Lyndall Angel

Nursing as a scientific undertaking and the intersection with science in undergraduate studies: implications for nursing management

AIM To explore the science-nursing tension and impact for nursing students studying bioscience. BACKGROUND Several studies have examined why nursing students struggle to be successful in bioscience subjects. Undeveloped science background and theory-practice gaps are noted as contributing factors. METHODS A qualitative study explored the science-nursing tension with 100 Australian Registered Nurses using focus groups and a survey. RESULTS The survey response rate was 85 from 550. Of survey respondents, 88% viewed nursing as an applied science. An emphasis on procedural skills and task busyness undermines theoretical understanding of care and can be a negative influence upon the student bioscience experience. Practicum mentors confident in scientific knowledge enhance the student experience of bioscience by providing opportunities for integration with practice. CONCLUSIONS Competing philosophies that reinforce the science-nursing tension have an impact upon student endeavours yet the nexus created by practice can be used to activate student curiosity and scientific understanding. IMPLICATIONS FOR NURSING MANAGEMENT Nurse managers need to structure the student practicum to encompass scientific theory applied to practice with equal emphasis on task efficiency. This improves student attitudes to learning bioscience and potentially minimizes the impact of the science-nursing tension on student learning.

Automation and Expert Systems in a Core Clinical Chemistry Laboratory

Clinical pathology has a major influence on clinical decisions and the past 60 years have seen an evolution brought about by advances in information technology and automation. The impact of the ever-changing technology in regard to responsibilities and training therefore needs continual appraisal. In this article, the authors have drawn on their experience on automation in clinical chemistry and the experience at Monash Medical Centre in Melbourne, Australia where one of the authors is based. Automation in other industries has also been reviewed, since the reasons to automate and the impact of automation have similarities and these include reduction in errors, increase in productivity, and improvement in safety. Advances in technology in clinical chemistry that have included total laboratory automation call for changes in job responsibilities to include skills in information technology, data management, instrumentation, patient preparation for diagnostic analysis, interpretation of pathology results, dissemination of knowledge and information to patients and other health staff, as well as skills in research. Research in clinical chemistry should not only emphasize evaluation of performance of automation but also should include pre- and postanalytical phases and training also needs to reflect this.

Automation in Clinical Biochemistry: Core, Peripheral, STAT, and Specialist Laboratories in Australia

Pathology has developed substantially since the 1990s with the introduction of total laboratory automation (TLA), in response to workloads and the need to improve quality. TLA has enhanced core laboratories, which evolved from discipline-based laboratories. Work practices have changed, with central reception now loading samples onto the Inlet module of the TLA. It is important to continually appraise technology. This study looked at the impact of technology using a self-administered survey to seniors in clinical biochemistry in NATA GX/GY–classified laboratories in Australia. The responses were yes, no, or not applicable and are expressed as percentages of responses. Some of the questions sourced for descriptive answers. Eighty-one laboratories responded, and the locations were 63%, 33%, and 4% in capital cities, regional cities, and country towns, respectively. Forty-two percent were public and 58% private. Clinical biochemistry was in all core laboratories of various sizes, and most performed up to 20 tests per sample. Thirty percent of the 121 surveyed laboratories had plans to install an automated line. Fifty-eight percent had hematology and biochemistry instrumentations in their peripheral laboratory, and 16% had a STAT laboratory on the same site as the core laboratory. There were varied instruments in specialist laboratories, and analyzers with embedded computers were in all laboratories. Medium and large laboratories had workstations with integrated instruments, and some large laboratories had TLA. Technology evolution and rising demand for pathology services make it imperative for laboratories to embrace such changes and reorganize the laboratories to take into account point-of-care testing and the efficiencies of core laboratories and TLA.