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Edney J, McDonall J, Khaw D, Hutchinson AF. Use of Wearable Devices to Monitor Postoperative Activity following Cardiac Surgery. A Systematic Scoping Review. Eur J Cardiovasc Nurs 2024:zvae054. [PMID: 38648510 DOI: 10.1093/eurjcn/zvae054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Revised: 04/13/2024] [Accepted: 04/17/2024] [Indexed: 04/25/2024]
Abstract
AIM There is an emerging trend of using wearable digital technology to monitor patient activity levels in acute care contexts. However, the overall extent and quality of evidence for their use in acute cardiac surgery care is unclear. The purpose of this systematic scoping review was to evaluate current literature regarding the use of wearable activity trackers/accelerometers to monitor patient activity levels in the first 30-days following cardiac surgery. METHOD A systematic scoping review was conducted. A search of CINAHL and MEDLINE Complete databases identified all peer reviewed research evidence published in English between 2010 and 2023. Studies evaluating the use of wearable, technology in adults who had undergone coronary bypass graft surgery (CAGS), and/valve replacement (VR) were included. Study data was summarised thematically. RESULTS A total of 853 citations were identified. Once duplicates were removed, 816 studies were screened by title and abstract, 54 full-text studies were assessed for eligibility and 11 studies included. Accelerometers were able to capture changing exercise and physical activity levels over an acute care admission. Device use was acceptable to clinicians and patients. Low activity levels in the early postoperative period were associated with longer length of stay and higher 30-day readmissions. CONCLUSION Wearable devices are acceptable and feasible to use in acute care. Use of wearable activity trackers by acute cardiac patients may increase patient participation in exercise and identify more sedentary patients who are a greater risk of increased length of stay and hospital readmission.
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Affiliation(s)
- Jessica Edney
- Cardiac Ward at Epworth HealthCare, 189 Bridge Rd, Richmond, Melbourne, Victoria, Australia
| | - Jo McDonall
- Deakin University School of Nursing & Midwifery, Institute of Health Transformation - Centre for Quality and Patient Safety Research - Epworth HealthCare Partnership, Melbourne, Victoria, Australia
| | - Damien Khaw
- Deakin University School of Nursing & Midwifery, Institute of Health Transformation - Centre for Quality and Patient Safety Research - Epworth HealthCare Partnership, Melbourne, Victoria, Australia
| | - Anastasia F Hutchinson
- Deakin University School of Nursing & Midwifery, Institute of Health Transformation - Centre for Quality and Patient Safety Research - Epworth HealthCare Partnership, Melbourne, Victoria, Australia
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Kondos NA, Barrett J, McDonall J, Bucknall T. A Delphi study to obtain consensus on medical emergency team (MET) stand-down decision making. J Clin Nurs 2023; 32:7873-7882. [PMID: 37607900 DOI: 10.1111/jocn.16859] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Revised: 07/15/2023] [Accepted: 08/10/2023] [Indexed: 08/24/2023]
Abstract
AIM A medical emergency team (MET) stand-down decision is the decision to end a MET response and hand responsibility for the patient back to ward staff for ongoing management. Little research has explored this decision. This study aimed to obtain expert consensus on the essential elements required to make optimal MET call stand-down decisions and the communication required before MET departure. DESIGN A Delphi design was utilised. METHODS An expert panel of 10 members were recruited based on their expert knowledge and recent clinical MET responder experience in acute hospital settings. Participants were emailed a consent form and an electronic interactive PDF for each survey. Two rounds were conducted with no attrition between rounds. The CREDES guidance on conducting and reporting Delphi studies was used to report this study. RESULTS Consensus by an expert panel of 10 MET responders generated essential elements of MET stand-down decisions. Essential elements comprised of two steps: (1) the stand-down decision that was influenced by both the patient situation and the ward/organisational context; and (2) the communication required before actioning stand-down. Communication after the decision required both verbal discussions and written documentation to hand over patient responsibility. Specific patient information, a management plan and an escalation plan were considered essential. CONCLUSION The Delphi surveys reached consensus on the actions and communication required to stand down a MET call. Passing responsibility back to ward staff after a MET call requires both patient and ward safety assessments, and a clearly articulated patient plan for ward staff. Observation of MET call stand-down decision-making is required to validate the essential elements. IMPLICATION FOR THE PROFESSION AND PATIENT/OR PATIENT CARE In specifying the essential elements, this study offers clinical and MET staff a process to support the handing over of clinical responsibility from the MET to the ward staff, and clarification of management plans in order to reduce repeat MET calls and improve patient outcomes. IMPACT Minimal research has been focussed on the decision to hand responsibility back to ward staff so the MET may leave the ward with safety plan in place. This study provided expert consensus to optimise MET stand-down decision-making and the ultimate decision to end a MET call. Communication of agreed patient treatment and escalation plans is recommended before leaving the ward. This study can be used as a checklist for MET responder staff making these decisions and ward staff responsible for post-MET call care. The aim being to reduce the likelihood of potentially preventable repeat deterioration in the MET patient population. REPORTING METHOD The CREDES guidance on conducting and reporting Delphi studies. PATIENT OR PUBLIC CONTRIBUTION None.
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Affiliation(s)
- Natalie A Kondos
- School of Nursing and Midwifery, Faculty of Health Deakin University, Victoria, Geelong, Australia
- Centre for Quality and Patient Safety Research - Alfred Health Partnership, Institute for Health Transformation, Deakin University, Victoria, Geelong, Australia
| | - Jonathan Barrett
- Centre for Quality and Patient Safety Research - Alfred Health Partnership, Institute for Health Transformation, Deakin University, Victoria, Geelong, Australia
| | - Jo McDonall
- School of Nursing and Midwifery, Faculty of Health Deakin University, Victoria, Geelong, Australia
| | - Tracey Bucknall
- School of Nursing and Midwifery, Faculty of Health Deakin University, Victoria, Geelong, Australia
- Centre for Quality and Patient Safety Research - Alfred Health Partnership, Institute for Health Transformation, Deakin University, Victoria, Geelong, Australia
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McDonall J, Hutchinson AF, Heynesbergh N, Redley B, de Steiger R, Khaw D, Botti M. MyStay – Development of nurse-facilitated condition-specific multimedia resources to facilitate patient participation in postoperative care. Patient Experience Journal 2022. [DOI: 10.35680/2372-0247.1631] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
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Montayre J, Alananzeh I, Bail K, Barnewall K, Beament T, Campbell S, Carmody C, Chan A, Donnelly F, Duff J, Ferguson C, Gibson J, Harbour P, Ireland CJ, Liu XL, Luyke P, Maneze D, McDonall J, McTier L, Mulquiney T, O'Brien J, Pelentsov LJ, Ramjan LM, Reedy N, Richards GM, Roche MA, Smith BW, Benjamin JY, Theobald KA, Tori KE, Wall P, Wallis E, Yokota L, Zugai J, Salamonson Y. Development and psychometric testing of the gender misconceptions of men in nursing (GEMINI) scale among nursing students. Contemp Nurse 2022; 58:253-263. [PMID: 35881770 DOI: 10.1080/10376178.2022.2107041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BACKGROUND Misconceptions about men in nursing may influence recruitment and retention, further perpetuating the gender diversity imbalance in the nursing workforce. Identifying misconceptions and implementing early intervention strategies to address these deep-rooted stereotypes remain challenging but is considered critical to support students who are commencing a nursing career. OBJECTIVE To develop and evaluate the psychometric properties of the 'Gender Misconceptions of meN in nursIng (GEMINI) Scale. DESIGN Cross-sectional survey. METHODS Pre-registration nursing students enrolled in undergraduate nursing programs across 16 nursing institutions in Australia were surveyed from July to September 2021. The 17-item self-report GEMINI Scale measured the gender misconceptions of men in nursing. RESULTS Of the 1410 completed surveys, data from 683 (45%) women were used for exploratory factor analysis showing a one factor structure, while data from 727 men (47%) were used for confirmatory factor analysis of the 17-item GEMINI Scale, which showed a good model fit. The scale demonstrated high internal consistency (Cronbach's alpha of 0.892). Men were found to have higher gender misconceptions (p < 0.001) while respondents who: a) identified nursing as their first career choice (p = 0.002); b) were in their final year of program enrolment (p = 0.016); and c) engaged in health-related paid work (p = 0.002) had lower gender misconceptions. CONCLUSION The GEMINI Scale is a robust, valid, reliable, and easy to administer tool to assess misconceptions about men in nursing, which may potentially influence academic performance and retention. Identifying and addressing specific elements of misconceptions could inform targeted strategies to support retention and decrease attrition among these students. IMPACT STATEMENT Genderism harms nursing, as well as the men and women working in the profession. Recruitment and retention of men into nursing is needed to cultivate male role models and diversify the workforce, however this is impeded by negative portrayals in popular culture and misconceptions entrenched in society.
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Affiliation(s)
- Jed Montayre
- Senior Lecturer, Western Sydney University, School of Nursing and Midwifery, Locked Bag 1797, Penrith NSW 2751, , Twitter: @JedMontayre
| | | | - Kasia Bail
- Associate Professor, University of Canberra, Discipline of Nursing, Ageing Research Group,
| | - Kate Barnewall
- Lecturer, Griffith University, School of Nursing and Midwifery,
| | - Tania Beament
- Director International, Edith Cowan University, School of Nursing and Midwifery,
| | - Steve Campbell
- Professor of Clinical Redesign, Nursing, University of Tasmania, School of Nursing, College of Health and Medicine,
| | - Cathy Carmody
- Lecturer, Griffith University, School of Nursing and Midwifery,
| | - Alex Chan
- Lecturer, University of Wollongong, School of Nursing,
| | - Frank Donnelly
- Head of School, University of Adelaide, Adelaide Nursing School,
| | - Jed Duff
- Chair of Nursing Royal Brisbane and Women's Hospital, Queensland University of Technology, Centre for Healthcare Transformation,
| | - Caleb Ferguson
- Associate Head of School (Research), University of Wollongong, School of Nursing,
| | - Jo Gibson
- Senior Lecturer - Nursing, University of Canberra, School of Nursing, Midwifery & Public Health,
| | - Peta Harbour
- Deputy Head of School, Australian Catholic University, School of Nursing, Midwifery and Paramedicine,
| | - Colin J Ireland
- Lecturer, University of South Australia, Clinical and Health Sciences,
| | - Xian-Liang Liu
- Undergraduate Honours Academic Lead
- Charles Darwin University, College of Nursing and Midwifery,
| | - Patricia Luyke
- Associate Lecturer, University of Southern Queensland, School of Nursing and Midwifery,
| | - Della Maneze
- Research Associate, Western Sydney University, School of Nursing and Midwifery,
| | - Jo McDonall
- Director of Undergraduate Studies, Deakin University, School of Nursing and Midwifery,
| | - Lauren McTier
- Associate Head of School (Teaching and Learning), Deakin University, School of Nursing and Midwifery,
| | - Tameeka Mulquiney
- Lecturer, Charles Sturt University, School of Nursing, Paramedicine and Healthcare Sciences,
| | - Jane O'Brien
- Lecturer, University of Tasmania, School of Nursing, College of Health and Medicine,
| | - Lemuel J Pelentsov
- Program Director, University of South Australia, Clinical and Health Sciences,
| | - Lucie M Ramjan
- Associate Professor, Western Sydney University, School of Nursing and Midwifery,
| | - Natasha Reedy
- Bachelor of Nursing Program Director, University of Southern Queensland, School of Nursing and Midwifery,
| | - Gina M Richards
- Adjunct Lecturer, Edith Cowan University, School of Nursing and Midwifery,
| | - Michael A Roche
- Professor, University of Canberra, Faculty of Health, Adjunct Professor, University of Technology Sydney, School of Nursing and Midwifery,
| | - Brandon W Smith
- Research Assistant, Western Sydney University, School of Nursing and Midwifery,
| | - Jing-Yu Benjamin
- Associate Dean Research, Charles Darwin University, College of Nursing and Midwifery,
| | - Karen A Theobald
- Academic Lead Education, Queensland University of Technology, School of Nursing,
| | - Kathleen E Tori
- Associate Professor, University of Tasmania, School of Nursing,
| | - Peter Wall
- Lecturer, Murdoch University, College of Science, Health, Engineering and Education,
| | - Emily Wallis
- Senior Lecturer, University of Canberra, School of Nursing, Midwifery and Public Health,
| | - Luke Yokota
- Inaugural Chair, Australian College of Nursing, Men in Nursing Working Party,
| | - Joel Zugai
- Lecturer, The University of Notre Dame, Faculty of Medicine, Nursing and Midwifery and Health Sciences,
| | - Yenna Salamonson
- Professor, Western Sydney University, School of Nursing and Midwifery, Locked Bag 1797, Penrith NSW 2751, , Twitter: @salamonson
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McDonall J, Redley B, Livingston P, Hutchinson A, de Steiger R, Botti M. Implementation of a nurse-led multimedia intervention to increase patient participation in recovery following knee arthroplasty: Implementation study (Preprint). JMIR Hum Factors 2022; 9:e36959. [PMID: 35588363 PMCID: PMC9164095 DOI: 10.2196/36959] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Revised: 04/04/2022] [Accepted: 04/23/2022] [Indexed: 11/13/2022] Open
Abstract
Background Advances in digital technology and the use of multimedia platforms to deliver information provide clinicians with a unique opportunity to develop innovative ways to consistently provide high-quality, accessible, and evidence-based information to support patient participation. Introducing new technologies into everyday acute care clinical practice can be difficult. Objective The aim of this paper was to provide a description of an implementation strategy and the subsequent evaluation undertaken to examine the contextual factors important to the successful adoption of new technology by nurses in the context of acute postoperative care. Methods Implementation of the intervention and process evaluation was undertaken in 3 phases: phase 1, preimplementation stakeholder engagement and identification of barriers and enablers to implementation; phase 2, supported implementation of the intervention; and phase 3, evaluation of uptake, usability, and acceptability of the intervention in clinical practice. Results The outcomes of the implementation of the multimedia intervention in the context of acute postoperative care were positive. Of the 104 patients in the intervention group, 103 (99%) received the intervention. All 103 patients completed the 8-item intervention questionnaire and 93.3% (97/103) were interviewed on day 3 to evaluate usability, uptake, and acceptability. Of these 97 patients, almost all (n=94, 91%) found the program easy to use and most (n=64, 62%) could view the MyStay Total Knee Replacement program as often as they wanted. The findings also suggest that the time to implement the program was minimal (5-10 minutes). Collaboration with nurses and patients before and during implementation to identify potential barriers to successful implementation of the intervention was essential to develop timely strategies to overcome these barriers. To ensure end-user engagement, careful consideration was given to nurses’ views on who was responsible for facilitating this intervention. Conclusions The findings provide evidence that the structured implementation of the multimedia intervention was robust and successful in terms of patient participant recruitment and application; however, it was difficult to assess the level of engagement by nurse clinicians with the program. Trial Registration Australian New Zealand Clinical Trials Registry (ANZCTR) ACTRN12614000340639; https://anzctr.org.au/Trial/Registration/TrialReview.aspx?ACTRN=12614000340639
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Affiliation(s)
- Jo McDonall
- School of Nursing and Midwifery, Faculty of Health, Deakin University, Geelong, Australia
| | - Bernice Redley
- School of Nursing and Midwifery, Faculty of Health, Deakin University, Geelong, Australia
- Centre for Quality and Patient Safety Research-Monash Health Partnership, Deakin University, Geelong, Australia
| | - Patricia Livingston
- School of Nursing and Midwifery, Faculty of Health, Deakin University, Geelong, Australia
| | - Ana Hutchinson
- School of Nursing and Midwifery, Faculty of Health, Deakin University, Geelong, Australia
- Centre for Quality and Patient Safety Research-Epworth HealthCare Partnership, Geelong, Australia
| | - Richard de Steiger
- Epworth HealthCare, Epworth Victor Smorgon Chair of Surgery, Department of Surgery, Richmond, Australia
- The University of Melbourne, Melbourne, Australia
| | - Mari Botti
- School of Nursing and Midwifery, Faculty of Health, Deakin University, Geelong, Australia
- Centre for Quality and Patient Safety Research-Epworth HealthCare Partnership, Geelong, Australia
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Wynter K, Redley B, Holton S, Manias E, McDonall J, McTier L, Hutchinson AM, Kerr D, Lowe G, Phillips NNM, Rasmussen B. Depression, anxiety and stress among Australian nursing and midwifery undergraduate students during the COVID-19 pandemic: a cross-sectional study. Int J Nurs Educ Scholarsh 2021; 18:ijnes-2021-0060. [PMID: 34889085 DOI: 10.1515/ijnes-2021-0060] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2021] [Accepted: 11/17/2021] [Indexed: 11/15/2022]
Abstract
OBJECTIVES To assess depression, anxiety and stress among undergraduate nursing and midwifery students during the COVID-19 pandemic, and identify socio-demographic and educational characteristics associated with higher depression, anxiety and stress scores. METHODS Cross-sectional study during August-September 2020, using an anonymous, online, self-administered survey. E-mail invitations with a survey link were sent to 2,907 students enrolled in the Bachelor of Nursing suite of courses, offered across four campuses of a single university in Victoria, Australia. Depression, anxiety and stress were assessed using the DASS-21. Data on socio-demographic and educational characteristics, self-rated physical health and exposure to COVID-19 were also collected. DASS-21 subscale scores were compared with existing data for various pre-pandemic and COVID-19 samples. Multiple regression was used to investigate factors associated with higher scores on depression, anxiety and stress subscales. RESULTS The response rate was 22% (n=638). Mean scores on all DASS-21 subscales were significantly higher (p<0.001) than means from all comparative sample data. The proportions of students reporting moderate to severe symptoms of depression, anxiety and stress were 48.5%, 37.2% and 40.2% respectively. Being a woman, being younger, having completed more years of study and having poorer self-rated general health were all significantly associated (p<0.05) with higher scores on at least one DASS-21 subscale. CONCLUSIONS Almost half of participants reported at least moderate symptoms of depression; more than a third reported at least moderate symptoms of anxiety or stress. Poor psychological wellbeing can impact students' successful completion of their studies and therefore, has implications for nursing and midwifery workforce recruitment and retention. During and after pandemics, universities should consider screening undergraduate students not only for anxiety and stress, but also for depression. Clear, low-cost referral pathways should be available, should screening indicate that further diagnosis or treatment is required.
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Affiliation(s)
- Karen Wynter
- School of Nursing and Midwifery, The Centre for Quality and Patient Safety Research in the Institute for Health Transformation, Deakin University, Geelong, VIC, Australia.,The Centre for Quality and Patient Safety Research - Western Health Partnership, St Albans, VIC, Australia
| | - Bernice Redley
- School of Nursing and Midwifery, The Centre for Quality and Patient Safety Research in the Institute for Health Transformation, Deakin University, Geelong, VIC, Australia.,The Centre for Quality and Patient Safety Research - Monash Health Partnership, Monash Health, VIC, Australia
| | - Sara Holton
- School of Nursing and Midwifery, The Centre for Quality and Patient Safety Research in the Institute for Health Transformation, Deakin University, Geelong, VIC, Australia.,The Centre for Quality and Patient Safety Research - Western Health Partnership, St Albans, VIC, Australia
| | - Elizabeth Manias
- School of Nursing and Midwifery, The Centre for Quality and Patient Safety Research in the Institute for Health Transformation, Deakin University, Geelong, VIC, Australia
| | - Jo McDonall
- School of Nursing and Midwifery, The Centre for Quality and Patient Safety Research in the Institute for Health Transformation, Deakin University, Geelong, VIC, Australia
| | - Lauren McTier
- School of Nursing and Midwifery, The Centre for Quality and Patient Safety Research in the Institute for Health Transformation, Deakin University, Geelong, VIC, Australia
| | - Alison M Hutchinson
- School of Nursing and Midwifery, The Centre for Quality and Patient Safety Research in the Institute for Health Transformation, Deakin University, Geelong, VIC, Australia.,The Centre for Quality and Patient Safety Research - Monash Health Partnership, Monash Health, VIC, Australia
| | - Debra Kerr
- School of Nursing and Midwifery, The Centre for Quality and Patient Safety Research in the Institute for Health Transformation, Deakin University, Geelong, VIC, Australia
| | - Grainne Lowe
- School of Nursing and Midwifery, The Centre for Quality and Patient Safety Research in the Institute for Health Transformation, Deakin University, Geelong, VIC, Australia
| | - Nicole Nikki M Phillips
- School of Nursing and Midwifery, The Centre for Quality and Patient Safety Research in the Institute for Health Transformation, Deakin University, Geelong, VIC, Australia
| | - Bodil Rasmussen
- School of Nursing and Midwifery, The Centre for Quality and Patient Safety Research in the Institute for Health Transformation, Deakin University, Geelong, VIC, Australia.,The Centre for Quality and Patient Safety Research - Western Health Partnership, St Albans, VIC, Australia.,Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.,Steno Diabetes Center, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark
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Rasmussen B, Hutchinson A, Lowe G, Wynter K, Redley B, Holton S, Manias E, Phillips N, McDonall J, McTier L, Kerr D. The impact of covid-19 on psychosocial well-being and learning for australian nursing and midwifery undergraduate students: a cross-sectional survey. Nurse Educ Pract 2021; 58:103275. [PMID: 34922092 PMCID: PMC8662551 DOI: 10.1016/j.nepr.2021.103275] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Revised: 10/20/2021] [Accepted: 12/07/2021] [Indexed: 02/07/2023]
Abstract
Aim To explore the impact of COVID-19 on psychosocial well-being and learning for nursing and midwifery undergraduate students in an Australian university. Background The World Health Organization has reported a substantial psychological impact of COVID-19 on healthcare professionals to date. Evidence is lacking, however, regarding university nursing and midwifery students of the pandemic and its impact on their educational preparation and/or clinical placement during the COVID-19 pandemic. Design Cross-sectional survey of nursing and midwifery undergraduate students enrolled in the Bachelor of Nursing suite of courses from the study institution in August- September 2020. Methods A cross-sectional self-administered anonymous online survey was distributed to current nursing and midwifery undergraduate students. The survey included three open-ended questions; responses were thematically analysed. Results Of 2907 students invited, 637 (22%) responded with 288 of the respondents (45%) providing a response to at least one of the three open-ended questions. Three major themes associated with the impact of the pandemic on psychosocial well-being and learning were identified: psychosocial impact of the pandemic, adjustment to new modes of teaching and learning, and concerns about course progression and career. These themes were underpinned by lack of motivation to study, feeling isolated, and experiencing stress and anxiety that impacted on students’ well-being and their ability to learn and study. Conclusions Students were appreciative of different and flexible teaching modes that allowed them to balance their study, family, and employment responsibilities. Support from academic staff and clinical facilitators/mentors combined with clear and timely communication of risk management related to personal protective equipment (PPE) in a healthcare facility, were reported to reduce students’ stress and anxiety. Ways to support and maintain motivation among undergraduate nursing and midwifery students are needed.
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Affiliation(s)
- Bodil Rasmussen
- School of Nursing and Midwifery; Centre for Quality and Patient Safety Research in the Institute for Health Transformation, Deakin University, 1 Gheringhap St, Geelong, VIC 3220, Australia; The Centre for Quality and Patient Safety Research in the Institute of Health Transformation -Western Health Partnership, Western Health, Furlong Road, St Albans VIC 3021 Australia; Faculty of Health and Medical Sciences, University of Copenhagen Blegdamsvej 3B, 2200 Copenhagen, Denmark; Faculty of Health Sciences, University of Southern Denmark and Steno Diabetes Center, Campusvej 55, Odense M, DK-5230, Denmark.
| | - Alison Hutchinson
- School of Nursing and Midwifery; Centre for Quality and Patient Safety Research in the Institute for Health Transformation, Deakin University, 1 Gheringhap St, Geelong, VIC 3220, Australia; The Centre for Quality and Patient Safety Research in the Institute of Health Transformation -Monash Health Partnership, Monash Health, 246 Clayton Road, Clayton, VIC 3168, Australia.
| | - Grainne Lowe
- School of Nursing and Midwifery; Centre for Quality and Patient Safety Research in the Institute for Health Transformation, Deakin University, 1 Gheringhap St, Geelong, VIC 3220, Australia.
| | - Karen Wynter
- School of Nursing and Midwifery; Centre for Quality and Patient Safety Research in the Institute for Health Transformation, Deakin University, 1 Gheringhap St, Geelong, VIC 3220, Australia; The Centre for Quality and Patient Safety Research in the Institute of Health Transformation -Western Health Partnership, Western Health, Furlong Road, St Albans VIC 3021 Australia.
| | - Bernice Redley
- School of Nursing and Midwifery; Centre for Quality and Patient Safety Research in the Institute for Health Transformation, Deakin University, 1 Gheringhap St, Geelong, VIC 3220, Australia; The Centre for Quality and Patient Safety Research in the Institute of Health Transformation -Monash Health Partnership, Monash Health, 246 Clayton Road, Clayton, VIC 3168, Australia.
| | - Sara Holton
- School of Nursing and Midwifery; Centre for Quality and Patient Safety Research in the Institute for Health Transformation, Deakin University, 1 Gheringhap St, Geelong, VIC 3220, Australia; The Centre for Quality and Patient Safety Research in the Institute of Health Transformation -Western Health Partnership, Western Health, Furlong Road, St Albans VIC 3021 Australia.
| | - Elizabeth Manias
- School of Nursing and Midwifery; Centre for Quality and Patient Safety Research in the Institute for Health Transformation, Deakin University, 1 Gheringhap St, Geelong, VIC 3220, Australia.
| | - Nikki Phillips
- School of Nursing and Midwifery; Centre for Quality and Patient Safety Research in the Institute for Health Transformation, Deakin University, 1 Gheringhap St, Geelong, VIC 3220, Australia.
| | - Jo McDonall
- School of Nursing and Midwifery; Centre for Quality and Patient Safety Research in the Institute for Health Transformation, Deakin University, 1 Gheringhap St, Geelong, VIC 3220, Australia.
| | - Lauren McTier
- School of Nursing and Midwifery; Centre for Quality and Patient Safety Research in the Institute for Health Transformation, Deakin University, 1 Gheringhap St, Geelong, VIC 3220, Australia.
| | - Debra Kerr
- School of Nursing and Midwifery; Centre for Quality and Patient Safety Research in the Institute for Health Transformation, Deakin University, 1 Gheringhap St, Geelong, VIC 3220, Australia.
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McDonall J, Heynsbergh N, Oxley S, Botti M, Hutchinson A. Opportunities for patients to engage in postoperative recovery following cardiac surgery: A systematic narrative review. Patient Educ Couns 2020; 103:2095-2106. [PMID: 32381287 DOI: 10.1016/j.pec.2020.04.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/02/2019] [Revised: 03/05/2020] [Accepted: 04/07/2020] [Indexed: 06/11/2023]
Abstract
OBJECTIVE To compare patient booklets with clinical guidelines and care pathways to assess: gaps in content and depth of information delivered, opportunities for patients participation and to review the trajectory of care to inform recovery. METHODS A systematic review of the grey literature was conducted using Google search engine and a variety of terms related to cardiac surgery, patient outcomes and recovery pathways. Patient books and care pathways were obtained from major hospitals in Melbourne. Resources were included if they were published between January 2013-August 2018 and written in English. RESULTS A total of 31 resources were included in the review, (n = 14 patient booklets, n = 17 clinician guides). Twenty-one topics of recovery were identified. Patient booklets provided information on more topics of recovery than clinician guides (50 % and 24 % respectively). Clinician guides provided more depth on information on topics of recovery than patient booklets (85 % and 73 % respectively). The majority of patient booklets outlined patient participation was in five topics of recovery. CONCLUSIONS Gaps in the type and depth of information exist between patient and clinician guidelines. Clearer guidelines on how patients can participate in care are needed. PRACTICE IMPLICATIONS Nurses are key drivers in facilitating patient participation in postoperative recovery.
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Affiliation(s)
- Jo McDonall
- Faculty of Health, School of Nursing and Midwifery, Centre for Quality and Patient Safety Research, Deakin University, Melbourne, 3220 Australia
| | - Natalie Heynsbergh
- Faculty of Health, School of Nursing and Midwifery, Centre for Quality and Patient Safety Research, Deakin University, Melbourne, 3220 Australia.
| | | | - Mari Botti
- Faculty of Health, School of Nursing and Midwifery, Centre for Quality and Patient Safety Research, Deakin University, Melbourne, 3220 Australia; Epworth HealthCare, Bridge Road, Melbourne, 3121 Australia
| | - Anastasia Hutchinson
- Faculty of Health, School of Nursing and Midwifery, Centre for Quality and Patient Safety Research, Deakin University, Melbourne, 3220 Australia; Epworth HealthCare, Bridge Road, Melbourne, 3121 Australia
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McDonall J, Hutchinson AF, Redley B, Livingston PM, Botti M. Usability and feasibility of multimedia interventions for engaging patients in their care in the context of acute recovery: A narrative review. Health Expect 2019; 22:1187-1198. [PMID: 31778023 PMCID: PMC6882257 DOI: 10.1111/hex.12957] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2019] [Revised: 08/02/2019] [Accepted: 08/11/2019] [Indexed: 11/30/2022] Open
Abstract
PURPOSE The purpose of this narrative review was to examine the usability and feasibility of multimedia intervention as a platform to enable patient participation in the context of acute recovery and to discover what outcomes have been measured. DATA SOURCES A narrative review of primary research articles identified through a search of four electronic databases (MEDLINE, CINAHL, EMBASE and PsycInfo) identified peer-reviewed research evidence published in English language with no limitation placed on time period or publication type. Two authors independently assessed articles for inclusion. From the 277 articles identified through the search, 10 papers reporting the outcomes of seven studies were included in this review. REVIEW METHODS Articles were independently assessed for quality and relevance by two authors. The most appropriate method for data synthesis for this review was a narrative synthesis. RESULTS From the narrative synthesis of study outcomes, two findings emerged as follows: (a) multimedia interventions are feasible and usable in the context of acute care, and (b) multimedia interventions can improve patients' perception of care-related knowledge. Identified gaps included a lack of evidence in relation to the effect of interventions on enhancing patients' ability to participate in their care and the impact on patients' health-related outcomes. CONCLUSIONS In conclusion, there is some evidence of the feasibility and usability of multimedia interventions in acute care. That is, patients can use these types of platforms in this context and are satisfied with doing so. Multimedia platforms have a role in the delivery of information for patients during acute recovery; however, the effectiveness of these platforms to engage and enhance patients' capability to participate in their recovery and the impact on outcomes needs to be rigorously evaluated.
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Affiliation(s)
- Jo McDonall
- Faculty of Health, School of Nursing and Midwifery, Centre for Quality and Patient Safety ResearchDeakin UniversityGeelongVicAustralia
| | - Anastasia F. Hutchinson
- Faculty of Health, School of Nursing and Midwifery, Centre for Quality and Patient Safety ResearchDeakin UniversityGeelongVicAustralia
| | - Bernice Redley
- Faculty of Health, School of Nursing and Midwifery, Centre for Quality and Patient Safety ResearchDeakin UniversityGeelongVicAustralia
| | - Patricia M. Livingston
- Faculty of Health, School of Nursing and Midwifery, Centre for Quality and Patient Safety ResearchDeakin UniversityGeelongVicAustralia
| | - Mari Botti
- Faculty of Health, School of Nursing and Midwifery, Centre for Quality and Patient Safety ResearchDeakin UniversityGeelongVicAustralia
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McDonall J, de Steiger R, Reynolds J, Redley B, Livingston PM, Hutchinson AF, Botti M. Patient activation intervention to facilitate participation in recovery after total knee replacement (MIME): a cluster randomised cross-over trial. BMJ Qual Saf 2019; 28:782-792. [PMID: 30975730 PMCID: PMC6860682 DOI: 10.1136/bmjqs-2018-008975] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2018] [Revised: 03/15/2019] [Accepted: 03/18/2019] [Indexed: 11/28/2022]
Abstract
Background Patient participation in care is a fundamental element of safe and high-quality healthcare with the potential to enhance health outcomes and improve patient satisfaction. Objectives To test the efficacy of a clinician-facilitated, bedside multimedia (MyStay) intervention designed to support patient participation in their recovery after total knee replacement surgery. The primary outcome was patients’ reported worst pain intensity on postoperative day 3. Secondary outcomes were patient activation, length of hospital stay, knee function and satisfaction with care. Methods Unmasked, cluster randomised, four-period cross-over trial with a simultaneous process evaluation within in a large private, not-for-profit, metropolitan teaching hospital. Statistical analyses used linear mixed models with random effects for wards, cohorts within wards and patients within cohorts and fixed effects for treatment and period. Results 241 patients were recruited between March 2014 and June 2015. Patients were admitted to intervention (104) or control (137) clusters. Intervention group patients reported significantly lower mean pain intensity scores on postoperative day 3 (6.1 vs 7.1, 95% CI −1.94 to −0.08, p=0.04). The percentages of patients who reported severe pain (score ≥7) were 43.7% and 64.2% in the intervention and control groups, respectively (χ2 9.89, p=0.002; generalised linear mixed model Wald test, p=0.05). Intervention group patients on average stayed in hospital one less day (5.3 vs 6.3, 95% CI 0.05 to 1.94, p=0.04), reported higher activation (45.1% vs 27.1% at level 4 activation) (p=0.04) and higher overall satisfaction with care (9.3 vs 8.6, 95% CI 1.09 to 0.219, p=0.01), and were more likely to refer family or friends to the health service (9.3 vs 8.7, 95% CI 1.07 to 0.13, p=0.02). Conclusion The clinician-facilitated, MyStay bedside multimedia intervention enhanced patients’ activation and participation in their care after surgery; pain intensity and length of stay in hospital were reduced and patients were more satisfied with their care. Trial registration ACTRN12614000340639 (http://www.anzctr.org.au/default.aspx).
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Affiliation(s)
- Jo McDonall
- Faculty of Health, School of Nursing and Midwifery, Centre for Quality and Safety Research, Deakin University, Geelong, Victoria, Australia
| | - Richard de Steiger
- Department of Surgery, Epworth Healthcare, The University of Melbourne, Melbourne, Victoria, Australia
| | - John Reynolds
- Faculty of Medicine Nursing and Health Sciences, Monash University, Clayton, Victoria, Australia
| | - Bernice Redley
- Faculty of Health, School of Nursing and Midwifery, Centre for Quality and Safety Research, Deakin University, Geelong, Victoria, Australia
| | - Patricia M Livingston
- Faculty of Health, School of Nursing and Midwifery, Deakin University, Geelong, Victoria, Australia
| | - Anastasia F Hutchinson
- Faculty of Health, School of Nursing and Midwifery, Centre for Quality and Safety Research, Epworth Partnership, Deakin University, Geelong, Victoria, Australia
| | - Mari Botti
- Faculty of Health, School of Nursing and Midwifery, Centre for Quality and Safety Research, Epworth Partnership, Deakin University, Geelong, Victoria, Australia
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McDonall J, de Steiger R, Reynolds J, Redley B, Livingston P, Botti M. Patient participation in postoperative care activities in patients undergoing total knee replacement surgery: Multimedia Intervention for Managing patient Experience (MIME). Study protocol for a cluster randomised crossover trial. BMC Musculoskelet Disord 2016; 17:294. [PMID: 27431239 PMCID: PMC4950599 DOI: 10.1186/s12891-016-1133-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2015] [Accepted: 06/23/2016] [Indexed: 12/05/2022] Open
Abstract
Background Patient participation is an important indicator of quality care. Currently, there is little evidence to support the belief that participation in care is possible for patients during the acute postoperative period. Previous work indicates that there is very little opportunity for patients to participate in care in the acute context. Patients require both capability, in terms of having the required knowledge and understanding of how they can be involved in their care, and the opportunity, facilitated by clinicians, to engage in their acute postoperative care. This cluster randomised crossover trial aims to test whether a multimedia intervention improves patient participation in the acute postoperative context, as determined by pain intensity and recovery outcomes. Methods/design A total of 240 patients admitted for primary total knee replacement surgery will be invited to participate in a cluster randomised, crossover trial and concurrent process evaluation in at least two wards at a major non-profit private hospital in Melbourne, Australia. Patients admitted to the intervention ward will receive the multimedia intervention daily from Day 1 to Day 5 (or day of discharge, if prior). The intervention will be delivered by nurses via an iPad™, comprising information on the goals of care for each day following surgery. Patients admitted to the control ward will receive usual care as determined by care pathways currently in use across the organization. The primary endpoint is the “worst pain experienced in the past 24 h” on Day 3 following TKR surgery. Pain intensity will be measured using the numerical rating scale. Secondary outcomes are interference of pain on activities of daily living, length of stay in hospital, function and pain following TKR surgery, overall satisfaction with hospitalisation, postoperative complications and hospital readmission. Discussion The results of this study will contribute to our understanding of the effectiveness of interventions that provide knowledge and opportunity for patient participation during postoperative in-hospital care in actually increasing participation, and the impact of participation on patient outcomes. The results of this study will also provide data about the barriers and enablers to participation in the acute care context. Trial registration Australian New Zealand Clinical Trials Registry ACTRN12614000340639 Trial Registration date 31/03/2014.
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Affiliation(s)
- Jo McDonall
- School of Nursing and Midwifery, Deakin University, Geelong, Australia.
| | - Richard de Steiger
- Surgery Epworth HealthCare, The University of Melbourne, Parkville, Australia
| | - John Reynolds
- Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, Australia
| | - Bernice Redley
- School of Nursing and Midwifery, Deakin University, Geelong, Australia
| | | | - Mari Botti
- School of Nursing and Midwifery, Deakin University, Geelong, Australia.,Epworth/Deakin Centre for Nursing Research, Epworth HealthCare, Melbourne, Australia
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