Managing the transition of Saudi new graduate nurses into clinical practice in the Kingdom of Saudi Arabia.

BACKGROUND: With the national policy of Saudization of the workforce, the numbers of Saudi new graduate nurses (NGNs) seeking employment is increasing. METHODS: A project report outlining an educational needs analysis of Saudi NGNs, and the subsequent development and expansion of a New Graduate Development Programme (NGDP) utilizing a Practise Development framework. Competence and safe practise in Saudi NGNs was evaluated using two specifically designed tools: the Final Clinical Competence Evaluation and the Clinical Challenge. RESULTS: A three-phase structured NGDP was successfully implemented resulting in NGNs developing improved confidence and competence. They were judged as being safe to practise and more patient centred, as measured against the established performance indicators. CONCLUSION: Adopting a practise Development (PD) framework provided a clear structure and direction for the NGDP. IMPLICATIONS FOR NURSING MANAGEMENT: Nurse Managers who invest human, financial and education resources into developing new graduate nurses are likely to retain such staff longer. In the Middle Eastern context, such investment is likely to rapidly promote the goal of increasing the number of indigenous nationals working as nurses.

Building social capital in first-time parents through a group-parenting program: a questionnaire survey.

BACKGROUND: Parents who are connected into strong family and community networks are said to have high social capital enabling them to provide a positive context where their children's social, emotional and educational needs are met. OBJECTIVES: To identify parent satisfaction with, strengths and weaknesses of, opportunities to build social capital, and the impact of a two-course pilot health and relationship focused Parenting Education Program-PEPE, designed for first-time parents, on the core work of the well-child nurse/health visitor. DESIGN: Retrospective descriptive survey using postal questionnaires. SETTING: Twelve pilot parenting courses facilitated across five regions of New Zealand. PARTICIPANTS: All parents (n = 105) and clinical nursing staff (n = 12) involved in the pilot parenting courses were invited to participate. Overall response rate was 82%. METHODS: Questionnaires developed by investigators were mailed to the eligible population. Numerical data was analysed using PC-SAS. Narrative data was subjected to thematic content analysis. RESULTS: Attendance at both parenting courses positively correlated with an increase in measures of social capital: development of strong social networks (82% Your New Baby course respondents: 95% CI, 75-89, and 98% Your Growing Baby course respondents: 95% CI, 96-100), and positive relationships with others (93% Your New Baby course respondents: 95% CI, 88-98, and 86% Your Growing Baby course respondents: 95% CI, 83-89). Increased confidence in respondent's parenting ability was also identified (96% Your New Baby course respondents: 95% CI, 92-100; 96% Your Growing Baby course respondents: 95% CI 93-99). CONCLUSIONS: The PEPE programme was well accepted by first-time parents leading to significant improvements in development of social capital and parenting confidence. Well-child health nurses are in a prime position to foster social capital and help rebuild communities within which they work to enhance parenting outcomes.

Waiting for hip arthroplasty: economic costs and health outcomes.

This prospective cohort study of 153 patients aimed to determine the economic and health costs of waiting for total hip arthroplasty (THA). Health-related quality of life, using self-completed WOMAC and EQ-5D questionnaires, was assessed monthly from enrolment preoperatively to 6 months postsurgery. Monthly cost diaries were used to record costs. The mean waiting time was 5.1 months and mean total cost of waiting for surgery was NZ 4305 dollars(US 2876 dollars) per person (pp) (NZ 1 dollar = US 0.668 dollar). Waiting more than 6 months was associated with a higher total mean cost (NZ 4278 dollars/US 2858 dollars pp) than waiting less than 6 months (NZ 2828 dollars/US 1889 dollars pp; P < .01). Improvements from preoperative to postoperative WOMAC and EQ-5D scores were identified (P < or = .01). Waiting longer led to poorer physical function preoperatively (P < or = .01). Those with poor initial health status showed greater improvement in WOMAC (P = .0001) and EQ-5D (P = .003) measures by 6 months after surgery. Longer waits for total hip arthroplasty incur greater economic costs and deterioration in physical function while waiting.

Grief as a transformative experience: weaving through different lifeworlds after a loved one has completed suicide.

Using Heidegger's hermeneutic phenomenology informed by van Manen's and Benner's work, this research is an exploration and interpretation of the lived experiences of family members since they lost a close family member to suicidal death. Data from in-depth interviews with six participants, the researcher's journal entries and published literature were analysed. Findings gave rise to a grief model where suicide survivors moved through four modes of being-in-the-world characterized by 13 lifeworlds or themes. Surviving suicide was a transformative process that in time enabled survivors to discover new ways of understanding and relating to the world. The findings have implications for nurses and counsellors working in the area of suicide bereavement.

An assessment of sleep disturbance in patients before and after total hip arthroplasty.

Patients with osteoarthritis commonly complain of sleep disturbance that may be due to pain. Osteoarthritic hip pain is commonly alleviated by total hip arthroplasty (THA). Forty-eight patients waiting for THA completed a sleep questionnaire and were monitored using actigraphy and sleep diaries for 4 to 5 nights, 1 month before and 3 months after surgery. For the group as a whole, significant improvements were seen in subjective and objective measures of sleep after THA. In this study, 75% of participants reported that their sleep was never or rarely disturbed by hip pain after surgery. Actigraphy indicated significant reductions in time in bed and activity during sleep, more efficient sleep and less fragmented (restless) sleep. Differences between patients aged < 65 and > or = 65 years were observed. These findings support the hypothesis that relief from the pain of osteoarthritis as a result of THA improves sleep quality. Improvements in sleep contribute to the improved quality of life and day-to-day functioning seen after THA.

An investigation of patient satisfaction following discharge after total hip replacement surgery.

PURPOSE: To investigate patient expectations of and satisfaction with in-hospital discharge planning after total hip-joint replacement surgery in early and late discharge patient groups. DESIGN: A qualitative study describing patients' experience of discharge planning. SAMPLE: Thirty-three consecutive patients requiring primary total hip-joint replacement from two metropolitan hospitals. METHODS: Participants completed in-depth, semistructured interviews on the day of discharge from the hospital and again 4 to 8 weeks later. Thematic analysis of the transcripts was made after comparing data from early and late discharge groups. FINDINGS: Attendance at preassessment clinic was facilitated acceptable satisfaction levels for patients in both early and late discharge groups. Although that written information provided was timely, restricted opportunity for dialogue with health professionals limited patient knowledge and understanding of recovery. CONCLUSIONS: Multidisciplinary teams in orthopaedic practice face the challenge of finding better ways to coordinate care and ensure people undergoing total hip-joint replacement therapy surgery have individualized care. A nurse mentor-coach could be one way to ensure patients' education needs in this area are met. IMPLICATIONS FOR NURSING RESEARCH: Future studies could investigate nurses' work in discharge planning and identify any influence that their holistic approach to care could bring to a collaborative discharge process.