Effectiveness of an educational intervention on first-year nursing students' knowledge and confidence to perform basic life support: a quasi-experimental study.

BACKGROUND: Knowing how to respond effectively to an acutely deteriorating patient is a National Safety and Quality Health Service Standard and a requirement for nurse registration with the Australian Health Practitioner Regulatory Authority. Literature has highlighted that a lack of knowledge, skills and confidence in healthcare professionals to perform basic life support may be a contributing factor to the high mortality and morbidity rates associated with cardiac arrest in the hospital setting. AIM: To explore first-year nursing students' knowledge and confidence to perform basic life support according to the Australian Resuscitation Council guidelines before and after watching an online video lecture. METHOD: A quantitative quasi-experimental pre- and post-test design to measure changes, if any, in first-year nursing students' knowledge and confidence to perform basic life support at an Australian university in 2021. FINDINGS: The collected data were analysed using Stata, a statistical software for data sciences. Participants' mean knowledge score increased from 9.3 (SD: 2.5) in the pre-test to 13.9 (SD: 3) (p < 0.001) in the post-test (maximum possible score: 19). Participants' mean confidence score increased from 17.0 (SD: 6.3) in the pre-test to 24.5 (SD: 4.4) (p < 0.001) in the post-test (maximum possible score: 30; p < 0.001). DISCUSSION: The most significant improvement in knowledge was observed in chest compression rate, breathing/ ventilation and checking patient response. The study found that the video lecture is an effective teaching method to increase students' confidence to perform basic life support. CONCLUSION: An online video-recorded lecture can increase undergraduate student nurses' knowledge and confidence to perform basic life support. This is one educational strategy that universities can use to improve students' knowledge and confidence to perform this essential skill for practice.

Pregnant persons and birth partners' experiences of shared decision-making during pregnancy and childbirth: An umbrella review.

OBJECTIVES: This umbrella review aimed to summarize evidence on pregnant persons and/or their birth partners' experiences and expectations of SDM during pregnancy and childbirth. METHODS: We searched eight databases from 2011 to 2023. Quantitative, qualitative and mixed methods systematic reviews were included in this review. RESULTS: We have identified 26 reviews that report on 622 primary studies involving over 213,000 pregnant persons and 22,000 birth partners, examining a broad range of decision-making scenarios in maternity care. The three-talk model was used to categorise the themes which include communication, weighing options, and making a decision. Multiple reviews have reported that pregnant persons and birth partners have mixed experiences in several decision-making scenarios, with insufficient information and inadequate consideration or answers to their questions being common issues. Pregnant persons and birth partners prefer clear explanations, simple communication, and involvement in decision-making. Exclusion from the decision-making during pregnancy and childbirth may lead to negative experiences, whilst involvement improves satisfaction, reduces distress and fosters empowerment. CONCLUSIONS: The review highlights the importance of promoting SDM in maternity care, as it is fundamental to promoting maternal, newborn, and family well-being. PRACTICE IMPLICATIONS: Health systems should redesign antenatal classes and train healthcare providers to enhance communication skills and encourage informed decision-making by pregnant persons and birth partners.

Co-designing preconception and pregnancy care for healthy maternal lifestyles and obesity prevention.

PROBLEM: A recognised gap exists between current and recommended practices in the provision of lifestyle advice and weight management support for women across preconception and pregnancy care. BACKGROUND: Preconception and pregnancy are critical stages for promoting healthy maternal lifestyles and obesity prevention. Co-design is a novel approach with the potential to strengthen existing models of care to facilitate the implementation of clinical practice guidelines promoting preconception and pregnancy health, especially in relation to preconception weight management and preventing excessive gestational weight gain. AIM AND METHODS: The aims of this discussion paper are to (i) define co-design in the context of preconception and pregnancy care, (ii) outline key considerations when planning co-design initiatives and (iii) describe co-design opportunities in preconception and pregnancy care for promoting women's health and obesity prevention. DISCUSSION: While several definitions of co-design exist, one critical element is the meaningful involvement of all key stakeholders. In this discussion, we specifically identified the involvement of women and expanding the role of practice nurses in primary care may assist to overcome barriers to the provision of healthy lifestyle advice and support for women during preconception. Co-designing pregnancy care will involve input from women, nurses, midwives, obstetricians, allied health and administration and management staff. Additional attention is required to co-design care for women considered most at-risk. CONCLUSION: There is potential to enhance current provision of preconception and pregnancy care using co-design. Nursing and midwifery professions are active across both preconception and pregnancy and therefore, they have an important role to play.

Preventive healthcare for young children: A systematic review of interventions in primary care.

High rates of preventable health problems amongst children in economically developed countries have prompted governments to seek pathways for early intervention. We systematically reviewed the literature to discover what primary care-targeted interventions increased preventive healthcare (e.g. review child development, growth, vision screening, social-emotional health) for preschool children, excluding vaccinations. MEDLINE, EMBASE, CINAHL, and Cochrane databases were searched for published intervention studies, between years 2000 and 2014, which reflected preventive health activities for preschool children, delivered by health practitioners. Analysis included an assessment of study quality and the primary outcome measures employed. Of the 743 titles retrieved, 29 individual studies were selected, all originating from the United States. Twenty-four studies employed complex, multifaceted interventions and only two were rated high quality. Twelve studies addressed childhood overweight and 11 targeted general health and development. Most interventions reported outcomes that increased rates of screening, recording and recognition of health risks. Only six studies followed up children post-intervention, noting low referral rates by health practitioners and poor follow-through by parents and no study demonstrated clear health benefits for children. Preliminary evidence suggests that multi-component interventions, that combine training of health practitioners and office staff with modification of the physical environment and/or practice support, may be more effective than single component interventions. Quality Improvement interventions have been extensively replicated but their success may have relied on factors beyond the confines of individual or practice-led behaviour. This research reinforces the need for high quality studies of pediatric health assessments with the inclusion of clinical end-points.

A qualitative study of the barriers and enablers to fertility-awareness education in general practice.

AIMS: To understand the barriers and enablers to fertility-awareness education in general practice. BACKGROUND: Most women along with their primary care practitioners - general practitioners and practice nurses - believe that women should be educated about fertility-awareness when first reporting trouble conceiving. To date, no in-depth study has examined the enablers and challenges of this type of education in general practice. DESIGN: A descriptive exploratory qualitative study using deductive content analysis. METHODS: General practitioners (N = 11) and practice nurses (N = 20) were recruited from general practices in three socioculturally diverse areas in Victoria, Australia. Data were collected through semistructured interviews based on the 12 domains of a theoretical behaviour change framework from April-August 2012. The participants' responses were organized into themes that fall under the framework domains. FINDINGS: The biggest barriers to fertility-awareness education in general practice were short consultations and time constraints faced by general practitioners together with a lack of patient educational materials and remuneration to support its delivery. The biggest enablers were a greater use of nurses trained in fertility-awareness in a collaborative team care arrangement with general practitioners. CONCLUSION: This study has identified several important barriers and enablers to fertility-awareness education in general practice. Translation into practice of our findings is imperative as the first step in establishing a primary care model in fertility-awareness. This would fill an important gap in the primary care of infertile women and build capacity in general practice to reduce infertility through women's enhanced fertility knowledge.

ASSISTING WOMEN TO CONCEIVE: A CLINICAL UPDATE ON FERTILITY-AWARENESS.

This update on fertility-awareness has two principle aims. First, to highlight the gaps in women's understanding of when in the menstrual cycle it is possible to conceive and second, to outline the accurate use of fertility-awareness methods to ensure correctly timed intercourse for a pregnancy. Nurses and midwives who provide sexual and reproductive healthcare services will find this clinical practice update particularly helpful.

FERTILITY--AWARENESS KNOWLEDGE, ATTITUDES, AND PRACTICES OF WOMEN ATTENDING GENERAL PRACTICE.

Infertility (the failure to conceive after 12 months of trying) affects one in six Australian couples. Infertile couples are increasingly being referred from general practice for assisted reproductive technology (ART) treatment. However, ART treatment is costly, highly invasive and associated with increases in morbidity and mortality for mothers and babies (Kamphuis et al. 2014).

ENHANCING FERTILITY LITERACY FOR NURSES AND MIDWIVES IN PRIMARY CARE.

Prevention in healthcare through improved health literacy is at the very heart of change in Australia's health system to improve overall population health, ensure health equity, and make Australia's health system sustainable into the future (Australian government Department of Health and Ageing, 2010).

Fertility-awareness knowledge, attitudes and practices of women attending general practice.

BACKGROUND: Most women who attend assisted reproductive technology (ART) clinics believe women should receive fertility-awareness education when they first report trouble conceiving. Interest in fertility awareness among women who attend general practice is largely unknown. We aimed to measure fertility-awareness knowledge, attitudes and practices of women attending general practice. METHODS: A cross-sectional survey of women attending three different general practices was conducted. RESULTS: Of the respondents, 37.1% actively tried to improve their knowledge of fertility awareness, 9.8% were actively planning a pregnancy and 4.3% were using fertility awareness as contraception. Yet, only 2.1% of the overall sample correctly identified the fertile period of the menstrual cycle. Most respondents (92.2%) believed women should receive fertility-awareness education when they first report trouble conceiving. DISCUSSION: One-third of women who attend general practice show interest in fertility awareness, but far fewer can correctly identify the fertile period of the menstrual cycle. All women who report using fertility awareness as contraception should be counselled on their actual knowledge and advised accordingly. Concordant with our previous study of women who experience infertility, most women who attend general practice believe that women should receive fertility-awareness education when they first report trouble conceiving. Further research is needed to determine how best to do this.

Fertility-awareness knowledge, attitudes, and practices of women seeking fertility assistance.

AIMS: To report a descriptive study of fertility-awareness knowledge, attitudes, and practice of infertile women seeking fertility assistance. BACKGROUND: Previous research has suggested that poor fertility-awareness may be a contributing cause of infertility among women seeking fertility assistance at assisted reproductive technology clinics. The actual practices and attitudes towards fertility-awareness in this particular group of women are unknown. DESIGN: A cross-sectional questionnaire-based survey. METHODS: The study was conducted over 6 months, from 2007-2008, of women on admission to two assisted reproductive technology clinics in a major city in Australia. RESULTS: Two hundred and four of 282 distributed questionnaires were completed (response rate = 72·3%). Eighty-three per cent had attempted conception for 1 year or more, 86·8% actively tried to improve their fertility-awareness from one or more sources of the information, 68·2% believed they had timed intercourse mainly within the fertile window of the menstrual cycle in their attempts at conception, but only 12·7% could accurately identify this window. Ninety-four per cent believe that a woman should receive fertility-awareness education when she first reports trouble conceiving to her doctor. CONCLUSIONS: Most women seeking assistance at assisted reproductive technology clinics attempt timed intercourse within the fertile window of the menstrual cycle. However, few accurately identify this window, suggesting that poor fertility-awareness may be a contributing cause of infertility.