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1.
J Clin Nurs ; 28(23-24): 4236-4249, 2019 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-31429987

RESUMEN

AIM: To examine the available evidence on the effects of care and support provided by volunteers on the health outcomes of older adults in acute care services. BACKGROUND: Acute hospital inpatient populations are becoming older, and this presents the potential for poorer health outcomes. Factors such as chronic health conditions, polypharmacy and cognitive and functional decline are associated with increased risk of health care-related harm, such as falls, delirium and poor nutrition. To minimise the risk of health care-related harm, volunteer programmes to support patient care have been established in many hospitals worldwide. DESIGN: A systematic scoping review. METHODS: The review followed the PRISMA Extension for Scoping Reviews (PRISMA-ScR) (File S1). Nine databases were searched (CINAHL, MEDLINE, EMBASE, Cochrane, Scopus, Web of Science, PubMed, ScienceDirect and JBI) using the following key terms: 'hospital', 'volunteer', 'sitter', 'acute care', 'older adults', 'confusion', 'dementia' and 'frail'. The search was limited to papers written in English and published from 2002-2017. Inclusion criteria were studies involving the use of hospital volunteers in the care or support of older adult patients aged ≥ 65 years, or ≥ 50 years for Indigenous peoples, with chronic health conditions, cognitive impairment and/or physical decline or frailty, within the acute inpatient settings. RESULTS: Of the 199 articles identified, 17 articles that met the inclusion criteria were critically appraised for quality, and 12 articles were included in the final review. CONCLUSIONS: There is evidence that the provision of volunteer care and support with eating and drinking, mobilising and therapeutic activities can impact positively upon patient health outcomes related to nutrition, falls and delirium. Further robust research is needed to determine the impact of volunteers in acute care and the specific care activities that can contribute to the best outcomes for older adults. RELEVANCE TO CLINICAL PRACTICE: Volunteers can play a valuable role in supporting care delivery by nurses and other health professionals in acute care services, and their contribution can improve health outcomes for older adults in this setting.

2.
J Interprof Care ; 33(6): 619-627, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-30822181

RESUMEN

Interprofessional education (IPE) programs in residential aged care facilities (RACF) contributes to the care of older adults whilst providing an environment for students to learn and practise in an interprofessional manner. Clinical placements are provided by RACF through funding and support from universities in collaboration with the RACF. Conducting a benefit-cost analysis (BCA) can determine the sustainability of a clinical placement program such as an IPE program but there is limited research reporting the economic aspects of clinical placements even though it is a university and government priority. This study provides a benefit-cost analysis of an interprofessional education program offered by a residential aged care provider in Western Australia. Analysis using a BCA methodology was conducted to provide information about the level and distribution of the costs and benefits from different analytical perspectives over the three-year period of the IPE program. The analysis showed that the program was highly beneficial from an economic efficiency viewpoint, even though it did not present a financial gain for the aged care provider. The benefits accrued mainly to students in terms of increased education and skill, and to residents in terms of health outcomes and quality of life, while the cost was mostly incurred by the care provider. An IPE program in a RACF is a valuable educational learning experience for students and is also socially beneficial for residents and the broader health sector. For IPE programs in aged care to be sustainable, they require the development of collaborative partnerships with external funding.

3.
JMIR Res Protoc ; 7(6): e137, 2018 Jun 12.
Artículo en Inglés | MEDLINE | ID: mdl-29895515

RESUMEN

BACKGROUND: Total hip arthroplasty is an effective surgical procedure commonly used worldwide for patients suffering the disabling effects of osteoarthritis when medical therapy is unsuccessful. Traditionally pre- and postoperative information for patients undergoing a hip arthroplasty has been provided by paper-based methods. Electronic health (eHealth) programs to support individualized patient education on preoperative preparation, in-patient care, and home rehabilitation have the potential to increase patient engagement, enhance patient recovery, and reduce potential postoperative complications. OBJECTIVE: The aim of this study is to compare the addition of an eHealth program versus standard care for pre- and postoperative education on patient outcomes for primary total hip arthroplasty. METHODS: One hundred patients undergoing a primary elective total hip arthroplasty will be recruited from a metropolitan hospital in Western Australia to participate in a 6-month parallel randomized control trial. Participants will be randomized to either the standard care group (n=50) and will be given the education booklet and enrolled to attend a 1-hour education session, or the intervention group (n=50), and will receive the same as the standard care plus access to an eHealth program titled "My Hip Journey." The eHealth program encourages the patient to log in daily, from 2 weeks prior to surgery to 30 days postsurgery. The information on the platform will be aligned with the patient's individual surgical journey and will include exercises to be completed each day for the duration of the program. The primary outcome measure is the Hip Dysfunction and Osteoarthritis Outcome Score, version LK 2.0. Secondary outcome measures include the EuroQoL EQ-5D-5L, a 5-level 5-dimension quality of life measure, and the Self-Efficacy for Managing Chronic Disease Scale. Data will be collected at pre-admission (presurgery) and at 6 weeks, 3 months, and 6 months postsurgery. A patient satisfaction survey will be completed 6 weeks postsurgery and Web-based analytics will be collected 6 months postsurgery. A cost-effectiveness analysis, using the intention-to-treat principle, will be conducted from the hospital's perspective. RESULTS: Enrollment in the study commenced in January 2018 with recruitment due for completion towards the end of the year. The first results are expected to be submitted for publication in 2019. CONCLUSIONS: The outcomes and cost of using an eHealth program to support a patient's recovery from a hip arthroplasty will be compared with standard care in this study. If the eHealth program is found to be effective, further implementation across clinical practice could lead to improvement in patient outcomes and other surgical areas could be incorporated. TRIAL REGISTRATION: Australian New Zealand Clinical Trials Registry (ANZCTR) ACTRN12617001433392; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=373657&isReview=true (Archived by WebCite at http://www.webcitation.org/6yzoTuggx). REGISTERED REPORT IDENTIFIER: RR1-10.2196/9654.

4.
J Clin Nurs ; 27(15-16): 3123-3130, 2018 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-29752859

RESUMEN

AIM AND OBJECTIVES: To examine students' beliefs, behaviours and attitudes in relation to interprofessional socialisation, and their expectations and experience, before and after a 2-week clinical placement in ambulatory care. BACKGROUND: Interprofessional clinical placements for students are important for developing an understanding of interprofessional collaboration and identity, for the benefit of patient care. Ambulatory care environment involves collaborative management of complex chronic problems. This educator supported placement that enabled final-year nursing and medical students to work together. DESIGN: A descriptive matched before-after study was conducted. METHODS: Students' completed an online questionnaire before and after their clinical placement. The questionnaire comprised of three sections: demographic information, the Interprofessional Socialisation and Valuing Scale and open-ended questions. Descriptive analysis and paired t-tests were conducted for the three subscales, and thematic analysis of qualitative responses was conducted. RESULTS: Sixty-two of the 151 students between 2011-2014 completed both surveys. There was a significant increase after placement in the overall Interprofessional Socialisation and Valuing Scale scores. The change was greater for nursing students compared with medical students, although for both groups the change was small. The majority had a good-to-very good experience learning each other's and their own professions and identified the nurse educator and teaching registrar as key to success. CONCLUSION: A clinical placement in an ambulatory setting for nursing and medical students resulted in an increase in self-perceived ability to work with others and in valuing working with others. RELEVANCE TO CLINICAL PRACTICE: Interprofessional clinical placements are essential for students to understand interprofessional practice for better patient outcomes and developing their own perspective of future work within an interprofessional team. Ambulatory care is an ideal environment for nursing and other health professional students to engage in interprofessional clinical placements.


Asunto(s)
Atención Ambulatoria/psicología , Conducta Cooperativa , Relaciones Interprofesionales , Estudiantes de Medicina/psicología , Estudiantes de Enfermería/psicología , Adulto , Femenino , Humanos , Aprendizaje , Masculino , Encuestas y Cuestionarios
5.
Clin Teach ; 2018 Feb 12.
Artículo en Inglés | MEDLINE | ID: mdl-29436114

RESUMEN

BACKGROUND: Interprofessional practice amongst health care professionals can facilitate effective collaboration and can improve health outcomes for patients. Interprofessional clinical placements have mainly been established within inpatient settings; however, ambulatory care settings can also provide interprofessional education. This study evaluates an interprofessional placement in ambulatory care for medical and nursing students. METHODS: Medical and nursing students undertook a 2-week interprofessional placement in respiratory, diabetes and chronic pain clinics, as well as within the patient's home. An electronic post-placement survey including 14 fixed-response and five open-ended questions was conducted to evaluate the students' experiences. RESULTS: Ninety-two students undertook the interprofessional placement: 74% were medical students and 26% were nursing students. The overall response rate was 81%. Students strongly supported the model of clinical supervision with the nurse educator and teaching registrar working collaboratively to facilitate the placement. Both medical and nursing students felt that the placement facilitated the development of interprofessional principles, with 78.7% agreeing or strongly agreeing with the statement 'the clinical placement allowed me to reflect on interprofessional learning and practice'. In terms of future practice, 67% of medical students and 81% of nursing students agreed that 'this placement has altered how [they] will practice as a professional in the future'. Interprofessional practice can facilitate effective collaboration and can improve health outcomes for patients DISCUSSION: Medical and nursing students found that the ambulatory care setting facilitated a mix of learning opportunities that complemented learning from the inpatient setting, and the interactions with other health professionals provided a valuable learning experience that contributed to their understanding of interprofessional practice.

7.
J Interprof Care ; 31(2): 147-153, 2017 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-28181848

RESUMEN

It is essential that health professionals are trained to provide optimal care for our ageing population. Key to this is a positive attitude to older adults along with the ability to work in teams and provide interprofessional care. There is limited evidence on the impact an interprofessional education (IPE) placement in a residential aged care facility (RACF) has on students. In 2015 in Western Australia, 51 students (30% male, median age 23 years), from seven professions, undertook a placement between 2 and 13 weeks in length at 1 RACF. Pre- and post-placement measurements of attitudes to the elderly were collected using the Ageing Semantic Differential (ASD) questionnaire and level of readiness for interprofessional learning with the Readiness for Interprofessional Learning Scale (RIPLS). A total of 47 students completed matched ASD and RIPLS surveys. The mean total score on the ASD survey decreased significantly from pre- to post-placement from 116.0 to 108.9 (p = 0.033), indicating attitudes became increasingly positive towards older adults. Significant differences post-placement were seen indicating better readiness for interprofessional learning, for two out of four subscales on the RIPLS, namely "teamwork & collaboration" (42.1-44.0; (p = 0.000)) and "positive professional identity" (18.2-19.3 (p = 0.001)). The degree of change is similar to findings from other settings. The results support IPE-focussed student placements within RACF positively influence student's attitudes towards the older adult as well as increase student's readiness for interprofessional learning, confirming RACF are valuable places for training health professionals.


Asunto(s)
Actitud del Personal de Salud , Hogares para Ancianos , Relaciones Interprofesionales , Estudiantes de Medicina/psicología , Adulto , Femenino , Humanos , Masculino , Encuestas y Cuestionarios , Australia Occidental , Adulto Joven
8.
Clin Teach ; 14(2): 100-103, 2017 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-26749340

RESUMEN

BACKGROUND: Residential aged care environments can provide valuable learning opportunities for health professional education. An aged care community-university partnership developed the Beyond the Teaching Nursing Home: Community Partnership of Learning and Care (BTTNH: CPLC) programme, where older adults volunteer in learning activities with health professional students. This article describes medical students' experience of participating in a clinical learning activity as part of the broader programme. METHOD: Fourth-year medical students (enrolled in a 6-year medical degree) on geriatric medicine rotation participated in a half-day clinical visit as part of the BTTNH: CPLC programme. Medical students participated in an interview activity with an older adult from the aged care facility. A survey was administered to evaluate medical students' experience of the structured clinical visit to a residential aged care facility. Residential aged care environments can provide valuable learning opportunities for health professional education RESULTS: Medical students valued the learning experience of interacting with older adults, observation of the residential aged care environment and learning about the needs of older adults living in residential aged care. CONCLUSIONS: Providing meaningful learning opportunities for medical students in residential aged care environments may contribute to a better understanding of residents, aged care environments, development of communication skills, professional role and clinical decision-making skills that are relevant for the care of older adults not only in aged care but also in other care settings.


Asunto(s)
Educación de Pregrado en Medicina/organización & administración , Servicios de Salud para Ancianos/organización & administración , Hogares para Ancianos , Casas de Salud , Estudiantes de Medicina/psicología , Australia , Competencia Clínica , Toma de Decisiones Clínicas , Comunicación , Humanos , Evaluación de Necesidades , Rol del Médico
9.
J Clin Nurs ; 25(13-14): 1977-86, 2016 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-27251784

RESUMEN

AIMS AND OBJECTIVES: To explore patient experiences of type 2 diabetes mellitus care delivered by general practice nurses in collaboration with the general practitioner. BACKGROUND: Australian general practice nurses are expanding their role in multidisciplinary type 2 diabetes care with limited research on patient perceptions of care provision within this collaborative model. DESIGN: Qualitative interpretive. METHODS: Purposeful sampling was used to invite the patients (n = 10). Data were collected from semi-structured face-to-face interviews. Braun and Clarke's () inductive coding thematic analysis process was used to interpret the data. RESULTS: All participants experienced their General Practice Nurse consultation as a clinical assessment for their General Practitioner. While they appreciated the extra time with the General Practice Nurse, they were unsure of the purpose of the consultation beyond clinical assessment. They described the ongoing challenge of living with T2DM and identified a need for additional information and advice. CONCLUSION: The results suggest that the model of general practice nurse type 2 diabetes care has an important role to play in the delivery of effective ongoing care of patients. However, this role requires further development to ensure that it is understood by the patients as a role that not only conducts clinical assessments but also provides relevant education and self-management support as part of a collaborative approach to care delivery with General Practitioners. RELEVANCE TO PRACTICE: The findings are relevant to primary health care clinicians providing diabetes care to inform more relevant supportive care by general practice nurses.


Asunto(s)
Diabetes Mellitus Tipo 2/terapia , Satisfacción del Paciente , Pautas de la Práctica en Enfermería , Pautas de la Práctica en Medicina , Anciano , Australia , Diabetes Mellitus Tipo 2/enfermería , Femenino , Humanos , Entrevistas como Asunto , Masculino , Persona de Mediana Edad
10.
J Adv Nurs ; 72(5): 1155-68, 2016 May.
Artículo en Inglés | MEDLINE | ID: mdl-26799533

RESUMEN

AIM: To establish a profile of men in nursing in Western Australia and explore the perception of men in nursing from the perspective of male and female nurses. BACKGROUND: A project team, including some of the current authors, produced a YouTube video and DVD about men in nursing which led to further enquiry on this topic. DESIGN: The study employed a non-experimental, comparative, descriptive research design focused on a quantitative methodology, using an online survey in early 2014. METHOD: A convenience sample incorporated registered and enrolled nurses and midwives in Western Australia. FINDINGS: The range of data included demographic information and the respondents' perceptions of men in nursing were collected. Findings indicated that the main reasons for choosing a career in nursing or midwifery were similar for both genders. Common mis-perceptions of men in nursing included: most male nurses are gay; men are not suited to nursing and men are less caring and compassionate than women. Suggestions to promote nursing to men included: nurses are highly skilled professionals; there is the potential to make a difference for patients; nursing offers stable employment, professional diversity and opportunities for team work. There is a diminished awareness of opportunities for men in nursing and negative stereotypes related to men in nursing persist. CONCLUSION: The study produced recommendations which included: using the right message to target the recruitment for men and promoting a more realistic understanding of the profile and perception of men in nursing.


Asunto(s)
Actitud del Personal de Salud , Enfermeros/psicología , Adulto , Investigación Empírica , Femenino , Humanos , Masculino , Persona de Mediana Edad , Enfermeras y Enfermeros/psicología , Encuestas y Cuestionarios , Australia Occidental , Adulto Joven
11.
Gerontol Geriatr Educ ; 37(2): 167-84, 2016 Apr-Jun.
Artículo en Inglés | MEDLINE | ID: mdl-26083643

RESUMEN

In changing higher education environments, health profession's educators have been increasingly challenged to prepare future health professionals to care for aging populations. This article reports on an exploratory, mixed-method research study that used an innovative photo-elicitation technique and interprofessional small-group work in the classroom to enhance the reflective learning experience of medical and nursing students. Data were collected from pre- and postquestionnaires and focus groups to explore shifts in perceptions toward older persons following the reflective learning session. The qualitative data revealed how using visual images of older persons provides a valuable learning space for reflection. Students found meaning in their own learning by creating shared storylines that challenged their perceptions of older people and themselves as future health professionals. These data support the use of visual methodologies to enhance engagement, reflection, and challenge students to explore and deepen their understanding in gerontology.


Asunto(s)
Actitud del Personal de Salud , Geriatría/educación , Relaciones Interprofesionales , Estudiantes de Medicina/psicología , Estudiantes de Enfermería/psicología , Adulto , Empatía , Grupos Focales , Humanos , Percepción , Fotograbar , Investigación Cualitativa , Adulto Joven
12.
Comput Inform Nurs ; 33(10): 443-7; quiz E1, 2015 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-26176638

RESUMEN

The introduction of learning technologies into educational settings continues to grow alongside the emergence of innovative technologies into the healthcare arena. The challenge for health professionals such as medical, nursing, and allied health practitioners is to develop an improved understanding of these technologies and how they may influence practice and contribute to healthcare. For nurse educators to remain contemporary, there is a need to not only embrace current technologies in teaching and learning but to also ensure that students are able to adapt to this changing pedagogy. One recent technological innovation is the use of wearable computing technology, consisting of video recording with the capability of playback analysis. The authors of this article discuss the introduction of the use of wearable Point of View video glasses by a cohort of nursing students in a simulated clinical learning laboratory. Of particular interest was the ease of use of the glasses, also termed the usability of this technology, which is central to its success. Students' reflections were analyzed together with suggestions for future use.


Asunto(s)
Tecnología Educacional , Aprendizaje , Entrenamiento Simulado/métodos , Grabación en Video/instrumentación , Humanos , Informática Aplicada a la Enfermería , Estudiantes de Enfermería
13.
J Interprof Care ; 29(4): 292-7, 2015.
Artículo en Inglés | MEDLINE | ID: mdl-25431833

RESUMEN

There are diverse perceptions about the primary purpose of evaluation. In interprofessional education (IPE), there has been a perceived focus on evaluating against the outcome of improved collaborative practice and quality of care. This paper presents an exploration of the nature and purpose of evaluation methods commonly utilized in the IPE literature with its focus on outcomes-based evaluation and particularly the Kirkpatrick framework. It categorises recent evaluations of pre-qualification (pre-certification) IPE interventions. Of the 90 studies included, most evaluated soon after the educational intervention, only five specifically referred to an evaluation framework and the most frequently used tool was the RIPLS. There was a noteworthy reliance on students' self-rated perceptions of their attitudes towards collaborative practice collected through surveys, focus groups and interviews. There appears to be a need to reconsider the type of evaluation required. In conclusion, this paper offers recommendations for evaluation practice that is moving towards realist approaches; describes the longer term effects of interventions on attitudes and behaviour; develops and validates data collection tools including direct observation of practice and more comprehensively engages with all stakeholders to ensure that evaluation activities are not only focused on improving IPE but also on enhancing our understanding of interprofessional practice.


Asunto(s)
Personal de Salud/educación , Relaciones Interprofesionales , Aprendizaje , Evaluación de Programas y Proyectos de Salud/métodos , Actitud del Personal de Salud , Humanos , Percepción , Evaluación de Programas y Proyectos de Salud/normas
14.
Aust J Prim Health ; 21(3): 360-4, 2015.
Artículo en Inglés | MEDLINE | ID: mdl-25102943

RESUMEN

Since 2010, a residential aged care provider has been in collaboration with universities in Western Australia to deliver an interprofessional education (IPE) program in residential aged care facilities. The program takes place within a residential aged care setting where university student placements from seven disciplines are integrated into a dynamic interdisciplinary team approach for care delivery. This approach provides the opportunity for two or more professionals to learn together to provide optimal care for residents. In 2012, an extensive research evaluation was performed to demonstrate, among other outcomes, the benefits to the residents and staff involved in the program. Residents, family members and staff from a residential aged care facility were invited to participate in the mixed methods evaluation. The qualitative aspects were digitally recorded, transcribed and thematically analysed. SPSS (SPSS Inc., Chicago, IL, USA) was used to analyse the quantitative data. All were exceptionally satisfied with the IPE program.


Asunto(s)
Actitud , Personal de Salud , Hogares para Ancianos , Preceptoría , Estudiantes del Área de la Salud , Anciano , Australia , Grupos Focales , Humanos , Entrevistas como Asunto , Encuestas y Cuestionarios
15.
Appl Nurs Res ; 27(2): 115-20, 2014 May.
Artículo en Inglés | MEDLINE | ID: mdl-24792131

RESUMEN

PURPOSE: This paper reports on three interrelated Australian studies that provide a nationally coherent and evidence-informed approach to interprofessional education (IPE). Based on findings from previous studies that IPE tends to be marginalized in mainstream health curriculum, the three studies aspired to produce a range of resources that would guide the sustainable implementation of IPE across the Australian higher education sector. METHOD: Nine national universities, two peak industry bodies and a non-government organization constituted the study team. Data were gathered via a mixture of stakeholder consultations, surveys and interviews and analyzed using quantitative and qualitative methods. RESULTS & CONCLUSION: An important outcome was a curriculum renewal framework which has been used to explore the implications of the study's findings on Australian nursing. While the findings are pertinent to all health professions, nursing is well placed to take a leading role in establishing IPE as a central element of health professional education.


Asunto(s)
Curriculum , Educación en Enfermería/organización & administración , Educación en Salud , Relaciones Interprofesionales , Australia , Conducta Cooperativa , Educación en Salud/normas , Humanos , Grupo de Atención al Paciente/normas , Competencia Profesional/normas
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