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Background End-of-life and bereavement care is an important consideration in intensive care. This study describes the type of bereavement care provided in intensive care units across Australia and New Zealand. Design Inductive qualitative content analysis was conducted on free-text responses to a web-based survey exploring unit-based bereavement practice distributed to nurse managers in 229 intensive care units in New Zealand and Australia. Results A total of 153 (67%) surveys were returned with 68 respondents making free-text responses. Respondents were mainly Australian ( n = 54, 85·3%), from the public sector ( n = 51, 75%) and holding Nurse Unit Managers/Charge Nurse roles ( n = 39, 52·9%). From the 124 free-text responses, a total of 187 individual codes were identified focussing on bereavement care practices ( n = 145, 77·5%), educational provision to support staff ( n = 15, 8%) and organisational challenges ( n = 27, 14·4%). Bereavement care practices described use of memory boxes, cultural specificity, annual memorial services and use of community support services. Educational provision identified local in-service programmes, and national bereavement courses for specialist bereavement nurse coordinators. Organisational challenges focussed on lack of funding, especially for provision of bereavement follow-up. Conclusions This is the first Australasian-wide survey, and one of the few international studies, describing bereavement practices within intensive care, an important aspect of nursing practice. However, with funding for new bereavement services and education for staff lacking, there are continued challenges in developing bereavement care. Given knowledge about the impact of these areas of care on bereaved family members, this requires review. Relevance to clinical practice Nurses remain committed to supporting bereaved families during and following death in intensive care. With limited resource to support bereavement care, intensive care nurses undertake a range of bereavement care practices at time of death, and after death through family bereavement follow-up. [ABSTRACT FROM AUTHOR]

Accessible summary The Mental Health Nurse Incentive Program ( MHNIP) is a funding scheme in Australia that enables mental health nurses to work in primary care settings with people with complex mental health problems for as long as necessary. This study examined the outcomes of the programme as reported by nurses., Nurses provided profiles of 64 people with whom they worked, including measures of symptoms and problems on admission to the programme and at a second point in time., The findings showed that people had high levels of symptom severity and distress on admission, and they experienced significant improvements in all problem areas except physical health over their time working with the nurse., The MHNIP appears to be addressing the needs of people with highly complex needs, but more sensitive measures of outcome ought to be routinely collected., Abstract The Mental Health Nurse Incentive Program ( MHNIP) provides a funding mechanism for credentialed mental health nurses to work in primary care settings in Australia with people with complex and serious psychosocial and mental health problems. This project explored the extent to which the programme contributed to positive outcomes. Sixty-four service user profiles were provided by nurses working within the programme, including the Health of the Nation Outcome Scales ( HoNOS), on admission and at the last review point. Mean total HoNOS scores on admission were higher than those typically seen on admission to inpatient care in Australia. Significant reductions in all problem areas except physical health problems were found at the last review point for this sample. These findings support the viewpoint that MHNIP is addressing the needs of people with the most complex needs in primary care and is achieving clinically significant outcomes. [ABSTRACT FROM AUTHOR]

Aims and objectives To identify nurse perceptions on the potential value of general and specific nursing approaches to improving physical health outcomes of people with serious mental illness. Background People diagnosed with serious mental illnesses experience heightened rates of physical illnesses and can be supported better via healthcare system prevention and management. Nurses working in mental health are a critical part of a system-wide approach to improving physical health care, but there is little known on their views on specific approaches within Australia (e.g. screening for risks, stigma reduction). Design A national, cross-sectional and nonrandom survey study delivered online. Methods Members of the Australian College of Mental Health Nurses ( n = 643), representing nurses employed in mental healthcare services across Australia (71·6% from public mental health services). Participants were asked to rate the potential of nine nurse-based strategies for improving physical health (options: 'yes', 'no', 'not sure') and the potential value of 10 nursing and general strategies for improving physical health (rating from 'negative value' to 'significant value'). Results There was a high endorsement of all nine nurse-based strategies for physical health (e.g. lifestyle programmes, screening, linking services), although there was less support for reducing antipsychotics or advocating for fewer side effects. Participants mainly viewed all strategies as of moderate to significant value, with the most promising value attached to colocation of primary and mental care services, lifestyle programmes and improving primary care services (reduce stigma, train GPs). Conclusions Australian nurses working in mental health services view a range of nurse-based strategies for improving physical healthcare services and standards as important. Relevance to clinical practice Nurses collectively need to work with consumers, health agencies and the general public to further define how to organise and implement physical health integration strategies, towards more comprehensive health care of people with serious mental illness. [ABSTRACT FROM AUTHOR]

Background: In most hospital environments emphasis is placed on time management and efficiency in all aspects of patient care. This emphasis also exists in palliative care units (PCUs), where there may be a lack of recognition of the complexity of care required. Aim: The aim of this quality improvement study was to examine the work and time associated with after-death care in a PCU in Australia. This included determining the length of time required to carry out after-death care, which factors lengthen an after-death episode and which health professionals provide after-death support for the bereaved family/friends and the amount and nature of that support. These findings were then compared with similar research carried out in 2005. Methods: Nurses completed a questionnaire following the death of a patient during two designated datacollection periods in the PCU. Each data-collection period lasted 1 month. Findings from both data-collection periods were examined separately and collectively. Results: Caring for the deceased patient is time consuming. Many processes and factors were identified that contribute to the 'hidden' nature of this work, e.g. care/counselling of family, religious/cultural requirements, staff availability, funeral directors and pastoral carers. Conclusion: The study provides a valuable insight into the work involved with after-death care, factors which surround after-death care and the unacknowledged role of the nurse in after-death care. [ABSTRACT FROM AUTHOR]

Health reform worldwide is required due to the largely aging population, increase in chronic diseases, and rising costs. To meet these needs, nurses are being encouraged to practice to the full extent of their skills and take significant leadership roles in health policy, planning, and provision. This can involve entrepreneurial or intrapreneurial roles. Although nurses form the largest group of health professionals, they are frequently restricted in their scope of practice. Nurses can help to improve health services in a cost effective way, but to do so, they must be seen as equal partners in health service provision. This article provides a global perspective on evolving nursing roles for innovation in health care. A historical overview of entrepreneurship and intrapreneurship is offered. Included also is discussion of a social entrepreneurship approach for nursing, settings for nurse entre/intrapreneurship, and implications for research and practice. [ABSTRACT FROM AUTHOR]