Biomedical subjects

D Pelletier

Publications and source records attributed to D Pelletier.

61 records · Page 4Linked to original sources

PubMedDate not supplied

Australian nurse educators identify gaps in expert practice.

In Australia, nurses face a double-barreled challenge to their role. With the rapid adoption of new health care technologies coupled with increasing economic constraints, they find themselves "doing more with less." In this context of continuous change, it is useful to determine what expert nurse clinicians deem the most essential skills, attitudes and knowledge required for practice in complex technological environments. Separate panels of 28 educators and 43 cardiac nurse clinicians participated in a national Delphi study rating the importance to the nursing role of 107 items drawn from the international literature on expert practice and technology. Indicating the importance of each item in both the "real" and "ideal" worlds of practice, educators identified 58 items where they felt actual practice was substantially far from the ideal. For 16 of these items relating to empowerment of patients, nursing research, and technology policy, the educators rated clinical behavior below the median of the real world scale, indicating substandard performance of a role or inadequate assimilation of a concept. The implications for the definition of expert practice and for curricula development are discussed.

Delphi Technique↗

PubMedDate not supplied

Nurses' perceptions of their professional growth on completion of two years of postgraduate education.

In a climate of diminishing financial resources in service industries such as health care and education, it is not surprising that a focus on measuring and ensuring appropriate outcomes is widespread. Graduate education has the potential to make a significant difference to the professional behaviour of graduates. Postgraduate nursing coursework programs have been developed and offered in such a climate, many now charging full course fees, which no doubt stimulates participants and employers to look for value for money in terms of outcomes. A ten year longitudinal study began in 1992 and was designed to determine the impact of postgraduate coursework nursing education on the careers and the professional and personal development of graduates. This paper reports graduates' perception of their personal and professional growth in terms of professional activities such as writing for publication, research, mentoring, and involvement in professional organisations at the completion of their university course. Respondents indicated the course had contributed to increased professional behaviours in all aspects and to a marked improvement in their clinical confidence. Improved self esteem and increased participation in professional activities reflects changing attitudes towards nursing work that have important implications for improved quality of patient care.

Attitude of Health Personnel↗

PubMedDate not supplied

Implantable defibrillator recipients' responses to device implantation and design.

The implantable cardioverter defibrillator (ICD) is a surgically inserted device that follows a well-established pattern of technology innovation and rapid adoption without extensive clinical trials. Few devices are as obviously life-saving in potentially fatal situations and deliver such sudden and sometimes painful therapy. Although patients' quality of life and adjustment to the device both physically and psychologically are relatively well-documented, few studies have explored recipients' responses to the device itself or elicited their thoughts on the technological design. The findings presented here are from a prospective Australian study that surveyed 110 ICD recipients pre-insertion and at 3, 12, and 18 months post-insertion. Recipients' responses to the device and their thoughts on design were sought. Respondents were overwhelmingly willing to: 1) accept the ICD, 2) recommend it to others, and 3) welcome such innovations as warning tones, device-controlled drug delivery, and telephone interrogation of the device.

Adolescent↗

PubMedDate not supplied

It's all in a name. When is a 'Delphi study' not a Delphi study?

As nursing researchers we need to fully understand the origins of the methods we are using in research investigations. Without an in-depth understanding, we may find ourselves violating fundamental underpinning assumptions or conventions through ignorance, and the resulting studies are unlikely to stand up to tests of congruence and rigour. This paper is a discussion of some complexities encountered while exploring the literature on the Delphi technique, a research method we had believed to be straightforward. The Delphi method had been used extensively since its development in the 1950s, and its use in nursing research appears to be increasing. Our explorations revealed that, rather than a simple means of obtaining the judgments of experts, modifications and adaptations over the years have dramatically changed 'the' Delphi. Anyone wishing to use the method needs a sound knowledge of complex theoretical issues associated with its implementation.

Consultants↗

PubMedDate not supplied

Australian clinicians and educators identify gaps in specialist cardiac nursing practice.

Change is endemic in both the health care and higher education sectors in Australia. Consequently professional roles and educational pathways must also evolve and adapt, often catalysed by those in leadership positions. Two national Delphi panels, one of cardiac nurse educators and the other of cardiac nurses, were convened to answer the question 'What knowledge, skills and attitudes are required for an expert nurse practising in the highly technological cardiac care environment?' Respondents indicated on a Likert scale the importance of 107 items to the nurse's role in both the 'real' and 'ideal' worlds of practice. Overall there was very strong agreement between the two panels with results indicating that Australian nurses perform close to their ideal in many areas of practice. For 31 of the items, both panels identified that the reality of practice is quite far from their ideal. Both panels agree that 10 of the behaviours are carried out or valued very little in practice. Reasons why nurses are not carrying out these elements of the role to their satisfaction are discussed and remediation strategies suggested. The findings can inform both curriculum development and clinical practice. In the dynamic health care arena, the nursing profession continues to respond to community and professional needs, seeking to establish sound research-based practice and maintain a high quality of clinical care and nursing management. The development of competencies by the Confederation of Critical Care Nurses (1996) is a good example of professional groups taking the initiative both in defining the practice role and providing tools that assist educational bodies to develop programs appropriate for a practice based discipline. Specialty nursing practice is 'under the microscope' in Australia as the profession seeks the best methods to weight nursing activities, measure nursing outcomes and recruit, retain and justify the use of specialist practitioners.

Attitude of Health Personnel↗

PubMedDate not supplied

Is there enough mentoring in nursing?

This paper examines the debate about the benefits of mentoring in nursing and argues that the evidence indicates that mentoring is a professional behaviour that contributes to career success and the development of professional leaders. Some strategies to facilitate mentoring are suggested. As well, the paper presents the findings from analysis of four studies which provided data on the incidence of mentoring among 317 nursing unit managers, 368 clinical nurse specialists, 478 RNs entering a graduate course and 235 of the latter group on completion of their course. The results show that, of those who reported their mentoring experience, more unit managers (45%) than clinical specialists (35%) experiencing mentoring and that 79% of graduating RNs reported that they had increased their mentoring of others since beginning their course. The overall incidence of mentoring was lower than that reported in the United States. Reasons for the findings are discussed.

Australia↗

PubMedDate not supplied

The impact of graduate education on the career paths of nurses.

This paper reports the findings of the first phase of a ten year longitudinal study of nurses graduating with higher degrees and diplomas. The higher education sector in Australia has been subjected to a variety of changes in the past decade. Amalgamations and restructuring, altered funding formulae, recognition of prior learning and credit transfer are some of the initiatives, many dictated by governmental bodies, which impact on the education system. Within this volatile context, graduate education in nursing has developed significantly in both quality and variety. These courses have been taken up vigorously by professionals who, until 1990, had limited opportunities for tertiary study in the discipline. Perhaps one of the most significant changes within education, and interestingly paralleled in the health sector, is the move to examine more carefully the outcomes of the process or service provided. The demographic profile, career movements and career plans of graduating students over a five year period from December 1992- December 1996 are presented.

Adult↗