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Article ; Online: Editorial Commentary: I Am Not a Number! I Am a Resident! Can the Assessment of Surgical Skill Be Reduced to a Score?

Middleton, Robert

Arthroscopy : the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy Association

2020 Volume 36, Issue 4, Page(s) 1174–1175

Abstract: Competency-based surgical training requires assessment tools, and these should be both valid and reliable. Global rating scales are one such method, with several developed and investigated for use in arthroscopic skills assessment. These global rating ... ...

Abstract	Competency-based surgical training requires assessment tools, and these should be both valid and reliable. Global rating scales are one such method, with several developed and investigated for use in arthroscopic skills assessment. These global rating scales have shown acceptable reliability and construct validity, most commonly demonstrated using simulated arthroscopic tasks. However, questions remain regarding their readiness for use in the operating room and for the assessment of complex tasks.
MeSH term(s)	Arthroscopy ; Clinical Competence ; Reproducibility of Results
Language	English
Publishing date	2020-03-19
Publishing country	United States
Document type	Editorial ; Comment
ZDB-ID	632528-2
ISSN	1526-3231 ; 0749-8063
ISSN (online)	1526-3231
ISSN	0749-8063
DOI	10.1016/j.arthro.2020.01.054
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Article ; Online: Nurses and nature; Does green space make a difference?

Middleton, Rebekkah / Astell-Burt, Thomas

Journal of clinical nursing

2023 Volume 32, Issue 15-16, Page(s) 4214–4216

Abstract: How we engage in and with nature is of growing interest in relation to our health and well-being. For nurses with stressful workloads that are contributing to fatigue, psychological burden, insomnia, and decreased coping strategies, interactions with ... ...

Abstract	How we engage in and with nature is of growing interest in relation to our health and well-being. For nurses with stressful workloads that are contributing to fatigue, psychological burden, insomnia, and decreased coping strategies, interactions with nature or green space are essential as it has been demonstrated to facilitate better environments and outcomes for nurses. Evidence of the impact of nature is limited. However, the value of interactions with nature has been prioritised by the World Health Organization and so healthcare organizations should be considering overt and practical ways to ensure nurses, and other healthcare providers, are exposed to nature to contribute towards healthier environments.
MeSH term(s)	Humans ; Parks, Recreational ; Adaptation, Psychological ; Health Personnel ; Workload ; Nurses
Language	English
Publishing date	2023-03-30
Publishing country	England
Document type	Editorial
ZDB-ID	1159483-4
ISSN	1365-2702 ; 0962-1067 ; 1752-9816
ISSN (online)	1365-2702
ISSN	0962-1067 ; 1752-9816
DOI	10.1111/jocn.16697
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Zs.A 3764: Show issues

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Article ; Online: Pressure injury prevalence in critical care settings: An observational pre-post intervention study.

Alshahrani, Bassam / Middleton, Rebekkah / Rolls, Kaye / Sim, Jenny

Nursing open

2024 Volume 11, Issue 2, Page(s) e2110

Abstract: Aim: To explore pressure injury prevention practices and evaluate the impact of an educational intervention on PI prevalence before and after an educational intervention.: Design: A multi-centre observational study.: Method: Data were collected at ...

Abstract	Aim: To explore pressure injury prevention practices and evaluate the impact of an educational intervention on PI prevalence before and after an educational intervention. Design: A multi-centre observational study. Method: Data were collected at two time points in May 2021 and April 2022 using a Qualtrics® online form. Two Registered Nurses at each site collected observational data at each time point by diagnosing and staging any identified pressure injuries as part of a prevalence study. Patients admitted to participating units were included. Results: A total of 181 patients in critical care units were included at the two-time points. Pressure injury prevalence was 60.9% at the outset, with 52.9% hospital-acquired, 37.9% unit-acquired and 23.0% medical device-related. Post-intervention prevalence decreased significantly to 28.7%, including 21.3% hospital-acquired, 14.9% unit-acquired, and 8.5% medical device-related. Pressure injuries were prominent in the sacral region, head area, and heels. Stages I and II pressure injuries were the most common. Increased age and longer ICU stays are linked to a heightened risk of pressure injury development in critically ill patients, whereas higher haemoglobin levels show an inverse relationship with the development of both pressure injury and severe stages in the univariate analysis. The predictive models revealed that increased age and longer ICU stays are predictors for both pressure injury development and progression to severe stages, while Braden scores predict the likelihood of developing severe stages of pressure injuries. Conclusions: This study has identified a benchmark for pressure injury prevalence in critical care units in Saudi Arabia. The results demonstrate that pressure injuries can be prevented in critically ill patients when evidence-based education strategies are implemented. Patient care impact: Pressure injuries are an important issue for critically ill patients and can be prevented with proper investments. Strategies to prevent pressure injuries from admission will result in fewer pressure injuries. Reporting method: Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines and the Template for Intervention Description and Replication (TIDieR) checklist. Patient or public contribution: No patient or public contribution.
MeSH term(s)	Humans ; Critical Care ; Critical Illness ; Crush Injuries ; Pressure Ulcer/epidemiology ; Pressure Ulcer/prevention & control ; Prevalence
Language	English
Publishing date	2024-02-23
Publishing country	United States
Document type	Journal Article ; Multicenter Study ; Observational Study
ZDB-ID	2809556-X
ISSN	2054-1058 ; 2054-1058
ISSN (online)	2054-1058
ISSN	2054-1058
DOI	10.1002/nop2.2110
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Article ; Online: Examining the roles of rural nurses in resuscitation care: An ethnographic study.

Riley, Katherine / Wilson, Val / Middleton, Rebekkah / Molloy, Luke

International emergency nursing

2024 Volume 73, Page(s) 101404

Abstract: Introduction: Rural nurses play a vital role in the provision of resuscitation care, as first responders and often the sole healthcare professionals delivering timely interventions with greater role autonomy and extended scope of practice. Whilst there ... ...

Abstract	Introduction: Rural nurses play a vital role in the provision of resuscitation care, as first responders and often the sole healthcare professionals delivering timely interventions with greater role autonomy and extended scope of practice. Whilst there is a developing body of literature describing the 'generalist' roles of rural nurses when providing care in acute care settings, little is known about the roles rural nurses assume during a resuscitation. Aim: The aim of this study was to explore the role/s that rural nurses enact when delivering resuscitative care to their rural community. Design/methods: An ethnographic methodology was used across two rural hospital sites in Australia, involving non-participant observation and interviews. Results: Reflexive thematic analysis led to three themes that described the resuscitative roles of rural nurses: Senior and junior nurse, formal and informal leadership roles, multiple roles. Conclusion: This study has placed a spotlight on rural nurse's capacity to be adaptive in a dynamic and highly variable resuscitative environment. Building leadership capacity should be a rural nursing workforce strategy, aimed at supporting the unique roles that rural nurses undertake when working with various external teams during resuscitations.
MeSH term(s)	Humans ; Rural Population ; Anthropology, Cultural ; Rural Nursing ; Australia ; Nursing Staff ; Nurse's Role
Language	English
Publishing date	2024-02-06
Publishing country	England
Document type	Journal Article
ZDB-ID	2420747-0
ISSN	1878-013X ; 1755-599X
ISSN (online)	1878-013X
ISSN	1755-599X
DOI	10.1016/j.ienj.2023.101404
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Article: Periprosthetic femoral fractures.

Williams, Jevan At / Khawar, Haseeb / Middleton, Rory

British journal of hospital medicine (London, England : 2005)

2024 Volume 85, Issue 2, Page(s) 1–9

Abstract: The incidence of periprosthetic femoral fractures is rising in the UK, because of an ageing population and an increasing number of hip arthroplasty operations being performed. They can occur intra- or postoperatively, and usually follow low energy trauma. ...

Abstract	The incidence of periprosthetic femoral fractures is rising in the UK, because of an ageing population and an increasing number of hip arthroplasty operations being performed. They can occur intra- or postoperatively, and usually follow low energy trauma. They present with pain, swelling over the thigh, and an inability to weight bear. Periprosthetic femoral fractures are usually classified as per the unified classification system. Their management usually is dependent on their classification, with type A (fracture at level of greater or lesser trochanter) managed non-operatively with protected weight bearing, type B (fracture adjacent to implant) managed with either open reduction internal fixation or revision surgery, and type C (fracture distal to implant) managed with open reduction internal fixation. Owing to their complexity, these patients must be adequately optimised before surgery and appropriately rehabilitated.
MeSH term(s)	Humans ; Femoral Fractures/etiology ; Femoral Fractures/surgery ; Femur ; Thigh ; Reoperation ; Aging
Language	English
Publishing date	2024-02-27
Publishing country	England
Document type	Journal Article
ISSN	1750-8460
ISSN	1750-8460
DOI	10.12968/hmed.2023.0378
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Article: Cauda equina syndrome.

Miller, James / West, Jasmine / Khawar, Haseeb / Middleton, Rory

British journal of hospital medicine (London, England : 2005)

2024 Volume 84, Issue 11, Page(s) 1–7

Abstract: Cauda equina syndrome is an uncommon but serious cause of lower back pain resulting from compression of the cauda equina nerve roots, most commonly by lumbar disc herniation. Red flag symptoms, such as bladder dysfunction, saddle anaesthesia and sciatica, ...

Abstract	Cauda equina syndrome is an uncommon but serious cause of lower back pain resulting from compression of the cauda equina nerve roots, most commonly by lumbar disc herniation. Red flag symptoms, such as bladder dysfunction, saddle anaesthesia and sciatica, should lead to high clinical suspicion of cauda equina syndrome. The British Association of Spinal Surgeons has published an updated standard of care for these patients because of the potentially debilitating effects of missed cases of cauda equina syndrome. This review summarises these standards and provides a framework to support quick triage of at-risk patients. Immediate magnetic resonance imaging, within 1 hour of presentation to the emergency department, is crucial in patients with suspected cauda equina syndrome to allow prompt diagnosis and treatment. Urgent decompressive surgery is usually recommended for the best outcomes, to reduce morbidity and complication rates.
MeSH term(s)	Humans ; Cauda Equina Syndrome/diagnosis ; Cauda Equina Syndrome/etiology ; Cauda Equina Syndrome/therapy ; Emergency Service, Hospital ; Triage
Language	English
Publishing date	2024-01-08
Publishing country	England
Document type	Review ; Journal Article
ISSN	1750-8460
ISSN	1750-8460
DOI	10.12968/hmed.2023.0012
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Article ; Online: Using data from mHealth apps to inform person-centred practice: A discussion paper.

Radbron, Emma / McCance, Tanya / Middleton, Rebekkah / Wilson, Valerie

Contemporary nurse

2024 Volume 60, Issue 1, Page(s) 96–105

Abstract: Background: mHealth applications (apps) are tools that can enhance research by efficiently collecting and storing large amounts of data. However, data collection alone does not lead to change. Innovation and practice change occur through utilisation of ... ...

Abstract	Background: mHealth applications (apps) are tools that can enhance research by efficiently collecting and storing large amounts of data. However, data collection alone does not lead to change. Innovation and practice change occur through utilisation of evidence. The volume of data collected raises questions regarding utilisation of data by nurses and midwives, and how data from mHealth apps can be used to improve person-centred practice. There is limited empirical evidence and a lack of direction from global health authorities to guide nurses and midwives in this area. Aim: To describe strategies for nurses and midwives that could enhance the effective use of data generated by mHealth apps to inform person-centred practice. The purpose of this paper is to stimulate reflection and generate actions for data utilisation when using mHealth apps in nursing research and practice. Methods: This discussion paper has been informed by current evidence, the integrated-Promoting Action on Research Implementation in Health Services (i-PARIHS) framework, and research experience as part of doctoral study. Findings: Before engaging in data collection using mHealth apps, nurses and midwives would benefit from considering the nature of the evidence collected, available technological infrastructure, and staff skill levels. When collecting data and interpreting results, use of a team approach supported by engaged leadership and external facilitation is invaluable. This provides support to operate apps, and more importantly use the data collected to inform person-centred practice. Conclusions: This paper addresses the limited available evidence to guide nurses and midwives when using mHealth apps to collect and use data to inform practice change. It highlights the need for appropriate technology, external facilitative support, engaged leadership, and a team approach to collect meaningful evidence using mHealth apps. Clinicians, leaders, and researchers can apply the strategies provided to enhance the use of mHealth apps and ensure translation of evidence into practice.
MeSH term(s)	Pregnancy ; Humans ; Female ; Midwifery ; Data Collection ; Leadership ; Telemedicine/methods
Language	English
Publishing date	2024-02-18
Publishing country	United States
Document type	Journal Article
ZDB-ID	1491361-6
ISSN	1839-3535 ; 1037-6178
ISSN (online)	1839-3535
ISSN	1037-6178
DOI	10.1080/10376178.2024.2316604
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Zs.A 5103: Show issues

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Article ; Online: Observing resuscitative practice. A novice researcher's experience of obtaining ethics approval.

Riley, Katherine / Molloy, Luke / Wilson, Val / Middleton, Rebekkah

Nursing ethics

2023 Volume 30, Issue 7-8, Page(s) 1190–1198

Abstract: Undertaking research involving vulnerable groups, such as those requiring resuscitation involves careful analysis during the ethical review process. When a person lacks the capacity to make an informed choice about their participation in a research study, ...

Abstract	Undertaking research involving vulnerable groups, such as those requiring resuscitation involves careful analysis during the ethical review process. When a person lacks the capacity to make an informed choice about their participation in a research study, a waiver of consent offers an alternative. This paper is based on a doctoral research study using ethnography to explore the resuscitative practices and experiences of rural nurses through observation and interviews. This paper aims to explore the ethical issues raised by the Human Research Ethics Committee relating to consent of vulnerable patients requiring resuscitation within a rural context. In particular, the challenges of addressing risk (privacy) vs benefit (public) associated with a waiver of consent. This paper will consider why the rural context should be championed during the ethical review process, when decisions about public benefit are being deliberated. Utilising a communitarianism approach that advocates for greater rural representation during the ethical review processes will ensure that rural research involving vulnerable groups can be addressed safely and benefit not only the experiences and practices of rural nurses but also the wider rural communities they serve.
MeSH term(s)	Humans ; Ethics, Research ; Anthropology, Cultural ; Privacy ; Rural Population ; Informed Consent
Language	English
Publishing date	2023-06-06
Publishing country	England
Document type	Journal Article
ZDB-ID	1200467-4
ISSN	1477-0989 ; 0969-7330
ISSN (online)	1477-0989
ISSN	0969-7330
DOI	10.1177/09697330231166071
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Article ; Online: Critical care nurses' knowledge and attitudes toward pressure injury prevention: A pre and post intervention study.

Alshahrani, Bassam / Middleton, Rebekkah / Rolls, Kaye / Sim, Jenny

Intensive & critical care nursing

2023 Volume 79, Page(s) 103528

Abstract: Objective: To explore nurses' knowledge and attitudes towards pressure injury prevention before and after implementing an educational intervention.: Design/method: A pre-and post-intervention study. Pre-intervention data collection involved ... ...

Abstract	Objective: To explore nurses' knowledge and attitudes towards pressure injury prevention before and after implementing an educational intervention. Design/method: A pre-and post-intervention study. Pre-intervention data collection involved administering an instrument, including demographic information, the Pressure Ulcer Knowledge Assessment Tool version 2, and the Attitudes towards Pressure Ulcer Prevention instruments. Following the analysis of pre-intervention data, an educational intervention was implemented. Post-intervention data were collected using the same instrument. Setting: Intensive care units at three Saudi Arabian hospitals. Main outcome measures: Nurses' knowledge and attitudes towards pressure injury prevention. Results: The pre-intervention phase included 190 participants, and the post-intervention phase included 195 participants. Participants completed a paper-based survey at two different time points between June 2021 and March 2022. The mean pre-intervention scores for nurses' knowledge and attitudes towards pressure injury prevention were 43.22% and 74.77%, respectively. Following the educational intervention, the knowledge and attitude scores increased significantly to 51.22% and 79.02%, respectively. Higher knowledge of pressure injury prevention was positively associated with positive attitudes towards prevention practices. Age, clinical nursing experience, and experience in intensive care units were identified as factors correlated with knowledge of pressure injury prevention. A Bachelor's qualification or higher predicted better knowledge and attitudes towards pressure injury prevention. Conclusions: Nurses' knowledge and attitudes towards pressure injury prevention greatly improved following tailored, evidence-based education. The educational intervention featured multiple on-site bedside discussions, case studies, small-group presentations, and the provision of printed resources. Implications for clinical practice: Nurses' knowledge and attitudes towards pressure injury prevention should be examined, and education provided to ensure evidence-based prevention practices are implemented. Tailored small-group education sessions delivered conveniently could be an effective approach. Efforts should focus on attracting and retaining experienced, highly qualified nurses to ensure the adoption of evidence-based prevention practices.
MeSH term(s)	Humans ; Pressure Ulcer/prevention & control ; Clinical Competence ; Saudi Arabia ; Nurses ; Critical Care ; Attitude
Language	English
Publishing date	2023-08-19
Publishing country	Netherlands
Document type	Journal Article
ZDB-ID	1105892-4
ISSN	1532-4036 ; 0964-3397
ISSN (online)	1532-4036
ISSN	0964-3397
DOI	10.1016/j.iccn.2023.103528
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Article ; Online: Career optimism and job-related well-being of Australian nurses during COVID-19: A cross-sectional study.

Almeida, Shamika / Gunasekara, Asanka / Wilson, Valerie / Middleton, Rebekkah

Worldviews on evidence-based nursing

2023 Volume 20, Issue 5, Page(s) 431–441

Abstract: Background: Australia has been confronted with a severe nursing deficit, making it difficult to maintain a strong healthcare workforce capable of meeting the mounting demands of healthcare organizations.: Aims: This study aimed to understand how ... ...

Abstract	Background: Australia has been confronted with a severe nursing deficit, making it difficult to maintain a strong healthcare workforce capable of meeting the mounting demands of healthcare organizations. Aims: This study aimed to understand how personal and organizational resources influence career optimism and job-related affective well-being of Australian nurses during a pandemic using the Conservation of Resource Theory. Methods: A cross-sectional online survey was emailed to 123 Australian nurses from January to February 2021. The survey consisted of self-reported measures, including mindfulness, career optimism, job-related affective well-being, personal and job resources measures, and the Dirty Dozen scale. Correlations, independent sample t-test, and a series of hierarchical regressions were conducted on the cross-sectional data with SPSS Version 27. The STROBE checklist was used to report the results. Results: Findings suggested that mindfulness, perceived supervisor support, and job autonomy were significant predictors of job-related well-being, whereas mindfulness, perceived supervisor support, and opportunities for professional growth contributed more to career optimism of nurses during a health crisis. Male nurses in this study reported significantly higher mindfulness, career optimism, and job-related well-being levels than female nurses. Linking evidence to action: Developing mindfulness among nurses, allocating organizational resources to facilitate more supervisor support, and providing job autonomy may enhance career optimism and job-related well-being of nursing staff who work in disruptive and high-demand work environments such as those experienced during the COVID-19 health crisis. Supervisors should also facilitate and encourage nurses to reflect and be mindful of their behaviors with their peers and patients which can help to reduce exploitative or arrogant behaviors in the workplace.
Language	English
Publishing date	2023-08-08
Publishing country	United States
Document type	Journal Article
ZDB-ID	2401967-7
ISSN	1741-6787 ; 1545-102X
ISSN (online)	1741-6787
ISSN	1545-102X
DOI	10.1111/wvn.12671
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