NURSING AND MIDWIFERY RESEARCH

CANDIDATE CONFERENCE 2010

Auspiced by the Victorian Deans of Nursing and Midwifery

Hosted by the School of Nursing and Midwifery, Monash University,
Monash University Conference Centre
Level 7, 30 Collins St

A warm welcome to this conference, we hope that you have an enjoyable

and educative few days. If you have any questions or concerns please feel
free to contact the organisers:
Conference Chair
Dr Simon Cooper
Associate Professor
Monash University
Conference Administrator
Belinda Schill
0408 63 1745

KEYONTE SPEAKERS
Professor Tracey Bucknall Cabrini Health and Deakin University
Tracey is a Professor at Deakin University and the new Head of the Cabrini-Deakin Centre for Nursing
Research at Cabrini Hospital. Prior to this appointment, she was an Associate Professor at the School of
Nursing, University of Melbourne, and Director of Nursing Research and Development at Western Health.
Tracey has clinical qualifications and extensive experience in critical care nursing, and has held a variety of
clinical, educational and research appointments in both private and public hospitals, and in the tertiary
sector.
She teaches in undergraduate and postgraduate nursing education programs, and supervises Masters and
PhD students in decision making research.
Her primary research interest has been clinical decision making. She has concentrated on understanding
how individuals make decisions routinely and in uncertainty, understanding the environmental and social
influences in health care. Tracey also researches the implementation of research into practice in areas such
as pain and sedation management, medication safety and health maintenance for the elderly. More recently
she has incorporated patient involvement in decision making as a means of influencing clinician uptake of
research evidence.

Professor Margaret OConnor AM Monash University

Professor OConnor is the inaugural Vivian Bullwinkel Chair in Palliative Care Nursing, School of Nursing
and Midwifery, Monash University in Melbourne, a position she has held since 2003. Prior to this she has
enjoyed a long and diverse career in palliative care, in roles that have encompassed the establishment and
management of mainly community-based palliative care services. Her current position formally
encompasses three clinical partners where Professor OConnor is actively involved in developing staff
research projects.
Professor OConnor is responsible for the Palliative Care Research Team in the School and manages a
number of clinical research projects, which have received more than $500,000 in funding from internal and
external sources. The growing research team includes a post-doctoral fellow and nine PhD students.
Research projects are centered on key areas - service system and policy issues and issues of culture and
palliative care. All projects involve the clinical partners and many research questions have arisen from within
the clinical setting. She is well published in these research areas.
Professor OConnor sits on many State and National committees, including the Australian Health Ethics
Committee of the National Health & Medical Research Council. She is a board member of the International
Association for Hospice & Palliative Care, the Asia-Pacific Hospice Network and on the working party for the
World Palliative Care Alliance. She became President of Palliative Care Australia in September 2006.
In 2002 and 2008 Professor OConnor was awarded the Nina Buscombe Prize from the Motor Neurone
Disease Association of Victoria. In 2005 Professor OConnor accepted the national honour of Member of the
Order of Australia, for service to the development and establishment of palliative care services in Victoria, an
acknowledgement of Margarets 20 year contribution to palliative care.

Professor Sanchia Aranda University of Melbourne

Sanchia Aranda is Professor/Director of Cancer Nursing Research at Peter MacCallum Cancer Centre
and Head of Nursing, Melbourne School of Health Sciences at the University of Melbourne. She has
worked in cancer and palliative care since 1979, predominantly in research and teaching roles since
1989.

Sanchias research interests are supportive care, symptom management and practice change. Sanchia
has received funding from the NHMRC, The Cancer Council, the National Breast Cancer Foundation and
Government sources. She is conducting a $3.5 million Government funded project with Professor Patsy
Yates to develop a framework for cancer nursing education and the production of readily accessible
learning materials. She has more than 100 publications (refereed journal articles, book chapters and
conference proceedings) and is an editorial board member of four international journals in cancer and
palliative care and is a reviewer for many more.
Sanchia is the President of the International Society of Nurses in Cancer Care and is on the Advisory
Council for Cancer Australia. She received the Oncology Nursing Society (USA) International Award for
Contributions to Cancer Care in 2001 and in 2009 was made a Fellow of the American Academy of
Nurses and received the Inaugural Excellence in Cancer Nursing Award from the Cancer Nurses Society
of Australia.

PROGRAM

Nursing and Midwifery Research Candidate Conference

Conference Program
Day 1: Tuesday 28 September
Arrival and Registration (morning tea available)
9.15-10am
Session One
10-10.15am: Welcome and introduction Chairman Dr Simon Cooper
10.15-10.45am: Keynote speaker Professor Tracey Bucknall, Cabrini Health and Deakin University,
Deteriorating patients and decision making in nursing
10.45-11am: Questions to speaker
Morning Tea
11-11.20am
Session Two (A) Acute Care
Chair: Associate Professor Lisa McKenna
11.20-11.40am: Malcom Elliot, Australian Catholic University, An examination of factors contributing to
adverse events in patients recently discharged from ICU

11.40am-12pm: Mohammed Aljohani, Monash University, Emergency department triage in Saudi Arabia:
towards five-level national triage system
12-12.20pm: Glenn Eastwood, Deakin University, Oxygen therapy: a detailed analysis of the factors that
influence practice in an ICU setting
12.20-12.40pm: Michele Hepponstall, University of Melbourne, Randomised controlled trail of remote
ischemic preconditioning in children undergoing heart surgery methodological considerations
12.40-1pm: Questions to speakers
Session Two (B) Workforce
Chair: Dr Virginia Plummer
11.20-11.40am: Zainah Mohamed, Monash University, Belongingness: great motivation for graduated
nurses
11.40am-12pm: Isobel Moase, Australian Catholic University, Workplace satisfaction, wellbeing and
nurse employment intention: an investigation of retention with year two to five registered nurses in rural
Victoria
12-12.20pm: Grainne Lowe, Monash University, What policy or organisational issues prevent increasing
utilisation of nurse practitioners in healthcare organisations?
12.20-12.40pm: Kate Kay, Australian Catholic University, An exploration of nurses beliefs, attitudes and
experiences relating to manual handling utilising the knowledge-to-action framework
12.40-1pm: Questions to speakers
Lunch
1-2pm
Session Three (A) Acute Care
Chair: Associate Professor Tony OBrien
2-2.20pm: Elise Sullivan, Monash University, All hands on deck: a collaborative practice model to
delivering emergency care in rural hospitals
2.20-2.40pm: Ruth Crampton, Deakin University, Exploring the experience of registered nurses caring for
prisoner patients in an acute environment
2.40-3pm: Yousef Al- Bothhi, Monash University, Nurses preparedness to practice in emergency
departments in the Kingdom of Saudi Arabia: an ethnographic study
3-3.20pm: Stephen McKeever, University of Melbourne, Changes in Amplitude-Integrated
Electroencephalogram (aEEG) And Spectral Edge Frequency (SEF90) during paediatric general
anaesthesia

3.20-3.45pm: Joanne Porter, Monash University, Evaluating the implementation and practice of family
presence in the emergency department setting: a mixed methods design
3.45-4.10pm:

Questions to Speaker

Session Three (B) Elderly Care / Mental Health

Chair: Dr Sonia Allen
2-2.20pm: Kusrini Kadar, Monash University, Promoting and maintaining wellness among the elderly in
South Sulawesi, Indonesia: an action research study
2.20-2.40pm: Joan Ostaskiewicz, Deakin University, Residential aged care staff knowledge and beliefs
about incontinence: a grounded theory study
2.40-3pm: Barbara McKenzie-Green, Australian Catholic University, Living in residential aged care: a
process of continuous adjustment
3-3.20pm: Joanne Grainger, Australian Catholic College, Empathic engagement in the provision of nursing
care to the person living with advanced dementia in residential care
3.20-3.40pm: Brett McKinnon, Monash University: Treatment planning and outcome measurement in
mental health made easy
3.40- 4pm: Questions to speaker
Closing Session
4pm: Christine Smith, Nurses Memorial Centre - presentation on scholarships
Afternoon Tea and Networking
4.15pm
Close
4.30pm
Conference Dinner
7pm

Day 2: Wednesday 29 September

Session Four
9-9.15am: Welcome and introduction
9.15- 09.45am: Keynote speaker Professor Margaret OConnor AM, Monash University, Understanding
ethical requirements on research: new and emerging processes

9.45-10am: Questions to speaker

Morning tea
10-10.20am
Session Five (A) Midwifery
Chair: Associate Professor Phil Maude
10.20-10.40am: Helen Hall, Monash University, Midwives and complementary and alternative medicine:
a grounded theory study
10.40- 11am: Gayle McLelland, Monash University, Using a mixed methodology to investigate the clinical
obstetric profile encountered by Victorian emergency paramedics
11-11.20am: Sharon Licqurish, Australian Catholic University, Applying a contemporary grounded theory
method to explore Bachelor of Midwifery Students Experiences of Achieving Competencies
11.20-11.40am: Meredith McIntyre, Monash University, Discourses influencing policy direction of the
reform of maternity services in Australia
11.40-12pm: Questions to speakers
Session Five (B) Palliative care
Chair: Dr Ken Sellick
10.20-10.40am: Christina Searle, Australian Catholic University, The palliative approach within the acute
hospital setting
10.40- 11am: Pathma Namasivayam, Monash University, Caring for families of the terminally ill in
Malaysia: a grounded theory from palliative care nurses perspective
11-11.20am: Melissa Bloomer, Monash University, End of life care in the acute hospital setting
11.20-11.40am: Joan Yalden, Monash University, How do practice development strategies enable the
implementation of evidence-based palliative approach guidelines in residential aged care?
11.40am-12pm: Questions to speakers
Lunch
12 -1.15pm
1.15 1.45pm: Keynote speaker Professor Sanchia Aranda, University of Melbourne, Designing and
testing nursing interventions
1.45-1.55pm: Questions to speaker
Session Six (A) Caring, Quality of Life and Decision Making

Chair: Professor Wendy Cross

2-2.20pm: Bridget Fussell, Australian Catholic University, Factors influencing the process of decision
making for registered nurses working in residential aged care facilities when a residents health status
changes
2.20-2.40pm: Sophie Jones, University of Melbourne, Quality of life assessment of children requiring
long-term oral anticoagulant therapy
2.40-3pm: Mei Chan Chong, Monash University, Malaysian nurses attitudes towards e-learning
3-3.20pm: Tracey McConnell-Henry, Monash University, How do you do phenomenology? Unravelling
the mystery of secret phenomenologists business!
3.20-3.40: Questions to speakers
Session Six (B) Workforce and Attitudes
Chair: Professor Karen Francis
2-2.20pm: Vicki Yarker-Hitchcock, Monash University, Professional supervision as a model for untrained
healthcare workers
2.20-2.40pm, Elisabeth Jacob, Monash University, ENs in Australia different role or just another name?
2.40-3pm: Saleh Altallal, Monash University, Impact of hospital organisational structure on patient
outcomes and nurse job satisfaction in Saudi Arabia
3-3.20pm: Mohammad Al-Motlaq, Monash University, Childrens attitudes towards their peers with
asthma in primary schools
3.20-3.40pm: Questions to speakers
Afternoon Tea and Final Session
3.40-4pm
Conference Closure
4pm

ABSTRACTS

ACUTE CARE
An examination of factors contributing to adverse events in patients recently discharged from ICU
Malcom Elliot

Australian Catholic University

Biography:
Malcolm Elliott is a PhD candidate in the School of Nursing, Australian Catholic University. He has clinical
experience in Intensive Care, High-Dependency and Coronary Care nursing. He has taught at both the
undergraduate and postgraduate levels and published on issues relating to quality and safety of care, and
nursing education.
Abstract
An examination of factors contributing to adverse events in patients recently discharged from ICU
Background:
Up to a third of patients will experience an adverse event soon after discharge from ICU. More than half of
these events have been deemed preventable with improved standards of care. Many factors affect the
quality of care delivered and these include factors unique to the organisation, the patient and individual
clinicians. It is not known how these factors contribute to adverse events in patients recently discharged
from ICU.
Objective: The aim of this PhD programme is to examine the relationship between system, human, patient
factors and adverse events, to improve the short term outcomes of patients recently discharged from ICU.
Method:
A mixed methods multi-phased approach is being used. The first phase was informed by grounded theory
and examined nurses experiences of ICU readmissions. The second phase will employ a survey design.
Results:
Thus far five factors have been found to contribute to ICU readmissions: premature ICU discharge, heavy
workloads, delayed medical care on the wards, lack of qualified staff and clinically challenging patients.
Recommendations:
Given the initial findings and high cost associated with adverse events, further examination of these events
after ICU discharge is warranted. Hence the second phase of this PhD programme will involve a survey of
ICU liaison nurses. A questionnaire informed by the literature and the findings of phase one will be used for
data collection.

Emergency department triage in Saudi Arabia: towards five-level national triage system

Mohammed Aljohani

Monash University Peninsula Campus

Biography:
Mohammed Aljohani has an extensive work experience in emergency department(ED) in Saudi Arabia. He
worked in ED for more than 17 years as a staff nurse and acting head nurse. His interest in ED triage
research has begun in 2006 during his master of nursing. The master thesis examined the consistency and
accuracy of ED triage decisions among clinicians using a standard 5-point urgency scale in one Saudi
Arabian emergency department.
Abstract:
Emergency Department Triage in Saudi Arabia: Towards Five-level National triage System

Background:
The number of patients presenting for care in emergency departments (ED) in Saudi Arabia (SA) is
increasing every year. Given this increase, it is essential that EDs utilise a systemic way to prioritise patients
care based on clinical urgency. Despite the increase in demand for ED services, formalise triage system is
not common practice in most of the public EDs in Saudi Arabia.
Aims:
This paper reports on a 3 stage research study to explorer the current triage practice in public EDs in Saudi
Arabia and to develop a national five-level triage system
Methods:

Study one, 15 paper-based simulation scenarios were used to examine the consistency and accuracy of
triage decision making among ED clinicians in public EDs.

Study two, document analysis was conducted for triage policy and procedure and education documents
in Saudi Arabia.

Study three, a modified Delphi technique was utilised to develop a triage scale and identify the clinical
descriptors for each triage category
Results:
The findings of study one and two illustrate that triage and its related works is not well organised in public
EDs in SA. More than 50 percent of the study participants believed that formal triage does not exist in their
EDs. Moreover, agreement in triage ratings among the ED clinicians was only fair (unweighted kappa
=0.25). Against the international recommendations, the current triage policy recommended a 3-level triage
scale.
Conclusion:
Current triage practice in public EDs is ad hoc and implementation is reliant on local interest. Regardless the
limited reliability and validity of the 3-level triage system recommended by the MOH triage policy, it seems
that public EDs do not adhere well to the policy. This study developed a five-level triage system to replace
the current system.

Oxygen Therapy: A detailed analysis of the factors that influence practice in an ICU setting
Glenn Eastwood

Deakin University

Biography:
Glenn is currently a PhD candidate in the School of Nursing (SON) at Deakin University. In addition, Glenn
currently works at Austin Health where he is the ICU Research Manager. The focus of his doctoral thesis is
the administration of oxygen therapy in the intensive care unit. This is Glenns final year of candidature and
he has in the process of writing up his thesis.
Abstract
Oxygen Therapy: A detailed analysis of the factors that influence practice in an ICU setting
Prolonged untreated severe hypoxaemia is lethal. Patients admitted to the intensive care unit (ICU) are at
an increased risk of hypoxaemia because of acute illness, chronic pathology or peri-operative care.
Inconsistencies in the oxygen therapy practices of intensive care nurses are problematic, given that practice
will influence patient outcome.
The aim of this doctoral program was to provide a detailed analysis of the efficacy of commonly used oxygen
delivery devices, intensive care nurses oxygen therapy practices, and the contextual factors influencing
oxygen therapy in order to inform effective oxygen therapy practices in the ICU.
This doctoral program involved four clinical trials: a randomised crossover trial; face-to-face structured
interviews; a retrospective medical record audit; and a clinical practice observational study.
First, for adult patients with low level oxygen supplementation requirements, nasal devices allow for less
oxygen consumption and greater comfort than FM while still maintaining SpO 2 95%. Second, differences
between the patients and nurses perspective of oxygen therapy illustrate the variety of factors that impact
on effective oxygen administration. Third, for cardiac surgical patients a lack of early intervention to address
hypoxemia and tachypneoa was identified. Fourth, poor documentation of oxygenation and respiratory rate
and a lack of oxygen titration in response to hypoxaemia and tachypnoea occurred in ICU despite: high
nursing/patient ratios, constant patient monitoring, and escalating of oxygen therapy interventions falling well
within the nursing scope of practice.
These findings have clear implications for patient safety, educational training, and quality improvement
activities for oxygen therapy in the intensive care unit context. In order to develop a sound evidence base
for nurses oxygen administration, further research needs to measure the contextual influences on nurses
oxygen administration decision making and patient outcomes.

Randomised controlled trail of remote ischemic preconditioning in children undergoing heart

surgery methodological considerations
Michele Hepponstall

University of Melbourne

Biography:
Michele holds degrees in Biomedical Science (Hons) and Nursing. Her PhD examines cardioprotective
strategies in children undergoing repair of cardiac defects. Michele maintains a dual clinical and research
focus with particular interest in neonatal cardiorespiratory physiology. Her research focuses on conducting
scientific research and translating the findings to clinical practice. She is also a casual lecturer/tutor in the
School of Nursing at The University of Melbourne.
Abstract
Randomised controlled trail of remote ischemic preconditioning in children undergoing hear surgery
methodological considerations
Background:
Cardiac surgery with cardiopulmonary bypass results in significant organ damage from ischemia and
systemic inflammatory responses. There is evidence that this injury can be attenuated using a therapy
called remote ischemic preconditioning where brief periods of transient ischemia provide protection against
an episode of significant ischemia. This intervention has been associated with significantly reduced postoperative inotrope requirement, as well as decreased myocardial and pulmonary injury in children
undergoing cardiac surgery. Despite the proven clinical benefits, little is known of the underlying
mechanisms responsible for providing this protection.
Aims and objectives:
The aim of this study is to explore proteins involved in the protective mechanisms with the hypothesis that a
protein or group of proteins is released into the blood following the preconditioning stimulus.
Research methods (actual or proposed):
Blood will be collected from children undergoing cardiac surgery at five time points. Proteins in the plasma
will be examined using 2D Differential In-Gel Electrophoresis. There are many proteins in plasma a few of
which are present in large quantities. The ability to identify candidate proteins necessitates removing these
high abundance proteins, in order to allow detection of a larger number of proteins that are found in low
abundance. Various techniques are available to deplete plasma of high abundance proteins. A significant
methodological focus of this study has become identifying the optimal experimental design to facilitate
achievement of the study aims.
Future plans:
The future direction of this project is focused on optimising methods of protein analysis as well as
recruitment of patients and data collection.

WORKFORCE
Belongingness : great motivation for graduated nurses
Zainah Mohamed

Monash University

Biography:
Author is a lecturer at School of Nursing, Faculty of Medicine, Universiti Kebangsaan Malaysia (UKM). Major
task is teaching undergraduate students. Basically, UKM is a Research University, where all teaching and
learning activities are focusing on research oriented, for example, enquiry technique, exploratory and
experiential learning, critical thinking and problem based learning. Previous research undertaken: i)
Intervention Education of Hub care On Neonates, and ii) Nurses Knowledge and Skin Care Practices of
Preterm Infants.
Abstract
Belongingness : Great Motivation for Graduated Nurses
The phenomenon of belongingness at nurses workplace has played an important role in the outcome of
nurses satisfaction. Result from previous studies has shown that the need to belong exerts a powerful
influence on human outcome including cognitive process, emotional patterns, behavioral response, health
and happiness. People deprived of belongingness are believed to experience diminished self-esteem which
is lower in self-confidence and difficulty to gain respect by others. This condition if not taken care of will lead
to de-motivation of staff. In the nursing literature, while there is paucity of studies about this salient issue,
there are inferences that newly graduated nurses expressed the view that being accepted by colleagues
was more important than being accepted by patient. While newly graduate nurses aim to be accepted by
colleagues, senior nurses seem to be lost in term of belongingness in their own workplace with influence by
other multidiscipline healthcare profession.
Therefore, this study seeks to explore how graduated nurses value belongingness in their working
environment. It aims to see how junior nurses (less than one year working experience) achieve
belongingness and how senior nurses (more than one year working experiences) maintain belongingness,
and is there any difference between these two groups.
This study will examine whether there is a
relationship between belongingness and clinical culture, level of nurses confidence, years of working
experience and education level. A mixed-method approach will be used and participants will be recruited
from graduated nurses working in Malaysian hospitals.

Workplace satisfaction, wellbeing and nurse employment intention: An investigation of retention

with year 2-5 registered nurses in rural Victoria
Isobel Moase
Biography:

Australian Catholic University

Isobels clinical interests are palliative care and aged care. Much of her clinical career has been spent
working with people with AIDS and in palliative care settings.
Her research interests include nurse satisfaction; nurse retention; rural and regional nursing issues; nursing
education; and, the experiences of palliative care for patients and families.
Abstract
Workplace satisfaction, wellbeing and nurse employment intention: An investigation of retention with year
2-5 registered nurses in rural Victoria

Background:
Australia like many other developed countries, experiences major issues with nurse retention. Subsequently
there is an overall shortage of nurses that effects health care delivery. Many new graduates do not have an
intention of remaining in employment due to job dissatisfaction. In regional and rural areas these issues are
compounded by fewer opportunities for ongoing employment, education and career progression, and the
need for an expanded skill set, which is sometimes unmet in graduate year programs.
Aims and Objectives:

Investigate retention of year 2-5 registered nurses in regional/rural Victoria.

Explore workplace satisfaction, wellbeing and nurse employment intention in year 2-5 nurses in
regional/rural Victoria.

Develop a retention implementation strategy for nurses in regional/rural Victoria via knowledge
translation.

Improve clinical patient outcomes by retaining nurses who are satisfied in their practice.
Research Methodology and Methods:
This research is emancipatory in nature and is thus located in the critical paradigm. A mixed
quantitative/qualitative triangulated design, incorporating survey questionnaire, semi-structured interviews
and reflective journaling will be utilised to achieve investigation of multiple points of view and ensure
strength in rigour, credibility and analysis.
Research outcomes: Future plans:
The expected outcomes and plans for this research are:

Greater depth of understanding of the experiences and needs of early career nurses working in
regional/rural Victoria.

Development of a workable retention implementation strategy for regional/rural early career nurses.

State policy changes in employment for early career nurses focused on workplace satisfaction and
improved retention.

What policy or organisational issues prevent increasing utilisation of nurse practitioners in

healthcare organisations?
Grainne Lowe

Monash University
Abstract

What policy or organisational issues prevent increasing utilization of Nurse Practitioners in healthcare
organisations?

Background:
Improved access to care, patient satisfaction and safety are reported benefits of Nurse Practitioner (NP)
models of care compared to traditional care models. It is recognised that for health services to remain
sustainable and effective, flexibility, dynamism and reform of workforce design are required. Pressure on
healthcare budgets, increasing service demand and workforce shortages have prompted the development of
the NP model of care as a potential solution.
Despite the proliferation of NP roles internationally, NP roles have not yet developed significantly in
Australian health service provision. This is made apparent by the relatively few NP positions within local
healthcare organisations.
Aim:
The aim of this research is to establish patterns associated with the continuing development and
implementation of the NP role into healthcare organisations. The research objectives are to identify positive
and negative perceptions of NP roles, establish issues associated with NP role implementation from key
stakeholder perspectives, and to describe barriers in role development.
Methodology:
A mixed methods approach will be used. This methodology has been chosen in order to provide a broad
perspective across various healthcare organisations through survey data followed by individual interviews.
Conclusion:
The need for a continued, cooperative approach by informed stakeholders is paramount for progression of
the NP role to assist in delivery of healthcare needs in a variety of settings. The results of this research are
expected to be significant in terms of the future direction of NP roles in healthcare organisations in Australia.

An exploration of nurses beliefs, attitudes and experiences relating to manual handling utilising the
knowledge-to-action framework
Kate Kay

Australian Catholic University

Biography:
Kate Kay is a cardiac nurse with post-basic qualifications in critical care. Her interest in manual handling
commenced several years ago when she participated in the introduction of a formal manual handling

program within her organization. The challenges of this role led to greater involvement in the manual
handling sphere and she currently holds the position of Manual Handling Training Coordinator at St Vincents
and Mercy Private. She commenced post-graduate study in 2010.
Abstract
An exploration of nurses beliefs, attitudes and experiences relating to manual handling utilising the
knowledge-to-action framework

Nursing care involves complex patient handling tasks, resulting in high musculoskeletal injury rates.
Epidemiological studies from the late 1980s estimated lifetime prevalence of lower back injuries for nurses
between 35 and 80%. Local and international papers continuing to mirror these findings.
Implementation activities targeting manual handling injury reduction in healthcare have had limited success.
Contemporary guidelines and policy-directed training have proved insufficient as evidenced by systematic
reviews regarding their efficacy. Recent research directs attention to multidimensional approaches, as
opposed to use of training in isolation, however the critical success factors are yet to be identified.
This research will explore the lived experiences of nurses in relation to manual handling in healthcare
settings. It will investigate nurses beliefs and attitudes towards manual handling, and identify barriers and
enablers for successful manual handling strategies.
The research questions are:

What are the beliefs, attitudes and perceptions of nurses pertaining to manual handling?

What is the context for manual handling experiences of nurses?

What are the barriers to implementation of safe handling practices?

What strategies have successfully facilitated safe practice?

The research methodology is the knowledge-to-action process. This provides an effective framework to
examine manual handling issues and develop appropriately tailored knowledge and interventions. The
methods included in this study are focus groups, semi-structured interviews and reflective journalling.
The expected outcome is a greater comprehension of the manual handling experiences of nurses. This will
inform knowledge translation interventions in order to improve nurses and patients safety.

ACUTE CARE
All hands on deck A collaborative practice model to delivering emergency care in rural hospitals
Elise Sullivan
Biography:

Monash University

Elise Sullivan is the Director of DPAR Consulting Pty Ltd, a company committed to working with
governments, health services and health professionals to deliver health care that responds to the changing
needs of their community. She is also the Project Manager of the South Coast Inter-professional Clinical
Supervision, which was recently funded under the Commonwealth Governments Increased Clinical Training
Capacity Program.
Elise has worked in the rural health arena developing state and commonwealth government policy,
managing programs, and practicing as a clinical nurse and manager. Elise was the Senior Nursing Advisor
for the Rural Health Branch in the Victorian Department of Health between 2003 and 2009.
She is undertaking a PhD with Monash University on building collaborative practice in the rural health
workforce. Today, Elise is presenting some of the findings of her PhD.
Abstract
All hands on deck A collaborative practice model to delivering emergency care in rural hospitals
Background:
As workforce shortages grow, rural hospitals in Victoria are increasingly limiting their hours of provision of
core emergency care because their model relies on a diminishing pool of visiting medical officers (VMO).
Proposed solutions have not tended to challenge the status quo regarding the professional division of labour
between nursing and medicine. Despite the stability and prominence of nursing in the rural health workforce
(up to 60 per cent), their voice seems conspicuously silent in key discussions and strategies to fix health
service and workforce problems associated with emergency care provision.
This study is based on the premise that strict divisions between the roles of nursing and medicine reduce
access to rural emergency care. The solution lies in enhancing nurses power to negotiate the division of
labour continuously, supported by their medical colleagues, advancing clinical scope of practice, hospital
policy and legislation so they can operate safely and confidently in a new negotiated division of labour.
Aim:
To establish the conditions needed to support a negotiated division of labour between doctors and nurses
delivering emergency care from four rural hospitals and one bush nursing centre in Victoria.
Methods:
An action research approach was used to engage nurses (15), doctors (3) and managers (8) in four rural
hospitals and one bush nursing centre across Victoria to change status quo.
Results:
The qualitative and quantitative results indicated that there was opportunity and support to enable nurses to
operate at a more advanced level to they could manage more patient presentations autonomously.
There were a range of actions implemented during the course of this 18-month project both at the local
health services level and state government levels to enable nurses to operate at this more autonomous
level.
The collaboration between the people involved in this project (including between health services and
government) was significant in achieve change in the way emergency care is delivered in the health
services, and legislative and policy change on a state level.
Conclusion:
Nurses and doctors in rural hospitals in Victoria need the capacity and opportunity to negotiate their roles in
order to sustain safe emergency care. There are a range of factors that enable nurses and doctors to flexibly
negotiate their roles in respect to each other, including advancing nurses clinical capacity, adapting hospital
and government policy, and creating opportunities for these rural health clinicians to learn, work and plan
change together. Action research provides the authority, forums, facilitation and data to support participants
in identifying and establishing the conditions needed to enable nurses and doctors to effectively negotiate
and enact their roles in delivering emergency care.

Exploring the experience of registered nurses caring for prisoner-patients in an acute environment
Ruth Crampton

Deakin University

Biography:
Ruth completed her undergraduate degree in NZ and has gained nursing experience in NZ, South Africa,
England and Australia in a variety of clinical settings. Following her nursing degree Ruth has completed a BA
(anthropology & education), Post graduate diploma (anaesthetics), and a Masters of Nursing (clinical
teaching). Currently Ruth is working as a Clinical Educator at St Vincents Hospital and is completing a PhD
with Deakin University which she hopes to submit late 2010.
Abstract
Exploring the experience of Registered Nurses caring for a prisoner-patients in an acute environment
Background & Aim:
The experience of caring for prisoner-patients is one which presents the Registered Nurse with unique
challenges. Fundamental to the nursing experience is the experience of care and caring, the attitude and
activity. Past studies have explored the experience of nursing prisoner-patients from a forensic perspective,
but there has been no examination to date of the unique circumstances experienced when a prisoner-patient
presents to a general hospital where the primary goal is care not custody.
Method & Methodology:
This phenomenological study used researcher journaling, 2 audio-taped in-depth interviews and
observations of practice of 12 registered nurses, to identify what it was like for them to care for prisoner
patients in an acute care peri-operative setting. The researcher, who was intimately familiar with the
research setting, used the philosophy of understanding espoused by German philosopher Hans Georg
Gadamer to draw out the participants prejudices (their verbalizations of their experiences); and their
horizons (summations about what the participants expressed); to develop fused horizons (understandings
that conveyed the essence of caring for prisoner patients from the participants fused and unique
perspectives).
Results &Conclusions:
Five key fused horizons or joint understandings resonated for all participants. They were:

Perfunctory care
Reactive care
Care as an emotionally draining experience
Knowing makes a difference

These were then drawn together in a Succinct Statement:

Caring for prisoner-patients is an emotionally draining experience where knowing the prisoner-patients
crime automatically creates prejudice and leads to the giving of reactive and perfunctory care.

Nurses preparedness to practice in emergency departments in the Kingdom of Saudi Arabia: An

ethnographic study
Yousef Al- Bothhi

Monash University

Biography:
Yousef Al-Bothhi is a PhD candidate at the School of Nursing and Midwifery at Monash University. His
research interests include emergency nursing, triage practice, nurses preparedness, and leadership. As a
requirement of Master Degree at Monash University, Yousef conducted a descriptive study utilising
questionnaire in three hospitals in Riyadh titled An Investigation of Triage Practice in Three Saudi Arabian
Hospitals. He attended and presented in several conferences and health seminars.
Abstract
Nurses Preparedness to Practice in Emergency Departments in the Kingdom of Saudi Arabia:
An Ethnographic Study
In the kingdom of Saudi Arabia (KSA) 73% percent of the nursing workforce are expatriates who have
diverse educational and experience backgrounds. The remaining 27% of this workforce are Saudi nurses.
There are no post-graduate emergency courses taught by universities in the KSA to prepare nurses for
practice in emergency departments (EDs). In an era when the Saudi government has adopted a policy of
recruiting Saudi nationals in all workplaces, hospitals are challenged to ensure that staff (Saudi and nonSaudi) are prepared for practice. This study seeks to understand the preparedness and support provided for
nurses in EDs in the KSA hospitals.
The research question how are nurses prepared and supported for practice in the EDs in the KSA? has
been addressed utilising a focused critical ethnographic approach. This study was conducted in three EDs of
Ministry of Health Hospitals in Al-Qassim Region in the KSA. Data collection included observation,
interviews with key informants, field notation and review of available related documents. All interviews were
transcribed verbatim. Thematic analysis which involves a process of data reduction, coding and recoding
was conducted.
This presentation will discuss preliminary findings found in this study. These will be related to the preparation
and support available for emergency nurses, leadership and management, and education and training.

Changes in Amplitude-Integrated Electroencephalogram (aEEG) And Spectral Edge Frequency

(SEF90) during paediatric general anaesthesia
Stephen McKeever

University of Melbourne

Biography:
Stephenss career has focused on the care of the critically ill child whilst working in intensive care and
emergency paediatric transport environments. Stephen is currently employed part time as a Clinical
Nurse Specialist on the paediatric intensive care unit at Royal Childrens Hospital, Melbourne. He is
enrolled full time as PhD candidate examining how the brainwaves of children respond to anaesthetics.
The ultimate aim of this work is to enhance the delivery of anaesthetics and sedation given to children. As
an active member of the Australian College of Critical Care Nurses Stephen is a Victorian representative
on the National Paediatric Advisory Panel.
Abstract
Changes in Amplitude-Integrated Electroencephalogram (aEEG) And Spectral Edge Frequency (SEF90)
During Paediatric General Anaesthesia
Introduction:
Critical to improving the outcomes of children receiving sedation or anaesthesia is achieving the correct
titration of somnolent agents. During adult anaesthesia monitoring the electroencephalogram has enabled
improvement in peri-operative outcomes. Knowledge of the infants electroencephalogram response to
anaesthetics is fragmentary. The aEEG and SEF90 parameters have been studied during adult anaesthesia
but their relevance in the paediatric setting is unspecified.
Objective:
To investigate aEEG and SEF90 during paediatric anaesthesia.
Methods:
A prospective observational study was conducted on children, without neurological complications, receiving
a general anaesthetic according to usual hospital practice. Sensors were applied in the frontal and biparietal
regions. Electroencephalogram data was collected using the BrainZ ReBrim monitor and periods of artefact
post collection filtered. The SEF90 and aEEG were analysed according to age and anaesthetic
concentrations.
Results:
178 children (range 24days-14years) were enrolled. Whilst anaesthetised children <18 months showed an
approximately linear increase in their aEEG with age, then after 18 months there was a plateau. SEF90
showed no association with age. A multi-comparison analysis demonstrated a consistent significant
difference between the children <6 months and all other ages in aEEG but not SEF90.
The aEEG and SEF90 showed little or no correlation with the anaesthetic end-tidal concentrations. This is
an unsurprising finding as anaesthetic equilibrium was not established.
Conclusion:
Identification of age dependant electroencephalogram variables during paediatric anaesthesia could explain
the poor performance of adult derived algorithms in children. These findings contribute to the understanding
required to develop an objective measure of paediatric sedation and anaesthesia.

Evaluating the implementation and practice of family presence in the emergency department setting:
a mixed methods design

Joanne Porter

Monash University

Abstract
Evaluating the implementation and practice of family presence in the emergency department setting:
a mixed methods design
Aim:
To evaluate the implementation and practice of family presence in the emergency department.
Method: Research conducted in the emergency department is a series of complex interventions which
requires both quantitative and qualitative evaluation. 1 A systematic review was conducted of the literature
surrounding family presence during resuscitation in the emergency department setting with both adult and
paediatric presentations. A mixed methods approach will identify the factors that influence the
implementation of family presence during resuscitation and its practice. 2 An Exploratory design will be
adopted to explore the phenomenon of family presence during resuscitation. The timing of the data
collection will be qualitative followed by quantitative. Semi- structured interviews will be conducted in the
United Kingdom, Sweden and Australia to inform the quantitative questionnaire design.
Conclusion: An exploratory design will be utilized to explore family presence in the emergency department
and inform the quantitative questionnaire design.
1.

Cooper, S. Porter, J. & Endacott, R. (2010). Mixed methods research: a design for emergency care
research? Emergency Medicine Journal.

2.

Creswell, J. & Plano Clark, V. (2007). Designing and Conducting Mixed Methods Research. SAGE
Publications, London.

ELDERLY CARE / MENTAL HEALTH

Promoting and maintaining wellness among the elderly in South Sulawesi, Indonesia: an action
research study
Kusrini Kadar

Monash University

Biography:

Mrs. Kadar is currently a PhD candidate at School of Nursing and Midwifery at Monash University and
also an academic staff at School of Nursing, Medicine Faculty, Hasanuddin University, Indonesia.
Areas of teaching and research interest are community health and family nursing, nursing education
and nursing research.

Professor Francis is a recognized nationally and internationally for her contribution to the
development of the discipline of rural nursing. Professor Francis has expertise in nursing leadership
and management and has presented a series of workshops on Thailand and Malaysia on these
issues. Professor Francis has served on many state/national committees and participated in forums
examining and developing policy and/or guidelines on nursing education and practice

Dr. Sellick has a long career as a nurse educator, researcher and academic in the university sector in
Australia and overseas. Professional qualifications include registration as a general and psychiatric
nurse and as a clinical psychologist. Areas of teaching expertise are health psychology; counseling;
community and community mental health nursing; and nursing research, especially quantitative
research design, methodology and data analysis.
Abstract
Promoting and maintaining wellness among the elderly in South Sulawesi, Indonesia:
An Action Research Study
Meeting the health needs of the elderly has become a major challenge for most countries globally as the
proportion of elderly within the population rises. This phenomena is not restricted to developed nations,
developing nations such as Indonesia are experiencing the similar demographic profile changes. Until
recently, providing aged care services has not been a high priority for the Indonesian Health Department.
Elderly persons living in rural areas of Indonesia have been notably neglected by Department of Health
initiatives.
Methods:
Two data collection methods were use: firstly interviews were undertaken with key staff from the three
health organizations responsible for age care services in the area. Secondly a self-report questionnaire
was distributed to health professionals working in local community health centres, independent health
practitioners, and volunteers. The questionnaire was designed to obtain demographic details and information
on the programs and services offered to the elderly.
Findings:
Interviews were conducted with three staff from the District Health Office, two staff from the local hospital,
and managers of 23 community health centers. A total of 18 questionnaires were completed by health
professionals. The results from the survey found that majority of the health professionals still do more
curative rather than promotive and preventive work for elderly in the community. Lack of budget and
multitasks at the community centers seems to be the main barriers; continuity training related to elderly and
more facilities are two main needs for the health professionals in providing services for elders in the
community. Information obtained from this survey will be considered by the action research team to design,
implement and evaluate supporting programs to meet the health needs of the elderly in rural South
Sulawesi, Indonesia.

Residential aged care staff knowledge and beliefs about incontinence: a grounded theory study

Joan Ostaskiewicz

Deakin University

Biography:
Joan has a clinical background in continence care in the frail aged. She works as a Research Fellow at
Deakin Southern Health Nursing Research Centre and is undertaking a PhD study on continence care in
residential aged care settings. Joan is involved in research activities on issues associated with quality and
risk management in the context of ageing. Her recent work has resulted in a set of evidence-based
continence assessment and management tools for use in the residential aged care sector.
Abstract
Residential aged care staff knowledge and beliefs about incontinence: A grounded theory study
Background:
More than 50% of individuals living in residential aged care facilities (RACF) are affected by urinary
incontinence and between 10% and 30% experience faecal incontinence [1]. Managing incontinence
consumes one third of the residential aged care subsidy [2]. Despite the significance of the issue, little is
known about how continence care is provided, the issues and strategies that staff encounter and staff
knowledge and beliefs that inform practice.
Aims and Objectives:
The aim of this study is to explore and describe how RACF staff determine, deliver and communicate
continence care to individuals living in RACF. This paper focuses on early coding analysis concerning staff
knowledge and beliefs about incontinence and continence care.
Research Methods:
Using grounded theory methods, data are derived from:

In-depth interviews with unregulated workers, Enrolled Nurses and Division 1 Registered Nurses in
The RACF sector as well as individuals involved in assessing the quality of care.

Field observations of continence care interactions between RACF staff and residents

An analysis of resident records and accreditation reports

Early Findings:
Early open coding analyses from five interviews reveals that staff focus on the use of pads to contain and
conceal incontinence to ensure residents are nice and clean and dignified. Staff believe incontinence is
either a behavioural response or an inevitable consequence of age and cognitive impairment. As such,
incontinence is anticipated. Pads are promoted as a strategy to promote residents dignity.
Future Plans:
These early findings will be enhanced with additional data to provide a grounded theory that describes and
explains how continence care is provided in RACF.
References:
1. Pearson, J., P. Finucane, et al. (2002). Incidence of incontinence as a factor in admission to aged care
homes. Report prepared for the Australian Government Department of Health and Ageing.
2. Australian Institute for Health and Welfare (2006). Australian incontinence data analysis and
development. Canberra, AIHW. cat. no. DIS 44

Living in residential aged care: a process of continuous adjustment

Barbara McKenzie-Green

Australian Catholic University

Biography:
Barbara McKenzie-Green has worked with older people in the acute, long term and community care settings
in Australia and New Zealand. Her teaching and research is situated within the gerontological specialty and
has included grounded theory studies on the work of RNs, charge nurses and staff in Residential Aged Care.
She is currently writing her PhD study which was commenced when working at ACU as research project
officer with Professor Barbara Bowers, the inaugural Chair in Aged Care.
Abstract
Living in Residential Aged Care: A process of continuous adjustment
There is limited research which explicates the strategies residents use to manage their lives in residential
aged care (RAC). The objective of this PhD study using grounded theory methodology was to learn how
residents manage life in RAC. The study was conducted in two Australian not for profit RACs. Data collection
included 24 days of participant observation and interviews with 23 residents and 19 staff. Theoretically
underpinned by Symbolic Interactionism, data collection and analysis were concurrent, with theoretical
sampling guiding the ongoing data collection. Findings reveal residents engage in three processes as they
adapt to aged care: presenting an acceptable self, living a communal life and preserving the self. Depending
on the residents priority at a particular time, one or more of these processes may be backgrounded or
foregrounded. Additionally, residents lives in any, or all of the three processes, can be shaped by staff or by
internal and external environmental conditions. The three processes, together with the conditions which
shape them, demonstrate that residents are in a process of continuous adjustment. This study explains the
effort that residents put into living in RAC and could serve to assist staff, management and policy makers to
examine the ways in which residents are supported to live their lives as effectively as possible. Limitations to
this study are that the majority of resident participants were assessed as having low care needs. Future
research plans are to focus on how high care residents can influence their life in residential aged care.

Empathic engagement in the provision of nursing care to the person living with advanced dementia
in residential care
Joanne Grainger

Australian Catholic College

Biography:
Ms Jo Grainger is a registered nurse with 20 years of clinical experience. Jo's postgraduate qualifications
include a Grad Dip in Critical Care and a Master in Bioethics. Other nursing positions held include
management and education at St Vincent's Private Hospital, The Alfred, and Notre Dame University (Sydney
Campus). Jo holds a permanent appointment in the School of Nursing and Midwifery at the Australian
Catholic University (Victoria) and lectures predominately in the area of ethics and spirituality in health care.
In 2009, she commenced her PhD in the area of empathic engagement in the provision of nursing care to
the person living with advanced dementia in residential care.
Abstract
Empathic engagement in the provision of nursing care to the person living with advanced dementia in
residential care
The term dementia is complex, in that it describes the symptoms of a large group of illnesses which cause
a progressive decline in a persons mental functioning. The number of persons living with dementia is
expected to increase by 327% between 2000 and 2050, with more than half of persons with moderate to
severe dementia living in residential care facilities (Alzheimers Australia, 2009).
Research into the care of the person with advanced dementia has until recent years been undertaken
predominately from a biomedical perspective. In 1997, UK psychologist Tom Kitwood presented an
alternative way of knowing dementia beyond a biomedical approach. Kitwood (1997) presented that it is
through empathic engagement of the person with dementia that care is truly person centred as opposed to
disease orientated. A person who has highly empathic skills is able to retain his or her own feeling states,
while also being aware of the feeling state of the other. However in the care of the person with advanced
dementia, this may be quite problematic as it may mean that the carer has to draw on their own feelings to
fully reconstruct anothers frame of reference.
This study aims to explore what is empathic engagement in nursing care provision generally, and identify
particular limitations, challenges and possibilities of such empathic engagement in caring for the person
living with advanced dementia in residential aged care. For the meta-theoretical design of my study I have
chosen a social constructionist research design within a critical inquiry theoretical framework and
ethnographical methodology.
Alzheimers Australia. (2005). Dementia estimates and projections: Australian States and Territories.
Retrieved from http://www.alzheimers.org.au/upload/EstimatesProjectionsNational.pdf
Kitwood, T. (1997). Dementia reconsidered: the person comes first. Buckingham: Open University Press

Treatment planning and outcome measurement in mental health made easy

Brett McKinnon

Monash University
Abstract
Treatment planning and outcome measurement in mental health made easy

The Victorian Mental Health Act (1986) governs the care afforded to the mentally ill. In 2004 this Act was
amended to include section 19A that stipulates that every patient receiving public mental health care shall
have a plan pertaining to such care developed for them, with them and where applicable have the wishes of
carers and significant others acknowledged as part of the planned care. The essence of section 19A is to
foster strong working relationships between clinical staff and their patients.
Nearly 6 years since the inception of Section 19A services are still having difficulties achieving consistency
in the development and delivery of such plans. In addition Outcome measures are a Commonwealth
initiative that serves as a tool to evaluate planned care and consumer perception. The outcome measures
suite of measurement tools consist of HoNOS, Basis 32 and Life Skills Profile (LSP) and serve as a
valuable entity to allow services to examine their success.
This research aims to examine the current difficulties in treatment planning and determine whether a
computer based program that has been developed by the candidate, makes a difference in terms of the
desirable outcomes of treatment planning and Outcome measurement.
Specifically, the research aims to 1. Investigate treatment planning and outcome measurement as
mandatory requirements in the care afforded to public system mental health patients. 2. Examine the current
issues experienced in the treatment planning process by public mental health clinicians at five health
services across the state. 3. Pilot a computer program that was developed by the research team and
evaluate its effectiveness after a 6-month trial.

MIDWIFERY
Midwives and complementary and alternative medicine: a grounded theory study
Helen Hall

Monash University

Biography:
Helen is a qualified midwife, nurse and naturopath. She has worked in both the community and hospital
settings in a variety of roles. She has been employed by Monash University since 2006 and is involved in
teaching and course coordination of the Bachelor of Midwifery degree. Helen is currently undertaking a PhD
exploring midwives response to the use of complementary and alternative medicine by pregnant women.
Helens primary interests include midwifery models of care, cultural aspects of midwifery care, Indigenous
womens health and complementary and alternative medicine.

Abstract
Midwives and Complementary and Alternative Medicine; a grounded theory study.
Complementary and Alternative Medicine (CAM) describes a group of therapies which are not generally
considered to be part of conventional medicine. The use of CAM has become increasingly popular in the
maternity setting in recent years. Research suggests there is widespread use of CAM during pregnancy and
the majority of pregnant women believe these therapies to be safe. Expectant women frequently rely on
advice from family and friends when deciding to consume CAM and many self prescribe. Midwives are
involved with the care and decision making of childbearing women and will be increasingly required to
assess the risks and benefits of CAM. The evidence suggests that they are eager supporters of
complementary medicine. However, currently there are limited opportunities to become educated about the
use of CAM in maternity care and few specific guidelines to assist midwives make informed decisions; this
has implications for the integrity of the profession, and the wellbeing of the families midwives care for.
This study aims to assist the midwifery profession and the health industry to better understand the
challenges and processes involved in the use of CAM in the maternity setting, and to contribute towards a
body of knowledge that results in better educational and practice guidelines. A grounded theory approach
will be used. Participants will be practicing midwives working in a variety of maternity settings providing both
antenatal and postnatal care. Data will be collected from relevant documentation (e.g. hospital
guidelines/policies) in-depth interviews, and observation of a subset of participants in the clinical setting.

Using a mixed methodology to investigate the clinical obstetric profile encountered by Victorian
emergency paramedics
Gayle McLelland

Monash University

Abstract
Using a mixed methodology to investigate the clinical obstetric profile encountered by
Victorian Emergency paramedics
Whilst it is widely accepted that paramedics are the emergency care provider for out of hospital pregnant
and labouring, very little is known about their management of obstetric cases. Very little literature that was
found regarding out of hospital obstetric cases encountered by paramedics after a thorough review of
national and international literature. Of the literature that was located, the majority focused on unplanned
births before arrival (BBA) to hospital. It was revealed that compared to in hospital and planned home birth,
maternal and neonatal outcomes from unplanned BBAs are significantly worse. The outcomes for mother
and baby do not seem significantly different regardless of whether or not paramedics attend. This may be in
part because documentation at these events has been noted as being poor. The small amount of content in
most paramedic undergraduate curriculum may contribute to the lack confidence experienced by
paramedics caring for a mother giving birth and the newborn baby. Un planned BBAs are only a minor part
of the obstetric workload encountered by paramedics.
This study aims to use a pragmatic mixed methodology to investigate the clinical obstetric profile
encountered by Victorian Emergency Paramedics. Using an explanatory framework, the first part of the
study is a retrospective quantitative study using Ambulance Victorias database. The second part will be a
qualitative study driven by results revealed by the initial study.

Applying a contemporary grounded theory method to explore Bachelor of Midwifery students

experiences of achieving competencies
Sharon Licqurish

Australian Catholic University

Section I.1 Biography:

Sharon Licqurish is a midwifery lecturer and PhD candidate at Australian Catholic University and an
independent midwife. Her PhD thesis explores midwifery students experiences of achieving competencies.
She is also part of a team exploring the impact of birth space on womens experience of childbirth and is coauthor of two papers, one published and one recently accepted by Midwifery, an A* rated journal. She also
has one paper under review by Nurse Researcher, an A rated journal.
Section I.2 Abstract
Applying a contemporary grounded theory method to explore Bachelor of Midwifery Students Experiences
of Achieving Competencies
In this study, a contemporary grounded theory methodology was used to answer the research question; how
and when do Bachelor of Midwifery students achieve competency for beginning practice? The methodology
was informed by Adele Clarke's (2008) conceptualisation of grounded theory, situational analysis. Situational
analysis uses traditional grounded theory methods of data collection and analysis but also draws on
postmodernist/poststructuralist theoretical perspectives, particularly those of Michel Foucault, in order to
identify the impact of discourses on individuals and situations. Situational maps are used to highlight the
actors, both human and non-human, as well as discourses and positions taken within the data. This
presentation will discuss the way in which the methodology was explored and applied during data collection
and analysis, as well as present preliminary findings from the study.

Discourses influencing policy direction of the reform of maternity services in Australia

Meredith McIntyre

Monash University

Biography:
Meredith is committed to the professional advancement of Midwifery in Australia in the interests of improving
the experience of women having babies. Research interests include; maternity services policy, measurement
of clinical competence in midwifery education and womens early parenting experience. Meredith is the past
President and Vice-President of the Australian College of Midwives (Vic branch) and actively involved in the
Victorian Midwives Academic group (MIDAC). Meredith is a PhD candidate in the area of maternity service
policy.

Abstract
Discourses influencing policy direction of the reform of maternity services in Australia
After a decade of inquiries, commissions and reviews advocating the need for reform Australian maternity
services are set to embark on a major program of change with the introduction of primary maternity care, a
major shift in national policy direction. Government response to the need for reform has been cautious due
to concerns that quality and safety standards might be jeopardised. These concerns have been reinforced
by the dominant medical discourse; childbirth is inherently risky. This paper reports on the discourses that
have influenced the direction of governments reform agenda despite strong medical opposition.
A critical discourse analysis approach was used in this study because of its ability to highlight issues of
power, an important element in the key stakeholder struggle to influence policy. Most recent maternity
services policy documents from each state, territory and national government from 2004 - 2010 and national
key stakeholder organisation submissions to the maternity services review 2008 were included in the study.
A three-step analytic framework described by Fairclough (2003) informed the critical analysis of text
including the following step by step processes; becoming familiar with the text, identifying themes and
examining relationships between discourses, identifying discursive strategies used to sustain the discourse
and examining the effects of the discourse.
(a)
Analysis revealed three dominant discourses including: Australia is one of the safest place to give birth or to
be born, but not for everyone; maternity care is about mothers and babies and government must ensure
provision of safe and sustainable maternity services.

PALLATIVE CARE
The palliative approach within the acute hospital setting
Christina Searle

Australian Catholic University

Bibliography:
Christina works at Austin Health as a Clinical Support Nurse for the graduate program on the
Oncology/Haematology, Renal and Endoscopy Units. In 2006, she completed her Masters in Nursing
Science with a qualitative study known as interpretive description, exploring the nurses perspective on
pressure care management in patients at the end of their life. The study resulted in conference
presentations, the Austin Health research award for a poster presentation and two articles published in 2008
Abstract
The Palliative Approach within the Acute Hospital Setting
Traditionally palliative care has been seen as relevant only to those approaching the terminal phase of their
life. More recently this concept has been broadened to recognize that the palliative approach, that takes a
holistic view to enhance the quality of life of those diagnosed with a life-limiting or life-threatening illness, can
be of value far earlier in the course of an illness. Palliative care in contemporary times has been seen to
offer people alternatives to exclusively curative interventions, and to act as an adjunct to such interventions.
Acute oncology inpatient units are primarily populated by those with a life-limiting or life-threatening illness,
and would arguably benefit from an incorporation of the principles of palliative care. However, generally the
two areas of oncology and palliative care operate distinctly from each other. Acute oncology has cure as its
focus, with palliative care only being considered when cure is no longer seen as a clinical or medical
possibility. An incorporation of the palliative approach within the acute oncology setting could potentially
reduce this split and provide treatment and care options for individuals earlier in the course of their illness.
From clinical observations, nurses caring for patients in the acute hospital setting experience concerns
about providing care during the patients transition from acute care management to palliative care. The aim
of this study is to explore how care within an acute oncology inpatient unit could be constructed to
incorporate a palliative approach. In this process patients are actively involved in the planning of their care,
taking into account their needs for comfort and dignity, especially when they are no longer able to express
their wishes and discomfort. This would include the patients wishes with respect to the role of their family
members in their care. As this project is in the early stages of development, the paper will present an
overview of relevant literature identified to date and an outline of the proposed methodology, which is
anticipated to be ethnographic in orientation.

Caring for families of the terminally ill in Malaysia: a grounded theory from palliative care nurses
perspective
Pathma Namasivayam

Monash University

Abstract
Caring for families of the terminally ill in Malaysia: a grounded theory from palliative care nurses perspective
Research problem:
Caring for families of terminally ill patients is considered an important aspect of nursing because of the
central role they play in care. Caring for families can be a challenge for nurses, in addition to providing care
for the terminally ill person. However, there is a lack of research that has examined how nurses care for
families of the terminally ill in Malaysian settings.
Research purpose:
The purpose of this study was to explore how palliative care nurses in Malaysia felt about caring for families
of the terminally ill.
Method:
A grounded theory approach was used to provide insight into the issues being studied, to enhance
understanding and provide a meaningful guide to action. Approximately 22 palliative care nurses working at
five palliative care organisations in Malaysia who had experience caring for families of the terminally ill were
selected using theoretical sampling method.
Results:
The metaphor of Indian music was used to illustrate the results of the research.
As the symbiotic
relationship of the Indian musician with his/her audience can be considered to be similar to the nurse family
relationship, therefore this was used to explain the results of the study. Furthermore, the theory of Indian
music, in which the technique of improvisation was used, was found to be similar to the strategies that
nurses used to resolve their main problem. The use of the metaphor of Indian music in relation to the
results of the study will be described in this presentation.
Conclusion:
Investigating this area of practice will help nurses understand their practice and enhance their knowledge of
the behaviours of family members of palliative care patients and enable them to work in partnership with
families.

End of life care in the acute hospital setting

Melissa Bloomer

Monash University

Biography:
Melissa has a background in diabetes education, intensive care nursing and nurse education. Melissas
primary research interests relate to end of life care in critical care environments. Melissas previous research
projects have focused on end of life clinical management in the ICU, and also clinician-family communication
regarding death and end of life care, and how this relates to the decision making and patient care.
Abstract
End of Life care in the acute hospital setting
Background:
The Intensive Care unit is where the sickest of patients receive the most technologically sophisticated care,
and many do not survive. End of Life (EOL) care is clearly defined and outlined in palliative care services
but its place or existence in acute health services is not so clear.
Aims:
The aims of this project are to:
1. Explore EOL care in acute settings
2. Develop practice guidelines for EOL care
3. Implement developed guidelines in 2 acute settings (ICU and General medical) and 2 regions (Rural
and Metro)
4. Evaluate the implementation of the EOL guidelines
Proposed methods:
A mixed methods approach will be taken and will include:

A systematic review of the literature

Survey of health care workers regarding their knowledge, attitudes and skills regarding EOL care in
acute settings

Survey of family members of recipients of their experiences of EOL in acute settings

Development of clinical guidelines using Joanna Briggs Templates and incorporating expert review

Develop the implementation strategy and action

Undertake a comparative analysis of the implementation of the guidelines across the 2 sites and
regions

Evaluate the implementation through individual interviews with clinicians, family members and recipients
of care if appropriate
Findings:
Data will be analysed using appropriate statistical processes for numerical data and thematic analysis for
narrative data. Findings will be incorporated into revised practice guidelines and will also be disseminated
through peer-reviewed journals, conference presentations and thesis.

How do practice development strategies enable the implementation of evidence-based palliative

approach guidelines in residential aged care?
Joan Yalden

Monash University

Brief biography:
Joan Yalden is currently completing doctoral research. She has a background in clinical nursing in the UK
and Australia and over the latter part of her career, in nurse education and research. Her previous studies
investigated older peoples experience of ageing, the development and implementation of a modified Tai Chi
exercise program to promote the health of the older person and screening tools for use by nurses in the
management of acute stroke.
Abstract
How to practice development strategies enable the implementation of evidence-based palliative approach
guidelines in residential aged care?

Background:
Over the past decade, considerable emphasis has been placed on policy and evidence-based guideline
development in attempting to make good quality palliative care more accessible to people in residential aged
care. How guidelines are translated into practice has received less attention. This paper focuses on the
outcomes of an evaluation of practice development strategies used in the development of a palliative
approach in a residential aged care facility in Victoria.
Aim:
To discuss how key strategies enabled the aged care team to implement a palliative approach in residential
aged care.
Method:
The participatory, inclusive and collaborative principles of action research and practice development
underpinned the study design. Data from multiple sources were used to evaluate the impact of strategies on
the implementation of a palliative approach.
Results:
Clinical strategies were developed through projects facilitated through active learning, critical and creative
activities in clinical and management groups and supporting education. They included the development and
use of an integrated palliative approach pathway; teamwork and communication; development of a holistic
model of end-of-life care. How these strategies enabled implementation and the utilisation of evidencebased guidelines will be discussed under broad themes that emerged from the analysis and in the context of
transformational processes.
Conclusions:
Implementation of a palliative approach is enabled by processes that create conditions to support
transformation in practice and are sustainable in the culture and context of care.

CARING, QUALITY OF LIFE AND DECISION MAKING

Factors influencing the process of decision making for registered nurses (RNs) working in
residential aged care facilities (RACFs) when a residents health status changes
Bridget Fussell

Australian Catholic University

Biography:
Bridget Laging is a lecturer in the School of Nursing and Midwifery at ACU. She has worked in emergency
departments throughout Australia since arriving from New Zealand in 2001. She has a strong interest in the
nursing management of older people and in 2008 she completed an Honours research entitled New
Graduate RNs experiences of working in aged care contexts: A case study. Bridget commenced her PhD
part-time in 2009.
Abstract
Factors influencing the process of decision making for Registered Nurses (RNs) working in Residential Aged
Care Facilities (RACFs) when a residents health status changes
Older people housed in Residential Aged Care Facilities (RACFs) are the sickest and frailest of people in
Australia, with severe or profound disability (Flicker, 2002). Currently, 6% of people aged 65 years or over
live in RACFs, with an average age of 83 years (ANHECA, 2004).
A common misconception is that residents needs are solely about day-to- day practical care and not the
management of complex and unstable clinical problems. The Australian aged care workforce has seen major
changes, particularly casualisation and the substantial substitution of personal care attendants (PCAs) for
qualified registered nurses (RN)s (Commonwealth of Australia, 2005). Consequently, the staff making clinical
decisions when a residents health status changes may range from a Division One RN who knows the
facility, its procedures and residents, to an agency staff member with or without nursing qualifications who is
unfamiliar with the facility or resident.
While it is known that there is a significant increase in the dependency of older persons living in RACFs and
a considerable reduction in the presence of RNs working there, there is a limited understanding of the issues
impacting on RACF staffs clinical decision-making when a residents health status changes. Very little is
known about the experiences and actions of RACF staff with regard to such clinical decision-making, despite
the centrality of their role. Using a critical ethnographic method, this study aims to explore the factors
impacting on the clinical decision making of staff working in RACFs when a residents health status changes.
This presentation will focus on a review of relevant literature and provide an overview of the planned
research methodology and design.

Quality of Life Assessment of Children Requiring Long-term Oral Anticoagulant Therapy

Sophie Jones

University of Melbourne

Brief biography:
Sophie has a degree in Nursing (Hons) and is currently completing her Masters of Philosophy (Nursing),
investigating the quality of life for children who require long-term oral anticoagulation therapy. Sophie has
previously completed research exploring the negotiation of care between parents and nurses in the
paediatric setting. Sophies previous and current research are relevant to her clinical role as a cardiac
clinical nurse specialist, where she has been involved in providing education to paediatric cardiac nurses
locally and internationally.
Abstract
Quality of Life Assessment of Children Requiring Long-term Oral Anticoagulant Therapy
Background:
Multiple studies have investigated the success of home international normalised ratio (INR) monitoring of
paediatric patients requiring oral anticoagulant therapy (OAT). Home monitoring of INRs is a means of
mobilising care from the critical and acute care practice setting to the community. No study has evaluated
what impact home INR monitoring has on a child and their familys quality of life (QoL).
Aims and objectives:
To assess baseline QoL in a cohort of paediatric patients requiring long-term OAT and their family and to
reassess QoL following commencement of home INR monitoring.
Research methods:
Children completed two child QoL questionnaires. One parent from each family completed three parentproxy QoL questionnaires. Questionnaires were completed once before commencing a home INR
monitoring program and again six to twelve months later. Participants also answered four open-ended
questions when completing the QoL questionnaires for the second time.
Results:
55 parents and 35 children participated. Preliminary results from the baseline child QoL assessment indicate
that 60% of children thought their parents were overprotective sometimes or always and 85.7% children
thought their parents worried. Being involved in sports was affected by OAT for 71.4% of children. The
majority of children felt safe most of the time that they would not develop a clot (71.5% of participants) or
bleed (65.8% of participants).
Conclusions:
Baseline QoL assessments indicate that whilst these children have experienced major health challenges and
long hospitalisations, their approach to life is not significantly impacted by their OAT. These early results
enhance evidence for clinicians to provide patient-centred care that promotes normal growth and
development.
Acknowledgement:
The Brockhoff Foundation supported this research study.

Malaysian nurses attitude toward e-learning?

Mei Chan Chong

Monash University

Biography:
The author is lecturer of University of Malaya; she is currently a PhD Candidate at Monash University,
Australia. Her research work is related to continuing professional education and readiness towards elearning among Malaysian Nurses. Her others interest in research are nursing education, problem based
learning, gerontology, infant feeding and community health nursing.
Abstract
Malaysian nurses attitude toward E-learning?
Back ground:
The study undertaken is understanding the need for CPE among Malaysian nurses and their readiness
towards e-learning which involve two phases of study. Phase one was aim to explore the Malaysian current
CPE practice. Second phase was to examine the Malaysian nurses readiness on e-learning.
Objective:
This presentation will focus on one objective which explains the assessment of the attitude of Malaysia
nurses towards e-learning as a means to CPE.
Methodology:
A cross-sectional survey was carried out on 300 nurses to determine the nurses attitude towards e-learning.
Sample was randomly selected from the previous pool of participant from previous survey on CPE who has
agreed to be involved in this study. Self explanatory questionnaires were used to collect data.
Results:
All participants (N=300) had returned the completed questionnaire. The participants attitude towards elearning were satisfactory with the mean score of 3.62, SD=0.42, (minimum score 1.93 and maximum score
is 4.82). The attitude score was categories into three groups, poor(less than 84points), good (84 to 111
points) and excellence (more than 111 points). Majority of them (224, 74.7%) had good attitude follow by
excellence (60, 20%) and only 16(5.3%) had poor attitude.
Conclusion:
Since Malaysian nurses are favorable in engaging CPE via e-learning mode, the Malaysia Nursing Board
may need to consider implementing e-learning .the public institute of higher learning should integrate more
e-learning module in the nursing curriculum and faculty members need to collaborate with the nursing
administrator in the clinical area to facilitate course using e-learning.

How do you do phenomenology? Unravelling the mystery of secret Phenomenologists business!

Tracey McConnell-Henry

Monash University

Biography:
Tracy is a postgraduate lecturer at Monash University. Concurrently she is employed as Senior Nurse in
Organ and Tissue Donation at Central Gippsland Health Service. Her doctoral thesis is by full publication
and is entitled When it is someone you know. Tracys other areas of interest and research include the use
of simulation in nursing education, high acuity and resuscitation education, end of life issues and psychosocial care of patients and bereaved families.
Abstract
How do you do phenomenology? Unravelling the mystery of secret Phenomenologists business!
Phenomenology, as influenced by Heidegger has baffled many a scholar with its esoteric use of language.
Furthermore the confusion is exacerbated by authors frequently glossing over the method or approach
employed to analyse the generated data, offering only generic terms such a thematic analysis without
defining or explaining these terms. As a budding researcher I became increasing frustrated and disillusioned
by the lack of information provided by researchers about the approach they used. Additionally the lack of
explanation offered in regards to methods of analysis continue to plague phenomenology, endangering the
integrity of this methodology as a rigorous research paradigm.
This presentation will endeavour to fill this void as I tease out and describe the approach I used in my PhD
study which explored what it is like for rural nurses and midwives to care for people they know. Not only will I
explain the way in which Heideggers philosophy was used to frame the study, I will also show how
philosophy can be transformed into a user friendly method suitable for contemporary nursing and midwifery
research.

WORKFORCE AND ATTITUDES

Professional supervision as a model for untrained health care workers.
Vicki Yarker-Hitchcock

Monash University

Abstract
Professional Supervision as a Model for Untrained Health Care workers
INTRODUCTION:
Unregulated health care workers (UHCWs) are fact of life in aged care and home care situations worldwide.
The issues that must be examined relate to their support, learning needs and assurance of quality service
provision. Clinical supervision (CS) has been widely used to facilitate health care workers needs for
reflective and quality practice. To date there is limited evidence of the use of CS with unregulated health care
workers.
This project seeks to engage UHCWs using action research methods to investigate the feasibility of various
models CS in aged care and home-based care. For the purpose of this project the term professional
support has been used to overcome some of the negative associations regarding the term clinical
supervision.
AIM:
To determine feasible models of professional support that relate to individual and organizational needs.
METHOD:
This project utilizes action research cycles to uncover the workable models of professional support that
recognize the organizational cultures and the personal characteristics that influence and underpin each
model.
Four groups, comprising both aged residential care and home-based care workers in either rural or urban
settings are participating in the project. Each model will be implemented over 12 months and evaluated
using a range of measures.
ANTICIPATED OUTCOMES:
Outcomes will reflect individual and organizational growth and improvement in quality measures as well as
the identification of enablers and challenges within the workplace or the process.
This presentation will outline the project and work to date.

ENs in Australia Different role or just another name?

Elisabeth Jacob

Monash University

Brief biography:
Elisabeth has a background in critical care and nursing education. She has been involved in several
research projects focusing on clinical placements for nurses and IPE. Having worked as a nurse educator in
industry, TAFE and tertiary sectors with both undergraduate registered nurses and enrolled nurses, she has
an interest in the difference in educational philosophy and curriculum for the different levels of nurses and
the resulting differences in scope of practice in Australia.
Abstract:
Abstract
ENs in Australia Different role or just another name
Background:
Enrolled nurses (ENs) were introduced in Australia in the 1960s to work as assistants to registered nurses
(RNs) under their supervision. The scope of practice for ENs has changed significantly since 2000. The
need for the increase in scope of practice was due to economic constraints and workforce shortages of
RNs. In 2006, the NBV introduced the enhanced scope of practice scheme for nurses in Victoria. This in
effect paved the way for ENs to practice any skill in any field in which they have been trained, deemed
competent and endorsed by their organisation, resulting in an increasing use of ENs in many acute patient
areas previously reserved for RNs. A major consequence of these developments is the overlap and role
confusion between the practice roles of RNs and ENs.
Research Aims:
This research aims to identify the differences in educational preparation and role expectations for the
different levels of nurses on graduation in Victoria.
Research Method:
The research will use a mixed method approach including a comprehensive literature review on the scope of
practice of ENs and RNs, examination of curriculum and course documents of 6 Victorian educational
institutions preparing RNs and ENs for practice, verification of result in interviews with educators, and
interviews with hospital personnel to determine required graduate attributes. Surveys will also be conducted
of RNs and ENs completing their basic training from the previously selected six educational institutions to
determine their initial understanding and expectations of their respective roles and scope of practice.

Impact of hospital organisational structure on patient outcomes and nurse job satisfaction in Saudi
Arabia
Saleh Altallal

Monash University

Abstract
Impact of Hospital Organisational Structure on Patient Outcomes and Nurse Job Satisfaction in Saudi
Arabia
Background:
Organisational researchers have long sought to establish and identify the impact of organisational structure,
particularly in hospitals regarding a number of important outcomes for patient and nurses (West, 2001). A
literature review showed that the structure of the health care delivery system and the work environment have
a significant impact on patient outcome and is a key factor in the level of workplace satisfaction for nurses.
There is empirical evidence which suggests that hospitals demonstrating organisational attributes which
enable nurses to fully utilise their knowledge and expertise, provide high quality of care (Havens, et al 1999).
In Saudi Arabia approximately 60% of health care services are provided by Ministry of Health (MOH) and the
rest by other government sectors and private hospitals. Within MOH hospitals, there are currently two
distinct management styles and from this arise two main organisational structures: autonomous structure
(Decentralised) and bureaucratic structure (Centralised). However, despite the clear differences, the
organisational structure and work environment of hospitals in Saudi Arabia has not been previously
examined.
Aim:
To examine the extent to which differences in patient outcomes, level of nurses job satisfaction and
perception of the intensive care/critical care work environment might be associated with selected hospital
organisational structures. The findings could provide a database to assist in the achievement of enhanced
quality care outcomes.
Method:
A descriptive comparative study utilising a mixed methods approach was used. The Index of Work
Satisfaction (IWS) (Stamps, 1997) was used to describe and compare the level of critical care nurses
satisfaction at seven hospitals represent two different hospital organisational structure. Critical care nurses
perception of their practice environment was measured using Practice Environment Scale of the Nursing
Work Index (Lake, 2004). A cross-sectional analysis of administrative data for three years from seven
hospitals will be linked to hospitals organisational structure and critical units nursing characteristics. Patient
outcomes of interest are mortality rate, medication errors, hospital acquired infection rate, and accidental
extubation. Unit nurse staffing data were obtained during the study period by a Background/Structure
Questionnaire developed by the student researcher and his supervisors and was completed by Nurse
managers in each unit. Semi-structured interviews were also conducted with Nursing Directors and Unit
Nurse Managers.
Results:
A total of 268 nurses (67%) responded to the questionnaire. Some surprising differences were seen in term
of respondents characteristics. Autonomous hospitals had higher RNs in workforce with significantly higher
education preparation than bureaucratic hospitals. An analysis of the IWS showed that respondents working
in autonomous hospitals were more satisfied (wages, task requirements, organisational policies, autonomy,
interaction and professional status) than those working in bureaucratic hospitals.
Practice environment showed to play a fundamental role in the quality of work life in regard to staffing
adequacy and levels, nursing leadership and support, availability of written nursing care plan, policies and
procedures. Positive conditions for nursing practice environment were also found in autonomous hospitals
than those working in other hospitals. Respondents working in autonomous hospitals have significantly more
positive perception of staffing and resource adequacy than did respondents in other hospitals. These
findings suggest that autonomous hospitals have adequate staffing (enough nursing personnel and RNs)
and support services to provide highly patient care. They also have positive perception of orientation

programme offered to newly employed nurses in their units. Furthermore, they rated their work environment
more pleasant and safe than did respondents in other hospitals.
Analysis of administrative data and interviews are still in progress.
Childrens attitudes towards their peers with asthma in primary schools
Mohammad Al-Motlaq

Monash University

Brief biography:
Mohammad Al-Motlaq is a PhD candidate and a research assistant in the School of Nursing and Midwifery
at Monash University. His research interests are childhood chronic illness, paediatric health promotion, and
developing instruments for nursing and public health research. Mohammad published and co-authored a
number of papers and presented at many national and international conferences.
Abstract
Childrens attitudes towards their peers with asthma in primary schools
The attitudes peers hold toward a child with asthma can significantly impact their self confidence. It can be
difficult for a child with asthma to spend their time in a class with peers who do not understand their situation
and physical limitations. As part of a larger study to evaluate the efficacy of the Asthma Friendly Schools
Program in Gippsland, Victoria, this paper sought to investigate the attitudes peers hold toward children with
asthma and aimed to explore factors associated with their attitudes towards their peers with asthma. A total
of 507 children without asthma completed an attitude towards children with asthma scale developed
specifically for this study. Results suggested that participants held a positive attitude towards their peers with
asthma.