Designing a standardised emergency nurse career pathway for use across rural, regional and metropolitan New South Wales, Australia: A consensus process.

BACKGROUND: Emergency nurses are the first clinicians to see patients in the ED; their practice is fundamental to patient safety. To reduce clinical variation and increase the safety and quality of emergency nursing care, we developed a standardised consensus-based emergency nurse career pathway for use across Australian rural, regional, and metropolitan New South Wales (NSW) emergency departments. METHODS: An analysis of career pathways from six health services, the College for Emergency Nursing Australasia, and NSW Ministry of Health was conducted. Using a consensus process, a 15-member expert panel developed the pathway and determined the education needs for pathway progression over six face-to-face meetings from May to August 2023. RESULTS: An eight-step pathway outlining nurse progression through models of care related to different ED clinical areas with a minimum 172 h protected face-to-face and 8 h online education is required to progress from novice to expert. Progression corresponds with increasing levels of complexity, decision making and clinical skills, aligned with Benner's novice to expert theory. CONCLUSION: A standardised career pathway with minimum 180 h would enable a consistent approach to emergency nursing training and enable nurses to work to their full scope of practice. This will facilitate transferability of emergency nursing skills across jurisdictions.

The Struggle Between Protecting Children From and Preparing Them for the Death of Their Parent: A Qualitative Study.

OBJECTIVES: The aim of this study was to gain a greater understanding of communicating with children about parental terminal illness from the perspective of the surviving parents. METHODS: A qualitative descriptive study was conducted using semi structured interviews with eligible participants. Data was analyzed using thematic analysis. RESULTS: The results highlight the pressures experienced by surviving parents, grappling with trying to support their children's needs on a practical and emotional level, while coping with the emotional upheaval of the impending death of their partner. The issue of communication with the children starts long before the terminal phase of illness and the results confirm that this is an ongoing process that continues after the death of the parent. The need for services to be more responsive to the diverse needs of families was also apparent as a key factor in supporting families during this time. CONCLUSIONS: This research provides valuable insights into the complexity of communicating with children about terminal illness from the perspective of the surviving parents. It reveals diverse views and experiences in terms of approaching communication with children and illustrates the need for services to be acutely attuned to the unique needs of parents and children throughout the disease trajectory.

Elder abuse: responsibilities of staff when safeguarding nursing home residents in the Republic of Ireland.

Elder abuse is a growing concern for nurses who work with older people, and safeguarding incidents can be challenging and complex to manage. In the Republic of Ireland, safeguarding agencies claim there is a lack of reporting of abuse to the authorities, raising questions as to whether nurses know how, when and where to report safeguarding concerns. Despite varying strategies and laws concerning the reporting of elder abuse worldwide, the principles of recognising and responding to abuse are similar. However, to date, there is no specific legislation governing safeguarding for adults in Ireland. This article discusses elder abuse and safeguarding nursing home residents from an Irish perspective, explaining the process of managing concerns in practice using an analysis of a case study.

Diet and Nutrition Advice After a Solid Tumor Diagnosis.

PURPOSE: Credible evidence-based diet and nutrition advice is essential for patients with cancer. This study aimed to explore what advice patients with cancer obtained before a formal dietetic visit. METHODS: A multicenter, observational study was conducted in seven hospital-based oncology services. Consecutive patients were recruited at first dietetic assessment. In addition to routine dietetic assessment, participants completed a four-item questionnaire describing diet and nutrition advice obtained since diagnosis. RESULTS: Seventy-seven patients participated. More than 80% had multiple nutrition-impact symptoms. In total, 53 (69%) obtained advice from professional and nonprofessional sources before dietetic visit. Family and friends were the most common sources of advice. More than one third got advice from (nondietetic) healthcare professionals. Most advice related to "foods to include" (61%) and "foods to avoid" (54%) in the diet. Many of the "foods to avoid" were important sources of micro- and macronutrients. Advice about dietary supplements (31%) and specific diets (28%) was common, rarely evidence-based, and frequently contradictory. Participants found it difficult to discern what advice was trustworthy and reliable. Despite this, most followed the advice. CONCLUSION: The majority of patients received diet and nutrition advice before first dietetic visit. Most of this came from nonprofessional sources. Any advice from nondietetic healthcare professionals was inconsistent or vague. This was mainly related to the avoidance and/or inclusion of particular foods and was often contradictory. Nevertheless, patients usually followed such advice fully. To help manage their frequent nutrition-impact symptoms and resolve the contradictory advice they had received, many expressed the need for earlier professional dietetic consultation.

Optimising the foliar uptake of zinc oxide nanoparticles: Do leaf surface properties and particle coating affect absorption?

Foliar absorption of zinc (Zn) is limited by several barriers, the first of which is the leaf cuticle. In this study, we investigated the absorption of Zn from Zn oxide nanoparticles (ZnO-NPs) in wheat (Triticum aestivum cv Gladius) and sunflower (Helianthus annuus cv Hyoleic 41) to determine the importance of NP surface coating for Zn absorption. Fourier transform infrared (FTIR) spectroscopy showed a higher polysaccharide content in the wheat cuticle than sunflower, indicated by a more pronounced glycosidic bond at 1020 cm-1 , but wax and cutin content were similar. Scanning electron microscopy (SEM) revealed that trichome density was twice as high in wheat (3600 ± 900 cm-2 ) as in sunflower (1600 cm-2 ) and stomatal density four times higher in sunflower (6400 ± 800 cm-2 in wheat and 22 900 cm-2 in sunflower). Suspensions of ZnO-NPs with coatings of different hydrophobicity were applied to leaves to compare Zn absorption using X-ray fluorescence microscopy (XFM) and inductively coupled plasma mass spectroscopy (ICP-MS). Absorption of Zn was similar between wheat and sunflower when Zn was applied at 1000 mg Zn l-1 , but much less Zn was absorbed from all ZnO products than from soluble Zn fertiliser. Particle coating did not affect Zn absorption, but it may facilitate particle adhesion to leaves, providing a longer-term source of resupply of Zn ions to the leaves. Differences in leaf surface characteristics did not affect Zn absorption, indicating that the cuticle is the main pathway of absorption under these conditions.