Palliative care education - does it influence future practice?

A group of year 3 undergraduate nursing students enrolled in an Oncology and Palliative Care Course took part in a study designed to uncover if their subsequent learning had a positive impact upon their capacity to practise palliative care. All the participants reported that the course assisted them in the clinical provision of palliative care.

Expanding the clinical placement capacity of rural hospitals in Australia: displacing Peta to place Paul?

In order to identify opportunities to build capacity for clinical placements, we mapped and described the organisation of student placements at three hospitals, each with multiple education providers, in rural Victoria, Australia. Using a cross-sectional, mixed method design, data were collected by survey, interviews and discussion with student placement coordinators representing 16 clinical health disciplines. Teaching and supporting students was regarded as an important part of the service each hospital provided and a useful staff recruitment strategy. There were peaks and troughs in student load over the year, though this was less marked for medicine and dentistry than for nursing and allied health disciplines. Whilst placements were managed largely on a discipline basis, each hospital had taken steps to communicate information about student placements across disciplines and to identify opportunities for interprofessional education (IPE). Placement capacity could be increased by sharing placement data within hospitals, smoothing the utilisation patterns across the year, capitalising on opportunities for IPE when there is concurrent placement of students from different disciplines, and through better employment of underutilised clinical areas.

Evaluation of a radial artery cannulation training program for intensive care nurses: a descriptive, explorative study.

BACKGROUND: Radial arterial line is required for critically ill patients to provide continuous blood pressure monitoring and arterial blood sampling. A program training experienced ICU nurses to perform radial artery cannulation was introduced in a Melbourne metropolitan ICU to allow early treatment and intervention to be delivered to patients while medical staff attend to more urgent diagnostic care. The aim of this research was to evaluate the effectiveness of the training program for radial artery cannulation in the ICU. METHOD: This descriptive explorative study involving a convenience sample of two groups of ICU nurses (11 and 10 participants) was conducted in a 20-bed multi-discipline adult ICU within this metropolitan hospital. Stage I involved data collection of all radial artery cannulation attempts made by participants for a period of 6 months from the training date. Stage II involved completion of questionnaires by participants to reflect on their experience 6 months post-training. The effectiveness of the training program was evaluated based on the success rates of cannulations, any reports of adverse events and participants' responses to questionnaires. RESULTS: 107 patients underwent a cannulation attempt of which 67 (63%) were successful with no reports of adverse events. Eleven nurses managed to achieve competency with a minimum of two successful cannulations. Sixty-seven percent (14 out of 21) responded to the questionnaire and 93% expressed that they would recommend this course to other colleagues. About half of the respondents stated that the ICU nurses' ability to perform radial artery cannulations may prevent patients from having to wait for long periods when doctors are held up. CONCLUSION: The findings showed that ICU nurses can safely insert radial arterial lines with improvements recommended.

The evaluation of a successful collaborative education model to expand student clinical placements.

Worldwide, universities have been encouraged to increase the number of students enrolled in nursing courses as a way to bolster the domestic supply of graduates and address workforce shortages. This places pressure on clinical agencies to accommodate greater numbers of students for clinical experience who, in Australia, may often come from different educational institutions. The aim of this study was to develop and evaluate a collaborative model of clinical education that would increase the capacity of a health care agency to accommodate student placements and improve workplace readiness. The project was undertaken in a medium sized regional hospital in rural Australia where most nurses worked part time. Through an iterative process, a new supported preceptorship model was developed by academics from three institutions and staff from the hospital. Focus group discussions and interviews were conducted with key stakeholders and clinical placement data analysed for the years 2004 (baseline) to 2007. The model was associated with a 58% increase in the number of students and a 45% increase in the number of student placement weeks over the four year period. Students reported positively on their experience and key stakeholders believed that the new model would better prepare students for the realities of nursing work.

Building capacity for the clinical placement of nursing students.

The current workforce crisis mandates that education providers increase the number of graduates from nursing courses. In a practice-based profession however, any growth in student numbers is constrained by the ability of clinical venues to accept students for clinical experience. Factors within the operating environment such as bed capacity, staffing mix and shortage of experienced clinicians to act as preceptors, clinical teachers, mentors or role models; limit the number of students that can be accommodated and both the quality and level of educational support provided. These factors are compounded in rural hospitals, where opportunities for placements can be also overlooked or ineffectively utilised. This paper reports on a project undertaken by a rural health service, two universities and a TAFE institute. It demonstrates that a greater number of students can be accommodated when all major stakeholders accept responsibility and agree to work together to create a learning community and find ways to overcome barriers and impediments that constrain capacity. It is concluded that the capacity of a rural hospital to accept students for placement can be increased when cancellation rates are reduced, the clinical timetable rationalised and more collaborative approaches to clinical education are implemented.