Amanda Henderson

Preparing pediatric healthcare professionals for end-of-life care discussions: An exploratory study

BACKGROUNDnPreparedness to initiate end-of-life (EoL) discussions is a confronting and daunting task for all healthcare professionals. We conducted a group interview to explore healthcare professionals experiences of preparing for EoL discussions with the patient and their family in a pediatric context.nnnAIMnTo identify what pediatric healthcare professionals consider important when preparing for an EoL discussion.nnnMETHODSnA qualitative design using a group interview. Two open-ended questions were asked: (1) How could preparedness to initiate EoL care discussions between healthcare professionals and the patient and family be enhanced? (2) What education resources/strategies could be developed to support preparation for EoL care discussions?nnnSETTING/SUBJECTSnHealthcare professionals, including medical, nursing, and allied health professionals working in pediatric palliative care settings across Queensland, Australia. These settings included major tertiary hospitals, general practice, community, and nongovernment organizations. A convenience sample of 36 healthcare professionals consented to participate in the study.nnnRESULTSnAn analysis of the data identified seven themes that had relevance for preparing for an EoL discussion: communication, healthcare professional perspectives, interdisciplinary team role, patient and family perspectives, practical issues, addressing mistakes, and healthcare professional education.nnnCONCLUSIONSnPediatric healthcare professionals confirmed that gaps exist in preparing for an EoL discussion. The findings support a need for further research in two areas. First, a systematic review of interdisciplinary resources that are available to support healthcare professionals in preparing for EoL discussions is recommended. Second, evidence-based interdisciplinary interventions to support pediatric EoL discussions need to be developed and evaluated.

Graduating nurses' self-efficacy in palliative care practice: An exploratory study

BACKGROUNDnEducational institutions and the health care industry agree that graduates from professional programs need to be work ready and capable of delivering competent and confident nursing care. One measure of program success is the students self-efficacy in meeting expected graduate capabilities. In this study students self-efficacy is related to palliative care graduate capabilities.nnnAIMnTo explore graduating Bachelor of Nursing Science (BNSc) students self-efficacy in caring for palliative care patients.nnnDESIGNnA qualitative design using semi-structured face-to-face interviews.nnnSETTINGnA regional Australian university.nnnPARTICIPANTSnA purposive sample of 10 students in their final semester of study in a Bachelor of Nursing Science degree program.nnnMETHODnSemi-structured face-to-face interviews were conducted. Interview questions were informed by published palliative care graduate capabilities. Interview data were transcribed verbatim and coded by capability. The coded data were then analysed to determine evidence of self-efficacy in caring for palliative care patients.nnnRESULTSnAll participants had experiences in caring for palliative care patients. However, the responses did not consistently reflect high degrees of self-efficacy in four documented palliative care graduate capabilities required to care for persons with a life-limiting illness.nnnCONCLUSIONSnThe findings support others that have identified gaps between curriculum and health care industry requirements in terms of students beliefs about their empowerment to deliver nursing care as graduates. Education interventions and approaches to program evaluation require further development to better support students growth of self-efficacy in undertaking their graduate roles.

The uptake and implementation of the Baby Friendly Health Initiative in Australia

PROBLEMnDespite evidence that implementation of the Initiative has been effective in increasing breastfeeding rates and duration of breastfeeding worldwide; the uptake is low with only 70 Baby Friendly accredited maternity facilities across Australia (approximately 23% of facilities).nnnBACKGROUNDnThe Ten Steps to Successful Breastfeeding and International Code of Marketing of Breastmilk Substitutes shaped the foundation for the Initiative to implement practices that protect, promote and support breastfeeding. There is evidence that implementation of the Initiative is impacted by individual and organisational culture, organisational support, and education. Organisational change is also identified as playing an important role in the successful implementation of the Initiative. Despite policy and guideline support for the Initiative at national and state levels in Australia the uptake of the Initiative is low.nnnAIMnThe aim of this research was to explore health practitioners perspectives about the uptake and implementation of the Initiative in Australia.nnnMETHODSnSemi-structured, face-to-face, telephone and Skype interviews were conducted with 12 health practitioners. Thematic analysis was used to analyse data.nnnRESULTSnParticipants identified that the uptake and implementation of the Initiative in Australia is complex. This complexity was related to six themes: (1) policy and guideline support for the Initiative, (2) leadership support to implement the Initiative, (3) improving breastfeeding and Initiative-related knowledge, (4) improving communication between stakeholders regarding the Initiative, (5) accreditation and reaccreditation processes, and (6) implementation complexity.nnnCONCLUSIONnUsing organisational change theories as a guide to implementation of the Initiative may be useful for facilities intending to become accredited.

Students take the lead for learning in practice: A process for building self-efficacy into undergraduate nursing education

To prepare graduate nurses for practice, the curriculum and pedagogy need to facilitate student engagement, active learning and the development of self-efficacy. This pilot project describes and explores an initiative, the Check-in and Check-out process, that aims to engage students as active partners in their learning and teaching in their clinical preparation for practice. Three interdependent elements make up the process: a check-in (briefing) part; a clinical practice part, which supports students as they engage in their learning and practise clinical skills; and a check-out (debriefing) part. A student evaluation of this initiative confirmed the value of the process, which has subsequently been embedded in the preparation for practice and work-integrated learning courses in the undergraduate nursing programs at the participating university. The introduction of a singular learning process provides consistency in the learning approach used across clinical learning spaces, irrespective of their location or focus. A consistent learning process-including a common language that easily transfers across all clinical courses and clinical settings-arguably enhances the students learning experience, helps them to actively manage their preparation for clinical practice and to develop self-efficacy.

Identifying and assessing the needs of carers of patients with palliative care needs: an exploratory study

BACKGROUND:nCarers of patients with palliative care needs require careful assessment and support to undertake their role effectively. The carer component of palliative care is embedded in complex situations that necessarily focus on the patient.nnnAIMS:nTo explore experiences of specialist palliative care nurses in identifying, assessing and planning care to support those looking after patients with palliative care needs.nnnRESULTS:nFindings identified gaps in identifying carers and their role, and in assessing carers needs.nnnCONCLUSIONS:nThis study confirmed the complexity in assessing carers needs within the palliative care context, that practice gaps exist and positive outcomes result when routine processes were adopted. Future research should explore how to systematically make improvements in supporting carers in all palliative care contexts, including specialist and non-specialist settings.