Nurses In Australia Research Articles

Hepatitis C elimination: amplifying the role of primary care nurses in Australia.

Background Australia's commitment to eliminate hepatitis C by 2030 is underpinned by the mobilisation of the primary care sector. Primary care nurses are well placed to contribute to achieving elimination given their unique access to people with/at risk of hepatitis C and their person-centred approach to care delivery. This study examines the enablers to primary care nurse involvement in elimination efforts. Methods Primary care nurses involved in the care of people with/at risk of hepatitis C were recruited through two national nursing organisations. Participants provided verbal consent to participate in an electronically recorded, semi-structured interview. Interview data were transcribed verbatim, coded and analysed using a thematic analysis. Results Sixteen interviews were conducted with nurses working in general practice, community health, alcohol and other drug services, and custodial settings, with the findings framed using a social-ecological model. The study identified individual attributes, such as empathy and advocacy for clients deemed 'too hard for everyone else'. Interpersonal enablers included participants' ability to effectively communicate with clients and colleagues, and using trusted professional relationships to improve client access to care. Public policy that addressed community factors, including stigma and confidentiality, were seen as supportive. Conclusions This study identified the critical and varied role primary care nurses play in hepatitis C elimination. Effective scale up of hepatitis C care involves recognising the pivotal role of primary care nurses, which will help to create an enabling environment that supports nurses to work to their full scope of practice and enhance their contribution to the elimination response.

Internationally qualified nurses' perspectives on transitioning specialty skills within Australia: A content analysis.

To explore internationally qualified nurses' perceptions regarding the facilitators and barriers to specialty skill transfer in Australia. The study utilised a descriptive research design with a cross-sectional survey. Data were collected from July to September 2022. A self-designed survey was distributed through social media, snowballing and nursing professional organisations. The survey included six open-ended questions which were analysed using thematic content analysis. Sixty-three participants completed the open-ended questions in the survey. The findings identified a range of facilitators (support, previous experience, self-agency) and barriers (systems barriers, bias/discrimination, being undervalued, lack of trust) to skill transition. Recognising and addressing facilitators and barriers, coupled with creating customised pathways for specialty skill integration, are essential for optimising the utilisation of specialised skills in internationally qualified nurses. This study aims to explore the barriers and facilitators involved in maximising skill utilisation among internationally qualified nurses in Australia. Identifying these barriers and facilitators is essential for improving patient care, as it will guide the development of strategies for safe nursing service delivery and the optimisation of skill usage. These findings hold significant implications for policymakers, healthcare organisations and nurses, providing valuable insights into how to address these obstacles and capitalise on the factors that make skill transfer smoother and more effective. Sixty-three internationally qualified nurses shared their experiences and opinions.

Examining workplace safety for remote area nurses in Australia: a cross-sectional descriptive study.

Australia's remote health sector has chronic understaffing issues and serves an isolated, culturally diverse population with a high burden of disease. Workplace health and safety (WHS) impacts the wellbeing and sustainability of the remote health workforce. Additionally, poor WHS contributes to burnout, high turnover of staff and reduced quality of care. The issue of poor WHS in Australian very remote primary health clinics was highlighted by the murder of remote area nurse (RAN) Gayle Woodford in 2016. Following her death, a national call for change led by peak bodies and Gayle's family resulted in the development of many WHS recommendations and strategies for the remote health sector. However, it is unclear whether they have been implemented. The aim of this study is to identify which WHS recommendations have been implemented, from the perspective of RANs. A cross-sectional online survey of 173 RANs was conducted during December 2020 and January 2021. The survey was open to all RANs who had worked in a very remote (MM 7 of the Modified Monash (MM) Model) primary health clinic in Australia more recently than January 2019. A convenience sampling approach was used. The survey tool was developed by the project team using a combination of validated tools and remote-specific workplace safety recommendations. Broad recommendations, such as having a safe clinic building, safe staff accommodation, local orientation, and 'never alone' policy, were broken down into specific safety criteria. These criteria were used to generate workplace safety scores to quantify how well each recommendation had been met, and clustered into the following domains: preparation of staff, safe work environment and safe work practices. Descriptive statistics were used and the safety scores between different states and territories were also compared. Overall, the average national workplace safety score was 53% (standard deviation (SD) 19.8%) of recommendations met in participants' most recent workplace, with median 38.5% (interquartile range (IQR) 15.4-61.5%) of staff preparation recommendations, median 59.4% (IQR 43.8-78.1%) of safe work environment recommendations, and median 50.0% (IQR 30.0-66.7%) of safe work practices recommendations met. Within domains, some recommendations had greater uptake than others, and the safety scores of different states/territories also varied. Significant variation was found between the Northern Territory (57.5%, SD 18.7%) and Queensland (41.7%, SD 16.7%) (p<0.01), and between South Australia (74.5%, IQR 35.9%) and Queensland (p<0.05). Last, many RANs were still expected to attend after-hours call-outs on their own, with only 64.1% (n=107/167) of participants reporting a 'never alone' policy or process in their workplace. The evidence from this study revealed that some recommended safety strategies had been implemented, but significant gaps remained around staff preparation, fatigue management and infrastructure safety. Ongoing poor WHS likely contributes to the persistently high turnover of RANs, negatively affecting the quality and continuity of health care in remote communities. Variation in safety scores between regions warns of a fragmentation of approaches to WHS within the remote health sector, despite the almost identical WHS legislation in different states/territories. These gaps highlight the need to establish and enforce a national minimum standard of workplace safety in the remote health sector.

Screening Accuracy for Developmental Dysplasia of the Hip by Child Health Nurses.

Developmental Dysplasia of the Hip (DDH) describes a spectrum of abnormalities that impact the normal function of the joint. These abnormalities are detectable during infancy using physical assessment, universal ultrasound, or a combination of both. In Australia, child health nurses predominantly screen for this disease using physical assessment. The aim of this study was to determine if child health nurses can accurately screen for DDH using physical assessment. This Australian study estimated the accuracy and utility of child health nurses using physical assessment to screen for DDH by comparing it to a handheld ultrasound device. This study (N = 44) concluded that using a point prevalence study design, child health nurses in Australia are unable to accurately assess for DDH in infants using physical assessment; overall, clinicians had 50.5% sensitivity (95% CI, 15.7 to 84.3), a specificity of 75.0% (95% CI, 57.8 to 87.9), and 71.3% accuracy (95% CI, 55.6 to 83.9). This study suggests that child health nurses cannot screen for DDH using physical assessment. Understanding education, experience and what assessments are used suggests that the utility of nurses performing DDH screening requires further investigation.

What are the perceived unmet needs for patient care, education, and research among genitourinary cancer nurses in Australia? A mixed method study

ObjectiveSpecialist genitourinary (GU) nurses provide care to a broad and diverse group of patients diagnosed with kidney, bladder, prostate, testicular, adrenal, and penile cancer. The purpose of this study was to identify GU cancer nurse perspectives of perceived unmet needs in service provision, specific educational and research priorities. MethodsA concurrent mixed methods study design incorporated quantitative and qualitative data collection from the GU Cancer nurses workforce in Australia. Quantitative data collected using an electronic survey instrument and were analysed using descriptive statistics. Qualitative data collected through semi-structured interviews and coded for thematic analysis. Ethical approval was gained. ResultsFifty responses were received from the electronic survey. 39/50 (78%) were female and 35 (70%) were metropolitan based. The highest domains of perceived unmet needs related to psychological/emotional needs – 17/23 (74%), intimacy needs – 15/23 (65%) and informational needs – 13/23 (57%). The themes from the qualitative interviews identified: (1) Patient needs – lack of tumour specific contact for cancer patients, fragmented delivery of cancer care, perception of better access to supportive care for public patients, lack of access to supportive care screening tools for needs assessment. (2) Educational needs – lack of GU specific cancer educational resources/learning opportunities and barriers to accessing educational opportunities. (3) Research priorities – impact on carers/partners, specific needs of different GU cancers, future focus on genetic testing/counselling, interventions for financial toxicity and development of models of care for geriatric GU patients. ConclusionsSpecialist GU cancer nurses support a broad group of patients. Given the prominence of addressing unmet cancer care needs among people with GU cancers in this study, cancer nursing as a discipline alongside the multidisciplinary team, requires innovative solutions to overcome fragmented care which is often highly complex, and develop individualised and integrated care across the cancer care continuum. We encourage clinicians, researchers, policy makers, people affected by cancer, and their care networks, to continue to drive innovation by (1) Embedding an integrated approach to cancer nursing, (2) Implementation of shared care, (3) Implementation of patient navigation, (4) Embracing emerging technologies, (5) Future focus on education, and (6) Future focus on nurse-led research.

Barriers and facilitators to the professional integration of internationally qualified nurses in Australia: a mixed methods systematic review

Objective: This review aimed to better understand barriers to and facilitators of the professional integration of internationally qualified nurses (IQNs) in Australia. Background: Nursing shortages are a critical global issue, including developed countries such as Australia, where about 20% of the nursing workforce has been trained overseas. IQNs face many challenges associated with the migration process itself; and their professional integration is crucial in retaining them in the workforce and in maintaining the quality of nursing care in Australia. Study design and methods: This review followed the JBI methodology for mixed methods systematic review. Web of Sciences, Scopus, Informit, ProQuest, Ovid, and Cinahl databases were searched from inception. Qualitative, quantitative, and mixed methods original studies, published in English, were considered. Screening, data extraction and quality assessment were conducted independently by two reviewers. The assessment of methodological quality used the JBI Qualitative Checklist and Checklist for Analytical Cross-Sectional studies, and the data were extracted using the JBI data extraction tool. Disagreements were resolved by a third researcher and the synthesis used a convergent integrated approach. Results: From an initial 110 studies, eight studies were included. Individual and social factors emerged as the main themes. The first theme was analysed in terms of two sub-themes: psychological adaptation plus communication and language. Social factors were analysed in terms of three sub-themes: a) cultural differences in the nursing role; b) support, mentoring and appreciation and c) discrimination and racism. Discussion: psychological adaptation and language proficiency are linked to personal factors. Cultural differences in the nursing role should be addressed with strong support and mentoring programs. Recognition of previous experience and appreciation of pre-existing skills are important facilitators. Discriminatory and racist behaviours continue in the work setting, yet are rarely reported. Conclusion: Discrimination and racism from colleagues, co-workers, and patients should be addressed with a more direct approach than is currently in place. Training of locally and internationally qualified nurses in intraprofessional cultural competence may improve interaction and communication, reduce racism and discriminatory practices, and increase quality of care. Implications for research, policy, and practice: This research may be of interest to policy makers, healthcare educators, healthcare workforce planners and healthcare institutions. This study contributes to our understanding of the phenomena of nurse migration, retention, and professional integration, especially in high income countries. It is also a call to address the persistence of discriminatory and racist practices in the Australian context, as well as the education in intraprofessional cultural competence of some local nurses who work with IQNs. What is already known about the topic? High-income countries like Australia rely on the attraction and retention of IQNs to meet their health outcomes. Personal characteristics, language proficiency, support and mentoring programs are strong facilitators for IQNs’ professional integration. The persistence of discriminatory and racist practices are barriers to integration of IQNs in Australia. What this paper adds: In Australia discrimination and racism continue to be dominant barriers to IQNs’ professional integration. It is crucial to improve the reporting of situations involving discrimination and racism and discuss further consequences for patients, visitors, and co-workers. It is essential to promote training programs in intraprofessional cultural competence, and to focus on working with IQNs, as well as caring for patients from culturally and linguistically diverse (CALD) backgrounds.

Predictors of anxiety and depression in operating room nurses during the COVID-19 pandemic: A multi-center cross-sectional study.

Operating room nurses (ORNs) who directly deal with the treatment and care of COVID-19 patients during the pandemic are at risk in terms of psychological stress and other mental health problems. The aim of the study was to compare the anxiety and depression levels of ORNs working in different countries in the COVID-19 outbreak, and to determine the predictors and the difference between countries. This was a descriptive and cross-sectional study. Data were collected online using a google form between February 2021-February 2022. The universe of the research is nurses who are members of national Perioperative Nurses Association (USA, Türkiye, Australia, England, India, Israel) and 1127 ORNs participated the study. In multivariate analysis, independent predictors of anxiety and depression status were examined by binary logistic regression analysis. The rate of anxiety is 5.46 times higher in nurses in the USA, 5.07 times higher among nurses in Australia, and 4.49 times higher for nurses in England. It was determined that the rate of depression in ORNs working in Türkiye was 5.97 times higher. It was found that the rate of depression is 1.59 times higher in ORNs living away from the family after care of COVID-19 patient. Despite some differences between countries in terms of health system, patient potential, economic and the opportunities offered, generally high levels of anxiety and/or depression indicate that all ORNs need urgent support. Identifying risk factors will help recognize anxiety and depression in ORNs and take measures to protect their mental health during the pandemic.

The cancer nursing workforce in Australia: a national survey exploring determinants of job satisfaction

BackgroundTo maintain and improve the quality of the cancer nursing workforce, it is crucial to understand the factors that influence retention and job satisfaction. We aimed to investigate the characteristics of cancer nurses in Australia and identify predictors of job satisfaction.MethodsWe analysed data from an anonymous cross-sectional survey distributed through the Cancer Nurses Society Australia membership and social media platforms from October 2021 to February 2022. The survey was compared to national nursing registration data. Data were analysed with non-parametric tests, and a stepwise, linear regression model was developed to best predict job satisfaction.ResultsResponses were received from 930 cancer nurses. Most respondents (85%) described themselves as experienced nurses, and more than half had post-graduate qualifications. We identified individual, organizational, and systemic factors that contribute to job satisfaction and can impact in workforce shortages. The findings include strategies to address and prioritize workforce challenges. There were 89 different titles for advanced practice nursing roles. Managing high workload was a reported challenge by 88%. Intention to stay less than 10 years was reported by nearly 60%; this was significantly correlated with job satisfaction and age. Significantly higher scores for job satisfaction were associated with those who had career progression opportunities, career development opportunities, adequate peer support and a clearly defined scope of role. Conversely, job satisfaction scores decreased the more people agreed there was a lack of leadership and they had insufficient resources to provide quality care.ConclusionCancer nurses are critical to the delivery of cancer care however, the workforce faces multiple challenges. This study provides an understanding of the Australian cancer nursing workforce characteristics, their roles and activities, and highlights important considerations for retaining nurses in the profession.

The perspectives of internationally qualified nurses regarding their specialty skill transition to Australia: A cross-sectional survey.

To identify barriers and facilitators of speciality skill transfer for internationally qualified nurses in Australia from the nurses' perspective. A cross-sectional study. A cross-sectional online survey was distributed through social media, snowballing and nursing professional organization. Data analysed using Statistical Package for the Social Sciences. Online survey data from participants matching the inclusion criteria were collected from July to September 2022. Survey results reveal facilitators (competence, scope of practice, linguistic sufficiency, understanding of decision-making) and barriers (lack of opportunity, transition pathways, confidence in overseas education, financial instability) for internationally qualified nurses' speciality skill utilization in Australia. Identifying and addressing barriers and facilitators, along with developing tailored transition pathways, are crucial for maximizing speciality skill utilization among internationally qualified nurses. These findings have implications for policymakers, healthcare organizations and nurses. They highlight the need to address barriers, facilitate smooth transitions and implement proactive measures for internationally qualified nurses to effectively utilize their specialty skills. The study addresses maximizing skill usage for internationally qualified nurses, identifies barriers and facilitators for specialty skill transfer in Australia and will impact policymakers, healthcare organizations and nurses by guiding strategies for safe nursing service delivery and optimizing patient care. STROBE checklist. A total of 71 internationally qualified nurses contributed their experiences and opinions. WHAT DOES THIS PAPER CONTRIBUTE TO THE WIDER GLOBAL CLINICAL COMMUNITY?: Lack of opportunity and the lack of transition pathways inhibit the use of specialty nursing skills by internationally qualified nurses. This study's findings contradict the result of other studies that suggest language is a significant obstacle to the utilization of specialty skills of internationally qualified nurses. The protocol is registered on OSF. The data for this study are available for sharing with the reviewers upon request. However, it is worth noting that ethical approval has not been obtained specifically for web sharing, and therefore, the data has not been posted in any repositories or public platforms.

Nurses’ education, knowledge and perceptions of peripheral intravenous catheter management: A web-based, cross-sectional survey

BackgroundPeripheral intravenous catheters (PIVCs) are the most used invasive medical device. Unfortunately, PIVCs fail for a variety of reasons and failure often results in serious adverse events leading to patient discomfort, infection, delays in treatment, increased healthcare costs, and even death. In Australia, qualified nurses assess, manage, and remove a PIVC as part of their clinical role. To date, no study has described the current state of knowledge and confidence (self-efficacy) about PIVCs from the perspectives of qualified nurses working in Australian hospital settings.AimsTo describe the current state of knowledge and confidence (self-efficacy) about PIVC management from the perspectives of qualified nurses working in Australian hospital settings. To explore how these related to the education received by these nurses.MethodsAn online cross-sectional survey.FindingsQualified nurses in Australia thought that education about PIVCs was important and that it should be underpinned by evidence-based guidelines. Knowledge Test score for the sample was 12.4/17 (SD 2.1), this equates to a mean grade of 73.0%. Respondents reported very high levels of confidence about caring for a patient with a PIVC in situ.ConclusionDespite the frequent and increasing use of PIVCs and importantly the documented adverse events associated with poor assessment, management and inappropriate removal, qualified nurses’ knowledge and confidence remain poorly reported. We demonstrated fundamental gaps in qualified nurses’ knowledge in relation to assessment, management, and removal of PIVCs.

Professional Adaptation Experiences of Chinese Migrant Nurses in Australia: A Qualitative Study.

Chinese-educated nurses are increasingly important to the international labor market. This study aimed to examine how Chinese migrant nurses adapt and evolve professionally while pursuing nursing careers in Australia, using a qualitative descriptive approach. A total of 17 Chinese-educated nurses were recruited by purposive and snowball sampling in Australia during 2017. Data were collected by individual semi-structured interviews and analyzed using thematic analysis. Three central themes and eight subthemes were generated. Perceived differences in nursing involved: work options and flexibility, professional autonomy and independence, and freedom of expressing professional opinions. Elements comprising challenges to adaptation included communication barriers, nursing workload and responsibilities, and collegial relationships. Participants' professional transition journeys were accompanied by two key areas of self-evolution: Embracing the authentic self and embracing individual differences. Our findings have important implications for migrant-host nursing workforce integration in Australia and internationally.

Authentic Leadership and Psychological Well-Being of Nurses: A Mediated Moderation Model

Aims. This study investigates how authentic leadership influences the psychological well-being of Australian nurses. We examined whether authentic leadership could reduce the prevalence of workplace incivility and tested whether shared values and person-organization (P-O) fit could moderate the relationship between workplace incivility and psychological well-being (PWB). A mediated moderation model underpinned by social learning theory was developed to test the influence of authentic leadership on PWB. Design. We adopted a descriptive correlational research design to test the hypothesized model with a cross-sectional sample of Australian nurses using an online survey. Data were collected across two-waves separated by a six-month interval (N = 230, response rate = 38.3%) to minimize the potential effects of common source bias. The hypotheses were tested using Hayes Process Macro (Model 14) on IBM SPSS. Results. The hypothesized model had good fit indices and supported the mediated moderation model. There was no support for the direct association between authentic leadership and PWB. The supervisor authentic leadership behavior was negatively associated with workplace incivility and PWB. The association between incivility and PWB was positively associated with P-O fit. Nurses with high P-O fit reacted strongly to the positive effect of authentic leadership in reducing workplace incivility, such that they experienced higher levels of PWB. Conclusion. Authentic leadership behavior is important in the healthcare workplace. It reduces workplace incivility and improves PWB for nurses with high levels of congruence. Implications: our study suggests that senior management should deploy strategies through which frontline supervisors can learn and enact authentic leadership behaviors. They will then be better equipped to improve the PWB of their followers by minimizing the prevalence of workplace incivility. Impact: the study found a significant indirect relationship between authentic leadership behavior and psychological well-being, as mediated by workplace incivility and moderated by person-organization fit. The findings highlight the importance of positive leadership behaviors on the well-being outcomes of nurses in Australia.

The Australian and New Zealand nephrology nursing workforce: clinical pressure and organisational culture

Background There has been increasing prevalence in the community of chronic kidney disease and an increased demand for nephrology trained nursing staff. Objective We explored how nephrology trained nurses are impacted by daily caseload pressure, organisational support and workplace education. Design and participants A co-designed 57-item questionnaire developed by the research team and clinical nephrology nurses hosted on Qualtrics™ was distributed to nephrology nurses in Australia and New Zealand. Results The 370 respondents described a strong professional identity as a nephrology nurse. 70% described pressure to work overtime and only 2% were adequately staffed. 40% felt at times that their patients clinical care was ‘unsafe’ and one-third described the erosion of work-based educational opportunities. However, team collegiality was high, a strength of the nursing profession. Conclusion The nephrology nursing workforce will face important challenges over the next decade and there must be an organisational response to prevent continued staff shortages.

Nurses Transitioning to Primary Health Care in Australia: A Practice Improvement Initiative.

Current nursing programs provide little pre-registration information and clinical exposure to primary health care nursing practice. Newly graduated nurses and those transitioning to primary health care report disorientation and confusion. Limited knowledge about the ideal elements of a program to support transitioning nurses is an imperative to understand how best to support nurses during this period. The peak body for nurses in primary health care was funded to develop and implement a 1-year transition to practice improvement initiative for nurses in Australia about to be employed in or who are new to primary health care. This quality improvement evaluation study aimed to determine the impact of the transition program on participants' nursing knowledge, skills, and confidence, and their overall satisfaction with the program. A mixed methods evaluation of the project utilized data from online pre- and post-participation surveys, mentor meetings, and field notes. Descriptive statistics and paired t-tests were employed for quantitative items. Free text and field notes were subject to broad thematic analysis. Findings from qualitative and quantitative data were triangulated. Ninety-three nurse participants and 62 mentors were recruited. There were statistically significant differences between mean summed post-completion and pre-completion self-assessment rating scores for knowledge, skills, and confidence. Program elements were well received. The orientation workshop, mentoring, and education activities were identified as most influential in supporting transition. The self-assessment framework was identified as least influential. A 12-month transition program was effective in building the knowledge, skills, and confidence of participants to deliver comprehensive and effective nursing services.

1128: REPORTS OF BULLYING, DISCRIMINATION AND SEXUAL HARASSMENT IN ICU NURSES IN AUSTRALIA AND NEW ZEALAND

Introduction: Bullying, discrimination, and sexual harassment are under-reported behaviours in healthcare. These behaviours affect staff well-being and patient care and may be seen as increased staff turnover and reductions in the quality of patient care and outcomes. There is little evidence of the extent and impact of these behaviours in nurses working in Intensive Care units worldwide and none in Australia and New Zealand. We wanted to understand the extent and experience of these behaviours in ICU nurses in Australia and New Zealand. Methods: A prospective, cross-sectional, online survey of ICU nurses in Australia and New Zealand was undertaken May – June 2021, distributed through critical care colleges, and social media. Questions addressed bullying, sexual harassment and discrimination. Results: We analysed 629 survey responses. In the preceding 12 months, respondents reported the extent of bullying, discrimination and sexual harassment as 57.1%, 32.6% and 12.9% respectively. Predominantly nurses were the main culprits of bullying (59.6% overall, with 57.9% of these being ICU nurses). Nurses were also reported as the main culprits of discrimination (51.7% with 49.3% being ICU nurses); while patients were the main culprits of sexual harassment (34.6%). Significant differences were observed in bullying and discrimination according to age, gender, ethnicity and/or country of residence. Behaviours were seen predominantly in public, metropolitan, Level 3 ICUs. Most commonly there were policies regarding these behaviours of concern, in ICUs or hospitals and mandatory training provided, however these behaviours were most often not reported (66%). Conclusions: Determining the true extent of these behaviours is challenging however it is clear that they are significant issues for ICU nurses in Australia and New Zealand. Of concern is that the culprits were often ICU nurse colleagues and that these behaviours are routinely not reported. We have identified a problem that needs to be recognised and owned and mechanisms developed and enacted to support and retain ICU nurses.

Helpful encounters with mental health nurses in Australia: A survey of service users and their supporters.

INTRODUCTION: Successive inquiries into mental health services in Australia have identified the need for major reform of services and proposed a return to direct-entry nursing training. To identify what service users, family and supporters have found helpful in their encounters with nurses in mental health settings. A survey of 95 service users and supporters rated the importance of the capabilities and competencies of nurses. They also shared examples of helpful encounters with nurses which were subject to thematic analysis. The most highly rated competencies were around demonstrating caring, empathy and understanding, and responding effectively in crisis situations. Helpful encounters involved enacted values, highly skilful interpersonal and psychotherapeutic engagement and practices that were facilitative and supportive. The process and content of pre-registration nursing training needs to refocus on the nurse meeting the needs of service users and supporters, rather than the instrumental needs of services today. Educational reform may be necessary but insufficient to address anticipated nursing workforce shortages. Policymakers and health service directors need to align services with mental health nursing values and promote practices aligned with what service users and their supporters report as helpful.

Strategies to prevent inadvertent retained surgical items: An integrative review

Background: The surgical count process is currently the recommended strategy for preventing unintentionally retained surgical items (RSIs) in Australia. Despite this, RSIs still occur and remain an internationally recognised issue and sentinel event associated with morbidity and mortality. There are numerous new and emerging strategies to prevent inadvertent RSIs, apart from the surgical count, and many involve the use of technology. These strategies are not currently specified in Standards for Perioperative Nursing in Australia (the ACORN Standards).

The role of high-involvement work practices, supervisor support and employee resilience in supporting the emotional labour of front-line nurses

Emotional labour (EL) is garnering increasing attention due to the potential negative consequences on employees and organisations. This is especially prevalent with front-line healthcare workers, resulting in high occupational turnover intention. Our study examines the use of high-involvement work practices (HIWPs), supervisor support and resilience as support resources for front-line nurses’ emotional labour and work engagement to mitigate occupational turnover intention among nurses in Australia. Data was collected via a nationwide survey of 2,984 nurses and midwives. A significant positive relationship was identified between EL and occupational turnover intentions, mediated by work engagement. The provision of HIWPs resources, supervisor support and individual resilience play an important role in ‘buffering’ the negative impact of emotional labour on work engagement and the occupational turnover intention of nurses. The key message of our study demonstrates that multi-level resources, organisational (HIWPs), relational (supervisor support) and individual (employee resilience) are important for mitigating the effects of emotional labour on occupational turnover intentions.

Practical advice for refugees aspiring to become registered nurses in Australia.

This paper describes practical advice for refugees aspiring to become Registered Nurses (RNs) in Australia. Qualitative description using a naturalistic inquiry framework. Between February 2018 and September 2019, the lead author conducted semi-structured interviews with employed RNs that are former refugees that speak English. Interviews were 45-90min in duration and digitally recorded. Participants provided voluntary informed consent and were sent questions beforehand. All transcription data were thematically analysed for key themes until no further themes were identified. This paper covers practical advice provided by the participants at the conclusion of their interviews. Twelve participants provided practical advice. Six themes were identified: (1) Find your purpose and set goals; (2) Work hard and never give up; (3) Seek support; (4) Capitalize on opportunities; (5) Be optimistic; (6) Give back. The last theme, give back, was salient across all interviews and was an inherent motivator for some participants once their RN status was achieved. Each participant set the goal of becoming a fully registered nurse and made it a life goal that provided meaning for them. Despite their experiences, the participants provided practical advice that could guide younger people aspiring to become successfully qualified RNs. The findings in this study are unique as they are derived from people with experiences as refugees who, despite their adversity, became RNs. The practical advice provides a framework not only for younger people from refugee backgrounds seeking to achieve their professional goals, but others looking to succeed in other workforce sectors. The practical advice for success will be useful in informing nursing authorities, tertiary institutions and private and public health organizations to develop effective approaches to guide the next generation of would-be RNs set to contribute to nursing practice in Australia. There were no patient or public contributions as the focus was the personal and professional lives of nurses with refugee backgrounds.

Exploring the impact of the COVID-19 environment on nursing delivery of family-centred care in a paediatric hospital.

To understand how the pandemic environment impacted the delivery of FCC of children and families from a nursing perspective in a major tertiary paediatric hospital. Family-centred care (FCC) is a well-established framework to promote parental involvement in every aspect of a child's hospitalization, however, rules and restrictions in place during the COVID-19 pandemic affected the ways in which Family-centred Care could be delivered in practice. This is a qualitative exploratory descriptive study to elicit the perspective of paediatric nurses delivering care to children in a hospital during the COVID-19 pandemic in Victoria, Australia. Nurses from all subspecialties in a tertiary paediatric hospital were invited to participate in virtual focus groups to discuss their experience of delivering FCC during the COVID-19 pandemic. Focus groups were recorded and transcribed, then analysed using Framework Analysis. Nineteen nurses participated across seven focus groups during June and July 2020. The four themes-Advocating with empathy, Enabling communication, Responding with flexibility, and Balancing competing considerations-and the eight subthemes that were generated, outline how nurses deliver FCC, and how these FCC actions were impacted by the COVID-19 environment and the related hospital restrictions. This study documents the experiences, resilience and resourcefulness of paediatric nurses in Australia during the COVID-19 pandemic as well as moving Family-centred Care from a theoretical framework into a practical reality. The findings from this study should inform consideration of the impacts of public health policies during infectious disease outbreaks moving forward. In addition by describing the core actions of Family-centred Care, this study has implications for educational interventions on how to translate FCC theory into practice. No public or patient contribution as this study explored nursing perceptions only.