Objective: The aims of the study were to investigate predictors and outcomes of psychiatric disorders among survivors postearthquake. Design: Cross-sectional design survey. Setting: Government-aided communities with temporary shelters. Subjects: A multistage stratified and cluster sampling strategy was employed to select participants via face-to-face interviews, and a total of 1,297 survivors participated in the research. Main outcome measure: Psychiatric disorders were measured with self-reporting questionnaire-20 (SRQ-20), and quality of life was measured with medical outcomes study 36-item short form health survey (SF-36) and a series of problems were made to evaluate the demographic characteristics of survivors. Results: The findings of the present study show that psychiatric morbidity was very prevalent among survivors (76.6%). Negative correlation was found between the total score of SRQ and PCS (rs= -0.525, p<0.001), and MCS(rs= -0.679, p<0.001) by Pearson correlation analysis. The multivariate logistic regression analysis demonstrated that female, aged 60 or older, having financial burden and having >2 chronic diseases were significant risk factors for psychiatric disorder. While married, monthly income > ¥1,500, and with medical insurance were significant protection factors against psychiatric disorders. Conclusions: The psychiatric morbidity was very prevalent among survivors two years after the earthquake. The survivors with psychiatric disorders tend to have poor quality of life. Appropriate public health and medical interventions should put an emphasis on survivors who are female, aged 60 or older, having financial burden and having >2 chronic diseases because they are at heightened risk for psychiatric disorders.

Objective: To provide contextual information about health literacy and its importance to health care, nursing, and health consumers. Primary argument: Health literacy is of concern to all health workers, including nurses, working in all areas of the Australian health care system. Low levels of health literacy is a significant problem in Australia. Population measurements of functional health literacy levels (ABS 2008) indicate that 59 per cent of the Australian population aged 15 to 74 years did not achieve an adequate health literacy skill level to meet the complex demands of everyday life and work in a knowledge-based economy. Nurses play a vital role in the care and education of health consumers. As such an understanding of health literacy and how it impacts on health care and health outcomes is central to providing patient-centred care, and improving health outcomes. Conclusion: An understanding by nurses of health literacy is central to enhancing the involvement of health consumers in their care, and improving health outcomes and the provision of safe health care.

Objective: The objective of this study is to obtain an in-depth understanding of the phenomenon of peri-operative nurses’ use of protective eyewear in the operating room (OR), and to understand nurses’ attitudes and beliefs towards protective eyewear. Design: Data was collected via one-on-one interviews with eight peri-operative nurses working in a private hospital in Melbourne. The data collected underwent rigorous thematic analysis using an extended version of Colaizzi’s method of phenomenological inquiry. Setting: The participating site is a large, private, metropolitan hospital that has 420 beds and employs 1,100 nurses and midwives, of which 31% are peri-operative nurses. Subjects: Eight registered nurses were recruited. They were all female, aged between early 20s to early 60s, ranging in experience in the peri-operative setting from more than six months to approximately twenty years. Main outcome measure: The investigation of the phenomenon of peri-operative nurses’ use of protective eyewear in the OR with information to help further understand peri-operative nurses’ attitudes and beliefs towards protective eyewear. Results: For nurses, being compliant with protective eyewear is a combination of intrapersonal, environmental and professional factors, including protecting self, risk appraisal, beliefs, previous experiences, fear, comfort and functionality, professionalism, leadership, forgetting versus routine, time pressure and accessibility, alternatives and patient-centred care. Conclusion: Individual nurse’s beliefs towards protective eyewear and its impact on work, life and patient care influence their decision to use protective eyewear. Peri-operative nurses are more compliant when they are well informed and are in a supportive work environment.

Aims: The aim of this study was to evaluate the influence of case management on family member or other caregivers involvement in residential aged care settings; staff?family relationships and family satisfaction with residential care. Method: This was a controlled before and after study involving pre and post intervention testing and comparison between intervention and control groups from two 30 bed rural high care residential aged care facilities. Staff from the intervention facility underwent case management training and resources were allocated to implement case management. General demographic information was collected about the family member and the residents. The Family Involvement Questionnaire and the Family Perception of Care Tool was used pre and post intervention to determine the level of family involvement and their perception of care provided. Results: Visiting levels increased in the intervention site but not the control site. No significant differences were found for the two sites over the two phases but increases were seen in correspondence, attendance at social activities, overseeing staff interactions, attendance at case conferences and rate of family member decision-making about treatments or care for the intervention site. The overall satisfaction with care and the relationships increased at the intervention site but the changes were not significant. Conclusion: Although there were no statistically significant results due to the sample size, there were positive changes at the intervention site. Case management is a potentially suitable model of care in the aged care setting.

Objective: The aim of this study is to evaluate the exposure status of nurses to hepatitis B and C, and to determine the precautionary measures taken for protection from these infections. Design: This descriptive study was performed between February and May 2008 among nurses working in surgery and internal medicine wards. Setting: A total of 300 nurses working in the Aziziye Research Hospital and Yakutiye Research Hospital. Subject: The nurses included in the study comprised those who had three different levels of education, namely undergraduate, associate degree and high school. The data were collected via a questionnaire composed of 34 questions. The questionnaire consisted of questions on socio‑demographic characteristics, questions for estimating the frequency of exposure to blood and bodily fluids, questions about precautions, and questions for estimating HBV, HCV and the vaccination status of the nurses. Main outcome measure(s) A questionnaire developed by the researchers and data collected through a review of literature. Result: The results of completed questionnaires were collated, and Chi‑square test and percentage tests was used for analysis. 94.9% of the nurses participating in the study stated they had contact with blood and bodily fluids, and 75.8% of them had taken precautions during contact. The mostly commonly used preventive methods were hand washing before and after the invasive procedures on the patients (85.6%), hand washing between the invasive procedures on different patients (69%), and use of gloves (67.9%), respectively. The least used method was wearing protective glasses (0.2%). Among the distribution, injuries whilst replacing the cap of the syringe were leading (87.7%), and the least frequent were injuries sustained during the disposal of medical waste (54.6%). It was seen that 20.5% of the nurses in the study had undergone vaccination for hepatitis B. Majority of the nurses who had not had the vaccination (12.6%) stated they had not yet had the opportunity. Conclusions: As a result of the study, it was found almost all of the nurses had been in contact with blood and bodily fluids. Above all healthcare workers should receive periodic training on universal precautions, with a view on improving the overall safety of patients and healthcare workers.

Objective: To compare and review medication documentation errors using handwritten versus pre‑printed ICU flowcharts. Design: Randomised retrospective audit comparing handwritten ICU flowcharts from 2004 and pre‑printed ICU flowcharts from 2009. Setting: Ten bedded, Level 2 Intensive Care Unit in Australia. Subjects: Total of 60 ICU flowcharts: 30 handwritten flowcharts from 2004 and 30 pre‑printed flowcharts from 2009. Main outcome measures: To determine whether using pre‑printed ICU flowcharts eliminated or significantly reduced the number of medication documentation errors compared to handwritten medication orders using ICU flowcharts. Results: Although the sample size of this audit was small, this audit showed that there was no overall difference when using handwritten and pre‑printed ICU medication flowcharts. Four error categories were initially measured against, but a fifth category was identified during the audit. The third category ‘prescribing documentation errors’ was identified as the largest category for errors, with a 44% error rate using handwritten ICU flowcharts and a 78% error rate using pre‑printed ICU flowcharts. Conclusion: This audit demonstrated although there was no overall difference using handwritten or pre‑printed ICU medication flowcharts, using pre‑printed ICU medication flowcharts reduces the risk of an adverse drug event that may result in patient harm by classifying error categories. This audit has also highlighted the need for further research into medication documentation errors using paper‑based or electronic medication charting in the ICU, the role of pharmaceutical review during the prescribing process and to explore the role of nurse practitioners in the ICU.

Objective: To evaluate the experience of, and services to, patients from rural and regional Australia referred to a large urban tertiary referral hospital for allogeneic haematopoietic cell transplantation (allo‑HCT) and to compare their quality of life with similar populations. Design and setting: A cross‑sectional survey of allo‑HCT recipients referred from the Calvary Mater Newcastle to Westmead Hospital, Sydney, NSW. Subjects: Thirty‑seven of forty adult survivors of allo‑HCT (92.5%) who underwent transplant between 1999 and 2008 and were at least three months post transplant. Intervention: All subjects completed a validated measure of quality‑of‑life (QoL) in bone marrow transplant recipients (FACT‑BMT Version 4) and the Regional/Rural BMT Needs Assessment Survey. Results: Most patients (79%) were between one and five years post transplant. Almost all reported having been sufficiently prepared for transplant and received most information and support from the Nurse Coordinator. Despite the fact that 89% of patients reported significant adverse effects of allo‑HCT, >60% still reported an acceptable quality of life. Importantly, however, about a third of patients experienced financial difficulties associated with transplantation and felt pressure to return to work. Conclusion: Patients referred for allo‑HCT should be advised about the arduousness of transplant but also reassured that most survivors will experience acceptable levels of functioning and QoL one to two years after transplant. With sufficient local support and with appropriate nursing care and coordination the experiences of regional/rural patients is comparable with other allo‑HCT patient populations. Further investigation into vocational rehabilitation is warranted due to the significant financial and occupational pressures reported by survivors of allo‑HCT.

Objective: This paper presents a discussion of the development of a framework to implement and sustain the nurse practitioner (NP) role within one health service designed to strengthen the capacity of the health system and which could be readily transferable to other health services. Setting: Eastern Health (EH) is a multi‑campus tertiary health care organisation servicing a population of approximately 800,000 people in the east and outer eastern suburbs of Melbourne, Australia. EH is committed to advancing the nursing profession and exploring innovative, research based models of practice that are responsive to the needs of the community it serves. Primary argument: The Framework documents the processes of providing a new career pathway for advanced practice nurses that incorporates education and training, and utilises current evidenced‑based practice guidelines to define and promote the scope of practice. Conclusion: Strong organisational support to facilitate interdisciplinary and multidisciplinary learning opportunities assists integration of the NP role into the healthcare team. Role clarity will assist interprofessional teams to understand and value the role NPs provide.

Objective: In using a flexible delivery of learning approach to nursing education, and taking into account the globalisation of education, this research argues that universities need to consider and take into account both the positive and negative aspects of this decision. Setting: Tertiary educational settings. Subjects: All undergraduate/postgraduate students. Primary Argument: As nursing education is undergoing some significant changes this study argues that universities must be prepared to adopt some changes to harmonise with the needs of learners, the major stakeholders and to remain financially competitive in the marketplace. Conclusion: These arguments need to be considered using the backdrop of what might be described as the globalisation of education and universities need to respond to the challenges that flexible online learning presents. Flexible delivery for nursing education may need to proceed forward with a degree of caution because financial considerations shouldn’t be a determinant of pedagogical quality.

Objective: To compare workplace conditions and levels of occupational stress in two samples of Australian nurses. Design: The research adopted a cross‑sectional design, using a structured questionnaire. Setting: Health centres in very remote Australia and three major Australian hospitals. Subjects: 349 nurses working in very remote Australia and 277 nurses working in three major hospitals in South Australia and the Northern Territory. Main Outcome Measures: The main outcome measures were psychological distress (assessed using the General Health Questionnaire‑12), emotional exhaustion (assessed using the Maslach Burnout Inventory), work engagement (assessed using the Utrecht Work Engagement Scale‑9) and job satisfaction (assessed using a single item measure based on previous relevant research). Results: Results revealed that nurses working in major Australian hospitals reported higher levels of psychological distress and emotional exhaustion than nurses working very remotely. However, both groups report relatively high levels of stress. Nurses working very remotely demonstrated higher levels of work engagement and job satisfaction. There are common job demands and resources associated with outcome measures for both nurses working very remotely and nurses working in major hospitals. Conclusion: This research has implications for workplace interventions and the retention of staff in both hospitals and remote area health care facilities.