A REVIEW OF AGED CARE PROVISION IN MULTIPURPOSE SERVICES (MPS).

The MPS model has been in place for over 20 years in NSW as a way to address the ongoing healthcare needs of small rural communities.

Student participation in clinical handover-an integrative review.

AIM AND OBJECTIVES: To examine the literature exploring the current understanding of student nurse participation in clinical handover whilst they are enrolled in an undergraduate preregistration course. BACKGROUND: The importance of handing over the care of a patient to ensure continuity and safety of care is well-recognised. Effective preparation of student nurses to competently perform this critical task requires the use of appropriate teaching strategies to support this learning, within undergraduate preregistration nursing programs. DESIGN: An integrative literature review. METHOD: An integrative literature review was conducted to establish what is known about student nurse participation in relation to clinical handover. This resulted in 18 articles for inclusion in the literature review. An analysis was then undertaken of these 18 articles to extract key themes. RESULTS: Learning and teaching strategies need to address a variety of methods of the clinical handover process including verbal and written handovers. Participating in clinical handover prior to being given the responsibility of patient care prepares students for the workplace. Key themes identified within the literature included: learning strategies, limitations and challenges involved in putting theory into practice, handover structure and issues regarding confidentiality. CONCLUSION: Simulation and clinical practice are commonly used to prepare students for this role during their undergraduate education. The use of simulation and structured handover techniques prior to clinical placement increases student confidence to engage in clinical handovers during their clinical placements. RELEVANCE TO CLINICAL PRACTICE: This article raises the awareness of both clinical staff and educators as to the need for student nurses to develop their skills in clinical handover practice and suggests strategies to prepare student nurses to conduct clinical handover competently in the clinical setting.

Chronic care undergraduate nursing education in Australia.

The Chronic Care Model developed by Wagner is recognised to provide a systematic approach to managing chronic care. It has been adapted by the World Health Organization to become the Innovative Care for Chronic Conditions Framework. Together these have been demonstrated to provide an effective framework for chronic care management in a variety of settings. In order to prepare Australian nursing graduates for a changing health system it is important to recognise global issues and to prepare them to work within well recognised models. This paper examines the publically available documentation of pre-registration nursing degrees in Australia for their alignment with the Chronic Care Model and the Innovative Care for Chronic Conditions Framework. Those aspects of each which are well addressed are identified along with those which could be improved.

Perceived social support, self esteem, and pregnancy status among Dominican adolescents.

UNLABELLED: Adolescent pregnancy is a major health concern among Dominicans in the U.S. and in the Dominican Republic (DR). Twenty three percent of adolescents age 15-19 have experienced pregnancy and this trend is rising. PURPOSE: The purpose of this study was to explore and compare social support, self-esteem and pregnancy between Dominican adolescents in the DR with those who have immigrated to the U.S. METHODS: This study used an exploratory, descriptive design including study samples from both the U.S. and DR. Findings showed that young women with stronger social support and higher self esteem experienced lower pregnancy rates in both the DR and U.S. RESULTS: Neither self esteem nor social support was found to be predictors of pregnancy. CONCLUSION: Important findings from this study will inform the development of interventions aimed at preventing pregnancy in adolescents.

Nursing bedside clinical handover - an integrated review of issues and tools.

AIMS AND OBJECTIVES: This article reviews the available literature that supports implementing bedside clinical handover in nursing clinical practice and then seeks to identify key issues if any. BACKGROUND: Clinical handover practices are recognised as being an essential component in the effective transfer of clinical care between health practitioners. It is recognised that the point where a patient is 'handed over' from one clinician to another is significant in maintaining continuity of care and that doing this poorly can have significant safety issues for the patient. DESIGN: An integrated literature review. METHOD: A literature review of 45 articles was undertaken to understand bedside clinical handover and the issues related to the implementation of this process. RESULTS: It was identified that there are a number of clinical handover mnemonics available that provide structure to the process and that areas such as confidentiality, inclusion of the patient/carer and involving the multidisciplinary team remain topical issues for practitioners in implementing good clinical handover practices. CONCLUSIONS: This literature review identified a lack of literature available about the transfer of responsibility and accountability during clinical handover and auditing practices of the clinical handover process. The nurses were more concerned about confidentiality issues than were patients. The use of a structured tool was strongly supported; however, no one singular tool was considered suitable for all clinical areas. RELEVANCE TO CLINICAL PRACTICE: Nursing clinicians seeking to implement best practice within their professional speciality should consider some of the issues raised within this article and seek to address these issues by developing strategies to overcome them.

The right staffing mix for inpatient care in rural multi-purpose service health facilities.

CONTEXT: The Multipurpose Service (MPS) model has been in existence in rural and remote Australia for more than 20 years yet there is little guidance about developing an appropriate staffing structure. ISSUES: Managers of these facilities face issues related to isolation, safety, funding models and the need to provide a variety of services with limited resources and staffing. Because MPS are designed to meet unique community needs, a single staffing structure is not suitable for every site. Managers need to consider these issues in order to determine the most effective staffing structure for their particular environment. LESSONS LEARNED: Issues and concerns for managers are highlighted including discussion which may enhance the ability of managers to make appropriate decisions for their unique site.

Recovery from virtual environment exposure: expected time course of symptoms and potential readaptation strategies.

OBJECTIVE: This study investigated potential means of facilitating a return to normal functioning following virtual environment (VE) exposure using a peg-in-hole exercise in recalibrating hand-eye coordination, a targeted gait movement (rail walking) in recalibrating vestibular (i.e., postural) aftereffects, and natural decay. BACKGROUND: Despite technology advances and considerable efforts focused on the identification and quantification of VE aftereffects, few have addressed means for recuperation, the focus of the current study. METHOD: After 15 min-60 min of VE exposure and recalibratory exercises, hand-eye coordination and postural stability were assessed electronically, the former via a 3-D measure capturing pointing errors, and the latter by head and body oscillations while standing in the tandem Romberg position. Both measurements were collected immediately after VE exposure and every 15 min up to 1 hr thereafter. RESULTS: Participants (more than 900 college students) who experienced the peg-in-hole readaptation strategy had a significant decrease (p < 0.000 in pointing errors following the exercise; the other two methods (i.e., rail walking, natural decay) showed no significant change. For posture, all groups showed significant improvement during the 15 minutes after VE exposure, yet none returned to baseline by 1 hr postexposure. CONCLUSION: Although hand-eye coordination readaptation strategies showed noticeable effects immediately after they were performed, aftereffects were not completely eliminated after 1 hr; hence further research on readaptation strategies is essential to achieve more substantial recalibratory gains in hand-eye coordination and posture. Additionally, hand-eye coordination and vestibular aftereffects may require a period exceeding the VE immersion time in order to recover. APPLICATION: These findings may serve as a guide in the development of monitoring policies following VE exposure.