Associate Professor Sarah Jeong

© 2019 Elsevier Ltd Background: Negative workplace behaviour among nurses is a globally recognised problem and new graduate nurses are at high risk for exposure. Negative behaviour has detrimental effects on new graduate nurses, the nursing profession and patients. Objectives: To synthesise evidence on negative workplace behaviour experienced by new graduate nurses in acute care setting and discuss implications for the nursing profession. Design: An integrative review guided by Whittemore and Knafl's (2005) framework. Data sources and review methods: A search of evidence-based research from five electronic databases (CINAHL, MEDLINE, ProQuest, JBI and Scopus) was conducted for the period of 2007-2017. Eligible articles were critically appraised using the Mixed Methods Appraisal Tool. Results: Eight qualitative and eight quantitative studies were identified and reviewed. There was a variety of terms and definitions used to describe the disrespectful, unprofessional and uncivil targeted behaviour towards new graduate nurses. The incidence of negative workplace behaviour varied from 0.3% as a daily occurrence to 57.1% experiencing sporadic exposure. The precipitating factors included the new graduates¿ perceived lack of capability, magnifying power and hierarchy, leadership style and influence of management. The negative behaviour was identified as either a personal or professional attack, which left new graduates feeling emotional distress, anxiety or depression, which in turn impacted upon job satisfaction, cynicism, burnout, and intention to leave. The lack of a definitional consensus and the range of negative workplace behaviour make identification, seeking assistance and intervention difficult. Specific or ongoing organisational support to address negative behaviours towards new gradute nurses was not identified. Instead, the way they used to deal with these behaviours were personal. Conclusion: Negative workplace behaviour towards new graduate nurses continues to be an international problem. Available studies are descriptive and exploratory in nature and there have been few effective strategies implemented in acute care setting to address towards new graduate nurses. Multi-level organisational interventions are warranted to influence the ¿civility norms¿ of the nursing profession. With a new understanding of the theoretical underpinnings of negative workplace behaviours towards new graduate nurses and the identification of limited intervention studies being undertaken, the nursing profession is provided with new directions in their future endeavours.

© 2017 This descriptive cross-sectional survey aimed to investigate the preferences of older inpatients and their family caregivers for life-sustaining treatments (LSTs) and their influential factors. Inpatients aged 60 and older and their family caregivers in three acute hospitals in Seoul, South Korea, were invited to participate in the study. A total of 180 surveys were returned from 90 pairs of patients and family caregivers with a response rate of 95%. Older inpatients expressed a significantly high desire for ¿not wanting to have cardiopulmonary resuscitation¿ (¿2 = 10.07, p = 0.007) and ¿mechanical ventilator¿ (¿2 = 10.35, p = 0.006) compared to their caregivers. Given that experiences of conversations about LSTs was a common factor in both groups and may prevent futile LSTs, it is important for nurses to initiate and support patients and family caregivers, helping them engage in formal and informal conversations about future healthcare preferences.

© 2017 American Society for Pain Management Nursing Previous studies have suggested that pain in older people with dementia is often underestimated and undertreated in acute hospitals. Undermanaged pain negatively affects a person's recovery and prolongs hospital stays. However, the issues related to pain assessment and management by nurses for this group have not been fully understood. (1) To synthesize evidence about pain assessment and management for older people with dementia in hospital settings, and (2) to discuss implications for nurses and their practice. Integrative literature review. A systematic search of evidence-based research from six electronic databases (CINAHL, MEDLINE, ProQuest, Cochrane, JBI, and Scopus) was conducted for the period of 2006-2016. Following Cooper's integrative review framework and a systematic screening process, the articles included were analyzed and synthesized to identify the common issues and relationships. Fourteen empirical research articles were examined and synthesized. Two main categories were identified and include: the nursing practice of pain assessment in older patients with dementia is less than optimal, and the nursing practice of pain management for this group varies. The lack of initiation of pain assessment and use of pain assessment tools may contribute to the inadequate pain management by nurses. Whereas this review uncovered the extent and challenges related to pain assessment and management, previous studies were explorative and descriptive. The findings from the review provide nurses with an opportunity to establish empirical evidence that may improve nursing practice of pain assessment and management for older people with dementia in hospital settings.

© 2017 International Nursing Association for Clinical Simulation and Learning Background: Empathy is integral to therapeutic relationships and person-centered care. Interventions specifically targeting empathy toward people who have a disability may be of benefit to nursing education. Method: In this article, we describe a novel point-of-view simulation designed to enhance empathy toward people who have a disability as a result of acquired brain injury. Nursing students' perspectives of the simulation were examined using a concurrent nested mixed methods design and using the Satisfaction with Disability Simulation Experience Scale, which includes 18 closed and one open-ended question. Results: A total of 384 second-year nursing students from a population of 488 participated, giving a response rate of 79%. The overall mean satisfaction score was 4.49/5.0 (standard deviation = 0.55), indicating a high level of agreement with each of the survey items. Thirty-five participants responded to the open-ended question, and analysis of their comments revealed three themes: A valuable experience, new insights, and standing in someone else's shoes. Conclusion: Given that there is compelling research about the benefits of empathic engagement with patients, the results from this study support continuing investment in point-of-view simulation experiences.

© 2016 Elsevier Ltd Aims: The aims of the present study were to report and compare regional and metropolitan Australian ED nurses¿ knowledge and understanding of age related characteristics of the older person. Background: ED nurses, who have a duty of care to deliver best practices for managing the older person, can be challenged due to the complexities and co-morbidities associated with older person presentations in the ED. Nurses in regional areas may have limited access to continuing education programmes and limited opportunities to attend such programmes. Design: A cross-sectional survey using previously validated instruments (OPACS and Palmore's Facts of Ageing Quiz) was conducted to measure emergency nurses knowledge and perceptions of physical, physiologic, and age related characteristics of older people; and aspects of hospitalisation that affect older people. Methods: Members of the College of Emergency Nursing Australasia (CENA) were invited to participate in the present study. There were 371 (39%) completed and valid surveys returned. Results: The OPACS results indicate that 66% of ED nurses had a basic knowledge about physical aspects and hospitalisation issues that affect older people. There were 59% correct responses for the Palmore's Facts of Ageing Quiz items measuring knowledge of physiologic and age related characteristics of older people. There were few differences between regional and metropolitan nurses. Conclusion: Increased knowledge of ageing is required for emergency nurses to continue to provide adequate care to older patients presenting to the ED to avoid adverse outcomes for these people.

© 2018 AJA Inc. Objective: To explore the experiences of older people receiving home care package (HCP) support following the introduction of consumer-directed care (CDC) by the Australian government on 1 July 2015. Methods: Thirty-one older people with existing HCP support from two service providers in regional New South Wales, Australia, participated in a face-to-face interview and/or a qualitative survey. Results: Analysis revealed the theme of Choices: Preferences, constraints, balancing and choosing. Participants described choosing to live at home with HCP support; however, they were constrained by poor communication and information about service changes and options, personal budgets and access to future care. HCP services remained largely unchanged during transition to CDC. Conclusion: Many aspects of the initial implementation of CDC were challenging for older people. Clear, relevant and timely communication and information about CDC and its consequences for consumers appear to be needed to enhance CDC.

© 2017 Elsevier Ltd Background Although empathy is an integral component of professional practice and person-centred care, a body of research has identified that vulnerable patients groups frequently experience healthcare that is less than optimal and often lacking in empathy. Aim The aim of this study was to examine the impact of an immersive point-of-view simulation on nursing students' empathy towards people with an Acquired Brain Injury. Setting and Participants A convenience sample of 390 nursing students from a cohort of 488 participated in the study, giving a response rate of 80%. Students undertook the simulation in pairs and were randomly allocated to the role of either a person with Acquired Brain Injury or a rehabilitation nurse. The simulated ¿patients¿ wore a hemiparesis suit that replicated the experience of dysphasia, hemianopia and hemiparesis. Design Characteristics of the sample were summarised using descriptive statistics. A two-group pre-test post-test design was used to investigate the impact of the simulation using the Comprehensive State Empathy Scale. t-Tests were performed to analyse changes in empathy pre post and between simulated ¿patients¿ and ¿rehabilitation nurses¿. Results On average, participants reported significantly higher mean empathy scores post simulation (3.75, SD = 0.66) compared to pre simulation (3.38 SD = 0.61); t (398) = 10.33, p < 0.001. However, this increase was higher for participants who assumed the role of a ¿rehabilitation nurse¿ (mean = 3.86, SD = 0.62) than for those who took on the ¿patient¿ role (mean = 3.64, SD = 0.68), p < 0.001. Conclusion The results from this study attest to the potential of point-of-view simulations to positively impact nursing students' empathy towards people with a disability. Research with other vulnerable patient groups, student cohorts and in other contexts would be beneficial in taking this work forward.

© 2016 Australian College of Nursing Ltd The Clinical Nurse Consultant (CNC) role emerged in New South Wales, Australia in 1986 as an advanced practice position. There is a growing body of literature seeking to articulate the multifaceted roles and responsibilities of the CNC within the Australian context. In this paper, we present a clinical case report that demonstrates how high risk medication administration errors via newly implemented syringe driver pumps, were identified and managed by a CNC. The CNC role was central in the identification of this series of medication errors that occurred across a number of hospitals, although these incidents could have been dismissed as human error. This report outlines the investigation, incident management process and subsequent release of a NSW state-wide Safety Alert. It also provides a discussion on the three key components for the successful management of a clinical incident investigation: leadership, teamwork and a ¿no blame¿ culture. The specific role of the CNC in this case report provides evidence that the role of the CNC is pivotal to patient safety.

© 2016 John Wiley & Sons Ltd Aims and objectives: To explore specific cultural and religious beliefs and values concerning death and dying, truth telling, and advance care planning, and the preferences for end-of-life care among older persons from culturally and linguistically diverse backgrounds. Background: Whilst literature indicates that culture impacts on end-of-life decision-making significantly, there is limited evidence on the topic. Design: A cross-sectional survey. Methods: A total of 171 community older persons who make regular visits to 17¿day care centres expressed in a questionnaire their; (1) beliefs about death and dying, truth telling, and advance care planning, and (2) preferences for end-of-life care. Results: More than 92% of respondents believed that dying is a normal part of life, and more than 70% felt comfortable talking about death. Whilst respondents accepted dying as a normal part of life, 64% of Eastern Europeans and 53% of Asia/Pacific groups believed that death should be avoided at all costs. People from the Asia/Pacific group reported the most consensual view against all of the life-prolonging measures. Conclusion: Cultural and religious beliefs and values may have an impact on preferences for treatment at end-of-life. The study offers nurses empirical data to help shape conversations about end-of-life care, and thus to enhance their commitment to help people ¿die well¿. Relevance to clinical practice: Information acquisition to extend understanding of each individual before proceeding with documentation of advance care planning is essential and should include retrieval of individuals¿ cultural and religious beliefs and values, and preferences for care. An institutional system and/or protocol that promote conversations about these among nurses and other healthcare professionals are warranted.

© 2017 La Trobe University. This paper reports phase one, conducted from March to June 2015, of a two-phase, qualitative descriptive study designed to explore the perceptions and experiences of older people before and after the introduction of consumer directed care (CDC) to home care packages (HCP) in Australia. Eligible consumers with a local HCP provider were mailed information about the study. Data collection occurred before the introduction of CDC and included face-To-face, in-depth interviews, summaries of interviews, field notes and reflective journaling. Semi-structured questions and 'emotional touchpoints' relating to home care were used to guide the interview conversation. Line-by-line data analysis, where significant statements were highlighted and clustered to reveal emergent themes, was used. Five older people, aged 81 to 91 years, participated in the study. The four emergent themes were: seeking quality and reciprocity in carer relationships; patchworking services; the waiting game; and technology with utility. Continuity of carers was central to the development of a trusting relationship and perceptions of care quality among older consumers. Care coordinators and workers should play a key role in ensuring older people receive timely information about CDC and their rights and responsibilities. Participants' use of contemporary technologies suggests opportunities to improve engagement of HCP clients in CDC.

© 2016 by De Gruyter 2016. The population of mature age students entering university nursing programs has steadily increased in both Australia and worldwide. The objective of the literature review was to explore how mature age students perform academically and to analyse the factors associated with their academic performance in nursing programs. A literature search was conducted in the following databases: CINAHL, ProQuest, Medline, Cochrane, Mosby's Index, Joanna Briggs Institute (JBI), and Scopus. Twenty-six (26) research papers published between 2000 and 2014 have met the selection criteria of this review. The key themes identified include; 1) ambiguity in definition of mature age and academic success, 2) age and academic success, 3) intrinsic factors (life experiences, emotional intelligence, and motivation and volition), and 4) extrinsic factors (peer, academic and family support; and learning style, components of the modules and mode of delivery). Current literature provides evidence that mature age nursing students perform at a higher level within the methodological issues discussed in this paper. Future research is warranted to advance the understanding of the complex relationship between extrinsic and intrinsic factors of mature age students and their academic success in higher education. Nursing educators will benefit from novel evidence, ideas and opportunities to explore and implement in nursing education.

© 2016 John Wiley & Sons Australia, Ltd. Because nurses are at the forefront of end-of-life care, it is imperative that nursing students are prepared for this role upon graduation. Research suggests that many nursing students are unprepared to deliver compassionate and quality end-of-life care. There have been many attempts to address this need; one emerging method is end-of-life care simulation. This paper explores the experiences of 18 undergraduate nursing students of end-of-life care simulation. Participants' stories were obtained via observation during end-of-life care simulation, audio-recorded post simulation debriefing, and semi-structured interviews. Using Clandinin and Connolly's three dimensions of Narrative Inquiry (temporality, spatiality, and sociality) participants' stories reflected convergence of time, place, and person. Findings revealed three distinct plotlines along a time continuum, specifically surrounding time of death: (i) "The privilege of end-of-life care;" (ii) "Witnessing death as surreal;" and (iii) "The honor of providing after-death care." Participants' narratives suggest that end-of-life care simulation is an important means of preparing students for clinical end-of-life care experiences. This has implications for nursing educators wishing to consider simulation in end-of-life care education.

© 2016 Informa UK Limited, trading as Taylor & Francis Group. Aim: To report nurses¿ attitudes towards older people in the emergency department (ED). Background: A nurse¿s attitude towards an older person can have an effect on nurses¿ work practices and interactions and can result in adverse outcomes for the older person. Design: A national cross-sectional survey using a previously validated instrument Older Person in Acute Care Survey (OPACS) was conducted to measure emergency nurses¿ attitudes towards older people in their care. Methods: Members of the College of Emergency Nursing Australasia (CENA) were invited to participate in the study. There were 371 (39%) completed surveys returned. Results: The OPACS survey identified that ED nurses have positive attitudes towards older people in the ED. Conclusion: The implications for practice are clinically significant because positive attitudes can result in prevention of discrimination and marginalisation of the older person in the ED.

© 2016 -IOS Press and the authors. All rights reserved. Recent statistics released by Alzheimer's Disease International has highlighted how prevalent dementia will become in the next couple of years. Along with the increased incidence of individuals being diagnosed with dementia, there has also been an increment in the number of informal carers for people living with dementia. A recent report highlighted that in Australia, there are an estimated of 200,000 informal carers as of 2011. Caring for people who are living with dementia is not an easy task. Previous studies have highlighted that as much as 65% of caregivers do experience symptoms suggestive of depressive symptoms in the process of care. With the rapid advances in technology, it is of no surprise that information technology and its related innovations have been used in dementia care. A review of the existing literature shows that much of these innovations are focused on the care of patients affiliated with dementia. However, clearly interventions focusing on the needs of the dementia cohort of patient are limited. There are currently more emerging studies demonstrating the efficacy of web-based interventional toolkits for carers who are caring for individuals with dementia. Whilst there are previous studies demonstrating the effectiveness of smartphone interventions for dementia patients, there remains a paucity of smartphone based interventions for caregivers who are living with people with dementia. This technical note describes the conceptualization of an evidence based smartphone intervention for patients living with dementia, as well as for carers of these patients.

© 2016 John Wiley & Sons Ltd Aim and objective: To report Australian nurses' practices caring for older people in the emergency department. Background: Unmet clinical needs of older patients in the emergency departments can have a negative impact on nurses and patients. Method and design: A national cross-sectional survey using a previously validated instrument, Older Person in Acute Care survey, was conducted to measure Australian emergency nurses' attitudes towards older people in their care. Members of the College of Emergency Nursing Australasia (CENA) were invited to participate in the study. There were 371 (39%) completed and valid surveys returned. Results: This study determined that Australian emergency department nurses report many positive practices used for older patients in their care. Conclusion: In this study, the Older Person in Acute Care survey has identified that, overall, emergency departments nurses have positive clinical practices towards their older patients in the emergency departments. The implications for clinical practice are significant as patient centred care in the Australian emergency departments will reduce adverse events for the older patient.

Background: Simulation is an evolving pedagogical approach to teaching in many undergraduate nursing curricula, however, there is little published literature on end of life care simulation as an effective means of teaching nursing students about end of life care. Literature review aims: To examine available literature on end of life care simulation. Review methods: An extensive literature search on end of life care simulation in the undergraduate nursing curriculum was conducted in CINAHL, Mosby's Index, Cochrane Database, Scopus, Eric via Proquest, and Medline. 6 research articles and 10 descriptive articles published between 2009 and 2013 that met the selection criteria are included in the review. Findings: Findings of these 16 articles are reported under 4 main themes: 1) Increased knowledge of end of life care through 'experiential learning'; 2) Impact of family presence on student learning; 3) the Debriefing imperative, and 4) Methodological issues raised from studies. Conclusion: The findings of the studies reviewed support end of life care simulation as a strong and viable pedagogical approach to learning for its positive effects on knowledge acquisition, communication skills, self-confidence, student satisfaction and level of engagement in learning. However, the important factors including psychological safety of students and the costs involved require careful consideration. Research on the use of simulation in nursing is still in its infancy, further research using various research designs is required to adequately explore the issues surrounding end of life care simulation. © 2013.

The migration of nurses has been a global phenomenon, and the integration of overseas-qualified nurses within host countries has led to debate worldwide. Evidence suggests that support provided by organizations can vary and that there is minimal information on the nature and extent of organizational support required to enhance a smooth transition of overseas-qualified nurses into nursing practice. This explorative study tour examined the organizational support provided to enhance overseas-qualified nurses' transition into the nursing workforce in two countries. The various support mechanisms provided to overseas-qualified nurses in different organizations include transition, acculturation, mentoring programs, and initial settlement assistance. The successful transition of overseas-qualified nurses into a host country is a complex issue. A robust support system for these nurses should be based on ethical considerations and a team approach that is linked to strong leadership. In addition, education and support for existing staff is essential for a successful transition of overseas-qualified nurses into practice. Lessons learnt from this study tour might also be relevant to the transition of other overseas-qualified health professionals, such as doctors and allied health professionals, in host countries. © 2013 Wiley Publishing Asia Pty Ltd.

Background: Research on end of life care education suggests that undergraduate nursing students are largely unprepared to provide end of life care to dying patients and their families. Although there have been attempts to address the issue of lack of preparedness, little is known on how to improve this. Literature Review Aims: To examine how end of life care education has been delivered to undergraduate nursing students and to critically discuss the research on modes of delivery and teaching strategies. Review Methods: An extensive literature search on end of life care education in the undergraduate nursing curriculum was conducted in CINAHL, Mosby's Index, Cochrane Database, Scopus, Eric via Proquest, and Medline. 18 research papers published between 1984 and 2012 that met the selection criteria are included in the review. Findings: Findings of these 18 articles are reported under two main themes: Modes of End of Life Education Delivery and End of Life Care Education Initiatives. Conclusion: This review highlights issues with end of life care education and suggests that end of life care simulation is an innovative strategy that may help to prepare undergraduate nursing students to provide quality end of life care. © 2013.

© 2014 AJA Inc. Objective: The purpose of this literature review was to determine nurses' knowledge and understanding of the ageing process and attitudes towards older people in emergency care settings. Methods: Primary research publications about emergency nurses' attitudes towards and knowledge about older people were sought in six databases and Google. Results: Sixteen articles were reviewed, including seven cross-sectional surveys, seven qualitative studies and two mixed-methods studies. Conclusion: Emergency department nurses' attitudes towards and knowledge about ageing processes may affect therapeutic interactions between nurses and their older patients. Issues such as managerial style, past experiences and the medical model used for health-care delivery were secondary factors shown to influence emergency nurses' negativity towards their older patients. Further research focused on nurses' attitudes to and awareness or knowledge of gerontological issues, in particular in the ED, is warranted and would contribute to achieving desired cultural change.