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Biomedical subjects

Amanda Henderson

Publications and source records attributed to Amanda Henderson.

At least 19 recordsLinked to original sources
PubMed2007

Enabling student placement through strategic partnerships between a health-care organization and tertiary institutions.

Nursing management needs to demonstrate its commitment to clinical education for undergraduate nursing students. The vision for the nursing leadership and management team at Princess Alexandra Hospital is to guide and support the development of hospital clinicians, at all levels in the organization, to effectively facilitate undergraduate students' learning during their clinical practical experiences. This paper examines the evolution of the meaning, commitment and practices that have been intrinsic to the development of strategic partnerships between the health-care organization and tertiary institutions to ensure that hospital staff who consistently facilitate student learning in the clinical context are well supported. The partnerships are based on open channels of communication between the health-care organization and the tertiary institutions whereby each party identifies its needs and priorities. This has resulted in increased hospital staff satisfaction through greater involvement by them in the placements of students, and enhanced understanding of clinicians of the student placement process that has contributed to improved satisfaction and outcomes for the students.

Attitude of Health Personnel↗
PubMed2006

Students' perception of the psycho-social clinical learning environment: an evaluation of placement models.

Nursing is a practice based discipline. A supportive environment has been identified as important for the transfer of learning in the clinical context. The aim of the paper was to assess undergraduate nurses' perceptions of the psychosocial characteristics of clinical learning environments within three different clinical placement models. Three hundred and eight-nine undergraduate nursing students rated their perceptions of the psycho-social learning environment using a Clinical Learning Environment Inventory. There were 16 respondents in the Preceptor model category, 269 respondents in the Facilitation model category and 114 respondents in the clinical education unit model across 25 different clinical areas in one tertiary facility. The most positive social climate was associated with the preceptor model. On all subscales the median score was rated higher than the two other models. When clinical education units were compared with the standard facilitation model the median score was rated higher in all of the subscales in the Clinical Learning Environment Inventory. These results suggest that while preceptoring is an effective clinical placement strategy that provides psycho-social support for students, clinical education units that are more sustainable through their placement of greater numbers of students, can provide greater psycho-social support for students than traditional models.

Attitude of Health Personnel↗
PubMed2006

Boundaries around the 'well-informed' patient: the contribution of Schutz to inform nurses' interactions.

AIM: The aim of this paper is to explore the operation of two different types of knowledge in health care and the position of the nurse to assist in the confluence of knowledge to develop the well-informed patient. BACKGROUND: If patients are to be active participants in their care they require useful information. Interactions in contemporary health care mostly involve 'medico-scientific' knowledge, that refers to the 'science' of patients' conditions, as opposed to 'everyday' knowledge, which refers to information that can assist patients in lifestyle matters relating to their condition. THEORETICAL PERSPECTIVE: This paper draws on the work of the 'well-informed citizen' as proposed by Schutz in the analysis of two patient case studies of practices in the acute care setting of the hospital. METHOD: Data collection was undertaken through fieldwork, incorporating participant observation and discussions with patients in general medical/surgical areas. RESULTS: Two patient case studies representative of the findings are analysed. Analysis identifies the predominant use of 'medico-scientific' knowledge to the detriment of 'everyday' knowledge during interactions between patients and all health professionals. CONCLUSIONS: There is predisposition in the acute context to interact in 'medico-scientific' knowledge as opposed to 'everyday' knowledge that does not facilitate a comprehensive understanding by patients of how they can best manage their lifestyle. RELEVANCE TO CLINICAL PRACTICE: Using the notion of Schutz's 'well-informed' citizen this study identifies strategies for nursing staff to capture and explore the development of 'everyday' knowledge that can assist patients to become more informed and improve their health management.

Adult↗
PubMed2006

The motivation of health professionals to explore research evidence in their practice: An intervention study.

AIM: To assess the impact of multifaceted clinically focused educational strategies that concentrated on introducing dementia care research evidence on health professionals' awareness and inclination to use research findings in their future practice. BACKGROUND: The promise of evidence-based practice is slow to materialize with the limitations of adopting research findings in practice readily identifiable. METHOD: A pre- and post-test quasi experimental design. The study involved the administration of: a pretest (baseline), an intervention phase, and a post-test survey, the same research utilization survey. TOOL: The Edmonton Research Orientation Survey (EROS), a self-report tool that asks participants about their attitudes toward research and about their potential to use research findings, was used to determine health professionals' orientation to research. INTERVENTION: The introduction of dementia care research evidence through multifaceted clinically focused educational strategies to improve practice. This was achieved through a resource team comprising a Clinical Nurse Consultant, as a leader and resource of localized evidence-based knowledge in aged care; an experienced Registered Nurse to support the introduction of strategies and a further experienced educator and clinician to reinforce the importance of evidence in change. RESULTS: Across all the four subscales that are measured in the Edmonton Research Orientation Survey, statistical analysis by independent samples t-test identified that there was no significant change between the before and after measurements. RELEVANCE TO CLINICAL PRACTICE: Successful integration of changes based on evidence does not necessarily mean that staff become more aware or are more inclined to use research findings in future to address problems.

Adult↗
PubMed2006

The development of picture cards and their use in ascertaining characteristics of Chinese surgical patients' decision-making preferences.

AIM: This exploratory pilot study developed and tested the validity of picture cards as a strategy to ascertain patients' desired participation in decision making. These were then used to ascertain characteristics of Hong Kong Chinese patients' decision-making preferences for surgery. VALIDATION OF TOOL: Two sets of analyses tested the validity of picture cards in an Australian and Hong Kong Chinese population. First, the ratings of the two groups of participants using the picture cards for three scenarios (severe, moderate and mild medical conditions) were correlated with mean ratings of three decision-making subscales of a self-report questionnaire for the three scenarios. Second, a 3 (Scenario) x 2 (Ethnic Group) mixed anova examined whether the picture cards are sensitive to differences relating to severity of medical conditions and ethnicity. SETTING AND PARTICIPANTS: A convenience sample of initially 35 Hong Kong and 24 Australian patients was used to validate the picture card tool. A convenience sample of a further 186 Hong Kong Chinese surgical inpatients used the tool. DESIGN: Participants selected the picture card that best represented their decision-making preference. MAIN VARIABLES: Demographic factors, prior knowledge, nature of surgery and preference for participation in decision making. RESULTS: Significant correlations were made between the questionnaire and the picture card tool. Using the tool, a significant difference was found between males' and females' decision-making preference, yet, no significant difference was found with respect to type or previous surgical operation.

Adult↗
PubMed2006

The evolving relationship of technology and nursing practice: negotiating the provision of care in a high tech environment.

Nurses proudly espouse that they provide 'care' in highly technological environments that focus on 'cure'. How care is achieved in such environments continues to be debated: There is evidence that care is dominated by the management of technology. The literature identifies that the nature of care provision by nurses is largely dependant on nurses' experience with complex technologies. More specifically, nurses familiar with the technology integral to the care environment are more likely to 'engage' with the patient in their care. There is evidence that nurses do provide patient-centred care in a technologically dominant world. The nature of such care is invariably dependant on the specific context of the user and the technology. This means nurses require highly developed capabilities to 'situate' themselves within these specific contexts to focus on the particular needs of the patient. Experienced nurses are able to articulate and demonstrate opportunities whereby they situate themselves with patients to learn about them and their needs. It is important that this knowledge and practice pertinent to this domain is articulated to assist in the development of capabilities for nurses to 'care' for patients' direct or indirect expressed needs in a highly technological environment.

Nursing↗
PubMed2005

Partner, Learn, Progress: a conceptual model for continuous clinical education.

In practice disciplines, such as nursing, learning can be maximised through experience located in the clinical setting. However, placement in the clinical setting does not automatically mean that the learner's professional practice will improve. Experiences in 'real-life' settings need to be effectively facilitated to obtain the desired outcomes. This paper through the discussion of 'Partner, Learn, Progress' details a conceptual model for promoting learning in the clinical context. 'Partner' refers to the positive association between the learner and the experienced clinician that engenders trust. It occurs on a personal level in the context of a broader social and political environment. 'Learn' refers to the process whereby the experienced clinician is able to assist the learner make sense of theoretical knowledge or knowledge that has previously been 'distal' to their practice to be integrated into their immediate practice. The clinician requires to be cognisant of the learner's existing knowledge level so that the activities and accompanying discussion assist in making connections between theory and practice. Learning incorporates mutual collaboration whereby the learner is able to practise the application of knowledge in a safe context and make their own connections. The further exploration of meanings through experiences, feelings, attitudes leads the learner to 'progress': the development of knowledge. Such a conceptual model provides a framework for educators and supervisors of clinical learning to educate and learn from the next generation of nurses that will lead the nursing profession into the future.

Attitude of Health Personnel↗
PubMed2005

Read, Think, Do!: a method for fitting research evidence into practice.

AIM: This paper discusses a process for research utilization that overcomes well-known barriers in order to influence clinical decision-making and practice change. Read, Think, Do! is a problem-solving approach to research utilization and practice development which has the potential to overcome barriers to research utilization. BACKGROUND: Any process for research utilization at the practice level needs to overcome numerous barriers in order to influence clinical decision-making and practice change. Access to research-based knowledge is an obvious first step in the evidence-based approach to care delivery, but is clearly inadequate alone in influencing the improvement of practice. DISCUSSION: Read, Think, Do! acknowledges the complexity of problem-solving processes from the outset by looking for (1) the evidence, (2) assessing the value to practice, and (3) addressing the social and cultural milieu of the practice setting to ascertain the best strategies for initiating and sustaining practice change. This approach draws distal forms of empirical knowledge that have the capacity to improve patient outcomes into the proximal knowledge base of the clinical nurse. This is achieved by collaboration, planning and evaluation involving all levels of staff and a specialist facilitator, the Clinical Nurse Consultant in evidence-based practice. CONCLUSION: Read, Think, Do! is a method of research utilization and practice development that has the potential to overcome barriers to research utilization and avoid the "misplaced concreteness" that can occur when trying to fit empiricism into practice. By addressing the breadth and diversity of issues surrounding research utilization in a systematic manner it presents a sustainable method for practice change informed by evidence.

Decision Making↗
PubMed2005

The value of integrating interpretive research approaches in the exposition of health care context.

AIM: This paper discusses the use of a nested set of methodologies (dramaturgy, ethno-methodology and ethnography) to characterize and interpret the settings, practices and interactions inherent in the health care environment. The aim is to explain how a set of methodologies can help make sense of research data in the clinical setting. BACKGROUND: Despite the recognition of the importance of the context of care there has been limited debate about the use and value of research methods and methodologies and how they can be best applied to the health care context. DISCUSSION: Using dramaturgy the physical and social scene can clearly be established, to enable insight into 'how the scene is contrived'. The ethno-methodological approach assists in the examination of taken-for-granted assumptions inherent in the interactions between individuals in the 'scene', and the underlying 'shared' knowledge within interactions. 'Shared knowledge' identifies knowledge as a medium for communication. The use of ethnography ensures that social and cultural symbols, which are an integral component of how individuals collectively attribute meaning to places and events, become a significant part in the interpretation of interactions. CONCLUSION: The combination of these methods is advantageous in assisting qualitative researchers in the health care environment to 'make sense' of their complex field notes.

Anthropology, Cultural↗
PubMed2005

Exploration of patients' needs for information on arrival at a geriatric and rehabilitation unit.

AIM: The aim of this study was to gather information about patients' needs prior to transferring from an acute care facility to a rehabilitation setting that could assist patients to engage actively in rehabilitation activities upon entering the unit. BACKGROUND: The provision of information is an important aspect of health care as it assists patients to become informed and actively participate in this care. Improved recovery has been associated with patients' adherence to care regimes. METHOD: Semi-structured interviews were undertaken with a convenient sample of nine patients shortly after admission/transfer to a rehabilitation unit and with four of these patients after discharge. The intent was to learn what information patients receive prior to admission to the rehabilitation unit, whether this information is useful and whether different information would be more useful to facilitate patients' engagement in the activities central to rehabilitation treatment. RESULTS: Interviews revealed that, generally, patients received very little information about what to expect on admission to the rehabilitation unit and patients' engagement was more dependent on perceptions about rehabilitation. Thematic analysis identified that, in general, rehabilitation was perceived as 'a ticket out' and 'a good thing'. In relation to provision of information of participants identified that 'doesn't matter that I don't know'; 'information is not always meaningful' and 'I will adjust in my own time'. RELEVANCE TO CLINICAL PRACTICE: Health professionals need to recognize that patients are often compliant with decisions made while they are inpatients of the current health care system. Even though patients may 'actively participate' in rehabilitation processes it is often still as a passive recipient of health care.

Activities of Daily Living↗
PubMed2005

'Working from the inside': an infrastructure for the continuing development of nurses' professional clinical practice.

AIM: This paper describes how the nursing executive of a tertiary referral facility revisited their management structures and responsibilities to create a new, sustainable infrastructure that supports research and education at the core of nursing practice and not at the periphery. BACKGROUND: Nursing executive and senior management groups are charged with the ultimate responsibility of ensuring the highest possible quality nursing care within their facility. In the current health care climate the aim for best practice conflates with evidence-based practice that can be notoriously difficult to achieve due to the many barriers to integrating research findings into practice. KEY ISSUES: Research and education activities have been established as fundamental to core business under a simple evidence-based practice model. CONCLUSION: The value of a synthesis between the clinical areas with the nursing education and research division has been recognized to better achieve the goal of improved services.

Australia↗
PubMed2005

A clinical development unit in cardiology: the way forward.

The clinical development unit (CDU) has been recognized as an effective strategy to progress creativity and resourcefulness in nursing practice to improve patient outcomes. Clinical development units, through transformational leadership, promote staff development, the use of research evidence and dissemination of research findings through publication and presentations. The aim of this paper is to clearly articulate the processes (in particular, research and education initiatives) related to the development of staff that address issues in the everyday workplace and, accordingly, have been instrumental in the success of the creation of a CDU in cardiology. These units aim to achieve and promote excellence in an identifiable area of nursing using a systematic, transparent and defensible approach. A review of acute coronary syndrome informed the needs and direction of staff activities in the cardiology unit of a tertiary referral hospital. Through a collaborative staff approach, evidence was carefully examined to plan its appropriate adoption into the clinical area. Nursing practice and education resulting from this review was scheduled into staff career progression. These initiatives have been incorporated into staff development learning, enabling the integration of research into practice, which ultimately has a positive impact on patient outcomes.

Australia↗
PubMed2005

'They survive despite the organizational culture, not because of it': a longitudinal study of new staff perceptions of what constitutes support during the transition to an acute tertiary facility.

Increasing difficulties of recruitment and retention of nursing staff strongly indicate that organizations should identify factors that contribute to successful transition of new staff to the workplace. Although many studies have identified problems facing new staff, fewer studies have articulated best practices. The purpose of this longitudinal study was to ascertain what new staff perceived as supportive elements implemented by the organization to assist their integration. Sixteen staff in Phase I and 12 staff in Phase II attended focus groups. The focus groups at 2-3 months provided specific information, with particular emphasis on negative interactions with other staff members and inadequate learning assistance and support. Different themes emerged within the focus groups at 6-9 months. Staff discussed being 'self-reliant' and 'getting to know the system'. Participants indicated that these skills might be beneficial to new staff in the development of organizational 'know how' and resourcefulness, rather than relying on preceptor support that, unfortunately, cannot be always guaranteed.

Attitude of Health Personnel↗
PubMed2004

The effect of music on preprocedure anxiety in Hong Kong Chinese day patients.

AIMS AND OBJECTIVES: To identify the effect of music on preprocedure anxiety levels of Hong Kong Chinese patients undergoing day procedures in a local community based hospital. DESIGN: Pre and post-test quasi experimental design with non-random assignment. METHOD: A total of 113 participants were assigned to the control group or intervention group depending on the day of their procedure. Participants' anxiety levels were measured objectively by comparing their vital signs and subjectively by the Spielberger State Trait Anxiety Scale. Participants' physiological parameters (blood pressure, pulse and respiration) and State Trait Anxiety Scale were measured at two time periods. The control group undertook the usual relaxing activities provided in the waiting room compared with the intervention group who listened to music of their own choice in reclining chairs while waiting for the procedure. RESULTS: The physiological parameters for both the control and intervention groups dropped significantly during the waiting period, however, only the intervention group had a significant reduction in reported anxiety levels. CONCLUSIONS: These results suggest that providing self-selected music to day procedure patients in the preprocedure period assists in the reduction of physiological parameters and anxiety, yet, a relaxing environment can assist in the reduction of physiological parameters. RELEVANCE TO CLINICAL PRACTICE: The administration of self-selected music to day procedure patients in the preprocedure period can be effective in the reduction of physiological parameters and anxiety.

Analysis of Variance↗
PubMed2004

Patient satisfaction: the Australian patient perspective.

The literature reveals little Australian academic study of the phenomenon of patient satisfaction and identifies several problems in current research practice. A theoretical discussion about the phenomenon of patient satisfaction' is for the most part absent, the rigour in the methods applied is often dubious, a definition of patient satisfaction is not agreed and the patient experience is often not the focus of research. To address some of these issues inductive research was conducted with Australian patients to explore what they considered important for patient satisfaction to exist. A series of 52 interviews were conducted with twenty elective surgery patients in an Australian teaching hospital Patients were interviewed on admission to hospital, within one week of discharge from hospital and between six and eight weeks after discharge. Research with patients identified 16 themes that were important to make a patients hospital stay satisfactory. Qualitative data have provided a foundation to better understand what patient satisfaction' means in its everyday use. Such an approach is faithful to the concerns and priorities of the patients who are the users of health care services.

Adult↗