Biomedical subjects

Jane Cioffi

Publications and source records attributed to Jane Cioffi.

7 recordsLinked to original sources

PubMed2006

Clinicians' responses to abnormal vital signs in an emergency department.

The importance of observing patient vital signs in emergency department (ED) practice has been stressed in the literature. Failure of clinicians to respond to abnormal vital signs (AVS) has been described as a potential reason for delayed management in ED practice, with a likelihood of increased morbidity. This study aimed to explore and describe clinicians' responses to AVS in a busy ED. A qualitative descriptive approach was used with three focus groups being conducted with 18 volunteer registered nurses (RNs) and medical officers (MOs) who worked in the ED of an area health service in Western Sydney. Transcribed focus group interviews were analysed using a process of constant comparison and contrast and a description of clinicians' responses to AVS written. An analysis of text from focus groups revealed three main categories of clinicians' responses to AVS: identification, reporting and implementing action. Clinicians in this study recognised, reported and acted on AVS. However, delays in responding to AVS occurred due to a variety of reasons. The main reasons identified were issues with documentation and the ability to seek advice of appropriate staff, ineffective communication, fear of reprimand, inexperience of working in EDs, workload, distractions and interruptions. In conclusion, environmental and human factors contribute to inappropriate delays regarding AVS in the ED. These factors can be acted on by initiating appropriate education programmes and establishing improved communication networks. Better use of the existing medical emergency team (MET) in the ED can act to alleviate situations associated with delays in managing AVS.

Adolescent↗

PubMed2006

Redesign of the model of nursing practice in an acute care ward: nurses' experiences.

OBJECTIVE: to describe nurses' experiences of the change associated with redesign of the model of nursing practice in an acute care ward in the preparatory and implementation phases. DESIGN: descriptive case study SETTING: a surgical ward in an acute care hospital in Greater Western Sydney SUBJECTS: fourteen registered and six enrolled nurses working on the surgical ward volunteered to be interviewed, eight in the preparatory phase and twelve six months into the implementation phase MAIN OUTCOME MEASURE: descriptions of nurses' experiences in the preparatory phase and six months into the implementation phase of the redesigned nursing practice model RESULTS: many nurses felt apprehensive in the preparatory phase, however, six months into implementation phase their willingness to trial the model was evident. Negativity pervaded both phases, as did their concerns for the quality of care being given. In the preparatory phase nurses described the clinical activities coordinator (CAC) role as having potential to be beneficial and this was realised to some degree six months into implementation phase. A preference for registered nurses over enrolled nurses as a dominant component of the staff was evident in both phases CONCLUSIONS: the struggle with the change that nurses experienced suggests redesign needs to be a more collaborative process involving strong communication and supportive education so nurses can empower themselves within the change.

Australia↗

PubMed2005

Why do registered nurses work when ill?

The authors discuss results of a study that found a sense of tension in the nurse and between the supervisor and the team that influenced the decision to come to work when ill. The tension with the supervisor was around reporting and legitimizing illness; with the team, around responsibility, staffing concerns, and peer pressure; and in the nurse was associated with community perception, work ethic, and financial security. Together, nurse administrators and clinicians should conduct reviews of policies and procedures to build cohesive relationships and promote the self-care practices of nurses.

Absenteeism↗

PubMed2005

A pilot study to investigate the effect of a simulation strategy on the clinical decision making of midwifery students.

The actual effect of the use of simulations on clinical decision making is inconclusive. This pilot study used a posttest design to determine the effect of a simulation strategy on the clinical decision-making process of midwifery students. Thirty-six graduate diploma students volunteered and were randomly assigned to two groups, with the experimental group receiving two simulation sessions (normal labor and physiological jaundice), and the control group receiving the two usual lectures. The main findings were that students who received the simulation strategy collected more clinical information, revisited collected clinical information less, made fewer formative inferences, reported higher confidence levels, and for the posttest normal labor simulation, reached a final decision more quickly. Such effects are reasonable for this type of intervention with the existent variability in each group. Further research with a larger sample size and more rigorous data collection strategies is required.

Attitude of Health Personnel↗

PubMed2005

Nurses' experiences of caring for culturally diverse patients in an acute care setting.

Identification of nurses' experiences of caring for culturally diverse patients in acute care settings contributes to transcultural nursing knowledge. This qualitative study aims to describe nurses' experiences of caring for culturally diverse adult patients on medical and surgical wards in an acute care setting. These experiences identify current practice and associated issues for nurses caring for culturally diverse clients. A purposive sample of ten registered nurses was interviewed and transcripts analysed. Main findings were acquiring cultural knowledge, committing to and engaging with culturally diverse patients. Strategies for change developed from these findings focus on increasing cultural competency of nurses by: implementing a formal education program; developing partnerships with patients and their families to increase cultural comfort; and increasing organisational accommodation of the culturally diverse with policy review and extension of resources. Further research to explore issues for bilingual nurses and to describe the experiences of culturally diverse patients and their families in general acute care settings is recommended.

Acute Disease↗

PubMed2002

Factors that enable and inhibit transition from a weight management program: a qualitative study.

Failure of clients to initiate closure and move out of weight management programs after it is considered they should have reached the stage of maintenance in their health behavior change has implications for clients' self-management, provision of health promotion programs and their cost-effectiveness. This study aims to identify factors that enable and inhibit class attendees' transition from a weight management program. Six short-term attendees who had left the program after two terms and six long-term attendees who had attended four or more terms of the program volunteered to participate in in-depth interviews. Enabling factors were identified to be program knowledge and attainment of set goal weight, and inhibiting factors were the perceived need to come to classes, concern about keeping in control, recognition of the potential to lapse and being involved with a group. Recommendations are made for the program to include a component addressing relapse prevention training and to trial some form of follow-up support strategy. Additionally, further research is needed into transition from weight management programs.

Adult↗

PubMedDate not supplied

Caring for women from culturally diverse backgrounds: midwives' experiences.

The aim of this study was to show how midwives cared for women from culturally diverse backgrounds. In-depth interviews were used to collect data from 12 experienced midwives who volunteered to participate in the study from a midwifery unit with a culturally diverse population. Study findings revealed that midwives preserved and accommodated the cultural preferences of women from a Chinese background by incorporating the forces of yin-yang into care, heeding the maternal hierarchy and women's stoicism; and for women from an Islamic background by heeding modesty and gender preferences (Hejab), the place of prayer in daily life (Salat), and the imperative of visiting by others (Hadith). Hence, midwives negotiated care that was culturally comfortable for women and their families. Furthermore, triangulated studies addressing the partnership between the midwife and the diverse client are needed, as well as the development of aspects of the health service that are more culturally sensitive.

Adult↗