Australian health review: a publication of the Australian Hospital Association
The Department of Paediatrics at John Hunter Hospital, Newcastle, was invited to represent paedia... more The Department of Paediatrics at John Hunter Hospital, Newcastle, was invited to represent paediatric services in the New South Wales Department of Health's customer focus initiative. Six health care organisations were selected to be pathfinder centres in customer focus under this initiative. The aim of these pathfinder centres was to trial customer-oriented projects that would be applicable to other health care organisations. This article will discuss the process through which three customer-focused projects were identified and implemented, and discuss some of the outcomes of these projects.
This article explores the value of using the Critical Incident Technique to capture qualitative d... more This article explores the value of using the Critical Incident Technique to capture qualitative data relating to nurses' experiences in three diverse clinical contexts: (i) neonatal intensive care; (ii) palliative care; and (iii) care of the demented elderly. It is suggested that this technique enables the researcher to capture the reality of contemporary nursing practise, and nurses' experiences of that practise. It is also suggested that the versatility and flexibility of the Critical Incident Technique reveals the subtleties and complexities in nurses' experiences of practising nursing in diverse contexts, thereby promoting a deeper understanding of meanings underpinning this practise.
This paper focuses on negotiation in nursing. It suggests that negotiation, in the form of negoti... more This paper focuses on negotiation in nursing. It suggests that negotiation, in the form of negotiated care, is a key element of nursing practice in the many contexts in which it takes place. To support this statement the process of negotiated care is illustrated by three examples. These examples portray negotiated care as it occurs between nurse manager (or leader) and nurse clinicians, in an interdisciplinary context, and between nurses, other health practitioners and patients/relatives. These examples demonstrate that negotiation which is aimed at achieving quality patient care pervades nursing practice. Nevertheless, it is suggested that nurses often do not recognise the centrality of negotiation in their nursing practice, nor are its implications for long-held beliefs about the role of the nurse considered. This paper also suggests that the successful outcome of negotiation in the context of nursing is dependent on nurses' confidence in, and their ability to articulate their knowledge about, nursing practice. It also relies on their commitment to the therapeutic nature of nursing practice and nurses' awareness that their practice is an essential component to patient care. The specialist nature of negotiation in nursing care, and its fundamental role in the care process, suggests that negotiation in nursing is more accurately termed negotiated care.
Australian Journal of Early Childhood, Mar 1, 2002
Description This paper examines the perceived service needs of families of Hunter region preschoo... more Description This paper examines the perceived service needs of families of Hunter region preschool aged children with disruptive behaviour problems, attending centre-based child care services. Families were recruited via clinics and child care services, using defined ...
The Australian journal of advanced nursing: a quarterly publication of the Royal Australian Nursing Federation
Shared care refers to the formalisation of parents' participation in the care of their ho... more Shared care refers to the formalisation of parents' participation in the care of their hospitalised children. In this paper the planning, implementation and evaluation of a pilot study of shared care in a New South Wales paediatric unit is described. Surveys conducted before and during the pilot study showed that nurses' attitudes to shared care were mostly positive. Parents who participated in shared care also responded positively to the initiative although most had chosen to limit their participation to basic care activities. According to State Trait Anxiety Inventory scores, 50% fewer parents who had experienced shared care were very anxious at the time their children were discharged than parents whose children were hospitalised prior to the introduction of shared care.
Parents frequently find it difficult to decide whether their child is sick, how sick their child ... more Parents frequently find it difficult to decide whether their child is sick, how sick their child is, and if and when they should seek medical advice. The presence of fever appears to be one influence, less is known about other behaviours, signs and symptoms which might guide ...
This paper reports on a study which comprised the first comprehensive evaluation of the Kids Kare... more This paper reports on a study which comprised the first comprehensive evaluation of the Kids Kare Line telephone triage service in which experienced registered nurses respond to parents' requests for health-care advice for their child. This service is located in an acute care hospital in regional New South Wales, Australia. One hundred and one parents who telephoned the Kids Kare Line responded to a telephone-administered survey designed to determine the service's efficiency and effectiveness. Responses demonstrated that parents sought advice about a range of issues, of which the management of fever was the most frequent. All but five parents considered their call to have been answered promptly, all parents understood the advice provided to them and 96% of parents were satisfied with this advice. Fifty parents identified that they had not used another service or health practitioner for the same issue subsequent to their Kids Kare Line telephone call.
This paper describes the process through which a Nursing Development Unit (NDU) was created in a ... more This paper describes the process through which a Nursing Development Unit (NDU) was created in a 29-bed unit in which nurses care for severely demented residents. The question about whether or not ethics clearance is required for the development phase of NDUs is discussed, and the framework in which to develop the NDU described. The benefits of using Participatory Action Research as the basis for undertaking a continuous process of reflection and change is highlighted. It is also suggested that two key elements necessary for NDUs are that they are 'owned' by the staff who work in them and that they are supported by senior management of the organisations in which they exist.
This study sought to identify parents' perspectives about issues relating to the provision of... more This study sought to identify parents' perspectives about issues relating to the provision of health care to their chronically ill children while they are at school. A survey of parents with school-aged children attending the paediatric subspecialty outpatients clinic in a large teaching hospital was designed to collect both qualitative and quantitative data about this topic. Findings included that 48% (n =161) of parents participating in the study said their child required some form of care or attention while at school. Highest scoring areas of need included supervision of meals (36%), administering insulin (19%), and administering nebulizers/puffers (19%). In addition, 75% of parents with children requiring health care while in school said that special knowledge and skill was required to deliver this care; 56% of these parents did not feel that teachers had the knowledge that would enable them too look after their chronically ill child during school hours.
To highlight from a doctoral student's perspective some o... more To highlight from a doctoral student's perspective some of the unexpected and challenging issues that may arise when collecting data in a complex, qualitative study. Using a qualitative approach to undertaking a PhD requires commitment to the research topic, the acquisition of a variety of research skills and the development of expertise in writing. Despite close research supervision and guidance, the first author of this paper experienced unexpected hurdles when collecting data. This article highlights these hurdles and compares them with similar and dissimilar challenges raised by a social researcher with 30 years' experience (White 2012). The first author's experience of field research during her PhD candidature. Informed by a critical theoretical perspective, a snowballing technique was used to examine issues related to data collection by a doctoral student in a qualitative research study. The first author found the logistics of qualitative data collection, concerns about transparency, role confusion and power differentials with participants, and the effective use of video recording technology, unexpectedly challenging. Many of these issues are highlighted in the literature and/or during research supervision. However, the student researcher remains a novice when entering the field. It is often only on reflection after encountering the hurdle that the student recognises future pre-emptive or alternative methods of data collection. The challenges faced as a doctoral student managing the data collection phase of the study concurred with White's discussion of some of the 'real life challenges that novice researchers might face' (2012). Specific guidance and prudence are needed by research students to know when enough data have been collected for manageable analysis within the limits of candidature. Use of reflexivity and mindfulness practised by the student during this phase assisted the ability to reflect, respond and learn from issues as they arose and aim for a harmonious work, study and life balance. This paper highlights these issues and offers suggestions for other research higher degree students facing similar challenges when collecting data in a complex qualitative study.
An 8-month pilot study conducted in urban, rural and remote areas of Australia sought to identify... more An 8-month pilot study conducted in urban, rural and remote areas of Australia sought to identify barriers to nurse-consumer partnerships, as well as strategies to overcome these barriers. One hundred and ninety-nine Registered Nurses (RNs) and 36 consumers participated across 14 workshops to collect data for the pilot study. Analysis of these data found that nurses' perceptions of partnership with consumers were diverse. Nevertheless, participants in the workshops identified 'communication' as the principal barrier to nurse-consumer partnerships. Contexts in which communication barriers occur grouped easily under the themes of information transfer, documentation, education, personal and interpersonal situations, guidelines and policy, organizational structures, politics, resources and time. Workshop participants also worked together to identify/recommend strategies through which the most important barriers to communication in nurse-consumer partnerships could be addressed.
Two linked descriptive qualitative studies, conducted 12 months apart aimed to identify parents&a... more Two linked descriptive qualitative studies, conducted 12 months apart aimed to identify parents' perceptions of discharge information relating to a recent admission of their child to hospital. Study one participants included parents (n = 7) who telephoned a paediatric telephone triage service seeking information about their child's postdischarge care. Study 2 included parents (n = 12) of children admitted to a regional hospital's general paediatric ward. Data were collected via semi-structured interviews conducted with parents following their child's discharge from hospital. These data were analysed using qualitative content analysis separately. The studies were linked in so far as the results from study one informed the modification of the design of study two and its interview protocol. Both studies revealed verbal as well as written information is helpful to parents, plain language usage is important, messages from the health-care team are sometimes inconsistent, and parents need information specific to their particular circumstances.
Australian health review: a publication of the Australian Hospital Association
The Department of Paediatrics at John Hunter Hospital, Newcastle, was invited to represent paedia... more The Department of Paediatrics at John Hunter Hospital, Newcastle, was invited to represent paediatric services in the New South Wales Department of Health's customer focus initiative. Six health care organisations were selected to be pathfinder centres in customer focus under this initiative. The aim of these pathfinder centres was to trial customer-oriented projects that would be applicable to other health care organisations. This article will discuss the process through which three customer-focused projects were identified and implemented, and discuss some of the outcomes of these projects.
This article explores the value of using the Critical Incident Technique to capture qualitative d... more This article explores the value of using the Critical Incident Technique to capture qualitative data relating to nurses' experiences in three diverse clinical contexts: (i) neonatal intensive care; (ii) palliative care; and (iii) care of the demented elderly. It is suggested that this technique enables the researcher to capture the reality of contemporary nursing practise, and nurses' experiences of that practise. It is also suggested that the versatility and flexibility of the Critical Incident Technique reveals the subtleties and complexities in nurses' experiences of practising nursing in diverse contexts, thereby promoting a deeper understanding of meanings underpinning this practise.
This paper focuses on negotiation in nursing. It suggests that negotiation, in the form of negoti... more This paper focuses on negotiation in nursing. It suggests that negotiation, in the form of negotiated care, is a key element of nursing practice in the many contexts in which it takes place. To support this statement the process of negotiated care is illustrated by three examples. These examples portray negotiated care as it occurs between nurse manager (or leader) and nurse clinicians, in an interdisciplinary context, and between nurses, other health practitioners and patients/relatives. These examples demonstrate that negotiation which is aimed at achieving quality patient care pervades nursing practice. Nevertheless, it is suggested that nurses often do not recognise the centrality of negotiation in their nursing practice, nor are its implications for long-held beliefs about the role of the nurse considered. This paper also suggests that the successful outcome of negotiation in the context of nursing is dependent on nurses' confidence in, and their ability to articulate their knowledge about, nursing practice. It also relies on their commitment to the therapeutic nature of nursing practice and nurses' awareness that their practice is an essential component to patient care. The specialist nature of negotiation in nursing care, and its fundamental role in the care process, suggests that negotiation in nursing is more accurately termed negotiated care.
Australian Journal of Early Childhood, Mar 1, 2002
Description This paper examines the perceived service needs of families of Hunter region preschoo... more Description This paper examines the perceived service needs of families of Hunter region preschool aged children with disruptive behaviour problems, attending centre-based child care services. Families were recruited via clinics and child care services, using defined ...
The Australian journal of advanced nursing: a quarterly publication of the Royal Australian Nursing Federation
Shared care refers to the formalisation of parents' participation in the care of their ho... more Shared care refers to the formalisation of parents' participation in the care of their hospitalised children. In this paper the planning, implementation and evaluation of a pilot study of shared care in a New South Wales paediatric unit is described. Surveys conducted before and during the pilot study showed that nurses' attitudes to shared care were mostly positive. Parents who participated in shared care also responded positively to the initiative although most had chosen to limit their participation to basic care activities. According to State Trait Anxiety Inventory scores, 50% fewer parents who had experienced shared care were very anxious at the time their children were discharged than parents whose children were hospitalised prior to the introduction of shared care.
Parents frequently find it difficult to decide whether their child is sick, how sick their child ... more Parents frequently find it difficult to decide whether their child is sick, how sick their child is, and if and when they should seek medical advice. The presence of fever appears to be one influence, less is known about other behaviours, signs and symptoms which might guide ...
This paper reports on a study which comprised the first comprehensive evaluation of the Kids Kare... more This paper reports on a study which comprised the first comprehensive evaluation of the Kids Kare Line telephone triage service in which experienced registered nurses respond to parents' requests for health-care advice for their child. This service is located in an acute care hospital in regional New South Wales, Australia. One hundred and one parents who telephoned the Kids Kare Line responded to a telephone-administered survey designed to determine the service's efficiency and effectiveness. Responses demonstrated that parents sought advice about a range of issues, of which the management of fever was the most frequent. All but five parents considered their call to have been answered promptly, all parents understood the advice provided to them and 96% of parents were satisfied with this advice. Fifty parents identified that they had not used another service or health practitioner for the same issue subsequent to their Kids Kare Line telephone call.
This paper describes the process through which a Nursing Development Unit (NDU) was created in a ... more This paper describes the process through which a Nursing Development Unit (NDU) was created in a 29-bed unit in which nurses care for severely demented residents. The question about whether or not ethics clearance is required for the development phase of NDUs is discussed, and the framework in which to develop the NDU described. The benefits of using Participatory Action Research as the basis for undertaking a continuous process of reflection and change is highlighted. It is also suggested that two key elements necessary for NDUs are that they are 'owned' by the staff who work in them and that they are supported by senior management of the organisations in which they exist.
This study sought to identify parents' perspectives about issues relating to the provision of... more This study sought to identify parents' perspectives about issues relating to the provision of health care to their chronically ill children while they are at school. A survey of parents with school-aged children attending the paediatric subspecialty outpatients clinic in a large teaching hospital was designed to collect both qualitative and quantitative data about this topic. Findings included that 48% (n =161) of parents participating in the study said their child required some form of care or attention while at school. Highest scoring areas of need included supervision of meals (36%), administering insulin (19%), and administering nebulizers/puffers (19%). In addition, 75% of parents with children requiring health care while in school said that special knowledge and skill was required to deliver this care; 56% of these parents did not feel that teachers had the knowledge that would enable them too look after their chronically ill child during school hours.
To highlight from a doctoral student's perspective some o... more To highlight from a doctoral student's perspective some of the unexpected and challenging issues that may arise when collecting data in a complex, qualitative study. Using a qualitative approach to undertaking a PhD requires commitment to the research topic, the acquisition of a variety of research skills and the development of expertise in writing. Despite close research supervision and guidance, the first author of this paper experienced unexpected hurdles when collecting data. This article highlights these hurdles and compares them with similar and dissimilar challenges raised by a social researcher with 30 years' experience (White 2012). The first author's experience of field research during her PhD candidature. Informed by a critical theoretical perspective, a snowballing technique was used to examine issues related to data collection by a doctoral student in a qualitative research study. The first author found the logistics of qualitative data collection, concerns about transparency, role confusion and power differentials with participants, and the effective use of video recording technology, unexpectedly challenging. Many of these issues are highlighted in the literature and/or during research supervision. However, the student researcher remains a novice when entering the field. It is often only on reflection after encountering the hurdle that the student recognises future pre-emptive or alternative methods of data collection. The challenges faced as a doctoral student managing the data collection phase of the study concurred with White's discussion of some of the 'real life challenges that novice researchers might face' (2012). Specific guidance and prudence are needed by research students to know when enough data have been collected for manageable analysis within the limits of candidature. Use of reflexivity and mindfulness practised by the student during this phase assisted the ability to reflect, respond and learn from issues as they arose and aim for a harmonious work, study and life balance. This paper highlights these issues and offers suggestions for other research higher degree students facing similar challenges when collecting data in a complex qualitative study.
An 8-month pilot study conducted in urban, rural and remote areas of Australia sought to identify... more An 8-month pilot study conducted in urban, rural and remote areas of Australia sought to identify barriers to nurse-consumer partnerships, as well as strategies to overcome these barriers. One hundred and ninety-nine Registered Nurses (RNs) and 36 consumers participated across 14 workshops to collect data for the pilot study. Analysis of these data found that nurses' perceptions of partnership with consumers were diverse. Nevertheless, participants in the workshops identified 'communication' as the principal barrier to nurse-consumer partnerships. Contexts in which communication barriers occur grouped easily under the themes of information transfer, documentation, education, personal and interpersonal situations, guidelines and policy, organizational structures, politics, resources and time. Workshop participants also worked together to identify/recommend strategies through which the most important barriers to communication in nurse-consumer partnerships could be addressed.
Two linked descriptive qualitative studies, conducted 12 months apart aimed to identify parents&a... more Two linked descriptive qualitative studies, conducted 12 months apart aimed to identify parents' perceptions of discharge information relating to a recent admission of their child to hospital. Study one participants included parents (n = 7) who telephoned a paediatric telephone triage service seeking information about their child's postdischarge care. Study 2 included parents (n = 12) of children admitted to a regional hospital's general paediatric ward. Data were collected via semi-structured interviews conducted with parents following their child's discharge from hospital. These data were analysed using qualitative content analysis separately. The studies were linked in so far as the results from study one informed the modification of the design of study two and its interview protocol. Both studies revealed verbal as well as written information is helpful to parents, plain language usage is important, messages from the health-care team are sometimes inconsistent, and parents need information specific to their particular circumstances.
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Papers by Diana Keatinge