Nursing - Theses
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ItemMissed nursing care - a nurse's perspective: an exploratory study into the who, what and why of missed care( 2016)BACKGOUND: Exploration of missed or delayed nursing care has become increasingly prevalent in international nursing literature over the past ten years. Evidence demonstrates that missed nursing care, or care that is left undone or passed on to the following shift, is common and the factors that lead to missed care are complex and numerous. Critically, patients report poorer experiences of care in hospitals where more nursing care is left undone. Despite strong international evidence, there has been little research to explore missed nursing care in Australia, and no papers focusing specifically on missed nursing care in the cancer setting. The aims of this study were to (i) explore nurses’ perceptions of what care is missed in one haematology/oncology in-patient setting in Victoria, Australia, and (ii) to identify factors contributing to missed care. METHODS: This study employed an exploratory mixed-methods approach that included an on-line survey of nurses’ views of missed care and factors leading to missed care, a description of the environment of care during the data collection period, and focus groups to explore, in depth, factors nurses believe result in missed care. RESULTS: Survey data were collected from 17 of 50 eligible nurses (34%) working on a haematology/oncology ward over a three week period in September, 2015. During the data collection period, 103 patients were cared for on the ward. The most common areas of missed care reported were: talking to patients (n=15, 88.2%), developing and updating nursing care plans (n=13, 76.5%), and educating patients and family (n=11, 64.7%). Data from the focus groups indicated acute awareness of missed care and multiple factors leading to missed care were identified. These included staff skill mix, organisation of nursing work, and non-nursing duties that detracted from time with patients. During the focus groups, nurses described considerable discomfort at being unable to provide emotional care they wanted to deliver to patients and their families. They also talked about the inability to take care of themselves. CONCLUSION: This preliminary, exploratory study offers an insight into missed nursing care and its consequences on patients and nurses in one Australian cancer setting. Data reflect the findings of earlier international studies and indicated potentially modifiable factors for reduction of missed nursing care. Multi-site research is needed to further explore missed care in cancer settings to better understand and make recommendations for optimal environments of care, caring and staff wellbeing.
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ItemA descriptive exploratory study of nurses’ and parents’ perceptions of family-centred care in paediatrics wards in hospitals in Semarang, Central Java, Indonesia( 2003)The study was conducted with the main purpose to explore the attitudes and understanding of family-centred care of nurses and parents in paediatric settings at four hospitals in Semarang, Central Java, Indonesia. The literature review highlighted that the nurses and the parents/families could work collaboratively to maximise the hospitalised child's welfare. However, nurses tend to have difficulties fulfIlling their obligation towards the parents of hospitalised children, for a number of reasons. In addition, the parents feel that they require expanding their roles to care for their children. Appropriate information regarding the children's health progress is needed by the parents to reduce their apprehension. The method applied was by administering questionnaires to the nurses who worked at paediatric wards and to the parents of hospitalised children who had stayed at least three days in hospital. The study was conducted at Dr. Kariadi Hospital, Semarang Municipal Hospital, Telogorejo Hospital and St. Elisabeth Hospital in Semarang, Indonesia. The participants were asked to complete the questionnaires anonymously and the questionnaires were collected in a sealed collecting box within two months. The findings demonstrated that there were some differences in the perceptions of roles in dealing with the children in hospital, the view and the experiences working together to care for the sick children. The results suggest despite these differences, both nursing staff and parents support the implementation of the family-centred care approach in the paediatric setting. Further research is essential to ensure the understanding of family-centred care in paediatric setting.