Lindy King

Constructivism: A Naturalistic Methodology for Nursing Inquiry

This article will explore the philosophical underpinnings of the constructivist research paradigm. Despite its increasing popularity in evaluative health research studies there is limited recognition of constructivism in popular research texts. Lincoln and Gubas original approach to constructivist methodology is outlined and a detailed framework for nursing research is offered. Fundamental issues and concerns surrounding this methodology are debated and differences between method and methodology are highlighted.

Coping and Resilience Factors in Pediatric Oncology Nurses CE

It is well established that pediatric oncology is perceived as a setting that is personally and professionally demanding. Many sources acknowledge the development of conditions, such as burnout, compassion fatigue and vicarious traumatization, as a result of being continuously subjected to highly stressful circumstances in a professional capacity. There are a myriad of individual and collaborative factors that are known to mediate stress in the oncology setting. One such factor is resilience. The purpose of this literature review is to investigate what is known about coping and its relationship with resilience in assisting pediatric oncology nurses to manage work-related stressors. From the themes identified within the reviewed studies, it is clear that the applicability of resilience in pediatric oncology nursing has not been thoroughly investigated. The literature suggests that the presence of resilience among pediatric oncology nurses is possible. What is not known is whether there is a link between this resilience and ability to cope with the stressors of pediatric oncology.

An integrative literature review on preparing nursing students through simulation to recognize and respond to the deteriorating patient.

Aims To synthesize studies that explored simulation as preparation of nursing students for recognition and response to the deteriorating patient. Background New graduate nurses are expected to have the skills to recognize and respond to rapidly deteriorating patient conditions. To this end, education programmes have turned increasingly to simulation to assist students to gain the necessary skills. Design Integrative review. Data Sources CINAHL, Informit, ProQuest, Ovid MEDLINE, SAGE Journals and Web of Knowledge electronic databases, keywords and inclusion/exclusion criteria were searched. Eighteen studies published between 2004–2012 were found. Review Methods Studies were appraised using recognized evaluation tools. Thematic analysis was undertaken and emergent themes were extracted with similar and divergent perspectives sought. Results Six themes were identified namely, ‘transferability of simulation skills to clinical practice’, ‘exposure to broader range of experiences’, ‘confidence levels in relation to simulation training’, ‘competence/performance’, ‘clinical judgment’ and ‘student perceptions of preparedness for practice following simulation’. Conclusion Simulation exposes students to a broader range of experiences whilst in a safe environment with transference of skills to clinical practice occurring. Confidence, clinical judgement, knowledge and competence, all vital in the care of a deteriorating patient, were enhanced. However, evidence of simulation used specifically to prepare nursing students to recognize and respond to the deteriorating patient appeared limited. This educational field appears rich for interprofessional collaboration and further research.

Attitudes of nursing students towards caring for people with HIV/AIDS: thematic literature review

TITLE Attitudes of nursing students towards caring for people with HIV/AIDS: thematic literature review. AIM This paper is a report of a literature review conducted to examine current research studies into attitudes of nursing students towards caring for people with HIV/AIDS and to identify factors that influenced those attitudes to inform current nursing practice and to develop nursing education regarding care provided to people with HIV/AIDS. BACKGROUND Attitudes of nurses towards people living with HIV/AIDS have long been scrutinized. Studies show that some nurses have negative attitudes and are reluctant to provide care to people with HIV/AIDS, resulting in poorer quality nursing support being provided. Attitudes of nursing students towards caring for people with HIV/AIDS is thus of vital importance since they become the future practising nurses. DATA SOURCES Eight electronic data bases were searched from 1996-2008. REVIEW METHODS Criteria used for study selection were: attitudes of nursing students towards caring for people with HIV/AIDS, primary research studies, published in English language in peer reviewed journals from 1996 to June 2008. Sixteen studies were identified for inclusion in this thematic review. RESULTS The following themes were identified: education and knowledge of HIV/AIDS; fear of contracting HIV/AIDS; reluctance to care for people with HIV/AIDS; homophobia; and stigma associated with HIV/AIDS. CONCLUSION There is reluctance on the part of some nursing students in specific regions of the world to provide care for people with HIV/AIDS. Educational programmes based on research evidence must play a leading role in developing strategies to help nursing students understand and overcome such attitudes.

Review article: Improving the hospital clinical handover between paramedics and emergency department staff in the deteriorating patient

Clinical communication and recognising and responding to a deteriorating patient are key current patient safety issues in healthcare. The aim of this literature review is to identify themes associated with aspects of the hospital clinical handover between paramedics and ED staff that can be improved, with a specific focus on the transfer of care of a deteriorating patient. Extensive searches of scholarly literature were conducted using the main medical and nursing electronic databases, including Cumulative Index to Nursing and Allied Health Literature, Medline and PubMed, during 2011 and again in July 2012. Seventeen peer‐reviewed English‐language original quantitative and qualitative studies from 2001 to 2012 were selected and critically appraised using an evaluation tool based on published instruments. Relevant themes identified were: professional relationships, respect and barriers to communication; multiple or repeated handovers; identification of staff in the ED; significance of vital signs; need for a structured handover tool; documentation and other communication methods and education and training to improve handovers. The issues raised in the literature included the need to: produce more complete and concise handovers, create respectful and effective communication, and identify staff in the ED. A structured handover tool such as ISBAR (a mnemonic covering Introduction, Situation, Background, Assessment and Recommendations) would appear to provide a solution to many of these issues. The recording of vital signs and transfer of these data might be improved with better observation systems incorporating early warning strategies. More effective teamwork could be achieved with further clinical communications training.

Preventing Ventilator-Associated Pneumonia Through Oral Care, Product Selection, and Application Method A Literature Review

OBJECTIVE Review the literature to identify the most effective method of oral hygiene to reduce the incidence of ventilator-associated pneumonia (VAP). BACKGROUND Ventilator-associated pneumonia is the most common nosocomial infection in patients being treated with mechanical ventilation. METHOD This study is a systematic literature review. The databases searched included Web of Science, Cumulative Index to Nursing and Allied Health Literature, Ovid, and MEDLINE. RESULTS Implementation of oral care protocols and nurse education programs reduced VAP. Although chlorhexidine was the most popular oral care product, no consensus emerged on concentration or protocols for oral care. CONCLUSION No consensus on best practice for oral hygiene in patients being treated with mechanical ventilation was found. Chlorhexidine was the most popular oral care product. Implementation of an oral care protocol, ongoing nurse education, and evaluation were important in reducing the incidence of VAP. Future research should analyze chlorhexidine concentration, application techniques, and frequency of oral care, to optimize VAP prevention.

Fourth Generation Evaluation of Health Services: Exploring a Methodology That Offers Equal Voice to Consumer and Professional Stakeholders

This article explores the need for a clear understanding of fourth generation evaluation as a necessary requirement for those hoping to achieve an effective analysis of health services. The weaknesses of the traditional approaches to evaluation are fully examined so that an effective choice of evaluation methodology can be made. Current health service thinking highlights the need to recognize the importance of both consumer and professional stakeholders, allowing each an equal voice. The authors aim to assist evaluators to select a methodology that will be the most effective medium for allowing this to occur.

The Timing of the Literature Review in Grounded Theory Research: An Open Mind Versus an Empty Head

The timing of the literature review in grounded theory has been debated for decades, with previous recommendations to delay the review now under question. Mounting evidence suggests that a preliminary review can enhance theoretical sensitivity and rigor and may lead to innovative insights. However, researchers must acknowledge the influence of prior knowledge during data analysis and theory development to avoid bias. This article critically examines the ongoing debate and recommends that we should not seek to avoid preconceptions but ensure that they are well grounded in evidence and always subject to further investigation, revision, and refutation. If used reflexively, a preliminary literature review may well enhance grounded theory research.

Consumer participation in early detection of the deteriorating patient and call activation to rapid response systems: a literature review

AIMS AND OBJECTIVES This review investigated the impact of consumer participation in recognition of patient deterioration and response through call activation in rapid response systems. BACKGROUND Nurses and doctors have taken the main role in recognition and response to patient deterioration through hospital rapid response systems. Yet patients and visitors (consumers) have appeared well placed to notice early signs of deterioration. In response, many hospitals have sought to partner health professionals with consumers in detection and response to early deterioration. However, to date, there have been no published research-based reviews to establish the impact of introducing consumer involvement into rapid response systems. DESIGN A critical research-based review was undertaken. METHODS A comprehensive search of databases from 2006-2014 identified 11 studies. Critical appraisal of these studies was undertaken and thematic analysis of the findings revealed four major themes. RESULTS Following implementation of the consumer activation programmes, the number of calls made by the consumers following detection of deterioration increased. Interestingly, the number of staff calls also increased. Importantly, mortality numbers were found to decrease in one major study following the introduction of consumer call activation. Consumer and staff knowledge and satisfaction with the new programmes indicated mixed results. Initial concerns of the staff over consumer involvement overwhelming the rapid response systems did not eventuate. Evaluation of successful consumer-activated programmes indicated the importance of: effective staff education and training; ongoing consumer education by nurses and clear educational materials. CONCLUSIONS Findings indicated positive patient outcomes following introduction of consumer call activation programmes within rapid response systems. Effective consumer programmes included information that was readily accessible, easy-to-understand and available in a range of multimedia materials accompanied by the explanation and support of health professionals. RELEVANCE TO CLINICAL PRACTICE Introduction of consumer-activated programmes within rapid response systems appears likely to improve outcomes for patients experiencing deterioration.

BEING A PARENT ON DIALYSIS: A LITERATURE REVIEW

SUMMARY Aim: This literature review explored the extant literature to further our understanding of the experience of being a parent on dialysis. Methods: Keywords used to search the literature were haemodialysis, hemodialysis, chronic kidney disease, end stage renal disease, parent and experience. Databases searched included CINAHL, Medline, Wiley/Blackwell, EBSCOHost, Web of Science, Pubmed and ProQuest. Years included were 1999–2009. Seventeen primary research articles (sixteen qualitative, one mixed methods) met the search criteria with only one on parents undergoing dialysis. Findings: The experience of the parent on dialysis has rarely been explored in the literature. Related research has indicated important themes including: restricted lives; relationships; adjustment; consequences and future outlook. Conclusions: More should be known about challenges that face parents who receive dialysis. This review established an urgent need for further research to determine the experiences and needs of this population to provide empirical, person-centred nursing care.AIM This literature review explored the extant literature to further our understanding of the experience of being a parent on dialysis. METHODS Keywords used to search the literature were haemodialysis, hemodialysis, chronic kidney disease, end stage renal disease, parent and experience. Databases searched included CINAHL, Medline, Wiley/Blackwell, EBSCOHost, Web of Science, Pubmed and ProQuest. Years included were 1999-2009. Seventeen primary research articles (sixteen qualitative, one mixed methods) met the search criteria with only one on parents undergoing dialysis. FINDINGS The experience of the parent on dialysis has rarely been explored in the literature. Related research has indicated important themes including: restricted lives; relationships; adjustment; consequences and future outlook. CONCLUSIONS More should be known about challenges that face parents who receive dialysis. This review established an urgent need for further research to determine the experiences and needs of this population to provide empirical, person-centred nursing care.