The Yapunyah project: embedding Aboriginal and Torres Strait Islander perspectives in the nursing curriculum

The Yapunyah Project is an initiative of the Faculty of Health at Queensland University of Technology. It was instigated to further improve the development of cultural competence in health graduates with respect to Aboriginal and Torres Strait Islander perspectives. The project was informed by the cultural competence in healthcare delivery models of Campinha-Bacote (1998a) and Cross, Bazron, Dennis and Isaacs (1989) and by the cultural safety reforms to nursing curricula in New Zealand. The Yapunyah Project involved extensive consultation and collaboration with Indigenous staff and health experts in the local Aboriginal and Torres Strait Islander community. A core curriculum, and associated graduate transcultural competencies, were informed by these discussions and earlier reforms in health curricula by the Committee of Deans of Australian Medical Schools and the Royal Australian College of General Practitioners. Although the overall project involved four separate schools within the faculty, this paper details the experience of embedding Indigenous perspectives within the undergraduate nursing curriculum. The experience has been a challenging and positive one, and the reforms have been supported by a sustainable framework. This paper outlines how one university faculty is endeavouring to educationally prepare nursing students to practice with evidence-based transcultural nursing knowledge based on culture care values, beliefs, and traditional lifeways of Indigenous people of Australia. As such, the project aims to contribute to the improvement and promotion of the health and well-being of Indigenous Australians in culturally and ethnohistorically meaningful ways.     

护理临床判断能力的研究进展

护理临床判断是临床实践的必备技能，也是临床决策的前提。培养护理临床判断能力在全球老龄化背景下显得尤为突出。国外对此进行了有益的探索，而国内相关研究鲜有报道。文章对国内外护理临床判断的相关研究进行综述，并在此基础上提出培养护理临床判断能力的可行路径，包括积极开展反思实践、情景模拟教学、形成性评价和老年护理教学研究。     

Evaluating a Web-enhanced bachelor of nursing curriculum: perspectives of third-year students

Little is known about nursing students' information literacy skills and perceptions of Web-enhanced educational approaches. This study examined graduating Bachelor of Nursing (BN) students' perceptions of a Web-enhanced learning environment, their computer literacy skills, and use of technology, and how these influenced their satisfaction. This Australian survey produced a 64% (n = 170) response rate. The 3-year BN program provides Web-enhanced learning opportunities by incorporating online activities and content such as quizzes, videos, and virtual laboratories that augment on-campus and off-campus learning approaches. Upon graduation, 61.4% of the students reported having competent information literacy skills. The quality and usefulness of the Web-enhanced material was rated fair to above average. The students' perception of technical and faculty support for Web-enhanced learning was low. Overall satisfaction with the Web-enhanced program was associated with level of information technology (IT) skills and perceived quality and usefulness of the Internet material. A regression analysis of factors contributing to students' overall satisfaction of a Web-enhanced learning environment (IT literacy skills, access, and perceived quality, usefulness, and support) accounted for 18.5% of variance. As more nursing programs use Web-based resources, greater attention should be given to the initial assessment and development of students' information literacy skills. Students with good IT skills are more likely to perceive Web-enhanced material as useful.     

The process of clinical judgment in nursing practice: the component of personality.

An exploratory study of the relationship of personality in the process of clinical judgment in nursing practice pointed out that changes in the profession--the extended role of nurses and the increasing number of men and older women who enter nursing--necessitate reexamination of the nurses' personality profile, development of a device to measure "successful' and "effective' clinical judgment, and evaluation of the effect of personality on nursing process.     

A model of clinical judgment processes in psychiatric nursing.

This study addressed judgment processes in psychiatric nursing by analyzing reported use of clinical cues cited as being relevant in the process of making a nursing judgment. Using an exploratory, qualitative approach, data were collected by interviewing 15 subjects who provided 36 in-depth interviews upon completion of an intake interview. Comparative content analysis was used to determine the underlying structure in subject reports. A model depicting judgment processes is presented and discussed. Results suggest that although judgments were highly context-dependent, all subjects assessed data labeled as universals in the psychiatric nursing assessment: suicidality, depression, drug and alcohol use, and patient functional abilities. Similarities among subjects were noted in that presenting behaviors were most salient, a categorization process occurs within the judgment process, and patients are included in the judgment process. Finally, nursing judgments uncovered an action orientation rather than a labeling function.     

The selection of clinical learning experiences in the nursing curriculum

This article presents a model for the selection of clinical learning experiences in nursing curricula. Three groups of factors are proposed as affecting the decision making process. These are the nature of nursing, health needs of populations, and nature of the educational environment. The authors urge a systematic approach to the identification and selection of clinical learning experiences.     

Thinking like a nurse: a research-based model of clinical judgment in nursing

This article reviews the growing body of research on clinical judgment in nursing and presents an alternative model of clinical judgment based on these studies. Based on a review of nearly 200 studies, five conclusions can be drawn: (1) Clinical judgments are more influenced by what nurses bring to the situation than the objective data about the situation at hand; (2) Sound clinical judgment rests to some degree on knowing the patient and his or her typical pattern of responses, as well as an engagement with the patient and his or her concerns; (3) Clinical judgments are influenced by the context in which the situation occurs and the culture of the nursing care unit; (4) Nurses use a variety of reasoning patterns alone or in combination; and (5) Reflection on practice is often triggered by a breakdown in clinical judgment and is critical for the development of clinical knowledge and improvement in clinical reasoning. A model based on these general conclusions emphasizes the role of nurses' background, the context of the situation, and nurses' relationship with their patients as central to what nurses notice and how they interpret findings, respond, and reflect on their response.     

Advancing mobile learning in Australian healthcare environments: nursing profession organisation perspectives and leadership challenges

Background

Access to, and use of, mobile or portable devices for learning at point of care within Australian healthcare environments is poorly governed. An absence of clear direction at systems, organisation and individual levels has created a mobile learning paradox, whereby although nurses understand the benefits of seeking and retrieving discipline or patient-related knowledge and information in real-time, mobile learning is not an explicitly sanctioned nursing activity. The purpose of this study was to understand the factors influencing mobile learning policy development from the perspective of professional nursing organisations.

Methods

Individual semi-structured interviews were undertaken with representatives from professional nursing organisations in December 2016 and January 2017. Recruitment was by email and telephone. Qualitative analysis was conducted to identify the key themes latent in the transcribed data.

Results

Risk management, perceived use of mobile technology, connectivity to information and real-time access were key themes that emerged from the analysis, collectively identifying the complexity of innovating within an established paradigm. Despite understanding the benefits and risks associated with using mobile technology at point of care, nursing representatives were reluctant to exert agency and challenge traditional work patterns to alter the status quo.

Conclusions

The themes highlighted the complexity of accessing and using mobile technology for informal learning and continuing professional development. Mobile learning cannot occur at point of care until the factors identified are addressed. Additionally, a reluctance by nurses within professional organisations to advance protocols to govern digital professionalism needs to be overcome. For mobile learning to be perceived as a legitimate nursing function requires a more wholistic approach to risk management that includes all stakeholders, at all levels. The goal should be to develop revised protocols that establish a better balance between the costs and benefits of access to information technology in real-time by nurses.

     

Greek psychiatric care reform: new perspectives and challenges for community mental health nursing

The purpose of this article is twofold: (1) to explore the main issues of psychiatric care reform in Greece and outline the operating way of the new residential structures of psychiatric care and rehabilitation; and (2) to focus on the implementation of mental health nursing roles in the primary care services such as supervisor-therapist, liaison, coordinator-crisis interventionist and counsellor-trainer within the context of a multidisciplinary therapeutic team. Given that multiple professionals are involved in mental health care in primary care, issues of role are likely to be crucial to the effective implementation of new workers. Moreover, there is existing evidence of ambiguity in the roles of different mental health professionals in primary care, relating to the problems they manage and the treatments they provide. The authors believe that more emphasis needs to be given to the mental health nursing specialty in Greece, because the large majority of patients requiring mental health care should have the possibility of taking better quality of care as the psychiatric structures at community are continuously developing.