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.