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ePROGRAM

AND ABSTRACTS

State Government Partner

Advancing nurse leadership 

Corporate Partner

Morning Tea Partner

#NNF2017 www.acn.edu.au


your future, divided On average, Australian women have just over half the super of men.* Maybe it’s time to change that?

hesta.com.au/mindthegap

Issued by H.E.S.T. Australia Ltd ABN 66 006 818 695 AFSL 235249, the Trustee of Health Employees Superannuation Trust Australia (HESTA) ABN 64 971 749 321. *According to Australian Bureau of Statistics (ABS) Retirement and Retirement Intentions, Australia, July 2012 to June 2013, women in Australia retire with 47% less in their super than men. abs.gov.au/ausstats/abs@.nsf/mf/6238.0


CONTENTS With thanks to our valued Partners, Sponsors, In-Kind Supporters and Exhibitors

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Welcome from the ACN President

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Overview6 A look back at the 2016 National Nursing Forum General information

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Maps11 Speakers14 Program20 Masterclass sessions

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Partners30 Sponsors31 Exhibition floor plan

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Exhibitors34 With thanks to The 2017 abstract review committee

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Concurrent abstracts

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List of posters

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Poster abstracts

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WITH THANKS TO OUR VALUED PARTNERS, SPONSORS, IN-KIND SUPPORTERS AND EXHIBITORS PARTNERS AND SPONSORS

State Government Partner

Corporate Partner

IN-KIND SUPPORTERS

EXHIBITORS

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Morning Tea Partner

Pamper Station Sponsor

Welcome Gift Sponsor

Name Tag Sponsor


WELCOME FROM THE ACN PRESIDENT

It’s a pleasure to welcome you to the 2017 National Nursing Forum. This year’s theme builds on some of the innovative ideas presented at the very successful 2016 National Nursing Forum - The Power of Now. The focus this year though is on action, ensuring that we have the knowledge and skills to speak out as individuals and a profession in constructive ways that will Make Change Happen. The purpose of the National Nursing Forum is to network; to connect with each other and share ideas, to improve our individual nursing practice, and to grow together as a profession. In our time together we will explore the innovative ways that nurses are making a difference to the health of individuals and communities at local, national and global levels. Across the next three days, there will be a series of highly informative presentations delivered by leaders across a variety of disciplines and settings; nursing, health, government and the private sector. There are four key streams — entrepreneurs, academia, education and industry. The concurrent sessions, master classes, poster presentations and keynote presentations will all provide different perspectives on how we as individual nurses and as members of the nursing profession can Make Change Happen. Those attending the entrepreneur sessions will discover innovative examples of leadership and be inspired to be proactive. Our academia stream will guide you through current research findings in our field — a very important element as we need to grow our practice based on facts and evidence. Our third stream, education, will engage delegates in thinking more deeply about questions of policy and global education. Lastly, the industry stream addresses challenges that are faced daily by many in our profession. Our keynote speakers are leaders in their field. I trust that you will be inspired by them and benefit from their knowledge, insights and expertise. Throughout the National Nursing Forum, there will also be a number of networking opportunities where you can strengthen or develop new relationships with peers, in particular, at our annual Gala Dinner. Whether you are a student, employed or retired as nurse leaders, each of you has the power to change the face of health care within Australia. I encourage you to make the most of the next few days. Think about what you want to get out of this National Nursing Forum, question your existing views and evaluate which actions will result in the best outcome for our patients, communities and the workplace. If we all work together we can Make Change Happen.

Professor Christine Duffield RN PhD FACN FAAN

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OVERVIEW The Australian College of Nursing (ACN) is the preeminent and national leader of the nursing profession. We are committed to our intent of advancing nurse leadership to enhance health care and strongly believe that all nurses, regardless of their job title or level of seniority, are leaders. Leadership is a mindset and a set of actions, commitments and beliefs that produce results. Nurse leaders and nurses with leadership skills are needed at every level of the health and aged care systems, to inform and shape the strategic direction and drive necessary changes. Our membership, events and higher education services allow nurses to stay informed, connected and inspired and become the best they can be. We are excited to lead change and create a strong, collective voice for nursing by bringing together thousands of extraordinary nurses from across the country.

The National Nursing Forum is ACN’s signature annual leadership and educational event bringing together nurses, students and other health professionals from around the country and across the globe. This year, the Forum will be held in the dynamic city of Sydney. Join other delegates in learning how to Make Change Happen for the benefit of patients and communities and use your voice as health professionals to lead change in nursing, health and aged care. In addition, you will have the opportunity to explore the creative ways nurses can make change happen in education, industry, academia and even as entrepreneurs. The program includes engaging keynote presenters, specialty concurrent sessions, stimulating discussions and workshops, along with opportunities to network and share ideas with leaders, colleagues and peers from across Australia and the globe.

TOP FIVE REASONS TO ATTEND THE NATIONAL NURSING FORUM IN SYDNEY THIS YEAR: 1. h  ighly topical sessions from local and international presenters 2. p  articipate in discussions on important and complex matters for nurses 3. interactive and engaging workshops with thought leaders in nursing 4. social functions and an opportunity to attend the Forum Gala Dinner 5. collaborate and exchange ideas with colleagues and peers from around Australia and internationally. REGISTER YOUR PLACE TODAY

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Call 13 19 01 or visit defencejobs.gov.au /Army THE NATIONAL NURSING FORUM 2017

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A LOOK BACK AT THE 2016 NATIONAL NURSING FORUM THE POWER OF NOW

Delegates

The 2016 Forum was held at the Melbourne Park Function Centre in the vibrant and diverse city of Melbourne, attracting over 300 delegates. The Power of Now was the Forum’s theme which brought a celebration of the passion, innovation and energy that exists across all generations of nursing. The majority of delegates ranked the program and content as excellent, which included 12 keynote speakers from a diverse range of backgrounds and perspectives. Kate Birrell OAM MACN was the Orator and delivered her presentation “Preparing for Now: Shaping your own Future.” There were 30 concurrent presentations that were insightful and engaging, focused around the topics of the Power of Nursing Care, the Power of Nursing Workforce, The Power of Nursing Leadership and the Power of Self Care.

ACN delegate session

The National Nursing Forum concluded with a spectacular Flash Mob performance which was a wonderful surprise to all guests.

Emerging Nurse Leaders

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Keynote speakers


I love the engagement. I can “ talk to inspirational people who are happy to share their expertise without agenda just because we are colleagues with a common goal.”

“ A great event.” ACN CEO Adjunct Professor Kylie Ward FACN

I found that it reinvigorated my “interest in nursing; provided such a broad perspective.” The keynote speakers were “inspirational. I was most impressed with the large numbers of engaged students and recently-qualified nurses, and that there seemed to be good connections with us more experienced nurses.”

Mary Wooldridge MP

Networking and understanding “ the next steps and strategies to build nursing leadership.” diversity of the program but “alsoThekeeping to core themes.”

Delegates

Positive vibe. Friendly, “collaborative.” THE NATIONAL NURSING FORUM 2017

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GENERAL INFORMATION VENUE AND DESTINATION The 2017 Forum will be held at the Event Centre, The Star, 80 Pyrmont Street, Pyrmont, Sydney. PARKING AND TRANSPORT The Event Centre is located on Level 3 of The Star. ACCESS FROM THE STAR CARPARK: If you are located in The Star carpark use the lift to main lobby – walk around to the Harbour side entrance and use the lift to the Event Centre. ACCESS FROM PIRRAMA ROAD ENTRANCE: • Take the escalators at the Pirrama Road entrance. • Continue up the next set of escalators to Level 1. • Take the escalator up one level then continue up the second set of escalators to the Event Centre. GETTING THERE: Please visit the venue website to find the most suitable transport option for you. PARKING AND TRANSPORT: The Star secure underground car park is accessible from Pyrmont Street and Pirrama Road. CARPARK RATES: 6-hour period (or part thereof) are as follow: 11:00pm – 5:00pm Monday to Thursday: $15.00 Friday to Sunday: $20.00 5:00pm – 11:00pm Monday to Thursday: $20.00 Friday to Sunday: $25.00

WALK: The Star is approximately a 15-minute walk from Town Hall over the Pyrmont Bridge. At the end of the bridge turn right into Murray Street, which becomes Pirrama Road. Enter The Star via the escalators. DROP OFF/ DISABLED ACCESS: Disabled parking bays are located close to the car park entrance lobbies, or the drop off area is at the Pirrama Road entrance. UBER UBER are providing $20 vouchers to every new UBER user that is attending the National Nursing Forum. Simply watch this ‘How To’ video here which explains how the app works and how to add the promotional code! The official NNF promotional code is NURSE17. INTERNET ACCESS Free wireless internet is available throughout the venue. To access the free WiFi logon to “The Star Free WiFi” account and follow the login instructions. A password is not required. CONNECT AT THE FORUM WITH PIGEONHOLE LIVE Post questions to speakers and vote for questions that others have asked on your mobile web device. Enter pigeonhole.at into your internet browser address bar, then enter passcode NNF2017. Pigeonhole Live will be available for use in the plenary sessions. SPEAKER SUPPORT

After your 6-hour period expires, an additional 6-hour period will be charged. In the event of a lost ticket, a maximum rate of $50.00 per 24-hour period will apply.

Speaker Support is located in the Attic Foyer on Level 3.

LIGHT RAIL: Catch the light rail from Central Railway Station to The Star. Exit via the escalators onto The Star’s ground level. Sydney Light Rail available from Central Station every 10–15 minutes from Monday – Thursday until 11:00pm.

We want to hear your feedback, complete the survey via Pigeonhole Live and go in the draw to win a two night’s accommodation voucher at a Hilton property.

BUS: Bus route 443 operates from Circular Quay to The Star. Get off at the Pirrama Road stop and enter The Star via the escalators. Bus Route 389 operates between North Bondi and Pyrmont.

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TAXI: The Taxi Rank is located at the interchange area off Pirrama Road.

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DELEGATE EVALUATION


MAPS

Follow escalators past Marquee up to Level 3

THE STAR

Escalator to Bistro 80 and Bistro PDR for concurrent sessions

Concurrent sessions

THE STAR EVENT CENTRE LEVEL 3

Speaker support Exhibition

Plenary and concurrent sessions

Concurrent sessions Escalator to Marquee Main Room for concurrent sessions

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REGISTRATION

GALA DINNER

The registration desk will be located as follows:

The Gala Dinner will be held from 7.00pm – 11.30pm on Tuesday 22 August 2017 in Room A, Event Centre, The Star, Sydney. The special guest speaker for the evening is Ms Louisa Hope from the Louisa Hope Fund for Nurses.

Monday 21 August 2017: Marquee Landing, Level 2 from 8.00am Tuesday 22 August 2017: Event Centre Main Foyer, Level 3 from 8.00am

The dress code is cocktail/after five wear. Cost to attend the Gala Dinner is included in full delegate registration. Additional Gala Dinner tickets can be purchased for $140.

Wednesday 23 August 2017: Event Centre Main Foyer, Level 3 from 8.00am Please make your way to the registration desk upon arrival at the Forum to collect your name badge and satchel.

DRESS

EXHIBITION AND CATERING

Gala Dinner – Cocktail/After Five Wear

Program Sessions and Welcome Reception – Smart Casual

The Forum exhibition and catering area will be located in The Main Foyer and Room B within the Event Centre.

SOCIAL MEDIA #NNF17 Join the Forum conversation on:

SPECIAL DIETARY REQUIREMENTS

Facebook: @acnursing

Please speak to the venue catering staff to request your special dietary requirements.

Twitter: @acn_tweet, @kylieward

CPD HOURS

MOBILE PHONES AND DEVICES

CPD hours are awarded to professional development activities that are organised by ACN or have been endorsed or accredited by ACN. One point equates to 60 minutes of education.

Attendees are asked to switch their mobile phones and other devices to silent when in sessions.

Instagram: @acn_nursing

PHOTOGRAPHY AND FILMING

Forum Delegates will receive the following:

Attendance date

Session

CPD hours

Monday 21 August

Forum day one

6

Tuesday 22 August

Forum day two

6

Wednesday 23 August

Forum day three

6

For promotional purposes, there will be professional filming and photography during the Forum. Photographs and video taken may be used in ACN publications or on ACN social media platforms. Unauthorised photography, taping or recording of any form is strictly prohibited at the Forum. If you do not wish to be photographed or filmed please inform the camera operator.

WELCOME RECEPTION

DISCLAIMER

The Welcome Reception will be held from 5:00pm – 6:00pm on Monday 21 August 2017 in the exhibition area, Level 3 of the Event Centre, The Star, Sydney. The Welcome Reception is open to all delegates, providing an opportunity to socialise and network at the conclusion of day one. Cost to attend is included in Monday day registration and full registrations.

ACN reserves the right to make alterations to the program where necessary and without notice, either before or during the event. Please note, this program is correct at the time of publishing. CERTIFICATE OF ATTENDANCE Following the Forum, delegates will be emailed a Certificate of Attendance detailing their CPD hours.

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INVITED GUESTS AND KEYNOTE SPEAKERS PRESIDENT’S WELCOME

ACN ORATOR

GALA DINNER SPEAKER

Professor Christine Duffield RN PhD FACN FAAN

Dr Glenn Elizabeth Gardner RN, PhD, FACN, HFACNP

Ms Louisa Hope Louisa Hope Fund for Nurses

Dr Christine Duffield is Professor of Nursing and Health Services Management at the University of Technology Sydney and Edith Cowan University. Christine has over 10 years clinical and managerial experience in the health industry in Canada, Australia, NZ and the UK and more than 25 years in senior management and research roles in the university sector. She has published more than 200 articles and book chapters on nursing workforce, staffing and leadership topics. Her work has had a significant impact on shaping nurse staffing in this country. She is consulted regularly by governments, industrial bodies, and the wider health industry, both in Australia and internationally. Professor Duffield is the President of the Australian College of Nursing.

Dr Glenn Gardner is recently retired from the position of Professor of Nursing at Queensland University of Technology. She has a distinguished reputation in nursing scholarship and her research activity has contributed to the applied, translational and theoretical aspects of nursing. Dr Gardner is recognised internationally for her research into advanced practice nursing and the practice and health service role of the nurse practitioner. She has been lead investigator on several landmark studies and has published extensively from this work in leading nursing journals. Dr Gardner has collaborated with nurse leaders and policy makers to provide a strong evidence base for nurse practitioner service development in Australia including foundation national standards for nurse practitioner education, regulation and practice. Her current research activity involves preparation of end user outputs from the final stages of a ten-year program of research that studied advanced practice nursing. Dr Gardner holds qualifications in nursing, sociology and education.

Almost two and a half years ago, Louisa was celebrating Christmas with her mother in the CBD, Sydney. A decision to enjoy a coffee at the Lindt café at Martin Place – would change their life forever. During the Sydney siege, Louisa was not only shot in the foot and abdomen, but was also used as a human shield. She spent three months in recovery, firstly at the Prince of Wales Hospital in Randwick and also at a private rehabilitation hospital. Her wonderful personality and warmth made her a very admired patient and even after all she had been through, Louisa wanted to make a difference to those who treated her every day. She generously donated the $25,000 she was gifted after her interview with Channel 9’s 60 Minutes program, to the Prince of Wales Hospital Foundation. A cheque not to be spent on her recovery, not to be splashed on luxury goods as deserved recompense, but a gift from a heart of gratitude. In March 2015, the Prince of Wales Hospital Foundation launched the Louisa Hope Fund for Nurses – to help nurses at the hospital have access to ‘seed money’, via a grant process, for any necessary equipment, research and education that nurses deem worthy! Louisa has tirelessly been fundraising and she has successfully raised over $180,000, for the “Louisa Hope Fund for Nurses at the Prince of Wales Hospital Foundation”. This year, Louisa has also initiated the “Louisa Hope Fund for Nurses at the Nepean Hospital Foundation” and is looking forward to ongoing fund raising with the Communities of both Hospitals.

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KEYNOTE SPEAKER

INTERNATIONAL KEYNOTE SPEAKER

Ms Janine Mohamed Chief Executive Officer, Congress of Aboriginal and Torres Strait Islander Nurses and Midwives (CATSINaM)

Mr Robert Nieves, JD, MBA, MPA, BSN, RN Vice President Health Informatics, Elsevier Clinical Solutions, USA

Janine Mohamed, a Kaurna/Narrunga woman from South Australia, has deep expertise and experience in how to work towards the improvement of healthcare and health outcomes for Aboriginal and Torres Strait Islander people. As a nurse and CEO of CATSINaM, Janine is an advocate for the unique and powerful roles that Aboriginal and Torres Strait Islander nurses and midwives have in the health system and their communities, as agents of change. Her leadership and work is informed by principles of health equity and justice, and she has a passionate commitment to working towards health systems that are culturally safe for Aboriginal and Torres Strait Islander patients, health professionals and employees. A graduate of the University of South Australia, where she now holds an adjunct position, Janine has sound clinical experience, as well as in research, policy and project leadership. Janine has also worked in senior positions for both the AHCSA and NACCHO, contributed to the establishment of the Close the Gap campaign, and was a member of an Indigenous peoples’ delegation that participated in the United Nations Permanent Forum on Indigenous Issues in 2011 and 2012. Janine is a strong advocate for self-determination and the community controlled health sector, which she believes offers the best model of health care for all Australia. Janine is married to Justin Mohamed, who also has a longstanding career in Aboriginal health, and together they have five children. Having an autoimmune disease, she has a keen appreciation for the importance of empowering people to manage their health.

Robert is the VP of Health Informatics for Elsevier Clinical Solutions. He is responsible for leading the global strategic direction for Health Informatics and the Integration, delivery, and optimization of Elsevier solutions within various HIT platforms. He has over 27 years of clinical experience as a Registered Nurse working in Critical Care, Emergency Services, Community Case Management, Long Term Care and Home Care. He has over 14 years of direct clinical informatics experience in the design and integration of evidencebased content within various electronic health records. Robert provides expert leadership in the field of clinical and interdisciplinary health informatics, with experience managing/ directing enterprise implementations of Healthcare Information Technology EHR software solutions. He has a proven ability to lead seamless implementations and deliver next-generation workflow, and technology solutions improving clinical outcomes and workplace productivity. His vision for patient-centered care, evidence-based clinical decision support and practice transformation forms the basis of his work. He has conducted numerous professional presentations and workshops at SINI, Epic UGM, Insight, NAHC, ANIA, SILAHUE, and the CPM International Conference. Internationally, he has conducted presentations and workshops in Spain, Mexico, Dubai, United Kingdom and Turkey. Robert resides in Ohio and holds a Juris Doctor, Masters in Business Administration, Masters in Public Administration, Bachelor of Science in Nursing from Cleveland State University.

KEYNOTE SPEAKER

The Hon Tanya Plibersek MP Deputy Leader of the Opposition, Deputy Leader of the Federal Parliamentary Labor Party, Shadow Minister for Education, Shadow Minister for Women, and the Federal Member for Sydney Tanya Plibersek is the Deputy Leader of the Opposition, Deputy Leader of the Federal Parliamentary Labor Party, Shadow Minister for Education, Shadow Minister for Women, and the Federal Member for Sydney. Tanya was previously the Shadow Minister for Foreign Affairs and International Development in the 44th Parliament. In government, Tanya was Minister for Health. Her other ministerial appointments have included Minister for Medical Research, Minister for Social Inclusion, Minister for Human Services, Minister for the Status of Women, and Minister for Housing. Tanya grew up in the Sutherland Shire of Sydney and is the daughter of migrants from Slovenia. Like many newly arrived migrants, Tanya’s parents helped build the country in which they made their new home. Her father worked on the Snowy River hydroelectric scheme in the 1950s. Tanya holds a BA Communications (Hons) from the University of Technology Sydney (UTS) and a Master of Politics and Public Policy from Macquarie University. Before entering parliament, Tanya worked in the Domestic Violence Unit at the NSW Ministry for the Status and Advancement of Women. Elected to Federal Parliament as the Member for Sydney in 1998, she spoke of her conviction that ordinary people working together can achieve positive change. Tanya lives in Sydney with her husband Michael and her three children, Anna, Joseph and Louis.

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KEYNOTE SPEAKER

KEYNOTE SPEAKER

KEYNOTE SPEAKER

Ms Veronica Croome ACT Chief Nurse, ACT Health

Ms Jacqui Cross Chief Nursing and Midwifery Officer, Nursing and Midwifery Office, NSW Ministry of Health

Adjunct Professor Debora Picone AM FACN (DLF) Chief Executive Officer, Australian Commission on Safety and Quality in Health Care

Veronica (Ronnie) Croome was appointed Chief Nurse for ACT Health in January 2009. Since commencing in the role, Ronnie has overseen the development of a career path for Enrolled Nurses, expansion of the Advanced Practice Nurse role, the employment of Eligible Midwives, the introduction of Assistants in Nursing and the creation of a Clinical Nurse Coordinator role as part of a Ward Leadership program. Ronnie has overseen a number of Enterprise Agreements for Nurses and Midwives in the ACT which have resulted in improved employment conditions, introduced a workload methodology for inpatient units, led the work on a publicly funded homebirth trial and held the important role of Executive Sponsor for the Respect, Equity and Diversity Framework, a whole of government initiative aimed at improving workplace culture. During her time with ACT Health, Ronnie has been nominated for several awards including finalist in the Telstra Business Women’s Awards (2012) and an ACT Public Service Award for Excellence in 2013. Ronnie was named as an Honoured Friend of CIT in 2014 and delivered the Occasional Addresses to graduands at the University of Canberra and at the Canberra Institute of Technology. She has served as a Board member on Our Wellness Foundation, the Canberra Hospital Foundation and as a Council member of the Canberra Institute of Technology.

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Jacqui Cross commenced in the role of the Chief Nursing and Midwifery Officer for NSW Health in July 2016. The role of the Chief Nursing and Midwifery Officer provides professional leadership and direction on a diverse range of nursing and midwifery issues across the system. Jacqui brings a breadth of experience to the role having worked within the public health system at a hospital and Local Health District level, as well as within the Ministry of Health. A registered nurse, Jacqui has held a variety of nursing roles within NSW Health including clinical nursing roles, as a Registered Nurse, Nursing Unit Manager and Nurse Manager. Throughout her career Jacqui has been a strong advocate for nursing and midwifery leadership and practice development. Jacqui has wide ranging experience in facilitating and leading clinical leadership programs and has previously been the Project Manager for the Essentials of Care Program at a State level. Jacqui has experience in senior nursing management positions as the Director of Nursing at the Children’s Hospital at Westmead from 2012-2015, with her most recent role being a member of the senior executive team as Director of Nursing and Midwifery at South Western Sydney LHD. Jacqui is a highly experienced clinical leader, who is committed to person centred care, and the development of effective workplace cultures to support that care.

Adjunct Professor Debora Picone is a highly respected Chief Executive and leader in public administration, with extensive operating and leadership responsibility in the provision of healthcare services extending from clinical, academic, hospital, area health service, DeputyDirector General and Director-General positions. Through a quality led governance approach and applying the value systems of learning organisations, Professor Picone has been privileged to make the lives of people better by consistently delivering high performing organisations, within a balanced budget, that have improved the health of people, patient safety and access to health care.


KEYNOTE SPEAKER

KEYNOTE SPEAKER

KEYNOTE SPEAKER

Ms Suzie Hoitink MACN Founder of the Clear Complexions Clinics & Head of Nursing

Adjunct Associate Professor Anna Shepherd MACN (Associate) Chief Executive Officer, Regal Home Health and Adjunct Associate Professor at the University of Sydney Nursing School

Mr Ashton Bishop Chief Executive Officer, Step Change

Suzie Hoitink is a healthy skin expert, founder of the Clear Complexions Clinics and registered nurse. Suzie opened the first Clear Complexions clinic in 2005 in Canberra and now boasts 6, soon to be 7, clinics in Sydney and Canberra combined. Her medical approach to skincare and expertise in light based therapies, combined with the use of cutting edge technology and her personal touch has led to a huge and loyal client base, and recognition and respect from within the industry. Suzie is a recipient of a Telstra Business Women’s Award and was a finalist in both the University of Canberra Distinguished Alumni Awards and the Nokia Innovation Award for developing the Clear Complexions Client Clinical Pathway. She is an in-demand authority on skin care, featured in national publications including Vogue, Harper’s Bazaar, Cosmopolitan, Australian Women’s Weekly, The Financial Review, The Daily Telegraph and The Australian Nursing Journal and most recently an expert contributor to the recently launched “Slow Ageing Guide to Skin Rejuvenation”. Suzie is a well-known and highly sought after keynote speaker at industry conferences on lasers and light based therapies and what constitutes ‘best practice’ in the rapidly evolving industry of skin rejuvenation. Proving that she is not all work and no play, Suzie trains and participates in triathlons, and has represented Australia at the Age Sprint Triathlon World Championships in Chicago in 2015 in the 40-44 age group.

Anna Shepherd, CEO (owner) of the Regal Health Group P/L trading as Regal Home Health and Adjunct Associate Professor at The University of Sydney Nursing School. Regal is renown for the delivery of the highest standards of clinical care to people in their own homes. Anna has a strong focus on quality and safety within an innovative and sustainable business model that sees health care professionals working as independent practitioners within an organisation structure similar to a virtual large teaching hospital. Over the past 34 years, Anna has worked as a passionate advocate for primary health nursing in the community. She has persisted in keeping community nursing on the national agenda and has driven the delivery and efficacy of high-quality clinical services in the home and was recognised as a winner in The Australian Financial Review and Westpac 100 Women of Influence Awards for 2015 in the Business Enterprise category.

Ashton is one of a rare breed when it comes to speakers in that he’s actually out in the field applying his theories and working the tools with some of Australia’s largest brands every day. This is because he believes that with things changing so quickly the only way to constantly provide value to audiences is to be a part of the madness himself. Ashton has spent the last 14 years working internationally on some of the world’s biggest brands, running milliondollar campaigns for billion-dollar brands – specialising in Predatory Marketing – pinpointing how brands can grow by outsmarting their competitors. He’s a business owner and serial entrepreneur, always challenging, often controversial, and always focused on what gets results. Ashton’s path to the stage was a somewhat unusual one. After graduating with a commerce/law degree, he turned his hand to street performing, TV presenting, stand-up comedy, film directing, and even literally ran away with the circus. Now that he has found his niche, he uses these past life skills to develop presentations that are a mix of theory, workshop, and Whose Line Is It Anyway – always relevant, topical, and entertaining. Ashton has won the coveted Speaker of the Year from the world’s #1 CEO network three times, received film awards, guestlectured at leading universities, won creative and strategic recognition from his peers, and was instrumental in developing Australia’s first mobile app.

Despite having over 60 people in the Clear Complexions team, Suzie continues to personally treat clients and educate and mentor her nurses and doctors. She works alongside her husband Alex, and together they are raising two beautiful teenage daughters. THE NATIONAL NURSING FORUM 2017

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CLOSING KEYNOTE SPEAKER

MC

MC

Adjunct Professor Debra Thoms FACN (DLF) Commonwealth Chief Nursing and Midwifery Officer

Ms Anne Samuelson FACN Executive Director, Education, Australian College of Nursing

Adjunct Professor Kylie Ward FACN Chief Executive Officer, Australian College of Nursing

Anne is a registered nurse and a long time Fellow of The College of Nursing, a predecessor organisation to ACN.

Adjunct Professor Kylie Ward has more than two decades of experience as a celebrated Nurse Leader, and a respected, senior level Health and Aged Care executive. Intimately aware of the significant contribution nurse leaders make to health and aged care, community outcomes, individualised care and patient experiences, Kylie also brings an innate passion for people, professionalism, service and leadership to the Australian College of Nursing (ACN).

Debra Thoms commenced in the position of Commonwealth Chief Nursing and Midwifery Officer at the end of August 2015. She was formerly the inaugural Chief Executive Officer of the Australian College of Nursing, a position she took up in mid-2012 following six years as the Chief Nursing and Midwifery Officer with NSW Health. During her career Debra has gained broad management and clinical experience including as a clinician in remote and rural Australia, as CEO of a rural area health service, general manager of the Royal Hospital for Women in Sydney and within the Health Departments of South Australia and New South Wales. In 2005 Debra was selected to attend the Johnson and Johnson Wharton Fellows Program and the Wharton School of Business at the University of Pennsylvania. Her contribution to nursing and health care has been recognised by an Outstanding Alumni Award from the University of Technology, Sydney and she also holds appointments as an Adjunct Professor with the University of Technology, Sydney and the University of Sydney.

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Her background and extensive experience in nurse education encompasses clinical teaching, course coordination, curriculum development and design and evaluation. More recently, she held the position of Manager Nursing and Midwifery Registration at the Australian Health Practitioner Regulation Agency (AHPRA,) which supported the Nursing and Midwifery Board of Australia. A key function of her role at AHPRA was the accreditation of international nursing and midwifery qualifications and registration. Prior to the implementation of the National Registration and Accreditation Scheme in 2010, Anne was a Professional Officer at the Nurses and Midwives Board of NSW. Having gained considerable experience in the implementation of legislation, regulation and change management, Anne was keen to build on and utilise her regulatory knowledge and experience and returned to an education environment. She joined the Executive team at ACN in July 2015, and is excited to be working once again with a peak professional body, having previously worked at The College of Nursing as the Manager of Continuing Professional Development where she developed and delivered short courses in a wide range of specialty areas.

Her distinguished career – including nursing with a clinical background in intensive care and aged care, Monash University lecturer and more recently as an expert in transformational leadership, culture and change management – has resulted Kylie’s exceptional skills in organisational design, culture shaping, insight and strategy development. In 2009, Kylie was awarded a Wharton Fellowship from the University of Pennsylvania. Her approach to leadership is modern, ethical and progressive, and focuses on building mental and spiritual resilience to meet organisational challenges and lead people through change. She is inspired by the power of leadership to engage and excite people, and ultimately drive business success. Kylie has enjoyed a long and active association with ACN and its founding organisations, and was awarded Fellowship of both organisations in 2007. She understands and honours their history and commitment to nursing in Australia and is passionate about leading ACN to become a dynamic and influential key professional organisation.


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ONGOING PROGRAMS TO MAINTAIN SUPERVISORY PRACTICE AND EXTEND SKILL DEVELOPMENT • 2-day workshops • 3-day ‘Refresher’ program Suitable for nurses, midwives, other health practitioners and professions providing human support services. Participants have recognised leadership qualities and skills, and a commitment to life-long learning.

For enquiries or to register your interest for a program commencing in 2017 and 2018 contact:

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m: 0410 033 342 m: 0470 557 833

Reflective clinical supervision provides individuals and groups with a supportive, open and professional forum to reflect on all aspects of their work, contributing to personal and professional development. Clinical Supervision Consultancy strongly believes reflective clinical supervision can result in a reduction in professional isolation, levels of stress, emotional exhaustion and burnout, and contribute to improved work culture and environments. Note: Clinical Supervision provided by CSC is regular and dedicated time for reflective practice, rather than supervision of a clinical encounter/procedure, or managerial oversight

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Happen for the benefit of patients and communities. Through this theme, explore how we can use our voice as health professionals to lead change in nursing, health and aged care. Check out our program below and register today!

PROGRAM PROGRAM Correct at time of printing (as at August 2017) however program is subject to change

DAY ONE Monday 21 August 2017 8.00am

Registration – MARQUEE LANDING, LEVEL 2 Arrival tea and coffee – MAIN FOYER AND ROOM B

8.45am

Opening Plenary Session – ROOM A ACN President welcome Professor Christine Duffield FACN

9.00am

9.20am

Ms Janine Mohamed, Chief Executive Officer, Congress of Aboriginal and Torres Strait Islander Nurses and Midwives (CATSINaM) "Nurses and Midwives: Instruments of change" Mr Robert Nieves, Vice President Health Informatics, Elsevier Clinical Solutions, USA “Changing our approach to care: Why engaging patients as equal partners when planning care is critical to improving care outcomes”

9.40am

The Hon Tanya Plibersek MP, Deputy Leader of the Opposition, Deputy Leader of the Federal Parliamentary Labor Party, Shadow Minister for Education, Shadow Minister for Women, and the Federal Member for Sydney

10.00am

Panel discussion

10.25am

HESTA Corporate Partner Address Bart Moye, General Manager National Partnerships

10.30am

Morning tea – MAIN FOYER AND ROOM B

11.00am

Speed Leading: Speed Learning and Networking Session – SKY TERRACE, LEVEL 3 Delegates have the opportunity to connect with senior nurse executives, clinicians and academics for career coaching, networking and advice in facilitated short sessions. Bring your questions with you!

12.30pm

Lunch – MAIN FOYER AND ROOM B

3

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Day one continued... 1.15pm– 3.40pm

1.15pm

1.40pm

Concurrent Session One (20 minute presentations including questions with 5 minutes changeover between each presentation) Session A: Entrepreneurs

Session B: Academia

Session C: Education

Session D: Industry

BISTRO 80, LEVEL 2

ROOM A, LEVEL 3

BISTRO PDR, LEVEL 2

ATTIC, LEVEL 3

Nurse-led telemonitoring in community aged-care: Project findings and nursing insights

Experiences of advanced practice nursing in general practice: A systematic review

Change for good – nursing leads

Alison Devitt MACN and Fiona Patterson

Michael Jakimowicz MACN

Making change happen in East Africa through capacity building – starting up a nursing specialty in stoma, wound and continence in Kenya

The emerging role of the Chief Nursing Information Officer in Australia: Leading change in a digital world

Building nursing research capacity to make change happen: An exploration of Australian BN Honours programs

Adjunct Associate Professor Naomi Dobroff MACN and Mr Aaron Jones MACN

2.05pm

2.30pm

Monica Hughes, Debra Cutler MACN and Briege Eva

Debra Pittam MACN

Hollie Jaggard MACN

Professor Sabina Knight FACN and Adjunct Associate Professor Michelle Garner MACN

Bullying in nursing: The need to make change happen

Transformation for evolution: Use of simulation to identify the future paediatric workforce

How emojis are changing care: Listening to children and adolescents in the co-production of a communication board

Professional boundaries – making change happen being mindful of relationships Dr Wendy McIntosh MACN

Peter Hartin

Supporting nurses to provide safe care: Strengthening professional practice management at the front line to ensure patient safety and improve staff outcomes

Emma Arnold MACN

Making change happen outback style: Recalibrating sustainability

Maria Brien and Laurel Mimmo

3.20pm

Professor Elizabeth Halcomb FACN

Graduate nurse programs: Making change and leading the way through quality improvement projects

Make a change in nursing education: Leadership drives engagement

Professor Karen-leigh Edward MACN and Jo-Ann Giandinoto MACN

2.55pm

Vicki Patton MACN

Influencing a Negative Culture Towards Positive Change Through Leadership Coaching

Nurses leading the way to make change happen for women with breast cancer

Cherry Millar MACN

Community Rapid Response Service (ComRRS) – building relationships to make change happen Fay Walsh MACN and Sharon Williams

Make change happen using a T.E.A.M. approach (together everyone achieves more) Gillian Bayliss and Julie Greaves

Robyn Galway

End-of-life care in hospitals: Utilising patient and family identified areas of importance as the foundation to make change happen

Implementing a person centred care bundle

Nursing on the ramp: Impact of patient dependency

Megan Hoffman

Wayne Varndell MACN

Claudia Virdun MACN Acute care registered nurses perceived confidence in responding to simulated code blue situations using cognitive aids

Building a sustainable specialist aged care workforce: The Sutherland Hospital and Garrawarra Centre “aged care stream”

Sally Wilcox MACN

Bronwyn Arthur

3.40pm

Afternoon tea – MAIN FOYER AND ROOM B

4.00pm

Oration and Investiture – ROOM A

How do we make effective change happen when we work with the Aboriginal community as nurses? Sharyn Amos MACN

Proudly Supported by HESTA

Minister Greg Hunt, Federal Member for Flinders, Minister for Health, Minister for Sport (Video Address) Orator, Professor Glenn Gardner FACN, Professor of Nursing, Queensland University of Technology Investiture of new Fellows, Distinguished Life Fellow and awards

5.00pm 4

Welcome Reception, Event Centre, The Star – ROOM B AND MAIN FOYER THE NATIONAL NURSING FORUM 2017 THE NATIONAL NURSING FORUM 2017 21


DAY TWO Tuesday 22 August 2017 8.00am

Registration, arrival tea and coffee – MAIN FOYER AND ROOM B Poster presentations – MAIN FOYER Delegates to view posters and meet the authors. Authors to be available at their poster to answer any questions. Delegates please cast your vote for the best poster on Pigeonhole Live.

8.45am

8.55am

Plenary Session – ROOM A MC Introduction Ms Veronica Croome, ACT Chief Nurse, ACT Health "Change can happen but if we don’t know where we came from we won’t know where we’re going"

9.15am

Ms Jacqui Cross, Chief Nursing and Midwifery Officer, Nursing and Midwifery Office, Ministry of Health "Engaging hearts and minds"

9.35am

Adjunct Professor Debora Picone AM FACN (DLF), Chief Executive Officer, Australian Commission on Safety and Quality in Health Care "Nurses as leaders"

9.55am

Panel discussion

10.25am

NNT Uniforms Morning Tea Partner Address Ben Tune, Uniforms Manager

10.30am

Morning Tea – MAIN FOYER AND ROOM B

Proudly Supported by NNT Uniforms

Poster presentations – MAIN FOYER 11.00am12.35pm

11.00am

11.25am

Concurrent Session Two (20 minute presentations including questions with 5 minutes changeover between each presentation) Session A: Entrepreneurs

Session B: Academia

Session C: Education

Session D: Industry

MARQUEE MAIN ROOM, LEVEL 2

ROOM A, LEVEL 3

BISTRO 80, LEVEL 2

BISTRO PDR, LEVEL 2

Harnessing change: An education and career framework for nurses in primary health care

Making change happen within a diverse workforce – hearing the voices of nurses

Rural paediatric clinical skills enhancement program “Keeping Kids Close to Home” initiative

Nurse practitioner’s leading the way with chronic disease management

Brie Woods

Ylona Chun Tie MACN and Professor Melanie Birks FACN

Jacqueline Ballard and Maria Brien

Cassandra Stone

Female circumcision – optimising our response

Compassionate patient-centred nursing in Australian intensive care units

Brick by brick – building connections in online learning

Southcare Outreach Service (SOS)

Marie Jones MACN

Samantha Jakimowicz MACN

11.50am

12.15pm

hospice@HOME – a disruptive nursing model with universal implications

Job satisfaction and turnover intention of Australian general practice nurses

Kim Macgowan

Professor Elizabeth Halcomb FACN

Celebrating 10 years of Essentials of Care at Prince of Wales Hospital – through the lens of change Alexa Buliak

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Musette Healey MACN

A culturally sensitive intervention for bullying in the nursing workplace as derived from the voices of the Filipino nurses Dr Benjamin Joel Breboneria

Kylie Ditton

Viability of nursing/AIN to resident ratio’s in Residential Aged Care Facilities (RACF) within the current Aged Care Funding Instrument (ACFI) Andrew Dean MACN

Effecting change through the power of a positive clinical placement

Nurses and capital punishment: Making change happen in ethical dilemmas

Just another routine day… team processes used by nursing teams to create successful outcomes

Professor Lorna Moxham FACN

Professor Linda Shields FACN

Leeann Whitehair MACN

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Day two continued... 12.35pm

Lunch – MAIN FOYER AND ROOM B

1.30pm– 3.00pm

Plenary Session – ROOM A

1.30pm

South Pacific Private Pamper Station Sponsor Address Tony Lane, Acting Director of Nursing

1.35pm

ACN Delegate Session This session will provide delegates with an update on current ACN activities, highlight future exciting plans for professional engagement and leadership opportunities and offer a mini leadership session that will leave you wanting more!

3.00pm

Afternoon tea – MAIN FOYER AND ROOM B

3.25pm– 5.00pm

Concurrent Session Three

3.25pm

(20 minute presentations including questions with 5 minutes changeover between each presentation) Session A: Entrepreneurs

Session B: Academia

Session C: Education

Session D: Industry

ROOM A, LEVEL 3

BISTRO 80, LEVEL 2

MARQUEE MAIN ROOM, LEVEL 2

BISTRO PDR, LEVEL 2

Enhanced nurse clinics: Establishing innovative models of nurse-led care in primary health care settings

How nurse educators negotiate boundaries to affect innovation and change

A recipe for change

Making practice development in nursing more scientific – moving from creating change to proving change

Linda Govan

3.50pm

Proudly Supported by HESTA

Using simulation to evaluate a publically funded homebirth service prior to commencement Louise Botha MACN

Kristen Bull

Dr Robyn Fox FACN

An evaluation of staff transitioning from a combined adult/child emergency department to a new paediatric emergency department: A qualitative study

Dr Greg Fairbrother and Claudia Green MACN Developing an age friendly nursing workforce: Why residential care placements are the place to make change happen! Dr Heather Moquin

Developing Nurse Leaders to influence change in practice: Capacity building in Timor-Leste Ben Dingle

Alison Peeler

4.15pm

Making change happen: Improving health care worker vaccine uptake through a Nurse Practitioner led vaccination service

ASSIST with substance Jennifer Harland

Make change happen: Nurses teaching nurses Carmen Marlow

Engendering a culture change in aged care facilities: An integrated model of care Kerry Turnbull MACN

Madeline Hall MACN

4.40pm

An evaluation of a Montessori program in an aged care facility in regional Victoria Dr Wendy Penney MACN

6

Exploring remote area nurses’ exposure to risk factors for workplace violence, what can we do to make change happen?

Making change happen by connecting care to patient safety Karen McLaughlin

Jennifer Wressell MACN

5.00pm

Close Day Two

7:00pm

Gala Dinner, Event Centre, The Star – ROOM A Guest speaker: Ms Louisa Hope, Louisa Hope Fund for Nurses

A shared responsibility for professional standards and safe cultures and systems – working together to make change happen – the role of the regulator and others Dr Margaret Cooke MACN and Adjunct Professor John Kelly

2017 201723 THE NATIONAL NURSING FORUMFORUM THE NATIONAL NURSING


DAY THREE Wednesday 23 August 2017 8.00am

Registration, arrival tea and coffee – MAIN FOYER AND ROOM B

8.45am

Plenary Session – ROOM A MC Introduction

8.50am

Ms Suzie Hoitink MACN, Founder of the Clear Complexions Clinics and Head of Nursing "The changing face of nursing"

9.10am

Adjunct Associate Professor Anna Shepherd MACN (Associate), Chief Executive Officer, Regal Home Health and Adjunct Associate Professor at The University of Sydney Nursing School "Be the change you wish to see in the world"

9.30am

Mr Ashton Bishop, Chief Executive Officer, Step Change "Sustaining change – the hard bit isn’t getting started, it’s keeping going. And here’s what makes the difference"

9.50am

Panel discussion

10.15am

Morning Tea – MAIN FOYER AND ROOM B

10.45am -11.55am

Concurrent Session Four

10.45am

Proudly Supported by NNT Uniforms

(20 minute presentations including questions with 5 minutes changeover between each presentation) Session A: Entrepreneurs

Session B: Academia

Session C: Education

Session D: Industry

ATTIC, LEVEL 3

ROOM A, LEVEL 3

BISTRO 80, LEVEL 2

BISTRO PDR, LEVEL 2

Utilising technology to make change happen in healthcare

A framework for support – the development of a professional governance framework for nurses and midwives at the Sydney Children’s Hospitals Network

Using contemporary research and data to inform nursing and midwifery policy

Measuring context not just clinical incident numbers; challenging assumptions to change the system

Tanya Vogt

Clinical Adjunct Professor Kath Riddell MACN

A change is on the way – Building leadership capability through contemporary governance models

Reducing avoidable ambulance presentation in emergency

Danielle Miller

Debra Cutler MACN and Melissa Mroz

11.10am

Transition to an entrepreneurial mind-set in professional practice – using in-house education to create a culture of opportunity recognition and innovation Dr Lois Hazelton and Emeritus Professor Murray Gillin

11.35am

Health assistants in nursing making change happen: Reducing pressure injuries, innovation from within Patrick McCrohan

11.55am

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Mental health day’ sickness absence amongst nurses and midwives: Findings of the “Fit for the Future” study Professor Lin Perry MACN

Linda Davidson MACN and Lynne Bickerstaff MACN

Research for change: How research can help organisations and communities develop and adapt in the 21st century

How data can transform practice: Using pressure injury prevalence surveys in practice to improve the quality and safety of nursing care

Dr Lorraine Venturato MACN

Dr Jenny Sim MACN

Nadia Yazdani and Rosalyn Ferguson MACN

Changing care of the elderly in RACFs and Eds: The CEDRiC project toolkit implementation Colleen Johnston and Kaye Coates

Lunch – MAIN FOYER AND ROOM B

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Day three continued... 12.40pm

Masterclass Session One Delegates select one to attend. Please register your preference at the registration desk. Masterclass A

Masterclass B

Masterclass C

Masterclass D

ROOM A, LEVEL 3

BISTRO PDR, LEVEL 2

BISTRO 80, LEVEL 2

ATTIC, LEVEL 3

A time for change – turning the tide on bullying in nursing

Changing how we change

Clinical leadership and mentoring for nurses

Professor Phillip Darbyshire MACN

Dr Drew Dwyer FACN

Turning the workforce into the heartforce: Be a change maker

Professor Melanie Birks FACN and Peter Hartin

1.40pm

Masterclass changeover

1.45pm

Masterclass Session Two (repeat masterclasses) Delegates select one to attend. Please register your preference at the registration desk. Masterclass A

Masterclass B

Masterclass C

Masterclass D

ROOM A, LEVEL 3

BISTRO PDR, LEVEL 2

BISTRO 80, LEVEL 2

ATTIC, LEVEL 3

A time for change – turning the tide on bullying in nursing

Changing how we change

Clinical leadership and mentoring for nurses

Professor Phillip Darbyshire MACN

Dr Drew Dwyer FACN

Turning the workforce into the heartforce: Be a change maker

Professor Melanie Birks FACN and Peter Hartin

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Vivienne Black

Vivienne Black

2.45pm

Afternoon tea – MAIN FOYER AND ROOM B

3.15pm

Closing Plenary Session – ROOM A

3.15pm

Keynote Speaker Adjunct Professor Debra Thoms FACN (DLF), Commonwealth Chief Nursing and Midwifery Officer

3.35pm

Forum close and announcement of prize winners

4.00pm

NNF concludes

5.00pm

ACN Graduation Ceremony – ROOM A ACN graduating students and guests

Proudly Supported by HESTA

2017 201725 THE NATIONAL NURSING FORUMFORUM THE NATIONAL NURSING


SPONSOR AD Effective caring requires knowledge and expertise. Access free, evidence-based and relevant online courses Register at: www.invivoacademy.org/register

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Masterclass B – Bistro PDR, Level 2

MASTERCLASS SESSIONS Delegates to choose one masterclass per session to attend. Please register your preference at the registration desk. Wednesday 23 August 2017

Professor Philip Darbyshire MACN Professor, Nursing and Midwifery, Monash University

Masterclass Session 1: 12.40pm – 1.40pm Changeover 1.40pm – 1.45pm Masterclass Session 2: 1.45pm – 2.45pm

CHANGING HOW WE CHANGE Professor Phillip Darbyshire MACN

Masterclass A – Room A, Level 3

Professor Melanie Birks FACN Professor and Head of Nursing, Midwifery and Nutrition, James Cook University

Mr Peter Hartin Lecturer, James Cook University

A TIME FOR CHANGE: TURNING THE TIDE ON BULLYING IN NURSING Professor Melanie Birks FACN, Mr Peter Hartin and Associate Professor David Lindsay Nursing is known to have a culture of bullying. While research describes the nature and prevalence of bullying in nursing, little has been done to address the problem at the level of the profession itself. This workshop aims to explore why bullying persists in nursing and to identify strategies to combat the problem at every level and in every area of practice. During this workshop, participants will: 1. Explore the ways in which bullying is manifested in nursing 2. Discuss how the nature of nursing contributes to the persistence of bullying 3. Examine factors external to the nursing profession that may fuel the prevalence of workplace incivility 4. Identify strategies for addressing the problem of bullying at education, practice and policy levels. The workshop will use an interactive format to engage participants from diverse backgrounds and areas of practice to ensure an in-depth examination of this complex and often confronting issue.

Introduction: Health services “change the way a third world dictatorship changes”, says Gary Hamel. Change is “infrequent, expensive and convulsive”. In Nursing and Healthcare we must be able to do better than this. We have even had to coin a neologism; ‘redisorganisation’ to describe the chaotic approach to change that has characterised the last 20-30 years. This Masterclass will open up other approaches to change. Expected Outcomes: • Greater awareness of the ‘new world’ of change and change processes. How ‘Platforms’ are changing how organisations change; • Concrete strategies and approaches to ‘Changing How We Change’ and avoiding mistakes of the past. Masterclass Activities: • Interactive event generating considerable interest and discussion • Sharing of key background, research and international perspectives with relevant examples by presenter • Q&A discussions on key issues and contemporary debates regarding Change in nursing and healthcare; • Provision of salient resources for participants, for example articles, reports, weblinks • Sharing of key, do-able, personal, professional and organisational strategies, because Change is NOT going away. Description of pertinent research: Presenter/Moderator will share key research from health and other industries and businesses re; Change and Change processes, eg Gary Hamel, Helen Bevan and more. Summary and conclusion: This will be a challenging, provocative and engaging Masterclass where participants will gain new, researchbased insights into Change and how best to promote and manage it.

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Masterclass C – Bistro 80, Level 2

Dr Drew Dwyer, BASS, BSN, MClinSc, PhD, FACN, QMACA, CFJBI. Consultant Gerontologist, Adjunct Associate Professor UQSoNMSW

CLINICAL LEADERSHIP AND MENTORING FOR NURSES Dr Drew Dwyer FACN Modern health care environments are characterised by turbulence, complexity and increasing frustration as a global increase in the older population places pressure on the healthcare system to provide choices in services that maintain a philosophy of healthy and positive wellness. An increased emphasis on the clinical leadership role of the registered nurse may have a positive impact on the status of registered nurses working in any domain or healthcare sector, and in turn it may improve standards of care for the recipients. The importance of leadership and clinical leadership has increasingly caught the attention of service delivery agencies and researchers over the past few decades. Currently there are numerous healthcare service organisations privately funding studies to develop strategies so that they can survive in the increasing diverse and changing workplace environments that are delivering care services to an ageing population requiring chronic disease management. Recruitment and retention of nurse leaders are important elements in maintaining a healthy workplace, albeit this emerging expert area of nursing practice is poorly recognised and attracts a lower pay parity with other nursing and professional roles, it remains attractive to nurses who have a strong fundamental for caring for other human beings and see nurse leadership as their call of duty. In the Australian context demonstrates that the consumer-driven healthcare is the new domain for an ageing population in Australia as aged care reform evolves out of government directives driven by the consumer groups and Medicare becomes the largest consumer of public health services. With the new healthcare reform comes an increasing call for innovation and leadership to steer the healthcare ship through the storm of change. Several systematic reviews and literature reviews have investigated the impact of leadership and management on staff experience in the healthcare services sector, as well as in the aged care context. These experiences have included staff turn-over patterns, staff members’ decisions to leave or continue working in healthcare care environments, and the impact of workforce movements

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on the quality of outcomes of all care sectors. Clinical leadership is generally acknowledged as being contextspecific, which provides challenges to healthcare services as they are heavily bureaucratic and highly regulated. Clinical leadership within contemporary practice will depend on the leadership style of the individuals in charge at specific times. Although well understood as a key performance indicator for the health organisation and its management, clinical leadership skills are not structured into the training of the registered nurse, and particularly not as a specialised skill for nurses transitioning into more senior roles. It is more the case that the nurse is expected to be the leader of a team of healthcare workers, and manage the assessment of care, care planning and ongoing review as only part of their Key Performance Area (KPA) within their given roles. Although registered health professionals are experienced in dealing with people, it is debatable that nurses in all healthcare settings are well prepared for the role and responsibility of care leadership and management. As a clinical leader and educator, it is important for training to provide evidence based platforms in clinical leadership of the registered nurse and recommend a tentative model for reaching best practice. Providing tools and resources to support the learning and reflective process. ‘Unless we are making progress in our nursing every year, every month, every week, take my word for it we are going back’. (Florence Nightingale) Nurses are traditionally and professionally best suited to be transformational leaders. This workshop will motivate, inspire and connect with nurses to find their role and autonomy in building capacity to lead others in the clinical domain. Topics Include: • Introduction to Clinical Leadership • Introduction to Clinical Governance • Understanding the role of a Clinical Leader in Nurse lead workplaces • Demonstrating Personal Qualities • Working with Others • Managing Services • Improving Services • Setting Direction and making decisions.


Masterclass D – Attic, Level 3 What are the POSITIVE symptoms and consequences of a Heart-Full workforce? Ms Vivienne Black Presenter, Facilitator, Coach

• Self-respect and respect for others • Care and kindness to self and others • Able to give AND receive in balance • Regain a sense of empowerment and job satisfaction

TURNING THE WORKFORCE INTO THE HEARTFORCE: BE A CHANGE MAKER Vivienne Black In an often highly charged environment working under time pressure, budget constraints and ever-changing legislations the workforce responsible for delivering care can suffer its own symptoms. Is your workforce Heart-Less or Heart-Full? What are the symptoms and consequences of a Heart-Less workforce? Sick leave, stress leave, short staffed, roster dissatisfaction; bullying/harassment; feel like you’re working in a ‘police state’ being micromanaged resulting in non-compliance; heightened anxiety and frustration – often taken out on colleagues/patients/loved ones; mistakes and oversights; drama; blaming the system – finger pointing at management or each other; people acting as if they don’t care!

• The power to consciously and deliberately choose your thoughts and actions • Uplifted and energized workforce • Heart connected purpose and passion • A collaborative working partnership with colleagues and patients – we’re in this together. In this 60-minute session be ready to heighten the connection within your own heart and take home implementable practical positive tools to turn a heartless workforce into a ‘Heartforce.’ Lead the way by being a Change Maker. You’ll explore: • your own values in action • two sponsoring thoughts that drive our actions/ reactions • strategies to manage overthinking • your inbuilt powerhouse of positivity and how to engage it.

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PARTNERS

The Chief Nursing and Midwifery Officer (CNMO) is the professional link between the NSW Minister for Health, the Secretary of the Ministry of Health and the public, private and education sectors of the nursing and midwifery professions in NSW. The CNMO is supported by staff in Nursing and Midwifery Office (NaMO), which includes nurses and midwives seconded from the NSW health system.

State Government Partner

NaMO provides advice on professional nursing and midwifery issues and on policy issues, monitors policy implementation, manages state-wide nursing and midwifery initiatives, represent the NSW Ministry of Health on various committees and allocates funding for nursing and midwifery innovation and strategies. NaMO meets regularly with key nursing and midwifery organisations and groups. www.health.nsw.gov.au/nursing/pages/default.aspx

Here for you We're a specialist industry super fund dedicated to people who provide some of the best health, early childhood education and community services in the world. With more than 820,000 members and $37 billion invested globally on their behalf, we've learned a thing or two about looking after our members.

Corporate Partner

hesta.com.au H.E.S.T. Australia Ltd ABN 66 006 818 695 AFSL No. 235249, Trustee of Health Employees Superannuation Trust Australia (HESTA) ABN 64 971 749 321.

As an experienced provider of uniforms to health and aged care facilities for over 50 years, NNT has a detailed understanding of the service requirements, industry specifications, policies and people that are so important to the provision of healthcare services in Australia.

Morning Tea Partner

We design garments specifically for the healthcare sector, working regularly with focus groups consisting of nurses, clinical and non-clinical staff to understand their unique requirements. In addition, we trial-wear all new designs and fabrics in a true work environment. NNT combine best in class products with a service offering that is tailored to match your organisational needs, crafting a uniform solution that empowers your employees to do what they do best... care. www.nnt.com.au

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SPONSORS

South Pacific Private is Australia’s leading multi-disciplinary mental health and addiction treatment facility offering inpatient and day programs to treat anxiety disorders, mood disorders, post-traumatic stress disorder, behavioural addictions, alcohol addiction and substance abuse.

Pamper Station Sponsor

Treatment at South Pacific Private offers the best possibility of recovery through its multidisciplinary, tailored programs, which are designed to meet the individual needs of clients. In addition to being a registered Acute Care Psychiatric Hospital fully licensed by the NSW Department of Health, South Pacific Private is accredited by the Australian Council on Health Care Standards (ACHS). www.southpacificprivate.com.au

PandaPearls Australia is a destinational shopping experience, based in Brisbane, specialising in beautiful pearls and antique enhancers. PandaPearls stock an extensive range of Australian South Sea, Baroque and Classic pearl strands along with beautiful pearl bracelets, earrings and antique jewellery. In addition, we display a range of vintage furs, silk swing coats, cashmere and rare treasures. Our iconic shop is a business inspired by beautiful things and we are honoured to partner with ACN as the Welcome Gift Sponsor the for the 2017 National Nursing Forum.

Welcome Gift Sponsor

www.pandapearls.com.au

Jon Baines Tours organises specialist tours, including health care study tours, around the world. Our study tours combine visits to hospitals, clinics and charities with talks and meetings with local nurses, midwives and doctors. Each tour also has a full programme of cultural visits and experiences.

Name Tag Sponsor

The tours are led by fellow professionals, often leading names in their profession. The tours provide participants with a deeper understanding of a country, its culture and its health care. Travelling with colleagues, they are also fun! We have been running these tours for over ten years and are based in Melbourne and London. www.jonbainestours.com

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EXHIBITION FLOORPLAN

Level 3. Event Centre, The Star, Sydney

ACN HUB

24 3 4

POSTERS

1 2

9 10

5

11

6

12

7

13

8

14

FOYER

25 16

17 26

18

19 27 28

20

21

22

23

15

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MAIN ENTRANCE

ArjoHuntleigh Australian Nurse Teachers’ Society

6

Australian Primary Health Care Nurses Association

10

Avondale College of Higher Education

12

Department of Health & Human Services Tasmania

19

Edith Cowan University

20

Elsevier

24

First State Super

31

Healthcare Australia

25

HESTA

21

James Cook University

27

NT Nursing and Midwifery

7

NNT Uniforms

8

Nurse & Midwife Support

32

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Nurses and Midwives Health

29

Nurses Christian Fellowship Australia

26

Nursing and Midwifery Board of Australia

11

Pulse Staffing

14

Recovery Camp

30

Rural Locum Assistance Programme South Pacific Private Total Face Group

3 1/2 4

Trendcare

22

University of New England

13

University of Southern Queensland

16

University of Tasmania

15

Urgo Medical

23

Western Sydney University

5

Wolters Kluwer

9

Your Nursing Agency

28


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EXHIBITORS THE AUSTRALIAN NURSE TEACHERS SOCIETY (ANTS) (BOOTH 6) The Australian Nurse Teachers Society (ANTS) has been an advocate for nurse and midwifery education for many decades. We provide a collegial environment to facilitate professional exchange including a biannual National Nurse Educator Conference. We participate in a variety of nursing forums representing the needs and views of nurse educators.

ARJOHUNTLEIGH (BOOTH 17) ArjoHuntleigh is passionate about preventative care and providing safe solutions to meet the physical and psychological needs of patients and staffs; and a better Return-OnInvestment for care facilities. Our solutions aim at actively preventing some of the most common healthcare-related incidents i.e. DVT, pressure injuries, staff injuries and patient falls.

DEPARTMENT OF HEALTH AND HUMAN SERVICES (BOOTH 19) Tasmania is a great place to work and live. We offer a wide range of services and great diversity with employment opportunities in over 350 sites and settings in urban, rural and remote island locations. We have it all – exceptional people, great lifestyle choices, modern workplace facilities, plus pristine wilderness and great beaches on your doorstep. What are you waiting for? www.dhhs.tas.gov.au/career/home

AVONDALE (BOOTH 12) AUSTRALIAN PRIMARY HEALTH CARE NURSES ASSOCIATION (BOOTH 10) APNA is collaborating with the nursing profession to develop a national Career and Education Framework and Toolkit to support the employment opportunities, recruitment and retention of nurses in primary health care settings. This project is being delivered under the Nursing in Primary Health Care Program, funded by the Australian Government Department of Health 2015-2018.

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Avondale’s Master of Nursing is designed to extend and deepen a registered nurse’s knowledge, skills and appreciation of advanced practice within complex health care environments. Nursing specialist qualifications can be developed in either Clinical Nursing, Clinical Teaching or Leadership and Management. All courses of study have received national accreditation.

EDITH COWAN UNIVERSITY (BOOTH 20) ECU’s School of Nursing and Midwifery offers a unique range of online postgraduate programs, developed in collaboration with industry partners to ensure students excel within diverse health care settings and contexts. Innovative research programs develop knowledge, evaluate effectiveness and implement change to transform and shape health care policy and practice.


ELSEVIER (BOOTH 24) Elsevier provides the latest evidence-based knowledge and clinical tools, helping clinicians make better decisions and deliver better care at every stage in the patient journey. Some of our flagship products include ClinicalKey for Nursing, a powerful reference solution; Order Sets and Care Planning workflow tools to help reduce variation in care; and Clinical Skills, a localised nurse training and competency management platform. Elsevier also publishes a wide range of highly respected nursing texts and journals including Collegian for the Australian College of Nursing. For more information, please visit www.elsevierclinicalsolutions.com. au/.

HEALTHCARE AUSTRALIA (BOOTH 25)

JAMES COOK UNIVERSITY (BOOTH 27)

Healthcare Australia (HCA) is the leading Health and Community Care recruitment solutions provider for Agency, Permanent and Regional Healthcare Professionals across Australia. Founded in 1972 under the name Malvern, HCA has grown to become the company it is today through a process of targeted acquisition and organic growth and now has 18 offices in Australia and 2 overseas.

James Cook University is one of the top 10 nursing educators in Australia. Our 100% online Master of Nursing is designed with a busy lifestyle in mind. Students can study anywhere, anytime while getting support from academics and connecting to peers through a cutting-edge learning environment.

HESTA (BOOTH 21) Here for you

FIRST STATE SUPER (BOOTH 31) First State Super is one of Australia’s largest providers of superannuation and advice services with more than $84bn in funds under management. The majority of First State Super’s 770,000 members work in education, health and servicebased vocations, including law enforcement, emergency services and other organisations that care for the community.

We're a specialist industry super fund dedicated to people who provide some of the best health and community services in the world. With more than 820,000 members and $37 billion invested globally on their behalf, we've learned a thing or two about looking after our members. hesta.com.au Issued by H.E.S.T. Australia Ltd ABN 66 006 818 695 AFSL No. 235249, Trustee of Health Employees Superannuation Trust Australia (HESTA) ABN 64 971 749 321. Before making a decision about HESTA products you should read the relevant Product Disclosure Statement (call 1800 813 327 or visit hesta.com.au for a copy), and consider all relevant risks (hesta.com.au/ understandingrisk).

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NNT UNIFORMS (BOOTH 8) As an experienced provider of uniforms to health and aged care facilities for over 50 years, NNT has a detailed understanding of the service requirements, industry specifications, policies and people that are so important to the provision of healthcare services in Australia. We design garments specifically for the healthcare sector, working regularly with focus groups consisting of nurses, clinical and non-clinical staff to understand their unique requirements. In addition, we trial-wear all new designs and fabrics in a true work environment. NNT combine best in class products with a service offering that is tailored to match your organisational needs, crafting a uniform solution that empowers your employees to do what they do best...care. www.nnt.com.au

NT NURSING AND MIDWIFERY (BOOTH 7)

NURSE AND MIDWIVES HEALTH (BOOTH 29)

NT Nursing and Midwifery represents the nursing and midwifery profession across the Northern Territory, including urban, rural and remote areas. Providing professional development, training and ongoing support to nurses and midwives is a key focus for NT Nursing and Midwifery, as is recruiting and retaining passionate health professionals to the Territory’s nursing and midwifery community. NT Nursing and Midwifery’s programs and initiatives help to build and maintain a highly-skilled and sustainable Northern Territory workforce – one that is committed to delivering client-centred care in a multi-disciplinary, multi-cultural environment.

Nurses & Midwives Health is the only health fund exclusively for nurses, midwives and their families. We’re dedicated to providing members with relevant and affordable health cover at every stage of life. As a not-for-profit, industry-based health fund, you can count on us putting your interests first through lower premiums, increased benefits and additional services. We’re proud to care for the carers. www.nmhealth.com.au/

NURSE & MIDWIFE SUPPORT (BOOTH 18) NURSING AND MIDWIFERY BOARD OF AUSTRALIA (BOOTH 11) The Nursing and Midwifery Board of Australia (National Board) works to keep the Australian public safe by regulating the nursing and midwifery professions. The National Board makes sure that persons seeking registration as a nurse or a midwife have the qualifications, skills and experience required to provide safe, quality care.

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Nurse & Midwife Support (NM Support) is a national support service for nurses, midwives and students. NM Support is a 24/7 telephone and interactive website support service. The service provides anonymous and confidential support to nurses, midwives and students no matter where they are in Australia. NM Support provides brief intervention counselling and referral to further support as required.


NURSES CHRISTIAN FELLOWSHIP (BOOTH 26) Nurses Christian Fellowship Australia is part of an international movement within the nursing profession. It provides spiritual and professional support to nurses, midwives and students. Our professional events offer ongoing education and a Christian perspective on nursing issues. We invite you to join our dynamic community of Christian nurses locally and worldwide.

RECOVERY CAMP (BOOTH 30) Recovery Camp is a clinical placement provider for health students and a recovery-oriented experience for people living with a mental illness. We also provide continuing professional development opportunities for health professionals. It’s our mission that by attending Recovery Camp, people realize their personal strengths and their contribution to the mental health of others. www.recoverycamp.com.au

ncf.australia@gmail.com www.ncf-australia.org

RURAL LOCUM ASSISTANCE PROGRAMME (BOOTH 3)

PULSE STAFFING (BOOTH 14) Pulse is a leading international provider of healthcare staffing; we are committed to delivering the highest levels of service through finding the right jobs for the right people. We support public and private sector organisations by placing nurses, midwives, doctors & AHPs, into permanent, temporary and casual shift-by-shift roles.

SOUTH PACIFIC PRIVATE (BOOTHS 1 & 2) South Pacific Private is Australia’s leading multi-disciplinary mental health and addiction treatment facility offering inpatient and day programs to treat anxiety disorders, mood disorders, post-traumatic stress disorder, behavioural addictions, alcohol addiction and substance abuse. Treatment at South Pacific Private offers the best possibility of recovery through its multidisciplinary, tailored programs, which are designed to meet the individual needs of clients. In addition to being a registered Acute Care Psychiatric Hospital fully licensed by the NSW Department of Health, South Pacific Private is accredited by the Australian Council on Health Care Standards (ACHS). www.southpacificprivate.com.au

Your organisation may be eligible for Australian Government funded support to help alleviate the pressure of finding a temporary replacement when your valuable healthcare team member goes on leave. You will be given all the support needed to recruit, screen and place a highly experienced temporary nurse that can hit the ground running from the moment they arrive.

“Our goal to support health organisations in providing compliant, expert and compassionate care has helped us become one of the fastest growing staffing agencies in the healthcare sector. Our candidates are at the heart of what we do as we wouldn’t be able to excel without their hard work and support.”

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TOTAL FACE GROUP (BOOTH 4)

TRENDCARE (BOOTH 22)

“We believe in a world where acceptance and compliments can come naturally”

TrendCare is the leading workload management and workforce planning system in Australasia, operating across five countries, winning National and International Awards for innovation, service delivery and training. TrendCare provides rostering, patient acuity, work allocation, risk assessments, care planning, handovers and HRM solutions. TrendCare promotes safe staffing, improved patient outcomes and productivity, and efficiency gains.

Total Face Group is Australia's largest group of premium cosmetic clinics, offering a range of cosmetic beauty treatments including Cosmetic Injectables, Skin Solutions and CoolSculpting. With clinics located in VIC, NSW, ACT and QLD, TFG employs a highly experienced team of Doctors, Aesthetic Nurse Consultants and Dermal Therapists as part of our commitment to customer service, excellence, education and safety.

UNIVERSITY OF NEW ENGLAND (BOOTH 13) At UNE we offer nursing at undergraduate and postgraduate levels so that you can study with flexible study options without losing any of the rigour required in a quality nursing education. You can study on campus for a traditional face-to-face education experience or study from wherever you are, utilising our new generation of online education that is making tertiary education more accessible than ever. You can also study at the pace you want, whether that be full-time, part-time or utilising the three annual study periods to fast track your degree. www.une.edu.au

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UNIVERSITY OF SOUTHERN QUEENSLAND (BOOTH 16) USQ’s nursing programs are fully accredited and align with current Australian professional nursing standards of practice and will give you the skills to deliver high-quality nursing care to people of all ages. With a combination of theory and clinical simulation in our wellresourced labs and nursing wards, you will be fully equipped to step straight into your nursing career.

UNIVERSITY OF TASMANIA (BOOTH 15) The University of Tasmania is one of the largest providers of postgraduate nursing education in Australia. Our postgraduate nursing programs offer high quality, comprehensive professional development for nurses at all stages of their careers, with pathway options including Clinical and Professional Honours, Graduate Certificate, Graduate Diploma and Masters level courses. For more information: www.utas.edu.au/ nursing-postgraduate


URGO MEDICAL (BOOTH 23)

WOLTERS KLUWER (BOOTH 9)

Urgo Medical is a leading French company specialized in wound healing, offering a complete range of wound management dressings and compression bandages.

Wolters Kluwer provides lifelong learning, research and practice information solutions for healthcare practitioners, researchers and students globally. Providing highquality medical, nursing and allied health content, precision search, workflow and point-of-care solutions to help build competency in education and practice and improve patient care - Ovid, Lippincott Solutions, LWW and more.

Now established worldwide including in Australia, its range of high quality and innovative products is supported by more than 55 clinical studies, making of Urgo Medical the global leader in clinical evidence.

WESTERN SYDNEY UNIVERSITY (BOOTH 5) Western Sydney University School of Nursing and Midwifery promotes an open and engaging learning environment. Our Postgraduate studies are designed to enhance the careers of nurses and midwives through the development of academic and critical thinking skills that support clinical practice. The university offers studies in Nursing with a range of specialisations, Mental Health, Primary Health Care, Child and Family Health and Midwifery.

YNA (BOOTH 28) YNA is Your Nursing Agency, recruiting experienced specialist nurses, general nurses, remote nurses, midwives, carers and health support staff. 100% Australian owned and with offices across Australia, YNA has opportunities to suit your lifestyle. Public and private facilities, rural/remote and community work available. Make YNA your nursing agency today.

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NO LONGER JUST FOR STUDENTS!

Emerging Nurse Leaders What’s in it for you? ACN’s Emerging Nurse Leader (ENL) program empowers current and future nurse leaders to achieve their goals and aspirations through personal and professional development. The prestigious program raises participants’ profiles and allows them to enhance their confidence and establish a strong career foundation. Emerging Nurse Leaders receive access to these exciting tools to support their leadership development.

12 month ACN membership

Exposure to ACN policy activities and professional representation

Access to professional development webinars

Full registration for the ACN National Nursing Forum

Opportunities to get published with the support of ACN

Mentoring and coaching

ARE YOU ELIGIBLE? The five different stages of the ENL program cater to nurses at various career points, from undergraduate nursing students to nurses with up to six years of experience. HOW TO APPLY? Applications are open to ACN members and non-members until 31 August 2017. Head to www.acn.edu.au/enl to apply.

Advancing nurse leadership

www.acn.edu.au/enl

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WITH THANKS TO THE 2017 ABSTRACT REVIEW COMMITTEE With sincere thanks to The National Nursing Forum abstract review committee members for your contribution and time this year.

Ms Karen Martin MACN Dr Deborah Massey MACN Ms Carey Mather MACN

Dr Sharon Andrew FACN Ms Nancy Arnold MACN Ms Donna Barton MACN Mrs Marie Baxter MACN Dr Catriona Booker FACN Ms Lesley Brown MACN Ms Lucy Burns MACN Mrs Anne Cameron MACN Dr Elaine Crisp MACN Mr Andrew Dean MACN Ms Helen Doyle MACN Dr Carolyn Ehrlich MACN Dr Beverley Ewens MACN Professor Karen Francis FACN Mr Robbie Haines MACN Mrs Courtney Hayes MACN Dr Deborah Ireson MACN Dr Sally Lima MACN Mrs Moira Maraun MACN

Ms Alison Monger MACN Mrs Judy Morton MACN Ms Judith Nelmes FACN Mrs Vicki Patton MACN Ms Linda Perry MACN Mrs Violet Platt MACN Ms Gim Gim Pua MACN Mrs Merridie Rees MACN Dr Farida Saghafi MACN Ms Anne-Marie Scully MACN Mrs Samantha Serginson MACN Professor Linda Shields FACN Ms Lesley Siegloff FACN Dr Wendy Smyth MACN Mrs Jenny Tait- Robertson MACN Mrs Julie Tucker MACN Dr Lorraine Venturato MACN Mr Steve Warren MACN Ms Rhonda Wilson MACN Professor Anne Wilson FACN

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CONCURRENT ABSTRACTS Abstract of presentations are printed here as submitted to ACN.

CONCURRENT SESSION ONE NURSE-LED TELEMONITORING IN COMMUNITY AGED-CARE: PROJECT FINDINGS AND NURSING INSIGHTS Monday 21 August 2017 1.15pm Session A – Entrepreneurs, Bistro 80, Level 2

Alison Devitt MACN, Glenda Goodall and Fiona Patterson

Summary: To date the projects undertaken by the team of nurses and their partners have found that nurse-led telemonitoring for community aged care has economic benefits for the wider community, promotes collaborative approaches to chronic disease management and improves health literacy and selfmanagement of patients and carers (Burmeister et al., 2016). The telehealth Nurse clinicians have provided valuable insights such as the need for a requisite level of clinical reasoning that is imperative to the nurse telemonitoring role and the need for the development of clinical policies that are specific to ‘telemonitoring’.

Introduction: A team of community nurses partnered with researchers and rural health organisations to undertake several nurse-led telemonitoring projects, each with a unique approach towards community aged care in rural settings. Their findings provide insights into the impact of this approach to healthcare delivery and identify opportunities for development from a nursing perspective.

Conclusion: Nurse-led telemonitoring in the community aged care sector is a relatively new area of research interest. Several projects undertaken by a team of community nurses provide evidence for this effective telehealth platform as well as barriers and opportunities for nursing consideration.

Research Description: The realm of telehealth is continuing to expand in Australia. Its application has primarily been forced onto hospitals and General Practices, with financial incentives for video and telephone consultations. However, there are many different applications of telehealth that if explored further could provide a different platform for healthcare delivery. There is a growing body of evidence supporting nurse-led home telemonitoring as a suitable method of healthcare delivery to help people actively manage their own health, improve quality of life and prevent unplanned hospital presentations (Celler et al., 2016; Lorentz, 2008).

Burmeister, O.K., Ritchie, D., Devitt, A., Chia, E., & Dresser, G. (2016). Evaluating the social and economic value of the use of telehealth technology to improve self-management by older people living in the community. Paper presented at Australasian Conference on Information Systems, Wollongong, Australia, 5-7 December 2016.

References

Celler, B., Vernfield, M., Sparks, R., Li, J., Nepal, S., JangJaccard, J., McBride., & Jayasena, R. (2016). CSIRO Telehealth Trial Final Report May 2016: Home Monitoring of Chronic Disease for Aged Care. Retrieved from https://www.csiro.au/en/Research/ BF/Areas/Digital-health/Improving-access/Home-monitoring Lorentz, M. (2008). Telenursing and home healthcare. Home Healthcare Nurse, 26(4), 237-243.

Based on this evidence, a team of community nurses are leading several telemonitoring projects, each with a unique application in the community aged care sector. They have partnered with Australian universities and rural health organisations to evaluate the impact of these projects on older people, health providers, health resources and the wider community. The projects include: • Evaluation of home telemonitoring technology and its economic, social and health impact. • Supporting residential facilities with telemonitoring and after-hours support. • Enhancing independent living for in-home aged care, using a nurse-led, interprofessional team care approach.

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THE EMERGING ROLE OF THE CHIEF NURSING INFORMATION OFFICER IN AUSTRALIA: LEADING CHANGE IN A DIGITAL WORLD

INFLUENCING A NEGATIVE CULTURE TOWARDS POSITIVE CHANGE THROUGH LEADERSHIP COACHING

Monday 21 August 2017 1.40pm Session A – Entrepreneurs, Bistro 80, Level 2

Monday 21 August 2017 2.05pm Session A – Entrepreneurs, Bistro 80, Level 2

Adjunct Associate Professor Naomi Dobroff MACN and Aaron Jones MACN Introduction: As we move closer and closer towards a complete digital health record in Australia, the role of the Chief Nursing Information Officer (CNIO) has emerged as one that can influence the development of electronic systems and safeguard nursing and midwifery practice. Summary: • In the last 2 years the CNIO role has begun to emerge in Australia. • In response to the emergence of this role, a core group of CNIOs has established a national forum to inform and contribute to the ongoing development of nursing informatics as well as developing a consensus statement on the direction of the CNIO role in Australia. • We believe that the CNIO role is instrumental in ensuring that digital health systems are implemented with nursing and midwifery’s core principles and professional standards at the centre of system requirements and workflow development. • We also believe it is important for us to articulate that the transition from paper to electronic medical record systems is more than just replicating what was on paper but it often requires significant change in the way nurses and midwives deliver patient centred care. • We strongly advocate nursing and midwifery’s core values of compassionate care and must ensure that technology is there to enable care and not prevent the humanness that has been at the centre of what we have always done. Conclusion: The CNIO role will continue to emerge throughout Australia and be instrumental in ensuring that nursing and midwifery practice is well represented in the ongoing development of the electronic health record.

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Debra Pittam MACN The job of leaders who inherit symptoms of a poor workplace culture such as difficult behaviour, rudeness, conflict, high negative emotion, blame, bullying and poor performance is to make change happen towards a positive culture. This however, is easier said than done. Understandably, many leaders lack the range of skills, the confidence and sometimes the support required for them to successfully have the challenging conversations with individuals and groups that are necessary to help people and teams turn such behaviors around. Drawing on both the experience of hundreds of hours of health leadership coaching and literature, this presentation will present and discuss: • The cornerstones leaders required to challenge and positively influence workplace culture: 1.Knowing and being able to articulate a personal leadership standard 2. Being connected in a reciprocal way to a network of inspiring and supportive people 3. Developing an understanding about workplace culture: what it is, how it works, how it influences and is influenced 4. Developing the skills and capabilities to feel more confident to have both challenging and enabling conversations • How a relationship with a leadership coach can assist leaders to both develop and implement these capabilities and behaviours. In summary, this presentation will discuss how leadership coaching can assist leaders to successfully manage, over time, the local behaviours that are implicit within a poor workplace or team culture.


NURSES LEADING THE WAY TO MAKE CHANGE HAPPEN FOR WOMEN WITH BREAST CANCER Monday 21 August 2017 2.30pm Session A – Entrepreneurs, Bistro 80, Level 2

Professor Karen-leigh Edward MACN, Dr Mitchell Chipman, Jo-Ann Giandinoto MACN, Kayte Robinson and Dr Roth Trisno Introduction: Clinical interventions aimed at reducing stress-related psychological complications following diagnosis of breast cancer reveal a positive impact on the woman’s life, including enhancing psychological resilience. However the interplay between personal resources (such as optimism and perceived control) and social resources (such as intimacy and bonding) remains unclear. The aim of this study was to evaluate health related quality of life, resilience and psychological morbidity post-early diagnosis in patients diagnosed with stage I, II or III breast cancer at three time points. We used a longitudinal cohort design. Questionnaires were administered at baseline (1-4 weeks), at 6 months and 12 months post-diagnosis and treatment (June-October 2013). The effect of age and stage of cancer on questionnaire scores was also assessed. Summary: Age was significantly associated with the control, future perspective and body image, with higher perceived levels of control recorded by younger patients at both time points; and higher levels of future perspective and body image recorded by older patients at both time points. Significant changes in body image scores between baseline and 12 months were found with body image significantly deteriorating within 12 months from baseline. A significant interaction between age and time with respect to body image scores was revealed. Conclusions: The findings revealed older women had a better body image and more positive future perspectives compared to their younger peers. Stage of cancer appears to have an effect on resilience experienced by these women. Nurses are well placed in health care to assess women for age-related impacts of breast cancer.

following the leadership principles of trust and values HOW leadership. EMOJIS ARE CHANGING CARE: LISTENING based TO CHILDREN AND ADOLESCENTS IN THE CO-PRODUCTION OF A COMMUNICATION BOARD Monday 21 August 2017 2.55pm Session A – Entrepreneurs, Bistro 80, Level 2

Maria Brien and Laurel Mimmo Partnering with patients to improve the care experience is well described in healthcare literature and a core aspect for healthcare accreditation against the ACHS National Standards. Listening and acting on the suggestions of children and adolescents challenges our beliefs on what is best for them. We describe our co-production experience with inpatient adolescents and their families in developing a communication board, owned by the patients, to tell us what is important, and what matters regarding their care. A key element of this project was that we listened and acted on the ideas of patients to incorporate emojis. This has proved to be central to the acceptance and utility of the boards in improving communication between children and hospital staff. We have found that the emojis prompt a conversation with and between the patient and/or family, which may be difficult to initiate with words, and is especially significant for those young people who are unable to express their needs and feelings verbally. In doing this, we have modelled how the patient voice is not about words, and changed how nurses interact with young people. Feedback from our patients and a video interview with a young person on their experience using the board will feature in this session. PDSA cycles will be presented in pictorial form to illustrate the evolution of the boards over time, based on feedback from patients. Results from surveys of nursing staff will be discussed as evidence of the benefits of this change for nursing care. This session offers the opportunity to showcase how children and adolescents can be actively engaged in the co-production and implementation of a change to improve the hospital experience for children and young people.

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PROFESSIONAL BOUNDARIES – MAKING CHANGE HAPPEN BEING MINDFUL OF RELATIONSHIPS

EXPERIENCES OF ADVANCED PRACTICE NURSING IN GENERAL PRACTICE: A SYSTEMATIC REVIEW

Monday 21 August 2017 3.20pm Session A – Industry, Bistro 80, Level 2

Monday 21 August 2017 1.15pm Session B – Academia, Room A, Level 3

Dr Wendy McIntosh MACN This presentation will use a number of action methods to demonstrate the relationship between professional boundaries and assisting individuals (colleagues and patients) to create and maintain change in meaningful ways. The facilitator will work with the participant stories that emerge in the initial discussions of the workshop. For professional boundaries to exist there requires constant reflection and acknowledgment of how one's own needs may create transgressions. Many professional boundary transgressions occur because of the kindness, goodwill and wish in nurses to follow their own moral compass. However it may be that in following their own moral compass they act against their professional boundary guidelines. Within the wanting to assist another (colleague, patient, patients support person) there could be a number of unconscious motivations which, when witnessed by another could be perceived as a transgression. Further depending on the information presented the action could be perceived to be a boundary violation.

Michael Jakimowicz MACN, Dr Danielle Williams and Dr Grace Stankiewicz Background: Efforts by the Nursing and Midwifery Board of Australia to distinguish advanced practice nursing from advanced nursing practice, have done little to clarify the status of nurses working at these levels in general practice. This review synthesises published qualitative studies reporting experiences of advanced practice nursing in general practice. The view provided by patients, nurses and doctors within this novel context, offers a fresh perspective on why advanced practice nurses have struggled to gain acceptance within the healthcare milieu more generally and in general practice more specifically. Methods: We conducted a systematic review of qualitative studies that explored the experiences of patients, nurses and doctors who had contact with advanced practice nurses working in general practice. Published work from 1990 to June 2016 was located using CINAHL and PubMed. The full text of relevant studies was retrieved after reading the title and abstract. After critical appraisal, the findings of included studies were analysed using the constant comparative method. Emergent codes were collapsed into sub-themes and themes. Results: Twenty articles reporting the experiences of 486 participants were included. We identified one major theme: legitimacy; and three sub-themes: (1) establishing and maintaining confidence in the advanced practice nurse, (2) strengthening and weakening the boundary between general practitioners and advanced practice nurses and (3) establishing and maintaining the value of advanced practice nursing. Conclusions: Regarding advanced practice nurses, we discovered that general practitioners and patients had concerns regarding responsibility, trust and accountability. Nurses working at this level, struggled to negotiate and clarify scopes of practice, while general practitioners had trouble justifying the costs associated with advanced practice nursing roles. While much work remains to establish and maintain the legitimacy of advanced practice nursing, our review creates a platform for change in the way services are delivered in general practice.

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BUILDING NURSING RESEARCH CAPACITY TO MAKE CHANGE HAPPEN: AN EXPLORATION OF AUSTRALIAN BN HONOURS PROGRAMS Monday 21 August 2017 1.40pm Session B – Academia, Room A, Level 3

Professor Elizabeth Halcomb FACN, Professor Lorna Moxham FACN, Professor Ritin Fernandez MACN and Associate Professor Vicki Traynor Background: Completion of the BN Honours program builds research capacity within the profession and prepares nurses to lead in the delivery of evidencebased nursing. Engaging nurses in Bachelor of Nursing (BN) Honours programs is an important opportunity to equip nurses with the skills required for higher degree study and, ultimately, independent research. To date, there has been limited attention paid to Australian BN Honours programs. However, understanding these programs will inform academics, as well as policy makers and key stakeholders. Objective: The aim of this study was to explore BN Honours programs across Australia. Method: After gaining ethical approval, an email invitation was sent to BN Honours Coordinators or Heads of Schools of Nursing and Midwifery faculty at Australian Universities to participate in an online survey. All data were analysed using descriptive statistics. Results: Fifteen (78.9%) of the 19 respondents reported offering a BN Honours program at their institution (response rate 52.7%). There was a mean of 2.58 fulltime enrolments, although mean enrolments decreased consistently since 2013. Most programs offered the option of full or part-time study. Program delivery varied, with six programs (42.9%) requiring on-campus attendance and only two (14.3%) actively facilitating virtual participation. Thirteen (86.7%) programs required a thesis be submitted. Other assessment items included; written tasks, oral presentations, and other assessments. The key challenges were low student numbers, lack of supervision capacity and support for combining study with new graduate programs. Conclusions: To effectively make change happen it is important to ensure that nurses gain skills in the knowledge generation, translation and implementation that underpin nursing policy and practice. Whilst BN Honours programs support developing these skills, the current variation in programs highlights a need to open the dialogue between institutions around how they can best support the development of research capacity to continue to grow nursing as a profession.

MAKE A CHANGE IN NURSING EDUCATION: LEADERSHIP DRIVES ENGAGEMENT Monday 21 August 2017 2.05pm Session B – Academia, Room A, Level 3

Hollie Jaggard MACN Background: Part of the registration renewal process for registered nurses is a declaration that their practice is current, safe and competent. All nurses and midwives accede to being responsible and accountable for participating in continuing professional development (CPD) as a method of continual development and improvement on best practice, and patient care. There is little research regarding the perspective and attitudes of Registered (emergency) Nurses towards mandatory CPD. Strong educational leadership is needed to encourages regular participation and engagement in CPD, as a method of protecting the public whilst providing leadership and support maintaining professional standards. Study Aim: The research aimed to examine the attitudes of emergency nurses toward CPD, and to explore the factors that influence perception of CPD, and identify implications for future practice. Design: a qualitative study was undertaken, with 6 focus groups. Participants (n=28) responded to open-ended questions, and discussion among participants was encouraged on each topic. Transcripts were analysed using thematic analysis. Institutional ethical approval was granted. Findings: Four main themes were identified: Questioning of mandatory CPD – nurses were unsure about what constituted CPD and why minimum hours were enforced; Extrinsic versus Intrinsic educational drive – the motivating factors that encourage nurses to engage in CPD; Barriers to CPD – the obstacles described as preventing regular engagement in; and Tailored Learning – educational opportunities that meet learners needs, encompassing appropriate skill levels, learning styles and accessible relevant education. Conclusion: Leadership in nursing education is necessary to promote inherent requirements and standards. Accountability and ownership for education needs to be established within the nursing profession; both to increase personal and professional drive for CPD and to assist in removing barriers and obstacles in prioritising education. Relevant and specific CPD is essential to increasing participation and engagement in ongoing professional development for the benefit of patients, staff and organisations.

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END-OF-LIFE CARE IN HOSPITALS: UTILISING PATIENT AND FAMILY IDENTIFIED AREAS OF IMPORTANCE AS THE FOUNDATION TO MAKE CHANGE HAPPEN

BULLYING IN NURSING: THE NEED TO MAKE CHANGE HAPPEN Monday 21 August 2017 2.30pm Session B – Academia, Room A, Level 3

Peter Hartin, Professor Melanie Birks FACN and Associate Professor David Lindsay This presentation will describe preliminary work regarding the phenomenon of bullying within the nursing profession in Australia. Workplace bullying in Australia is not a recent phenomenon and appears to be increasing. Anecdotally, nurses have likened their clinical setting to that of a ‘battlefield’ and describe the environment in which they work as a place of professional turmoil. This research will explore bullying and other forms of incivility in the nursing profession in Australia. The study will focus in particular on the factors that contribute to bullying and allow it to persist in the various settings in which nurses are employed. There is a significant body of academic research on the nature and incidence of bullying in nursing that has greatly contributed to our understanding of the individual, organisational and social factors that contribute to its persistence. In spite of this, bullying remains a pervasive issue within the nursing profession. There is little substantive data from Australian nurses on the contributing factors that allow bullying to continue in the workplace. Less work exists on how to identify and counter it. The research described in this presentation aims to assist nurse leaders, educators and policymakers to better understand bullying in the Australian health care workforce and thus inform strategies to address the problem. Understanding and recognising the phenomenon of bullying will ensure the best possible outcomes for the nursing profession and, more importantly, the patients for whom we provide care. Making change happen in the area of bullying within the nursing profession requires us to not only acknowledge ‘the elephant in the room’, but also examine closely the antecedents and impacts of this increasingly pernicious phenomenon. Bullying occurs in all organizations, and nurses need to develop the capabilities to manage it when it occurs  

Monday 21 August 2017 2.55pm Session B – Academia, Room A, Level 3

Claudia Virdun MACN, Dr Tim Luckett and Professor Jane Phillips FACN Introduction: The majority of palliative care deaths in Australia occur in hospitals where optimal end-oflife care cannot be assured. Understanding what is important for patients and families receiving end-of-life care in hospital, and how to measure this, is pivotal to enable improvements. Aim: To understand the elements that are most important to patients and their families in relation to hospital end-of-life care and how these can be routinely measured to inform improvement efforts. Methods: Two systematic reviews (one focused on quantitative data and one on qualitative data) were conducted to identify consumer-rated areas of importance and an environmental scan completed to outline current measurement practices. Summary: Data were synthesised from studies with 1,215 patients and 3,399 family members. Five themes were noted as important across both reviews: (1) Expert care (good physical care, symptom management and integrated care); (2) Effective communication and shared decision making; (3) Financial affairs; (4) Adequate environment for care (5) Respectful and compassionate care. Two additional themes from quantitative data were: (1) Trust and confidence in clinicians; (2) Minimise burden. Seven additional themes from qualitative data were: (1) Family involvement; (2) Maintenance of sense of self; (3) Maintenance of patient safety and prevention of harm; (4) Preparation for death; (5) Enabling patient choice (6) Care extending to the family after patient death. The environmental scan outlines current practices used across 15 countries leading in quality of end-of-life care, and maps these practices to the above themes. An overview of all three studies will be presented. Conclusion: Patients and families have consistently outlined what is important for hospital end-of-life care. Our challenge now is to systematically evaluate in line with such areas of importance to make changes happen that matter most to patients who are at the end of their lives and their families.  

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ACUTE CARE REGISTERED NURSES PERCEIVED CONFIDENCE IN RESPONDING TO SIMULATED CODE BLUE SITUATIONS USING COGNITIVE AIDS Monday 21 August 2017 3.20pm Session B – Academia, Room A, Level 3

MAKING CHANGE HAPPEN IN EAST AFRICA THROUGH CAPACITY BUILDING - STARTING UP A NURSING SPECIALTY IN STOMA, WOUND AND CONTINENCE IN KENYA Monday 21 August 2017 1.15pm Session C – Education, Bistro PDR, Level 2

Sally Wilcox MACN, Associate Professor Nikki Phillips, Dr Lauren McTier and Erin Guiney

Vicki Patton MACN, Patricia Griffin, Elizabeth English

Background: Code blue situations occur infrequently on general wards and are stressful for the nurses involved. Cognitive aids such as prompt cards or flowcharts have been shown to reduce the cognitive load experienced during times of extreme stress.

Introduction: Change can only come about by building capacity through education. In developed countries this occurs with collaboration, infrastructure and using existing frameworks. So how can you achieve change in developing countries when none of these exist?

Aim: The aim of this study was to explore acute care registered nurses perceived confidence in a simulated code blue situation when cognitive aids are used.

Summary: In 2013 through collaboration with Aga Khan University in Kenya, The World Council of Enterostomal Nurses (WCET)and Australian Association of Stomaltherapy Ten Australian RN’s from all over the country flew to Nairobi and commenced a commitment to run three separate programmes over four years to educate East African Nurses in Stomaltherapy, wound care and continence. We were unfunded, naïve but confident of our expertise in our practice.

Method: A descriptive design was used for this study. All acute care registered nurses from general surgical and medical wards at three hospital sites of a Melbourne healthcare organisation were invited to participate. Participants were surveyed twice: (i) before a simulated code blue situation and (ii) following the simulation. The questions explored perceived level of confidence in performing the various roles required in a code blue situation, such as team leader and airway support. Results: Twenty-one nurses participated in the study. All participants were female and their age ranged between 21 to 58 years (mean 38.3 years, SD 12.8). Nursing experience was broad, from ten months to 41 years. Prior to the simulation session just over half of the participants (57.1%, n=12/21) reported being “confident” participating in code blue situations. None felt very confident and 42.8% were either uncertain or lacked confidence. After participating in the simulated code blue situation where the cognitive aids were used 90.5% of the participants (n = 19/21) reported that using the cognitive aids would increase their confidence when performing in a code blue situation.

The keys to the success of the programme can be summarized in several points: 1. Relevant and appropriate: The need was initially recognized by the Kenyans’ themselves and the invitation was extended. 2. Support from people / organisations on the ground: In this case from Aga Khan University. They allowed us to access local infrastructure for clinical training and provided teaching space. 3. Within a framework: We used a framework from WCET through an existing model “twinning project” between Australia and Kenya. This gave the programme structure and baseline of objectives for the course. These were then adapted to the Kenyan situation.

Conclusion: The findings of this research suggest that nurses in this study found the use of cognitive aids, in the form of prompt cards and role identification stickers, increased their confidence in participating in a simulated code blue situation.

4. Collaboration from Kenyan Nursing Council, Kenyatta National, Kjabe Mission and Aga Khan University Hospitals allowed us to provide clinical tutoring facilitating the practical aspect of the course.

Conclusion: Our commitment is now complete. To date we have educated 49 nurses from Kenya, 2 from Tanzania, 1 from Togo and Botswana. Kenya now has wound ostomy and continence nurses association. Things have changed in Kenya since 2013 by building capacity of nurses.

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GRADUATE NURSE PROGRAMS: MAKING CHANGE AND LEADING THE WAY THROUGH QUALITY IMPROVEMENT PROJECTS

MAKING CHANGE HAPPEN OUTBACK STYLE: RECALIBRATING SUSTAINABILITY Monday 21 August 2017 2.05pm Session C – Education, Bistro PDR, Level 2

Monday 21 August 2017 1.40pm Session C – Education, Bistro PDR, Level 2

Emma Arnold MACN, Karen Gullick MACN, Carmel Scott MACN, Jillian Thomson, Anne Green and Rosemary Saunders MACN Registered Nurses are required to be involved in quality improvement activities as part of delivering safe, high quality care for patients. Graduate Registered Nurses (GRNs) often have limited knowledge and practical understanding of quality improvement processes and their application to clinical care. Graduate Nurse Programs provide ideal opportunities to embed knowledge and practice of quality standards and quality improvement processes. An innovative approach was implemented at an Australian private hospital where Registered Nurses (RNs) in a Graduate Nurse Program (GNP) led quality improvement projects (QIP) relating to one of the National Safety and Quality Health Service Standards. The aim of the GNP QIP was to assist GRNs understanding of quality improvement processes while engaging in meaningful and stimulating projects linked to actual clinical care. GRNs worked in groups with guidance of the Graduate Coordinator, Clinical Quality Officer and the Chair of the relevant National Standard Committees to identify an appropriate project. The GRN groups developed the project proposal, collected, analysed the data, presented the project findings at a GRN quality forum, produced a poster, and submitted a written report as part of the GNP requirements. Results of the project indicate GRNs found the GNP QIP contributed to their knowledge of QI, skills in documentation, teamwork, communication and reflection. Staff involved since the inception of this project found the GNP QIP enabled GRNs to better understand quality and safety, supported collaborative integration of GRNs in the hospital and contributed to improved QI practices at the hospital. The inclusion of a QIP in a GNP provides valuable learning experiences for GRNs, including increase in knowledge, opportunities for collaboration, and in making a significant contribution to hospital quality improvement practices. This presentation will describe development of the GNP QIP, GRN experience, implications for practice and lessons learned in implementing the hospital wide initiative.  

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Professor Sabina Knight FACN and Adjunct Associate Professor Michelle Garner MACN Australian remote areas are characterised by health workforce maldistribution, vast distances, torrid climate extremes, infrastructure lag and diverse, dispersed populations with high health need and social disadvantage. The North West region of Queensland not only typifies these features but also competes with mining for its health career market. Mining offers highly paid jobs with relative low requirements for formal qualifications resulting in a magnification of the health workforce maldistribution. Exacerbating the situation is high staff turnover. Nurses recruited from metropolitan areas are unfamiliar with the context of practice, the burden of disease, the health services and the cultural context. One full time full time equivalent is not the same effective value as a local experienced full time equivalent placing further stress on health services across rural and remote Australia. Our hypothesis is that local graduates are more likely to be work ready and therefore effectively useful to the service in the first two years. Mount Isa Centre for Rural and Remote Health, James Cook University and The North West Hospital and Health Service have collaborated on an innovative approach to developing a nursing workforce in and for the region. This paper discusses the strategies and outcomes and next steps leveraged by the program. These included local recruitment and marketing, local access to the JCU Nursing program, enhanced curriculum, engagement of local nurse leaders as lecturers and tutors, regional clinical placements, preceptor and mentor development, student accommodation, academic and library support and a pipeline into a rural and remote graduate program. The paper will candidly discuss impediments and lessons learnt and will describe the particular strategies necessary for success, notions of what constitutes sustainability and viability in health workforce redistribution and the role of partnerships and the leverage opportunities for innovative nursing education models in underserved and outback areas.  


TRANSFORMATION FOR EVOLUTION: USE OF SIMULATION TO IDENTIFY THE FUTURE PAEDIATRIC WORKFORCE

IMPLEMENTING A PERSON CENTRED CARE BUNDLE Monday 21 August 2017 2.55pm Session C – Education, Bistro PDR, Level 2

Monday 21 August 2017 2.30pm Session C – Education, Bistro PDR, Level 2

Robyn Galway, Marguerite Cusack, Ingrid Wolfsberger and Sally Whalen

Megan Hoffmann, Kristie Mackenzie MACN and Rebecca Lewin

Paediatric nursing is a complex entity. Whilst the nursing process remains unchanged, a unique focus in the paediatric setting is ensuring the psychosocial and developmental wellbeing of the child whilst managing the needs of the entire family. The Sydney Children’s Hospitals Network (SCHN) recent experiences with recruitment have found that registered nurses (RNs) have minimal understanding of the nuances of paediatric nursing. An opportunity was seen to enhance the nursing recruitment process in order to improve the identification of RNs with the innate qualities necessary for nurses in this specialised setting that will promote the holistic paediatric approach and thus change the health care experience for children and their families.

The Person Centred Care Bundle was implemented across the Royal Melbourne Hospital over an eighteen month period and consists of five critical strategies, nursing assessment and care planning, bedside handover, patient safety rounding, patient bedside whiteboards and safety huddles.

A simulated scenario was introduced to form part of the interview process during the recruitment of a cohort of RNs with no or limited paediatric clinical experience. The simulation was developed to provide nursing candidates with the opportunity to demonstrate their communication, interpersonal skills, teamwork, prioritisation and reflective skills in relation to the care of a paediatric patient and their family. Fifteen applicants were interviewed across the SCHN with all applicants completing the same simulated scenario. The aims of this pilot project were to ascertain if nurses enacted the qualities they profess during a standard interview format, if the scenario provided insight and assistance for on-going workplace interactions and the enduring value of utilising simulation in the recruitment process to ensure appropriate staff selection. Initial feedback from the recruitment teams have been very positive towards utilisation of simulation, particularly in being able to realistically assess applicants interpersonal and communications skills within the paediatric environment. The findings of this innovative recruitment method will be further explored to ultimately improve the quality of nurses caring for paediatric patients and their families.

At the ward level, there was significant variation in the approach to providing safe person centred care. Our patient experience data highlighted the need to improve how we communicated and engaged our patients in their care. 37% of our patients and their families were not as involved as they wanted to be in decisions about their care. There were also concerns regarding rates of clinical incidents related to nursing sensitive indicators. A change needed to occur in our approach to patient care and we needed to ensure that our patients were being delivered safe and reliable care across every ward, on every shift every day. Improvement occurred in a number of measures including patient feedback as well as process and outcome data linked to nurse sensitive indicators, including pressure injuries, falls, hand hygiene and the identification of malnutrition. Development and implementation of the Bundle required a coordinated organisational wide approach around redesign, building capability and change management that focused on meaningful engagement with nurses throughout the change process. Visual electronic dashboards were created to provide managers and bedside nurses with transparent information, regarding current clinical practice and to highlight successes and opportunities for improvement. There was executive support, including nursing leadership commitment to ensure that the Bundle is ‘hardwired’ into our everyday clinical practice.  

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BUILDING A SUSTAINABLE SPECIALIST AGED CARE WORKFORCE: THE SUTHERLAND HOSPITAL AND GARRAWARRA CENTRE “AGED CARE STREAM” Monday 21 August 2017 3.20pm Session C – Education, Bistro PDR, Level 2

Bronwyn Arthur, Geoff Dulhunty, Emily Matthews and Rebecca Kelly Historically it has been difficult to recruit to and maintain a skilled and sustainable Registered Nurse (RN) workforce in Aged Care. In 2011 The Sutherland Hospital (TSH) and The Garrawarra Centre, a Residential Aged Care Facility (GC), received funding to develop a pilot program to cultivate a sustainable workforce of skilled specialised Aged Care RNs. A literature review confirmed the need for a specialist Aged Care workforce; however no suitable training models were found. TSH and GC undertook the development of a one year program for first year “Transition to Professional Practice” (TPPs) RNs, which commenced in 2012. At the end of 2012 the program was reviewed and suggestions were made for improvements. In 2014 it was agreed to apply to the NSW Nursing and Midwifery Office to formalise the program, and in 2015 the program became officially embedded into the organisations. A longitudinal review of the program has evidenced a high retention rate in those who participated in the “Aged Care Stream”; those staff demonstrated an increased commitment to further professional education in the years following this training with many advancing to senior nursing roles in the organisations. RNs who were not initially involved in the “Aged Care Stream”, requested that a program be developed to meet their educational and career needs. Later a program was established to facilitate the ongoing development and training of specialist Aged Care RNs being “The Aged Care Career Pathway”. Not only has the “Aged Care Stream” met its original aims, it has exceeded our expectations. It has led to the development of a career pathway for specialist Aged Care RNs, has improved team morale, and has raised the profile of Aged Care nursing to that of specialty status.  

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‘CHANGE FOR GOOD’ – NURSING LEADS Monday 21 August 2017 1.15pm Session D – Industry, Attic, Level 3

Cherry Millar MACN Change occurs every day in the clinical environment. Driving forces include evidence based practice, strong leadership and inevitably the health dollar. Today with the increasing acknowledgement of burden of cost surrounding in-hospital care, and use of technology in the management of patients with chronic and complex disease processes, there is greater recognition and appreciation of successful nurse led programmes. This gradual shift in healthcare provision is now providing increasing numbers of experienced nurses with opportunity for new learning and strong leadership roles in the clinical arena. One of the newer arrivals to the Australian healthcare arena is in the highly resource dependant renal speciality – ‘Conservative management with renal supportive care’. This initiative now provides an alternative treatment option for a select patient cohort who may not have a significant increase in longevity or quality of life with renal replacement therapy. This particular model has been utilised effectively overseas and was initially piloted in Australia at St George Hospital Sydney. The outcomes were so successful it is now being trialled throughout NSW with considerable interest from other states. This presentation explores the gradual and ongoing evolution of the programme at St Vincent’s Hospital Sydney. While providing a potential road map to the introduction and implementation of a new way of thinking, it also identifies barriers and strategies and places emphasis on the essential roles of communication, liaison, collaboration and overall leadership required in the facilitation of change.  


SUPPORTING NURSES TO PROVIDE SAFE CARE: STRENGTHENING PROFESSIONAL PRACTICE MANAGEMENT AT THE FRONT LINE TO ENSURE PATIENT SAFETY AND IMPROVE STAFF OUTCOMES Monday 21 August 2017 1.40pm Session D – Industry, Attic, Level 3

Monica Hughes, Debra Cutler MACN and Briege Eva The early identification and management of professional practice issues can prevent the worsening and recurrence of issues which can lead to patient harm. Professional practice management, the application of good human resource management principles to the clinical setting, is a recognised strategy for improving individual practice which can in turn improve patient care. Following a series of professional misconduct cases, the Sydney Children’s Hospitals Network (SCHN) recognised the need to change the attitudes and approach to professional practice management of nurses and midwives. This led to a quality improvement process to standardise and provide structure to the professional practice management of nurses and midwives. To understand what needed to be changed, a review of current practice was undertaken to inform the development of the framework. Guba and Lincoln’s fourth generation evaluation was used to identify the opportunities and barriers to professional practice management as perceived by 148 key stakeholders. A desktop review of case management files was used to compare the phenomenological themes generated by stakeholders to practice.

COMMUNITY RAPID RESPONSE SERVICE (COMRRS) - BUILDING RELATIONSHIPS TO MAKE CHANGE HAPPEN Monday 21 August 2017 2.05pm Session D – Industry, Attic, Level 3

Fay Walsh MACN, Sharon Williams, Meredith Prestwood MACN and Bridget Brown Introduction: In 2012, the Tasmanian Department of Health and Human Services (DHHS) identified Tasmanian Health Services (THS) community nursing needed reorientating to meet changing community needs. GP’s have had limited options for patients requiring increasing high level of clinical care within the intermediate space between General Practice and Emergency Departments (ED), resulting in increasing number of people presenting to the ED for treatment. ComRRS is an innovative service model that provides high acuity/high frequency intermediate care for patients with acute illness/injury or acute exacerbation of chronic and complex conditions, often resulting in the need for the patient to present at the emergency department. The ComRRS model is based on a “shared care” relationship with the patients GP. Description: Management utilised transformational leadership, focusing on understanding drivers between different sectors of the health system to identify common goals. Service design brings together the needs each these sectors, patient preferences, and incorporates characteristics from both national and international models.

The data generated by different stakeholder groups provided insight into the barriers and needs of different staff groups towards professional practice management across SCHN. Thematic analysis highlighted three key domains to be considered in the development of the framework: System and Process; Support for Staff; and Culture. The fourteen ‘issue constructs’ provided instruction from stakeholders on what they wished to see included in a local framework for professional practice management.

The Steering Committee includes high level representation from each sector, supported by a GP Reference Group. The GP Reference Group provided guidance throughout implementation, still provides leadership and clinical advice.

The review of current practice led to the development and implementation of a framework for the professional practice management of nurses and midwives, based directly on the needs of stakeholders. A multi-service, co-design methodology was employed through the framework development process. This approach increased ownership, accountability and awareness of professional practice management for nurses and midwives.

Within six months ComRRS received over two hundred referrals from 59 individual GPs, resulting in more than two thousand service events. ComRRS maintains GP support with high patient and GP satisfaction rates.

Results: ComRRS success has been highlighted by establishment of multi-sector partnerships and strong relationships with GPs within the local area and positive patient outcomes.

Conclusions: ComRRS has demonstrated different sectors can work together productively when effective change strategies are utilised ensuring patients receive the right care, in the right place, at the right time, by the most appropriately skilled. ComRRS has potential to significantly impact potentially preventable hospitalisation occurrences, while ensuring quality outcomes for people in the community.

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MAKE CHANGE HAPPEN USING A T.E.A.M. APPROACH (TOGETHER EVERYONE ACHIEVES MORE)

NURSING ON THE RAMP: IMPACT OF PATIENT DEPENDENCY Monday 21 August 2017 2.55pm Session D – Industry, Attic, Level 3

Monday 21 August 2017 2.30pm Session D – Industry, Attic, Level 3

Gillian Bayliss and Julie Greaves Introduction: Quality improvement has become an accepted concept that continues to change the nursing profession with many studies acknowledging the benefit of ‘coalface nurses’ in identifying and shaping quality improvement. Summary: Based on this principle, an initiative was undertaken to influence quality improvement and change using a T.E.A.M. (Together Everyone Achieves More) approach where coalface nurses, within a Critical Care Area, were asked to assess their performance, voice their opinions (without retribution), and outline their values on the standard of care and nursing practices provided to their patients. In addition, audits were undertaken on bedside handovers, fluid balances, patient assessments and workload completion to assess the actual effectiveness of their standard of care and collated with staff surveys to determine areas where improvement and change may be required. As a result of this approach, coalface nurses inevitable identified gaps in nursing practices and unknowingly identifying strategies to reduce the gaps and improve the standard of care provided to their patients. In addition, the project has also provided clarity on the duties being performed and reduced confusion and team disharmony when practices, perceived to be necessary, weren’t completed. Perhaps the most unexpected outcome of this project, was the discovery that a change in team culture was achieved with many nurses indicating that prior to the project they felt powerless to influence change with no voice or strategy to impact change and now were freely and actively participating in discussions to develop new strategies to promote quality improvement and change. Conclusion: This approach has proved to be successful in identifying gaps in the Standard of Care and Nursing Practices within a Critical Care Area and facilitating quality improvement while unknowingly changing the culture of a TEAM to embrace and participate in quality improvement.  

Wayne Varndell MACN, Elizabeth Ryan, Alison Jeffers and Nadya Maquez-Hunt Introduction: The number of patients presenting to ED by ambulance is increasing. During periods of peak demand for emergency care, overcrowding and access block can occur, resulting in patients being delayed in the ambulance bay. The impact of ramping on emergency nursing workload is not known. Aim: The purpose of this prospective study was to characterise patients occupying the ambulance bay and determine the ensuing nursing workload. Method: Nursing workload was assessed using the Jones Dependency Tool. A modified Work Observation Method By Activity technique was used to estimate direct nursing care time. Results: A total of 640 patients occupied the ambulance, 205 (32%) were evaluated using the JDT. On reviewing patient flow data, an average of 4 (SD 2, range 0-12) patients occupied the ambulance bay for nearly an hour (mean 0.9h; SD 0.7h; range 0.3h-4.8h); occupancy peaked at two distinct times (13:00hrs and 17:00hrs), with the bulk (n=332; 51.9%) presenting mid to late afternoon. A total of 150.6 hours of direct nursing care were consumed by patients located in the ambulance bay. Patients occupying the ambulance bay typically originated from the waiting room (n=107; 52%), male (n=106; 52%), aged 54 years (SD 22y), with semi-urgent symptoms (ATS 3, n=146; 71%) requiring acute area level care (n=152; 74%) and admission (n=103; 50.2%). Patients were largely (n=134; 65.4%) of moderate dependence, compared to those of total (n=2; 0.9%), high (n=2; 0.9%) or low (n=67; 32.7%) dependence. Patient reassessment (27.6%), pain management (19.7%) and pathology collection (18.7%) formed the majority of direct nursing care. No correlation between triage category and JDT level was found (p=0.67). Conclusion: Early detailed assessment and symptom management of patients occupying the ambulance bay is extensively undertaken by emergency nurses, total numbers and triage category may be insufficient to describe the impact on nursing workload.  

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HOW DO WE MAKE EFFECTIVE CHANGE HAPPEN WHEN WE WORK WITH THE ABORIGINAL COMMUNITY AS NURSES? Monday 21 August 2017 3.20pm Session D – Industry, Attic, Level 3

Sharyn Amos MACN Introduction: Working alongside our First Nation communities is a privilege that I never understood as a mental health / alcohol and drug nurse in 1995. My understanding as a young nurse was that because I was there “helping” Aboriginal communities that I was making a change. It is as an older nurse that I learned to understand that my idea of “helping” was and is never of benefit to Aboriginal communities. Summary: Through learning with Elders, of Aboriginal communities, respected nurses within Aboriginal communities in Victoria and Northern Territory an understanding developed that it is what clinical skills a nurse brings to the community and which are delivered in a cultural safe practice that the community will be enhanced. It is a shared journey with areas that I have no control over and the only control I have is my role as a nurse, what my clinical skills I bring to the relationship and a continual reflection on how do I provide culturally safe practice. This paper will work towards exploring what has been shared by Elders and respected nurses with myself, that in order to make change happen for Aboriginal patients I had to make change happen within myself. This will be explored through identified stages of reflective practice that were discovered to ensure culturally safe practice when developing mental health / alcohol and drug programs with communities and how this was defined as a clinical outcome for patients. Conclusion: Through this presentation nurses will either be challenged or affirmed on their own understanding on what is culturally safe practice when nurses deliver their clinical care.  

CONCURRENT SESSION TWO HARNESSING CHANGE: AN EDUCATION AND CAREER FRAMEWORK FOR NURSES IN PRIMARY HEALTH CARE Tuesday 22 August 2017 11.00am Session A – E  ntrepreneurs, Marquee Main Room, Level 2

Brie Woods There is significant change underway within the Australian nursing workforce based in primary health care (PHC) settings. Opportunities for career progression and innovative nurse-led models of care are developing rapidly and there is a growing body of research to demonstrate the value of the PHC nursing workforce in improving health outcomes. To support this change, the Australian Primary Health Care Nurses Association (APNA) received funding to develop an Education and Career Framework for Nurses in Primary Health Care. Project objectives include improving employment opportunities, recruitment and retention; building capacity; and supporting the transferability of nursing skills across areas of practice. Integral to the project was an extensive consultation phase conducted during 2016, involving a range of evidence-based consultation methods. Consultation included interviews with 53 experts from a range of nursing and PHC domains and 19 in-depth user experience interviews to explore the design needs of an online Framework. Additionally, 18 workshops for nurses and their colleagues were conducted across all jurisdictions, supplemented by an online series to facilitate access for non-metropolitan health professionals. Qualitative data from all consultation methods was comprehensively analysed through thematic analysis. The need for a Framework was articulated by all stakeholders, demonstrating the current gap. Most significantly, all stakeholders saw potential in the Framework in improving the perceived value and professionalism of the nursing role in PHC. Other major themes consistent across the range of consultations included the positive impact the Framework would have on strengthening undergraduate nursing curricula and clinical placements, the development of transition support programs, supporting recruitment and retention, identifying relevant education pathways, and its role in describing the breadth of nursing roles, the opportunities for career progression and as a promotional tool. This presentation will report on the consultation findings and explore how this has informed the development of the Framework.

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FEMALE CIRCUMCISION – OPTIMISING OUR RESPONSE

HOSPICE@HOME – A DISRUPTIVE NURSING MODEL WITH UNIVERSAL IMPLICATIONS

Tuesday 22 August 2017 11.25am Session A – E  ntrepreneurs, Marquee Main Room, Level 2

Tuesday 22 August 2017 11.50am Session A – E  ntrepreneurs, Marquee Main Room, Level 2

Marie Jones MACN and Helene Johns

Kim Macgowan

The Royal Women’s Hospital in Melbourne, Australia provides an innovative nurse led African Women’s Clinic (AWC) that provides support and counselling for woman affected by female circumcision and an outpatient deinfibulation service. Changing practice environments have seen a transition of care from a specialist gynaecologist to a nurse led self-referral service. The AWC was established after a review of patient outcomes in nurse led facilities and community consultation. Women are assessed by the experienced nurse who performs the deinfibulation under local anaesthetic.

Some 70% of Australians would like to die at home. Only 14% do so1. That most people do not experience death in a place of their choice is evidence of our failure as a society at a time of life that occurs for us all.

The AWC provides information to empower women, their partners, families and the broader community to raise awareness of the impact of female circumcision on women’s health. Community awareness of the clinic and demand for the services provided is reflected in increasing booking numbers as well as direct verbal and anecdotal reports of patient satisfaction. Women are encouraged to return to the clinic for a review appointment four weeks after the procedure. As the clinic has become better known young women are increasingly likely to present for consultation earlier, prior to their first sexual relationship or at least early in pregnancy. Where indicated specialist physiotherapy consultation and sexual counselling are provided. Women requiring deinfibulation who have more complex needs (extensive genital scarring, vivid memories of the original procedure and/or a propensity to experience flash backs) are referred to facilitate a gynaecologist lead procedure under general anaesthesia.  

The District Nurses in Tasmania, through its hospice@HOME pilot project, which has been operating since 2013, is allowing more people to fulfil that wish. In the 12 months to June 30 2016 62% of hospice@HOME clients who said they wanted to die at home did so. hospice@HOME, funded as part of the Better Access to Palliative Care program allows people to take charge of the end of their life through the provision of coordinated, community based, wrap around packages of in-home care. The project is on track to deliver the 2000 packages which were projected in the initial planning. hospice@ HOME has implemented a system and partnership approach requiring collaboration across varying health and other care providers with a focus on the individual. hospice@HOME is the first end of life program where activities in all action areas of the World Health Organisation (WHO) Ottawa Charter are connected and grounded in the principles of patient centeredness, equity, primary care and universal health coverage. The significance of the hospice@HOME project cannot be underestimated. Longitudinal data collected from the implementation of the project from 2013 until 2016, has evaluated the economic and workforce impacts and patient satisfaction, along with a comprehensive examination of enablers and inhibitors of implementing such an innovative model of end of life program. Additionally, the richness of the quantitative and qualitative data provides unparalleled details about the impacts on the health care system and on patient satisfaction. For policy and decision makers across the globe this nurse led project has far reaching implications on end of life planning. 1  Swerissen&Duckett

Grattan Institute  

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(2014) Dying Well, Carlton,


CELEBRATING 10 YEARS OF ESSENTIALS OF CARE AT PRINCE OF WALES HOSPITAL THROUGH THE LENS OF CHANGE

MAKING CHANGE HAPPEN WITHIN A DIVERSE WORKFORCE - HEARING THE VOICES OF NURSES

Tuesday 22 August 2017 12.15pm Session A – E  ntrepreneurs, Marquee Main Room, Level 2

Tuesday 22 August 2017 11.00am Session B – A  cademia, Room A, Level 3

Alexa Buliak, Mary Mulcahy and Michelle Gibbons This presentation utilises an Appreciative Inquiry approach to explore Essentials of Care (EoC) 10th year anniversary at The Prince of Wales Hospital. Stakeholder interviews, using Emotional Touch points, highlight reflections of how the program has enhanced a person-centred and a compassionate culture through a review of achievements, improvements changes to practice. In 2017 we will celebrate 10 years of EoC at Prince of Wales and showcase our commitment to person centred care, patient safety and providing quality improvement processes that value collaboration, evaluation, and enable innovation and a culture of human flourishing. To showcase the work, key stakeholders are interviewed utilising Appreciative Inquiry and Emotional touch points, capturing their stories and celebrations of practice changes that EoC has enabled. Emotional Touchpoints are a powerful means of helping people to share their experiences, aspects of care that are important to them. Summary: This presentation captures the history, progression and outcomes of EoC, inspiring and motivating teams to continue their commitment to person centred compassionate cultures. In conjunction with EOC, SESLHD’s ‘The heart of Caring’ framework that identifies connecting ‘human to human’ and ‘engaging as a team’, are central to providing holistic person centred compassionate care. The underpinning framework of EOC has enabled the flourishing and sustained engagement of both frameworks within POWH, inspiring staff to remain committed to the creation of person centred cultures. Throughout this reflective piece, many key outcomes are highlighted; what’s working well in the organisation and why. We hope to demonstrate how projects from the frontline can influence and shape our health care organisations, how we practice and enhance person centred compassionate care at the POWH. Conclusion: Our best hope is that the combined oral and multimedia presentation demonstrates ten things that ten years of EOC have achieved, through a ten minute presentation, to inspire others towards making change happen.  

Ylona Chun Tie MACN and Professor Melanie Birks FACN The Australian nursing workforce is made up of over 150 different nationalities and cultures, delivering healthcare to a multicultural population in diverse locations. Internationally qualified nurses make up approximately 20 percent of this workforce. Therefore, it is imperative that international nurses integrate successfully into the Australian Health Care System to ensure provision of quality care. While some work has been done about the impact of internationally qualified health care professionals working in Australia, less is known about how the experiences of nurses can be utilised to guide and inform processes to best support nurse integration that will ensure safe, culturally sensitive, person-centred care. Aim: The aim of this study is to explore how registered nurses educated both in Australia and internationally experience working together in Australia in a culturally and geographically diverse workforce. Method: A link to an online survey using Survey Monkey was disseminated to registered nurses via nursing organisations. Results: Survey responses n=86. Respondents included both Australian qualified registered nurses and internationally qualified registered nurses. Survey responses were received from all Australian states and territories. Summary: Nurses voiced their opinions based on experience and observations and contributed valuable insight into requirements for improving integration processes. Effective integration of nurses into a new health service requires an understanding of what is occurring at the local and ward level. The need for ongoing cultural competence education was highlighted. Conclusion: Relevance to practice: This study will produce recommendations that aim to improve the quality of the dynamic work environment for RNs in Australia. Findings will also guide cultural competency education, with the aim of improving nurse retention, and ensuring the provision of culturally sensitive, person-centred care. Keywords: Australia, cultural competence, healthcare system, internationally qualified, nurses, workforce.

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COMPASSIONATE PATIENT-CENTRED NURSING IN AUSTRALIAN INTENSIVE CARE UNITS

JOB SATISFACTION AND TURNOVER INTENTION OF AUSTRALIAN GENERAL PRACTICE NURSES

Tuesday 22 August 2017 11.25am Session B – A  cademia, Room A, Level 3

Tuesday 22 August 2017 11.50am Session B – A  cademia, Room A, Level 3

Samantha Jakimowicz MACN, Professor Lin Perry MACN and Dr Joanne Lewis MACN

Professor Elizabeth Halcomb FACN, Ms Christine Ashley FACN and Ms Elizabeth Smyth

Aim: To develop an explanatory framework of social processes around compassion and patient-centred care in the context of intensive care nursing in Australia.

Background: The Australian general practice nursing (GPN) workforce has grown exponentially in recent years to meet the growing demand for health care. Nurses are more likely to remain working if they are satisfied with their jobs. However, there is limited evidence to describe job satisfaction amongst nurses in general practice.

Background: The aggressive curative setting of ICU may compromise elements of patient-centred nursing. ICU nurses are at high risk of anxiety and fatigue because they are expected to employ bio-medical nursing expertise while delivering patient-centred nursing to severely, biophysically compromised patients. An understanding of the nature of patient-centred nursing and compassion will inform efforts to bridge the theory-practice gap in ICU specifically and nursing more broadly. This will enable us to make change happen through the development of strategies to maintain a compassionate, well-equipped critical care nursing workforce capable of delivering effective patient-centred nursing. Methods: This was a two-phase mixed method study entailing a survey and interviews with nurses of two NSW ICUs, underpinned by a constructionist, epistemological view. Summary of findings: Place of work and tenure were predictors of compassion satisfaction and fatigue. Experience, tenure and education saw critical care nurses’ compassion satisfaction levels rise and burnout levels decrease. Mid and early career nurses were most at risk of fatigue. To enhance critical care nurses’ compassion satisfaction, they needed to be enabled to meet role expectations of the employer, colleagues, patients/ families and self. To meet expectations nurses depend on each other for emotional and practical support, and on their employer for resources. The hallmarks of social processes enabling effective and compassionate patient-centred nursing in Australian critical care are therefore reciprocity of expectations and dependency. Conclusion: Findings identify ways to make change happen by delivering support and removing obstacles to critical care nurses meeting expectations of providing patient-centred nursing. High levels of compassion satisfaction produce a healthy and stable critical care nursing workforce. Reciprocity ensures a better experience and health outcomes for both nurses and patients.

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Objective: The aim of this study was to investigate the job satisfaction and turnover intentions of Australian GPNs. Method: A cross-sectional online survey of nurses employed in general practices across Australia was conducted using convenience and snowball sampling. Job satisfaction was measured with Delobelle et als’ (2011) 29-item job satisfaction scale. Turnover intention was measured using a modified version of the Nurses’ Retention Index (Cowin, 2002). Open-ended questions allowed participants to provide comments. Results: Nine-hundred and fifty GPNs responded to the survey. The mean satisfaction score was 109 of a total possible 145, indicating a high level of satisfaction. Despite this positive finding, 14.3% indicated that as soon as it was convenient they would leave general practice, with a further 18.9% undecided. Whilst respondents were fairly certain that they would remain as a GPN in the next year, 33% respondents were undecided whether they would remain in GP in the next five years and 16.4% were undecided whether they would remain in GP in the foreseeable future. Conclusions: The exponential growth of the Australian GPN workforce has been a positive step for the nursing profession, expanding career opportunities to deliver primary nursing care. However, consideration of factors such as job satisfaction is essential if we are to recruit and retain high quality nurses in this setting. Understanding job satisfaction in general practice nursing can enable policy makers, employers and nurses to make change happen and ensure that the general practice provides a satisfying environment for nurses to work and thrive.  


EFFECTING CHANGE THROUGH THE POWER OF A POSITIVE CLINICAL PLACEMENT Tuesday 22 August 2017 12.15pm Session B – A  cademia, Room A, Level 3

Professor Lorna Moxham FACN, Christopher Patterson MACN, Dr Renee Brighton MACN, Dr Dana Perlman and Ellie Taylor Nurses play an integral role in the effective treatment of people with a mental illness. Their conceptualisation of consumers impacts treatment outcomes and recovery. Despite increasing awareness among the general population, the stigmatisation of people with a mental illness is still widely apparent and remains common among many health care professionals, including nurses. This paper presents findings from research that aimed to explore the effect of clinical placement on student nurse attitudes toward people with a mental illness. Two cohorts; an intervention group (attended nontraditional clinical placement known as Recovery Camp) and a comparison group (traditional clinical placement) participated in the study. Utilising the Social Distance Scale, data was collected on three occasions (pre- and post-clinical placement, and at three month follow-up). Findings suggest that a non-traditional mental health clinical placement is effective in reducing mental health stigma among undergraduate nursing students. This was not the case for students who attended a traditional mental health clinical placement. Practical implications for nursing education will be discussed, with a focus on the benefits of immersive learning experiences designed to enhance cognitive, affective and psychomotor domains of nurse education outside the ‘typical’ hospital setting.  

RURAL PAEDIATRIC CLINICAL EXPERIENCE PROGRAM “KEEPING KIDS CLOSE TO HOME” INITIATIVE Tuesday 22 August 2017 11.00am Session C – E  ducation, Bistro 80, Level 2

Jacqueline Ballard and Maria Brien Far West Local Health District and The Sydney Children’s Hospitals Network have collaborated to run a project titled “Keeping Kids Close to Home”. The aim of this project is to ensure that paediatric nursing staff working in rural and remote health care facilities have the specialist knowledge and resources to care for patients in their local rural referral hospitals and to ensure that children and young people are being cared for consistently across the state. Initially SCHN will work collaboratively with Far West Local Health District to deliver this project. Between 2009 and 2014 Far West LHD provided care for 3518 paediatric patients. The need to keep paediatric patients, and their families, within their local community and local support networks is strong. By performing a more detailed data and needs analysis within the patient and staff cohort we can tailor specialised knowledge, relationships and resources that may need to be developed. This project is enabling Registered Nurses from the Broken Hill Health Service to travel to Sydney to undertake a two week individualised Clinical Experience Placement within the Sydney Children’s Hospitals Network. Increased confidence of the local registered nurses to care for paediatric patients awaiting transfer to a tertiary facility gives our nurses the opportunity to challenge and change existing models of care for rural and remote paediatric care. It is also an opportunity to make changes in how we as nursing leaders offer recruitment and retention strategies. We hope this initiative will close the gap regarding the specialised nursing profession between tertiary nurses and remote/ rural nurses to be able to support each other to make education change happen.  

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A CULTURALLY SENSITIVE INTERVENTION FOR BULLYING IN THE NURSING WORKPLACE AS DERIVED FROM THE VOICES OF THE FILIPINO NURSES

BRICK BY BRICK - BUILDING CONNECTIONS IN ONLINE LEARNING Tuesday 22 August 2017 11.25am Session C – E  ducation, Bistro 80, Level 2

Musette Healey MACN How does a nurse educator with responsibility for online post-graduate studies in Cancer nursing create an individualised and safe learning environment to make change happen? In 2016 a quality improvement project commenced exploring ways of effectively engaging post-graduate students in online learning environments, providing connections and learning experiences synonymous with face to face learning. An existing 12 month study program was utilised and consisted of 19 students with an average age of 40.2 years and age range of 28-55 years. Students were located in 6 out of 7 Australian states and territories. 63% of students were over the age of 35yrs and based in metro, regional, rural, remote and isolated regions. All students under 35 were located in metropolitan areas. The aim was to change practice and culture within online learning creating an environment that was student centered, engaging, positive, safe and allowed for peer learning through exploration and connectivity with course material and peers. The course was based on constructivist and connectivist theory, therefore the connections students make are integral to successful learning, however we were not living the pedagogy. The learning management system, content and technology tools were not altered. What did change is how they were utilised. The student’s stories become paramount and tailoring support was a focus for success, we were bravely honest with students and sought feedback regularly especially on the new initiatives. Through leadership and use of existing ICT we have been able to achieve measurable outcomes including an increased level of student engagement with peers, academic staff and course content, increased course satisfaction for students, decreased student attrition rates and increased job satisfaction of academic staff. We have provided a safe culture through individualised learning within the boundaries of available resources resulting in clinical practice changes for improved patient outcomes.  

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Tuesday 22 August 2017 11.50am Session C – E  ducation, Bistro 80, Level 2

Dr Benjamin Joel Breboneria Bullying in the nursing workplace is a global phenomenon. Despite many research studies conducted on workplace bullying and effective interventions in the global perspective, there is still a need to draw from the experiences of victims in the Philippines. The current study explored the experiences of staff nurses in the Philippines from their unique stories. It utilized narrative inquiry as the research design. There were ten participants obtained using the purposive and snowball sampling techniques. The qualitative data were collected through in-depth unstructured interviews, written narratives, and investigator field notes. Data was analyzed using Riessman’s method of narrative analysis. Content and thematic analysis was also utilized and patterned after the order of data analysis suggested by Lacey & Luff (2009) to create the meta-story for this study. The analysis resulted in a culturally sensitive model for bullying in the Filipino nursing workplace, derived from the six major themes that explained the antecedent phase, structural bullying phase, and outcome phase. The major findings of the study also resulted in the development of the culturally sensitive intervention which was pilot tested by means of a consciousness raising session and yielded positive feedbacks from the staff nurses. The research study contributes to the body of knowledge as it voices out the experiences and feelings of the staff nurses in the Philippines about workplace bullying. The detailed knowledge of the phenomenon helps the organization to either intervene or prevent the relevant processes. The study suggests future researchers in the Philippines for the development of a culturally sensitive instrument to generalize the findings of this study. Insights gained from this inquiry can inform nursing service, nursing education, and nursing research for advocating healthy workplace environments in the Philippines.  


NURSES AND CAPITAL PUNISHMENT: MAKING CHANGE HAPPEN IN ETHICAL DILEMMAS

NURSE PRACTITIONER’S LEADING THE WAY WITH CHRONIC DISEASE MANAGEMENT

Tuesday 22 August 2017 12.15pm Session C – E  ducation, Bistro 80, Level 2

Tuesday 22 August 2017 11.00am Session D – I ndustry, Bistro PDR, Level 3

Professor Linda Shields FACN, Professor David Stanley MACN and Professor Philip Darbyshire MACN

Cassandra Stone, Jennifer Abel, Maureen Barnes, Dr Clint Douglas MACN and Prof Ann Bonner MACN

In 2007, a US nurse – ‘Nurse Karen’ - who helped with executions of condemned prisoners by inserting IV access for lethal drugs, gave her rationale for involvement1. She believed that any person, regardless of circumstance, required the best nursing care she could give; that providing care to someone about to lose their life was akin to working in any end-of-life or palliative care situation, and that if she did not insert the IV lines then someone unqualified would do so and potentially increase the prisoner’s suffering.

Background: Historically, there has been little coordination across settings, providers and treatments for patients with multiple chronic diseases. In addition, the treatments for chronic disease are often complicated, making it difficult for patients to adhere with treatment regimens. Three nurse practitioners (NPs) commenced an innovative integrated approach for patients with multiple chronic diseases in a Brisbane metropolitan hospital. The Integrated Chronic Disease Nurse Practitioner (ICDNP) is a community based outreach clinic where patients with at least two chronic diseases (chronic kidney disease, heart failure, diabetes) are managed at one appointment; avoiding the necessity for multiple separate appointments.

Post World War Two, trials of those involved in the Nazi regime were held in Nuremberg. In 1960, the final trial was of 14 nurses who participated in the Nazi “euthanasia” programmes where people with disabilities, chronic illnesses and other conditions were killed2. All were acquitted. These nurses believed their actions were right, that they were following orders, that the patients knew them and, given the inevitability of the patients’ deaths, it was kinder and gentler to die at the hands of someone they knew. The world’s major nursing organisations have policies strongly advocating that nurses must never participate in capital punishment. This masterclass will discuss the thinking and actions of nurses who killed in Nazi Europe and relate this history to both the injunctions in current nursing organisations’ policies and to the reasoning of Nurse Karen. The ethics and philosophies of all sides of the argument will be presented and participants will be encouraged to discuss connections with current clinical practice where nurses either doing or not doing ‘the right thing’ is a major issue3. Participants will be able to make change in stances around ethical dilemmas happen because they will be able to do so from an informed perspective. Learning outcomes: 1. Ways of discussing ethical dilemmas in nursing that avoid polarising or emotive stances 2. Knowing how history can inform and illuminate current clinical and ethical dilemmas 3. Client choice and the dilemma of non-vs-active participation by health professionals in ethically challenging care-focused situations

Aim: This presentation will first describe the implementation of the ICDNP clinic and present some of the results of an imbedded research project. Methods: Evaluation of the ICDNP clinic, using a longitudinal, prospective, cohort design, is examining the impact of the NP service on patient outcomes. A range of data is collected from patient records (clinical results, emergency department presentations and hospital admissions), level of patient satisfaction, and qualitative interviews with patients. Results: During the first 12 months, there have been 278 occasions of service for 55 patients. Nearly 96% all patients attended their scheduled appointment (96%), 78% had no emergency admissions (due to exacerbation of their chronic disease), and only 5% patients required admission through ‘hospital in the home’, avoiding 25 hospital bed days. Patients reported being very satisfied with the clinic. The qualitative findings captured the patient-reported benefits of attending the clinic as being: i) having good communication and interaction with the NPs, ii) being able to build trust, and iii) having a better understanding of their chronic diseases. Conclusion: The ICDNP clinic and research continues. The ICDNP model of care has shown that NPs can drive change and develop effective client centred models of care that really make a difference. This model of care could be replicated nationally.

1 Hinojosa M. (2006). Week of 7.14.06: Web-Extended Interview: "Nurse Karen". http://www.pbs.org/now/shows/228/nurseexecution.html. 2 Benedict S, Shields L. Nursing in Nazi Germany: the “euthanasia” programs. New York: Routledge History, 2014. 3 Shields L, Watson R, Darbyshire P, McKenna H, Williams G, Hungerford C, Stanley S, Ben-Sefer E, Benedict S, Goodman B, Draper P, Anderson J. Nurse participation in legal executions: an ethics round table discussion, Nursing Ethics, 2016, 1(14), dpi: 10.1177/0969733016677870

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VIABILITY OF NURSING/AIN TO RESIDENT RATIO’S IN RESIDENTIAL AGED CARE FACILITIES (RACF) WITHIN THE CURRENT AGED CARE FUNDING INSTRUMENT (ACFI)

SOUTHCARE OUTREACH SERVICE (SOS) Tuesday 22 August 2017 11.25am Session D – I ndustry, Bistro PDR, Level 3

Tuesday 22 August 2017 11.50am Session D – I ndustry, Bistro PDR, Level 3

Kylie Ditton Introduction: Prior to 2014 there was no rapidly responding community service supporting aged care patients in their home that could intervene quickly to prevent presentation or re-presentation to the Sutherland Emergency Department (ED). All community services had waiting lists of a number of weeks. In January 2014 funding was received from an ‘Innovation in Integrated Care’ grant for the purpose of allowing myself to create a community based, rapid response, multidisciplinary team, for clients over 65 years of age who reside in the Sutherland Shire. Description of pertinent research: • Over 800 clients assessed • 70% have required referral and integration with appropriate services to be maintained safely at home. • Post discharge 93% of clients remain out of hospital at the 28 day follow-up. • ED presentations have decreased by >90% in the pre and post 28 day discharge period. • Hospital admissions show a 69% reduction in the pre and post 28 day discharge period. • 95% of client’s report they would have gone into hospital were it not for the SOS. • ALL GPs contacted by SOS staff about their patient reported they found this helpful for the care planning and management of their patient. Summary: The SOS works in the primary health sector taking referrals directly from GPs, NSW Ambulance Service, community services and clients/ carers. The SOS meets client’s needs through rapid person centred assessment; within 1 – 48 hours, care planning and clinical interventions for 6 weeks by Nursing, Physiotherapy and Occupational Therapy. The SOS integrates and coordinates clients care with their General Practitioner (GP) and executes care plan requirements including referral on to services. If a client cannot be safely maintained at home we have developed new protocols with Kareena Private Hospital and local Residential Aged Care Facilities allowing for seamless, expedient admissions to these facilities. Conclusion: Due to the success of the model the service has become permanent.

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Andrew Dean MACN In recent times there has been a large push to create Nursing/AIN to Resident ratios in the Residential Aged Care System. The prima facie purpose of such ratios is to improve resident care and reduce staff workloads. While research is being undertaken into the necessity of ratios there is little evidence apart from anecdotal that any potential increase in staffing levels or less flexibility is viable given the Aged Care Funding Instrument (ACFI). The viability of Residential Aged Care Facilities (RACF) are hidden by commercial in confidence and are extremely difficult to quantify even when the RACF’s are public companies or NFP organizations. The model presented has been created from the Author’s knowledge of the requirements of an RACF, all financial data has been gathered from public sources and as such does not represent any specific RACF. The model seeks to give an indication of the viability of multi case RACF’s. The oral presentation would seek to look at two common RACF sizes, 60 bed and 120 bed. The viability would be contrasted between standard staffing levels and increased staffing levels of nurses both EEN and RN. The Author does not seek to justify either position rather seeks to answer the question whether it is possible for the RACF’s to implement staffing ratio’s and remain viable. Further research is required into the efficacy of changes to Nurse/AIN – Resident ratios. The long term aim of this model is to allow researchers to test new staffing regimes against the viability of RACF’s with the aim of creating an optimised Residential Aged Care System. To make change happen we need to be pragmatic and be able to fund our hopes. The best outcome remains a dream unless our society is willing to pay for it.  


JUST ANOTHER ROUTINE DAY…TEAM PROCESSES USED BY NURSING TEAMS TO CREATE SUCCESSFUL OUTCOMES

CONCURRENT SESSION THREE ENHANCED NURSE CLINICS: ESTABLISHING INNOVATIVE MODELS OF NURSE-LED CARE IN PRIMARY HEALTH CARE SETTINGS

Tuesday 22 August 2017 12.15pm Session D – I ndustry, Bistro PDR, Level 3

Tuesday 22 August 2017 3.25pm Session A – E  ntrepreneurs, Room A, Level 3

Leeann Whitehair MACN, Dr John Hurley MACN and Dr Steve Provost Background: Recently, a nursing model based on the principles of teams and teamwork created by the NSW Department of Health1 was rolled out across public hospitals situated on the eastern coast of NSW. The model aimed to achieve successful teamwork through a collaborative and co-operative approach where responsibility for work is shared, roles are clearly defined and clear and open communication is pivotal1. Introducing team nursing models is considered a good solution based on the current pressures facing Australian healthcare services2, however little is known about the processes nursing teams use within such models to create successful outcomes. Team processes constitute the ways by which members interact to organise task work to meet desired outcomes3. Aim: The aim of this qualitative pilot study was to explore what team processes support clinical nursing teams in hospital wards during routine daily activities. Methods: Data was collected using ethnographic methods with nursing teams on a single NSW public hospital ward. The team leader was shadowed as they interacted with staff and patients and field notes collected over seven shifts. At the shift conclusion, team leaders were asked whether the shift was routine, or not, and why. All staff in the study gave informed consent, data was transcribed then analysed using thematic analysis. Preliminary findings: Findings to date reveal team processes important to team functioning to include: communication; team orientation, mutual performance monitoring, back-up behaviour, team leadership, mutual trust and a shared mental model. Conclusion: Clinical work is rarely simple and straightforward4, yet, for the major portion of the time patients are kept safe. Such work cannot always be mandated by policies, procedures, or standards alone and we can learn about how teams adapt by looking at this success…we do not need something to fix, in order to make change happen in healthcare. 1.

2.

3.

4.

Linda Govan and Jane Henty Australia’s health care system is facing unprecedented challenges, with increasing levels of chronic and complex disease, a rapidly ageing population, and a shortage of nurses. Innovative strategies are needed to address recruitment and retention issues in the primary health care nursing workforce. The Australian Primary Health Care Nurses Association (APNA) received funding from the Australian Government Department of Health under the Nursing in Primary Health Care Program to develop original models of clinical care delivered by nurses in primary health care settings. Integral to the three year Enhanced Nurse Clinics program is the selection of 11 agencies, who are developing innovative and replicable models of nurseled care. The 11 clinics are based in a range of primary health care settings and across metropolitan, rural and remote Australia – based on local population health needs. The paper is an exploration of the key characteristics of the nurse-led clinics and a discussion of the findings to date. Findings are derived from a literature review of nurse-led clinics, and in-depth interviews and surveys with nurses leading the clinics. The results have identified key structural barriers and enablers to commencing such clinics, and a provisional model of care for nurse-led clinics. The evaluation of the 11 clinics can be used to develop a framework for nurse-led care delivery in primary care. It will challenge traditional approaches to primary health care services, and offer a new approach, based on a nurse-led model of care.  

NSW Department of Health. WOW: Ways of working in nursing, resource package. North Sydney, NSW: NSW Department of Health, 2011. Fairbrother G, Chiarella M, Braithwaite J. Models of care choices in today’s nursing workplace: Where does team nursing sit? Australian Health Review 2015;39(5):489-93. Marks MA, Mathieu JE, Zaccaro SJ. A temporally based framework and taxonomy of team processes. Academy of Management Review 2001;26(3):356-76. Anderson JE, Ross AJ, Back J, et al. Implementing resilience engineering for healthcare quality improvement using the CARE model: a feasibility study protocol. Pilot and Feasibility Studies 2016;2(1):61

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MAKING CHANGE HAPPEN: IMPROVING HEALTHCARE WORKER VACCINE UPTAKE THROUGH A NURSE PRACTITIONER LED VACCINATION SERVICE

USING SIMULATION TO EVALUATE A PUBLICALLY FUNDED HOMEBIRTH SERVICE PRIOR TO COMMENCEMENT Tuesday 22 August 2017 3.50pm Session A – E  ntrepreneurs, Room A, Level 3

Louise Botha MACN Introduction: The use of simulation to evaluate new healthcare services, offers unique opportunities to observe, analyse and improve resourcing, whilst exposing systems issues that might otherwise go unnoticed. This promotes patient safety and generates cost savings in the short and long term. Recently, simulation teams have been involved in testing newly constructed healthcare facilities/services prior to accepting patients. Simulated events in the actual service (“in-situ” simulation) allow teams to practice responses to uncommon or catastrophic events. Aim: The purpose of the simulations was to identify clinical risks and patient safety issues in the provision of a new publically funded homebirth service prior to implementation of the new service. Discussion: 3 realistic birthing scenarios were delivered as simulated events. 2 were held in the planning for service phase and 1 was held immediately prior to first client being accepted into the service. Simulations were held in the home of a volunteer that fit the criteria relating to the catchment area for the service. The scenarios included both maternal and neonatal emergencies and sought to: assess deficiencies in resources, identify system issues, and assess communication with external agencies (Ambulance). Each scenario included transfer to hospital of mother, baby or both. Observers from specialities, quality and safety and external agencies were invited to attend and give feedback against the objectives. A consumer representative was present at the 3rd simulated event to offer valuable feedback from the “Patient” perspective. Issues: Despite these simulations being an activity related to process, rather than clinical ability, emotions and reflections on clinical ability were evidenced in the participants who were actively participating in the simulations Simulations will now form part of an ongoing opportunity for midwives to practice clinical emergencies. The simulations have assisted ACT to implement a safe home birth service that increases birthing options for women.  

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Tuesday 22 August 2017 4.15pm Session A – E  ntrepreneurs, Room A, Level 3

Madeline Hall MACN Context: Healthcare workers are at increased risk of contracting vaccine preventable diseases, and may also potentially transmit these diseases to other staff and vulnerable patients. Analysis: A literature review was undertaken which identified that compliance with healthcare worker vaccination recommendations is not always optimal, and a lack of convenient access has been cited in many studies as a barrier to vaccination of healthcare workers, particularly annual influenza vaccination. The use of dedicated staff or ‘champions’ to promote and encourage staff vaccination has been shown to effectively increase staff vaccination, either alone or in combination with other strategies. Factors influencing access were identified, including adequate supply and availability, financial affordability, socio-cultural acceptability, and organisational accessibility. Process: A Nurse Practitioner (NP) led Workforce Screening and Vaccination Service commenced at the Royal Brisbane and Women’s Hospital in April 2015, and strategies to increase access to staff vaccination that were identified in the literature review were also implemented. Outcomes: For the 2015 influenza season, there was an increase of approximately 15 percent in the number of staff receiving seasonal influenza vaccine, compared to the two previous years. Conclusion: Increased access to healthcare is a key reason for the formation of the NP role; the change to allocate a dedicated NP service to be responsible for healthcare worker screening and vaccination, in combination with other strategies, resulted in an increase in annual staff influenza vaccination. It is anticipated through this expanded scope of practice and increased access that compliance with other healthcare worker vaccinations and screening will also improve.  


AN EVALUTATION OF A MONTESSORI PROGRAM IN AN AGED CARE FACILITY IN REGIONAL VICTORIA

HOW NURSE EDUCATORS NEGOTIATE BOUNDARIES TO AFFECT INNOVATION AND CHANGE

Tuesday 22 August 2017 4.40pm Session A – E  ntrepreneurs, Room A, Level 3

Tuesday 22 August 2017 3.25pm Session B – A  cademia, Bistro 80, Level 2

Dr Wendy Penney MACN

Dr Robyn Fox FACN

Research provides clear evidence of decreases in agitation and increased levels of engagement and participation in activities when Montessori approaches are introduced to older people who have dementia or physical impairments. The implementation of Montessori as a model of care into an aged care facility in regional Victoria has changed the attitudes of staff caring for older people. Furthermore, the impact on residents and family has been profound. Using appreciative inquiry to conduct the evaluative research has revealed significant stories and ‘wow’ moments that has changed the lives of residents and re-energised staff who work in the facility. Registered nurses, enrolled nurses, patient care attendants, lifestyle coordinators and support staff who work in the facility were invited to participate in an individual 1:1 interview and a focus group meeting. During the semi -structured interviews participants were asked a series of questions aimed at exploring their understanding of the Montessori Program, what is working well and what change is required to improve the implementation. The evaluation reveals the impact of the change but more importantly what is required to sustain the momentum and embed Montessori philosophy into the organisation. This paper clearly defines the change management process that is needed as well as the organisational commitment required for success.

Research was under taken to explore the role of the public-sector hospital employed nurse educator in the Australian context as the research context was one of ambiguity surrounding this role in the development of a culture of learning in nursing (Forster, 2005). National and international literature provides evidence of lack of role clarity and variable role enactment.

An interpretative design was adopted with the theoretical tenets of symbolic interactionism informing data collection and analysis. A grounded theory approach of Corbin and Strauss (2008) using semi-structured in-depth interviews were undertaken. Data analysis led to development of the theoretical understanding of negotiating boundaries, which explains how nurse educators negotiated social, political and symbolic boundaries to establish order by which they were accepted as, a resource safety net, and a champion of practice standards within health care organisations. The concept of negotiating boundaries, presents a way of interpreting the world that offers an explanation of the complexities and tensions of the nurse educator role, and the implications for the role in fulfilling continuing education needs. As such, it has been applied with positive effect over the previous 18 months to energise, engage, and lead nursing and midwifery education services across a Hospital and Health Service comprising over five thousand nurses and midwives. Governance, models, plans, workshops and increased support processes have been implemented to enhance interaction, innovation, lessen duplication of effort, and reduce contradictory dimensions of the contemporary role of the nurse educator. This approach has resulted in increases in human, fiscal and physical resources. Additionally there has been articulated appreciation by the nursing and midwifery executive community of practice of the role, engagement, and service outcomes. This change has been coupled with increased sponsored opportunity to influence practice change, and foster engagement in scholarly pursuits, and a culture of ongoing learning.  

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AN EVALUATION OF STAFF TRANSITIONING FROM A COMBINED ADULT/CHILD EMERGENCY DEPARTMENT TO A NEW PAEDIATRIC EMERGENCY DEPARTMENT: A QUALITATIVE STUDY Tuesday 22 August 2017 3.50pm Session B – A  cademia, Bistro 80, Level 2

Alison Peeler, Professor Paul Fulbrook, Associate Professor Karen-Leigh Edwards and Dr Francais Kinnear Background: Provision of paediatric specific service areas within a hospital servicing both adult and paediatric populations is relatively novel. In Australia this is an emerging model for service delivery that takes into account the specific health needs of paediatric patients. To date, information related to the practice transition required by staff when adopting this model of care is lacking. Such information can contribute to informing service quality and identify staff perceived barriers and enablers during adoption of the model. The potential benefit of such knowledge is the early mitigation of issues and delineation of professional development requirements. The aim of this study was to investigate staff experiences of transitioning from an essentially adult emergency department with minimal paediatric presentations to a new co-located paediatric emergency department. Methods: A qualitative descriptive design was used. Semi-structured interviews were conducted with 18 emergency department staff (10 Nursing, 8 Medical) before and after the opening of the paediatric emergency department. Data were analysed thematically. Results: Five themes emerged from the data analysis, these were: 1) I am really scared that I won’t have the skills necessary, 2) Having a good knowledge base helps, 3) Open, transparent communication is definitely the best thing, 4) Personality plays an important role and 5) Perceptions regarding need to separate the services Conclusions: The findings demonstrated the complexity of the change process and highlights various factors that staff found contributed positively to the change process. These included the need for clear and open communication at all levels, focused educational opportunities, and employment of staff with a positive attitude towards change. Relevance to practice: Clear organisational communication and professional support are central components identified by staff to enable a more successful transition from one type of service to another. Keywords: Paediatric, emergency department, new services, change process, qualitative method.  

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ASSIST WITH SUSTANCE Tuesday 22 August 2017 4.15pm Session B – A  cademia, Bistro 80, Level 2

Jennifer Harland Screening and Brief Intervention for Nurses Background: The harmful effects of alcohol, tobacco, cannabis, amphetamines and other drugs well known. Nurses are ideally placed to identify substance misuse and provide brief intervention and / or a referral into specialist treatment. However, a review of the research evidence suggests that a lack of confidence and knowledge about substances, and the perceived time taken to administer a questionnaire are known barriers to screening for substance use. Using the principles of translation research, a team led by a Registered Nurse at the DASSA-WHO Collaborating Centre, University of Adelaide, have developed a interactive training resource specifically for nurses. The resource utilizes the Alcohol, Smoking and Substance Involvement Screening Test (ASSIST), developed by the World Health Organization, to guide nurses in starting a conversation about a person’s substance use and exploring options for change. Aims: The aims of this session are to: 1. Introduce participants to the ASSIST and resources. 2. Provide an overview of how the ASSIST can be implemented into a range of clinical settings. 3. Outline how administering the ASSIST and linked brief intervention can promote a positive change in a patients / clients life. Outcome: By the end of the session, participants will have an overview of the ASSIST and the benefits of providing a linked brief intervention. Summary: Nurses are ideally placed to conduct screening and brief intervention to identify substance use and intervene to reduce the associated risk and harms. This session will give participants the opportunity to enhance their knowledge, learn new skills and implement change in their practice.  


EXPLORING REMOTE AREA NURSES EXPOSURE TO RISK FACTORS FOR WORKPLACE VIOLENCE, WHAT CAN WE DO TO MAKE CHANGE HAPPEN? Tuesday 22 August 2017 4.40pm Session B – A  cademia, Bistro 80, Level 2

Jennifer Wressell MACN, Professor Andrea Driscoll and Associate Professor Bodil Rasmussen Workplace violence is a significant issue on the health industry with upto 80% of nurses experiencing verbal or physical assaults in the workplace (Clements et al, 2005). Workplace violence has a flow on effect across an organisation resulting in high levels of professional burnout, difficulty with recruitment and retention and decreased quality of care. At an individual level long term effects such as increased anxiety, depression and post-traumatic stress have been identified (Brown et al, 2011). A theoretical proposition of our study was that workplace violence is such a common occurrence in the health workspace that health professionals have become desensitised to both assessing risks and the effects of violence on self. In August, 2016 we collected data using a quantitative explorative descriptive design approved by Deakin University Human Ethics Committee. Exploring risk factors for external and client mediated workplace violence across the domains of environment, occupational and client characteristics (Anderson, Fitzgerald & Luck, 2010) allowed for a structure approach to risk factor identification. Our study explored exposure to these characteristics by 99 remote area nurses and health service managers working in remote health clinics across Australia. The research findings reflected wide spread exposure of nurses across environmental, occupational and client characteristics, which has created areas of interest for future research and possible approaches to make change happen into the future. As a profession we need to work together into the future to make change happen, creating a safe workplace and supportive organisational culture, a culture that recognises risk factors for workplace violence and minimises exposure.  

A RECIPE FOR CHANGE Tuesday 22 August 2017 3.25pm Session C – Education, Marquee Main Room, Level 2

Kristen Bull Background: In the past, haemodialysis units had to develop their own local education packages for new nursing staff. The level of renal nurse education was left to the discretion of the individual unit and did not promote a standardised state-wide approach. There had been several excellent documents produced but a need was identified by our South Australian Renal Nurses education group to have a single cohesive educational tool that would meet the requirements of both the metropolitan and country haemodialysis units across the state. As such, the renal education team have developed a standardised education tool for use across all haemodialysis clinical settings within SA Health. Aims: To implement the education tool to promote best practice guidelines and consistent haemodialysis education throughout the state whilst maintaining a record of participants’ progress. Methods: Local educational packages were analysed and assisted in the development and creation of a single haemodialysis education tool. The education tool is flexible, transferable, and easily adaptable to any haemodialysis clinical setting regardless of the geographical location, resources or patient population. Results: The standardised education tool was constructed and piloted for 3 months in a haemodialysis unit. Feedback was received from staff and industry consultation was achieved from multiple sources. The education tool was implemented state-wide in February 2015. Conclusion: The haemodialysis education tool allows the unit manager, student and educator to keep a written record of education received and more importantly can identify the individual educational requirements that remain outstanding throughout the induction process. The education tool serves to standardise the delivery and quality of education received by new haemodialysis nurses state-wide.

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DEVELOPING AN AGE FRIENDLY NURSING WORKFORCE: WHY RESIDENTIAL CARE PLACEMENTS ARE THE PLACE TO MAKE CHANGE HAPPEN! Tuesday 22 August 2017 3.50pm Session C – Education, Marquee Main Room, Level 2

Dr Heather Moquin and Dr Lorraine Venturato With the shift towards an increasingly older population, it is vital that undergraduate nursing students are well prepared to contribute to an age-friendly healthcare workforce. Despite this, persistent ageism within society and within heath care continues to negatively influence undergraduate nursing students’ interest in gerontology careers, making change in workforce capacity almost nonexistent in this area. We argue that residential aged care placements are increasingly important for undergraduate nursing education. Such educational potential is being explored within a partnership between the Faculty of Nursing, University of Calgary and a non-profit continuing care organization in Alberta, Canada. A participatory action research project is underway within this partnership to develop an undergraduate nursing placement program aimed at better understanding and enhancing student attitudes towards older adults and perceptions of working with older adults outside of the acute care sector. This presentation will detail students’ descriptions of the diverse influences and factors impacting and changing their perceptions of older adults while on placement. With an increasingly ageing population globally, and the trend in nursing students not choosing gerontology careers, it is important to better understand the diversity of factors informing and shifting students’ attitudes towards older adults. Such insights can hopefully open pathways to positive student experience on residential aged care placement and foster greater interest in gerontology careers.  

MAKE CHANGE HAPPEN: NURSES TEACHING NURSES Tuesday 22 August 2017 4.15pm Session C – Education, Marquee Main Room, Level 2

Carmen Marlow Nursing education is a fundamental means of revising existing knowledge, learning or updating skills, and delivering data-driven information, as well as a legal requirement to maintaining registration. The accessibility of multi-modal education programs to nursing staff is key to ensuring best practice and meeting optimal patient health outcomes. Effective nurses make a difference to patient’s lives, to communities and impact upon health outcomes nationally and globally. Understanding the patient experience throughout their multi-disciplinary healthcare journey can play a significant role in providing effective nursing care. Diagnostic and interventional radiology processes are one such specialty that calls for a collaborative model of care across nursing professions. In an effort to address an organisation-wide knowledge gap between radiology and wards, a nursing education program was created. The Barwon Medical Imaging (BMI) Communication and Visibility Program, was designed to answer the unit specific questions that arose from this complex care provision overlap. In place for over 14 months, the program delivers specialized in-services, and has seen significant improvements in communication, care abilities and a significant reduction in errors. Approximately 50 in-services have been delivered across 12 clinical units, reaching over 400 nurses, enhancing knowledge of radiology procedures and aftercare needs. Preventable complications can arise when information is omitted or inaccessible, hence, supportive and structured learning measures should be instituted broadly. Effective nurse-physician communication is also an essential component in achieving optimal patient health outcomes in a modern healthcare setting. Known nursephysician communication barriers include: historical attitudes towards collaboration, and lack of efforts to involve nurses in interdisciplinary ward rounds. Providing nurses with more information, support, resources, and opportunities can improve this communication, thereby directly impacting patient care capabilities. Addressing the areas of difficulty within this collaboration can facilitate achieving optimal health outcomes, improve job satisfaction and recognition for the nursing workforce.  

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MAKING PRACTICE DEVELOPMENT IN NURSING MORE SCIENTIFIC - MOVING FROM CREATING CHANGE TO PROVING CHANGE

MAKING CHANGE HAPPEN BY CONNECTING CARE TO PATIENT SAFETY Tuesday 22 August 2017 4.40pm Session C – Education, Marquee Main Room, Level 2

Tuesday 22 August 2017 3.25pm Session D – A  cademia, Bistro PDR, Level 2

Karen McLaughlin and Jenny Greig Description: This interactive connecting care with safety workshop has been developed to help nurses to link compassionate care with risk assessment and management to improve patient safety, particularly in the areas of falls reduction. Clinician safety is also explored by examining elements of self-care. This full day interactive workshop is being provided throughout Hunter New England Local Health District (HNELHD) in 2016-17. Participants are invited to define compassionate care and identify what it looks like on a personal and professional level. Real patient stories are used to demonstrate the need for effective communication and the direct impact this has on patient safety. Falls prevention is highlighted and communication tools such as patient care boards, hourly patient rounding, risk assessment documentation, clinical bedside handover and safety huddles are discussed and demonstrated. Clinical scenarios are role played and participants encouraged to practice their communication skills. A connectivity exercise invites participants to identify how all of the aspects of patient safety are linked to compassionate care and communication. Summary: To date 69 clinicians have participated in the workshop and overwhelmingly positive feedback has been received. Participants felt that the workshop highlighted the connection between compassionate care and improved patient safety. They felt that the importance of communication and self- care in the provision of safe clinical care was demonstrated and empowered them to influence practice change. They felt able to implement these changes immediately and influence others to reflect on their current practice. Conclusion: These workshops will continue to be facilitated across the HNELHD and will be contextualised to specialty areas such as Maternity, Paediatrics and Mental Health. A reduction in patient falls and an increase in the effective use of communication tools has been identified across HNELHD.  

Dr Greg Fairbrother and Claudia Green MACN Practice development (PD) approaches are today important drivers of positive patient and family-centred practice and work culture change at unit level in Australian nursing and midwifery. Until now, most PD work has not placed a strong emphasis on building scientifically strong study designs into the PD change process. In our capacity-building roles in the Sydney LHD, we increasingly find that our experiences of working with clinical practice developers in making their activities more evidentiary, yields many ‘within-project’ advantages, as well as positioning projects as potentially evidentiary. The development of a framework which enables a stronger research design footing for PD work has become a strategic priority for Sydney LHD Nursing & Midwifery. PD work consistently yields some of the most interesting and potentially ground-breaking thought-trails – many of which go on to become innovative projects. The reason for this may be that PD explicitly offers a structured process which is values-centred and which supports whole-team culture and local context. Because PD is such a strong means of throwing up new ideas, the need for evidentiary designs around such work is paramount – as without these, the ideas (even if realised in practice locally), will never find their way into the published literature and will hence be lost to the nursing knowledge development train. Our presentation will propose a process for the routinized marriage of PD activity with scientific study design, and draw on case study examples from the Sydney LHD, to illustrate the potential of this approach to not only making change happen, but also proving that change has happened. With ‘proof’ comes generalisability and a much larger potential to spread and share nursing innovation.  

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DEVELOPING NURSE LEADERS TO INFLUENCE CHANGE IN PRACTICE: CAPACITY BUILDING IN TIMOR-LESTE

ENGENDERING A CULTURE CHANGE IN AGED CARE FACILITIES: AN INTEGRATED MODEL OF CARE

Tuesday 22 August 2017 3.50pm Session D – A  cademia, Bistro PDR, Level 2

Tuesday 22 August 2017 4.15pm Session D – A  cademia, Bistro PDR, Level 2

Ben Dingle, David Ramsay, Catherine Birrell, Catherine Gillespie and Lance Wade Jarvis Timor-Leste is a young country with a troubled history, only gaining full independence in 2002. It still has significant advances to make in its infrastructure, not least of all in healthcare. Since 2004, St John of God Health Care has had a presence at the National Hospital in Dili in pathology and nursing from 2010. As part of our approach to address leadership and management capability we developed a Health Manager Program for emerging and established nurse (and other hospital) leaders, which not only provided participants with knowledge and skills, but prompted them to undertake quality improvement processes as part of their course-work, thus enabling change in practice within whole units. Fifteen Hospital Managers including 9 Nurse Unit Managers participated in the 2016 pilot course. They undertook 3 blocks of 3 days of interactive training over 10 months and were required to complete workbook activities and give presentations on the progress of their quality improvement projects. Projects included the development of a bedside handover at the change of each shift in a medical unit, improving medication safety by storing and administering patient medication from bedside cabinets in gynaecology, and addressing staff punctuality in the hospital’s paediatric unit. Participants of the course were encouraged to utilise the skills learned in the course to further the progress of their project over the 10 months. These included discovering your leadership style, change management, quality improvement, identifying clinical risk, ethical decision making, patient focused care, communication strategies (including performance management conversations) and developing the team. The course has assisted in making measurable change happen across multiple units as nurse leaders grow in their ability and confidence to lead progress. Developing leadership as part of the SJGHC Social Outreach capacity building approach has been significant in advancing care at the national hospital of Timor-Leste.  

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Kerry Turnbull MACN and Leigh Darcy Introductory Sentence: This integrated model aims to change Residential Aged Care Facility (RACF) staff perceptions of the right place of care as customary RACF practice is to transfer unwell residents to the Emergency Department rather than care for them at home in the facility. Research: Evaluation of this service shows a significant reduction in Emergency Department (ED) presentations, admissions and hospital length of stay, and more efficient use of NSW Ambulance resources. Summary: Research has shown that residents of RACFs experience less complications if cared for in house when they become ill. However, the shifting nature of the workforce within RACFs can hamper implementing and embedding practice change, thus requiring a multifaceted change approach to achieve the right care at the right time in the right place. This service works on the premise that with education, empowerment and support RACF staff can manage low acuity illnesses or end of life issues in house rather than transfer the resident to the ED. Engagement of managers occurs through access to best practice clinical algorithms; 24/7 staff support and education; alignment with accreditation standards; a community of practice to showcase updates and innovations and a place to network and discuss industry concerns. This is an integrated model where all stakeholders involved in the care of the unwell resident actively work on building respectful communication and relationships to keep the resident as safe as possible. Change champions include not just RACF management but also General Practitioners, Practice Nurses, Paramedics and ED staff. Conclusion: Stakeholders working together to embed change through an integrated approach has produced a highly successful model that achieves the right care in the right time at the right place for residents of aged care facilities.  


A SHARED RESPONSIBILITY FOR PROFESSIONAL STANDARDS AND SAFE CULTURES AND SYSTEMS - WORKING TOGETHER TO MAKE CHANGE HAPPEN – THE ROLE OF THE REGULATOR AND OTHERS

CONCURRENT SESSION FOUR UTILISING TECHNOLOGY TO MAKE CHANGE HAPPEN IN HEALTHCARE Wednesday 23 August 2017 10.45am Session A – E  ntrepreneurs, Attic, Level 3

Tuesday 22 August 2017 4.40pm Session D – A  cademia, Bistro PDR, Level 2

Dr Maragret Cooke MACN and Adjunct Professor John Kelly This presentation will explore the importance of professional standards, safe cultures and systems to prevent and minimise harm to patients (and to health practitioners). It will clarify the role of regulators and in particular, the Nursing and Midwifery Council in influencing and working with others to achieve this common goal. The Council manages complaints about individual nurses’ and midwives’ performance health and conduct. In the last five years, there has been a philosophical change from being reactive to these complaints to being more proactive and preventative. The Council aims to facilitate practitioner engagement with professional standards and to encourage the practitioners to consider their role in maintaining safe practice and safe cultures. De-identified exemplars of the work of the Council during the management of complaints will be provided to illustrate this. How individual nurses, service providers and nursing organisations currently assist in this process will be discussed. The challenges for the Council in influencing change, when potential cultural and system issues are identified, will be explored. It is critical that the Council identifies innovative strategies of working in partnership with others to share intelligence, influence and when appropriate providing support or leadership. Part of this is being aware of the Council’s functions and its span and reach as well as acknowledging the strengths, expertise and resources of strategic partners.  

Danielle Miller and Brianna Zink Health information technology offers hospitals a means to manage labor costs better by leveraging the data collected through their electronic medical records that drive clinical staffing and clinical assignments and delivers superior clinical and financial outcomes. Objectives: Identify the current uses of technology and how technology will affect clinical practice. Understand the advantages of using technology in the healthcare arena. Demonstrate an understanding of innovation tools used to improve patient safety and support best outcomes. GRASP methodology has been successfully implemented in every clinical department and support service. This evidenced based data can assist a facility with developing instruments reflective of the care required by the patient and being provided in their organization. GRASP methodology is automated and updated regularly to produce meaningful reports essential to the decision-making process. The methodology has been used prospectively and retrospectively, to capture workload statistics for different purposes. Organizations have a means to capture workload to meet organizational needs. Simplifying how care is organized: -Staffing workload analysis -Optimize staffing efficiency -Customizable reports on utilization Provide Patient centered focus: -Accurate information on patients -Visibility on industrywide interventions -Provide care based on the individual needs of the patient, not diagnosis Patient acuity and nurse staffing systems enhance patient safety and quality of care as well as provide an analysis of the transactional data collected during their use. Understanding the clinical needs of each patient, the systems tally up the workload requirements for patients and match those requirements to the workload capacity of each nurse. Analysis of that data offers insight into processes and delivered workflow to identify potential areas for process improvement. Utilizing the innovations in technology can provide clinical decision support to nurse leader that can be used to improve patient outcomes, increase patient and employee satisfaction and provide care in a cost effective manner.  

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TRANSITION TO AN ENTREPRENEURIAL MIND-SET IN PROFESSIONAL PRACTICE – USING IN-HOUSE EDUCATION TO CREATE A CULTURE OF OPPORTUNITY RECOGNITION AND INNOVATION

HEALTH ASSISTANTS IN NURSING MAKING CHANGE HAPPEN: REDUCING PRESSURE INJURIES, INNOVATION FROM WITHIN Wednesday 23 August 2017 11.35am Session A – E  ntrepreneurs, Attic, Level 3

Wednesday 23 August 2017 11.10am Session A – E  ntrepreneurs, Attic, Level 3

Dr Lois Hazelton and Emeritus Professor Murray Gillin Entrepreneurship is now a topic of conversation in the broader domain. It is increasingly acknowledged that entrepreneurial leadership encourages entrepreneurial behaviour and an entrepreneurial culture supports the development of innovations. The associated development of an ‘entrepreneurial mindset’, or a way of thinking about opportunities that surface in an organisation’s internal and external environments is relevant to nursing leadership and the challenge of leading for effective and contemporary change. The development and use of ‘tailored’ in-house education to engender an active innovation culture within health organisations is presented.

Patrick McCrohan and Jo Mapes MACN Introduction: The power to innovate from within an organisation is often one of the most undervalued and under-utilised tool at the disposal of organisational leaders. Often the best solution costs nothing. Description: At Eastern Health, one of Melbourne’s largest metropolitan public health services, it was evident that pressure injuries were an ongoing organisational wide problem. Incidences of pressure injuries were remaining high especially in the general medicine and continuing care programmes, despite a focussed prevention effort in this area. Between the four months May through to August 2016 there were 14 incidences of Pressure Injuries acquired in care recorded on general medicine ward 6.1. With no apparent cause for the spike in incidences the ward decided actively strive to improve results with ideas from within. With no extra funding for additional equipment (e.g. air mattresses) the ward had to utilise all available resources. With no additional staffing and an increasingly complex patient workload the Nurse Unit Manager and the Health Assistant in Nursing (HAN) decided to work together and developed a strategy to improve pressure injury incidence and prevention. Every morning at the start of shift the HAN liaises with the Nurse in Charge of the ward to identify the patients that are identified as high risk of developing pressure injury or at high deteriorating pressure injuries. The HAN then incorporates frequent turning and pressure area care for these patients in conjunction with the nursing teams throughout the shift, and drives this as a care priority. What started as a new concept has become part of the HAN’s standard daily work. In the four months following the introduction of this strategy there have been only two incidences of pressure injuries. This is without any extra resources or funding. Conclusion: We cannot change the direction of the wind, but we can adjust our sails to reach our destination. The demands of this cohort of general medicine patients may not change, but we can change our practices to ensure that we continue to deliver the best care possible and reduce any harm in our care. Through ownership of our issues and a passion to improve we can make change happen.  

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A FRAMEWORK FOR SUPPORT - THE DEVELOPMENT OF A PROFESSIONAL GOVERNANCE FRAMEWORK FOR NURSES AND MIDWIVES AT THE SYDNEY CHILDREN’S HOSPITALS NETWORK Wednesday 23 August 2017 10.45am Session B – A  cademia, Room A, Level 3

Debra Cutler MACN and Melissa Mroz Introduction: Governance structures are critical to ensuring that organisations meet their professional and legal requirements. The amalgamation of The Children’s Hospital Westmead, Sydney Children’s Hospital Randwick, the Newborn Emergency Transport Service (NETS) and the Perinatal Services Network (PSN) to form the Sydney Children’s Hospitals Network (SCHN) necessitated a comprehensive review of the professional reporting lines for all nurses and midwives. This project aimed to clarify and define the professional reporting lines for nurses and midwives and to develop a supporting professional governance framework for nurses and midwives. Description: Professional reporting lines were identified and mapped from front line staff to the Chief Executive level. Additionally, a supportive framework was developed outlining the role of governance and linking to the Nursing and Midwifery Board of Australia’s standards for practice as well as the Australian Commission on Safety and Quality in Healthcare (ACSQHC) National Safety and Quality in Healthcare (NSQHS) Standards 2012. A process of wide consultation was undertaken with nursing and midwifery staff from across the network who were provided with the opportunity to review and comment on the newly developed SCHN Professional Nursing and Midwifery Governance Framework prior to endorsement by the Network Director of Nursing, Midwifery and Education and the Chief Executive. Senior medical and allied health staff were also invited to review and comment on the framework. Summary: Via a process of consultation and collaboration, a Professional Nursing and Midwifery Governance Framework was developed for the SCHN. The framework recognises the SCHN’s purpose, its legislative, policy and ethical obligations, as well as its workforce and employment responsibilities. Additionally, it supports the organisation’s CORE values and structures and is underpinned by the seven governance standards for organisations in a health portfolio. The framework supports professional governance and outlines the organisational structure and legislative requirements for the SCHN nursing and midwifery community.

MENTAL HEALTH DAY’ SICKNESS ABSENCE AMONGST NURSES AND MIDWIVES: FINDINGS OF THE “FIT FOR THE FUTURE” STUDY Wednesday 23 August 2017 11.10am Session B – A  cademia, Room A, Level 3

Professor Lin Perry MACN, Professor Christine Duffield FACN, Professor Robyn Gallagher MACN, Professor David Sibbritt and Scott Lamont Background: Occupational stress affects 45.5%-60%1,2 of nurses and is increasingly recognised as a major risk for poor health3 and absenteeism. Taking a ‘mental health day’ (MHD) is anecdotally common but little studied4. Examination of the workplace, workforce, psychosocial and health characteristics of nurses and midwives in relation to their self-reported use of ‘MHD’ sickness absence may indicate ways to make change happen to improve workplace wellbeing and reduce sickness absence. Methods: A cross-sectional web-based survey was employed to collect data on nurses’ work, health and health-related behaviours between June 2014 and February 2015, delivered to members of NSW Nurses and Midwives Association and snowballed through the NSW nursing workforce. The questionnaire comprised demographic, workforce and general health and well-being items from established tools5. Summary Findings: Of 5,041 respondents, 54% reported taking MHDs. Findings demonstrated consistent and significant differences, with those reporting MHD more likely to report poor to fair general health, a battery of symptoms linked with poorer mental health, some form of lifetime psychiatric diagnosis and current psychotropic medications. Using multivariate logistic regression to take account of all characteristics, those who took MHDs were significantly more likely to have experienced workplace abuse, to be younger, work shifts or be current smokers. They were more likely to report recent common mental health diagnosis and current psychotropic medication use. They more often reported accomplishing less than they desired due to emotional problems and plans to leave their current job within twelve months. Conclusion: Nurses taking MHDs were more likely to report suboptimal health, wellbeing and work performance. Organisations and managers can use this information to identify early those showing high risk characteristics and make changes to support these nurses, to create cultures that embrace proactive and supportive intervention and address, where possible, the source problems underpinning absenteeism.

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Funding for this study was provided by the Australian Research Council and the New South Wales Nurses and Midwives Association. References: 1.

2. 3.

4. 5.

Al-Makhaita et al. (2014) Predictors of work-related stress among nurses working in primary and secondary health care levels in Dammam, Eastern Saudi Arabia. J Fam Comm Med 21(2), 79. Buerhaus et al. (2006) State of the registered nurse workforce in the United States. Nurs Econ, 24(1), 6. Ebert et al. (2014) Efficacy of an Internet-based problem-solving training for teachers: Results of a randomized controlled trial. Scand J Work Environ Health, 40(6), 582-96. Hall, L.M. (2005) Quality work environments for nurse and patient safety. Jones & Bartlett Learning. Perry et al. (2016) Does nurses’ health affect their intention to remain in their current position? J Nurs Manag 24 (8):1088-1097

RESEARCH FOR CHANGE: HOW RESEARCH CAN HELP ORGANISATIONS AND COMMUNITIES DEVELOP AND ADAPT IN THE 21ST CENTURY Wednesday 23 August 2017 11.35am Session B – A  cademia, Room A, Level 3

Dr Lorraine Venturato MACN and Dr Suzanne Goopy It is said that change is the one constant in society today. This is certainly true in health care, where there is an increasing focus on change as synonymous with progress. But what drives change? or perhaps more importantly, who drives change? And how do we know that we are changing the right things? This masterclass will explore different types of change and the increasing prevalence of academic - service partnerships in driving and supporting change in units, organisations and communities. We will draw on our recent experience working with different groups in Australia and Canada to present three exemplars of partnered research that serve to drive change and that foster creativity and innovation. These exemplars use a variety of research methods in studies as diverse as enhancing death and dying in long-term care and public transit and walkability for healthy communities. What these projects have in common is a partnered approach to conception and delivery, and a collective sense of ownership by all partners. We will argue that partnered research can play an essential role in helping individuals and groups understand and identify opportunities for meaningful change that captures the imagination of staff and bridges the gap between research and practice. Indeed, at the community level, we will argue that it is a positive way forward for engaging with and fostering healthy communities.

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A CHANGE IS ON THE WAY - BUILDING LEADERSHIP CAPABILITY THROUGH CONTEMPORARY GOVERNANCE MODELS

USING CONTEMPORARY RESEARCH AND DATA TO INFORM NURSING AND MIDWIFERY POLICY Wednesday 23 August 2017 10.45am Session C – E  ducation, Bistro 80, Level 2

Tanya Vogt The Nursing and Midwifery Board of Australia (NMBA) regulates nurses and midwives who are registered to practise in Australia. The Code of conduct for nurses and the Code of conduct for midwives (the Codes) are part of the professional practice framework developed by the NMBA. The Codes set out the principles of professional behaviour that guide practice, and clearly outline the conduct expected of nurses and midwives by their colleagues and the broader community. This presentation shares the outcomes of the project the NMBA undertook in its first full review of the Codes since 2008. The project maximised the opportunity to contemporise the Codes using research led strategies and risk-based regulatory approaches. The research led strategies to inform the review of the Codes included a comprehensive review and analysis of national and international literature, interrogation of the internal database of notifications (complaints) made with respect to nurses and midwives on conduct, behaviour and boundaries, and a qualitative study using a series of focus groups with nurses, midwives and health consumers. The outcomes from the research led strategies identified practice, conduct and behaviours that needed to be included in the Codes which reflect the dynamic change in the roles, contexts and scope of nursing and midwifery practice. The revised Codes set out the legal requirements, contemporary professional behaviour and conduct expectations of nurses and midwives, with a focus on the identification of good conduct and professional behaviour exemplars, and also articulate specific aspects of conduct that is not acceptable.  

Wednesday 23 August 2017 11.10am Session C – E  ducation, Bistro 80, Level 2

Linda Davidson MACN, Lynne Bickerstaff MACN and Michelle Sirrat Contemporary leadership is ever changing and is likened to riding the white water rapids. Nursing and Midwifery leadership can be steeped in tradition, history and industrial frameworks making status quo a comfortable place. The result of this level of comfort is low turnover and long standing managers. The impact is a nursing workforce disengaged and disconnected from contemporary nursing leadership paradigms. Leadership models require strong governance structures and communication links to ensure vision, direction and objectives are clear. Engagement and dissemination of organisational strategies, goals and outcomes are imperative to achieve success. At LHS a review of the governance structure was undertaken highlighting meetings lacked direction, consistency and an absence of alignment to organisational or professional objectives. Similarly, the nursing and midwifery leaders undertook reflection regarding their leadership acumen and future focus. Literature was searched, models investigated and it was agreed that a shared governance model of leadership was required to ensure that decisions relating to nursing and midwifery practice/ policy was driven through a contemporary model. The concept of a Nursing and Midwifery Council (NMC) started monocular but was shared by some of the leadership team. The lens was widened through further brainstorming and collaboration in determining what ‘shared governance’ would look like. The vision grew as clinical nurses and midwives started hearing about the NMC. All levels of nursing and midwifery were represented. In the first 12 months of operation there have been and the change has been a little uncomfortable as the new look leaders decide what should happen. To date the challenges for the new governance structure and a shared governance strategy is the usual ‘change’ reaction. The most interesting observation so far has been the discomfort many have felt when the numbers of meetings were reduced. The comfort was restored as the achievements or actions closed in these meetings over a period of time determined that there was more value in less ‘meeting’ time and more ‘action’ time. We are still in a ‘novice’ state of our journey to ‘expert’ and our learnings are many and varied.  

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HOW DATA CAN TRANSFORM PRACTICE: USING PRESSURE INJURY PREVALENCE SURVEYS IN PRACTICE TO IMPROVE THE QUALITY AND SAFETY OF NURSING CARE Wednesday 23 August 2017 11.35am Session C – E  ducation, Bistro 80, Level 2

Dr Jenny Sim MACN, Dr Joanne Joyce McCoach and Lucinda Dunstan Pressure injuries can be a significant negative outcome from hospitalisation. Pressure injury prevalence has been estimated to be between 3 and 37% within Australian health care settings (Prentice et al. 2003). The prevalence rate of pressure injuries varies significantly in different studies and care settings (Nguyen et al. 2015). This presentation describes how pressure injury prevalence studies conducted as part of data collection for the Australian Nursing Outcomes Collaborative (AUSNOC) have been used to transform practice and improve care for patients in an acute hospital in NSW, Australia. The data obtained from a pressure injury prevalence study conducted in October 2016 was confronting to staff due the high prevalence of hospital acquired pressure injuries identified in the survey. Data from the survey was used to drive change and improve care practices in 3 wards. As a result of these practice improvements significant changes have occurred in ownership of, engagement with and outcomes associated with hospital acquired pressure injuries in participating wards. This presentation will present data from pressure injury prevalence surveys taken initially and then following the practice improvements. This project describes the pressure injury prevalence survey methodology, the participatory action research methodology used in the practice improvement process and data from before and after the practice improvements. Attendees will gain information about how they can make change happen in their care setting and the importance of data in the change management process.  

MEASURING CONTEXT NOT JUST CLINICAL INCIDENT NUMBERS; CHALLENGING ASSUMPTIONS TO CHANGE THE SYSTEM Wednesday 23 August 2017 10.45am Session D – I ndustry, Bistro PDR, Level 2

Clinical Adjunct Professor Kath Riddell MACN Introduction: Understanding clinical performance is an imperative for all health services in order to identify gaps, action improvements and ensure optimal patient outcomes. A large Victorian metropolitan public health service identified an unacceptably high level of hospital acquired pressure injury. Many pressure injuries are considered to be preventable and those which are hospital acquired are acknowledged as a risk to quality and safe patient care (Australian Commission on Safety and Quality in Health Care, 2011; Chaboyer et al., 2015). Discussion: Development of pressure injury is generally perceived as a deficit in nursing practice. It was hypothesised that patients’ were mobilising less frequently as a result of focused campaigns to reduce patient falls. Anecdotal reports suggested that driving nursing decision making was a desire to keep patients safe as time limitations preventing them from providing adequate supervision to patients who were not independently mobile. Was this really the case? Had nursing staff divested this responsibility to their allied health colleagues? Across the health service a specialist team coordinated a Pressure Injury and Mobility Point Prevalence Survey (PIMPPs). In total 662 patients in both acute and subacute facilities received a skin check, with patient’s given the opportunity to ‘opt out’ if they did not wish to participate. All patients identified as having a pressure injury received a more thorough assessment which included a patient interview and examination of all clinical documentation. The findings confirmed a high prevalence of pressure injuries, 9%, of which 68% were hospital acquired. However, there was no association between a patient’s mobility and having an acquired pressure injury, suggesting that appropriate prevention strategies were being used. There were also some unexpected findings which included lack of patient engagement and a failure to identify patients at greatest risk, as evidenced through risk rating tools. Conclusion: The PIMPPs exercise highlighted the requirement to examine the full context of patient incident data. Improvements strategies are now focusing on the identification of patients at risk, integration of risk assessment tools and new ways to engage patients and carers in education about optimal skin management and pressure injury prevention.

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REDUCING AVOIDABLE AMBULANCE PRESENTATION IN EMERGENCY Wednesday 23 August 2017 11.10am Session D – I ndustry, Bistro PDR, Level 2

Nadia Yazdani and Rosalyn Ferguson MACN NSW Ambulance and GRACE (Geriatric Acute Care Evaluation) team at Hornsby Ku-ring-gai Health Service (HKHS) has developed and implemented a simple low cost mechanism taking advantage of already available resources in the local health district to streamline patient presentations to the ED (Emergency Department) with sub-acute or chronic health issues. This mechanism allows the GRACE team access to the booking icon alert when an ambulance is booked for response to RACFs (Residential Aged Care Facility) in the area. As a result of this innovation we have achieved an additional 15% reduction in unnecessary hospital presentations.  

CHANGING CARE OF THE ELDERLY IN RACFS AND EDS: THE CEDRIC PROJECT TOOLKIT IMPLEMENTATION Wednesday 23 August 2017 11.35am Session D – I ndustry, Bistro PDR, Level 2

Colleen Johnston, Kaye Coates, Andrea Taylor, Dr Alison Craswell MACN and Dr Marc Broadbent Geriatric care is a specialty field and the unique needs of the elderly are often unmet leading to adverse outcomes, including potentially avoidable hospital presentation and prolonged admission. The Care coordination through Emergency Department, Residential Aged Care and Primary Health Collaboration (CEDRiC) project had two interconnected components: The Health Intervention Program for Seniors (HIPS) in one residential aged care facility (RACF) and the Geriatric Emergency Department Intervention (GEDI) situated in a hospital Emergency Department (ED). HIPS aims to provide primary care in the RACF by utilising an onsite Nurse Practitioner Candidate (NPC) to deliver an advanced level of care to residents in collaboration with the General Practitioner (GP). GEDI provide a dedicated, single point of contact for all people aged 70 years and over, including residents from an RACF for: rapid review on presentation to identify people with highest need; provide targeted assessment, streamlined patient flow, clear and timely inter-sectoral communication, focused transition planning and ongoing health professional education and training. Although each can be implemented as a standalone service, CEDRiC research demonstrates that in combination, HIPS and GEDI can improve health outcomes of older people by: providing advanced care in the RACF to avoid unnecessary hospital presentation or admission. This strengthens the capacity of the ED to deliver high quality, appropriate care for older adults and improves interaction between the RACF, primary and secondary healthcare sectors. This presentation introduces an Implementation Toolkit, designed to outline the process for facilities to establish the CEDRiC model of care including a comprehensive overview, strategies and tools for organisational change.

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LIST OF POSTERS 1. Nurse Managers' perceptions of simulated learning to address clinical training in the workplace: An examination of the barriers and enablers Louise Botha MACN 2. Engaged? or "It's complicated" Dianna Burr MACN 3. Postgraduate curriculum development for paediatric emergency nurses Jane Clark MACN 4. Exploring patients' knowledge of their cardiovascular risk factors Susie Corby MACN 5. Viability of Nursing/AIN to Resident ratios in Residential Aged Care Facilities (RACF) within the current Aged Care Funding Instrument (ACFI) Andrew Dean MACN 6. The Refugee Health Early Childhood Nurse Program – why a change HAD to happen! Sandy Eagar FACN, Angii Higgins, Susan Passey and Sarah Marsh 7. Nurses leading the way to make change happen for women with breast cancer Professor Karen-leigh Edward MACN, Dr Mitchell Chipman, Jo-Ann Giandinoto MACN, Kayte Robinson and Dr Roth Trisno 8. Make Change Happen: Organising nursing Marilyn Gendek FACN 9. Make Change Happen: International placements as legitimate learning experiences Pauline Hill MACN and Dr Wendy Abigail

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VOTE FOR YOUR FAVOURITE POSTER VIA PIGEONHOLE LIVE! 10. Volunteering in dementia care in the acute setting: A way for the future? Alicia Hurst MACN, Dr Elisabeth Coyne MACN, Dr Ursula Kellett and Dr Judith Needham MACN

18. The NMHP Champion Program; promoting a healthy nursing and midwifery workforce through a professional peer-based training model Glenn Taylor MACN and Natalie Spencer

11. Making compassion happen: combatting compassion fatigue Samantha Jakimowicz MACN, Professor Lin Perry MACN and Dr Joanne Lewis MACN

19. SCHN Evaluation: harnessing the power of now to ensure the sustainability of change Shaun Thompson, Sarah Coye and Simone Nast-Clarke

12. Graduate Clinical Facilitator Support Service: An evaluation of service Renee Langridge

20. ED revisits revisited: Identifying a role for nurse-led services Wayne Varndell MACN, Professor Lin Perry MACN, Sarah Lyons and Karlie Clark

13. The Drop-in-Support-Centre: Connecting with academic support, study buddies, and more... Marian Martin MACN, Dr Yenna Salamonson, Dr Paul Glew MACN, Dr Bronwyn Everett MACN and Dr Lucie Ramjan MACN 14. Is the cost of caring too high? Catelyn Richards MACN 15. The Australian Nursing Outcomes Collaborative: Using data to improve the quality & safety of nursing care Dr Jenny Sim MACN, Dr Joanne Joyce McCoach, Dr Rob Gordan and Professor Patrick Crookes MACN 16. Moving ALS Education from Theory to Simulation – Challenges of change in a rural setting Kim Stevens MACN and Andrea Flenley MACN 17. Collaboration leads to successful change in Pacific Island countries Sally Sutherland-Fraser MACN and Menna Davies FACN

21. From "I am just a student" to "we made change happen"; how one student group became a catalyst for change Suzanne Lee VolejnikovaWenger MACN 22. Learning to nurse in the international setting Jackson Vukovic MACN 23. Early engagement in schools to promote a career in health Karen Webster MACN and Jessica Staunton MACN 24. Genomic literacy of registered nurses and midwives in Australia: A cross-sectional survey Helen Wright MACN, Dr Lin Zhao, Professor Melanie Birks FACN and Professor Jane Mills 25. Cognitive impairment – making change happen for a new model of care Brendan Zornig MACN, Angelka Opie, Monica Davis, Bianca Johnston, Tinika Lewin and Meryl Banister


POSTER ABSTRACTS Delegates will have the opportunity to view posters and meet the authors on Tuesday 22 August from 8:00am - 8:45am and during the morning tea break. Authors will be available at their posters to answer any questions. Delegates are requested to cast their votes for the best poster on Pigeonhole Live. 1. NURSE MANAGERS' PERCEPTIONS OF SIMULATED LEARNING TO ADDRESS CLINICAL TRAINING IN THE WORKPLACE: AN EXAMINATION OF THE BARRIERS AND ENABLERS Louise Botha MACN Introduction: Simulation is recognised as a safe and effective way to teach healthcare practitioners. In Australia, there has been a renewed focus in the last decade on both increasing the use of simulation modalities and generating evidence to support continued increase in the use of simulation with a focus on undergraduate healthcare students. Survey data collected by the researcher identified that nurse educators would like to adopt simulation modalities in the work place but lack training in a variety of aspects of simulation to do so. They further identified a perceived lack of support from managers to do so. There is evidence on the challenges academics face when implementing simulation but it is unknown whether nurse managers in the clinical setting experience the same challenges in implementing simulated learning activities. Methods: This was a qualitative study using semistructured interviews conducted with nurse managers working in the public sector. Results: Three themes identified barriers to using or increasing the use of simulation in the clinical environment and relate to infrastructure and resources, realism in simulation and concern regarding the potential dangers in simulation. Three themes identified enablers that facilitate the use of simulation include linking to key strategic objectives of the organisation, having a lead to guide others and access to equipment and education. Discussion: The study provides insight into practices that promote managers to support using simulation in the public health sector and allows for an examination into obstacles encountered. These findings are important if the region is to expand the simulation capability within health service organisations in the next five years. Conclusions: The implementation and continued use of simulation modalities is complex within a health service and requires a well-planned approach to the delivery of sessions together with appropriate understanding and support for educators to do so.

2. ENGAGED? OR "IT'S COMPLICATED" Dianna Burr MACN Anecdotal reports from nursing academic colleagues at the Rural School of Health at La Trobe University in Victoria describe undergraduate nursing students who have previously studied the Diploma of Nursing at Wodonga TAFE as contributing to their enjoyment of teaching. This study examines the perceptions of student engagement by nursing academics at the Rural School of Health La Trobe University with undergraduate Bachelor of Nursing students, and whether particular characteristics of different cohorts of students contribute to levels of engagement and the enjoyment of teaching. Mixed methods qualitative phenomenography was used for this study. An anonymous online survey issued to a potential cohort of 26 nursing academics at the Rural School of Health La Trobe University, based on a framework of engagement designed by Sharon Pittaway (2012), together with follow up telephone interviews with 5 nursing academics, provided rich qualitative data. Analysis of the data showed that nursing academics perceptions of engagement and enjoyment of teaching is related to particular student characteristics, and particular cohorts of undergraduate Bachelor of Nursing students. This study indicates that students’ recent prior exposure to higher education, particularly the Diploma of Nursing, is perceived to greatly contribute to high levels of engagement with the course which directly impacts nursing academics enjoyment of teaching. It also agrees with the established literature on levels of engagement, in that first year students are minimally engaged with the course and learning, whereas mature age students with previous higher education experience show high levels of engagement with the course and their learning. What can be learned from this study is that students who undertake the Diploma of Nursing and subsequently articulate to the Bachelor of Nursing are perceived to be well prepared for studies in higher education; they are also perceived to be more fully engaged in learning.

 

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3. POSTGRADUATE CURRICULUM DEVELOPMENT FOR PAEDIATRIC EMERGENCY NURSES

4. EXPLORING PATIENTS' KNOWLEDGE OF THEIR CARDIOVASCULAR RISK FACTORS

Jane Clark MACN

Susie Corby MACN

Introduction: An interest in this phenomena developed from the lack of courses available in both Australia and Finland to for those wanting to specialise in a Master of Nursing (Paediatric Emergency Nursing). A review of the literature identified a gap between what guiding bodies and organisation recommend for training and the current opportunities.

Research was undertaken to establish the level of knowledge patients’ have of their risk factors for cardiovascular disease.

Aim: To identify key content areas for curriculum development of a specialist paediatric emergency nursing and critical care programs for Finland in the future. Methodology: Developed a training needs assessment instrument. Conduct a cross sectional pilot study of the instrument. Results: This study developed an instrument that could be adequately used to identify the future directions of paediatric nursing curriculums. The elements of curriculum most informed by the Paediatric Nursing Training Needs Analysis (Emergency & Critical Care) instrument is the student learning outcomes, end of program level objectives and the implementation plan. Conclusion: A strong argument exists for post-registration university based specialization courses for paediatric nursing especially in Finland. Recommendations: This project provides a foundation for future research into post-graduate paediatric nursing education in Finland. An evaluation of the training needs analysis instrument should be repeated with a greater sample size amongst a similar student population. This would allow for statistical tests to be performed to test the instruments reliability and validity. A validated instrument could be applied to a West Australian nursing population to determine the needs of learners in Western Australia for Paediatric nursing Emergency and Critical care to inform and make change happen across nursing education in Australia.  

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Patients admitted under the cardiology team at a metropolitan hospital who had one or more cardiovascular risk factors were selected to take part in the study. The cohort consisted of 219 patients, 148 males and 71 females, aged from 36 to 91 years. Initially, an explanation of the terminology ‘risk factor’ was given. Then patients were asked if they could identify any risk factors they had. Patients self-reported risk factors were compared with risk factors identified following discussion with the patient and those recorded in their medical history. The overall results showed that the average number of risk factors generally increased with each decade of life. However, there was one exception this; the 4049 year age group had on average more risk factors than patients in their 50’s and 60’s. Interestingly the 40-49 year olds were the most knowledgeable group, identifying more of their risk factors compared with the other age groups. The individual risk factors were analysed for each age group and in the main demonstrated a lower level of knowledge with each decade of life. Hypertension and being overweight were the two most common risk factors identified. Less than half of the participants with these conditions could identify the correlation with cardiovascular disease. In conclusion, it is well known that cardiovascular health can be greatly influenced by lifestyle and behaviour change. This research has enabled me to adopt a more targeted approach to health promotion strategies for cardiac in-patients. Whilst some patients need more education on risk factors for cardiovascular disease others need more confidence and skills in changing unhealthy behaviours.  


5. VIABILITY OF NURSING/AIN TO RESIDENT RATIOS IN RESIDENTIAL AGED CARE FACILITIES (RACF) WITHIN THE CURRENT AGED CARE FUNDING INSTRUMENT (ACFI) Andrew Dean MACN In recent times there has been a large push to create Nursing/AIN to Resident ratios in the Residential Aged Care System. The prima facie purpose of such ratios is to improve resident care and reduce staff workloads. While research is being undertaken into the necessity of ratios there is little evidence apart from anecdotal that any potential increase in staffing levels or less flexibility is viable given the Aged Care Funding Instrument (ACFI). The viability of Residential Aged Care Facilities (RACF) are hidden by commercial in confidence and are extremely difficult to quantify even when the RACF’s are public companies or NFP organizations. The model presented has been created from the Author’s knowledge of the requirements of an RACF, all financial data has been gathered from public sources and as such does not represent any specific RACF. The model seeks to give an indication of the viability of multi case RACF’s. The poster presentation seeks to examine two common RACF sizes, 60 bed and 120 bed. The viability would be contrasted between standard staffing levels and increased staffing levels of nurses both EEN and RN. The Author does not seek to justify either position rather seeks to answer the question whether it is possible for the RACF’s to implement staffing ratios and or increased staffing levels and remain viable. Further research is required into the efficacy of changes to Nurse/AIN – Resident ratios. The long term aim of this model is to allow researchers to test new staffing regimes against the viability of RACF’s with the aim of creating an optimised Residential Aged Care System.

6. THE REFUGEE HEALTH EARLY CHILDHOOD NURSE PROGRAM - WHY A CHANGE HAD TO HAPPEN! Sandy Eagar FACN, Angii Higgins, Susan Passey and Sarah Marsh With the unprecedented movement of people across the globe, The Australian government has offered an additional 12,000 places to refugees from Syria and Iraq. With the arrival of this cohort came the opportunity to critically review existing programs, and to introduce programs that met the needs of these most vulnerable groups. We reviewed existing programs for children 0-5 years. Current service models were designed for families with adequate health literacy, existing medical records, English language competency, and access to private transport…all factors that excluded newly arrived refugee families who were bewildered and often overwhelmed with the demands of resettlement, and the sophistication of the health systems. Service data confirmed that despite good intentions, the model was not working Something had to change! An innovative model, the Refugee Health Early Childhood Nurses has been introduced in Sydney, NSW. Using a hybrid approach, the Refugee Health Early Childhood Nurses see most families in their homes, use qualified health interpreters, and assist families to navigate the systems of a first world country. So what? Well, the data we will present will confirm the need for this program, the preliminary health outcomes, the challenges and the victories! We will show you why change HAD to happen, and share with you how we did it!

To make change happen we need to be pragmatic and be able to sell improvements to an increasingly financially driven society. Without an understanding of the financial underpinnings of a RACF resident care changes will be difficult to undertake.  

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7. NURSES LEADING THE WAY TO MAKE CHANGE HAPPEN FOR WOMEN WITH BREAST CANCER Professor Karen-leigh Edward MACN, Dr Mitchell Chipman, Jo-Ann Giandinoto MACN, Kayte Robinson and Dr Roth Trisno Introduction: Clinical interventions aimed at reducing stress-related psychological complications following diagnosis of breast cancer reveal a positive impact on the woman’s life, including enhancing psychological resilience. However the interplay between personal resources (such as optimism and perceived control) and social resources (such as intimacy and bonding) remains unclear. The aim of this study was to evaluate health related quality of life, resilience and psychological morbidity post-early diagnosis in patients diagnosed with stage I, II or III breast cancer at three time points. We used a longitudinal cohort design. Questionnaires were administered at baseline (1-4 weeks), at 6 months and 12 months post-diagnosis and treatment (June-October 2013). The effect of age and stage of cancer on questionnaire scores was also assessed. Summary: Age was significantly associated with the control, future perspective and body image, with higher perceived levels of control recorded by younger patients at both time points; and higher levels of future perspective and body image recorded by older patients at both time points. Significant changes in body image scores between baseline and 12 months were found with body image significantly deteriorating within 12 months from baseline. A significant interaction between age and time with respect to body image scores was revealed. Conclusions: The findings revealed older women had a better body image and more positive future perspectives compared to their younger peers. Stage of cancer appears to have an effect on resilience experienced by these women. Nurses are well placed in health care to assess women for age-related impacts of breast cancer.  

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8. MAKE CHANGE HAPPEN: ORGANISING NURSING Marilyn Gendek FACN Introduction: The history of nursing is always a foreword to the future development of the nursing profession. Understanding the nurse led change that has happened provides contextual perspective for the challenges of tomorrow. Summary: This largely visual poster presentation provides a historical account of the beginning of the regulation of nursing in New South Wales and Australia in the early 20th century. Before there was statutory regulation of nurses in Australia, a system of registration was pursued by the expanding profession. The global push in this direction was influenced by the organisation of nurses and an establishment of an international organisation, The International Council of Nurses. This history is an example of a professional push for change that materialised and provided a foundation for the ongoing pursuit of quality nursing care.


9. MAKE CHANGE HAPPEN: INTERNATIONAL PLACEMENTS AS LEGITIMATE LEARNING EXPERIENCES Pauline Hill MACN and Dr Wendy Abigail Healthcare is increasingly moving towards services based in the community and the home with an increased need for healthcare professionals to be adequately prepared to work in diverse environments (Lemetti et al. 2015). Contemporary nursing curricula and increasing enrolments require suitable learning opportunities that reflect this changing landscape and enable students to apply their knowledge and skills in different settings. In Australia, nursing student placements include rural and more recently community settings to provide more varied learning experiences. However, there is limited published information on community and international placements for nursing curricula, particularly in Australia (Cummins et al. 2010; Murphy et al. 2012). This paper reports on the learning experiences from three consecutive nursing and midwifery study abroad programs in Surabaya, Indonesia. The program provides students with cultural and professional learning opportunities with a specific health focus each year. Students develop new knowledge and build upon prior cultural understandings throughout the international exchange. They return with broader perspectives of the world and a desire to make change happen in healthcare. During these experiences students use their knowledge and skills to conduct health promotion activities, health education sessions and health assessments. The art of communicating with people who have limited English and different cultural approaches to health expand the students understandings and increase their communication skills. One example was a session to educate patients and staff members about infection control and the impact individuals can have to reduce the spread of disease in the community and hospital settings. Students used universal symbols, emoticons, cartoons and games to educate and demonstrate infection control concepts, with a view to reducing the burden of disease from preventable infections.

10. VOLUNTEERING IN DEMENTIA CARE IN THE ACUTE SETTING: A WAY FOR THE FUTURE? Alicia Hurst MACN, Dr Elisabeth Coyne MACN, Dr Ursula Kellett and Dr Judith Needham MACN Introduction: Caring for people with dementia is a challenge for health professionals particularly in the acute hospital setting. Volunteers are used within the community and aged care setting to assist with management of clients. Within the hospital setting there is little research exploring the experience of volunteers. However, literature identifies benefits for patients, carers, families and staff working with patients with dementia in acute and non-acute care settings. This research has explored the experience of volunteering in dementia care within an acute hospital setting. Method: An interpretative phenomenological approach was used to explore the experience of six volunteers working in an acute care setting with dementia patients. Individual interviews were conducted and a thematic analysis was undertaken to reveal common experimental themes. Results: Themes identified related to the volunteer’s main role, motivations, positive and negative experiences and possible areas of improvement. The everyday role varied from talking to the patient to giving manicures. The volunteers reported enjoyment in their roles and discussed why they started volunteering in terms of wanting to help others. The volunteers talked about the need for health professional or peer support to help them to debrief about challenges experienced whilst working with patients with dementia. Conclusion: Volunteer support with dementia clients in the acute care setting strengthens the health professional support for this complex patient group. However further research is needed to explore the experience of the volunteers in acute care setting with clients who have dementia. The research identified the need for support and debrief sessions or networking with other volunteers to enable a sense of balance of the volunteer needs and sharing when working with the complex needs of dementia clients.

These international student placements in nursing and midwifery are legitimate learning experiences and give students an opportunity to make change happen on the global stage.

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11. MAKING COMPASSION HAPPEN: COMBATTING COMPASSION FATIGUE

12. GRADUATE CLINICAL FACILITATOR SUPPORT SERVICE: AN EVALUTATION OF SERVICE

Samantha Jakimowicz MACN, Professor Lin Perry MACN and Dr Joanne Lewis MACN

Renee Langridge

Schwartz Rounds™ are described as an intervention to enhance compassion satisfaction and prevent health professionals’ compassion fatigue.1Could the introduction of Schwartz Rounds in Australian critical care make change happen by improving our nurses’ well-being, workforce retention and patient experience? Regular exposure to traumatic events places critical care nurses at risk of compassion fatigue.2 Ideally, these nurses should experience high compassion satisfaction and low compassion fatigue. However, recent research has shown that levels are only ‘average’ in Australian critical care nurses.3 Compassion fatigue has been identified as a reason why critical care nurses leave the profession.4 Schwartz Rounds™ are a possible intervention to enhance compassion satisfaction and combat compassion fatigue, leading to a healthier nursing workforce; one more likely to be retained. Adopted widely in the US and UK, Schwartz Rounds™ are an evidence based means of preventing compassion fatigue for nurses and other members of the medical team.1, 5 The Rounds provide a space to discuss social and emotional aspects of caring for others in a safe and structured forum. In drawing together the multidisciplinary team, this project offers an innovative means of relieving health professionals’ distress and dismantling communication barriers. The Rounds focus on preventing the situation where nurses, and other members of the team, feel little, if any compassion, towards their patients due to repeated exposure to traumatic events. Nurses who are personally supported by colleagues are more likely to experience enhanced compassion satisfaction and deliver comprehensive, compassionate care. This commitment to excellence also enriches communication and well-being, improving health outcomes for nurses, other health professionals and patients. Critical care is an area where the highest levels of vicarious trauma are experienced; Schwartz Rounds™ could make change happen in Australian intensive care and emergency units by enhancing compassion satisfaction and combatting compassion fatigue. 1.

Goodrich J. Supporting hospital staff to provide compassionate care: do Schwartz Center Rounds work in English hospitals? J Royal Soc Med 2012;105:117-22.

2.

van Dam K et al. Securing intensive care: towards a better understanding of intensive care nurses’ perceived work pressure and turnover intention. J Adv Nurs. 2013;69(1):31-40. Jakimowicz S et al.. Compassion satisfaction and compassion fatigue in Australian intensive care nurses. Submitted J Clin Nurs 2017.

3.

Sawatzky J et al. Identifying the key predictors for retention in critical care nurses. J Adv Nurs 2015;71(10):2315-25.

4.

Chadwick R et al. Support for compassion care: quantitative and qualitative evaluation fo Schwartz Center Rounds in an acute general hospital. Roy Soc Med 2016;7(7), online version.

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Introduction: Assisting newly qualified nurses and midwives transition to practice can be challenging. This research explored the experience of graduates across a local health service with the support of a dedicated Graduate Clinical Facilitator Support Service (GCFSS), for a twenty week period from February to June 2016. Graduate Clinical Facilitator (GCF) support was available across all shifts seven days per week. GCF were managed by dedicated facility Nurse Educators and overseen by Nursing Directors of Education. Method: Quantitative and qualitative data was collected from graduates, Nurse and Midwifery Unit Manages, unit Educators, unit Clinical Facilitators, and GCFs. A survey of the GCFSS utilised a mixture of short answer and selected answer questions, using multiple choice and Likert scales. The data analysis process mirrored Norwood’s ‘Qualitative Data Analysis Process’ and through group discussion, meaning and interpretation was built around identified themes. Results: Data analysis revealed the GCFSS supported graduates with clinical skills, specifically those with limited exposure or familiarity, urgent or high risk tasks; achieve expected professional development goals; contribute to their feeling of belonging and being supported; variation in perceived versus actual support required by graduates; characteristics required to be a GCF; and management expectations of the GCFSS. Graduates and GCFs reported a positive response to the GCFSS and desire to continue the service. Areas of improvement for future reiterations of the GFCSS were identified for GCF recruitment and education, structure of service and communication. Conclusion: The GCFSS has been a positive outcome in supporting graduates and the units involved in the service. A number of service refinements have been recommended to improve the GCFSS. Generally, consistency of expectations and provision of similar support could increase the level of graduate transition over the time period the service is provided. These have been incorporated in the model from 2017 graduate intake.


13. THE DROP-IN-SUPPORT-CENTRE: CONNECTING WITH ACADEMIC SUPPORT, STUDY BUDDIES, AND MORE... Marian Martin MACN, Dr Yenna Salamonson, Dr Paul Glew MACN, Dr Bronwyn Everett MACN and Dr Lucie Ramjan MACN An under-utilised space at a regional university was taken as an opportunity to pilot a Drop-in-SupportCentre for students, where they would be free to come and go as they wished, choose to access academic support if required, meet other students or just use the space for quiet study.

Conclusions: The study highlighted the value of a unique non-threatening, relaxed space where students feel they belong and are accepted and can receive immediate feedback/guidance from staff and peers on academic tasks. Nursing faculty staff initiating an innovative way to support undergraduate student learning, many attendees EAL students and mature aged students returning to study. The space may also be used for group study sessions. This has seen an improvement in grades and student confidence.  

Background: Research finds that students spend less time on campus – may not even know who their peers are. Less time spent working in teams – less experienced when entering clinical setting and needing to establish peer working relationships. No sense of connection and belonging, using innovative learning spaces for change. Students who work part-time find it more difficult to make new friends. Objective: This study explored the experiences of undergraduate nursing students who attended a weekly Drop-in-Support-Centre (DISC). Interventions/Methods: In 2016, a weekly Drop-inSupport-Centre initiative was piloted in a large School of Nursing and Midwifery. The room utilised for the study was a large conference room with floor to ceiling windows on two sides, kitchen facilities where breakfast and light snacks were available. Seating was around a large oval table but students were able to utilise other break out spaces in small groups Thirteen students participated in semi-structured face-to-face interviews which were audiotaped and transcribed. Qualitative data was thematically analysed. Results: Qualitative analyses revealed student’s developed a sense of community. “It's not like a school. It's not like a study day. It's more like a homey, friendly coffee shop [laughs] thing... Relaxed atmosphere". "It's a quiet space to study. We've got support here should we need it." "This is definitely a more relaxed atmosphere. You can just work on whatever you need to. It's not structured." "I come, I sign up, I make my coffee and I throw myself at work." "Just a quiet place where you can get some help if you need it."

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14. IS THE COST OF CARING TOO HIGH? Catelyn Richards MACN This abstract was written as a reflection on how compassionate fatigue manifests throughout a nurse’s career, focussing specifically in their early training. It was written as a case study in conjunction with a small review of the literature. “I’ll never forget the first time a patient turned to me, bloated by her appreciation for my support, and called me her ‘angel’. The self and societal depiction of nurses as saviours, is a comforting idealisation to clothe oneself in, until the day where a patient inevitably experiences trauma under one’s direct care. As such, it comes as no surprise that nurses often lose their passion for a once romanticised role. Though, compassion and empathy are invaluable to the development of a nurse’s ethos, compassionate practice becomes problematic when nurses invest high levels of emotion into their practice leading to fatigue and burnout. So as a student under supervision, what do we then say to our preceptors when we witness them openly screaming orders at a patient whom is known to experience severe cognitive impairment? What are we lead to believe when we see nurses performing painful procedures on a crying, flailing child, whilst seemingly experiencing no emotional turmoil as a result? Is this a part of our job? Or can we make change happen? The question still stands; is enough being done to prepare students for their entrance into an emotionally demanding workforce? Though it is tempting to celebrate nursing students whom appear to be ‘thick skinned’ this may be a misguided analysis. These students may instead possess flawed coping mechanisms, which may over time lead to the breakdown of adequate care. Current policy and tertiary curriculum is limited, as emphasis is placed upon the risk counter-transference poses to patients, as opposed to articulating how it leads to compassion fatigue in the practicing nurse. Existing training and education programs should therefore include training on compassion fatigue, and developing resilient nurses through mindful practice. Overwhelmingly in order for change to happen, views on compassion fatigue must be first be reformed.”  

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15. THE AUSTRALIAN NURSING OUTCOMES COLLABORATIVE: USING DATA TO IMPROVE THE QUALITY & SAFETY OF NURSING CARE Dr Jenny Sim MACN, Dr Joanne Joyce McCoach, Dr Rob Gordan and Professor Patrick Crookes MACN This presentation will describe the development and ongoing evolution of the Australian Nursing Outcomes Collaborative (AUSNOC). AUSNOC is a collaborative research centre that assists hospitals to collect data on the quality and safety of nursing care. Structure, process and outcome data is collected using four constructs: Care and Caring; Communication; Coordination & Collaboration; and Safety. The data collected includes administrative data, adverse events (falls, pressure injuries, medication errors, staphylococcus blood stream infections), observational studies of processes of care and the use of three periodic surveys that use validated tools (Nursing Work Index – Revised: Australian; Caring Assessment Tool; and one of a number of approved Patient Experience Surveys). Feasibility testing of the AUSNOC indicator set was undertaken in 2016 in three hospitals in NSW, Australia. This presentation will describe the key findings from the feasibility study and statistically significant relationships between structural measures, the practice environment and the four constructs.  


16. MOVING ALS EDUCATION FROM THEORY TO SIMULATION - CHALLENGES OF CHANGE IN A RURAL SETTING Kim Stevens MACN and Andrea Flenley MACN Introduction: This presentation will focus on moving staff from didactic ALS (Advanced Life Support) learning and assessment to a simulation based model of education and skill checks in a small rural health service in Victoria. Summary: In January 2016, Beaufort and Skipton Health Services restructured their education portfolio, moving from external educational providers and Clinical Support Nurses, to employing 2 Clinical Nurse Educators, who were tasked with changing the delivery of education throughout the service to a more progressive and responsive model. This resulted in the formation a project focused around ALS which was deemed to be high priority as required by National Standards and staff reporting feeling under confident, in their ability to manage an event, citing no opportunity for consolidation of theory and limited comprehension of their roles and responsibilities. The implementation of this change focused on moving from an annual externally delivered theory and assessment process, to a workplace accessible, more wholistic simulation based skill check. The challenge of implementation revolved around staff anxiety and resistance associated with the unknown ‘simulation’ environment and expectations of new ‘emergency trained’ education staff. This project contributes its successes to having a change process based on effective communication, buy-in from staff and the allocation of appropriate resources. Staff buy-in was facilitated by explaining the need for change using the ‘why, how, what’ model of change. This promoted trust in the educators and the desire to engage in the process. Conclusion: At the completion of the project staff reported higher levels of satisfaction, improved perceptions of competence and greater confidence in the practical application of ALS. An unexpected by product was that Staff that had previously felt anxious about progressing from BLS to ALS, embraced the learning opportunities provided and progressed to achieving competency.

17. COLLABORATION LEADS TO SUCCESSFUL CHANGE IN PACIFIC ISLAND COUNTRIES Sally Sutherland-Fraser MACN and Menna Davies FACN Introduction: A collaboration between 14 Pacific Island countries and Australia is working to improve nurses’ compliance with perioperative standards for practice and make that change happen. Summary: Patient safety is strongly influenced by health professionals' knowledge of and compliance with agreed standards for practice. Specialist nurses working in Australian operating theatres are required to comply not only with the Nursing and Midwifery Board of Australia’s (NMBA) national standards for practice but also with the standards developed by the Australian College of periOperative Nurses (ACORN). In Pacific Island countries, there have been no agreed standards for such specialist nurses. This has led to wide variation in the delivery of care, which can compromise patient safety in operating theatres. This poster will describe a recent collaboration between perioperative nurses in 14 Pacific Island countries and Australia, which established the first specialty practice standards for perioperative nurses in the Pacific. The project was initiated in response to reports from surgical teams visiting Pacific Island operating theatres, who were concerned by the lack of consistency in the standards of nursing practice. A team of nurses and educators representing 14 Pacific Island countries and Australia collaborated to develop a bundle of six standards for practice and a set of observational tools to audit clinical practice in operating theatres. Implementation of the bundle has commenced across the Pacific, and is being supported by education and mentoring. Early outcomes of practice audits suggest that nurses are improving their compliance with the new perioperative standards for practice. Conclusion: This project grew from a recognised need for improvement in nurses’ standards for practice in Pacific Island operating theatres and brought together a team that has been successful at making that change happen.  

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18. THE NMHP CHAMPION PROGRAM; PROMOTING A HEALTHY NURSING AND MIDWIFERY WORKFORCE THROUGH A PROFESSIONAL PEERBASED TRAINING MODEL Glenn Taylor MACN and Natalie Spencer Introduction: The Nursing & Midwifery Health Program Victoria (NMHPV) commenced delivery of the innovative NMHP Champion Program in 2013. It is designed to improve the health and wellbeing of the nursing and midwifery workforce through interactive training workshops. The target audience are nurses, midwives, students of nursing and midwifery along with profession specific management and HR staff. Summary: The Champion Program operates on the premise that nurses & midwives who are invested in their colleague’s health and wellbeing and who possess a sound understanding of their local work environments and systems will make for effective and credible conduits of information, assisting to influence important health-related behaviour change. Evidence suggests peer-based interventions are highly effective in creating sustainable change and we believe the Champion Program can be this. Experiencing a mental health and/ or substance use issue as a nurse or midwife can be isolating due to the stigma attached. The Champion Program aims to provide participants with the tools to confidently and sensitively engage their colleagues when they are in need. Workplaces with peer educated Champions promotes the opportunity to confidently engage peers who may be experiencing a health challenge due to their substance use and/or mental health issues. This can assist to disrupt and challenge the stigma ‘we’ often associate with seeking help for these health challenges. The presentation will showcase the; • Training implementation process including data and regions serviced; • Role and ongoing function of the Champion and the NMHPV, within the Champion’s organisation and community; • Feedback and evaluation outcomes from trained Champions Conclusion: The Champion Program has been operating in Victoria since 2013 with clear service objectives. We believe these objectives have proved successful, are transferrable across jurisdictions and that the initiative is an innovative way to make change happen within our professions.

19. SCHN EVALUATION: HARNESSING THE POWER OF NOW TO ENSURE THE SUSTAINABILITY OF CHANGE Shaun Thompson, Sarah Coye and Simone NastClarke Introduction: The Essentials of Care (EoC) program flow and structure is multifaceted, incorporating several phases that not only encompass quality activities and evaluation but also focus on culture and team dynamics (source: EoC program: NSW Ministry of Health). Background & Method: The Sydney Children’s hospital Network (SCHN) has engaged with EoC across a number of wards since 2010. The program is consistently reviewed and modified to cater the needs of the parties involved. To support more sustainable outcomes for EoC projects, a workshop was held to gain a better understanding of needs, wants and concerns regarding the use of the EoC framework specifically in relation to evaluation. Representatives collaborated to identify challenges of current evaluation processes used within the EoC program and brainstorm alternative solutions. The outcome saw the development of A SCHN Evaluation Framework with the aim to provide structure and guidance for teams to progress through EoC phases whilst ensuring adequate consideration for evaluation. The SCHN Evaluation Framework was structured around the EoC Phases, incorporating workshop feedback, key resources, change management and evaluation processes with key checkpoints throughout. An accompanying Guide outlines clear steps to achieve each phase, and identifies key capability tools to assist implementation of projects within SCHN. Conclusion/ Next Steps: The new framework is currently being trialled on three allocated wards at each Hospital within the SCHN. Feedback will be used to make any relevant changes to the framework using a Plan, Do, Study, Act evaluation cycle. Once this framework has been deemed fit for purpose, it will then be finalised and endorsed by executive. Using this strategy of consistently evaluating the needs of our hospital service and adapting our programs to fit this need, not only are we going to be able to make change happen, we are going to be able to evaluate it along the way. References: NSW Ministry of Health, Working with the Essentials of Care Program: a guide for facilitators, 2nd edition, January 2014 http://www.health.nsw.gov. au/nursing/projects/Documents/EOC_resource.pdf accessed: 16/01/2017.

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20. ED REVISITS REVISITED: IDENTIFYING A ROLE FOR NURSE-LED SERVICES Wayne Varndell MACN, Professor Lin Perry MACN, Sarah Lyons and Karlie Clark Background: Many chronic diseases are characterised by enduring health loss despite treatment, and are associated with frequent exacerbations and comorbidities requiring ED attendance, often multiple revisits to the ED. The purpose of this study was to identify factors associated with revisits: i) potentially amenable to inpatient clinical nurse consultant led intervention; ii) suitable as components of future admission avoidance programs; iii) and to inform the development of re-presentation risk assessment tools. Method: Retrospective mixed-method study, conducted in a large metropolitan ED. Results: Analysis of ED revisits (n=6,889) by patients (n=1,465; 2.5%) diagnosed with chronic obstructive pulmonary disease, chronic heart failure, diabetes, elderly falls or chest pain, identified that the majority of revisits (n=5,191; 75%) resulted in admission to hospital, and that the shortest symptom-free period occurred between the first and second revisit (mean 19 days; SD 38 days). In financial terms, based upon the NSW average cost per admitted ($960) and nonadmitted ($451) episode of ED care, chronic disease revisits were costed at $3.7m and $0.7m respectively, and approximately $9.8m expenditure in the first 24hrs of hospitalisation. Document analysis (n=146; 10%) identified five factors associated with triggering revisits: i) exacerbation of index chronic disease; ii) development of infection, commonly respiratory or skin (e.g. cellulitis); iii) under/overdosing or poly-pharmacy adverse interaction of newly prescribed or altered medications for index chronic disease and/or comorbidities; iv) poor patient/carer medication/health literacy; and v), ability to access follow-up service. The document analysis did however highlight that patients were able to detect deteriorating symptom control within the first 48-72hrs of being discharge from hospital or prior to attend ED. Conclusion: Strategies to improve self-management, symptom control and admission avoidance are essential to reduce the burden of chronic disease on patients, carers and the ED. Factors amendable to nurse-led intervention have been identified.

21. FROM "I AM JUST A STUDENT" TO "WE MADE CHANGE HAPPEN"; HOW ONE STUDENT GROUP BECAME A CATALYST FOR CHANGE Suzanne Lee Volejnikova-Wenger MACN Students at most universities liken their adult learning to a contract between the university and themselves, as in a business model. Nursing and Midwifery students are no different and often think that problems need to be solved by the provider they are paying for their degree. When confronted by the idea that they can be part of the solution, the comment most heard is “I am just a student”. This reflection focusses on how one Nursing and Midwifery student group made change happen, by listening to students, by owning their own learning and by actively seeking ways, through peer support, to change a culture of perceived passiveness. The poster will explore the impact of the student group at a regional university and show how individual students have benefitted from grassroots peer support and advocacy. Student group leaders fostered a sense of belonging by creating a physical place to meet, which positively impacted retention of Nursing and Midwifery students and was well received by the Head of School and academics. Other initiatives implemented by the Nursing and Midwifery student group include: individual welcome packs which also contained Australian College of Nursing (ACN) material on orientation day, twiceweekly drop in sessions with library and academic skills support, pre-placement and exam information sessions, colloquial Australian and nursing jargon sessions for international students, secure facebook page with currently 953 members, supported nursing lab sessions and much more. These student leaders are now graduating and are experiencing the difficulty of securing a graduate position in a health care system oversaturated with novice nurses. Moving on from a student perspective, the next big issue is being a collective voice for Nursing and Midwifery graduates and starting the conversation with education providers, employers and professional organisations such as the ACN. Watch this space, because “we can make change happen”. Research used to support development of student group: Fontaine, K 2014, ‘Effects of a Retention Intervention Program for Associate Degree Nursing Students’, Nursing Education Perspectives, vol. 35, no. 2, pp. 94-99, doi:2048/10.5480/12-815.1 Jeffreys, MR 2013, Nursing and Student Retention – Understanding the Process and Making a Difference, Springer Publishing Company, New York. Keeffe, P 2013, ’A Sense of Belonging: Improving Student Retention’, College Student Journal, vol. 47, no. 4, pp. 605-613.

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22. LEARNING TO NURSE IN THE INTERNATIONAL SETTING

23. EARLY ENGAGEMENT IN SCHOOLS TO PROMOTE A CAREER IN HEALTH

Jackson Vukovic MACN

Karen Webster MACN and Jessica Staunton MACN

How does exposure to foreign healthcare influence our home-grown nurses?

Introduction: We know the demand for nursing jobs in future will not be met by the available workforce. Demand will outstrip supply. We have an aging population, increase in chronic disease coupled with a decrease in workforce numbers with only 4% of Year 12 completers entering the health care industry. To meet demand we need 1 in 4 school leavers to enter a career in health. So how do we engage students and promote a career in health throughout their early years to make change happen???

Introduction: Undergraduate nursing programs can often offer international study and exposure programs as part of their courses, however these can often be underpromoted and expensive for students to participate in. I believe the experiences I gained from the programs I participated in have had a huge influence on the way I approach healthcare, understand the perspective of the consumers within it, and ultimately have had a unique impact on the way I nurse which cannot be achieved in our local academic setting. I believe that we can make a change to the way we educate our nurses by making international study and exposure programs more accessible and affordable. Description: The focus of my discussion piece is on the benefits of international study and exposure programs that are available to nursing students in the undergraduate setting, the accessibility and affordability of these and the influence these have on students training as nurses. The discussion is focussed on nursing students who participated in these programs, and how they feel it has influenced their development as a nurse. My ultimate goal would be for this to lead to a research project that could contribute to gaining more accessibility and financial support for these programs in the university setting. Discussion topics: • What are the benefits of experiencing healthcare in the international setting on developing as a nurse? Does it make for better nurses? • How accessible are international study and exposure programs in undergraduate nursing programs? • How can we make them more promoted and supported, and financially accessible? • What are the benefits of having exposure to healthcare in other countries? Summary & Conclusion: Nursing is a profession with such a large focus on understanding the human person, and their each and every different perspective that we care for. If we could better promote and support our undergraduate nurses to have exposure to healthcare around the world, we can help make our home-grown nurses have a greater perspective of the world, and for the people who live in it. I would love to model this through creating a discussion piece around nursing students who have been a part of these programs, and present this as poster discussion piece to promote recognition of the value of these programs as part of the National Nurse Forum in 2017.

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Description: In 2015 we embarked on initiating a school based trainee program within our hospital with a focus on promoting health careers and supporting the youth in our community. Within a partnership model we liaised with local schools to support seven (7) year eleven students though a school based traineeship (SBT). The SBT program was undertaken by local school students throughout their last two (2) years of school. The program entailed students completing a Certificate III in Aged Care coupled with a minimum of fifty (50) clinical placement days working in direct patient care under the provision of a registered nurse. The successful completion of the traineeship provided students with a formal qualification, experience within a clinical environment and early exposure to the fundamentals of lifelong learning. Summary: The program has supported changed in how we promote entry into health careers. The outcomes and benefits are evident by: • a 100% successful completion rate; • 6 out of 7 students progressing to study Bachelor of Nursing; • 4 out of 7 applied for an Assistant in Nursing position with the casual pool and were successful in gaining employment; • The expansion of the program across multiple facilities and an increase of students numbers to thirteen (13). Conclusion: The program has ‘made change happen’ by attracting and retaining students into health careers, nurturing and supporting their passion for health and learning to meet the needs of the professions and community into the future.  


24. GENOMIC LITERACY OF REGISTERED NURSES AND MIDWIVES IN AUSTRALIA: A CROSSSECTIONAL SURVEY Helen Wright MACN, Dr Lin Zhao, Professor Melanie Birks FACN and Professor Jane Mills Introduction: Registered nurses and midwives require a degree of genomic literacy if they are to adequately communicate with other healthcare professionals and provide optimal nursing and midwifery care to patients and their families. Description: Genomic literacy has been described as the “knowledge of genetics and genomics as these topics relate to, and affect, professional nursing practice” (Giarelli & Reiff, 2012, p. 529). The aim of this study is to provide a baseline measure of the genomic literacy of Australian registered nurses and midwives through assessing participants’ understanding of genomic concepts most critical to nursing and midwifery practice. This study is a cross-sectional survey using the Genomic Nursing Concept Inventory (GNCI©). The survey was administered over a 6-month period in 2016. Registered nurses and midwives in Australia were eligible to participate. Participants were primarily recruited via the Australian Nursing and Midwifery Federation (ANMF) and the Australian College of Nursing (ACN). Two hundred and fifty-three (N=253) valid responses were recorded. Data were analyzed using Statistical Package for the Social Sciences™. Descriptive and inferential statistics were performed. A number of respondents believed genomics was very relevant (27.7%, n=70/253) or extremely relevant (11.1%, n=28/253) to nursing and/or midwifery practice. In contrast, few respondents rated their knowledge of genomics as it relates to nursing and/or midwifery practice as very good (2.4%, n=6/253) or excellent (0.4%, n=1/253) and 41.4% (n=105/253) rated their knowledge as poor/limited. This is reflected in the GNCI© scores. The GNCI© mean score was 13.3/31 (±4.559) with 53% (n=134/253) and 47% (n=119/253) of respondents scoring above and below the mean, respectively. Conclusion: The genomic literacy of registered nurses and midwives in Australia is poor. This needs to change. It is our professional responsibility to make this change to ensure that registered nurses and midwives have the genomic literacy they require to provide optimal patient care.

25. COGNITIVE IMPAIRMENT – MAKING CHANGE HAPPEN FOR A NEW MODEL OF CARE Brendan Zornig MACN, Angelka Opie, Monica Davis, Bianca Johnston, Tinika Lewin and Meryl Banister Older people with cognitive impairment are at increased risk of adverse events whilst in hospital, including mortality, longer length of hospital stay, functional and cognitive decline and medical and surgical complications. This ward has historically attempted to mitigate the risk of adverse events in cognitively impaired patents by providing a 1-on-1 nurse special. The specials model was extremely resource intensive and did not provide optimal outcomes for patients. For example, an analysis of clinical incident data revealed that most of the ward’s hospital-acquired pressure injuries and falls were patients being managed under the specials model. 60% of in-hospital falls in a two-year period, and 80% of patients who had multiple in-hospital falls, were patients managed under the specials model. During the same two-year period, 74% of hospitalacquired pressure injuries attributed to this ward, and 80% of patients with multiple pressure injuries, were patients managed under the specials model. Similar patterns were also found with other indicators including medication incidents, occupational violence and malnutrition. Meanwhile, the ward was using an average of 13.1 FTE (>$95,000) per month to provide the nursespecials. A literature review was conducted revealing several strategies to reduce the incidence and duration of delirium. These strategies include frequent mobilisation, toileting, pain assessment and maintenance of a healthy sleep-wake cycle. Although these strategies could be considered “good basic nursing care”, these strategies were not being implemented reliably with the existing model. The cognitive impairment rounding model was devised by the nursing team, which replaced the 1-on-1 special with one additional nurse each shift to round on cognitively impaired patients and implement the evidence-based strategies. These nurses were also provided specific training, and diversional therapy equipment was obtained. The preliminary results of this model (3 months into trial period) are significant reductions in hospital-acquired pressure injuries, falls and occupational violence.

References: Giarelli, E., & Reiff, M. (2012). Genomic literacy and competent practice: Call for research on genetics in nursing education. Nursing Clinics of North America, 47(4), 529-545

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