Nurse resilience is attracting increasing attention in research and practice. Possession of a high level of resilience is cited as being crucial for nurses to succeed professionally and manage workplace stressors. There is no agreed definition of nurse resilience. A concept analysis was undertaken to examine nurse resilience using a priori selected analysis framework. This concept analysis aims to systematically analyse resilience as it relates to nurses and establish a working definition of nurse resilience. Sixty-nine papers met the search criteria for inclusion. Key attributes of nurse resilience were social support, self-efficacy, work-life balance/self-care, humour, optimism and being realistic. Resilience enables nurses to positively adapt to stressors and adversity. It is a complex and dynamic process which varies over time and context and embodies both individual attributes and external resources. Sustaining nurse resilience requires action and engagement from both individuals and organisations.

Aim To evaluate and synthesize research that has investigated nurse resilience, to develop an understanding of what nurses' feel affects their resilience, their experiences and how resilience can impact individual nurses, patients and employers. Design Integrative review. Data Sources CINAHL, MEDLINE and PsycINFO, searched from the date each database was available to July 2019. Review Methods Primary research studies explicitly investigating resilience in any type of licensed nurse were eligible for inclusion. Studies were critically appraised for methodological quality using the Joanna Briggs Institute Quality Appraisal Framework. Data from each study were abstracted, coded and themes were identified according to the review aims and key findings of each study. Results Twenty‐seven studies met the inclusion criteria. Eight sub‐themes and three main themes were identified: The Resilient Nurse, Nurses' Experiences of Resilience and Employment Conditions and Nurse Resilience. Conclusion Nurse resilience is a complex and dynamic process, and high levels of resilience are associated with reduced psychological harm and increased well‐being. Attempts to determine the characteristics of the resilient nurse have been inconclusive and research has predominately focussed on individual factors which could affect resilience, with minimal research exploring external factors which affect nurse resilience including work environment and conditions. Nursing work was characterized by adversity and nurses described the development and use of strategies to maintain their resilience. Impact This review found that individual factors have received most attention in research investigating nurse resilience. Findings suggest that nurse resilience protects against negative psychological outcomes and nurses independently develop and use strategies to manage adversity. Factors in the workplace which affect resilience are under‐researched, and addressing this gap could assist with the development of comprehensive interventions and policies to build and maintain nurse resilience.

Ultrasound-guided FNB is not superior to ultrasound-guided FICB, with both facilitating an equivalent analgesia effect in patients with a neck of femur or proximal femur fracture.

Aims and objectives To measure time spent on clinical documentation and nurses and midwives’ perceptions of this aspect of their role. Background Nurses and midwives rely on accurate documentation when planning care. However, documenting and communicating care can be onerous, time‐consuming and at times duplicated or redundant. While documentation provides a record and means of communicating care, it should not detract from the delivery of care. Design An observational time and motion study and survey design reported using the Strengthening the Reporting of Observational Studies in Epidemiology guidelines. Methods The study was conducted with Western Australian nurses and midwives working in a private not‐for‐profit hospital from July–October 2019. An observational study was undertaken to measure the practice of documentation on each shift. Participants’ perceptions of clinical documentation were measured using a self‐report survey. Results A total of 120 hr of observation were undertaken. Total observed time spent on documentation was 28.1% on morning shifts, 22.7% on afternoon shifts and 20.9% on night duty. The mean self‐reported time for clinical documentation was 50.4% on morning shifts, 40.7% on afternoon shifts and 37.9% on night duty. Issues with duplication and unnecessary paperwork were identified. Conclusions Although participants tended to overestimate time spent on documentation, it still consumed a significant proportion of time. Frustrations with paperwork may amplify nurses' negative perceptions of documentation. Clinical documentation needs to be reviewed, revised and reduced to release time back to direct patient care and reduce clinician dissatisfaction. Relevance to clinical practice Clinical documentation is required in all areas of clinical practice and forms an important legal record. Understanding the demands of clinical documentation can assist in reviewing and improving documentation to release time back to direct patient care.

Aim To develop a validated tool to measure nursing and midwifery documentation burden. Background While an important record of care, documentation can be burdensome for nurses and midwives and may remove them from direct patient care, resulting in decreased job satisfaction, associated with decreased patient satisfaction. The amount of documentation is increasing at a time where staff rationalisation results in decreasing numbers of clinicians at the bedside. No instrument is available to measure staff perceptions of the burden of clinical documentation. Design Survey development, followed by rwo rounds of content validation (April and May 2019). Methods Based on the literature a 28 item survey, with items in 6 subscales, representing key areas of documentation burden was developed. Item (I‐CVI), subscale (S‐CVI/Ave by subscale) and overall content validity indexes (S‐CVI/Ave) were calculated following two review rounds by an expert panel of clinical and academic nurses and midwives. Results Level of agreement for the first iteration of the survey was low, with many items failing to reach the critical I‐CVI threshold of 0.78. No subscale reached a S‐CVI/Ave above 0.8 and the overall scale only achieved a S‐CVI/Ave score of 0.67. Thirteen items were removed, seven were edited and five new items added, based on the expert panel feedback, substantially improving the content validity. All individual items achieved an I‐CVI ≥0.78, the S‐CVI/Ave was above 0.85 for all subscales and the total S‐CVI/Ave was 0.94. Conclusion The Burden of Documentation for Nurses and Midwives (BurDoNsaM) survey can be considered as content valid, according to the content validity analysis by an expert panel. Impact The BurDoNsaM survey may be used by nurse leaders and researchers to measure the burden of documentation, providing the opportunity to review practice and implement strategies to decrease documentation burden, potentially improving patient satisfaction with the care received.

Strategies to maximise response rates from a target population should be used when conducting surveys.

Aims and objectives:To determine the prevalence and pattern of use of peripheral intravenous cannulae in hospital wards.Background: Peripheral intravenous cannulae are commonly used in acute health care to directly access the bloodstream for the administration of medications, intravenous fluids and blood products. Peripheral intravenous cannulae are associated with multiple adverse events including hospital-acquired bloodstream infection, thrombophlebitis and pain/discomfort. Administration of intravenous fluids is associated with impaired mobility and nocturia which may increase falls risk in the older people.Design: Observational, point prevalence study.Methods: Three private hospitals comprising a total of 1,230 beds participated in the study. Nurses recorded the presence of a peripheral intravenous cannulae, duration of insertion, state of the dressing and whether the peripheral intravenous cannulae was accessed in the previous 24 hr and for what purpose. Nurses were also asked whether they would replace the peripheral intravenous cannulae should it fail.Results: Approximately one-quarter of patients had a peripheral intravenous cannulae, the majority of which had been present for <24 hr. The major use of the peripheral intravenous cannulae was antibiotic administration. Administration of intravenous fluids occurred in the presence of normal oral fluid intake. Nurses would not replace one-third of peripheral intravenous cannulae in the event of failure. A majority of patients were at increased falls risk, and one-third of these were receiving intravenous fluids. Relevance to clinical practice: Vigilance is required in the use of peripheral intravenous cannulae. Consider transition of medication administration to oral intake

When a patient's circumstances allow, a consultation with a BCN in the preoperative period should be offered. Ideally, this consultation should be conducted face-to-face to provide the education and psychosocial and practical support that patients undergoing breast surgery require. When this is not possible, a telephone consultation should be offered, as opposed to waiting until after surgery.