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Papers by leanne hunt

Presenting a summary of study characteristics of the 17 trials on daily CHG bathing of ICU patien... more Presenting a summary of study characteristics of the 17 trials on daily CHG bathing of ICU patients. (DOCX 35Â kb)

Contemporary Nurse, 2021

BACKGROUND COVID-19 has caused significant disruption. This has been particularly evident within ... more BACKGROUND COVID-19 has caused significant disruption. This has been particularly evident within the university student population where their traditional ways of learning were abruptly reorganised and support structures removed. OBJECTIVE This paper aims to explore undergraduate student nurses' perceptions of the support required from the university during COVID-19 using the Achievement Goal Theory framework. DESIGN Data were collected via an online survey of undergraduate student nurses from an Australian university. This paper is reporting the data from a single open-ended item asking participants about their support needs from the University. Data were analysed using thematic analysis. RESULTS Of the 178 students who responded 206 individual statements were provided about the support they would like from the university. Four primary themes emerged, Support beyond academia, Academic support, Online learning readiness and Clinical practice units and clinical placement. The students identified that their needs during this pandemic include financial needs, social isolation, needs for more communication and unpreparedness for online teaching. CONCLUSION Several factors were identified by participants about the additional support required from the university during COVID-19. Understanding and addressing these factors has the potential to improve student support during COVID-19 and support students in future crises. IMPACT STATEMENT Understanding what support students perceive they require from the university during significant disruption will assist in future crisis management planning.

Acta Anaesthesiologica Scandinavica, 2018

Background: Elevated intra-abdominal pressure (IAP) is a common occurrence in mechanically ventil... more Background: Elevated intra-abdominal pressure (IAP) is a common occurrence in mechanically ventilated patients in the intensive care unit (ICU). This study was undertaken to determine the relationship between IAP, pulmonary compliance and the duration of mechanical ventilation. Methods: A prospective study of 220 consecutively enrolled mechanically ventilated patients admitted to a mixed surgical-medical ICU in a tertiary referral hospital. The IAP was measured at least twice daily, benchmarked against consensus guidelines. Dynamic pulmonary compliance was calculated together with admission Acute Physiology and Chronic Health Evaluation (APACHE III) score and daily Sequential Organ Failure Assessment (SOFA) score. Results: No relationship between highest IAP for the day and pulmonary compliance (P = 0.61) was found. For each 5 mm Hg increase in IAP, the risk of remaining intubated increased 19% (HR = 1.19, 95% CI: 0.98-1.44); for each standard deviation increase in SOFA score (3.7 points), the risk of remaining intubated increased by 14% (HR = 1.14, 95% CI: 0.98-1.33); and for each 1 L increase in fluid balance, the risk of remaining intubated increased by 11% (HR = 1.11, 95% CI: 1.04-1.19). A nomogram was developed to predict the probability of extubation based on daily highest IAP for the day, SOFA score and fluid balance. Conclusion: IAPs did not correlate with pulmonary compliance in critically ill patients. Increased IAP was associated with a longer duration of mechanical ventilation. A nomogram integrating daily IAP, SOFA score and fluid balance may be used to predict the duration of mechanical ventilation.

Nurse Education in Practice, 2016

Indigenous people are the most disadvantaged population within Australia. The Bachelor of Nursing... more Indigenous people are the most disadvantaged population within Australia. The Bachelor of Nursing program at a large university in Western Sydney embedded Indigenous health into the undergraduate teaching program. This paper reviews the negative responses received towards course content on evaluation of the Indigenous health unit and explores the predictors for the negative attitudes towards Indigenous Australians. Two surveys were used (baseline and follow-up) to: 1. Determine the main predictors for negative attitudes towards Indigenous people and; 2. Explore students' perceptions of the educational quality of the Indigenous health unit. The surveys allowed collection of socio-demographic, academic data and included the 18 item 'Attitude Toward Indigenous Australians' (ATIA) scale and openended responses. Students who were: 1. Overseas born, 2. Enrolment category: International student and; 3. Whose primary source of information about Indigenous Australians were the media and school were significantly more likely to have higher negative attitudes towards Indigenous Australians. Qualitative data revealed some unfavourable comments dismissing the value and educational quality of the content within the Indigenous health unit. Community engagement is paramount to enhancing the student experience. Movement away from media driven 'hype' to an educated perspective is necessary to create an accurate portrayal of the Indigenous community.

Critical care and resuscitation : journal of the Australasian Academy of Critical Care Medicine, 2010

Readmission to intensive care during the same hospital stay has been associated with a greater ri... more Readmission to intensive care during the same hospital stay has been associated with a greater risk of in-hospital mortality and has been suggested as a marker of quality of care. There is lack of published research attempting to develop clinical prediction tools that individualise the risk of readmission to the intensive care unit during the same hospital stay. To develop a prediction model using an inception cohort of patients surviving an initial ICU stay. The study was conducted at Liverpool Hospital, Sydney. An inception cohort of 14 952 patients aged 15 years or more surviving an initial ICU stay and transferred to general wards in the study hospital between 1 January 1997 and 31 December 2007 was used to develop the model. Binary logistic regression was used to develop the prediction model and a nomogram was derived to individualise the risk of readmission to the ICU during the same hospital stay. Readmission to the ICU during the same hospital stay. Among members of the stud...

Journal of Trauma and Acute Care Surgery, 2012

BACKGROUND: Intra-abdominal pressure (IAP) measurement has become an important tool in the assess... more BACKGROUND: Intra-abdominal pressure (IAP) measurement has become an important tool in the assessment of critically ill patients. The World Society of the Abdominal Compartment Syndrome consensus guidelines recommend using a maximum volume of 25 mL of sterile saline instilled into the bladder for intermittent IAP measurements. It is postulated that the volume of fluid instilled may have an impact on the estimation of IAP. METHODS: This study sought to compare measured bladder pressures after the instillation of 25, 10, and 0 mL volumes of sterile saline using measurement analysis. Measurement was performed using the modified Kron technique, and treatment allocation was applied by prospective, alternate patient treatment allocation. Transvesical IAP measurements were undertaken using volumes from 0 mL to 25 mL. Recordings were taken with the catheter unclamped, clamped, 10 mL instillation, and 25 mL instillation. This measurement analysis was conducted in a mixed intensive care unit at a Level I trauma hospital over a period of 14 weeks. IAP measurements were performed on 37 patients with varying disease processes using 25, 10, and 0 mL of sterile saline instilled into the bladder. RESULTS: Medical, surgical, and trauma patients were distributed equally across the treatment groups. Twenty-three patients were male, and the mean age was 58 years T 18 years. The concordance correlation coefficient between 25 mL and 10 mL was 0.95. The concordance correlation coefficient between 25 mL and no fluid with an unclamped and clamped catheter was 0.55. CONCLUSION: In a general intensive care unit population, measured intra-urinary bladder pressure measurements using a volume of 10 mL fluid instillation provides comparable results to using 25 mL fluid.

Acta Clinica Belgica, 2014

Objectives: Assessment of intra-abdominal pressure (IAP) and the likelihood of abdominal compartm... more Objectives: Assessment of intra-abdominal pressure (IAP) and the likelihood of abdominal compartment syndrome using valid and reliable measures is an important tool in the assessment of critically ill patients. The current method of relying on a single IAP per measurement period to determine patient clinical status raises the question: is a single intermittent IAP measurement an accurate indicator of clinical status or should more than one measurement be taken per measurement period? Methods: This study sought to assess the reliability of IAP measurements. Measurements were taken using the modified Kron technique. A total of two transvesical intra-abdominal pressure measurements were undertaken per patient using a standardized protocol. Recordings were taken at intervals of 5 minutes. Results: The majority of participants (58%) were surgical patients. Thirty-two were males and the mean age was 58 years (SD: 16.7 years). The concordance correlation coefficient between the two measurements was 0.95. Both the scatter and Bland-Altman plots demonstrate that the comparisons of two measurements are highly reproducible. Conclusion: The findings of this study suggest that conducting two IAP measurements on single patient produce comparable results; therefore, there appears to be no advantage in doing two IAP measurements on a single patient. The measurement of an IAP requires the implementation of a standardized protocol and competent and credentialed assessors trained in the procedure.

Intra-abdominal hypertension (IAH) and abdominal compartment syndrome (ACS) are increasingly reco... more Intra-abdominal hypertension (IAH) and abdominal compartment syndrome (ACS) are increasingly recognised as complications for critically ill patients requiring accurate diagnosis and timely management. Increases in intra-abdominal pressure, beyond normal physiological parameters, can alter organ perfusion and as a consequence end organ function. The incidence of IAH is reported to be 50% of the critical care population. Of these 50%, 32.1% develop IAH and 4.2% develop ACS within the first 24 hours in the intensive care unit. Intra abdominal hypertension and ACS can impact on the care of a range of critically ill patients. Preventing complications, secondary to IAH and ACS, is important to improving patient outcomes. Early detection and intervention of intra-abdominal hypertension and abdominal compartment syndrome has the potential to reduce time in critical care, overall length of hospital stays and improve patient outcomes. Nurses are responsible for measuring and reporting of intr...

Nursing in Australia, 2020

The Australian Nursing and Midwifery Journal, 2018

The clinical learning environment experienced by undergraduate nursing students during clinical p... more The clinical learning environment experienced by undergraduate nursing students during clinical placements form an integral component of nursing education (Bisholt et al. 2014), to connect theory with practice, and develop the clinical skills necessary to transition into graduate practice as a registered nurse (Cooper et al. 2015). The clinical facilitator, also known as clinical instructor, supervisor or preceptor plays a pivotal role in this learning experience by supporting, supervising and monitoring students' clinical capabilities by benchmarking against industry standards and expectations.

Collegian, 2021

Background: Numeracy skills are essential for patient safety; therefore, it is vital that registe... more Background: Numeracy skills are essential for patient safety; therefore, it is vital that registered nurses are proficient in performing calculations, notably medication calculations. However, the literature indicates that a large proportion of undergraduate nursing students and registered nurses are not competent in numeracy. The manifestation of numerical and calculation errors is thought to stem from failing to comprehend key mathematical principles from primary or secondary school, as well as the minimal admission requirements to enter nursing programs. Tertiary education providers teach and assess numeracy within nursing programs using a diverse range of pedagogical and instructional approaches. These programs of nursing study are underpinned by the Australian Nursing & Midwifery Accreditation Council standards, and lead to nursing registration in Australia. These accreditation standards do not incorporate numeracy, placing the onus on the tertiary education providers to design content and assessment types, as well as establish a benchmark to gauge the competence of the student prior to graduating. Question: Why the Australian Nursing & Midwifery Accreditation Council does not require graduates to demonstrate numeracy proficiency, and why there are no recommendations for undergraduate numeracy content and assessment in Australia. Method: An exploratory sequential mixed methods design across 5 stages will be used. Findings: No data has been collected to date. Discussion: No discussion has been written to date. Conclusion: To contribute knowledge to improve the competence of undergraduate nursing students in relation to numeracy education, and ultimately the safety of Registered Nurses when calculating medications in practice.

Journal of Clinical Nursing, 2021

Aims and Objectives: To compare knowledge, anxiety, academic concerns and preventative behaviours... more Aims and Objectives: To compare knowledge, anxiety, academic concerns and preventative behaviours between undergraduate nursing students in Australia and India during the COVID-19 pandemic. Background: Based on the World Health Organization's direction for containment of the novel coronavirus (COVID-19), countries implemented varying levels of restrictions including closure of university campuses and providing on line undergraduate education. Methods: Students in NSW, Australia and Kerala, India completed an online survey assessing their (a) knowledge and source of information about COVID-19; (b) anxiety; and coping strategies; (c) academic concerns; and (d) preventative behaviours. Descriptive and inferential statistics were used to summarise the data. Results: Data from 99 Australian and 113 Indian undergraduate nurses were analysed. Greater number of Indian students indicated having sufficient knowledge of COVID-19 (OR 0.22; 95% CI 0.08, 0.63), getting information about COVID-19 from social media (OR 0.03; 95% CI 0.01, 0.07) and being concerned about 'attending clinical placement' (MD-1.08; 95% CI −1.94, −0.23). Australian students reported significantly higher levels of anxiety (

Contemporary Nurse, 2021

Background Many nursing programmes have had to swiftly move online in response to COVID-19. Nursi... more Background Many nursing programmes have had to swiftly move online in response to COVID-19. Nursing students are often a heterogenous group that traverses generational boundaries. Exploring generational differences may assist in developing support systems for specific groups. This study sought to examine psychological wellbeing and preventative behaviours among nursing students from the iGeneration in comparison to older generations. Method A prospective cross-sectional study was undertaken using a convenience sample of pre-registration nursing students studying at two Australian Universities, one regional and one metropolitan. About 631 pre-registration nursing students completed an online survey. Results An independent samples t-test revealed that students from the iGeneration possess higher anxiety compared to nursing students from older generations (p = .000). Compared to iGeneration participants, older generation participants had significantly higher scores for knowledge of COVID-19 (p = .015). iGeneration participants utilised social media to source information about COVID-19 far more than older generations (p = .008). iGeneration participants were significantly more concerned than older generations about the impact of COVID-19 on completing their clinical placement (p = .014). Older generations tended to have higher academic preventative behaviours, with significant mean scores for not attending university if they or others they knew had symptoms of COVID-19. Conclusion Given the differences between generation groups with regard to psychological wellbeing, knowledge about COVID-19, and concerns about studying in an altered study environment, strategies should be targeted to generational groups. Anxiety negatively impacts the quality of life, educational performance and clinical practice and is experienced more frequently in the iGeneration. Therefore it is crucial for nursing educators to reflect on how they engage this generation in the online space to provide support, stability and a sense of connection. This will contribute towards ensuring a well-prepared future nursing workforce who may encounter other pandemics and isolating events. Impact statement Compared with other generations, iGeneration students have a greater likelihood to experience mental health issues, isolation and insecurity. Nursing leaders and educators must be sensitive to such intergenerational differences, to ensure they are developing a skilled and productive workforce.

Journal of Clinical Nursing, 2021

BACKGROUND Nursing has been identified as a stressful profession with the potential to have negat... more BACKGROUND Nursing has been identified as a stressful profession with the potential to have negative impacts on nurses' physical and mental health. Nurses working in emergency departments face unique daily stressors. AIMS AND OBJECTIVES This study aimed to profile stress, exploring whether demographics and/or other factors uniquely contribute to stress for emergency departments nurses. METHOD A cross-sectional survey was distributed in May 2019 to ED nurses working in New South Wales (NSW), Australia. A total of 242 nurses completed the survey, of which 190 cases were analysed. A standardised scale was used in the survey, the Expanded Nursing Stress Scale (ENSS). The sampling method for this research was non-probability purposive sampling. STROBE checklist was used for this manuscript. RESULTS The results of this study indicated that emergency department nurses experience stress in their work settings. Stress is experienced predominantly because of problems in dealing with patients and their families, high workloads, and uncertainty concerning treatment. CONCLUSION The results of this study provide valuable insights into the work-related stress experienced by emergency department nurses This information can be used to inform the development of strategies to minimise stress for emergency nurses. RELEVANCE TO CLINICAL PRACTICE This study builds on existing, and contributes to new, knowledge about the current stressors for emergency department nurses. The results provide insights into how policies and procedures may need to be adjusted and interventions developed, that can help in reducing stress.

Background As the population ages clinical frailty among older adults admitted to intensive care ... more Background As the population ages clinical frailty among older adults admitted to intensive care has been proposed as an important determinant of patient outcomes. Among this group of frail patients an acute episode of delirium is also common, and both frailty and delirium increase the risk of mortality. However, the complex relationship between frailty, delirium and mortality has not been extensively explored in the intensive care setting. Therefore, the aim of this study was to explore the relationship between clinical frailty, acute delirium and hospital mortality of older adults admitted to intensive care. Methods This study is part of a Delirium in Intensive Care (Deli) study that is being conducted across the South Western Sydney Local Health District, between May 2019 and April 2020. During the initial 6-month baseline period, clinical frailty status on admission to ICU, among adults aged 50-years or more, acute episodes of delirium, and the outcomes of ICU and hospital stay ...

Nurse Education in Practice, 2020

Clinical placement experience is an integral component of nursing education as students acquire t... more Clinical placement experience is an integral component of nursing education as students acquire the essential knowledge and skills through learning in a supervised clinical environment. The role of the facilitator is pivotal to ensure students are practising safely and competently. The aim of this review was to explore the clinical performance issues identified by clinical facilitators, examine the relationship between students' academic and clinical performance, and factors influencing performance and attrition. A scoping review was undertaken to identify relevant literature, emerging themes and gaps in the literature, searching five electronic databases for primary and secondary papers, and the grey literature. No date limit was set for the review. Fifteen papers met the inclusion criteria. The top three themes relating to clinical performance issues included: i) Poor communication skills, ii) Inadequate knowledge or clinical incompetence and, iii) Unprofessional behaviour. The review also identified the relationship between academic and clinical performance, and negative experiences influencing students' decisions to leave the course. This scoping review highlighted the paucity of literature relating to clinical performance from the perspective of the facilitator, as well as the relationship between student characteristics and clinical performance and attrition.

Presenting a summary of study characteristics of the 17 trials on daily CHG bathing of ICU patien... more Presenting a summary of study characteristics of the 17 trials on daily CHG bathing of ICU patients. (DOCX 35Â kb)

Contemporary Nurse, 2021

BACKGROUND COVID-19 has caused significant disruption. This has been particularly evident within ... more BACKGROUND COVID-19 has caused significant disruption. This has been particularly evident within the university student population where their traditional ways of learning were abruptly reorganised and support structures removed. OBJECTIVE This paper aims to explore undergraduate student nurses' perceptions of the support required from the university during COVID-19 using the Achievement Goal Theory framework. DESIGN Data were collected via an online survey of undergraduate student nurses from an Australian university. This paper is reporting the data from a single open-ended item asking participants about their support needs from the University. Data were analysed using thematic analysis. RESULTS Of the 178 students who responded 206 individual statements were provided about the support they would like from the university. Four primary themes emerged, Support beyond academia, Academic support, Online learning readiness and Clinical practice units and clinical placement. The students identified that their needs during this pandemic include financial needs, social isolation, needs for more communication and unpreparedness for online teaching. CONCLUSION Several factors were identified by participants about the additional support required from the university during COVID-19. Understanding and addressing these factors has the potential to improve student support during COVID-19 and support students in future crises. IMPACT STATEMENT Understanding what support students perceive they require from the university during significant disruption will assist in future crisis management planning.

Acta Anaesthesiologica Scandinavica, 2018

Background: Elevated intra-abdominal pressure (IAP) is a common occurrence in mechanically ventil... more Background: Elevated intra-abdominal pressure (IAP) is a common occurrence in mechanically ventilated patients in the intensive care unit (ICU). This study was undertaken to determine the relationship between IAP, pulmonary compliance and the duration of mechanical ventilation. Methods: A prospective study of 220 consecutively enrolled mechanically ventilated patients admitted to a mixed surgical-medical ICU in a tertiary referral hospital. The IAP was measured at least twice daily, benchmarked against consensus guidelines. Dynamic pulmonary compliance was calculated together with admission Acute Physiology and Chronic Health Evaluation (APACHE III) score and daily Sequential Organ Failure Assessment (SOFA) score. Results: No relationship between highest IAP for the day and pulmonary compliance (P = 0.61) was found. For each 5 mm Hg increase in IAP, the risk of remaining intubated increased 19% (HR = 1.19, 95% CI: 0.98-1.44); for each standard deviation increase in SOFA score (3.7 points), the risk of remaining intubated increased by 14% (HR = 1.14, 95% CI: 0.98-1.33); and for each 1 L increase in fluid balance, the risk of remaining intubated increased by 11% (HR = 1.11, 95% CI: 1.04-1.19). A nomogram was developed to predict the probability of extubation based on daily highest IAP for the day, SOFA score and fluid balance. Conclusion: IAPs did not correlate with pulmonary compliance in critically ill patients. Increased IAP was associated with a longer duration of mechanical ventilation. A nomogram integrating daily IAP, SOFA score and fluid balance may be used to predict the duration of mechanical ventilation.

Nurse Education in Practice, 2016

Indigenous people are the most disadvantaged population within Australia. The Bachelor of Nursing... more Indigenous people are the most disadvantaged population within Australia. The Bachelor of Nursing program at a large university in Western Sydney embedded Indigenous health into the undergraduate teaching program. This paper reviews the negative responses received towards course content on evaluation of the Indigenous health unit and explores the predictors for the negative attitudes towards Indigenous Australians. Two surveys were used (baseline and follow-up) to: 1. Determine the main predictors for negative attitudes towards Indigenous people and; 2. Explore students' perceptions of the educational quality of the Indigenous health unit. The surveys allowed collection of socio-demographic, academic data and included the 18 item 'Attitude Toward Indigenous Australians' (ATIA) scale and openended responses. Students who were: 1. Overseas born, 2. Enrolment category: International student and; 3. Whose primary source of information about Indigenous Australians were the media and school were significantly more likely to have higher negative attitudes towards Indigenous Australians. Qualitative data revealed some unfavourable comments dismissing the value and educational quality of the content within the Indigenous health unit. Community engagement is paramount to enhancing the student experience. Movement away from media driven 'hype' to an educated perspective is necessary to create an accurate portrayal of the Indigenous community.

Critical care and resuscitation : journal of the Australasian Academy of Critical Care Medicine, 2010

Readmission to intensive care during the same hospital stay has been associated with a greater ri... more Readmission to intensive care during the same hospital stay has been associated with a greater risk of in-hospital mortality and has been suggested as a marker of quality of care. There is lack of published research attempting to develop clinical prediction tools that individualise the risk of readmission to the intensive care unit during the same hospital stay. To develop a prediction model using an inception cohort of patients surviving an initial ICU stay. The study was conducted at Liverpool Hospital, Sydney. An inception cohort of 14 952 patients aged 15 years or more surviving an initial ICU stay and transferred to general wards in the study hospital between 1 January 1997 and 31 December 2007 was used to develop the model. Binary logistic regression was used to develop the prediction model and a nomogram was derived to individualise the risk of readmission to the ICU during the same hospital stay. Readmission to the ICU during the same hospital stay. Among members of the stud...

Journal of Trauma and Acute Care Surgery, 2012

BACKGROUND: Intra-abdominal pressure (IAP) measurement has become an important tool in the assess... more BACKGROUND: Intra-abdominal pressure (IAP) measurement has become an important tool in the assessment of critically ill patients. The World Society of the Abdominal Compartment Syndrome consensus guidelines recommend using a maximum volume of 25 mL of sterile saline instilled into the bladder for intermittent IAP measurements. It is postulated that the volume of fluid instilled may have an impact on the estimation of IAP. METHODS: This study sought to compare measured bladder pressures after the instillation of 25, 10, and 0 mL volumes of sterile saline using measurement analysis. Measurement was performed using the modified Kron technique, and treatment allocation was applied by prospective, alternate patient treatment allocation. Transvesical IAP measurements were undertaken using volumes from 0 mL to 25 mL. Recordings were taken with the catheter unclamped, clamped, 10 mL instillation, and 25 mL instillation. This measurement analysis was conducted in a mixed intensive care unit at a Level I trauma hospital over a period of 14 weeks. IAP measurements were performed on 37 patients with varying disease processes using 25, 10, and 0 mL of sterile saline instilled into the bladder. RESULTS: Medical, surgical, and trauma patients were distributed equally across the treatment groups. Twenty-three patients were male, and the mean age was 58 years T 18 years. The concordance correlation coefficient between 25 mL and 10 mL was 0.95. The concordance correlation coefficient between 25 mL and no fluid with an unclamped and clamped catheter was 0.55. CONCLUSION: In a general intensive care unit population, measured intra-urinary bladder pressure measurements using a volume of 10 mL fluid instillation provides comparable results to using 25 mL fluid.

Acta Clinica Belgica, 2014

Objectives: Assessment of intra-abdominal pressure (IAP) and the likelihood of abdominal compartm... more Objectives: Assessment of intra-abdominal pressure (IAP) and the likelihood of abdominal compartment syndrome using valid and reliable measures is an important tool in the assessment of critically ill patients. The current method of relying on a single IAP per measurement period to determine patient clinical status raises the question: is a single intermittent IAP measurement an accurate indicator of clinical status or should more than one measurement be taken per measurement period? Methods: This study sought to assess the reliability of IAP measurements. Measurements were taken using the modified Kron technique. A total of two transvesical intra-abdominal pressure measurements were undertaken per patient using a standardized protocol. Recordings were taken at intervals of 5 minutes. Results: The majority of participants (58%) were surgical patients. Thirty-two were males and the mean age was 58 years (SD: 16.7 years). The concordance correlation coefficient between the two measurements was 0.95. Both the scatter and Bland-Altman plots demonstrate that the comparisons of two measurements are highly reproducible. Conclusion: The findings of this study suggest that conducting two IAP measurements on single patient produce comparable results; therefore, there appears to be no advantage in doing two IAP measurements on a single patient. The measurement of an IAP requires the implementation of a standardized protocol and competent and credentialed assessors trained in the procedure.

Intra-abdominal hypertension (IAH) and abdominal compartment syndrome (ACS) are increasingly reco... more Intra-abdominal hypertension (IAH) and abdominal compartment syndrome (ACS) are increasingly recognised as complications for critically ill patients requiring accurate diagnosis and timely management. Increases in intra-abdominal pressure, beyond normal physiological parameters, can alter organ perfusion and as a consequence end organ function. The incidence of IAH is reported to be 50% of the critical care population. Of these 50%, 32.1% develop IAH and 4.2% develop ACS within the first 24 hours in the intensive care unit. Intra abdominal hypertension and ACS can impact on the care of a range of critically ill patients. Preventing complications, secondary to IAH and ACS, is important to improving patient outcomes. Early detection and intervention of intra-abdominal hypertension and abdominal compartment syndrome has the potential to reduce time in critical care, overall length of hospital stays and improve patient outcomes. Nurses are responsible for measuring and reporting of intr...

Nursing in Australia, 2020

The Australian Nursing and Midwifery Journal, 2018

The clinical learning environment experienced by undergraduate nursing students during clinical p... more The clinical learning environment experienced by undergraduate nursing students during clinical placements form an integral component of nursing education (Bisholt et al. 2014), to connect theory with practice, and develop the clinical skills necessary to transition into graduate practice as a registered nurse (Cooper et al. 2015). The clinical facilitator, also known as clinical instructor, supervisor or preceptor plays a pivotal role in this learning experience by supporting, supervising and monitoring students' clinical capabilities by benchmarking against industry standards and expectations.

Collegian, 2021

Background: Numeracy skills are essential for patient safety; therefore, it is vital that registe... more Background: Numeracy skills are essential for patient safety; therefore, it is vital that registered nurses are proficient in performing calculations, notably medication calculations. However, the literature indicates that a large proportion of undergraduate nursing students and registered nurses are not competent in numeracy. The manifestation of numerical and calculation errors is thought to stem from failing to comprehend key mathematical principles from primary or secondary school, as well as the minimal admission requirements to enter nursing programs. Tertiary education providers teach and assess numeracy within nursing programs using a diverse range of pedagogical and instructional approaches. These programs of nursing study are underpinned by the Australian Nursing & Midwifery Accreditation Council standards, and lead to nursing registration in Australia. These accreditation standards do not incorporate numeracy, placing the onus on the tertiary education providers to design content and assessment types, as well as establish a benchmark to gauge the competence of the student prior to graduating. Question: Why the Australian Nursing & Midwifery Accreditation Council does not require graduates to demonstrate numeracy proficiency, and why there are no recommendations for undergraduate numeracy content and assessment in Australia. Method: An exploratory sequential mixed methods design across 5 stages will be used. Findings: No data has been collected to date. Discussion: No discussion has been written to date. Conclusion: To contribute knowledge to improve the competence of undergraduate nursing students in relation to numeracy education, and ultimately the safety of Registered Nurses when calculating medications in practice.

Journal of Clinical Nursing, 2021

Aims and Objectives: To compare knowledge, anxiety, academic concerns and preventative behaviours... more Aims and Objectives: To compare knowledge, anxiety, academic concerns and preventative behaviours between undergraduate nursing students in Australia and India during the COVID-19 pandemic. Background: Based on the World Health Organization's direction for containment of the novel coronavirus (COVID-19), countries implemented varying levels of restrictions including closure of university campuses and providing on line undergraduate education. Methods: Students in NSW, Australia and Kerala, India completed an online survey assessing their (a) knowledge and source of information about COVID-19; (b) anxiety; and coping strategies; (c) academic concerns; and (d) preventative behaviours. Descriptive and inferential statistics were used to summarise the data. Results: Data from 99 Australian and 113 Indian undergraduate nurses were analysed. Greater number of Indian students indicated having sufficient knowledge of COVID-19 (OR 0.22; 95% CI 0.08, 0.63), getting information about COVID-19 from social media (OR 0.03; 95% CI 0.01, 0.07) and being concerned about 'attending clinical placement' (MD-1.08; 95% CI −1.94, −0.23). Australian students reported significantly higher levels of anxiety (

Contemporary Nurse, 2021

Background Many nursing programmes have had to swiftly move online in response to COVID-19. Nursi... more Background Many nursing programmes have had to swiftly move online in response to COVID-19. Nursing students are often a heterogenous group that traverses generational boundaries. Exploring generational differences may assist in developing support systems for specific groups. This study sought to examine psychological wellbeing and preventative behaviours among nursing students from the iGeneration in comparison to older generations. Method A prospective cross-sectional study was undertaken using a convenience sample of pre-registration nursing students studying at two Australian Universities, one regional and one metropolitan. About 631 pre-registration nursing students completed an online survey. Results An independent samples t-test revealed that students from the iGeneration possess higher anxiety compared to nursing students from older generations (p = .000). Compared to iGeneration participants, older generation participants had significantly higher scores for knowledge of COVID-19 (p = .015). iGeneration participants utilised social media to source information about COVID-19 far more than older generations (p = .008). iGeneration participants were significantly more concerned than older generations about the impact of COVID-19 on completing their clinical placement (p = .014). Older generations tended to have higher academic preventative behaviours, with significant mean scores for not attending university if they or others they knew had symptoms of COVID-19. Conclusion Given the differences between generation groups with regard to psychological wellbeing, knowledge about COVID-19, and concerns about studying in an altered study environment, strategies should be targeted to generational groups. Anxiety negatively impacts the quality of life, educational performance and clinical practice and is experienced more frequently in the iGeneration. Therefore it is crucial for nursing educators to reflect on how they engage this generation in the online space to provide support, stability and a sense of connection. This will contribute towards ensuring a well-prepared future nursing workforce who may encounter other pandemics and isolating events. Impact statement Compared with other generations, iGeneration students have a greater likelihood to experience mental health issues, isolation and insecurity. Nursing leaders and educators must be sensitive to such intergenerational differences, to ensure they are developing a skilled and productive workforce.

Journal of Clinical Nursing, 2021

BACKGROUND Nursing has been identified as a stressful profession with the potential to have negat... more BACKGROUND Nursing has been identified as a stressful profession with the potential to have negative impacts on nurses' physical and mental health. Nurses working in emergency departments face unique daily stressors. AIMS AND OBJECTIVES This study aimed to profile stress, exploring whether demographics and/or other factors uniquely contribute to stress for emergency departments nurses. METHOD A cross-sectional survey was distributed in May 2019 to ED nurses working in New South Wales (NSW), Australia. A total of 242 nurses completed the survey, of which 190 cases were analysed. A standardised scale was used in the survey, the Expanded Nursing Stress Scale (ENSS). The sampling method for this research was non-probability purposive sampling. STROBE checklist was used for this manuscript. RESULTS The results of this study indicated that emergency department nurses experience stress in their work settings. Stress is experienced predominantly because of problems in dealing with patients and their families, high workloads, and uncertainty concerning treatment. CONCLUSION The results of this study provide valuable insights into the work-related stress experienced by emergency department nurses This information can be used to inform the development of strategies to minimise stress for emergency nurses. RELEVANCE TO CLINICAL PRACTICE This study builds on existing, and contributes to new, knowledge about the current stressors for emergency department nurses. The results provide insights into how policies and procedures may need to be adjusted and interventions developed, that can help in reducing stress.

Background As the population ages clinical frailty among older adults admitted to intensive care ... more Background As the population ages clinical frailty among older adults admitted to intensive care has been proposed as an important determinant of patient outcomes. Among this group of frail patients an acute episode of delirium is also common, and both frailty and delirium increase the risk of mortality. However, the complex relationship between frailty, delirium and mortality has not been extensively explored in the intensive care setting. Therefore, the aim of this study was to explore the relationship between clinical frailty, acute delirium and hospital mortality of older adults admitted to intensive care. Methods This study is part of a Delirium in Intensive Care (Deli) study that is being conducted across the South Western Sydney Local Health District, between May 2019 and April 2020. During the initial 6-month baseline period, clinical frailty status on admission to ICU, among adults aged 50-years or more, acute episodes of delirium, and the outcomes of ICU and hospital stay ...

Nurse Education in Practice, 2020

Clinical placement experience is an integral component of nursing education as students acquire t... more Clinical placement experience is an integral component of nursing education as students acquire the essential knowledge and skills through learning in a supervised clinical environment. The role of the facilitator is pivotal to ensure students are practising safely and competently. The aim of this review was to explore the clinical performance issues identified by clinical facilitators, examine the relationship between students' academic and clinical performance, and factors influencing performance and attrition. A scoping review was undertaken to identify relevant literature, emerging themes and gaps in the literature, searching five electronic databases for primary and secondary papers, and the grey literature. No date limit was set for the review. Fifteen papers met the inclusion criteria. The top three themes relating to clinical performance issues included: i) Poor communication skills, ii) Inadequate knowledge or clinical incompetence and, iii) Unprofessional behaviour. The review also identified the relationship between academic and clinical performance, and negative experiences influencing students' decisions to leave the course. This scoping review highlighted the paucity of literature relating to clinical performance from the perspective of the facilitator, as well as the relationship between student characteristics and clinical performance and attrition.