Nursing & Health

Permanent URI for this collectionhttps://research.avondale.edu.au/handle/123456789/457

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    Use of the Supportive and Palliative Care Indicators Tool (SPICT™) for End-of-Life Discussions: A Scoping Review
    (BioMed Central (BMC), 2024-05-16) Mahura, Melanie; Karle, Brigitte; Sayers, Louise; Dick-Smith, Felicity; Elliott, Rosalind
    Background In order to mitigate the distress associated with life limiting conditions it is essential for all health professionals not just palliative care specialists to identify people with deteriorating health and unmet palliative care needs and to plan care. The SPICT™ tool was designed to assist with this. Aim The aim was to examine the impact of the SPICT™ on advance care planning conversations and the extent of its use in advance care planning for adults with chronic life-limiting illness. Methods In this scoping review records published between 2010 and 2024 reporting the use of the SPICT™, were included unless the study aim was to evaluate the tool for prognostication purposes. Databases searched were EBSCO Medline, PubMed, EBSCO CINAHL, APA Psych Info, ProQuest One Theses and Dissertations Global. Results From the search results 26 records were reviewed, including two systematic review, two theses and 22 primary research studies. Much of the research was derived from primary care settings. There was evidence that the SPICT™ assists conversations about advance care planning specifically discussion and documentation of advance care directives, resuscitation plans and preferred place of death. The SPICT™ is available in at least eight languages (many versions have been validated) and used in many countries. Conclusions Use of the SPICT™ appears to assist advance care planning. It has yet to be widely used in acute care settings and has had limited use in countries beyond Europe. There is a need for further research to validate the tool in different languages.
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    Investigating the Effect of Enhanced Cleaning and Disinfection of Shared Medical Equipment on Health-Care-Associated Infections in Australia (CLEEN): A Stepped-Wedge, Cluster Randomised, Controlled Trial
    (Elsevier, 2024) Browne, Katrina; White, Nicole M; Russo, Philip L; Cheng, Allen C; Stewardson, Andrew J; Matterson, Georgia; Tehan, Peta E; Graham, Kirsty; Amin, Maham; Northcote, Maria; Kiernan, Martin; King, Jennie; Brain, David; Mitchell, Brett G
    Summary Background There is a paucity of high-quality evidence based on clinical endpoints for routine cleaning of shared medical equipment. We assessed the effect of enhanced cleaning and disinfection of shared medical equipment on health-care-associated infections (HAIs) in hospitalised patients. Methods We conducted a stepped-wedge, cluster randomised, controlled trial in ten wards of a single hospital located on the central coast of New South Wales, Australia. Hospitals were eligible for inclusion if they were classified as public acute group A according to the Australian Institute of Health and Welfare, were located in New South Wales, had an intensive care unit, had a minimum of ten wards, and provided care for patients aged 18 years or older. Each cluster consisted of two randomly allocated wards (by use of simple randomisation), with a new cluster beginning the intervention every 6 weeks. Wards were informed of their allocation 2 weeks before commencement of intervention exposure, and the researcher collecting primary outcome data and audit data was masked to treatment sequence allocation. In the control phase, there was no change to environmental cleaning practices. In the intervention phase, a multimodal cleaning bundle included an additional 3 h per weekday for the dedicated cleaning and disinfection of shared medical equipment by 21 dedicated cleaning staff, with ongoing education, audit, and feedback. The primary outcome was the number of confirmed cases of HAI, as assessed by a fortnightly point prevalence survey and measured in all patients admitted to the wards during the study period. The completed trial is registered with Australia New Zealand Clinical Trials Registry (ACTRN12622001143718). Findings The hospital was recruited on July 31, 2022, and the study was conducted between March 20 and Nov 24, 2023. We assessed 220 hospitals for eligibility, of which five were invited to participate, and the first hospital to formally respond was enrolled. 5002 patients were included in the study (2524 [50·5%] women and 2478 [49·5%] men). In unadjusted results, 433 confirmed HAI cases occurred in 2497 patients (17·3%, 95% CI 15·9 to 18·8) in the control phase and 301 confirmed HAI cases occurred in 2508 patients (12·0%, 10·7 to 13·3) in the intervention phase. In adjusted results, there was a relative reduction of –34·5% (–50·3 to –17·5) in HAIs following the intervention (odds ratio 0·62, 95% CI 0·45 to 0·80; p=0·0006), corresponding to an absolute reduction equal to –5·2% (–8·2 to –2·3). No adverse effects were reported. Interpretation Improving the cleaning and disinfection of shared medical equipment significantly reduced HAIs, underscoring the crucial role of cleaning in improving patient outcomes. Findings emphasise the need for dedicated approaches for cleaning shared equipment. Funding National Health and Medical Research Council.
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    Challenges in Building and Running a 4,000-bed COVID-19 Intensive Care Unit in an Exhibition Center
    (Cambridge University Press, 2023-03-16) Kiernan, Martin
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    Cost-Effectiveness of Temporary Isolation Rooms in Acute-Care Settings in Asia
    (Cambridge University Press, 2023-03-16) Graves, Nicholas; Cai, Yiying; Fisher, Dale; Kiernan, Martin; Mitchell, Brett
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    New Frontiers in Healthcare Environmental Hygiene: Thoughts from the 2022 Healthcare Cleaning Forum
    (Springer Nature, 2023-02-07) Peters, Alexandra; Parneix, Pierre; Kiernan, Martin; Severin, Juliette; Gauci, Tracey; Pittet, Didier
    Healthcare environmental hygiene (HEH) has become recognized as being increasingly important for patient safety and the prevention of healthcare-associated infections. At the 2022 Healthcare Cleaning Forum at Interclean in Amsterdam, the academic lectures focused on a series of main areas of interest. These areas are indicative of some of the main trends and avenues for research in the coming years. Both industry and academia need to take steps to continue the momentum of HEH as we transition out of the acute phase of the Covid-19 pandemic. There is a need for new ways to facilitate collaboration between the academic and private sectors. The Clean Hospitals® network was presented in the context of the need for both cross-disciplinarity and evidence-based interventions in HEH. Governmental bodies have also become more involved in the field, and both the German DIN 13603 standard and the UK NHS Cleaning Standards were analyzed and compared. The challenge of environmental pathogens was explored through the example of how P. aeruginosa persists in the healthcare environment. New innovations in HEH were presented, from digitalization to tracking, and automated disinfection to antimicrobial surfaces. The need for sustainability in HEH was also explored, focusing on the burden of waste, the need for a circular economy, and trends towards increasingly local provision of goods and services. The continued focus on and expansion of these areas of HEH will result in safer patient care and contribute to better health systems.
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    Patient Perspectives of Healthcare Associated Infection
    (Australasian College for Infection Prevention and Control, 2022) Mitchell, Brett G.; Northcote, Maria; Rickett, Carolyn; Russo, Phil; Amin, Maham; De Souza, Fiona; Pearce, Kirsty; Sim, Jenny; Curryer, Cassie
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    Academic Dishonesty in University Nursing Students: A Scoping Review
    (Elsevier, 2024-06) Xuhua He, Flora; Fanaian, Mahnaz; Ming Zhang, Nancy; Lea, Xanthe; Geale, Sara Katherine; Gielis, Lisa; Razaghi, Kazem; Evans, Alicia
    Objective This review seeks to deepen our understanding of the factors contributing to nursing students' academic dishonesty and the repercussions of such behaviours on their learning in both classroom and clinical settings, and on the integrity of the nursing profession. Design and methods It was a scoping review in which a five-stage methodological framework informed its process. Six databases were searched for relevant original studies. Other search methods were also conducted using Google Scholar, Trove, and ProQuest Dissertations for theses pertinent to the topic. An inductive descriptive approach was used to analyse and synthesise data. Results Twenty-seven studies and nine doctoral theses were selected and included in the scoping review. Of these, 25 studies used a quantitative approach, nine studies a qualitative one, and two studies used mixed methods. Three categorical factors, intrapersonal, interpersonal, and external, contributed to nursing students' academic dishonesty. Conclusion Academic dishonesty in nursing students is concerning. Noted factors contributing to academic dishonesty include stress and pressure experienced by students, the prevalence of peer cheating, and lack of knowledge. Most alarming is the significant correlation between academic dishonesty and clinical dishonesty. The evidence suggests that students who engage in dishonest behaviour in academic settings may be more likely to engage in dishonest behaviour in clinical settings. This raises serious concerns about integrity, ethics, patient safety and the reputation of nursing students, universities, healthcare providers and health professionals.
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    Healthcare-associated Infections in Australia : Principles and Practice of Infection Prevention and Control.
    (Elsevier, 2024) Mitchell, Brett G.; Shaban, Ramon Z.; Russo, Philip L.; MacBeth, Deborough
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    Decision-making in Nursing Research and Practice—Application of the Cognitive Continuum Theory: A Meta-Aggregative Systematic Review
    (Wiley, 2023-12) O'Connor, Tricia; Gibson, Jo; Lewis, Joanne; Strickland, Karen; Paterson, Catherine
    Aim To explore how the Cognitive Continuum Theory has been used in qualitative nursing research and to what extent it has been integrated in the research process using the Qualitative Network for Theory Use and Methodology (QUANTUM). Background Theory, research and nursing are intrinsically linked, as are decision-making and nursing practice. With increasing pressure on nurses to improve patient outcomes, systematic knowledge regarding decision-making is critical and urgent. Design A meta-aggregative systematic review. Methods Databases CINAHL, Medline, PsycINFO, Embase and PubMed were searched from inception until May 2022 for peer-reviewed research published in English. Seven studies were included and assessed for methodological quality using the Joanna Briggs Institute checklist for qualitative research. A meta-aggregative synthesis was conducted using Joanna Briggs methodology. The QUANTUM typology was used to evaluate the visibility of the Cognitive Continuum Theory in the research process. Results The review identified five synthesised findings, namely: 1. the decision-making capacity of the individual nurse, 2. nurses’ level of experience, 3. availability of decision support tools, 4. the availability of resources and 5. access to senior staff and peers. Only two of seven studies rigorously applied the theory. The included studies were mainly descriptive-exploratory in nature. Conclusion The transferability of the Cognitive Continuum Theory was demonstrated; however, evolution or critique was absent. A gap in the provision of a patient-centric approach to decision-making was identified. Education, support and research is needed to assist decision-making. A new Person-Centred Nursing Model of the Cognitive Continuum Theory has been proposed to guide future research in clinical decision-making. Relevance to Clinical Practice Nurses make numerous decisions every day that directly impact patient care, therefore development and testing of new theories, modification and revision of older theories to reflect advances in knowledge and technology in contemporary health care are essential.