Anndrea Flint

Psychometric Analysis of the Brisbane Practice Environment Measure (B-PEM)

PURPOSE To undertake rigorous psychometric testing of the newly developed contemporary work environment measure (the Brisbane Practice Environment Measure [B-PEM]) using exploratory factor analysis and confirmatory factor analysis. METHODS Content validity of the 33-item measure was established by a panel of experts. Initial testing involved 195 nursing staff using principal component factor analysis with varimax rotation (orthogonal) and Cronbachs alpha coefficients. Confirmatory factor analysis was conducted using data from a further 983 nursing staff. RESULTS Principal component factor analysis yielded a four-factor solution with eigenvalues greater than 1 that explained 52.53% of the variance. These factors were then verified using confirmatory factor analysis. Goodness-of-fit indices showed an acceptable fit overall with the full model, explaining 21% to 73% of the variance. Deletion of items took place throughout the evolution of the instrument, resulting in a 26-item, four-factor measure called the Brisbane Practice Environment Measure-Tested. CONCLUSIONS The B-PEM has undergone rigorous psychometric testing, providing evidence of internal consistency and goodness-of-fit indices within acceptable ranges. The measure can be utilised as a subscale or total score reflective of a contemporary nursing work environment. CLINICAL RELEVANCE An up-to-date instrument to measure practice environment may be useful for nursing leaders to monitor the workplace and to assist in identifying areas for improvement, facilitating greater job satisfaction and retention.

The intravenous cannula for newborn infants requiring only intravenous medication: continuous infusion or intermittent flushing?

In August 2003, the practice in the Royal Brisbane and Womens Hospital neonatal unit changed to the use of intermittent flushing of intravenous cannulas (instead of running a continuous infusion) for infants who only required an intravenous cannula for medications. In this historical cohort comparison study, the authors determined that the duration of cannula use and the numbers of cannulas needing removal were similar before and after the change. The authors conclude that the use of intermittent flushing for intravenous cannulas is a safe and viable alternative to continuous infusion for well term infants who only require intermittent intravenous antibiotics.

The use of overnight oximetry in neonates: A literature review: Overnight oximetry in neonates

There is much debate between neonatologists and paediatricians about appropriate oxygen saturation targets for babies with chronic neonatal lung disease (CNLD). Overnight oximetry is used to guide the fraction of inspired oxygen to use. We did this literature review to examine the current literature on the use of overnight oximetry in term infants, preterm infants and babies with CNLD (especially relevant to ex‐preterm babies with CNLD going home on oxygen). We reviewed the literature from January 1990 to October 2017 by searching the following databases: Cochrane Central Register of Controlled Trials, The Joanna Briggs Institute, CINAHL, MEDLINE, Scopus, EMBASE, ProQuest and Science Direct. Sixteen articles were included in the review. The literature available on overnight oximetry in neonates is limited, it is not contemporary, and it reports studies that did not use oximeters with modern software for data collection and analysis. It is imperative that reference ranges be defined for overnight oximetry parameters so that babies are not inadvertently administered inappropriate amounts of oxygen.