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Biomedical subjects

C Duffield

Publications and source records attributed to C Duffield.

At least 19 recordsLinked to original sources
PubMed2000

The role of the Advanced Casualty Management Team in St John Ambulance Australia (New South Wales District).

St John Ambulance is a household name synonymous with the teaching and provision of first aid. Recently the organisation has developed pre-hospital emergency care services through the introduction of the St John Ambulance Australia Advanced Casualty Management Team in New South Wales. The Advanced Casualty Management Team represents a move away from the practice of first aid by lay personnel and is a natural extension of the traditional work and principles of St John Ambulance. This article provides an overview of the Advanced Casualty Management Team and discusses its contribution to pre-hospital trauma care delivery.

Efficiency, Organizational↗
PubMed1999

Nursing as a career choice: perceptions of school students speaking Arabic, Serbo-Croatian, Spanish, Turkish or Vietnamese at home.

Australia is a multicultural society and nowhere is this more evident than in Sydney where 25% of the population speaks a language other than English. In one of the largest area health services in New South Wales, the five most frequently spoken languages at home are Arabic, Serbo-Croatian, Spanish, Turkish or Vietnamese, with these language groups comprising 12% of Sydney's population. Yet nurses speaking one of these five languages comprise less than 1% of the nursing workforce. A cost-effective method of addressing the shortage of nurses speaking languages other than English is to recruit students who already speak another language into the profession. This study examined high school students' perceptions of nursing in order to determine appropriate methods of recruiting students speaking one of these languages. Implications for the design of recruitment campaigns are also discussed.

Attitude to Health↗
PubMed1998

Australian nurses and device use: the ideal and the real in clinical practice.

Clinical nurses use an increasing number of technological devices when providing care. While the clinical devices themselves must undergo rigorous multidimensional assessment, it is the proficiency of the user that ultimately determines the devices' efficacy. Thus, the knowledge, skills and attitudes that nurses bring to their decision-making and use of technology are crucial elements in the technology assessment process. Technological proficiency is imperative in the current climate of rapid patient throughput in complex technological environments. This paper reports some of the findings of an Australian study, using two national Delphi panels, whose primary objective was to determine the knowledge, skills and attitudes required of expert clinicians for practice in cardiac care. Panels of 28 educators and 42 cardiac nurse clinicians completed a questionnaire indicating the importance of 107 characteristics of expert cardiac practice for both the 'real' and 'ideal' worlds of practice. Comparative results will be reported for 29 items within the thematic groups. Effective use of technology, Informed decisions regarding equipment and Critical approach to the use of technology. Both panels accepted all 29 items in these three thematic groups but indicated differences in the level of agreement on the importance of items between the 'real' and 'ideal' worlds of practice. Discussion centres around those areas where improvement is needed.

Australia↗
PubMed1997

Determining and discerning expert practice: a review of the literature.

Although the nature and characteristics of expert practice have been described in the literature, the description is incomplete. How expertise is gained is not fully understood, and definitions of expert competencies have yet to be developed. Essential issues for education arise from the demand for knowledge for expert practice. Because expertise is gained in the context of practice, expertise cannot be achieved out of context or taught as an academic exercise. A clear picture of the practice of expert nurses is necessary so that those in the profession can know and articulate expert practice and direct it to the community.

Clinical Competence↗
PubMed1997

The cardiac nurse's role: an Australian Delphi study perspective.

In Australia, as in many parts of the Western world, technological advances in healthcare have affected the roles of healthcare professionals, including nurses. Cost constraints, efficiency, and effectiveness measures also influence staffing numbers, roles, and skill mix. Specialty nurse education programs are changing, and many are moving from the hospital environment to the higher education sector. Initiatives to introduce the American Advanced Nurse Practitioner role in some environments have begun, although the current advanced practice roles are proving problematic. Specialist professional groups are striving to develop competencies or standards for practice. An understanding of what is required of expert clinicians for practice in complex technological environments such as cardiac care would be useful for both practitioners and academics. A national Delphi study was undertaken to determine what knowledge, skills, and attitudes were required of expert cardiac nurses in relation to technology in the cardiac care environments in both the "real" and the "ideal" worlds of practice. Separate panels of 28 cardiac educators and 42 cardiac nurse clinicians were given a questionnaire of 107 items and asked to indicate on a 6-point Likert scale the importance of each item to the nursing roles in both the "real" and "ideal" worlds. On the final, third round, respondents ranked the three most important items in each of the 13 thematic groups. Overall, the clinicians accepted all 107 items as important to their role, and for the majority of these they, felt that they were performing quite close to their "ideal." This article presents the 32 items for which the clinicians felt the "real" world was quite far from the "ideal" as represented by a gap of > or = 2 between the real and ideal medians. Also, despite being accepted as part of the role through the ideal scores, 21 items achieved a real world median of 3.5 or less, which indicates that in the real world these aspects of nursing are not being valued or practiced to the level clinicians would like. These two sets of items should be of greatest interest to clinicians currently in the role and to those interested in specialty education at all levels.

Australia↗
PubMed1996

The impact of the technological care environment on the nursing role.

Proliferation of acute health care technology creates problems and benefits for nurses and patients. In this paper the impact of technology on the nursing work role is reviewed through the international literature. The thrust of the nursing literature has, not surprisingly, matured over time as the use of technology has become well established in the acute care environment, and three themes can be identified. The implications for acute care nurse specialists, including their educational needs, are set in context of the Australian health care system, with particular reference to the cardiac care environments.

Australia↗
PubMed1996

Do clinical nurse specialists and nursing unit managers believe that the provision of quality care is important?

The nursing profession has a long tradition of evaluating the quality of its product in order to ensure that the best possible care can be given. However, in the climate of economic rationalism which prevails worldwide, it is possible that the emphasis on fiscal restraint has distracted nurses from their previous focus on quality. This paper discusses the findings of two research studies designed to determine the competencies expected of nursing unit managers and clinical nurse specialists. Discussion focuses specifically on their roles in the provision of quality care.

Clinical Competence↗
PubMed1995

CNSs' perceptions of role competencies: one Australian perspective.

A survey of 373 CNSs employed in hospitals in New South Wales, Australia, was undertaken to determine the competencies they believed necessary to fulfill that role. This study was designed as a sequel to a similar study of role competencies of first-line nurse managers in the same state. Factor analysis was used to identify a variety of role dimensions. Results indicate that CNSs perceive their role as extremely comprehensive, yet a significant potential to overlap with the role of managers was evident. In addition, some interesting features of the CNS role emerged that may generate both professional approval and concern. The strength of the respondents' acceptance of competencies that link their clinical role to activities that directly influence the quality of care is heartening; however, a number of clinically based competencies, including some of those related to patient care management or quality of care, either loaded weakly or did not load at all on the factor structure. Concern may be felt regarding the claim of these specialized clinicians to competencies traditionally seen as strongly associated with the managerial role. Should specialist clinicians take on too many managerial functions, significant role overload could result, and affect quality care provision.

Attitude of Health Personnel↗
PubMed1995

A profile of the clinical nurse specialist in one Australian state.

The nursing profession in Australia implemented progressively in each state new clinical career structures commencing in 1986. While the structures differ, all states introduced the position of CNS. The role and responsibilities associated with this position also differ. The role of CNS in Australia is different from that described in the North American literature. Findings of a study that established a profile of CNSs in the heavily populated state of New South Wales are described. Data on education, experience, and career plans were obtained from 373 CNSs in 19 hospitals. The results enable some comparison with first-line nurse managers whose role is very similar to the American position of head nurse. As with their managerial counterparts, the Australian CNSs' lack formal educational preparation and were demonstrating a low rate of participation in educational programs at the time of the study. However, 82% of respondents intended to remain in clinical practice. This is significant since this was a major goal in development of a clinical career structure.

Adult↗
PubMed1995

Nurse managers and their future in New South Wales.

The goal of International Perspectives is to share the views of nurse leaders, from countries other than the United States, on global healthcare issues. The focus is on identifying healthcare management problems and their implications, research priorities, policy development, and ethicalmoral dilemmas faced by nurse administrators. You are encouraged to send the names and addresses of international nurse leaders who might be interested in participating, as well as your ideas, for format and content of the department.

Forecasting↗
PubMed1994

The effects of graduate nurse education on clinical practice and career paths: a pilot study.

The recent proliferation of graduate courses in nursing has increased the need for educational administrators to evaluate the impact of such programmes on clinical practice and the career of participants. 40 registered nurses undertaking graduate studies were surveyed as a pilot for an extensive longitudinal study of their perception of the effects of study on work performance and career opportunities. Overall, positive effects were noted by respondents on their job satisfaction, self-esteem, professional thinking and career moves. Increases in professional behaviours such as mentoring, research and writing for publication were noted. Negative consequences were noted by a minority and were related to alterations to health status and increased levels of stress.

Career Mobility↗
PubMed1994

Caring nurses: the dilemma of balancing costs and quality.

This paper explores the tensions visible in the rhetoric and practice of today's health care system. This system is becoming dominated by the views of economic rationalists where decisions are based on principles more frequently associated with private enterprise. One could argue that health care should be managed as a business, however, the ethics which guide such a business must be examined closely to ensure the integrity of the caring which is implicit in much of the practice in health care. Individuals in today's society value humanistic functions more than ever before. The caring function of nursing is perhaps the most significant determinant of the quality of care received from a patient's perspective, and one to which there is little cost attached in dollar terms. While it is difficult to measure and cost the caring that nurses provide, it must be done to ensure that these qualities are maintained and enhanced. More importantly, strategies must be developed to provide cost-effective quality indicators of the caring function implicit in the nurse's role. (This is an abridged version of a paper delivered at the Nursing Economic$ International Symposium 1993 in Hobart, Tamsania.)

Australia↗
PubMed1994

Role overlap between clinical nurse specialists and nursing unit managers.

Role ambiguity is a serious and costly phenomenon that the healthcare delivery system can ill afford. Classically, it results from a lack of clarity or information concerning the expectations of a role, and it often results in several staff members undertaking the same activities. The resultant inefficiencies are costly to the organization because job satisfaction decreases and the number and quality of applicants for positions decline because people are unsure about the role and its functions. The authors describe an example of role ambiguity that resulted when the new classifications of nursing unit manager and clinical nurse specialist were introduced in New South Wales, Australia, in 1986.

Hospital Units↗
PubMed1994

Nursing unit managers: defining a role.

Using Katz's classification scale, a panel of experts--nurse managers, nurse academics and professional and industrial nursing organization representatives--identified roles expected of first-line nursing managers in New South Wales hospitals. The 156 competencies defined by this group were classified into technical, human and conceptual skills. Classifications determine the manager's responsibilities, authority and performance accountability.

Delphi Technique↗
PubMed1993

The Delphi technique: a comparison of results obtained using two expert panels.

The Delphi technique is a useful method of obtaining group consensus. However, "consensus" is not usually defined when this technique is used. This paper describes a study in which two panels of experts (registered nurses who were nurse managers or involved in management education) were asked to identify the competencies expected of first-line nurse managers using the Delphi technique. The results from both panels are compared. Prior to the commencement of the Delphi rounds a baseline mean of 3.00 ("agree" on the Likert scale used) was set for the inclusion of items. The level at which consensus was achieved was defined as the point at which 10% or less of the 168 competencies provided to the panel moved above or below this point of inclusion. A total of 156 of the 168 competencies (93%) presented to the two panels were either retained or rejected by both.

Delphi Technique↗
PubMed1993

First-line nurse managers in NSW: perceived role competencies (Part I).

A survey of 412 first-line nurse managers employed in hospitals in New South Wales, Australia was undertaken to determine the competencies they believed an individual should possess to fulfil that managerial role. Factor analyses identified both the significant functions of the role as well as areas of role conflict and confusion. Thirteen factors identified from four major scales indicated that first-line nurse managers perceived their role to be extremely comprehensive in terms of managerial knowledge and skills. The analyses clearly indicate that competencies related to staffing and financial issues are perceived to be essential to role performance. However, the correlation coefficients (factor loadings) indicate that ambiguity exists with competencies concerning patient care, perhaps as the remnants of the charge nurse role are discarded.

Clinical Competence↗