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Evaluating the implementation of the Deadly Aboriginal and Torres Strait Islander Nursing and Midwifery Mentoring (DANMM) programme: a mixed-methods pilot study conducted across four Local Health Districts in New South Wales, Australia

Por: Fealy · S. · McMillan · F. · Damm · A. · Biles · B. · Dawson · N. · Anderson · J. · Biles · J.
Objective

Cultural safety is critical to addressing healthcare disparities for Aboriginal and Torres Strait Islander peoples. The Deadly Aboriginal and Torres Strait Islander Nursing and Midwifery Mentoring (DANMM) programme was developed to support Aboriginal and Torres Strait Islander Nurses and Midwives through culturally responsive mentorship. This pilot study evaluates the feasibility and acceptability of the DANMM programme and its impact on cultural safety knowledge and workplace experiences.

Design

A mixed-methods exploratory study research design was employed. Data collection methods were underpinned by the Ngaa-bi-nya evaluation framework.

Setting

Four Local Health Districts in New South Wales, Australia.

Participants

20 participants completed the Ganngaleh nga Yagaleh (GY) cultural safety tool (n=12 pre-DANMM programme and n=8 post-DANMM programme), between June 2023 and October 2024. Five of these participants also took part in individual yarns between August and November 2024.

Primary outcome measures

Changes in median cultural safety knowledge scores (pre- to post-programme), measured using the GY tool, were analysed using the Wilcoxon rank-sum test for unpaired data (p

Results

Statistically significant positive changes in median GY tool scores (pre to post) were observed for item 13 (median pre=4.5, post=5.0; p=0.02), item 32 (median pre=4.0, post=5.0; p=0.03) and item 40 (median pre=3.5, post=5.0; p=0.03); with a statistically significant negative change in scores observed for item 6 (median pre=3.0, post=2.0; p=0.01). Qualitative themes included: (1) fostering growth and navigating barriers, (2) the power of connection and (3) navigating prejudice and racism in the workplace. Participants valued the mentorship model, though programme participation was affected by organisational barriers, including time constraints and a lack of managerial support.

Conclusion

The DANMM programme was found to be acceptable and feasible with evidence of enhanced cultural safety knowledge and mentorship benefits. However, the findings highlight the enduring impacts of colonial and cultural load and the need for greater organisational support to ensure the successful implementation and long-term sustainability of cultural safety initiatives. Future research should examine the longer-term effects on workforce retention and overcoming barriers to implementation and scalability.

Exploring the Experiences and Perceptions of the Utilisation of Structured Clinical Handover Frameworks by Nurses Working in Acute Care Settings: A Scoping Review

ABSTRACT

Background

There is increased interest in implementing structured clinical handover frameworks to improve clinical handover processes. Research postulates that structured clinical handover frameworks increase the quality of handovers; yet inconsistencies enacting these frameworks exist which has a potential to jeopardise the quality of communication during handovers thereby defeating the purpose of these frameworks.

Aim

This scoping review aims to analyse and synthesise what is currently known of the nurses' experiences and perceptions in implementing structured clinical handover frameworks and identify knowledge gaps in relation to this topic area.

Design

A scoping review guided by the PRISMA-ScR checklist.

Methods

A systematic search of five electronic databases was undertaken to identify peer-reviewed primary research studies which met the predetermined eligibility criteria. In total, 301 studies were imported into COVIDENCE, screened and assessed for eligibility resulting in 23 studies remaining. From the eligible studies, data was extracted, collated, appraised, summarised and interpreted.

Data Sources

MEDLINE, CINHAL, ProQuest, EMCARE, Web of Science and Informit.

Results

Twenty three studies were included in this review which yielded the following major themes: (1) quality and completeness of information transfer; (2) interprofessional collaboration; (3) challenges impacting the experience of implementing the structured clinical handover frameworks and (4) perceived impacts on quality, patient safety and health outcomes.

Conclusion

There are key benefits and issues experienced and perceived by nurses implementing structured clinical handover frameworks and this review identifies opportunities for further improvements. Future research should explore the perceived associations with patient outcomes.

Relevance to Clinical Practice

This review highlights the importance of structured clinical handover frameworks, the nurses' experiences in implementing these frameworks and strategies to improve the effectiveness of these frameworks.

Patient or Public Contributions

No Patient or Public Contributions as this study is a review of published primary evidence.

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