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Aspects of Nursing Education: The Types Of Skills And Knowledge Required To Meet The Changing Needs Of The Labour Force Involved In Nursing - Literature Review

• Chapter 1 Introduction
  • The Purpose of the Report
  • The Scope of the Literature Review
  • Methodology
    • Search Strategy
    • Database Searching
    • Internet Searching

Chapter 1 

Introduction

The Purpose of the Report

In April 2001, The Ministers for Education, Training and Youth Affairs, and Health and Aged Care jointly announced a National Review of Nursing Education to examine the current context of health services and preparation for nursing practice, and to ensure that nursing education is able to meet the changing needs of the labour market.

In mid July, the Victorian Centre for Nursing Practice Research, located at the School of Postgraduate Nursing, University of Melbourne was appointed by the Department of Education, Training and Youth Affairs, and Department of Health and Aged Care to undertake a literature review on aspects of Nursing Education.

This interim report outlines the process of review, the evidence gathered and analysed, and a summary presented.

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The Scope of the Literature Review

The aim of this literature review is to identify recent and predicted changes in health care that impact upon nursing and to identify the types of skill and knowledge the nurse has required and will require to deal with these changes.

The specific objectives addressed in this review are

• To describe changes in the types of service provided, including what, where and how those services are provided, over the past five years which have impacted on nursing
• To describe changes in the roles of health professionals which have impacted on nursing
• To summarise narratively how the above impact on the skills and knowledge required by the nursing workforce.

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Methodology

Criteria for Considering Studies for this Literature Review

As the overall purpose of this literature review was to identify recent changes in health care which impact on nursing, studies across a wide variety of topics and methodologies were sought.

Studies were considered appropriate if they

• Had been conducted in Australia, New Zealand, United Kingdom, Canada, United States of America, Holland or Scandinavia AND
• Documented a change in health care service provision OR a change in the role of a healthcare provider in the last five years AND
• The change had an actual or potential impact on nursing. This impact may have been explicitly stated in the text, or alternatively, the reader of the abstract believed there was a possible impact even though it was not stated.

The type of studies included was initially kept broad. It was acknowledged that information about changes occurring in health care service provision and providers was likely to be descriptive and the number of studies that met the criteria for the four National Health and Medical Research Council (NHMRC) levels of evidence (Table 1) was unknown.

Table 1 Designation of levels of evidence

Source: NHMRC 1999

Search Strategy

The search sought both published journal articles, reports and legislation; and unpublished theses. In addition, information was gathered from both professional and government Internet sites.

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Database Searching

An extensive search of databases was conducted. This included

A combined search of Journals@Ovid, Cochrane Database, CINAHL, Current Contents and MEDLINE. The search terms used relate to the objectives of the literature review and were used in the fields: title, abstract, key word, subject heading and outline headings. Search terms:

(service provision) and (chang$ or new) and nurs$

(health care provision) and (chang$ or new) and nurs$

(health care professional) and role and (chang$ or new)

(model$ of care) and (chang$ or new)

(case manager) and (role adj chang$) or (role adj new)

(coordinated care) and (role adj chang$) or (role adj new)

(shared care) and (role adj chang$) or (role adj new)

telehealth

telemedicine

(hospital in the home) and (role adj chang$) or (role adj new)

(minimally invasive surgery)

(primary care) and (role adj chang$) or (role adj new)

(preventative care) and (role adj chang$) or (role adj new)

nurs$ and (role adj chang$) or (role adj new)

nurs$ and (independent practice)

nurs$ and (scope of practice)

radiology and (role adj chang$) or (role adj new)

(diagnostic studies) and (role adj chang$) or (role adj new)

(organ procurement) and nurs$ and (role adj chang$) or (role adj new)

(transplant coordination) and nurs$ and (role adj chang$) or (role adj new)

angiography and (role adj chang$) or (role adj new)

(telephone triage) and (role adj chang$) or (role adj new)

(protocol adj driven) and nurs$ (role adj chang$) or (role adj new)

leadership (role adj chang$) or (role adj new)

management (role adj chang$) or (role adj new)

(general practitioner) and (role adj chang$) or (role adj new) or role

doctor and (role adj chang$) or (role adj new) or role

midwi$ and (role adj chang$) or (role adj new)

carer and (role adj chang$) or (role adj new)

Note that the truncation symbol used is $, so "nurs$" will locate articles including nurse, nurses and nursing.

A search of PsycINFO with the terms

nurs

practitioner

midwi

carer

doctor

(changing role)

(new role)

health

hospital

protocol

triage

leader

No truncation symbol however the search term "midwi" locates articles including midwife, midwives and midwifery.

A search of Australian Digital Theses Program with the terms

nurs? and (chang? role) or (new role)

(medical practitioner) and (chang? role) or (new role)

doctor and (chang? role) or (new role)

midwi?

health sector

Truncation symbol = ?

A search of the abstract field of UMI Proquest Digital Dissertations with the terms

nurs? and (chang? role) or (new role)

(medical practitioner) and (chang? role) or (new role)

doctor and (chang? role) or (new role)

midwi? and role

carer

(general practitioner)

(health sector)

(health care)

Truncation symbol = ?

Web of Science Proceedings with the terms

(health service provision) and (chang? or new)

(health care provision) and (chang? or new)

(health care professional) and role and (chang? or new)

(model? of care) and (chang? or new)

(telehealth or telemedicine) and ((randomi?ed controlled trial) or (clinical trial))

(hospital in the home) and role

(minimally invasive surgery) and role

(primary care) and ((chang? role) or (new role))

(preventative care) and ((chang? role) or (new role))

nurs$ and ((chang? role) or (new role))

(telephone triage) and ((chang? role) or (new role))

midwi? and ((chang? role) or (new role))

carer and ((chang? role) or (new role))

Truncation symbol = ?

Searching of all databases was limited to the English language and the years 1996 to 2001 inclusive.

All abstracts, resulting from the literature search of the databases, were examined to identify that the content related to changes in health care service provision or changes in the roles of health professionals effecting nursing.

Following the selection of abstracts, the articles were retrieved electronically or by hand. On identification of appropriate theses' abstracts the electronic databases were searched to identify if the writer of the thesis had published an article related to the topic of interest. Where the writer had published, the article was retrieved. Where the writer had not published the work a summary of the thesis was retrieved. This was read and where appropriate a copy of the full thesis was requested.

Articles were sorted according to major recurring themes and then according to level of evidence. All articles meeting the NHMRC levels of evidence were included. Where other descriptive information in articles added to the knowledge this was also included.

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Internet Searching

Internet information and reports published by health and nursing authorities were also sought. These were particularly useful for information on the role of the nurse practitioner in Australia since many pilot projects have been or are being conducted and the majority have not been reported in the published literature.

Sites searched included

ACT Department of Health, Housing and Community Care 

Australian Nursing Council Inc. 

Canadian Nurses Association 

Department of Human Services, Victoria 

Health Department of Western Australia 

Nurse Directories on: The Nurse Friendly Nurse Practice Acts, Legal and Medical Links 

Nursing Board of Tasmania 

Nursing Council of New Zealand 

Nurses Registration Board New South Wales 

Queensland Nursing Council 

Royal College of Nursing 

South Australian Department of Human Services 

Territory Health Services, Northern Territory Government 

The Canberra Hospital, Research Centre for Nursing Practice 

United Kingdom Central Council for Nursing Midwifery and Health Visiting 

Victorian Legislation and Parliamentary Documents Home Page 

In addition, the National Health and Medical Research Council Internet site was searched for clinical practice guidelines. These were then scanned for recommendations that had specific implications for nursing roles.

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