Papers by Yenna Salamonson
BMC Nursing
Background: Given the increasing complexity of acute care settings, high patient acuity and deman... more Background: Given the increasing complexity of acute care settings, high patient acuity and demanding workloads, new graduate nurses continue to require greater levels of support to manage rising patient clinical care needs. Little is known about how change in new graduate nurses' satisfaction with clinical supervision and the practice environment impacts on their transitioning experience and expectations during first year of practice. This study aimed to examine change in new graduate nurses' perceptions over the 12-month Transitional Support Program, and identify how organizational factors and elements of clinical supervision influenced their experiences. Methods: Using a convergent mixed methods design, a prospective survey with open-ended questions was administered to new graduate nurses' working in a tertiary level teaching hospital in Sydney, Australia. Nurses were surveyed at baseline (8-10 weeks) and follow-up (10-12 months) between May 2012 and August 2013. Two standardised instruments: the Manchester Clinical Supervision Scale (MCSS-26) and the Practice Environment Scale Australia (PES-AUS) were used. In addition to socio-demographic data, single-item measures were used to rate new graduate nurses' confidence, clinical capability and support received. Participants were also able to provide open-ended comments explaining their responses. Free-text responses to the open-ended questions were initially reviewed for emergent themes, then coded as either positive or negative aspects of these preliminary themes. Descriptive and inferential statistics were used to analyse the quantitative data and the qualitative data was analysed using conventional content analysis (CCA). The study was approved by the relevant Human Research Ethics Committees. Results: Eighty seven new graduate nurses completed the follow-up surveys, representing a 76% response rate. The median age was 23 years (Range: 20 to 53). No change was seen in new graduate nurses' satisfaction with clinical supervision (mean MCSS-26 scores: 73.2 versus 72.2, p = 0.503), satisfaction with the clinical practice environment (mean PES-AUS scores: 112.4 versus 110.7, p = 0.298), overall satisfaction with the transitional support program (mean: 7.6 versus 7.8, p = 0.337), satisfaction with the number of study days received, orientation days received (mean: 6.4 versus 6.6, p = 0.541), unit orientation (mean: 4.4 versus 4.8, p = 0.081), confidence levels (mean: 3.6 versus 3.5, p = 0.933) and not practising beyond personal clinical capability (mean: 3.9 versus 4.0, p = 0.629). Negative responses to the open-ended questions were associated with increasing workload, mismatch in the level of support against clinical demands and expectations. Emergent themes from qualitative data included i) orientation and Transitional Support Program as a foundation for success; and ii) developing clinical competence.
British Journal of …, 2010
Background: The Cardiac Depression Scale (CDS) is a disease-specific instrument for measuring dep... more Background: The Cardiac Depression Scale (CDS) is a disease-specific instrument for measuring depression in cardiac patients. This study was designed to validate the CDS in an Iranian population. Methods: Translation and back translation of the 26-Item CDS scale was performed using recommended procedures. The Iranian translation of the CDS (I-CDS) was administered to 261 individuals in Iran, concurrently with the Beck Depression Inventory. The factor structure of the I-CDS was examined using exploratory factor analysis procedures to enable comparison with previous psychometric evaluation of the CDS. Receiver operating characteristic (ROC) curves were used to examine the ability of the I-CDS to discriminate between categories of depression. Results: First-order exploratory factor analysis uncovered two robust factors, consistent with the second-order dimensions originally reported by the developers of this instrument. Cronbach's alpha was 0.88 for the total 26-item I-CDS, indicating satisfactory internal consistency of the I-CDS. Intercorrelation between the total scores for the I-CDS and BDI was 0 .62 (P< .001). For the I-CDS cut off of 90, the sensitivity was 85%, and specificity was 61% with a computed area under the curve (AUC) of .81 (95% CI, .76-.87). For the I-CDS cut off of 100, the sensitivity was 81% and specificity was 63% with a computed AUC of .81 (95% CI, .76-.87). Conclusion: This validation study of the Iranian version of the CDS proved that it is an acceptable, a reliable and valid measure of depression in cardiac patients.
Pain Management Nursing, 2005
The purpose of this study was to examine differences in opioid consumption in patients prescribed... more The purpose of this study was to examine differences in opioid consumption in patients prescribed patient-controlled analgesia (PCA) versus intramuscular injection (IMI) in the early postoperative period after open abdominal surgery. A retrospective audit of 115 patients elicited demographic and clinical data. No significant differences were found between the demographic variables of the PCA and IMI groups. There was a significant difference in the mean opioid dose used during the first 3 postoperative days (p < .01). Mean opioid consumption was 136.89 mg for the PCA group and 50.79 mg for the IMI group. Although there was a reduction in the amount of opioid consumed over the first 3 postoperative days, the PCA group consistently consumed more opioid analgesia compared with the IMI group. Furthermore, there was a disproportionate reduction in opioid consumption between the two groups from Day 1 (r ؍ .34; p < .01) to Day 3 (r ؍ .14; p ؍ .14). This study shows that the amount of analgesia consumed during the postoperative period by patients who had abdominal surgery varied markedly depending on the mode of analgesia (PCA or IMI). The difference in analgesic consumption was also found to increase throughout the 3-day postoperative period. This divergence in the amount of opioid consumption between patients who were prescribed PCA and patients who were prescribed IM analgesia heightens the need for vigilance in assessment and management of pain during the early postoperative period, particularly in patients prescribed IM analgesia on an "as-needed" basis.
Journal of Clinical Nursing, 2009
Aim. To evaluate the existing literature to inform nursing management of people undergoing percu... more Aim. To evaluate the existing literature to inform nursing management of people undergoing percutaneous coronary intervention.Background. Percutaneous coronary intervention is an increasingly important revascularisation strategy in coronary heart disease management and can be an emergent, planned or rescue procedure. Nurses play a critical role in delivering care in both the independent and collaborative contexts of percutaneous coronary intervention management.Design. Systematic review.Method. The method of an integrative literature review, using the conceptual framework of the patient journey, was used to describe existing evidence and to determine important areas for future research. The electronic data bases CINAHL, Medline, Cochrane and the Joanna Briggs data bases were searched using terms including: (angioplasty, transulminal, percutaneous coronary), nursing care, postprocedure complications (haemorrhage, ecchymosis, haematoma), rehabilitation, emergency medical services (transportation of patients, triage).Results. Despite the frequency of the procedure, there are limited data to inform nursing care for people undergoing percutaneous coronary intervention. Currently, there are no widely accessible nursing practice guidelines focusing on the nursing management in percutaneous coronary intervention. Findings of the review were summarised under the headings: Symptom recognition; Treatment decision; Peri-percutaneous coronary intervention care, describing the acute management and Postpercutaneous coronary intervention management identifying the discharge planning and secondary prevention phase.Conclusions. Cardiovascular nurses need to engage in developing evidence to support guideline development. Developing consensus on nurse sensitive patient outcome indicators may enable benchmarking strategies and inform clinical trial design.Relevance to clinical practice. To improve the care given to individuals undergoing percutaneous coronary intervention, it is important to base practice on high-level evidence. Where this is lacking, clinicians need to arrive at a consensus as to appropriate standards of practice while also engaging in developing evidence. This must be considered, however, from the central perspective of the patient and their family.
Nurse Education Today, 2008
Most of the attrition from nursing courses occurs in the first year of study. Devising university... more Most of the attrition from nursing courses occurs in the first year of study. Devising university strategies to reduce attrition requires an understanding of why students leave. The aim of this study was to explore whether students who leave a nursing course in the first semester leave for the same or different reasons than students who leave in the second semester of study. Seventeen students who had left the course were interviewed by telephone: seven in the first semester and ten in the second. In the first semester, students who leave consider themselves unprepared for university, have competing roles outside university and develop a strong dislike of the nursing course. They decide quickly that the course is unsuitable and leave. Those who leave in second semester would prefer to stay but events in their life create a crisis where they can no longer cope with university studies. These students hope to return to nursing whereas students who leave in the first semester are unlikely to consider returning. Attempts to retain students in the first semester may be futile as these students may be unsuited or uncommitted whereas there is greater scope to retain those who leave in the second semester.
Resuscitation, 2008
Although unplanned admissions to the intensive care unit (ICU) are associated with poorer prognos... more Although unplanned admissions to the intensive care unit (ICU) are associated with poorer prognoses, there is no published prognostic tool available for predicting this risk in an individual patient. We developed a nomogram for calculating the individualised absolute risk of unplanned ICU admission during a hospital stay. Hospital administrative data from a large district hospital of consecutive admissions from 1 January 2000 to 31 December 2006 of aged over 14 years was used. Patient data was extracted from 94,482 hospital admissions consisted of demographic and clinical variables, including diagnostic categories, types of admission and time and day of admission. Multivariate logistic regression coefficients were used to develop a predictive nomogram of individual risk to patients admitted to the study hospital of unplanned ICU admission. A total of 672 incident unplanned ICU admissions were identified over this period. Independent predictors of unplanned ICU admissions included being male, older age, emergency department (ED) admissions, after-hour admissions, weekend admissions and six principal diagnosis groups: fractured femur, acute pancreatitis, liver disease, chronic airway disease, pneumonia and heart failure. The area under the receiver operating characteristic curve was 0.81. The use of a nomogram to accurately identify at-risk patients using information that is readily available to clinicians has the potential to be a useful tool in reducing unplanned ICU admissions, which in turn may contribute to the reduction of adverse events of patients in the general wards.
Journal of Advanced Nursing, 2006
Aim. This paper reports a study examining the influence of age, ethnicity and part-time employme... more Aim. This paper reports a study examining the influence of age, ethnicity and part-time employment on nursing students’ academic performance for second year pathophysiology and nursing practice subjects.Background. Age and ethnicity are known to be significant predictors of academic achievement among nursing students. The endemic nursing shortage has increased the impetus to diversify, resulting in more mature-age students and students from diverse ethnic and cultural groups in nursing programmes. There is increasing pressure for nursing students to participate in part-time employment whilst undertaking higher education, and this may affect their academic performance.Methods. A prospective, quantitative survey design was used to collect data from a regional university in Australia over a 2-year period from 2001 to 2002. A total of 267 nursing students were included in the study.Findings. More than three-quarters (78%) of second year students were participating in paid employment, with the majority in nursing-related jobs. Of those working, half did so more than 16 hours per week during the semester. Students who were not in paid employment had the highest academic achievements in both pathophysiology and nursing practice. Age was positively related with academic performance, but hours of part-time employment and ethnicity were negatively associated with academic performance, with the amount of time spent in paid employment being the strongest predictor of academic performance in both pathophysiology and nursing practice.Conclusion. Working more than 16 hours per week had a detrimental impact on the academic performance of nursing students. More importantly, this study shows that nursing-related employment is not advantageous to students’ academic performance, even for a nursing practice-based subject. If the current practice of employing nursing students in clinical settings is to continue, this experience needs to be aligned to the academic curriculum if it is to be beneficial to students’ knowledge and skill acquisition.
Journal of Womens Health, 2009
Coronary heart disease (CHD) is a major cause of morbidity and mortality globally, and risk facto... more Coronary heart disease (CHD) is a major cause of morbidity and mortality globally, and risk factors for CHD are associated with social and cultural attribution as well as individual psychological factors. The aims of this study were to explore the causal attributions of risk factors for CHD and to describe the relationship between their physiological status and causal attributions among immigrant Arabic, Turkish, and Iranian women living in Australia. Fifty-five women of Turkish, Iranian, and Persian backgrounds were recruited from community groups in metropolitan Sydney using snowball sampling and the assistance of bilingual health care workers. Body weight and blood pressure were assessed, and a questionnaire, including investigator-developed instruments and the Depression, Anxiety and Stress Scale, was administered. Health interpreters assisted with study procedures and translation of study instruments. There was a low level of awareness of the risk of heart disease among women, although participants had knowledge of risk factors for heart disease broadly. The most highly attributed risk factors for CHD among participants were obesity, physical inactivity, and psychological distress. Women who rated highly on psychological distress scores were more likely to attribute negative emotions as causative factors for heart disease. Strategies to promote the awareness of the association between heart disease and women are required among migrant women. Further investigation is required to overcome the barriers to engaging in effective risk minimizing behaviors for heart disease.
Resuscitation, 2009
Background: Almost one in every 10 patients who survive intensive care will be readmitted to the ... more Background: Almost one in every 10 patients who survive intensive care will be readmitted to the intensive care unit (ICU) during the same hospitalisation. The association between increasing severity of illness (widely calculated in ICU patients) with risk of readmission to ICU has not been systematically summarized.
Intensive and Critical Care Nursing, 2006
Nurses are the main group of clinicians who activate the medical emergency team (MET), placing th... more Nurses are the main group of clinicians who activate the medical emergency team (MET), placing them in an excellent position to provide valuable insights regarding the effectiveness of this system. This descriptive study aimed to explore nurses' satisfaction with the MET, perceived benefits and suggestions for improvement. The study also sought to examine the characteristics of nurses who were more likely to activate the MET. Using a survey design, descriptive statistics as well as content analysis were used to analyse the data. Seventy-three nurses (79% response rate) returned their completed surveys. A positive and significant relationship was found between years of nursing experience and MET activation (p = 0.018). Overall, nurses were satisfied with the MET, with suggestions for improvement including more education on medical emergencies for both ward and MET staff. Whilst the MET system is meeting the expectations of the majority of ward nurses, there is room for improvement, which includes a more positive attitude of the MET when summoned for 'borderline' cases. Investment in ongoing education of clinicians and interdisciplinary communication is likely to encourage less experienced nurses to utilise this system, whilst decreasing the reticence of some nurses to call the MET.
Nursing Outlook, 2007
This article addresses the roles of race-ethnicity and gender in university student orientation t... more This article addresses the roles of race-ethnicity and gender in university student orientation toward diversity. Differences in orientation toward diversity were found between men and women as well as among racial-ethnic groups (Asian/Asian American, African American, Latino, Anglo-American). Anglo-American students' scores were significantly lower than those of people of color, but no differences were found among groups of color. Men's scores were significantly lower than women's scores. Discussion addresses implications for higher education diversity programming.
Nurse Education Today, 2010
s u m m a r y Internationally, nursing faculty shortages have been reported and there is a potent... more s u m m a r y Internationally, nursing faculty shortages have been reported and there is a potential for them to worsen into the next decade as existing faculty age. To, in part, address this issue, across disciplines there is clearly an international trend towards the increasing casualisation of the higher education workforce. Despite the potential impact of this two-tiered workforce structure, there has been limited examination of the discipline specific issues related to the employment of a growing number of sessional nursing staff. This paper provides a critical review of the literature related to the employment of sessional teachers in higher education. The paper advances the discourse around the role and implications of employing sessional teachers in undergraduate nursing schools. Recommendations for supporting sessional staff and further research are presented.
Nurse Education Today, 2009
The aim of this study was to examine the psychometric properties, including predictive validity, ... more The aim of this study was to examine the psychometric properties, including predictive validity, of the newly-developed nursing self-efficacy for mathematics (NSE-Math). The NSE-Math is a 12 item scale that comprises items related to mathematic and arithmetic concepts underpinning medication calculations. The NSE-Math instrument was administered to second year Bachelor of Nursing students enrolled in a nursing practice subject. Students' academic results for a compulsory medication calculation examination for this subject were collected. One-hundred and twelve students (73%) completed both the NSE-Math instrument and the drug calculation assessment task. The NSE-Math demonstrated two factors 'Confidence in application of mathematic concepts to nursing practice' and 'Confidence in arithmetic concepts' with 63.5% of variance explained. Cronbach alpha for the scale was 0.90. The NSE-Math demonstrated predictive validity with the medication calculation examination results (p = 0.009). Psychometric testing suggests the NSE-Math is a valid measure of mathematics self-efficacy of second year nursing students.
International Journal of Nursing Studies, 2009
International Journal of Nursing Studies, 2009
Physical activity is an important strategy in effective secondary prevention. Participation in ca... more Physical activity is an important strategy in effective secondary prevention. Participation in cardiac rehabilitation and also adherence to recommendations for physical activity are less than optimal.
Australian Critical Care, 2007
European Journal of Cardiovascular Nursing, 2008
In spite of the benefit in participating in cardiac rehabilitation (CR) programs, low participati... more In spite of the benefit in participating in cardiac rehabilitation (CR) programs, low participation rates are well documented. Participation rates are potentially lower in people who have undergone percutaneous coronary interventions (PCI). Assessment of the barriers to CR participation in PCI patients could provide vital information for the development of alternate strategies for coronary risk factor modification. The aim of this study was to develop and evaluate the psychometric properties of a scale to assess obstacles to cardiac rehabilitation enrolment in patients following PCI. Item generation for the 15 items of this scale was based on a comprehensive review of the literature and data collected from telephone interviews of CR coordinators related to cardiac rehabilitation enrolment obstacles (CREO). Content validity of the scale was undertaken using a reference group comprising of clinicians and patients. Construct validity was undertaken using a factor analysis. Data for the CREO scale was collected from December 2004 to March 2005 from 114 PCI patients recruited from a cardiology database in a Sydney metropolitan hospital. Factor analysis revealed a two-factor structure: patient-related obstacles and health service-related obstacles, which accounted for 58% of cumulative explained variance. The scale showed good internal consistency (Cronbach&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s alpha=0.89) and satisfactory divergent validity. This scale can be used as a useful tool for the early identification of patients who would not normally enrol into CR and offer them alternate strategies for health-related lifestyle modification.
Journal of Clinical Nursing, 2008
Aims. The purpose of this study was to describe the demographic and employment characteristics o... more Aims. The purpose of this study was to describe the demographic and employment characteristics of Australian practice nurses and explore the relationship between these characteristics and the nurses’ role.Background. Nursing in general practice is an integral component of primary care and chronic disease management in the United Kingdom and New Zealand, but in Australia it is an emerging specialty and there is limited data on the workforce and role.Design. National postal survey embedded in a sequential mixed method design.Methods. 284 practice nurses completed a postal survey during 2003–2004. Descriptive statistics and factor analysis were utilized to analyse the data.Results. Most participants were female (99%), Registered Nurses (86%), employed part-time in a group practice, with a mean age of 45·8 years, and had a hospital nursing certificate as their highest qualification (63%). The tasks currently undertaken by participants and those requiring further education were inversely related (R2 = −0·779). Conversely, tasks perceived to be appropriate for a practice nurse and those currently undertaken by participants were positively related (R2 = 0·8996). There was a mismatch between the number of participants who perceived that a particular task was appropriate and those who undertook the task. This disparity was not completely explained by demographic or employment characteristics. Extrinsic factors such as legal and funding issues, lack of space and general practitioner attitudes were identified as barriers to role expansion.Conclusion. Practice nurses are a clinically experienced workforce whose skills are not optimally harnessed to improve the care of the growing number of people with chronic and complex conditions.Relevance to clinical practice. Study data reveal a need to overcome the funding, regulatory and interprofessional barriers that currently constrain the practice nurse role. Expansion of the practice nurse role is clearly a useful adjunct to specialist management of chronic and complex disease, particularly within the context of contemporary policy initiatives.
Research in Nursing & Health, 2008
Students who speak English as a second language (ESL) face considerable challenges in English lan... more Students who speak English as a second language (ESL) face considerable challenges in English language universities, but little is known about the relationship between English-language acculturation and academic performance. A prospective, correlational design was used to validate the English Language Acculturation Scale (ELAS), a measure of the linguistic aspect of acculturation, and to determine the relationship between English-language acculturation and academic achievement among 273 first-year nursing students. Exploratory factor analyses demonstrated that the ELAS was a valid and reliable measure (α = .89). When ELAS scores were examined in relation to students' grades, students with the lowest ELAS scores also had the lowest mean subject grades, highlighting the need to place greater emphasis on identifying English-language acculturation among ESL students. © 2007 Wiley Periodicals, Inc. Res Nurs Health 31:86–94, 2008
Nurse Education Today, 2010
Bioscience Blended learning English as a second language (ESL) Web-based learning s u m m a r y T... more Bioscience Blended learning English as a second language (ESL) Web-based learning s u m m a r y Tailoring information to the needs of the learner is an important strategy in contemporary education settings. Web-based learning support, informed by multimedia theory, comprising interactive quizzes, glossaries with audio, short narrated Power Point Ò presentations, animations and digitised video clips were introduced in a first year Bachelor of Nursing biological sciences subject at a university in metropolitan Sydney. All students enrolled in this unit were invited to obtain access to the site and the number of hits to the site was recorded using the student tracking facility available on WebCT, an online course delivery tool adopted widely by many educational institutions and used in this study. Eighty-five percent of students enrolled in the subject accessed the learning support site. Students' perception of the value of a learning support site was assessed using a web-based survey. The survey was completed by 123 participants, representing a response rate of 22%. Three themes emerged from the qualitative data concerning nursing students' perception of the web-based activities: 'enhances my learning', 'study at my own pace', and 'about the activities: what I really liked/disliked'. Web-based interventions, supplementing a traditionally presented nursing science course were perceived by students to be beneficial in both learning and language development. Although students value interactive, multimedia learning they were not ready to completely abandon traditional modes of learning including face-to-face lectures. The findings of this study contribute to an understanding of how web-based resources can be best used to support students' learning in bioscience.
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Papers by Yenna Salamonson