Robert Eley

Barriers to use of information and computer technology by Australia's nurses: a national survey

AIMS AND OBJECTIVES To support policy planning for health, the barriers to the use of health information and computer technology (ICT) by nurses in Australia were determined. BACKGROUND Australia, in line with many countries, aims to achieve a better quality of care and health outcomes through effective and innovative use of health information. Nurses form the largest component of the health workforce. Successful adoption of ICT by nurses will be a requirement for success. No national study has been undertaken to determine the barriers to adoption. DESIGN A self-administered postal survey was conducted. METHOD A questionnaire was distributed to 10,000 members of the Australian Nursing Federation. Twenty possible barriers to the use of health ICT uptake were offered and responses were given on a five point Likert scale. RESULTS Work demands, access to computers and lack of support were the principal barriers faced by nurses to their adoption of the technology in the workplace. Factors that were considered to present few barriers included age and lack of interest. While age was not considered by the respondents to be a barrier, their age was positively correlated with several barriers, including knowledge and confidence in the use of computers. CONCLUSIONS Results indicate that to use the information and computer technologies being brought into health care fully, barriers that prevent the principal users from embracing those technologies must be addressed. Factors such as the age of the nurse and their level of job must be considered when developing strategies to overcome barriers. RELEVANCE TO CLINICAL PRACTICE The findings of the present study provide essential information not only for national government and state health departments but also for local administrators and managers to enable clinical nurses to meet present and future job requirements.

Workplace violence: differences in perceptions of nursing work between those exposed and those not exposed: a cross-sector analysis

Nurses are at high risk of incurring workplace violence during their working life. This paper reports the findings on a cross-sectional, descriptive, self-report, postal survey in 2007. A stratified random sample of 3000 of the 29 789 members of the Queensland Nurses Union employed in the public, private and aged care sectors resulted in 1192 responses (39.7%). This paper reports the differences: between those nurses who experienced workplace violence and those who did not; across employment sectors. The incidence of workplace violence is highest in public sector nursing. Patients/clients/residents were the major perpetrators of workplace violence and the existence of a workplace policy did not decrease levels of workplace violence. Nurses providing clinical care in the private and aged care sectors experienced more workplace violence than more senior nurses. Although workplace violence was associated with high work stress, teamwork and a supportive workplace mitigated workplace violence. The perception of workplace safety was inversely related to workplace violence. With the exception of public sector nursing, nurses reported an inverse relationship with workplace violence and morale.

Construct validity and reliability of the Practice Environment Scale of the Nursing Work Index for Queensland nurses

This article reports on construct validity and reliability of 30 items of the Practice Environment Scale of the Nursing Work Index (PES-NWI). Australia, like other countries, is experiencing a shortage of nurses; a multifactor approach to retention of nurses is required. One significant factor that has received increasing attention in the last decade, particularly in the USA, is the nursing practice environment. The reliability of the 30 items of the PES-NWI was assessed by Cronbachs alpha and factor analysis was performed using principal component analysis. The PES-NWI was completed by nurses working in the aged-care, private and public sectors in Queensland, Australia. A total of 3000 surveys were distributed to a random sample of members of the Queensland Nurses Union. Of these, 1192 surveys were returned, a response rate of 40%. The PES-NWI was shown to be reliable demonstrating internal consistency with a Cronbachs alpha of the total scale of 0.948. The 30 items loaded onto five factors explaining 57.7% of the variance. The items across the factors differed slightly from those reported by the original author of the PES-NWI. This study indicates that the PES-NWI has construct validity and reliability in the Australian setting for nurses.

Enhancing the knowledge and skills of advisory and extension agents in mental health issues of farmers

Objectives: The aim of this study was to increase knowledge and skills of Advisory and Extension Agents (AEAs) in recognizing the symptoms of mental disorders, providing initial help, and offering the referral pathway for appropriate professional help. Method: Mental Health First Aid (MHFA) training was provided to AEAs and knowledge and skills pre-training were compared to 6-months post-training. Results: The MHFA training improved the AEAs’ ability to recognize a mental disorder, it increased their confidence level in providing help to someone with a mental health problem, it decreased social distances and positively changed their beliefs about treatment. Conclusion: MHFA training is effective in enhancing the mental health knowledge and skills of AEAs. The agents, who are a main line of contact of farmers, are able to recognize mental disorders of people and help them appropriately. They are more willing to work with stigmatized people and know who to refer people to for help.

The contribution of individual psychological resilience in determining the professional quality of life of Australian nurses

Research Topic: The aim of this study was to determine the relative contribution of trait negative affect and individual psychological resilience in explaining the professional quality of life of nurses. Materials and Methods: One thousand, seven hundred and forty-three Australian nurses from the public, private, and aged care sectors completed an online Qualtrics survey. The survey collected demographic data as well as measures of depression, anxiety and stress, trait negative affect, resilience, and professional quality of life. Results: Significant positive relationships were observed between anxiety, depression and stress, trait negative affectivity, burnout, and secondary traumatic stress (compassion fatigue). Significant negative relationships were observed between each of the aforementioned variables and resilience and compassion satisfaction (CS). Results of mediated regression analysis indicated that resilience partially mediates the relationship between trait negative affect and CS. Conclusion: Results confirm the importance of both trait negative affect and resilience in explaining positive aspects of professional quality of life. Importantly, resilience was confirmed as a key variable impacting levels of CS and thus a potentially important variable to target in interventions aimed at improving nurse’s professional quality of life.

The value of a breast care nurse in supporting rural and remote cancer patients in Queensland

The role of the breast care nurse (BCN) in the Queenslands Supporting Rural Women With Breast Cancer Project was evaluated by mixed methodology. Through questionnaire and interview, patients provided views about the nurses role under the categories of awareness, access, coordination, information, and psychosocial, emotional, and practical support. Of the 51 participants, 37 resided in rural and remote areas. Eighteen lived between 100 and 500 miles from specialized breast care services. The BCN met patients at their regular hospital visits and was available by telephone at any time. There was overwhelming agreement among the participants that the timing of contact, ease of accessibility, information provided, and support offered were extremely valuable in making their treatment and recovery easier. Most participants would recommend hospitals with a BCN to their friends. Members of the multidisciplinary care team provided views on awareness of the BCN, influence on care management, communication, and patient outcomes. They recognized the benefits of the BCN to patients and to coordination and liaison of the team. The findings concur with unpublished Australian reports that demonstrate the success of BCNs. The BCN model of care could be used to support other medical conditions in rural and remote Australia.

Didgeridoo playing and singing to support asthma management in aboriginal Australians

CONTEXT Asthma affects over 15% of Australian Aboriginal people. Compliance in asthma management is poor. Interventions that will increase compliance are required. PURPOSE The purpose of the study was to determine whether Aboriginal children, adolescents and adults would engage in music lessons to increase their knowledge of asthma and support management of their asthma. METHODS Participants were recruited from schools and through the local Aboriginal Medical Service. All participants identified as Aborigines and were diagnosed as being asthmatic. The intervention was a 6-month program of once weekly music lessons using a culturally significant wind instrument, the didgeridoo, for males and singing lessons for females. FINDINGS High school students enthusiastically engaged and had excellent retention in what they considered to be a most enjoyable program. Respiratory function improved significantly in both junior and senior boys who also reported a noticeable improvement in their health. Similar but less significant improvement was seen in the high school girls, although like the boys, they too perceived an improvement in their asthma. CONCLUSIONS The project demonstrated that music has great potential for engaging and thus supporting asthma. Furthermore, cultural awareness was increased by those playing the didgeridoo and social skills were noticeably improved in the girls. Similar culturally appropriate activities have applications far beyond Aboriginal communities in Australia.

Trypanosoma-Congolense in the Microvasculature of the Pituitary-Gland of Experimentally Infected Boran Cattle (bos-Indicus)

The pituitary glands of seven Boran cattle (Bos indicus), five infected with a clone of Trypanosoma congolense IL 1180 (ILNat 3.1) transmitted by Glossina morsitans centralis and two uninfected controls, were examined by light and electron microscopy 43 (experiment 2) or 56 (experiment 1) days after fly challenge. The three cattle used in the first experiment included a 15-month-old female (No. 1), a 24–month-old female (No. 2), and a 21–month-old male (No. 3) as a control. In the second experiment, four cattle were used: two females (Nos. 4, 5) and one male (No. 6), all between 15 and 24 months of age, and one female control (No. 7) of similar age. In all the infected animals, dilation of both the sinusoids and microvasculature was apparent, as was an increase in the thickness of the extracellular matrix between the pituitary lobules. Trypanosomes were found in the microvasculature of the adenohypophysis and neurohypophysis in all the infected animals. Focal degenerative changes were seen in the adenohypophyseal section of glands from the infected animals euthanatized 56 days post-infection. These degenerative structural changes were confined to the somatotrophs cells. The possible role that trypanosomes in the microvasculature may play in inducing pituitary damage and dysfunction is discussed.

TRYPANOSOME-INDUCED HYPOTHYROIDISM IN CATTLE

Three Boran (Bos indicus) cattle infected with T. congolense IL 1180, and two uninfected control Boran cattle were used to study the effect of trypanosomiasis on the function of the thyroid gland. On a weekly basis, plasma thyroxine (T4) was measured by 125I-radioimmunoassay. Results indicated that T. congolense caused a significant decline in plasma T4 concentration in infected animals.

S100B protein as a screening tool for computed tomography findings after mild traumatic brain injury: Systematic review and meta-analysis.

Abstract Primary objective: To determine whether S100B protein in serum can predict intracranial lesions on computed tomography (CT) scan after mild traumatic brain injury (MTBI). Research design: Systematic review and meta-analysis Methods and procedures: A literature search was conducted using Medline, Embase, Cochrane, Google Scholar, CINAHL, SUMSearch, Bandolier, Trip databases, bibliographies from identified articles and review article references. Eligible articles were defined as observational studies including patients with MTBI who underwent post-traumatic head CT scan and assessing the screening role of S100B protein. Main outcomes and results: There was a significant positive association between S100B protein concentration and positive CT scan (22 studies, SMD = 1.92, 95% CI = 1.29–2.45, I2 = 100%; p < 0.001). The pooled sensitivity and specificity values for a cut-point range = 0.16–0.20 µg L−1 were 98.65 (95% CI = 95.53–101.77; I2 = 0.0%) and 50.69 (95% CI = 40.69–60.69; I2 = 76.3%), respectively. The threshold for serum S100B protein with 99.63 (95% CI = 96.00–103.25; I2 = 0.0%) sensitivity and 46.94 (95% CI = 39.01–54.87; I2 = 95.5%) specificity was > 0.20 µg L−1. Conclusions: After MTBI, serum S100B protein levels are significantly associated with the presence of intracranial lesions on CT scan. Measuring the protein could be useful in screening high risk MTBI patients and decreasing unnecessary CT examinations.