Nel Glass

Debunking the manual handling myth :An investigation of manual handling knowledge and practices in the Australian private health sector

Nursing care involves complex patient handling tasks. Strategies to address associated manual handling issues commonly include training programmes, despite conflicting evidence regarding training efficacy for manual handling injury reduction. Resultant knowledge acquisition and skills transfer from training programmes are prerequisites for subsequent practice changes in the clinical setting. This paper draws upon the findings from a questionnaire completed by 100 nurses in an Australian private hospital in 2008. A substantial knowledge deficit was identified, despite previous training undertaken by participants. A striking finding was that although 82% (n = 82) of nurses surveyed believed they used safe manual handling practices, only 18% (n = 15) of these nurses correctly answered items assessing manual handling knowledge. The study suggests prudence in the assumption of skills and knowledge acquisition during manual handling training. It informs the development of future implementation strategies, and provides a contributory explanation for the limited application of recommended practices after training completion.

Care in the home for seriously ill children with complex needs A narrative literature review

This article reviews contemporary literature on home care of the seriously ill child with complex care needs and the sick child/parent dyad. The literature search revealed three major themes, namely the increasing acuity of child illness, the evolving role of the parent as care provider, and the health professional as care provider. While there is much known about the complexity of care of children and the role of family in that care, little is known about what families require in terms of support and sustenance during the long years of care provision.

Mobile subjectivities: positioning the nonunitary self in critical, feminist and postmodern research

Most scholarly work is written from the perspective of the author being a unitary subject occupying a sole, rational, and unified position. This article argues that scholarship may be enhanced by the author adopting multiple subject positions as a methodological framework. Such an adoption is advantageous in working against the romance of the notion of a single truth while also maintaining teleological values congruent with critical and feminist agendas. This article outlines the conceptual development of this methodological framework, the rationale for its development, an explication of the concept of multiple subjectivity, and an exemplar of its application within nursing research.

A person-centred lifestyle change intervention model : Working with older people experiencing chronic illness

A person-centred health promotion model of care to improve self-care and lifestyle changes for older people with chronic illnesses is conceptualized in this paper. The model supports effective interpersonal communication with nurses and health-care consumers and is developed to concept stage. Older people with chronic illnesses who experience stress, anxiety or social isolation are more likely to be admitted and re-admitted to acute hospitals. Interventions to decrease the risk factors are frequently unsuccessful in this patient group. Programmes, led by nurses, aimed at reducing stress, anxiety and social isolation while supporting older people postdischarge from hospital might be successful. The model integrates research from synthesized case studies and a critical literature review. The practices of interrelating four key elements-construct, context, process and outcome-are proposed for nurses to assist patients advancing self-care and lifestyle change. The model is designed for implementation in outpatient, clinic or community settings.

Nurses’ Experiences of Managing and Management in a Critical Care Unit:

In this article, we describe the major findings of an ethnographic study undertaken to investigate nurses’ experiences of managing nurses and being managed by nurses in an Australian critical care unit. Our purpose was to valorize and make space for nurses to speak of their experiences and investigate the cultural practices and knowledges that comprised nursing management discourses. Subjugated practices, knowledges, and discourses were identified, revealing how nurses were inscribed by, or resisted, the discourses, including their multiple mobile subject positions. Informed by critical, feminist, and postmodern perspectives, nine mobile subject positions were identified. Direct participant observation, participant interviews, and reflective field notes were analyzed for dominant and subjugated discourses. The major finding described is the subject position of “junior novice.” Nurses informed by dominant patriarchal and organizational discourses participated in constructing and reinscribing their own submissive identity reflected in interprofessional relations that lacked individual valuing and undermined their self-esteem.

It’s not about the hoist: A narrative literature review of manual handling in healthcare

The manual handling of people and objects is integral to the provision of nursing care to patients globally. Despite over 30 years of research intended to guide improvements for nurses’ safety, substantial rates of manual handling injuries persist internationally within the nursing profession. This paper reviews the contemporary international literature regarding manual handling interventions noting the unique context for injury prevention strategies within healthcare. The review includes the recognition of underlying assumptions inherent in the conceptualisation of manual handling and its management, and the preponderance of the post-positivist paradigm in this field. The complexity of manual handling in healthcare has resulted in a theoretical shift from single factor interventions based on technique training towards an emerging multidimensional approach. However the key elements for sustainable solutions to reduce nurses’ manual handling injuries have not yet been identified and consensus is lacking regarding the implementation and appropriate evaluation of injury prevention programmes. Furthermore, whilst the literature is replete with data derived from surveys or insurance industry records of compensation claims, there is a dearth of literature exploring nurses’ manual handling experiences. The in-depth investigation of nurses’ perspectives on manual handling may uncover new knowledge critical to improvement of the manual handling issues.

Ethnicity and patient satisfaction with tuberculosis care: A cross-sectional study.

Patients presenting in major tuberculosis (TB) centres in two Australian metropolitan hospitals and three central hospitals in Malawi were interviewed for health and other information, including their satisfaction with nursing care. The main objective of the study was to investigate differences in satisfaction rates among ethnically similar and different patients coming from two dissimilar health systems. A multivariable Generalized Estimating Equations model was constructed to identify sociodemographic and health-related factors associated with dissatisfaction, while focusing on ethnic differences between and within each country. The Australian and Malawian patients were similar in age, gender, marital status, and employment. However, the Malawians were mostly inpatients, with recurrent TB episodes, and were more seriously ill with impaired physical and mental wellbeing. Nonetheless, being Australian was more associated with dissatisfaction observed in all components of care. However, Australian ethnic minorities were less dissatisfied than their Anglo-Saxon or European counterparts, being more similar to Malawian patients irrespective of the health care provided. Our study suggests that patients coming from similar ethnic backgrounds may express similar satisfaction irrespective of the health system they belong to.Patients presenting in major tuberculosis (TB) centres in two Australian metropolitan hospitals and three central hospitals in Malawi were interviewed for health and other information, including their satisfaction with nursing care. The main objective of the study was to investigate differences in satisfaction rates among ethnically similar and different patients coming from two dissimilar health systems. A multivariable Generalized Estimating Equations model was constructed to identify sociodemographic and health-related factors associated with dissatisfaction, while focusing on ethnic differences between and within each country. The Australian and Malawian patients were similar in age, gender, marital status, and employment. However, the Malawians were mostly inpatients, with recurrent TB episodes, and were more seriously ill with impaired physical and mental wellbeing. Nonetheless, being Australian was more associated with dissatisfaction observed in all components of care. However, Australian ethnic minorities were less dissatisfied than their Anglo-Saxon or European counterparts, being more similar to Malawian patients irrespective of the health care provided. Our study suggests that patients coming from similar ethnic backgrounds may express similar satisfaction irrespective of the health system they belong to.