Nursing Research Online – October 2013

The latest edition of the Australian Journal of Advanced Nursing ( has published an interesting article regarding open access to nursing journals, among many others.

Open access to nursing journals: an audit of the 2010 ERA journal list
Kasia Bail, Jamie Ranse, Roger Clarke, Ben Rattray, University of Canberra.

Nurses work in a wide range of settings, with variations in resources, including hardware and software, and in non-patient-load (super-numerary) time for educational and research endeavours. In most settings, uninhibited access to professionally relevant information is valuable. A scan of lists of open access journals shows that many journals that are categorised as openly accessible are not available in English, or are not peer-reviewed.

A view from the outside: nurses’ clinical decision making in the 21st century
Joan Deegan, Lecturer Acute Care School of Nursing and Midwifery Faculty of Health Sciences, La Trobe University

Clinical decision making is an integral part of nurses’ work and vital to health outcomes for patients. If based on reliable decision making criteria, it can constitute a legally defensible position for the nurse in the event of a malpractice accusation. However, when handling large volumes of rapidly changing clinical information, coupled with organisational imperatives, nurses need to consider a range of factors to guide and support the decision making processes. Using the findings from a small qualitative study on the experiences of a culturally and linguistically diverse (CALD) group of nurses enrolled in competency based assessment programs in Melbourne; this paper highlights observations of clinical decision making processes made by CALD nurses, in relation to elderly patients in particular. It explores the professional and legal implications for nurses when there is an over reliance on experiential knowledge and routine tasks, without mindful application of evidence and consideration of ethico-legal imperatives.

Career choices and destinations of rural nursing students undertaking single and double degrees in nursing
Noelene Hickey, The University of Newcastle and Linda Harrison, Charles Sturt University.

Trans-disciplinary undergraduate double degrees (DDs) involving nursing were introduced at a time (2002–08) when the Australia federal government had increased the number of nursing funded places to universities. By 2007 in Australia more than one third of nursing students were studying via a DD mode. Numerous studies in Australia and overseas have investigated the career choices and preferences of Bachelor of Nursing (or equivalent) students. Earlier studies showed that nursing career specialty preferences did not change significantly during a degree. Yet, later studies demonstrate that positive clinical experiences impact on career preference decisions. It is unknown however, if these latter factors are equally relevant for nursing students in a DD program. The aim of this study was to identify and compare the location and career preferences of students enrolled in single and DD programs in nursing at a rural university, and to gain an understanding of what influenced and motivated these students to enrol in nursing.

Diabetes – a significant contributor to complications in cardiac surgery: how and when to optimise glycaemic control
Melissa Penrose, Intensive Care Unit, Alfred Hospital, Melbourne and Geraldine A Lee, King’s College London

As well as the potential complications of renal dysfunction/failure, peripheral neuropathy and blindness; those with diabetes (especially poorly controlled) are at an increased risk of coronary artery disease (CAD). However, one of the problems with diabetes is the lack of symptoms (in particular angina) from CAD due to neuropathy and thus these patients present later and with more severe CAD that often requires coronary artery bypass surgery (CABS) for multi-vessel disease. Surgical revascularisation is the most commonly performed cardiac surgical procedure with approximately one third of persons undergoing CABS having diabetes.

Optimising care in those with diabetes should be a priority and given the number of undiagnosed cases, any patient who presents with hyperglycaemia and a suspected coronary event should undergo diagnostic tests for diabetes. The aim of this paper is i) to present the association between hyperglycaemia and post-operative complications and ii) to review the current interventions (pre surgery, peri /intra-and post-operatively) that have been undertaken in those in diabetes undergoing cardiac surgery.