AIM:The aim of this review was to explore the influencing factors that contribute to medication administration errors (MAEs) made by novice registered nurses (NRNs). BACKGROUND:MAEs are a significant yet preventable risk to patient safety in healthcare settings, compromising both patient health and care quality. Evidence suggests that NRNs are more prone to MAEs, highlighting the importance of exploring the contributing factors to develop effective prevention strategies. DESIGN:An integrative review. METHODS:An electronic literature search was conducted in which articles were restricted to peer-reviewed, full-text articles published in the English language between January 2013 and December 2023. Quality assessments and data syntheses were conducted by two independent authors. DATA SOURCES:CINAHL Complete, MEDLINE, APA PsycArticles, APA PsycInfo, PubMed, Cochrane Library and Web of Science. RESULTS:Eleven studies met the inclusion criteria. The main influencing factors identified in this review were intrinsic factors (lack of confidence, reduced coping skills and reluctance to seek assistance) and extrinsic factors (time pressures, hectic workloads, low staffing and high-stress environments). Clinical, educational and research implications were also identified. CONCLUSION:This integrative review explored the various influencing factors contributing to MAEs by NRNs in healthcare settings. These included gaps in pharmacological knowledge, limited simulation-based learning and challenges in using electronic medical records. Addressing these issues through targeted education and increased simulation experiences in undergraduate curricula could enhance NRNs' competence and confidence. REPORTING METHOD:Preferred Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. PATIENT OR PUBLIC CONTRIBUTION:No patient or public contribution was made due to the study design. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE:Understanding the factors behind medication administration errors among new nurses helps organisations develop strategies to address these issues, reducing patient harm and enhancing nursing practice. Our findings offer recommendations to improve nursing education worldwide.
ABSTRACTAimThe overarching aim of this study was to explore patients' falls risk awareness in hospitals using section A of the validated Self Awareness of Falls Risk Measure (SAFRM).DesignDescriptive cross‐sectional study design.SettingThree rural/regional hospitals in the State of Victoria, Australia.MethodsUsing a purposive sampling strategy, patients were eligible to participate if aged ≥ 40 years, English‐speaking, and have ambulatory capacity prior to hospital admission. Participants were excluded from the study if they returned a Standardised Mini‐Mental State Examination (SMMSE) score < 18. Falls risk awareness data was collected from both patient and health professionals using section A of the SAFRM. Patient demographic data was collected from patient medical records.ResultsA total of 77 patients (72.9 years ±11.2) and 58 health professionals were recruited. Patients had a significant difference in falls risk awareness when compared to their clinician (z = −2.08, p = 0.038). Regression analyses showed that patients were more likely to overestimate their falls risk if they used anticoagulant medication and if their highest education level was less than or equal year 11. An exploratory factor analysis (EFA) revealed a three‐factor solution from section A of the SAFRM, which were labelled Physical Activity Awareness, Cognitive Awareness and Balance Awareness.ConclusionsThere was a significant difference in patients' falls risk awareness compared to a health professional. The independent associations of variables with falls risk awareness, such as age, education level and medication use, further our understanding of the differences in falls risk awareness. The findings also establish that the 15‐item section A SAFRM is a reliable and feasible falls risk perception measure for use in hospitals, with future research recommended to evaluate the proposed three‐factor model with the addition of tailored hospital falls education.Implications for the Profession and/or Patient CareThe findings from this study establish a significant difference in patients' falls risk awareness compared to their health professional. Section A of the SAFRM is a reliable tool for nurses and other health professionals to establish the presence of a falls risk disparity. The ability to empirically measure this disparity and to determine an under‐ or overestimation of falls risk is a useful addition to clinical practice. The SAFRM facilitates a person‐centred approach to falls prevention by providing opportunities for the clinician to collaborate with the patient and tailor fall prevention strategies.ImpactProblem: Inpatient falls in hospital settings. Main Findings: There was a significant difference in patients' falls risk awareness compared to a health professional. Section A of the Self‐Awareness of Falls Risk measure is a reliable and feasible tool to identify under‐ or overestimation of falls risk perception in hospitals. Patients were more likely to overestimate their falls risk if they used anticoagulant medication and if their highest education level was less than year 11. The findings for a three factor‐model Physical Activity Awareness, Cognitive Awareness and Balance Awareness could inform future hospital falls education. Impact: Registered nurses, health professionals, inpatients. Reporting Method: STROBE checklist for cross‐sectional studies. Patient or Public Contribution: This study involved the collection of data from patient participants and registered nurses.
IMPORTANCE:Physical activity during menopause can be effective in reducing the physiological changes associated with reproductive aging that increase risks for noncommunicable diseases, yet many women do not meet the recommendations for physical activity.OBJECTIVE:This study aimed to synthesize factors influencing physical activity for women across menopausal transition phases using a socioecological approach.EVIDENCE REVIEW:The Preferred Reporting Items for Systematic Reviews and Meta-Analysis was used to systematically search 10 databases between 2001 and 2021. A comprehensive search strategy was used to identify studies on physical activity of women in various stages of menopause. A socioecological model was used to categorize the reported barriers and enablers.FINDINGS:Twenty studies met the inclusion criteria. The findings highlight several intrapersonal barriers such as existing health complaints versus enablers such as awareness of the health benefits of physical activity during menopause. Ensuring women's safety, preventing injury, and enhancing exercise self-efficacy were important components of programs. Social support was also an important enabler of women's engagement in activities.CONCLUSIONS AND RELEVANCE:Several barriers and enablers were identified and can inform practitioners and future interventions to encourage physical activity among women in various stages of menopause. For instance, when encouraging physical activity during menopause, practitioners should consider other health complaints, safety, and injury prevention while discussing the benefits of physical activity related to managing menopausal symptoms. There was a lack of theoretically informed studies exploring the barriers and enablers to physical activity for women in various stages of menopause; thus, research designs may not have fully accounted for influences. Future research that combines socioecological and individual theories of behavior is needed to comprehensively understand the complexity of physical activity among women across the menopausal transition.
This review explored the impact of physical literacy programs designed to engage two- to five-year-old preschool children. The Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) was used. Six EBSCO host databases were searched for the period 2011 to April 2021 using the search terms "physical literacy," "early childhood," and "impact." Articles were excluded if physical literacy was not the focal intervention. The final data set consisted of seven-peer reviewed articles meeting the eligibility criteria and quality assessment for this review. Three themes were created using Braun and Clark's (2006) approach to thematic analysis: Holistic benefits of physical literacy, Barriers to physical literacy and Education begins at home. Early childhood physical literacy programs provide holistic benefits for children; however, further research is needed in an Australian context. Families and community members working in the early childhood sector could benefit from further education and training to improve physical literacy awareness.
Physical inactivity continues to be a global issue with many adolescents and adults failing to meet the recommendations for daily exercise. Efforts to reduce physical inactivity in adults include the incorporation of strategies such as workplace physical activity programs, especially for sedentary workers. In this systematic literature review we examined current literature about the efficacy of workplace physical activity programs, as well as the barriers and enablers to these programs. Six EBSCO databases were searched (Academic Search Complete, CINAHL Complete, MEDLINE, APA PsycInfo, APA PsycArticles and SPORTDiscus with full text) between a ten year period (2011 to 2021). The search terms used were "physical activity", "workplace" and "program" along with their variations. Following a systematic process, eighteen papers met the eligibility criteria. The authors analysed the findings using a narrative synthesis, in which four themes emerged from the data. These include Benefits to physical health, Benefits to mental health, Barriers to workplace physical activity and Workplace activity enablers. These findings provided several recommendations for organizations that endeavour to improve the health of workplace employees. Generalised workplace physical activity programs were viewed favourably by both employees and employers. Incorporating these practices into daily work structures may provide favourable outcomes such as increased work productivity and reduced physical inactivity.
OBJECTIVES:The impact of disasters on individual and community health can be extensive. As such, there exists the need to establish recovery measures that provides support psychologically and with additional mental health services and resilience building for affected people and their communities. Nature-led recovery is one such approach that has the ability to positively impact the mental health of people and their communities after a disaster. Nature-led recovery focuses on the social, economic and environmental recovery through activities that connect people and their communities to nature and the natural environment with the aim to foster recovery after a disaster. Nature-led recovery initiatives support the connection of people with nature and the natural environment to support such recovery processes. This review considers both community and government-led responses pertaining to nature-led recovery. The aim of this review is to systematically explore the literature on the impact of nature-led recovery initiatives on individual and community health following a disaster. CONTENT:This review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) following a three-step process of planning, conducting and reporting the review. At least three authors reviewed all eligible articles. SUMMARY:There was significant methodological heterogeneity between the sources identified (n=9). A narrative synthesis identified five key themes; A symbol of loss; Nature: the provider; Fostering community connectedness; Spiritual and emotional nourishment; and Regeneration leads to recovery. OUTLOOK:The positive benefits from nature-led recovery initiatives provide an opportunity to promote community connectedness and resilience following a disaster. Further research is needed to explore the implementation and evaluation of these initiatives for community recovery.
Falls prevention in hospital continues to be a research priority because of the poor health outcomes and financial burdens that can arise. Recently updated World Guidelines for Falls Prevention and Management strongly recommend evaluating patients' concerns about falling as part of a multifactorial assessment. The aim of this systematic review was to evaluate the quality of falls risk perception measures for adults in a hospital setting. This review was conducted using the Consensus-based Standards for the selection of health Measurement Instruments guidelines and provides a comprehensive summary of these instruments, including psychometric properties, feasibility and clinical recommendations for their use. The review followed a prospectively registered protocol, in which a total of ten databases were searched between the years 2002 and 2022. Studies were included if the instruments measured falls risk perception and/or other psychological falls constructs, if they were conducted in a hospital setting and if the target population contained hospital inpatients. A total of 18 studies met the inclusion criteria, encompassing 20 falls risk perception measures. These falls risk perception instruments were grouped into five falls-related constructs: Balance Confidence, Falls Efficacy/Concern, Fear of Falling, Self-Awareness and Behaviour/Intention. Two of the patient reported outcome measures (PROMs) received Class A recommendations (Falls Risk Perception Questionnaire and the Spinal Cord Injury-Falls Concern Scale); however, this rating is only applicable for the populations/context described in the studies. Thirteen PROMs received Class B recommendations, solidifying the need for further validation studies of these PROMs.
Patient falls in hospital may lead to physical, psychological, social and financial impacts. Understanding patients’ perceptions of their fall risk will help to direct fall prevention strategies and understand patient behaviours. The aim of this study was to explore the perceptions and experiences that influence a patient’s understanding of their fall risk in regional Australian hospitals. Semi-structured, individual interviews were conducted in wards across three Australian hospitals. Participants were aged 40 years and over, able to communicate in English and were mobile prior to hospital admission. Participants were excluded from the study if they returned a Standardised Mini-Mental State Examination (SMMSE) score of less than 18 when assessed by the researcher. A total of 18 participants with an average age of 69.8 years (SD ± 12.7, range 41 to 84 years) from three regional Victorian hospitals were interviewed for this study. Data were analysed using a reflexive thematic analysis identifying three major themes; (1) Environment (extrinsic) (2) Individual (intrinsic), and (3) Outcomes, as well as eight minor themes. Participants recognised the hazardous nature of a hospital and their personal responsibilities in staying safe. Falls education needs to be consistently delivered, with the focus on empowering the patient to help them adjust to changes in their clinical condition, whether temporary or permanent.
Aim: The aim of this study is to investigate the compliance of mental health clinicians in applying the Zero Suicide (ZS) approach to their clinical practice in a rural and regional health community setting. Methods: A retrospective clinical audit of six mental health teams was undertaken at a single site. A clinical audit tool was developed and validated using a six-step approach. The data was extracted and analysed via descriptive and inferential statistics and compared to a specialised mental health team, experienced with the ZS approach. Results: A total of 334 clinical records were extracted for January, April, August, November 2019 and June 2020. The clinical audit and analysis confirmed that the mental health teams are not consistently using the assessments from their training and are therefore not implementing all of these elements into their practice. This could have implications for the risk formulation and treatment for people at risk of suicide. Conclusions: The use of a validated clinical audit tool can be beneficial to establish compliance with the mental health clinicians and to determine any areas requiring further improvement. Further education and reinforcement may be required to ensure consistency with incorporating the elements of ZS into everyday clinical practice.
Patient falls in hospitals continue to be a global concern due to the poor health outcomes and costs that can occur. A large number of falls in hospitals are unwitnessed and mostly occur due to patient behaviours and not seeking assistance. Understanding these patient behaviours may help to direct fall prevention strategies, with evidence suggesting the need to integrate patients' perspectives into fall management. The aim of this scoping review was to explore the extent of the literature about patients' perceptions and experiences of their fall risk in hospital and/or of falling in hospital. This review was conducted using a five-stage methodological framework recommended by Arksey and O'Malley. A total of nine databases were searched using key search terms such as "fall*", "perception" and "hospital." International peer-reviewed and grey literature were searched between the years 2011 and 2021. A total of 41 articles, ranging in study design, met the inclusion criteria. After reporting on the article demographics and fall perception constructs and measures, the qualitative and quantitative findings were organised into five domains: Fall Risk Perception Measures, Patients' Perceptions of Fall Risk, Patients' Perceptions of Falling in Hospital, Patients' Fear of Falling and Barriers to Fall Prevention in Hospital. Approximately two-thirds of study participants did not accurately identify their fall risk compared to that defined by a health professional. This demonstrates the importance of partnering with patients and obtaining their insights on their perceived fall risk, as this may help to inform fall management and care. This review identified further areas for research that may help to inform fall prevention in a hospital setting, including the need for further research into fall risk perception measures.
The need for continued research into suicide prevention strategies is undeniable, with high global statistics demonstrating the urgency of this public health issue. In Australia, approximately 3000 people end their lives each year, with those living in rural and regional areas identified as having a higher risk of dying by suicide. Due to decreased access and support services in these areas, community-based suicide prevention initiatives provide opportunities to educate and support local communities. A scoping review was conducted to explore the literature pertaining to such programs in rural and/or regional communities in Australia. This review follows the five-stage Arksey and O'Malley (2005) framework and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) checklist. Nine databases were searched, from which studies were considered eligible if suicide prevention programs were community-based and catered for adults (aged ≥ 18 years) in rural or regional Australia. Ten papers that met our inclusion criteria were included in this review, showcasing a variety of interventions such as workshops, a digital intervention, art therapy, and initiatives to increase education and reduce stigma around suicide. Program engagement strategies included the importance of providing culturally appropriate services, the inclusion of lived experience mentoring, and tailoring the suicide prevention program to reach its targeted audience. Overall, there is a dearth of literature surrounding community-based suicide prevention initiatives for adults in rural and regional Australia. Further evaluation of community-based projects is required to ensure quality improvement and tailored suicide prevention initiatives for rural and regional Australians.
Suicide continues to impact rural and regional families and communities across Australia and has become a key focus of healthcare, research, and government policy in recent years. The challenge for healthcare organizations is to translate policy visions and research for clinicians to effectively embed in day to day practice when supporting people who experience suicidal crisis. This study explored the introduction of an evidence-based Zero Suicide framework that includes a suicide prevention pathway and training package to a rural and regional community mental health team in Victoria, Australia. A qualitative semi-structured interview technique was used to explore the perceptions of mental health clinicians of the Zero Suicide approach, the training package and the barriers to inform its implementation across a specialist mental health service. Clinicians were complimentary of the intent of Zero Suicide and the training package and felt they had increased confidence in delivering suicide safe care. Four major themes were identified through thematic analysis: (i) Minimizing risk with realistic expectations; (ii) A good approach to making a difference; (iii) Lessons learnt; and (iv) Barriers to implementation needing to change culture. Overall participants identified the importance of continued regular suicide prevention training for all staff but also in tailoring it to different consumer and clinician needs. In addition, organizational structure and adequate staff resourcing were important to participants as was working within a safety culture.
Mental health and suicide prevention are national health priorities in Australia, with research currently focussed towards the ZERO Suicide (ZS) initiative. The aim of this review was to evaluate the impact of suicide prevention programmes, in particular the ZS prevention initiative. A systematic review using the PRISMA guidelines was conducted using six EBSCO Host databases; Academic Search Complete, Australian/New Zealand Reference Centre, CINAHL Complete, MEDLINE, APA PsycINFO, and APA Psyc Articles. The data extracted from the eligible papers were analysed using a thematic approach. The final data set consisted of fourteen (n = 14) peer-reviewed articles meeting the eligibility criteria, which included quantitative (n = 10), mixed methods (n = 2), and qualitative studies (n = 2). Results indicated variances between suicide prevention programmes with some papers examining single workshops and others assessing multimodal, organizational interventions. Five major themes were produced from this review including measuring the success of suicide prevention programmes, improvements to the delivery of suicide prevention programmes, barriers to implementing changes, cultural considerations, and further research required for suicide prevention programmes. This review concludes that further long-term research is required to evaluate the implementation and efficacy of suicide prevention programmes in health care. Cultural awareness in suicide prevention training is another area that may benefit from further research. A growing body of evidence establishes the need for multimodal and organizational approaches for suicide prevention initiatives.
This study explores a weekly community-based exercise program (CBEP) for ageing adults in Gippsland, Victoria, Australia. This program aims to improve the health and well-being of ageing adults and was evaluated using an exploratory qualitative study design. Four focus group discussions and two individual interviews were conducted before a thematic analysis using Braun & Clark's (2006) six-step approach. A total of 23 participants were involved in the study over a 6-week period. The thematic analysis resulted in two main themes: (a) meeting community needs and (b) benefits to health and well-being. Five minor themes stemmed from these two themes, in which participants identified that a service gap existed within the community and the program was adaptive in its design to meet community needs. Participants reported benefits to health and well-being, specifically perceived improved mobility and independence, social connections and 'recharging the batteries to feel good'. The inclusion of Tai Chi exercises was noted for increased vitality and pain management benefits. The role of the exercise instructor was deemed to be instrumental to the success of the CBEP. The CBEP provides motivation for older adults to attend, increasing physical activity. Future CBEPs for ageing adults should provide a social component and relevant health education for participants. Exercises should be safely adapted by the exercise instructor to suit people of various abilities and to promote a more 'inclusive' environment.