Nursing Online – June 2009

The latest nursing research and scholarship

The Australian Journal of Advanced Nursing continues to provide a valuable forum for original research and scholarship. The latest edition of AJAN is available at www.ajan.com.au. Highlights include:

Comorbid illness affects health-related quality of life after coronary artery bypass graft surgery
Geraldine Lee, MPhil, DipEd, BSc, RGN

The purpose of this study was primarily to examine patients’ health-related quality of life (HRQoL) and secondarily to examine the effect of comorbid illness on HRQoL five years after coronary artery bypass graft surgery (CABGS).

The study concludes that the presence of comorbid illness impacts significantly on physical HRQoL five years after CABGS but no such effect is noted in mental wellbeing. From a nursing perspective, the importance of comorbid illness should be taken into account when planning physical activities after CABGS, when educating patients about the benefits of CABGS and when setting realistic expectations after surgery.
www.ajan.com.au/Vol26/26-3_Lee.pdf

Exploration of interaction and shared care arrangements of generalist community nurses and external nursing teams in a rural health setting
Gay Woodhouse, RN, CM, GradCert Community Nursing, GradCert Advanced Rural Nursing, Master of Clinical Nursing

The purpose of this pilot study was to determine the understanding of nurses within a shared care model and the degree of interaction evident in their practice in the shared-care nursing environment in a rural care setting. Sharing of care between different nursing teams can allow for the improved use of minimal resources available in rural communities. The objectives of the research were firstly, to identify the interactions of nursing teams in a shared care model and secondly, to determine how shared care is evident in their practice. The final objective was to draw attention to the importance of shared care models in rural health settings and to develop recommendations to support shared care models.

Results suggest that confusion around roles, skills, communication, care planning and coordination of care within a shared care model are creating barriers to effective sharing of care. Co-location of services should enhance sharing of care. These results should facilitate the development of care approaches that maximise health outcomes.
www.ajan.com.au/Vol26/26-3_Woodhouse.pdf

Population ageing and the politics of demographic alarmism: implications for the nursing profession
Megan-Jane Johnstone, PhD, BA, RN, FRCNA; Olga Kanitsaki, AM, PhD, MEdStud, BAppSc (AdvNsg), RN, FRCN

This article provides a brief examination of the prejudices and politics framing current public debate on population ageing in Australia and the possible implications of this for the allocation of required health and social sector resources. The role and responsibility of nurses and professional nursing organisations to engage in and influence public policy debate concerning the health and social care of older people is highlighted.

The cost of meeting the future health and social care needs of older Australians is predicted to be unsustainable. Officials argue government has a stringent responsibility to ration current and future resources in the health and social care sector, cautioning that if this is not done, the nation’s public services will ultimately collapse under the strain of the ever-increasing demands placed on these services. This characterisation of population ageing and its consequences to the nation’s social wellbeing may, however, be false and misleading and needs to be questioned.

The nursing profession has a fundamental role to play in ensuring responsible debate about population ageing and contributing to public policy agenda.
www.ajan.com.au/Vol26/26-3_Johnstone.pdf

Implementing clinical guidelines for acute stroke management: do nurses have a lead role?
Kelvin Hill, Sandy Middleton, Elizabeth O’Brien and Erin Lalor

Health professionals should be aware of, and implement, best practice clinical guidelines for stroke care. Using the latest National Stroke Foundation Clinical Guidelines for Acute Stroke Management, this study aimed to determine which member of the multidisciplinary team would most likely be responsible for taking the lead role for implementing each recommendation.
Neuroscience nurses have a key role in the multidisciplinary stroke team.
www.ajan.com.au/Vol26/26-3_Middleton.pdf