-
[show abstract]
[hide abstract]
ABSTRACT: Most Australian public health-care services have established a range of initiatives designed to help 'protect' nurses and midwives from patient and visitor assault (PVA); however, few studies have specifically examined their effectiveness. The present study is part of a larger survey that explored nurses' and midwives' experiences of PVA using the Department of Human Services, Victoria (2007) definition of occupational violence and bullying. Participants were asked about the presence of 'protective' factors in their workplace and the importance of having these factors to prevent and manage workplace aggression. Binary logistic regression was applied to ascertain the association between 'protective' factors and the occurrence of PVA, with adjusted odds ratios and their reported 95% confidence intervals for ascertaining the significance of the associations. The study found more 'protection' from assault when there was a high standard of patient facilities, sufficient staffing, effective enforcement of policies, and when staff were provided with personal protective equipment. Working in private health care, and being a registered nurse, also conferred 'protection'. A higher occurrence of staff assault was associated with specific clinical settings, and being on rotation and on night duty. Findings point to important insights into factors associated with 'protection' for PVA.
International journal of mental health nursing 12/2012; · 1.07 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: BACKGROUND: Workplace aggression remains an important source of distress among nurses and midwives and has negative effects on staff health, patient care and organisations' reputation and fiscal health. OBJECTIVES: To report on the nature and extent of workplace aggression, including bullying experienced by nurses and midwives in Victoria, Australia. DESIGN: A descriptive study design was chosen. SETTINGS AND METHODS: The Nurses Board of Victoria posted 5000 surveys to the randomly selected registered nurses and midwives in Victoria, Australia, in 2010. The participants were asked about their experiences of violence (from clients) and bullying (from colleagues) within their most recent four working weeks. In addition, the study investigated staff actions following incidents, staff training and safety at work, and what staff believe contribute to incidents. Data analysis involved descriptive statistics, including frequencies and percentages. Chi square tests and P value were used to assess differences in categorical data. FINDINGS: 1495 returned questionnaires were included in the study (30% response rate). Over half of the participants (52%) experienced some form of workplace aggression. Thirty-six percent experienced violence mostly from patients or their visitors/relatives and 32% experienced bullying mostly from colleagues or from their managers/supervisors. Significant differences were found between those who experienced aggression from patients and those who were bullied in respect to handling of incidents; factors thought to contribute to incidents; and organisations' handling of incidents. CONCLUSION: The study suggests that staff are less worried by patient initiated aggression compared to bullying from colleagues. For all types of aggression, respondents clearly wanted better/more realistic training, as well as enforcement of policies and support when incidents arise.
International journal of nursing studies 07/2012; · 1.91 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: This paper draws on theory and evidence to develop a conceptual staff training model for the management of 'challenging behaviour'.
Staff working with clients who are experienced as challenging commonly report negative feelings such as anxiety, anger, guilt, fear, self-blame and powerlessness, as well as dissatisfaction with their jobs. Current training programmes in challenging behaviour offer a 'smorgasbord' of content, without a clearly defined conceptual framework.
Medline and PsychInfo were searched for papers in English from 1998 to 2008, linking 'nurs*' to 'challenging behavio*' and its related terms. Additional hand-searching identified informative papers from disciplines outside nursing older than the search period.
We developed an applied model for training educators in respect of challenging behaviours. The model directs educators to consider: the influence of the nurse, including their values, emotional processes and behavioural skills; features of the client; and features of the situation in which the behaviour occurs, including its culture and working practices and physical environment.
The most striking implication of the model is that it explicitly recognizes the importance of domains of learning other than skill. This enables educators to find educationally appropriate responses to resource limitations that inevitably constrain training.
Challenging behaviour should be considered as a product of several intertwined factors: the actors involved - nurses, clients and others - and the situation in which the behaviour occurs, including its culture and working practices and physical environment.
Journal of Advanced Nursing 05/2010; 66(7):1644-55. · 1.48 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: Nurses and other health care staff frequently encounter a range of aggressive and other 'challenging behaviours' at work from clients and colleagues. In response to staff concerns, an abundance of state and national policies are now available but it is left up to individual employers to decide how best to implement them at a local level. In this paper we offer an education and training model which is conceptually sound, practical in application, and suitable for health care staff at different levels in the organisation. The importance of understanding challenging behaviour from an interactional perspective, and the educational principles on which training should be founded, are discussed. Finally, the cost of training and the need for program evaluation are considered.
Contemporary nurse: a journal for the Australian nursing profession 12/2009; 34(1):110-8. · 0.67 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: On-line learning is increasingly being used in nursing education. Nevertheless, there is still insufficient evidence to demonstrate: whether students respond positively when this form of learning is used to teach relatively practical or clinical subjects; whether it is effective; and whether it is fair to students with less access to, or familiarity with, computers and the internet. In 2003, an on-line Unit on clinical communication was developed for Australian undergraduate nurses in partnership between an Australian School of Nursing and the Department of Clinical Psychology. Students were overwhelmingly positive in their evaluation of the Unit although some regretted the lack of face-to-face contact with tutors and peers. The best aspects of the Unit included the content and structure being perceived as interesting, fun and informative, the relevance of the material for them as nurses, flexibility to work independently, promotion of critical thinking and gaining an understanding of client issues. Neither their evaluation nor their final grades were related to students' age or whether they preferred on-line or traditional learning. Students who had readily available computer access, however, had better final grades. Also, students' grades were correlated with how often they accessed the Unit.
Nurse Education Today 08/2007; 27(5):427-35. · 1.24 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: This paper reports a study of workplace aggression among nurses in Tasmania, Australia. There is international concern about a perceived rise in occupational violence as a major worldwide public health problem, with associated financial costs.
There is reason to suspect that aggression towards nurses is increasing. For example, increased illicit drug use puts nurses at the sharp end in managing patients admitted with drug-related problems. Such people are often resistant to healthcare intervention, and often have associated disorders, including mental illness. Despite this increased awareness, comprehensive data on occupational violence in nursing are not available.
A specially designed questionnaire was sent to all nurses registered with the Nursing Board of Tasmania (n = 6326) in November/December 2002, with 2407 usable questionnaires returned. The response rate was 38%.
A majority of respondents (63.5%) had experienced some form of aggression (verbal or physical abuse) in the four working weeks immediately prior to the survey. Patients/clients or their visitors were identified as the main perpetrators, followed by medical and nursing colleagues. Abuse influenced nurses' distress, their desire to stay in nursing, their productivity and the potential to make errors, yet they were reluctant to make their complaints 'official'. As well as reporting high levels of verbal and physical abuse, nurses were distressed because they could not provide the appropriate care to meet patients' needs. Few working environments were free of aggression.
Future research should try to determine the specific factors, including staff characteristics and environment, associated with the high levels of aggression reported in 'hot spots' where, on the basis of the present results, many staff experience high levels of verbal and physical abuse. Unless managers take steps to improve the situation, attrition from the profession for this reason will continue.
Journal of Advanced Nursing 10/2006; 55(6):778-87. · 1.48 Impact Factor
-
Gerald A. Farrell
[show abstract]
[hide abstract]
ABSTRACT: Cover title. "September, 1996." Thesis (M.S.)--University of Tasmania, 1996. Includes bibliographical references (leaves 220-242). "Submitted in fulfillment of the requirements for the Degree of Doctor of Philosophy."
