants scored significantly higher on the management-by-exception than older participants (p = 0.05). There were no significant associations with the year the leadership program was completed, gender or profession and Multifactor Leadership Questionnaire Form - 6S scores. Most participants (72.5%) strongly agreed that the program enhanced their leadership development and 91.3% strongly agreed or agreed that they routinely apply the skills and knowledge learnt in the program in their workplace. CONCLUSION: Formal leadership education is important in developing a transformational nursing workforce. This study found that program graduates had adopted a transformational leadership style. Education, years of experience and age impacted the specific leadership elements. Future work needs to incorporate longitudinal follow-up to relate changes in leadership with impact on clinical practice. IMPLICATIONS FOR THE PROFESSION: Transformational leadership as a dominant style can contribute to nurses and other disciplines positively contributing to innovative and person-centred approaches to health service delivery. SUMMARY STATEMENT: What already is known-Leadership amongst nurses and other health professionals impacts patients, staff, organizations and ultimately healthcare culture. What this paper adds-Formal leadership education is important in developing a transformational healthcare workforce. Implications for practice/policy-Transformational leadership can enhance nurses and other disciplines commitment to innovative and person-centred approaches. IMPACT STATEMENT: This research identifies that lessons learnt from formal leadership education are retained over time by healthcare providers. This is important for nursing staff, and other healthcare providers, who are leading teams and overseeing care delivery, can ensure leadership behaviours and practices are enacted to influence a transformational workforce and culture. REPORTING METHOD: This study adhered to STROBE guidelines. No Patient or Public Contribution.

Nurses and nature; Does green space make a difference?

How we engage in and with nature is of growing interest in relation to our health and well-being. For nurses with stressful workloads that are contributing to fatigue, psychological burden, insomnia, and decreased coping strategies, interactions with nature or green space are essential as it has been demonstrated to facilitate better environments and outcomes for nurses. Evidence of the impact of nature is limited. However, the value of interactions with nature has been prioritised by the World Health Organization and so healthcare organizations should be considering overt and practical ways to ensure nurses, and other healthcare providers, are exposed to nature to contribute towards healthier environments.

Adaption of the Cancer Information Overload Scale for pandemics and assessment of infodemic levels among nurses and midwives.

AIM: This study was conducted in three phases. Phase 1 aimed to adapt the Cancer Information Overload Scale and conduct content validity testing. Phase 2 aimed to conduct factorial validity testing of the scale. Phase 3 aimed to assess information overload and the sources of information used by nurses and midwives to keep up-to-date about COVID-19. DESIGN: A cross-sectional survey of nurses and midwives working in a metropolitan Local Health District in Sydney, Australia, was conducted from May to June 2020. METHODS: Adaptation of the Cancer Information Overload Scale and content validity of the modified scale (as the Pandemic Information Overload Scale) was undertaken by an expert panel comprising of senior nurses and researchers. Factorial validity and reliability of the Pandemic Information Overload Scale were evaluated using exploratory factor analyses using one subsample of the data. Using the second subsample of the data, information overload and sources of information used by nurses and midwives to keep up-to-date about COVID-19 were examined. RESULTS: The Pandemic Information Overload Scale is a reliable and valid instrument for measuring information overload among nurses during a pandemic. Its internal consistency was high (α = 0.81, M = 3.84). CONCLUSION: The 8-item PIO scale is a brief, reliable and psychometrically sound instrument for measuring nurses' and midwives' perceptions of information overload during COVID-19. Mean scores across this study indicated that participants were experiencing above average information overload. Implementing strategies to reduce this overload would optimize clinical decision making and promote patient safety.

Qualitatively exploring the attributes of adaptability and resilience amongst recently graduated nurses.

AIM: To explore newly graduated nurse's understandings and practices of adaptability and resilience in clinical environments. BACKGROUND: The everyday practice of nursing work involves managing emotional and practical everyday demands related to the role. Adaptability and resilience are two critical attributes that equip nurses for this by enabling them to manage challenges and be flexible with their practices and expectations in the face of rapidly changing and unpredictable circumstances. DESIGN: Informed by the theoretical underpinnings of the Person-centred Practice Framework, semi-structured interviews using topic guides were conducted with nine newly graduated registered nurse participants recruited through purposive sampling. Interviews occurred between March-October 2020 with participants working across seven different healthcare settings in three Local Health Districts in NSW, Australia. RESULTS: Analysis of the data generated the core themes of: 1) 'Making sense' explored how nurses defined resilience and adaptability; 2) 'Surviving as the nurse' focused on how nurses experienced adaptability and resilience as a newly qualified nurse; 3) 'Trusting oneself' reflected the interconnection of nurses' developed adaptability and resilience to their clinical self-assurance; and 4) 'Doing it again' described how adaptability and resilience can be further supported by the university sector. Findings demonstrated that adaptability and resilience in combination are essential attributes and required for effective nursing practice post-graduation. However, both collegial and organizational support were found to be lacking in positively reinforcing these attributes in this study. CONCLUSION: Newly graduated nurses can develop adaptability in clinical practice, so they are a more resilient future workforce. However, greater organizational leadership is required to model and strengthen these attributes for nurses. When perceptions, knowledge and experiences of adaptability and resilience are developed using person-centred approaches, they will be used in person-centred ways. TWEETABLE ABSTRACT: Newly graduated nurses can develop adaptability in clinical practice, so they are a more resilient future workforce. However, greater organizational leadership is required to model and strengthen these attributes for nurses. When perceptions, knowledge and experiences of adaptability and resilience are developed using person-centred approaches, they will be used in person-centred ways.

Life during lockdown: Coping strategies used by preregistration nursing students during COVID-19.

AIM: To explore the coping strategies used by Australian preregistration nursing students during the COVID-19 pandemic 'lockdown' period. BACKGROUND: COVID-19 has had a significant impact on preregistration nursing students, both physically and psychologically. As campuses closed and online learning commenced, clinical placement access was reduced, with heightened concern about personal and family safety. As such, nursing students were forced to adopt coping strategies to manage their self and the environment. DESIGN: A descriptive qualitative study. METHODS: One hundred and fifty-five preregistration nursing students enrolled at a regional Australian university completed a self-administered online survey. RESULTS: Overwhelmingly, student responses revealed that staying connected was the key coping strategy to ensure emotional and mental health wellbeing. Heightened vigilance in infection control measures was also evident, personally and for others. Routines, including exercise, facilitated physical and mental wellbeing. Overall, coping strategies identified by nursing students demonstrated applied resilience during the isolation period. CONCLUSIONS: Understanding the adaptive coping strategies used by nursing students can enable nurse academics to understand how to best provide support. This study emphasises the importance of recognising that not all students are able to adapt and 'cope' without supports in place. Future studies should investigate the longer-term impact of COVID-19 within the broader preregistration nursing experience and how this might impact nursing students' future careers.

The experience of staff utilizing data to evaluate and improve person-centred practice: An action research study.

AIM: Explore how nurses and midwives use patient experience data collected from a mobile health app to influence the development of person-centred practice. DESIGN: Participatory action research, underpinned by the Person-Centred Nursing Framework and Practice Development principles. METHODS: Six clinical units in a large health district engaged in three action cycles from 2018 to 2020 using a mobile health app. Nursing/midwifery staff on the units (N = 177) utilized data collected via the app to evaluate and improve person-centred practice. A pre-post survey using the PCPI-S was conducted to evaluate staff perceptions of person-centredness. Data from the surveys (n = 101 in 2018 and n = 102 in 2020) and 17 semi-structured interviews were used to understand the influence working with these data had on person-centred practice. The Guidelines for Best Practices in the Reporting of Participatory Action Research have been used to report this study. RESULTS: Improvements in person-centred practice were noted across both data sets. There was a statistically significant increase in two domains of the PCPI-S in the independent t-test and across all three domains in the paired t-test results. Thematic analysis resulted in the identification of six themes: Getting everyone on board, once we understood, keeping on track, there's a person in the bed, knowing you're doing a good job and improving over time. CONCLUSION: Engaging with the data collected from the app in a facilitated and collaborative way results in increases in person-centredness. IMPACT: This study provides insight into how nurses and midwives used data from a mHealth app to evaluate and improve person-centred practice. Utilizing the data generated by the app resulted in increased person-centredness amongst staff and changes to practice and culture. Nursing and midwifery teams who are supported to engage with patient experience data in an action-oriented way will see person-centred practice improvements, affecting patients and staff.

Development and Evaluation of the Altered Student Study Environment Tool: A Tool to Measure Nursing Student Concerns Relating to Academic Progression During the COVID-19 Pandemic.

BACKGROUND: Rapid alterations to study environments during COVID-19 raised concerns for nursing students about their academic progression. AIM: The study aim was to investigate the psychometric properties of the Altered Student Study Environment Tool (ASSET) and the relationship between students' concerns, demographics, COVID-19-related knowledge, and communication received from the university. METHOD: The 11-item ASSET and investigator-developed questions were administered to prelicensure nursing students using an anonymous online survey. RESULTS: Responses were obtained from 234 students. Exploratory factor analysis supported a three-factor structure, namely, attending clinical placement, completion of clinical placement, and grade attainment. Students with higher scores on knowledge had significantly lower concerns for the subscale attending clinical placement. Full-time students had significantly higher concerns for the subscale completion of clinical placement. CONCLUSION: The ASSET is a valid and reliable instrument that can be used to measure concerns relating to the effects of altered study environments on academic progression.

Voices from the 'resus room': An integrative review of the resuscitation experiences of nurses.

BACKGROUND: Nurses are often the first responders to resuscitations. Understanding their experiences of resuscitation will highlight the resuscitative context nurses work within and identify the conditions that support or hamper their delivery of safe and effective resuscitative care. AIM: The aim of this integrative review is to develop an understanding of nurses' experience of resuscitation, to gain knowledge of their challenges and identify gaps in evidence. DESIGN: Integrative review. METHODS: The electronic databases CINAHL, MEDLINE, Scopus and Web of Science were systematically searched from 2000-2021. Methodological quality of the papers was evaluated using the Mixed Methods Appraisal Tool (MMAT). The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 checklist was used to guide and report the integrative review. RESULTS: Eleven articles met criteria for review. Four themes arose from the literature that addressed nurses experiences of resuscitation: Chaos (external/internal), ethical dilemmas, clinical confidence and need for support. CONCLUSION: Nurses' experiences of resuscitation are multifaceted. Addressing the challenges that nurses experience during resuscitation will help ensure that nurses' are supported in their professional growth and personal well-being. Relevance to clinical practice and research: Building nursing leadership capacity within resuscitations is an area of clinical practice/research that is gaining traction as a valid solution to address the challenges nurses experience during resuscitations. Whilst the barriers to debriefing requires a greater level of consideration within the workplace.

How nurses and midwives engage with patient experience data to inform person-centred quality and safety improvements.

AIMS AND OBJECTIVES: To explore how nurses and midwives engage with patient experience data collected via a mobile health app to inform person-centred practice improvements. BACKGROUND: A large amount of data is collected in healthcare, yet there is limited evidence outlining how nursing and midwifery staff utilise patient experience data to inform person-centred quality and safety improvements. METHODS: This study utilised action research, underpinned by Practice Development methodology and has been reported using the SQUIRE 2.0 checklist. Six clinical units (medical short stay, acute medical, surgical, oncology/haematology, day surgery and maternity) in a large health district in Australia engaged in three cycles of data collection using a mobile health app. The app captured patient experience data relating to the person-centred KPIs developed and tested by McCance et al. (2012). Staff used the data to develop and evaluate person-centred practice. RESULTS: A number of improvements in scores and practice occurred through engaging with the data in a cyclical way. All six clinical units saw an improvement in four or more of the KPIs in the patient survey results from cycle one to cycle three, with two clinical units improving in all eight. On average across the six units, there was also an increase in time nurses/midwives were visible to their patients, an increase in clinical documentation reflecting the patients' needs and what was important to them, an increase in positive comments and a decrease in negative comments in patient stories. CONCLUSION: This study shows that collecting and utilising data from the person-centred KPIs in a collaborative and cyclical way lead to enhanced patient experience and the development and implementation of person-centred quality and safety improvements. RELEVANCE TO CLINICAL PRACTICE: Capturing and utilising data that are meaningful to nursing/midwifery teams in a cyclical, action-orientated approach result in person-centred practice improvements that enhance the experience of those that are receiving and delivering patient care.

The COVID-19 pandemic - A focus on nurse managers' mental health, coping behaviours and organisational commitment.

BACKGROUND: The emergence of COVID-19 has substantially impacted frontline health care workers, including nurse managers. To date, no studies have been conducted to examine the impact COVID-19 has had on Nurse Managers' mental health, coping strategies and organisational commitment. AIM: To investigate the mental health, coping behaviours, and organisational commitment among Nurse Managers during the COVID-19 pandemic. METHODS: Cross-sectional study involving 59 Nursing Managers from one Local Health District in Sydney Australia during the first wave of the COVID-19 pandemic. Data were collected relating to demographics, anxiety, coping strategies and organisational commitment. RESULTS: Overall, approximately three quarters of the Nurse Managers had high anxiety scores. Managers who had worked longer as a nurse had higher scores for adaptive coping strategies and 41% of Nurse Managers considered leaving their jobs. CONCLUSIONS: Strategies to minimise anxiety and enable coping as part of organisational disaster, emergency or crisis planning for Nurse Managers may result in decreased anxiety and stress levels, increased use of adaptive coping strategies and lower intent to leave the organisation and the nursing profession.

Understanding the support needs of Australian nursing students during COVID-19: a cross-sectional study.

Background: COVID-19 has caused significant disruption. This has been particularly evident within the university student population where their traditional ways of learning were abruptly reorganised and support structures removed.Objective: This paper aims to explore undergraduate student nurses' perceptions of the support required from the university during COVID-19 using the Achievement Goal Theory framework.Design: Data were collected via an online survey of undergraduate student nurses from an Australian university. This paper is reporting the data from a single open-ended item asking participants about their support needs from the University. Data were analysed using thematic analysis.Results: Of the 178 students who responded 206 individual statements were provided about the support they would like from the university. Four primary themes emerged, Support beyond academia, Academic support, Online learning readiness and Clinical practice units and clinical placement. The students identified that their needs during this pandemic include financial needs, social isolation, needs for more communication and unpreparedness for online teaching.Conclusion: Several factors were identified by participants about the additional support required from the university during COVID-19. Understanding and addressing these factors have the potential to improve student support during COVID-19 and support students in future crises.Impact statement: Understanding what support students perceive they require from the university during significant disruption will assist in future crisis management planning.

Generational differences in psychological wellbeing and preventative behaviours among nursing students during COVID-19: a cross-sectional study.

BACKGROUND: Many nursing programmes have had to swiftly move online in response to COVID-19. Nursing students are often a heterogenous group that traverses generational boundaries. Exploring generational differences may assist in developing support systems for specific groups. This study sought to examine psychological wellbeing and preventative behaviours among nursing students from the iGeneration in comparison to older generations. METHOD: A prospective cross-sectional study was undertaken using a convenience sample of pre-registration nursing students studying at two Australian Universities, one regional and one metropolitan. About 631 pre-registration nursing students completed an online survey. RESULTS: An independent samples t-test revealed that students from the iGeneration possess higher anxiety compared to nursing students from older generations (p = .000). Compared to iGeneration participants, older generation participants had significantly higher scores for knowledge of COVID-19 (p = .015). iGeneration participants utilised social media to source information about COVID-19 far more than older generations (p = .008). iGeneration participants were significantly more concerned than older generations about the impact of COVID-19 on completing their clinical placement (p = .014). Older generations tended to have higher academic preventative behaviours, with significant mean scores for not attending university if they or others they knew had symptoms of COVID-19. CONCLUSION: Given the differences between generation groups with regard to psychological wellbeing, knowledge about COVID-19, and concerns about studying in an altered study environment, strategies should be targeted to generational groups. Anxiety negatively impacts the quality of life, educational performance and clinical practice and is experienced more frequently in the iGeneration. Therefore it is crucial for nursing educators to reflect on how they engage this generation in the online space to provide support, stability and a sense of connection. This will contribute towards ensuring a well-prepared future nursing workforce who may encounter other pandemics and isolating events. IMPACT STATEMENT: Compared with other generations, iGeneration students have a greater likelihood to experience mental health issues, isolation and insecurity. Nursing leaders and educators must be sensitive to such intergenerational differences, to ensure they are developing a skilled and productive workforce.