Australian Journal of Advanced Nursing最新文献

{"title":"The non-medical surgical assistant and inequity in the Australian healthcare system","authors":"Toni Hains, D. Rowell, H. Strand","doi":"10.37464/2020.374.278","DOIUrl":"https://doi.org/10.37464/2020.374.278","url":null,"abstract":"Objectives: The objective of this discussion paper is two-fold. The first is to quantify if the non-medical surgical assistant increases access to surgery by investigating what percentages of cases these clinicians undertake in the private sector surgical units where they work. The second is to examine procedural and distributive justice and how they impact on private sector surgical care. Aim: The aim of this paper is to investigate if the non-medical surgical assistant increases equity via access, for the patient, to private sector surgical care; and if government policy has an impact on equity in the form of access. Background: The private healthcare sector completes approximately two-thirds of all elective surgery in Australia; without this contribution, there would be more pressure on the public healthcare sector. In the private sector, recognition and federal funding of the surgical assistant differs depending on whether this clinician has a medical or non-medical, eg. nursing, qualification. The role of the non-medical surgical assistant is well established internationally and this role has been practiced in Australia for more than 20 years. Discussion: Inequity; as a result of the procedural injustice of government funding policy, impacts the private sector surgical patient causing distributive injustice. This distributive injustice results in an out-of-pocket expense to the patient. Rising outof-pocket expenses has started a trend of patients moving away from private health insurance and into the public sector. The registered nurse and nurse practitioner are qualified to practise as a non-medical surgical assistant and provide increased access to care, and effective care compared to the medical surgical assistant. The nurse practitioner is an eligible provider of Medical Benefits Schedule services but restricted from accessing the intraoperative assisting item numbers. Conclusion: The non-medical surgical assistant; or at least the nurse practitioner as non-medical surgical assistant; require access to the Medical Benefits Schedule intraoperative item numbers. Access would alleviate the out-of-pocket expense incurred by Australian patients when a non-medical surgical assistant assists with their surgery. Lack of access to these item numbers means patients may have their surgery delayed until an appropriately skilled medical surgical assistant is available, or the public healthcare sector can accommodate them. AUTHORS TONI HAINS RN, MClinSc (PNSA), MNPractSt, PhD Cand.1 DAVID ROWELL RN, MHEcon (Advanced), PhD (Econ.)3 HAAKAN STRAND RN, MNPractSt, PhD1,2 1 The University of Queensland, School of Nursing, Midwifery and Social Work, St Lucia, Queensland, Australia. 2 College of Nursing and Midwifery, Charles Darwin University, Casuarina, Northern Territory, Australia. 3 The University of Queensland, Centre for the Business and Economics of Health, Woolloongabba, Queensland, Australia. The non-medical surgical assistant and inequity in the Au","PeriodicalId":55584,"journal":{"name":"Australian Journal of Advanced Nursing","volume":"37 1","pages":"59-67"},"PeriodicalIF":1.4,"publicationDate":"2020-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46943474","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The role of telehealth in supporting mothers and children during the COVID-19 pandemic","authors":"Wendy Smith, Sarah Taki, L. Wen","doi":"10.37464/2020.373.168","DOIUrl":"https://doi.org/10.37464/2020.373.168","url":null,"abstract":"The role of telehealth in supporting community has become increasingly important during the COVID-19 pandemic as we found this coincidently in delivering the Healthy Beginnings program over the phone. We would urge an action to be taken to integrate telehealth into existing health services.","PeriodicalId":55584,"journal":{"name":"Australian Journal of Advanced Nursing","volume":"37 1","pages":"37-38"},"PeriodicalIF":1.4,"publicationDate":"2020-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44769476","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prehospital interventions to prevent hypothermia in trauma patients: a scoping review","authors":"M. Mota, Madalena Cunha, Margarda Reis Santos, E. Santos, Filipe Melo, T. Abrantes, A. Santa","doi":"10.37464/2020.373.88","DOIUrl":"https://doi.org/10.37464/2020.373.88","url":null,"abstract":"Objective: The aim of this review is to map the prehospital rewarming measures used to prevent hypothermia among trauma victims. Background: Hypothermia is responsible for an increase of the mortality and morbidity in trauma victims and its recognition and early treatment are crucial for the victim’s haemodynamic stabilisation. Prehospital interventions are particularly important, especially those that target bleeding control, haemodynamic stability, and safe body temperature. Registered nurses may be pivotal to prevention and minimisation of the dangerous effects of hypothermia. Study design and methods: A scoping review was used to identify articles from several online databases from 2010 to 2018. Studies in English, Spanish, and Portuguese were included. Two reviewers performed data extractions independently. Results: Seven studies were considered eligible for this review: two quantitative research studies, one qualitative research study, and four literature reviews. Rewarming measures can be divided into two main groups: passive rewarming, which includes the use of blankets, positioning the response unit to act as a windbreak, removing the patients’ wet clothes, drying the patient’s body, and increasing the ambient temperature; and active rewarming which includes the use of heating pads, heated oxygen, warmed intravenous fluids, peritoneal irrigation, arteriovenous rewarming, and haemodialysis. Discussion: Active measures reported by the included studies were always used as a complement to the passive measures. Active rewarming produced an increase in core temperature, and passive rewarming was responsible for intrinsic heat-generating mechanisms that will counteract heat loss. Patients receiving passive warming in addition to active warming measures presented a statistically significant increase in body core temperature as well as an improvement in the discomfort caused by cold. Conclusion: Rewarming measures seem to be essential for the prevention of hypothermia and to minimise the discomfort felt by the patient. In many countries registered nurses can play important roles in the  prehospital context of trauma victim’s assistance. Greater understanding of these roles is necessary to the development of better practices. \u0000Implications for research, policy, and practice: The findings of this study highlight that passive and active rewarming measures must be implemented as soon as possible for trauma victims. Many measures are incorporated in trauma relief protocols; however, the lack of consensus on their inclusion results in an undervaluation of this issue, which inevitably compromises the safety and wellbeing of trauma victims. In practice, supportive frameworks and an intervention plan (based on heat loss reduction and heat supply) are required to ensure that first responders including registered nurses are able to prevent and treat hypothermia. \u0000What is already known about the topic?• Hypothermia is a serious threat to trauma victims in th","PeriodicalId":55584,"journal":{"name":"Australian Journal of Advanced Nursing","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2020-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47819922","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A national survey of nurses who care for people with intellectual and developmental disability","authors":"N. Wilson, James Collison, Sarah Feighan, V. Howie, L. Whitehead, M. Wiese, K. O'Reilly, Hayden Jaques, P. Lewis","doi":"10.37464/2020.373.120","DOIUrl":"https://doi.org/10.37464/2020.373.120","url":null,"abstract":"Objective: To describe the roles that Australian nurses play, the breadth of skills that they deploy, and the range of contexts in which they practice. Study design and methods: This cross-sectional study used a descriptive survey where data were collected online using Qualtrics©. Survey respondents were nurses whose primary role was caring for people with intellectual and developmental disability. In addition to demographic data, the main outcome measures were: nursing roles, practice and context. Results: Complete responses were collected from 101 nurses; 78 females and 22 males completed the survey, the majority of whom (n=70) were from New South Wales. The major focus of care was direct assessment and care, followed by supervision of support workers, education, and advocacy for people with intellectual and developmental disability. Physical healthcare was consistent across body systems, as it was for all adaptive behaviour domains. Support for mental illness was more likely to be for depression and anxiety. Nurses liaise with a multitude of health and social agencies as part of their nursing practice. Discussion: This is the first study to capture the roles, practice and contexts of these Australian nurses. Nurses caring for people with IDD play a variety of roles and engage in a vast array of practice related to the physical and social needs of people with intellectual and developmental disability across the whole of the lifespan and in multiple, disparate contexts. Conclusion: It is important for the ongoing care of people with intellectual and developmental disability that the value added by this nursing workforce not be overlooked as disability and health policies evolve. \u0000Implications for research, policy and practice: This cross sectional study lays the groundwork for further research about these Australian nurses, in particular more focussed research about the economic benefits of disability services employing nurses, description and effect of nursing interventions specific to people with intellectual and developmental disability, as well as theoretical work to conceptualise new, National Disability Insurance Scheme-ready, models of nursing care for people with intellectual and developmental disability. \u0000What is already known about the topic?• In the Australian context, little is known about the contemporary roles and practice of nurses who care for people with intellectual and developmental disability.What this paper adds:• This paper offers a detailed and modern insight into the roles and nursing practice of this marginalised group of nurses. Although all nurses offer physical nursing care, unique to these nurses is the breadth and depth of social, behavioural, emotional and adaptive behaviour support across the lifespan.","PeriodicalId":55584,"journal":{"name":"Australian Journal of Advanced Nursing","volume":"37 1","pages":""},"PeriodicalIF":1.4,"publicationDate":"2020-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42818990","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effects of a hospital-based perinatal breastfeeding program on exclusive breastfeeding in Taiwan: a quasi-experimental study","authors":"Ching-Hsueh Yeh, Ya-Pi Ng Yang, Bih-O Lee","doi":"10.37464//2020.373.81","DOIUrl":"https://doi.org/10.37464//2020.373.81","url":null,"abstract":"Objective: To examine if a perinatal breastfeeding program would improve the exclusive breastfeeding rate at a baby-friendly hospital. Background: The Ten Steps to Successful Breastfeeding and Baby-Friendly Hospital Initiative have been widely used to improve breastfeeding outcomes worldwide. A hospital-based multi-strategy intervention may provide an opportunity to increase breastfeeding in different countries. Study design and methods: The study used a quasi-experimental design. Data was collected in a Baby Friendly hospital. A total of 60 mother-infant dyads were included. The experimental group took part in the multi-component perinatal breastfeeding program, while the control group received routine care. The multi-strategy program included prenatal breastfeeding education, birth kangaroo mother care (skin-to-skin contact and non-separation practices) at first breastfeed, continuous 24-hour rooming-in, ongoing kangaroo mother care with breastfeeding on cue, and hospital support visits. The exclusive breastfeeding rate was measured at hospital discharge, and one-month postpartum. Results: The mothers who participated in the intervention had a greater exclusive breastfeeding rate at hospital discharge and one month postpartum than those in the control group. In the experimental group, 90% of the infants completed the first feeding within two hours after birth. At discharge, 93.3% of the mothers in the experimental group and 53.3% in the control group were exclusively breastfeeding. At one month postpartum, 83.3% of the mothers in the experimental group and 36.7% in the control group were still exclusively breastfeeding. Discussion: The intervention program used in the current study is different to previous studies. The current intervention not only included prenatal education and postpartum support, but also included birth kangaroo mother care at first breastfeed and ongoing kangaroo mother care with breastfeeding on cue. Breastfeeding should be promoted through perinatal comprehensive clinical and social support starting in the prenatal period and continuing through intrapartal, postpartum, and follow-up periods. Conclusion: This study was the first study to use a hospital-based multi-strategy intervention including the non-separation of mother-infant dyads and other breastfeeding support for mothers in Taiwan. The program was associated with a significant improvement in the exclusive breastfeeding rate at one month postpartum.","PeriodicalId":55584,"journal":{"name":"Australian Journal of Advanced Nursing","volume":"1 1","pages":""},"PeriodicalIF":1.4,"publicationDate":"2020-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43323091","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Recognition for registered nurses supporting students on clinical placement: a grounded theory study","authors":"C. Anderson, L. Moxham, M. Broadbent","doi":"10.37464/2020.373.98","DOIUrl":"https://doi.org/10.37464/2020.373.98","url":null,"abstract":"Objective: This study examined registered nurses’ perspectives of being supportive of nursing students and providing them with learning opportunities when on clinical placements. Background: In Australia, as part of their three-year Bachelors degree, undergraduate nursing students undertake a minimum of 800 hours of clinical placement. During these clinical placement hours, nursing students are supervised by registered nurses who are required to be supportive of the students and provide them with learning opportunities. Study design and methods: This study used a grounded theory approach. In this qualitative study there were fifteen registered nurse participants. Thirteen participants were female participants and two were male. Participants were individually interviewed. Transcripts from these in–depth interviews were analysed using constant comparative analysis. Results: The major category, an added extra, emerged from this study. An added extra is about registered nurses’ perception that having a student is an added extra to their daily duties. The major category an added extra is informed by three emergent themes. The first theme was time, the second theme was workload and the third theme was wanting recognition. Discussion: Registered nurses perceived that their workloads tend not to be taken into consideration when they have nursing students. The literature suggests that nursing students often miss out on learning opportunities when they are on clinical placement because registered nurses do not have additional time to effectively support students’ clinical learning. Conclusion: Participants in this study believed being supportive of nursing students and providing them with learning opportunities was an added extra to their daily nursing duties. Findings revealed registered nurses want to be recognised for the extra time and effort they dedicate to students’ learning.","PeriodicalId":55584,"journal":{"name":"Australian Journal of Advanced Nursing","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2020-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46023731","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"COVID-19 and residential aged care in Australia","authors":"J. Ibrahim","doi":"10.37464/2020.373.226","DOIUrl":"https://doi.org/10.37464/2020.373.226","url":null,"abstract":"The aged care sector requires transformation. The havoc wreaked by the COVID-19 pandemic globally and nationally may create an environment where the required changes are lost to other priorities. \u0000Australia’s success with the emergency response and management of COVID-19 pandemic are in a large part due to inherent underlying geographic and population factors. \u0000When reflecting on this pandemic we must objectively examine the domains of governance, workforce, models of care, evaluation and finally, resources and infrastructure. The COVID-19 pandemic highlighted major gaps in each domain. A prudent approach is required if we are to guard against the high COVID-19 case fatality rate of residents in aged care homes and to progress with much needed long-term changes.","PeriodicalId":55584,"journal":{"name":"Australian Journal of Advanced Nursing","volume":"37 1","pages":"1-3"},"PeriodicalIF":1.4,"publicationDate":"2020-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46284121","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Registered nurses as role models for healthy lifestyles","authors":"Penny Heidke, W. Madsen, E. Langham","doi":"10.37464/2020.372.65","DOIUrl":"https://doi.org/10.37464/2020.372.65","url":null,"abstract":"Objective: The aim of this paper is to report on registered nurses’ adherence to current Australian health behaviour recommendations. Barriers and facilitators to healthy lifestyles, and their attitudes towards being role models and promoting healthy lifestyles to their patients. \u0000Background: It is widely accepted that a healthy diet, limiting alcohol consumption, abstinence from smoking and regular physical exercise are important components of healthy lifestyles and play a significant role in preventing chronic diseases. Nurses are well situated to contribute to providing health and patient education regarding modifiable health risk factors, however their own adherence to health behaviours may impact this. \u0000Study design and methods: The research is a mixed methods study of 123 registered nurses from both public and private organisations in Regional Queensland. Data for this paper were generated from an online survey which is the first of two phases in the broader study. \u0000Results: Four health risk factors were examined; diet, smoking, physical exercise and alcohol consumption. BMI was also calculated and considered as a fifth risk factor. Of this sample, 13% of participants met the guidelines for fruit and vegetable intake, 5.2% smoked, and only 24.2% exercised enough to be classed sufficiently active for their health. Of the 93.62% of participants whom consumed alcohol, 69.3% consumed more than 2 standard drinks/day. The most common barriers to adhering to healthy lifestyles were shift work, long working hours and family commitments. \u0000Conclusion: Many nurses are not adhering to healthy lifestyle recommendations. It is recommended that the health and wellbeing of our health professionals, especially nurses be considered.  Providing support and resources to enable them to care for themselves, may in turn allow them to better care for patients. \u0000Implications for research, policy, and practice: Research is needed into strategies to enable registered nurses’ better work/life balance. To make a real difference to health outcomes, nurses own health and health education needs to be made a priority that is supported and implemented at multiple points: by policymakers, within nursing practice, nursing curriculum, and in healthcare institutions. Nurses need to be supported in the provision health education to their patients with better resources, education and time allocation. Future research should include studies conducted in different regions or ideally a large nationally representative sample.","PeriodicalId":55584,"journal":{"name":"Australian Journal of Advanced Nursing","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2020-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43974916","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nurses documentation of falls prevention in a patient centred care plan in a medical ward","authors":"Caglayan Yasan, T. Burton, Mark Tracey","doi":"10.37464/2020.372.103","DOIUrl":"https://doi.org/10.37464/2020.372.103","url":null,"abstract":"Objective: To evaluate the consistency of nurses' documentation in the falls prevention assessment tool, and to ascertain whether patients identified as high risk of falling had falls preventative strategies implemented. \u0000 \u0000Background: Falls are one of the leading causes of adverse events for patients in the hospital setting. The current practice of implementing falls prevention strategies for patients has not been able to be sustained, which remains a challenge for healthcare providers. Among the falls prevention strategies, falls risk assessment tools have been identified as a crucial element in falls prevention so as the number of falls are minimised. \u0000 \u0000Study design and methods: Descriptive Cohort design, with the auditing of falls assessment documentation on the Patient Centred Care Plan. \u0000 \u0000Results: The Patient Centred Care Plan audit revealed that 60.8% of patients (n=508) were identified as high risk of falls by the principal investigator. For the cohort of patients identified as by the nurses as having a high risk of falling (53.4%), 53.7% of patients had falls prevention strategies implemented, and only 17.5% of patients were engaged with their falls prevention plan. The strategies that were documented by the nurses on the care plan for the high-risk cohort were not implemented for 16.8% of the patients, and 29.5% of high risk of falls patients did not have documentation on the plan indicating their falls status. \u0000 \u0000Discussion: The findings show that there is a significant gap in the identification of high falls risk patients and the documentation and implementation of falls prevention strategies, between nursing staff records on the Patient Centred Care Plan and the audit conducted by the principal investigator for patients who are identified as high falls risk. As part of the audit patient engagement in their falls prevention plan revealed that patients were not informed of their falls risk status by the nursing staff. \u0000 \u0000Conclusion: The outcome from this audit signifies that not all high falls risk patients were identified as a high falls risk, and most of the high falls risk patients were not engaged in their falls prevention plan. \u0000 \u0000Implications for research, policy and practice: Understanding the current practices of falls prevention and raising nursing staff awareness of the identified variance in the implementation of falls prevention strategies will improve the quality, efficiency of healthcare and the patient safety.","PeriodicalId":55584,"journal":{"name":"Australian Journal of Advanced Nursing","volume":"37 1","pages":"19-24"},"PeriodicalIF":1.4,"publicationDate":"2020-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42543428","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The organisational socialisation of new graduate nurses and midwives within three months of their entrance into the health workforce","authors":"S. Ohr, Doreen Holm, M. Giles","doi":"10.37464/2020.372.102","DOIUrl":"https://doi.org/10.37464/2020.372.102","url":null,"abstract":"Objective: To investigate if the current onboarding process influences the organisational socialisation of new graduate nurses and midwives into the workforce.  \u0000Background: Positive organisational socialisation experience for new graduate nurses and midwives during their entry into the healthcare environment is an important contributor when building an organisation’s ability to increase workforce capacity. However, few studies have investigated the onboarding processes to promote their organisational socialisation. \u0000Study design and methods: A quantitative, descriptive, cross-sectional study design was conducted at a large Local Health District that provides health services to almost one million people in metropolitan, rural and remote locations. Participants were 170 new graduate nurses and midwives who commenced their transition program at 21 acute and community healthcare settings within the District in January and February 2017. Data was collected through a document review of current onboarding processes and by an online survey of new graduates. Data sets were analysed using descriptive statistics and content analysis. \u0000Results: The survey response rate was 47% (n= 80). Findings highlight that the onboarding process provided by the District was useful for the new graduate’s transition into the workplace. The findings also indicated that the onboarding process was inconsistent across different contexts in the District and required more relevant and practical components. In addition, the current onboarding did not adequately provide strategies to build relationships for new graduates within their work environments. \u0000Discussion: This study provides valuable insight into current onboarding practices in both metropolitan and rural contexts and highlights gaps in this process across the health District. The findings of the study provide insights and future direction for improvements with addressing the inconsistency in the structure and content of orientation programs. The need for more accessible and consistent organisational information and a more structured framework for the organisational wide onboarding process was also identified. \u0000Conclusion: Re-design of an onboarding process that is relevant, consistent and enhances relationship-building is imperative to meeting both the professional and organisational needs of new graduate nurses and midwives. \u0000Implications for research, policy and practice: The findings of the study imply a need to streamline the onboarding process to provide greater opportunity for new graduates to develop and sustain professional networks and associated workplace relationships regardless of their locations. They also signal a need to develop policies practice and future research to assist a better organisational socialisation, in particular, the allocation of resources, better utilisation of time spent on education and workplace support in the transition into their clinical workplaces. \u0000What is already known about the","PeriodicalId":55584,"journal":{"name":"Australian Journal of Advanced Nursing","volume":"37 1","pages":"3-10"},"PeriodicalIF":1.4,"publicationDate":"2020-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43862277","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}