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Gordon CJ, Fernandez T, Chen E, Basheti M, Rahimi M, Saini B. Nurses' attitudes, beliefs and knowledge of sleep health in residential aged care: An integrative literature review. J Adv Nurs 2024. [PMID: 38819604 DOI: 10.1111/jan.16249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Revised: 04/25/2024] [Accepted: 05/10/2024] [Indexed: 06/01/2024]
Abstract
AIM To identify, synthesize and evaluate primary research on registered nurses' (RN) knowledge, attitudes and beliefs about sleep health and sleep health management of older adults living in residential aged care. DESIGN Integrative review. DATA SOURCES Medline, Embase and CINAHL databases from inception to September 2023. REVIEW METHODS Databases were searched using a combination of key words, subject heading terms. All abstracts and full-text articles were screened by two researchers. Qualitative synthesis of the included articles was conducted. Inductive content analysis was used to identify themes and analyse data. RESULTS A total of 923 abstracts were screened resulting in a final yield of 13 articles. Three themes were identified: (i) RN experience with sleep-disturbed residents, (ii) the emotional burden of sleep disturbances on RN and, (iii) organizational barriers to promoting resident's healthy sleep. Inappropriate administration of benzodiazepines and psychotropic drugs to manage residents' sleep disturbances was a major issue and lack of resources in residential aged care to facilitate sleep. There were concerns on nursing activity that disturbed residents' sleep and striking a balance between facilitating sleep and meeting managerial expectations was challenging. CONCLUSION This review identified that nurses' decision-making has an integral role in the management of sleep health in residents in aged care. Whilst evidence-based guidelines for managing sleep in residential aged care are available, there is a lack of translation to practice. Understanding RN perspectives is critical to improving sleep health models of care in residential aged care. IMPACT This review found that RN are attuned to the implications of sleep disturbance in residential aged care but are constrained by current sleep health models of care. PATIENT OR PUBLIC CONTRIBUTION Not applicable.
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Affiliation(s)
- Christopher J Gordon
- Department of Health Sciences, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, New South Wales, Australia
- Centre for Sleep and Chronobiology, Woolcock Institute of Medical Research, Sydney, New South Wales, Australia
- Susan Wakil School of Nursing and Midwifery, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
| | - Tracee Fernandez
- Susan Wakil School of Nursing and Midwifery, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
| | - Emily Chen
- Sydney Pharmacy School, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
| | - Mariam Basheti
- Centre for Sleep and Chronobiology, Woolcock Institute of Medical Research, Sydney, New South Wales, Australia
- Sydney Pharmacy School, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
| | - Matthew Rahimi
- Centre for Sleep and Chronobiology, Woolcock Institute of Medical Research, Sydney, New South Wales, Australia
| | - Bandana Saini
- Centre for Sleep and Chronobiology, Woolcock Institute of Medical Research, Sydney, New South Wales, Australia
- Sydney Pharmacy School, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
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Kim HJ, Lee SH, Lee JJ, Seong SS, Yang H, Lee HY. [Analysis of the Adequacy of Nurse Staffing Level through the Estimation of Nursing Activity Hours and Implementation of Focus Group Interviews in a Tertiary Hospital: Using a Mixed-Method Design]. J Korean Acad Nurs 2024; 54:237-249. [PMID: 38863191 DOI: 10.4040/jkan.22142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Revised: 04/13/2023] [Accepted: 06/27/2023] [Indexed: 06/13/2024]
Abstract
PURPOSE This study aimed to examine the adequacy of current nurse staffing levels by identifying nursing activities and workload. METHODS The study used a mixed-method design. A nursing activity survey was conducted using the work sampling method over 2 working days with 119 general ward nurses. A focus group interview was conducted with 12 nurses. Quantitative and qualitative data were analyzed using SPSS 20.0 and content analysis, respectively. RESULTS The most amount of time was spent on medication (in direct nursing) and electronic medical record documentation (in indirect nursing). The appropriate nurse-to-patient ratio is 1:7.7 for the day shift, 1:9.0 for the evening shift, and 1:11.9 for the night shift. However, the current nurse-to-patient ratio is 1:9.4, 1:11.0, and 1:13.8 for the day, evening, and night shifts, respectively. Therefore, the current nurse staffing level is insufficient for the workload. In the focus group interview, the main reasons cited for being unable to complete tasks within working hours were communication and coordination, and the nursing electronic medical record. The essential nursing activities of basic nursing and emotional support were overlooked owing to a heavy workload. Therefore, an adequate nurse staffing level should be higher than the measured quantitative workload. CONCLUSION These results suggest the general wards of tertiary hospitals should evaluate the adequacy of their current nurse staffing and allocate sufficient nurses to improve patient safety and nursing care quality.
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Affiliation(s)
- Hyun-Joo Kim
- Seoul St. Mary's Hospital Nursing Department, The Catholic University of Korea, Seoul, Korea
| | - Sun-Hee Lee
- Seoul St. Mary's Hospital Nursing Department, The Catholic University of Korea, Seoul, Korea
| | - Jai-Jung Lee
- Seoul St. Mary's Hospital Nursing Department, The Catholic University of Korea, Seoul, Korea
| | - Sun-Suk Seong
- Seoul St. Mary's Hospital Nursing Department, The Catholic University of Korea, Seoul, Korea
| | - Hee Yang
- Seoul St. Mary's Hospital Nursing Department, The Catholic University of Korea, Seoul, Korea
| | - Hyang-Yuol Lee
- College of Nursing, The Catholic University of Korea, Seoul, Korea.
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Sheehy L, Crawford T, River J. The reported experiences of internationally qualified nurses in aged care: A scoping review. J Adv Nurs 2024; 80:1299-1313. [PMID: 37904718 DOI: 10.1111/jan.15913] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Revised: 09/05/2023] [Accepted: 10/15/2023] [Indexed: 11/01/2023]
Abstract
AIM To examine the experiences of internationally qualified nurses, including those from culturally and linguistically diverse backgrounds, transitioning to and working in the aged care sector of high-income countries. DESIGN A scoping review. DATA SOURCES CINAHL, MEDLINE and PSychINFO databases were searched to find eligible literature published from January 2010 onwards. REVIEW METHODS This scoping review was based on the framework by Arksey and O'Malley and the PRISMA-ScR guidelines. The literature search was conducted by the first author, and all three authors reviewed the retrieved studies for eligibility and inclusion. RESULTS Fourteen articles were eligible. Data was categorized into three broad themes: stress of migration and transition; miscommunication, racism and discrimination; and aged care specific challenges which included two sub-themes 'shock of aged care' and 'bottom care'. CONCLUSION Internationally qualified nurses, particularly if they are culturally and linguistically diverse, face unique stresses and challenges in aged care and face barriers in the recognition of skills and qualifications. The under-utilization of skills is not only a loss in terms of patient care but is linked to fears of de-skilling, losing professional development and opportunities for career progression. IMPACT Internationally qualified nurses are positioned as a solution to aged care shortages in high-income countries; however, there is a scarcity of research exploring their experiences. In the context of the global aged care staffing crisis, an understanding of the stresses and challenges faced by internationally qualified nurses will further strengthen efforts to recruit, support and retain skilled nurses in aged care.
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Affiliation(s)
- Louise Sheehy
- Faculty of Medicine and Health, The University of Sydney, Camperdown, New South Wales, Australia
| | - Tonia Crawford
- Faculty of Medicine and Health, The University of Sydney, Camperdown, New South Wales, Australia
| | - Jo River
- Faculty of Health, UTS and Northern Sydney Local Health District, Sydney, New South Wales, Australia
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Cameron E, Noble N, Bryant J, Norton G, Allanson Oam V, Sanson-Fisher R. Job satisfaction and regulation in the aged care sector: staff perspectives. BMC Health Serv Res 2023; 23:1421. [PMID: 38102701 PMCID: PMC10722849 DOI: 10.1186/s12913-023-10472-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2023] [Accepted: 12/12/2023] [Indexed: 12/17/2023] Open
Abstract
BACKGROUND The quality of care provided in residential aged care facilities is largely dependent on the job satisfaction of employees and the organisational framework and systems that they provide care in. This study aimed to explore aged care staff perceptions of job satisfaction, regulation of the sector and the Royal Commission into Aged Care Quality and Safety. METHODS A cross-sectional survey conducted in 2019-early 2020 with staff employed in various roles at residential aged care services in Australia. The study specific survey collected views and experiences about working in the aged care sector as well as information about their role. RESULTS A total of 167 aged care staff completed the survey of which 71% worked in a direct care role. Most participants indicated they thought they were doing a worthwhile and important job (98%), were proud to work in the sector (94%) and found the job personally rewarding (94%). However, participants also reported feeling emotionally drained by the work (37%) and fatigued by having to face a day of work (30%). 72% of participants felt the Royal Commission would lead to improvements in the care provided to residents. CONCLUSION Aged care staff have an overall positive feeling towards their work. Additional support including increasing skills to deliver high-quality care, creating a supportive work environment to reduce job stressors and changes to the way the sector is regulated, are likely to lead to improved care.
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Affiliation(s)
- Emilie Cameron
- Health Behaviour Research Collaborative, School of Medicine and Public Health, College of Health and Wellbeing, University of Newcastle, Callaghan, NSW, 2308, Australia.
- Priority Research Centre for Health Behaviour, University of Newcastle, Callaghan, NSW, 2308, Australia.
- Hunter Medical Research Institute, Locked Bag 1000, New Lambton, NSW, 2305, Australia.
| | - Natasha Noble
- Health Behaviour Research Collaborative, School of Medicine and Public Health, College of Health and Wellbeing, University of Newcastle, Callaghan, NSW, 2308, Australia
- Priority Research Centre for Health Behaviour, University of Newcastle, Callaghan, NSW, 2308, Australia
- Hunter Medical Research Institute, Locked Bag 1000, New Lambton, NSW, 2305, Australia
| | - Jamie Bryant
- Health Behaviour Research Collaborative, School of Medicine and Public Health, College of Health and Wellbeing, University of Newcastle, Callaghan, NSW, 2308, Australia
- Priority Research Centre for Health Behaviour, University of Newcastle, Callaghan, NSW, 2308, Australia
- Hunter Medical Research Institute, Locked Bag 1000, New Lambton, NSW, 2305, Australia
| | - Grace Norton
- Health Behaviour Research Collaborative, School of Medicine and Public Health, College of Health and Wellbeing, University of Newcastle, Callaghan, NSW, 2308, Australia
- Priority Research Centre for Health Behaviour, University of Newcastle, Callaghan, NSW, 2308, Australia
- Hunter Medical Research Institute, Locked Bag 1000, New Lambton, NSW, 2305, Australia
| | - Viv Allanson Oam
- Maroba Caring Communities, 58 Edith Street, Waratah, NSW, 2298, Australia
| | - Rob Sanson-Fisher
- Health Behaviour Research Collaborative, School of Medicine and Public Health, College of Health and Wellbeing, University of Newcastle, Callaghan, NSW, 2308, Australia
- Priority Research Centre for Health Behaviour, University of Newcastle, Callaghan, NSW, 2308, Australia
- Hunter Medical Research Institute, Locked Bag 1000, New Lambton, NSW, 2305, Australia
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Developing a nurse practitioner to work in residential aged care: A qualitative evaluative study. Collegian 2023. [DOI: 10.1016/j.colegn.2022.12.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/03/2023]
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Usher AM K, Jackson D, Massey D, Wynaden D, Grant J, West C, McGough S, Hopkins M, Muller A, Mather C, Byfield Z, Smith Z, Ngune I, Wynne R. The mental health impact of COVID-19 on pre-registration nursing students in Australia: Findings from a national cross-sectional study. J Adv Nurs 2023; 79:581-592. [PMID: 36453452 PMCID: PMC9877832 DOI: 10.1111/jan.15478] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2022] [Revised: 08/25/2022] [Accepted: 10/06/2022] [Indexed: 12/04/2022]
Abstract
AIM The study aimed to measure and describe the mental health impact of COVID-19 on Australian pre-registration nursing students. BACKGROUND The COVID -19 pandemic has had a swift and significant impact on nursing students across the globe. The pandemic was the catalyst for the closure of schools and universities across many countries. This necessary measure caused additional stressors for many students, including nursing students, leading to uncertainty and anxiety. There is limited evidence available to identify the mental health impact of COVID-19 on Australian pre-registration nursing students currently. DESIGN A cross-sectional study was conducted across 12 Australian universities. METHODS Using an anonymous, online survey students provided demographic data and self-reported their stress, anxiety, resilience, coping strategies, mental health and exposure to COVID-19. Students' stress, anxiety, resilience, coping strategies and mental health were assessed using the Impact of Event Scale-Revised, the Coronavirus Anxiety Scale, the Brief Resilience Scale, the Brief Cope and the DASS-21. Descriptive and regression analyses were conducted to investigate whether stress, anxiety, resilience and coping strategies explained variance in mental health impact. Ethical Approval was obtained from the University of New England Human Research Ethics Committee (No: HE20-188). All participating universities obtained reciprocal approval. RESULTS Of the 516 students who completed the survey over half (n = 300, 58.1%) reported mental health concerns and most students (n = 469, 90.9%) reported being impacted by COVID-19. Close to half of students (n = 255, 49.4%) reported signs of post-traumatic stress disorder. Mental health impact was influenced by students' year level and history of mental health issues, where a history of mental health and a higher year level were both associated with greater mental health impacts. Students experienced considerable disruption to their learning due to COVID-19 restrictions which exacerbated students' distress and anxiety. Students coped with COVID-19 through focusing on their problems and using strategies to regulate their emotions and adapt to stressors. CONCLUSION The COVID-19 pandemic has considerably impacted pre-registration nursing students' mental health. Strategies to support nursing students manage their mental health are vital to assist them through the ongoing pandemic and safeguard the recruitment and retention of the future nursing workforce. IMPACT STATEMENT This study adds an Australian understanding to the international evidence that indicates student nurses experienced a range of negative psychosocial outcomes during COVID-19. In this study, we found that students with a pre-existing mental health issue and final-year students were most affected. The changes to education in Australian universities related to COVID-19 has caused distress for many nursing students. Australian nursing academics/educators and health service staff need to take heed of these results as these students prepare for entry into the nursing workforce. PATIENT OR PUBLIC INVOLVEMENT The study was designed to explore the impact of COVID-19 on the mental health of undergraduate nursing students in Australia. Educators from several universities were involved in the design and conduct of the study. However, the study did not include input from the public or the intended participants.
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Affiliation(s)
- Kim Usher AM
- School of HealthUniversity of New EnglandArmidaleNew South WalesAustralia
| | - Debra Jackson
- School of NursingUniversity of SydneySydneyNew South WalesAustralia
| | - Debbie Massey
- School of Health & Human SciencesSouthern Cross UniversityGold Coast CampusQueenslandAustralia
| | - Dianne Wynaden
- School of NursingCurtin UniversityPerthWestern AustraliaAustralia
| | - Julian Grant
- Faculty of Science & HealthCharles Sturt UniversityBathurstNew South WalesAustralia
| | - Caryn West
- College of Healthcare ScienceJames Cook UniversityCairnsQueenslandAustralia
| | - Shirley McGough
- School of NursingCurtin UniversityPerthWestern AustraliaAustralia
| | - Martin Hopkins
- Discipline of NursingMurdoch UniversityPerthWestern AustraliaAustralia
| | - Amanda Muller
- College of Nursing & Health SciencesFlinders UniversityAdelaideSouth AustraliaAustralia
| | - Carey Mather
- School of NursingUniversity of TasmaniaLauncestonTasmaniaAustralia
| | - Zac Byfield
- School of HealthUniversity of New EnglandArmidaleNew South WalesAustralia
| | - Zaneta Smith
- School of HealthUniversity of New EnglandArmidaleNew South WalesAustralia
| | - Irene Ngune
- School of Nursing & MidwiferyEdith Cowan UniversityPerthWestern AustraliaAustralia
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Rushing Care by Care Aides Associated With Experiences of Responsive Behaviors From Residents in Nursing Homes. J Am Med Dir Assoc 2021; 23:954-961.e2. [PMID: 34818521 DOI: 10.1016/j.jamda.2021.10.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Revised: 10/20/2021] [Accepted: 10/23/2021] [Indexed: 11/22/2022]
Abstract
OBJECTIVES Residents with cognitive impairment favor "slow care," so rushed care may cause additional responsive behaviors (eg, verbal threats, hitting) among residents. We assessed the association of rushed care (physical and social) by care aides with their experiences of responsive behaviors from residents. DESIGN Cross-sectional analysis of survey data. SETTING AND PARTICIPANTS A total of 3547 care aides (response rate: 69.97%) in 282 care units in a stratified random sample (health region, nursing home size, owner-operator model) of 87 urban nursing homes in Western Canada. METHODS Data collection occurred between September 2019 and February 2020. The dependent variables were care aide self-report of 4 types of verbal and physical responsive behavior (yes/no). The independent variables were care aide self-report of rushed physical care (count, range = 0-6) and rushed social care (yes/no). We conducted a 2-level random-intercept logistic regression with each dependent variable, controlling for care aide, care unit, and nursing home characteristics. RESULTS In their most recent shift, 2182 (61.5%) care aides reported having rushed at least 1 physical care task and 1782 (50.2%) reported having rushed talking with residents (social care task). When care aides rushed an additional physical care task, they had 8% higher odds of reporting having experienced yelling and screaming [odds ratio (OR) 1.08, 95% CI 1.01-1.15; P = .019]. When care aides rushed social care (talking with residents), they had 70% higher odds of reporting having experienced yelling and screaming (OR 1.70, 95% CI 1.28-2.25; P < .001). We observed the same pattern for the other types of responsive behaviors. CONCLUSIONS AND IMPLICATIONS Rushing of physical or social care tasks by care aides was associated with increased likelihood of responsive behaviors from residents. One approach to reducing both rushed care and resident responsive behaviors may be to improve the care environment for care aides and residents.
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Comment on Peters, M.D.J., Marnie, C., Butler, A., 2021. Delivering, funding, and rating safe staffing levels and skills mix in aged care. Int J Nurs Stud 2021; 119:103947. [PMID: 33979741 DOI: 10.1016/j.ijnurstu.2021.103947] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Revised: 04/08/2021] [Accepted: 04/08/2021] [Indexed: 11/21/2022]
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