Nurses In Australia Research Articles

Willingness of veterinarians in Australia to recommend Q fever vaccination in veterinary personnel: Implications for workplace health and safety compliance.

Q fever vaccine uptake among veterinary nurses in Australia is low, suggesting veterinarians are not recommending the vaccination to veterinary personnel. This study aimed to determine the willingness of veterinarians to recommend Q fever vaccination to veterinary personnel and to identify factors influencing Q fever vaccine uptake by veterinary nurses in Australia. An online cross sectional survey targeted veterinarians and veterinary nurses in Australia in 2014. Responses were analysed using multivariable logistic regression. Factors significantly (p<0.05) associated with a willingness to recommend the vaccination, expressed by 35% (95% CI 31–38%) of veterinarians (n = 828), were (1) being very concerned for colleagues regarding Coxiella burnetii (OR 4.73), (2) disagreeing the vaccine is harmful (OR 3.80), (3) high Q fever knowledge (OR 2.27), (4) working within small animal practice (OR 1.67), (5) disagreeing the vaccine is expensive (OR 1.55), and (6) age, with veterinarians under 39 years most likely to recommend vaccination. Of the veterinary nursing cohort who reported a known Q fever vaccination status (n = 688), 29% (95% CI 26–33%) had sought vaccination. This was significantly (p<0.05) associated with (1) agreeing the vaccine is important (OR 8.34), (2) moderate/high Q fever knowledge (OR 5.51), (3) working in Queensland (OR 4.00), (4) working within livestock/mixed animal practice (OR 3.24), (5) disagreeing the vaccine is expensive (OR 1.86), (6) strong reliance on work culture for biosecurity information (OR 2.5), (7) perceiving personal exposure to Coxiella burnetii to be at least low/moderate (OR 2.14), and (8) both agreeing the vaccine is safe and working within a corporate practice structure (OR 4.28). The study identified the need for veterinarians to take greater responsibility for workplace health and safety promotion, and calls for better education of veterinary personnel to raise awareness of the potential for occupational exposure to C. burnetii and improve the perception of the Q fever vaccine as being important, safe and cost-effective.

Cynicism about Change, Work Engagement, and Job Satisfaction of Public Sector Nurses

AbstractThis paper uses the job demands‐resources theory to examine the consequences of changes on nursing work. Data were collected from 220 public sector nurses in Australia to test the model. We conducted a two‐wave data collection process where independent variables (organisational change, workload, job control, nursing administrative stressors, cynicism about organisational change, and demographic variables) were collected in Time 1. The dependent variables (nursing work engagement and job satisfaction) were collected 6 months later. Changes to nursing work were found to cause high workload and an increase of administrative stressors that leads to an increase in nurses’ change cynicism. Job control was needed to cope with the increase in workload and reduction in cynicism about change. Cynicism about organisational change was found to have a direct negative effect on nurses’ engagement which in turn was found to negatively impact job satisfaction. Our contribution to theory and practice arises from the discovery that the connections between organisational change, work environment variables, and job outcomes of nurses are more complicated than previous research suggests. Theoretical and practical implications will be discussed.

Consensus-based clinical research priorities for emergency nursing in Australia

IntroductionResearch is vital to responding to contemporary challenges of providing safe, high quality emergency nursing care, yet the research priorities for emergency nursing practice in Australia are unknown. This study aimed to establish research priorities for emergency nursing in Australia. MethodsA two-stage descriptive, exploratory study was conducted. First, research themes were identified through a survey of 232 emergency nurses the Delphi Technique (2 rounds) was used to rank and prioritise the research themes. ResultsThere were five research themes with a CVI≥0.90: (i) recognising and responding to deteriorating ED patients; (ii) effect of access block on clinical care of admitted ICU patients; (iii) effects of ED overcrowding on clinical care; (iv) scope of practice of specialist emergency nurses; and (v) effect of access block on clinical care of admitted ward patients. These are reflected in four broad research priority areas: professional issues, patient safety, emergency care of vulnerable populations, and healthcare system issues. ConclusionFuture research should focus on these priority areas in partnership with other emergency disciplines to enable safe, high quality emergency care, and, to inform the practice of emergency nursing in Australia.

Training General Practice Registrars on conducting child health and developmental surveillance. Evaluation of a blended eLearning Program

Introduction: Community-based integrated care initiatives for children and families had been developed in Sydney Australia over five years. One of those is the Healthy Homses and Neighbourhoods Integrated Care (HHAN) Initiative. The HHAN design includes several sector workforce capacity building initiatives. A partnership was formed with: primary health networks (PHN), child and family nurses, practice nurses, a general practice training organisation, Sydney Children's Hospita Network and the local health district. Child health checks are conducted by Child and Family Nurses in Australia. Due to many reasons, most families do not return for their checks. However they still frequent their GPs for a range of health needs, a setting where follow up checks can be implemented and an opportunity for postgraduate learning. Theory/Methods: GP registrars were invited to participate in an eLearning program followed by a clinical skills workshop. A curriculum blueprint mapping to learning objectives underpinned the program. Content was extracted from well child check resources and developed into individual learning objects, multimedia and interactive quizzes within a blended learning platform. Results: Eighty-eight percent felt that the online program was useful, 66% felt learning objectives were fully met with 100% at least partially met. An overwhelming majority felt that the workshop reinforced knowledge gained from online modules and improved confidence in applying learnt content. More results will be presented at the conference. Discussion: Development of eLearning for general practice is a growing field. GPs are busy and often bombarded with many requirements for CPD. Ensuring that there are adequate incentives as well as instructional design that is interesting, relevant and time efficient is the mainstay of GP education. Conclusion: Learning to conduct child health checks can occur in an online setting. Blended learning opportunities should be provided where possible to consolidate specific clinical skills. There is potential for learning to occur in more remote geographical regions and for busy clinicians. Lessons learned: Designing an eLearning program for GPs need to take into consideration their work practices, IT setup and convenience in order to achieve program completion. Embedding eLearning within a CPD context provides incentives and endorsement of education standards. Limitation: The evaluation numbers were constrained by web site technical matters. Suggestions for future research Further e-Learning modules are planned as part of the district integrated care initiative. Qualitative research projects are planned to assess impact.

Roles and functions of enrolled nurses in Australia: Perspectives of enrolled nurses and registered nurses.

To determine, from the perspectives of enrolled nurses and registered nurses, the current scope of enrolled nurse practice and to identify the activities that most enrolled nurses frequently performed in their workplace. Enrolled nurse scope of practice in Australia has evolved and expanded over the past decade. However, the unclear role, function and competency differentiation between enrolled nurse and registered nurse leads to role confusion and ongoing professional debate. Exploratory Descriptive Study. A cross-sectional online survey of enrolled nurses and registered nurses across Australia was conducted examining their levels of agreement on statements related to the scope of practice and the clinical and nonclinical activities that enrolled nurses were required to perform in their workplace. Valid responses were received from 892 enrolled nurses and 1,198 registered nurses. Enrolled nurses mostly agreed that they understood their scope of practice; did not undertake roles for which they were unprepared; sometimes undertook activities other than direct patient care; and believed that they operated equally to many registered nurses. The majority of enrolled nurses reported that they performed tasks mostly related to basic patient care in their workplace. There were a number of significant differences between perspectives of registered nurses and enrolled nurses. Clarifying the roles and scope of practice between the registered nurse and the enrolled nurse is important, and explicit differences in responsibility and accountability between their roles must be clearly articulated to harmonise perceptions about role and capability. Health service providers, policymakers and education providers need to work collaboratively to ensure that facets of enrolled nurse education and scope of practice in line with regulation are affirmed by all concerned. Health service providers, policymakers and education providers need to work collaboratively to ensure that facets of enrolled nurse education and scope of practice in line with regulation are affirmed by all concerned.

Reshaping perioperative nursing practice to get the job done: A constructivist grounded theory study

An estimated 234 million operations are performed in hospitals each year and complications of surgery are common and often preventable1. The rates of complications vary between studies with reports of perioperative death rates of between 0.4 and 0.8 per cent and rates of complications between 3 and 17 per cent. Adverse events can lead to patient disability, death, or increased length of stay, imposing a significant burden on the health care system, patients and their families. Perioperative nurses have a key role in securing patient safety and preventing mistakes and these are recognised as both the nurses’ responsibility and within their locus of control. Research and evidence based actions to minimise the risk of patient harm inform the standards developed by the Australian College of Perioperative Nurses. These standards are closely aligned with similar standards in the UK, US and Canada and represent the accepted standard of professional practice for perioperative nurses in Australia.

Capability: How is it recognised in student nurses undertaking postgraduate studies in neonatal intensive care?

Historically, nursing practice has been evaluated by assessing competence. While competence is a necessary component of clinical practice it does not provide an holistic picture of performance in practice; Capability is more comprehensive. This paper presents the findings from research, using the iterative principles of grounded theory to gather qualitative data to elicit nuances implying Capability in neonatal nurses. Semi-structured interviews with experienced mentors of students enrolled in any Postgraduate Certificate in Neonatal Intensive Care (PG Cert NIC) in Australia were undertaken to clarify what it is that students demonstrate, which provides evidence of being Capable in practice. The implications drawn from these interviews is that Capability is evaluated through various verbal and non-verbal behavioural cues. Although this research focuses on registered nurses in Australia undertaking PG Cert NIC, ideally these findings could be applied internationally, to any post-registration qualification in the specialty area of neonatal intensive care nursing.

Experiences of gynecological cancer patients receiving care from specialist nurses: a qualitative systematic review.

The care needs of women with gynecological cancer are complex and change over the course of their cancer journey. Specialist nurses are well positioned to play a role in meeting the needs of women with gynecological cancer although their role and scope of practice have not been well defined. As patients are a key stakeholder, understanding their experience of care is an important step in better defining the role and scope of practice of specialist nurses in gynecological oncology in Australia and New Zealand. This review sought to consider gynecological cancer patients' experiences of specialist nursing care. Exploring the patient's experience of care by a specialist nurse is one step in the process of better defining the role and scope of practice of specialist gynecological-oncology nurses in Australia and New Zealand. This review included studies with a focus on women with gynecological cancer who had been cared for by a specialist nurse. Studies of women with gynecological cancer at any point on the continuum of care from pre-diagnosis to survivorship or end of life, including those with a recurrence of the disease, were included, with no limit to the duration of care received for inclusion in the review. Studies that explored how women with gynecological cancer experience the care and interventions of specialist nurses were included. Qualitative studies including, but not limited to, designs such as phenomenology, grounded theory, ethnography, action research and feminist research were considered for review. This review also considered the qualitative components of mixed method studies. Research conducted in any country was considered for inclusion in this review providing that the study was reported in English. Studies conducted in any setting including, but not limited to, acute hospitals, outpatient/ambulatory clinics, chemotherapy or radiotherapy units, support groups, palliative care units or the patient's home were included. A three-step search strategy was utilized in this review. An initial limited search of MEDLINE and CINAHL was undertaken followed by a comprehensive search using all identified keywords and index terms across all included databases. The reference lists of all identified reports and articles were hand searched for additional studies. Each paper was independently assessed by two independent reviewers for methodological validity prior to inclusion in the review using the standardized critical appraisal instrument from the Joanna Briggs Institute the Qualitative Assessment and Review Instrument. When disagreement arose between the reviewers, the given paper was independently appraised by a third reviewer. Data were extracted from papers included in the review using the standardized data extraction tool from Joanna Briggs Institute the Qualitative Assessment and Review Instrument. Data extraction was completed independently by two reviewers. Extracted findings from seven included papers were grouped according to similarity in meaning from which 11 categories were developed. These categories were then subjected to a meta-synthesis that produced a set of three synthesized findings. Key findings were extracted from six included papers and classified as unequivocal (U) or credible (C). A total of 30 findings were extracted and aggregated into 11 categories based on similarity in meaning. From the 11 categories, three synthesized findings were developed: i) Tailored care: specialist nurses play a role in understanding and meeting the individual needs of women with gynecological cancer; ii) Accessible care: specialist nurses guide women with gynecological cancer along the continuum of care and are an easily accessed source of knowledge and support; iii) Dependable expertise: women with gynecological cancer express trust and reassurance in the experience and expertise of the specialist nurse. This systematic review synthesized the findings of seven studies that captured the experiences of women with gynecological cancer who received care from a specialist nurse. The specialist nurse offers tailored, accessible and expert care to women with gynecological cancer. From the synthesis it is recommended that women with gynecological cancer have access to the services of a specialist nurse at key points on the continuum of care, that specialist nurses provide information to patients on their disease and treatment in the form preferred by the patient and ensure that this information has been understood, and that specialist nurses are afforded time to spend with patients to enable greater exploration and identification of patient needs and the provision of personalized care. Further study that considers other key stakeholders in the specialist nurse role in gynecological oncology is recommended in order to gain a full understanding of specialist nurses' contribution to the care of women with gynecological cancer. Additionally, it is recommended that further studies be conducted to seek the perspectives of women with gynecological cancer from culturally and linguistically diverse backgrounds and Indigenous populations on specialist nursing care as they appear to be under-represented in current research.

The factors impacting personal and professional experiences of migrant nurses in Australia: An integrative review

ObjectiveThis integrative review presents an exploration of the literature on the factors that impact on internationally educated nurses’ personal and professional experiences during their journey into the Australian health workforce. BackgroundOver the past few decades there has been an increase in the number of internationally educated nurses migrating to work in other developed countries. In Australia, these nurses have been sought to curb nurse shortages to support the forecasted ageing population. Using a validated integrative review framework, databases such as Scopus; MEDLINE; CINAHL; PubMed; Web of Science and Google Scholar were searched for qualitative studies published before 2016. Reviewed articles were analysed for data that was reduced, compared and synthesised and outlined in a figure. MethodsUsing a validated integrative review framework, databases such as Scopus; MEDLINE; CINAHL; PubMed; Web of Science and Google Scholar were searched for qualitative studies published before 2016. Reviewed articles were analysed for data that was reduced, compared and synthesised and outlined in a figure. FindingsFrom the twenty-two articles that met the inclusion criteria-eight factors were identified. The majority (n=6) of these were challenging factors common to personal and professional experiences, which include: pre-migration processes; recognising and adapting to a new reality; living and working in the English language; economic and social stress; discrimination and feeling like an ‘outsider’ and resolving issues and finding meaning in the new reality. The remaining two factors facilitated nurses’ experiences personally with personal support systems and professionally with recruitment and working conditions. ConclusionThis review reports that internationally educated nurses predominantly face challenging factors that impact their lives socioeconomically in andout of the workplace. Policy makers, managers and educators working with these nurses could develop strategies that minimise challenging factors and maximise facilitating factors leading to successful transitions.

A review for Australian nurses: Cannabis use for anti-emesis among terminally ill patients in Australia

Objective: The objective of this article is to describe the potential benefits of medicinal cannabis in emesis control and the position of nurses looking after palliative patients who are on medicinal cannabis treatment in Australia. Setting: Palliative care. Primary argument: Cannabis is the most commonly abused drug and its use for medical purposes was restricted throughout the world since the early 20th century. However many clinical studies show that the natural cannabinoid compounds can stimulate the cannabinoid receptors in the brain leading to attenuation of signal transmission, resulting in alleviation of the vomiting stimuli. The debate about the use of cannabis as an anti-emetic agent in patients with life-limiting conditions has renewed interest in recent years. The principle of palliative care is to improve the quality of life of patients living with life-limiting conditions based on the best evidence available. Although some evidence suggests cannabis may have therapeutic effects on some palliative patients and the Australian Commonwealth Government has recently changed the legislation, the concept of using medicinal cannabis in emesis control is very new to many Australians including the health care providers. Conclusion: In comparison to conventional medications, medicinal use of cannabis in palliative care is a new phenomenon and nurses as well as general public may be less prepared for the use of cannabis as a medical modality in all clinical settings. This review is intended to raise awareness of the physiological mechanism of cannabis and its medicinal use to the nurses in Australia.

Examining relationships between socio-demographics and self-efficacy among registered nurses in Australia

BackgroundSelf-efficacy in nursing is the nurses’ perception of their abilities to show caring orientations, attitudes, and behaviours and to develop caring relationships with patients. Self-efficacy is associated with years of experience, higher levels of job satisfaction and changes to nursing practices that conform with best practice. There is currently a paucity of evidence and no Australian studies were found examining the relationships between socio-demographic variables and self-efficacy in Australian nurses. AimThe aim of this study was to examine if relationships existed between the socio-demographic variables, years of experience, age, gender, marital status, level of education, years employed in the same workplace, employment status, geographical location, specialty area, health sector and Australian state and the perceived self-efficacy of Australian registered nurses. ResearchDesign Cross-sectional survey of Australian registered nurses. MethodsA stratified random sample of registered nurses was drawn from the database of a national industrial and professional organisation. The Caring Efficacy Scale (CES) was categorised into quartiles, and bivariate and multivariable relationships were examined using ordinal logistic regression. ResultsThe proportion of nurses reporting low caring efficacy scores tended to decrease with years of experience and was lower in nurses who have been married. After adjustment in the final multivariable model, marital status and years of experience remained significantly related to caring efficacy (p<0.05). ConclusionA relationship exists between years of nursing experience, marital status and perceived self-efficacy among Australian registered nurses who belonged to an industrial and professional organisation. Targeted professional development programmes that support the improvement of perceived self-efficacy of all levels of nurses, might improve nurses’ confidences and abilities to develop caring relationships with patients.

Comparing the impact of management on public and private sector nurses in the UK, Italy, and Australia

ABSTRACTThe research examined the impact of management upon employee outcomes (perceptions of discretionary power, well-being, engagement, and affective commitment), comparing public and private sector nurses in Australia, the United Kingdom, and Italy. Overall, 1,945 nurses participated in a self-report survey within these core- and laggard-New Public Management countries. While management influenced employee outcomes for each country, there were significant differences between the public and private sectors, with private sector nurses reporting higher perceptions of outcomes. Importantly, nurses’ engagement was affected by management practice for each country. This study raises important implications for nurse managers, especially public sector managers, described within.

The structure of nursing: a national examination of titles and practice profiles.

To identify the practice patterns of the Australian registered nurse workforce according to position title and to map these disparate titles across all jurisdictions of the country. Effective nursing workforce planning can contribute to improved patient care and increased effectiveness and efficiency of healthcare systems. The prevailing approach to nursing workforce planning focuses on number of nursing staff needed in relation to the number of patients. The level of expertise and skill mix of registered nurses as a variable in workforce planning is rarely considered. A national cross-sectional electronic survey of registered nurses in Australia was conducted using the validated Advanced Practice Role Delineation tool developed from the Strong Model of Advanced Practice. The study involved a sample of 5599 registered nurses. Sixty-six nursing position titles nationally were mapped using cluster analysis technique and gave rise to seven clusters of equivalent Australian jurisdictional nursing position titles and practice profiles. Effective workforce policy and planning is reliant upon access to reliable evidence. This research is an international first in that it has provided comprehensive knowledge of the clinical level and practice profiles of a national nursing workforce. Effective, patient-centred workforce planning must consider both the numerical and expertise mix of a nursing workforce. This research provides Australian health service and policy planners with evidence-base knowledge of the nursing workforce. Internationally, this research establishes a platform from which to develop validated tools and established processes to support replication of this research.

Mental health nursing: Daring to be different, special and leading recovery-focused care?

How mental health nursing is differentiated from other disciplines and professions, and what special contribution mental health nurses make to health services, is a question at the heart of contemporary practice. One of the significant challenges for mental health nurses is identifying, developing and advancing those aspects of their practice that they consider differentiate them in the multi-disciplinary mental health care team and to articulate clearly what a mental health nurse is and does. This paper draws on data from interviews with 36 mental health nurses in Australia who identified their practice as autonomous. Participants were asked the question, "What's special about mental health nursing?" Constructivist grounded theory techniques were applied to the research process. Findings were formulated and expressed as the 'Ten P's of the professional profile that is mental health nursing', which are 'present', 'personal', 'participant partnering', 'professional', 'phenomenological', 'pragmatic', 'power-sharing', 'psycho-therapeutic', 'proud' and 'profound'. The combined elements of the findings present a theoretical construct of mental health nursing practice as something distinctive and special. It provides a model and exemplar for contemporary practice in mental health nursing, embracing the role of mental health nurses in the health care workforce as being well placed as providers of productive and effective care.

Is the Counterweight Program a feasible and acceptable option for structured weight management delivered by practice nurses in Australia? A mixed-methods study.

Nurse-led weight management programs, like the Counterweight Program in the United Kingdom, may offer a way for Australian general practices to provide weight management support to adults who are overweight or obese. During Counterweight, nurses provide patients with six fortnightly education sessions and three follow-up sessions to support weight maintenance. This study examined the feasibility, acceptability and perceived value of the Counterweight Program in the Australian primary care setting using a mixed-methods approach. Six practice nurses, from three general practices, were trained and subsidised to deliver the program. Of the 65 patients enrolled, 75% (n=49) completed the six education sessions. General practitioners and practice nurses reported that the training and resource materials were useful, the program fitted into general practices with minimal disruption and the additional workload was manageable. Patients reported that the program created a sense of accountability and provided a safe space to learn about weight management. Overall, Counterweight was perceived as feasible, acceptable and valuable by Australian practice staff and patients. The key challenge for future implementation will be identifying adequate and sustainable funding. An application to publically fund Counterweight under the Medicare Benefits Schedule would require stronger evidence of effectiveness and cost-effectiveness in Australia.

Doctoral education for nurses today: the PhD or professional doctorate?

Objective: This paper seeks to stimulate discussion and debate about the future of doctoral education for nurses in Australia. Setting: A large Magnet recognised acute care private hospital in New South Wales and a large regional university in Australia. Primary argument: Healthcare today and into the future is increasingly more complex and requires ever more highly skilled healthcare professionals to meet the challenges of providing safe, quality care. Doctoral research and education based in the workplace and designed to improve healthcare while skilling up nurses and other professionals in research methods has never been more relevant and appropriate. Conclusion: Nurses have generally not seen the PhD as the best fit for their higher professional development. The professional doctorate offers a compelling and dynamic alternative to the more academic focus of the PhD and prepares ‘inquiry driven leaders’ for tomorrow’s challenges.

Responding to families with complex needs: a national survey of child and family health nurses.

The aim of this study was to explore the extent to which Australian child and family health nurses work with families with complex needs and how their practice responds to the needs of these families. Many families with young children face challenges to their parenting capacity, potentially placing their children at risk of poorer developmental outcomes. Nurses increasingly work with families with mental health problems, trauma histories and/or substance dependence. Universal child health services must respond effectively to these challenges, to address health inequalities and to promote the best outcomes for all children and families. The descriptive study used cross-sectional data from the first national survey of child and family health nurses in Australia, conducted during 2011. Survey data reported how often, where and how child and family health nurses worked with families with complex needs and their confidence in nursing tasks. Many, but not all, of the 679 respondents saw families with complex needs in their regular weekly caseload. Child and family health nurses with diverse and complex caseloads reported using varied approaches to support their clients. They often undertook additional professional development and leadership roles compared with nurses who reported less complex caseloads. Most respondents reported high levels of professional confidence. For health services providing universal support and early intervention for families at risk, the findings underscore the importance of appropriate education, training and support for child and family health professionals. The findings can inform the organization and delivery of services for families in Australia and internationally.

Family centred care before and during life-sustaining treatment withdrawal in intensive care: A survey of information provided to families by Australasian critical care nurses

BackgroundA core component of family-centred nursing care during the provision of end-of-life care in intensive care settings is information sharing with families. Yet little is known about information provided in these circumstances. ObjectiveTo identify information most frequently given by critical care nurses to families in preparation for and during withdrawal of life-sustaining treatment. DesignAn online cross-sectional survey. MethodsDuring May 2015, critical care nurses in Australia and New Zealand were invited to complete the Preparing Families for Treatment Withdrawal questionnaire. Data analysis included descriptive statistics to identify areas of information most and least frequently shared with families. Cross tabulations with demographic data were used to explore any associations in the data. ResultsFrom the responses of 159 critical care nurses, information related to the emotional care and support of the family was most frequently provided to families in preparation for and during withdrawal of life-sustaining treatment. Variation was noted in the frequency of provision of information across body systems and their associated physical changes during the dying process. Significant associations (p<0.05) were identified between the variables gender, nursing experience and critical care experiences and some of the information items most and least frequently provided. ConclusionsThe provision of information during end-of-life care reflects a family-centred care approach by critical care nurses with information pertaining to emotional care and support of the family paramount. The findings of this study provide a useful framework for the development of interventions to improve practice and support nurses in communicating with families at this time.

Transformational leadership and social identity as predictors of team climate, perceived quality of care, burnout and turnover intention among nurses

PurposeThe purpose of this paper is to examine the role of transformational leadership (TL) in developing social identity and its subsequent impact on team climate, intention to leave, burnout and quality of patient care among nurses.Design/methodology/approachData for this cross-sectional study were collected from a sample of 201 registered nurses in Australia through questionnaires. Structural equation modelling was used to test the hypotheses.FindingsResults illustrate that social identification appears to be the psychological mechanism through which TL impacts important employee outcomes, including perceived quality of patient care.Practical implicationsThis study provides valuable insights into understanding the critical role of human resource management (HRM) practice and policy in healthcare environments. Findings from this study indicate that human resource managers can assist nurse unit managers to deliver their HRM roles effectively when adequate support and relevant HRM infrastructures are put in place.Originality/valueThis research considers the role of first-line nurse managers in healthcare organisations. It provides evidence-based knowledge about the type of leadership style required to achieve desirable employee outcomes and the essential HRM opportunities to facilitate this.

Diet and physical activity behaviour in nurses: a qualitative study

Issue addressed: Previous research has shown that approximately 60% of nurses in Australia are overweight or obese, insufficiently active and have an unhealthy diet. The aim of this study was to gain an understanding of nurses’ determinants contributing to these behaviours. This will inform a needs assessment for a future workplace health promotion program (WHPP) in this group. Methods: Four focus group discussions (n = 17) were conducted with a convenience sample of nurses aged 25–59 years from three hospitals in the Brisbane metropolitan area. Questions addressed barriers and motivation towards diet and physical activity (PA), and suggestions for future WHPP. Data were analysed with Nvivo10 following a thematic analysis with a realistic approach using Self-determination theory as a framework. Results: Work environment was the main barrier for healthy diet behaviours. Long working hours and lack of breaks challenged nurses’ self-control and self-regulation when making dietary choices. Fatigue was the main barrier for PA. However, relaxation, feeling energised before work and better sleep after working night shifts motivated nurses to do PA. Social environment at work seemed to be an effective external motivation to encourage healthy diet and regular PA. Goal-setting, self-monitoring and social support at work were identified as potential WHHP strategies. Conclusion: The workplace and job demands negatively impacts nurses’ lifestyle behaviours. Future interventions should include social support from colleagues, which could motivate nurses to make healthier food choices at work and be more active outside work.