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To explore the experiences of new graduate registered nurses in caring for the deteriorating patient in rural areas.
New graduate registered nurses often feel unprepared to care for the deteriorating patient. Whilst literature has recognised new graduate registered nurses working within metropolitan areas feel ill-equipped to care for deteriorating patients, there is a paucity of literature focused on experiences within the rural context.
Qualitative, descriptive phenomenological approach.
In-depth interviews were undertaken with 7 participants in rural Eastern Australia with collected data being subject to thematic analysis.
Three themes were identified that shares the lived experiences of the participants as they transitioned into the rural team: First encounters—Transition to the rural team; Practice support for managing deterioration; and The road to confidence.
New graduate registered nurses are unprepared to care for the deteriorating patient in rural areas. Practice support and barriers to ongoing education are influential on their experience with findings from this study supporting focused rural healthcare preparation from tertiary education providers, plus structured practice support from senior rural nurses and health facility orientation programs. Preparation should include the use of digital technologies and escalation and management of the deteriorating patient alongside rural policies and procedures to enhance patient safety and support new graduate rural nurses.
The findings have implications for tertiary undergraduate nursing education and those supporting New Graduate Registered Nurses in their transition to practice in rural areas. Enhancement of new graduate nurses' skills and abilities in recognition and responding to patient deterioration through both technological and personnel support will enhance patient safety within rural health care.
Standards for Reporting Qualitative Research (SRQR).
7 participants were involved in the study.
This scoping review aimed to explore and identify literature about the scope of practice for nurse practitioners working as immunisers in primary healthcare.
The review was conducted according to the JBI scoping review framework.
A comprehensive literature search was conducted on 11 December 2023 to identify primary studies examining the role of nurse practitioners in immunisation delivery within global primary healthcare settings. The inclusion criteria were limited to peer-reviewed primary research that specifically examined nurse practitioners’ roles in primary healthcare settings in immunisation clinics and/or administering immunisations. Data were systematically extracted using a data extraction table, and article screening was independently performed by two reviewers. Reporting of findings was guided by the PRISMA-ScR checklist.
Medline, Scopus and CINAHL including peer-reviewed literature from January 2000 to December 2023.
A total of 1025 articles were identified; following screening and removal of duplicates, 52 articles underwent full-text screening and 8 articles that met the inclusion criteria were included in this review. Themes were identified using a qualitative descriptive approach: nurse practitioner scope of practice in primary healthcare; nurse practitioners addressing service gaps in primary healthcare; and the nurse practitioner's role in immunisation provision in primary healthcare.
Findings suggest that the roles and responsibilities of nurse practitioners working in primary healthcare are highly variable. Little research has been conducted to explore the nurse practitioner's immuniser role in primary healthcare.
No patient or public involvement was included in this scoping review.
This review provides insight into the current knowledge about the Nurse Practitioner Immuniser role in Primary Healthcare. While Nurse Practitioners have contributed to public immunisation efforts globally, the role and scope of nurse practitioner immunisers in primary healthcare are still evolving.
To explore whether sleep deprivation contributes to medication errors in registered nurses (RNs).
Sleep deprivation is a potential issue for RNs, particularly those who work shifts. Sleep deprivation has been found to have a negative impact on numerous cognitive processes. Nurses administer several medications to patients a day, potentially while sleep deprived—anecdotal reports suggest that this could result in an increased risk of error occurring.
A scoping review was conducted using the Prisma-ScR extension framework to explore what is known about the effect of RNs' sleep deprivation on medication administration errors.
A search of databases generated 171 results. When inclusion and exclusion criteria were applied, 18 empirical studies were analysed. Studies included retrospective analysis of errors, surveys of perceptions of causes and observational studies.
Data indicated that RNs consider fatigue, which may be caused by sleep deprivation, to be a contributing factor to medication errors. The search only identified three observer studies, which provided conflicting results as to whether lack of sleep contributes to the error rate. Of the numerous tools used to measure sleep, the Pittsburgh Sleep Quality Index was the most frequently used.
Although RNs anecdotally consider a lack of sleep potentially contributes to medication errors, there is insufficient research to provide robust evidence to confirm this assumption.
Patient or public contributions were not required for this scoping review.
Sleep deprivation is a potential issue for nurses, especially those who work shifts. Poor sleep impacts cognitive processes that potentially could increase errors. Nurses should be aware of the impact sleep may have on patient safety.
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