Oral care practices and hospital-acquired pneumonia prevention: A national survey of Australian nurses.

BACKGROUND: Hospital-acquired pneumonia (HAP) also known as non-ventilator associated pneumonia, is one of the most common infections acquired in hospitalised patients. Improving oral hygiene appears to reduce the incidence of HAP. This study aimed to describe current practices, barriers and facilitators, knowledge and educational preferences of registered nurses performing oral health care in the Australian hospital setting, with a focus on the prevention of HAP. We present this as a short research report. METHODS: We undertook a cross sectional online anonymous survey of Australian registered nurses. Participants were recruited via electronic distribution through existing professional networks and social media. The survey used was modified from an existing survey on oral care practice. RESULTS: The survey was completed by 179 participants. Hand hygiene was considered a very important strategy to prevent pneumonia (n = 90, 58%), while 45% (n = 71) felt that oral care was very important. The most highly reported barriers for providing oral care included: an uncooperative patient; inadequate staffing; and a lack of oral hygiene requisite. Patients' reminders, prompts and the provision of toothbrushes were common ways believed to help facilitate improvements in oral care. CONCLUSION: Findings from this survey will be used in conjunction with consumer feedback, to help inform a planned multi-centre randomised trial, the Hospital Acquired Pneumonia PrEveNtion (HAPPEN) study, aimed at reducing the incidence of HAP. Findings may also be useful for informing studies and quality improvement initiatives aimed at improving oral care to reduce the incidence of HAP.

Challenges and reflections from an international, humanitarian, short-term surgical mission on collecting ethnographic data in a remote environment.

BACKGROUND: The experiences of nurses participating in ethnographic fieldwork have been well documented, but often feature short-term, intermittent periods in the field of less than a day. AIM: To provide an overview of methodological issues related to collecting data while undertaking a focused ethnography of nurses volunteering with a humanitarian organisation providing surgical care in a remote setting. DISCUSSION: Particular challenges during the fieldwork included limited space and privacy influencing data collection and secure storage; sporadic and unreliable communications limiting contact with other members of the research team; the challenges of withdrawing from the intensity of the setting; and navigating blurred boundaries between the roles of clinician and researcher. CONCLUSION: Social research in practice, despite the best of intentions and significant planning, may not always travel the expected path of rational enquiry. IMPLICATIONS FOR PRACTICE: Awareness of the challenges involved before embarking on longer term entry into remote environments may help prepare future nurse ethnographers.

Nurses' contribution to short-term humanitarian care in low- to middle-income countries: An integrative review of the literature.

AIMS AND OBJECTIVES: To appraise the literature related to voluntary humanitarian work provided by international nurses in low- to middle-income countries. BACKGROUND: Nurses and other health professionals are engaged with both governmental and nongovernmental organisations to provide care within international humanitarian relief and development contexts. Current literature describes accounts of charitable health professional activity within short-term health-focused humanitarian trips; however, there is minimal research describing the care that nurses provide and the professional roles and tasks they fulfil whilst participating in international volunteer healthcare service. DESIGN: Integrative review. METHODS: A search of articles published between 1995-2015 was conducted using seven bibliographic databases. Inclusion criteria incorporated nurses and allied health professionals' involvement in a volunteer short-term medical team capacity. Papers describing military and/or disaster response with a service-learning focus were excluded. Nineteen papers were selected for review, description and discussion of findings. RESULTS: Findings revealed limited data describing the care nurses provide and the professional roles and tasks they fulfil within the context of international humanitarian short-term medical trips. Issues raised included a description of demographic data regarding participants and sending agencies, motivation for volunteer participation, perceptions of effectiveness of particular programmes and sustainability issues related to cultural, ethical or moral obligations of foreign health professionals working in a low- to middle-income countries. CONCLUSION: Study findings highlighted that although nurses are recruited and participate in health-focused humanitarian activities in low- to middle-income countries, there is extremely limited documented research about the amount and type of care that nurses specifically provide in this context. Furthermore, when identified, it is most often hidden within studies outlining services provided by healthcare teams and not specific to the discipline of nursing. Further research is therefore required to enable greater understanding of nursing care in this context and to inform prospective volunteers of expected nursing practice. RELEVANCE TO CLINICAL PRACTICE: This article provides an analysis of available literature describing nursing involvement within the particular context of short-term medical teams delivering charitable health care.

Evaluation of student nurses' perception of preparedness for oral medication administration in clinical practice: a collaborative study.

BACKGROUND: Attainment of oral medication administration skills and competency for student nurses is challenging and medication errors are common. The ability of nurses to master a clinical skill is dependent upon educational instruction and practice. OBJECTIVES: The aim of this study was to evaluate nursing students' perception of preparedness for oral medication administration in two practice environments and determine possible relationship between student demographics and their perceived preparedness for oral medication administration. DESIGN: This was a cross sectional, exploratory study. PARTICIPANTS: Eighty-eight second year students from a baccalaureate nursing course from two metropolitan Australian tertiary institutions participated. METHODS: Student nurses' perception of preparedness for oral medication administration was measured via a self-administered, adapted, and validated questionnaire. RESULTS: The overall mean Total Preparedness Score was 86.2 (range 71-102). There was no significant difference for perceived total preparedness to administer oral medications between the two facilities. Whilst there was no significant relationship established between student demographics and their perceived preparedness to administer oral medications, four single questions related to clinical practice were shown to be significant. CONCLUSION: Low fidelity simulated teaching environments that incorporate time management and post medication situations, may improve student nurses' perceived preparedness for oral medication administration.