Amanda Towell

Nursing practice environment: A strategy for mental health nurse retention?

Historically, mental health services have faced challenges in their ability to attract and retain a competent nursing workforce in the context of an overall nursing shortage. The current economic downturn has provided some respite; however, this is likely to be a temporary reprieve, with significant nursing shortages predicted for the future. Mental health services need to develop strategies to become more competitive if they are to attract and retain skilled nurses and avoid future shortages. Research demonstrates that creating and maintaining a positive nursing practice environment is one such strategy and an important area to consider when addressing nurse retention. This paper examines the impact the nursing practice environment has on nurse retention within the general and mental health settings. Findings indicate, that while there is a wealth of evidence to support the importance of a positive practice environment on nurse retention in the broader health system, there is little evidence specific to mental health. Further research of the mental health practice environment is required.

Use of ultrasound by registered nurses—a systematic literature review

BACKGROUND In Western Australia (WA), most stable patients undergoing haemodialysis receive treatment in a satellite setting where no doctors are on-site during treatment hours, so nurses must make critical decisions about fluid removal. Some patients regularly experience adverse events during dialysis (intradialytic), often due to excessive ultrafiltration goals, with intradialytic hypotension being particularly challenging. Ultrasound of the inferior vena cava has been previously demonstrated being a rapid and non-invasive method for volume assessment on haemodialysis patients, thus could hold valuable information for the treating nurse. AIM This paper examines the existing literature in regards to the use of ultrasound measurements of the inferior vena cava in patients on haemodialysis for objective assessment of their intravascular volume status by renal nurses. METHOD A systematic literature review was performed within medical and nursing databases including CINAHL Plus with Full Text, SCOPUS, Web of Science and MEDLINE. RESULTS Renal nurses are conscious of the significance of intradialytic hypotension and have only limited options for its prevention. Ultrasound of the inferior vena cava could add another objective dimension for intravascular volume assessment and prevention of intradialytic hypotension, but to date renal nurses have not been using this technique. CONCLUSIONS Ultrasound of the inferior vena cava has the potential to assist in defining the ultrafiltration goal for that particular dialysis session, thus reducing the risk of intradialytic hypotension. Additionally, it has potential to change current renal nursing practice when added to clinical nursing assessment methods. Further studies are required to validate this assessment tool carried out by a renal nurse compared with a skilled ultrasonographer.

The role of the family in supporting the self-management of chronic conditions: A qualitative systematic review

AIMS AND OBJECTIVES To explore the contribution of family members in promoting and supporting the self-management of chronic conditions amongst adult family members. BACKGROUND The prevalence of chronic disease continues to grow globally. The role of the family in chronic condition management and support for self-management has received little attention. DESIGN A systematic review of qualitative literature using the Joanna Briggs Institute approach for qualitative systematic reviews. METHODS Ovid (MEDLINE, CINAHL and PsycINFO) were searched for the period of database inception-2016. The QARI (Qualitative Assessment and Review Instrument) critical appraisal instrument was used to assess the quality of each study. Using the Joanna Briggs Institute-QARI data extraction tool, findings related to the family role in the self-management of chronic conditions were extracted and each finding rated according to Joanna Briggs Institute-QARI levels of credibility. Findings were categorised and synthesised to produce a final set of aggregated findings. RESULTS Families were key in constructing an environment that was conducive to family engagement and support. Adaptation within the family included maintaining cohesion between family members, normalisation and contextualisation of the chronic condition. CONCLUSIONS Whilst evidence on the value of the family in promoting positive health outcomes is clear, research on how families can specifically support the self-management of chronic conditions is emerging. RELEVANCE TO CLINICAL PRACTICE Family adaptability has been found to be the most powerful predictor of carer depression. Families may need support to change their home and family organisation to adapt to the challenges they face overtime. Change in roles and subsequent adaptation can be stressful, even for those family members at a distance. Nurses working in hospital and community settings can play an important role in assessing how families are adapting to living with chronic illness and to explore strategies to cope with challenges in the home setting.

Can a renal nurse assess fluid status using ultrasound on the inferior vena cava? A cross-sectional interrater study

Introduction: Ultrasound of the inferior vena cava (IVC‐US) has been used to estimate intravascular volume status and fluid removal during a hemodialysis session. Usually, renal nurses rely on other, imprecise methods to determine ultrafiltration. To date, no study has examined whether renal nurses can reliably perform ultrasound for volume assessment and for potential prevention of intradialytic hypotension. This pilot study aimed to determine if a renal nurse could master the skill of performing and correctly interpreting Point of Care Ultrasound on patients receiving hemodialysis.

The emotional intelligence of registered nurses commencing critical care nursing

Background Critical care is described as complex, detailed healthcare in a unique, technologically rich environment. Critical care nursing requires a strong knowledge base and exceptional clinical and technological skills to cope in this demanding environment. Many registered nurses (RNs) commencing work in these areas may lack resilience, and because of the stress of the critical care environment, coping mechanisms need to be developed. To prevent burnout and to enable critical care nurses to function holistically, emotional intelligence (EI) is essential in the development of such coping mechanisms. Objective The aim of this study was to describe the EI of RNs commencing work in critical care units in a private hospital group in Gauteng, South Africa. Method The design used for this study was a quantitative descriptive survey. The target population were RNs commencing work in critical care units. Data were collected from RNs using the Trait Emotional Intelligence Questionnaire – Short Form and analysed using the Statistical Package for the Social Sciences software. Results The sample (n = 30) had a mean age of 32 years. Most of the participants (63%) qualified through the completion of a bridging course between 2010 and 2012. The majority (62%) of the sample had less than 2 years’ experience as RNs. Conclusion The EI of RNs commencing work in a critical care environment was indicative of a higher range of Global EI, with the well-being factor scoring the highest, followed by the emotionality factor, then self-control, with the sociability factor scoring the lowest.