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Aims and Objective: To capture the experiences of nurses in relation to the acutely physiologically deteriorating consumer., Background: Improving the physical health care of consumers with mental illness has been widely adopted as a priority for mental health nursing. Much of the effort thus far has focused on routine screening, prevention and treatment of common comorbidities including cardiovascular disease, diabetes mellitus and cancer. There has been less focus on the acutely physiologically deteriorating consumer in the mental health setting. Further study is warranted since this issue poses a set of highly complex challenges for nurses within the inpatient setting., Method: An exploratory, descriptive study was employed using focus groups to gather narrative data, which was then subject to qualitative analysis. Eleven mental health inpatient wards within a local health district in Sydney, Australia, were studied, comprising ward-based nurses (n = 64) and nurse unit managers (n = 8). This paper follows the COREQ guidelines for reporting qualitative health research., Results: Qualitative data analysis revealed three themes central to the nurses' experience: (a) lack of clarity (subthemes: procedures and leadership accountability); (b) confidence in the workforce (subthemes: knowledge and skills, training needs, relevant experience, collaboration with emergency and medical teams, stigmatising attitudes); and (c) complexity (subthemes: complexity as the new norm and suitability of the mental health environment)., Conclusion: The themes found in this study can be used to guide and inform healthcare policy, protocols, education and processes around building a more confident nurse workforce for the acutely physiologically deteriorating consumer., Relevance to Clinical Practice: Findings provide a rich data set for the generation of measurement tools and protocols to guide physical health care and evaluate performance., (© 2019 Commonwealth of Australia Journal of Clinical Nursing © 2019 John Wiley & Sons Ltd.)

Aims and Objectives: This study sought to explore undergraduate nursing students' perceptions of the role and value of their bioscience tutors in a blended learning curriculum., Background: Blended learning approaches typically have reduced face-to-face contact with tutors-particularly in bioscience subjects which nursing students have traditionally found difficult, and the move to more web-based learning resources may compound this difficulty., Design: Qualitative descriptive study., Methods: This qualitative study was conducted with 19 undergraduate nursing students enrolled in bioscience subjects, at a large university in outer metropolitan Sydney, Australia in 2016. Semi-structured interviews were conducted over the telephone or face-to-face. Duration of interviews ranged from 13 to 71 min. Results were thematically analysed. EQUATOR guidelines for qualitative research (COREQ) applied., Results: Two main themes with accompanying sub-themes were identified. The first theme identified the importance of the tutor in bioscience, including their qualities, expertise and contextualisation of learning. The second theme provided insights into students' perceptions of what they considered good and poor approaches to learning., Conclusions: This study has clearly shown that while nursing students appreciated the flexibility offered by the online component of a blended learning curriculum, they still wanted an experienced bioscience tutor with clinical experience for their face-to-face classes. While the tutor was seen as crucial to providing clarification and context for content that was often challenging, they also played a key role in engaging and motivating students and creating a learning environment where students felt empowered to ask questions and debate issues with their peers. Given the increased use of online learning, further research could determine if the current study findings are also applicable in nonscience areas of study., Relevance to Clinical Practice: The importance of students having a sound understanding of the biosciences for safe, effective clinical practice cannot be underestimated., (© 2019 John Wiley & Sons Ltd.)

Aims and Objectives: To explore the experiences of first-year nursing students, their motivations for working and how they juggled study and other commitments while engaging in paid work., Background: There has been a global rise in the number of students balancing full-time study, paid work and other commitments, with the main antecedent financial reasons., Design: Qualitative exploratory study., Methods: Drawn from a larger Australasian sequential exploratory mixed-method study, this qualitative study was conducted with fifty first-year undergraduate nursing and midwifery students who commenced their nursing studies in 2017. Telephone or face-to-face interviews were conducted with purposively selected students engaged in either nursing or non-nursing fields of work. Interviews were conducted from April-July 2017. Interviews lasted from 15-40 min. Results were thematically analysed. EQUATOR guidelines for qualitative research (COREQ) applied., Findings: Two main themes and accompanying subthemes were identified. The first theme explored students' motivation behind combining work and study and identified the need for financial security and "me time". The second theme "Juggling many balls" provided insights into the benefits students perceived, how they kept the "balls" in the air and at times dropped "balls" while balancing work, study and other commitments., Conclusions: The motivation behind paid work was mainly financial; however, students also reported work allowed an escape and time for self which had social and health benefits. Working provided a range of positive benefits, including a sense of achievement, improved self-esteem and financial independence., Relevance to Clinical Practice: Being able to juggle and multi-task improved skills such as organisation and the ability to prioritise, all skills that have applicability for the role as registered nurse., (© 2019 John Wiley & Sons Ltd.)

Aim and Objectives: To examine the factors that influence nursing students' mathematics self-efficacy, the effect of numeracy instruction on self-efficacy, and the association between self-efficacy and numeracy test performance., Background: Medication administration errors, including administering incorrect dosages or infusion rates, can result in serious harm to patients. Hence, it is essential that nursing students are adequately prepared with the necessary numeracy skills during their nursing program., Design: This quasi-experimental cohort study used a pre- and post-test survey design. The study complied with the STROBE checklist for cohort research., Methods: In total, n = 715 undergraduate first year nursing students participated in the study from June to October 2017 at a single multi-campus university in the Western Sydney region of Australia. Data were collected at three time-points: (a) baseline, including assessing pre-instruction mathematics self-efficacy (NSE-Math scale); (b) 6-week follow-up; including assessing post-instruction mathematics self-efficacy; and (c) numeracy test performance was collected at 7-week follow-up., Findings: At baseline, those with high NSE-Math scale scores were more likely to be male and have at least high school advanced mathematics level education. Following structured numeracy instruction, NSE-Math scale scores increased significantly, and those who obtained a satisfactory grade in their numeracy assessment were more likely to have high NSE-Math scale scores and high academic performance in the previous semester., Conclusion: The study shows that structured numeracy instruction improved mathematics self-efficacy, which in turn influenced numeracy test performance., Relevance to Clinical Practice: Using a structured medication numeracy pedagogical approach, to teach skills in nursing undergraduate programs, provides students with the foundations to improve mathematics self-efficacy and to be successful and safe with medication numeracy calculations and administration in clinical practice., (© 2019 John Wiley & Sons Ltd.)

Aims and Objectives: To explore the experiences of commencing first-year undergraduate nursing students who were studying full time while engaging in 20 or more hours of paid work each week., Method: Using a qualitative exploratory design, commencing full-time nursing students who were employed in paid work for at least 20 hr per week were interviewed between May-June 2016. Data were thematically analysed using the following approach: data familiarisation, generating initial codes independently, searching and reviewing themes and subthemes, and defining and naming these themes and subthemes., Results: Four main themes were identified which illustrated students' experiences of working and studying: (a) "Work is a necessity…not a choice" identified how students relied heavily on the financial income from paid work to support themselves and others during their studies, (b) "Something's got to give" highlighted the sacrifices that needed to be made to avoid negative effects on their studies, (c) "It's a balancing act!" demonstrated how students studied strategically and balanced their workload despite challenges, and lastly (d) "Being supported to work and study" described the overwhelming support from others for students to succeed academically., Conclusions: Despite support, working 20 hr or more per week while studying full time often overwhelmed students' personal resources and negatively impacted on course grades. Inflexible University timetables compounded the challenges experienced by students who struggled to balance work and study commitments., Relevance to Clinical Practice: Nursing employers play a pivotal role in enabling students to juggle effectively their work-study commitments, through providing work flexibility. Students may also benefit if the nursing workforce advocates that they be awarded exclusion from selected clinical placement requirements, particularly if the clinical placement focus is closely related to their current nursing employment., (© 2018 John Wiley & Sons Ltd.)

Aims and Objectives: To investigate the feasibility of a 13-week mentoring programme in providing social support to promote hope for recovery in anorexia nervosa., Background: With no clear first-line psychological treatment for people with anorexia nervosa, mentoring support programmes, as an adjunct to treatment, may provide the social support necessary to promote hope for recovery., Design: A mixed-method study; participatory action research., Methods: Women (n = 11), recovering and who had recovered from anorexia nervosa, participated in the programme and completed self-report questionnaires related to quality of life, distress and the mentoring relationship at different time points. Qualitative feedback from logbooks, workshop evaluation questionnaires, interviews and focus groups was also collected to assess the programme's acceptability., Results: General compliance for completing most study outcome questionnaires was 90%; however, the mentoring relationship questionnaires were not completed to the same degree. Five key themes emerged from the focus group/interview data: (i) she understands me and could relate to me; (ii) reconnecting with the world-asking questions and being challenged; (iii) mentors' altruistic motivations and the transformation and discovery of self; (iv) instilling hope-recovery is possible; and (v) effective communication-the key to successful mentoring., Conclusions: Further research is needed; however, the results provide preliminary support for the mentoring programme's feasibility as an adjunct to treatment. We found that having someone who understands, to talk and share with, met a clear need for people with anorexia nervosa., Relevance to Clinical Practice: While further research is warranted mentoring support or recovered mentors, may play a potentially valuable role in supporting those in community settings., (© 2017 John Wiley & Sons Ltd.)

Aims and Objectives: To identify the prevalence and antecedents of plagiarism within nursing education and approaches to prevention and management., Background: There has been growing media attention highlighting the prevalence of plagiarism in universities, including the academic integrity of undergraduate nursing students. A breach of academic integrity among nursing students also raises further concern with the potential transfer of this dishonest behaviour to the clinical setting., Design: Integrative review., Methods: A systematic search of five electronic databases including CINAHL, MEDLINE, SCOPUS, ProQuest Nursing & Allied Health Source, and ERIC was undertaken. Only primary studies related to plagiarism and nursing students (undergraduate or postgraduate) studying at a tertiary education institution or nursing faculty were included. Both qualitative and quantitative study designs were included., Results: Twenty studies were included in this review with six key themes identified: (1) prevalence; (2) knowledge, understanding and attitudes; (3) types of plagiarism; (4) antecedents to plagiarism; (5) interventions to reduce or prevent plagiarism; and (6) the relationship between academic honesty and professional integrity. Plagiarism is common among university nursing students, with a difference in perception of this behaviour between students and academics. The review also highlighted the importance of distinguishing between inadvertent and deliberate plagiarism, with differing strategies suggested to address this behaviour. Nevertheless, interventions to reduce plagiarism have not been shown to be effective., Conclusions: The current punitive approach to plagiarism within nursing faculties has not reduced its occurrence. There is a need to promote awareness, knowledge and provide students with the appropriate referencing skills, to reduce the significant amount of inadvertent plagiarism., Relevance to Clinical Practice: The importance of promoting honesty and academic integrity in nursing education is highlighted. Cheating within the academic setting has been associated with dishonesty in the clinical setting, which highlights the importance of nurturing a culture of honesty and integrity at university., (© 2016 John Wiley & Sons Ltd.)