Australian Health Care Workforce Research Articles

Investigating consumer preferences and experiences of telehealth services in Australian allied health practice: a study protocol

IntroductionTelehealth service provision and uptake has rapidly increased since the COVID-19 pandemic, allowing healthcare to be delivered safely and reducing non-essential face-to-face (F2F) contact. In Australia, the expansion of subsidisation...

Healthcare worker access to molnupiravir: A case series.

Molnupiravir, an oral antiviral shown to reduce COVID-19 severity, is available in Australia via the Pharmaceutical Benefits Scheme (PBS) for treatment of mild-moderate COVID-19. For people less than 70 years of age it is only available with risk factors for severe disease, hence the majority of healthcare workers do not qualify. Currently, Australian health services are under considerable strain due to COVID-related staff shortages. Thirty staff members of a tertiary hospital, not eligible under the PBS, were offered molnupiravir within the first five days of COVID-19 illness. Their median age was 43 years, and 73% were female. All completed treatment with rates of adverse events that were low and comparable with clinical trial data. The reported duration of illness ranged from 1-16 days with a median of four days. A negative rapid antigen test on the final day of treatment was reported in 81% of people, and 73% reported being well enough to return to work at the completion of mandatory isolation. Only 22% of people reported transmission in their household after they commenced treatment. The implementation of a policy allowing access to molnupiravir outside of PBS recommendations for healthcare workers with mild-moderate COVID-19 may have important individual benefits to workers health and wellbeing and help alleviate the acute staff shortages experienced currently by the Australian healthcare workforce.

Transition experiences of Middle Eastern midwives into Australian practice: A multiple case narrative study.

To explore transition experiences of Middle Eastern qualified midwives into practice in Australia. This was a qualitative study using multiple case narrative approach underpinned by structuration theory. A total of 19 Middle Eastern qualified midwives from different states of Australia participated in this study. Individual semi-structured interviews were conducted between November 2020 and September 2021, digitally recorded and then transcribed. Transcriptions were analysed in three stages, with three main categories generated in the second stage and a core category that was developed in third. Entering the Australian workforce, Middle Eastern qualified midwives had to reframe their professional identities to fit the new system by adjusting to three aspects of the practice, including preparation for practice, scope of practice and context of practice. While they were prepared by medically oriented curricula, worked in systems that had limitations for midwives to practise in antenatal and postnatal and lacked regulation standards, they learned to practise autonomously in their full scope in a standardized context in Australia. Middle Eastern qualified midwives in Australia re-evaluated their practice in their home countries, realized the gaps and adjusted to new ways of practising in Australia. To effectively use the potential of Middle Eastern midwives for workforce sustainability in Australia, support should be available to enable them to develop the necessary competencies for safe practice in Australia including provision of context-specific transition programmes prior to registration and supporting mentorship after their integration into the Australian healthcare workforce. Patient or public contribution does not apply to this study as its purpose was to explore the transition experiences of Middle Eastern qualified midwives themselves.

Protecting the Herd: Why Pharmacists Matter in Mass Vaccination.

Background: The COVID-19 pandemic is ongoing. The unprecedented challenges worldwide implore the urgent development of a safe and effective COVID-19 vaccine. Globally, pharmacists have been delivering important public health services as part of the COVID-19 response. It remains to be seen what role they will play once a vaccine is available. This review examines herd immunity and the potential role of the pharmacy profession in mass vaccination against COVID-19, particularly within the Australian context. Aim: A literature review was conducted to review the global development of COVID-19 vaccines, and the Australian healthcare workforce capability and existing policy for mass vaccination and the potential role of the pharmacist. Method: ScienceDirect, Scopus, The National Centre for Biotechnology Information (NCBI), Wiley Online Library, PubMed, and Google Scholar were used to search for relevant literature using keywords COVID-19, vaccines, immunisation, herd immunity, pandemic, pharmacist and Australian healthcare. Results: A large portion of the literature was journal articles, and information from governmental and international bodies such as the World Health Organisation were often referenced. Over 20 million Australians need to be immunised through vaccination or acquire immunity through natural infection for the country to achieve herd immunity for COVID-19. When examining state and territory pandemic plans, pharmacists are underutilised. Modifying legislation to allow pharmacists to administer approved COVID-19 vaccines will enable a trained and skilled workforce to be deployed to increase the rate of mass vaccination. Conclusion: In preparation for a successful COVID-19 vaccine, the Australian Government must consider various elements in their vaccination policy. This includes the estimated herd immunity threshold, methods of vaccine delivery, vaccine clinic locations, staffing arrangements and training, and strategies for vaccine prioritisation. Pharmacists can and should play a key role in the roll out of mass COVID-19 vaccination.

Experiences of internationally qualified registered nurses enrolled in a bridging program in Australia: A pilot study

BackgroundThe recruitment of internationally qualified registered nurses (IQNs) is one strategy to meet Australia’s healthcare needs. New Australian Standards require some IQNs to complete an approved bridging program run by an eligible higher education institution in Australia. Little is known about the experiences of the IQNs enrolled in these bridging programs or their intention to remain in the workforce. AimThe aim of this pilot study was to investigate the experiences of IQNs enrolled in an approved bridging program and explore their intention to remain and seek employment in the Australian healthcare system. MethodsStudents enrolled in the Graduate Certificate in Australian Nursing program for internationally qualified registered nurses at a regional Australian university were invited to participate. A longitudinal, mixed-methods, exploratory design was used. Participants completed the Six-dimension Scale of Nursing Performance (Schwirian, 1978) and the Casey-Fink Graduate Nurse Experience Survey (Casey et al., 2004) pre, and post-program, and also participated in post-program focus groups. FindingsThe program met participant expectations, provided confidence in clinical practice and perceived competence, particularly in the leadership domain. However, the cultural differences and expectations in nursing and academia experienced by participants require further investigation and intervention. Over time, the participants experienced stress related to social and financial issues, with the greatest concern around gaining employment. All participants indicated their intention to remain and seek employment in the Australian healthcare system. DiscussionIQNs enrolled in approved bridging programs intend to remain in the workforce. Consideration of how to support IQNs experiencing social and financial stress, and achieve successful employment post program is warranted. ConclusionA transition to professional practice program may support the integration of IQNs into the Australian healthcare workforce.

Enhancing the Capacity of the Australian Health Care Workforce to Support Veterans’ Mental Health: A Collaborative Interdisciplinary Approach

Abstract Introduction Military personnel and veterans can have higher rates of mental health problems than the general population, but are no more likely to receive appropriate mental health care. A lack of experience among Australia’s mental health workforce in treating veteran-specific issues has been identified, pointing to a need for strategies to strengthen the workforce capacity. To this end, the Department of Veteran’s Affairs joined with the Mental Health Professionals Network (MHPN) to produce and deliver a series of veteran-specific webinars for health professionals working with military personnel, veterans and their families. Materials and Method Five webinars were produced and delivered between August 2016 and July 2017. Each involved a panel of health professionals with content expertise and was facilitated by a nationally recognized expert in veteran mental health. Each webinar was evaluated using an online survey to address whether learning needs were achieved, likely improvements to work practice, and improvements in knowledge of and confidence in treating veteran mental health issues. Results Of the 5,127 attendees across the five webinars, registration data was collected for 4,809 (94%) and post-webinar data for 3,334 (70%) of registrants. Of these, over 90% indicated that their learning objectives were achieved, that the content was relevant to their practice, and that their work practices would be improved as a result of their participation. Further, almost three quarters reported increased knowledge and skills, and two-thirds increased confidence in treating veterans’ mental health needs. Conclusions The Veterans’ webinar series was effective in engaging a large number and a wide range of professionals working in mental health care in Australia, underscoring the strength of MHPN’s initiatives in terms of scale and reach. With its emphasis on interdisciplinary practice and collaborative care, MHPN is well-placed to continue to support Australia’s mental health workforce.

Exploring healthcare professionals' understanding and experiences of artificial intelligence technology use in the delivery of healthcare: An integrative review.

The integration of artificial intelligence (AI) into our digital healthcare system is seen as a significant strategy to contain Australia's rising healthcare costs, support clinical decision making, manage chronic disease burden and support our ageing population. With the increasing roll-out of 'digital hospitals', electronic medical records, new data capture and analysis technologies, as well as a digitally enabled health consumer, the Australian healthcare workforce is required to become digitally literate to manage the significant changes in the healthcare landscape. To ensure that new innovations such as AI are inclusive of clinicians, an understanding of how the technology will impact the healthcare professions is imperative. In order to explore the complex phenomenon of healthcare professionals' understanding and experiences of AI use in the delivery of healthcare, an integrative review inclusive of quantitative and qualitative studies was undertaken in June 2018. One study met all inclusion criteria. This study was an observational study which used a questionnaire to measure healthcare professional's intrinsic motivation in adoption behaviour when using an artificially intelligent medical diagnosis support system (AIMDSS). The study found that healthcare professionals were less likely to use AI in the delivery of healthcare if they did not trust the technology or understand how it was used to improve patient outcomes or the delivery of care which is specific to the healthcare setting. The perception that AI would replace them in the healthcare setting was not evident. This may be due to the fact that AI is not yet at the forefront of technology use in healthcare setting. More research is needed to examine the experiences and perceptions of healthcare professionals using AI in the delivery of healthcare.

Beyond the pipeline: a critique of the discourse surrounding the development of an Indigenous primary healthcare workforce in Australia.

A central strategy in addressing health disparities experienced by Indigenous people has been based on a concern with workforce improvement. In this paper, the Indigenous Australian healthcare workforce literature since 1977 is reviewed and its scope of concern, as being often limited to questions of 'supply', is critiqued. The pipeline metaphor, whether used explicitly or implied, regularly focuses attention on closing the gap on Indigenous representation within the health workforce. The exception though is the discourse concerning Indigenous Health Workers (IHWs), where questions concerning the legitimacy of the role continue to abound within a workforce hierarchy where community knowledge, though shown to be crucial to culturally safe health service provision, is trumped by the other health professions whose knowledges and legitimacy are not in question. This contrast exemplifies the need to examine the working of power not just 'supply'. The pipeline metaphor is disrupted with concerns about a range of other 'gaps' - gaps in the recognition of Indigenous knowledges, in organisational structures, in governance and in self-awareness by the health professions of their whiteness. As the health system continues to measure workforce development in terms of pipeline capacity, our study questions what happens beyond the pipeline.

Confronting the cultural challenge of the whiteness of nursing: Aboriginal registered nurses’ perspectives

This paper presents the findings of a study that interviewed Aboriginal nurses to explore their experiences of the whiteness of nursing. Despite concerted efforts to improve the health of Aboriginal Australians, it still remains equivalent to third world countries. One strategy identified to address this is to increase the participation rates of Aboriginal registered nurses within the Australian healthcare workforce. Presently Aboriginal nurses account for only a small percentage of the nursing workforce. While there has been research into the recruitment and retention strategies dedicated to improving the numbers of Aboriginal registered nurses, this paper focus on the experiences of Aboriginal registered nurses within Australia’s mainstream healthcare system, where they are exposed and subjected on a daily basis to the ‘whiteness of nursing.’

Confronting the cultural challenge of the whiteness of nursing: Aboriginal registered nurses' perspectives.

Abstract This paper presents the findings of a study that interviewed Aboriginal nurses to explore their experiences of the whiteness of nursing. Despite concerted efforts to improve the health of Aboriginal Australians, it still remains equivalent to third world countries. One strategy identified to address this is to increase the participation rates of Aboriginal registered nurses within the Australian healthcare workforce. Presently Aboriginal nurses account for only a small percentage of the nursing workforce. While there has been research into the recruitment and retention strategies dedicated to improving the numbers of Aboriginal registered nurses, this paper focus on the experiences of Aboriginal registered nurses within Australia's mainstream healthcare system, where they are exposed and subjected on a daily basis to the 'whiteness of nursing.'

Confronting the Cultural Challenge of the Whiteness of Nursing: Aboriginal Registered Nurses' Perspectives.

Abstract This paper presents the findings of a study that that interviewed Aboriginal nurses to explore their experiences of the whiteness of nursing. Despite concerted efforts to improve the health of Aboriginal Australians, it still remains equivalent to third world countries. One strategy to address this that has been identified is to increase the participation rates of Aboriginal registered nurses within the Australian healthcare workforce. Presently Aboriginal nurses account for only a small percentage of the nursing workforce. While there has been research into the recruitment and retention strategies dedicated to improving the numbers of Aboriginal registered nurses, this paper focus on the experiences of Aboriginal registered nurses within Australia's mainstream healthcare system, where they are exposed and subjected on a daily basis to the 'whiteness of nursing'.

Determining frameworks for interprofessional education and core competencies through collaborative consultancy: The CARE experience

It is claimed that an interprofessional approach to health care aims to provide optimal client care, reduce duplication of services, address gaps in service delivery and prevent adverse consequences to patients. Hence there is widespread international interest in interprofessional education in undergraduate programs. However, after employment in the Australian health care workforce, there is limited opportunity for this. The continued education and training of health professionals and other care workers frequently occurs in a climate where professional development is dominated by the existence of professional demarcations.In order to enhance interprofessional collaboration in health care practice and education, mechanisms to guide individual performance within a multi-professional health team are required. This paper presents both the process and outcomes of a consultancy undertaken in order to determine core competencies for collaborative interprofessional practice in a community and aged care service.

The status of Australian nurse practitioners: the second national census

To profile Australian nurse practitioners and their practice in 2009 and compare results with a similar 2007 census. METHODS; Self-administered questionnaire. A total of 293 nurse practitioners responded (response rate 76.3%). The majority were female (n=229, 81.2%); mean age was 47.3 years (s.d.=8.1). As in 2007, emergency nurse practitioners represented the largest clinical specialty (n=63, 30.3%). A majority practiced in a metropolitan area (n=133, 64.3%); a decrease from 2007. Consistent with 2007, only 71.5% (n=208) were employed as a nurse practitioner and 22.8% (n=46) were awaiting approval for some or all of their clinical protocols. Demographic data, allocations of tasks, and patterns of practice remained consistent with 2007 results. 'No Medicare provider number' (n=182, 91.0%), 'no authority to prescribe using the Pharmaceutical Benefits Scheme' (n=182, 89.6%) and 'lack of organisational support' (n=105, 52.2%) were reported as 'limiting' or 'extremely limiting' to practice. Our results demonstrate less than satisfactory uptake of the nurse practitioner role despite authorisation. Barriers constraining nurse practitioner practice reduced but remained unacceptably high. Adequate professional and political support is necessary to ensure the efficacy and sustainability of this clinical role.

Migration of nurses in Australia: where and why?

The Australian health care workforce has benefited from an increasing migration of nurses over the past decades. The nursing profession is the largest single health profession, making up over half of the Australian health care workforce. Migration ofnurses into the Australian nursing workforce impacts significantly on the size ofthe workforce and the capacity to provide health care to the Australian multicultural community. Migration of nurses plays an important role in providing a solution to the ongoing challenges of workforce attraction and retention, hence an understanding of the factors contributing to nurse migration is important. This paper will critically analyse factors reported to impact on migration of nurses to Australia, in particular in relation to: (1) globalisation; (2) Australian society and nursing workforce; and (3) personal reasons. The current and potential implications of nurse migration are not limited to the Australian health care workforce, but also extend to political, socioeconomic and other aspects in Australia.

Mood Change and Perception of Workload in Australian Midwives

Investigations of mood and workload in health care settings have focussed primarily on nurses and junior doctors. Given the critical shortfall in the Australian midwifery workforce, and the specialised nature of midwifery as an occupation, it is important to understand how mood and workload are experienced by midwives. Twenty midwives (18F, 2M) in an Australian metropolitan hospital completed logbooks assessing daily fluctuations in subjective mood and workload. Participants also provided information about history of psychopathology and sleep quality. Results revealed that midwives were relatively stable in terms of mood but did experience increased fear and decreased happiness when at work. Further, workload factors significantly predicted mood at work. Specifically, when participants felt that their work was more demanding and frustrating and required more effort, or when they felt that they could not accomplish all that was expected, mood was negatively influenced. This supports the connection between workload and negative mood change in healthcare. Given the potential for mood to influence a multitude of functions relevant to safety, performance and psychosocial wellbeing it is important to understand the factors which influence mood, particularly in light of the current shortfall in the Australian healthcare workforce.

Issues facing the future health care workforce: the importance of demand modelling.

This article examines issues facing the future health care workforce in Australia in light of factors such as population ageing. It has been argued that population ageing in Australia is affecting the supply of health care professionals as the health workforce ages and at the same time increasing the demand for health care services and the health care workforce.However, the picture is not that simple. The health workforce market in Australia is influenced by a wide range of factors; on the demand side by increasing levels of income and wealth, emergence of new technologies, changing disease profiles, changing public health priorities and a focus on the prevention of chronic disease. While a strong correlation is observed between age and use of health care services (and thus health care workforce), this is mediated through illness, as typified by the consistent finding of higher health care costs in the months preceding death.On the supply side, the health workforce is highly influenced by policy drivers; both national policies (eg funded education and training places) and local policies (eg work place-based retention policies). Population ageing and ageing of the health workforce is not a dominant influence. In recent years, the Australian health care workforce has grown in excess of overall workforce growth, despite an ageing health workforce. We also note that current levels of workforce supply compare favourably with many OECD countries. The future of the health workforce will be shaped by a number of complex interacting factors.Market failure, a key feature of the market for health care services which is also observed in the health care labour market – means that imbalances between demand and supply can develop and persist, and suggests a role for health workforce planning to improve efficiency in the health services sector. Current approaches to health workforce planning, especially on the demand side, tend to be highly simplistic. These include historical allocation methods, such as the personnel-to-population ratios which are essentially circular in their rationale rather than evidence-based. This article highlights the importance of evidence-based demand modelling for those seeking to plan for the future Australian health care workforce. A model based on population health status and best practice protocols for health care is briefly outlined.

Australian enrolled nurses have their say – Part 1: Teamwork and recognition

Nurses are a cornerstone to the Australian health care workforce and are under increasing pressure to respond to changes in health care demands, the redistribution of health care funding and shortages in nursing workforce availability and skill mix. It is in this context that the role and function of the enrolled nurse has come under recent scrutiny. This paper reports on the qualitative semi-structured interviews conducted as one aspect of an Australia wide multi-phased investigation of enrolled nursing practice and competency standards for this practice. In the reported phase, enrolled nurses from a variety of settings and from all states and territories participated in telephone interviews exploring their experiences of practice and the role of the enrolled nurse. Findings indicated various enabling and limiting influences on enrolled nurse role and function. In this paper two core themes of teamwork and recognition are described as they illustrate the rich interpersonal rewards of enrolled nursing and the significance of recognition by others of the enrolled nurse contribution to health care delivery. These themes are presented as an introduction to part two of this paper which reports more broadly on the dimensions of the enrolled nurse scope of practice.