Samantha Clune

Aim: To explore the experiences and perspectives of clinical facilitators supervising first‐year nursing students in nursing homes. Design: The qualitative clinical facilitator interview component of a two‐stage sequential mixed methods study exploring the impact of student nurses' clinical placements in nursing homes on career choices. Methods: Clinical facilitators from three nursing schools that offered a Bachelor of Nursing in 2023 participated in semi‐structured interviews. All interviews were audio recorded and transcribed. Data were analysed thematically. Results: Ten experienced clinical facilitators participated in an interview. All but one were female. All had worked casually for more than one nursing school for an average of 12 years, had experience in acute specialist nursing settings but only three had worked as registered nurses in a nursing home. While clinical facilitators felt nursing homes were an appropriate venue for first‐year nursing students, there were caveats to this endorsement, which the three themes generated illustrate: (1) the clinical placement setting, (2) the supervision, and (3) the students. Clinical facilitators felt their role was to advocate, educate, and support students in this environment because students are often unprepared for, overwhelmed by, and have limited opportunities to apply their learning. Conclusion: In line with the literature, these findings highlight the pivotal role of clinical facilitators in the learning experience of student nurses on clinical placement in nursing homes. Pre‐placement contact and being available daily allay student anxiety and increase learning opportunities. However, challenges associated with nursing homes as the first placement remain, including the readiness of nursing homes to facilitate students, the competence of the staff supervising students, and students' preparedness for the setting. Implications for Practice: These findings should encourage nursing schools to review the provision of ongoing education to clinical facilitators as their knowledge and experience, like that of nurse academics who teach theoretical content to students, are pivotal to student learning. Casual status should not be a determinant of access to ongoing professional education. If nursing schools cannot ensure the quality of supervision to first‐year students on clinical placement in nursing homes, they should reconsider these settings for the first clinical placement. Adverse experiences in nursing homes, including inadequate clinical facilitation with an inexperienced registered nurse and exposure to poor clinical practices during the first clinical placement, are likely to impact students' consideration of gerontological nursing as a career. Public Contribution: No public contribution. All the participants of this study were Australian registered nurses employed as clinical facilitators by participating schools of nursing.

Aim: Exploration of factors associated with clinical placements in nursing homes for first‐year nursing students which may impact their career choices. Design: This paper reports on Stage I of a larger study which comprised a 2‐stage sequential mixed‐methods design. Methods: Stage I was a national survey conducted as a telephone interview with nurse academics involved in arranging clinical placements for first‐year student nurses; and Stage II which included: interviews with student nurses before and after their first clinical placement in a nursing home, and interviews with clinical supervisors. The Stage I national survey was conducted as a telephone interview and was audio recorded. Transcripts of the interviews were analysed using descriptive statistics, content analysis, and reflexive thematic analysis. Results: All Australian nursing schools that offered a Bachelor of Nursing in 2023 were invited to participate. Twenty‐nine (81%) participated. The first clinical placement for most (79%) Australian student nurses is in a nursing home. Four themes were identified from the data analysis: (1) clinical placements are increasingly organised by centralised teams (48%); (2) the supervision model and the clinical supervisor are determined by placement agreements where students can be supervised by someone ill equipped for the role; (3) the purpose of this first‐year clinical placement is difficult to articulate, other than to practise fundamental skills; and (4) nursing homes can provide positive learning experiences for student nurses, if they are prepared for the setting and supervised appropriately. Conclusion: While many of these findings have been documented for decades, clinical placements in nursing homes may provide student nurses with valuable experiences. Schools of nursing need to better prepare students for clinical placements in nursing homes (especially if it is their first clinical placement) and ensure they are appropriately supervised. If not, graduate nurses will not consider aged care nursing as a career option. Implications for Practice: These findings should encourage nursing schools to reconsider their curriculum design, especially the timing of clinical placements in nursing homes, and their employment of clinical supervisors. The Australian Nursing and Midwifery Accreditation Council (ANMAC) should mandate a care of older persons subject in all undergraduate nursing curricula to be undertaken before students undertake a clinical placement in a nursing home. Public Contribution: There was no public contribution to this research. All participants were nurse academics from participating Australian schools of nursing.

Aims: To review current evidence on the implementation and impact of virtual nursing care in long‐term aged care. Design: An integrative rapid literature review. Data Sources: Medline, CINAHL, Web of Science, Embase, Ageline and Scopus. Review Methods: The review included studies involving virtual care interventions provided by nurses (or by a multidisciplinary team including nurses) to older people in residential aged care that reported health outcomes or stakeholder experiences. Consistent with PRISMA guidelines, databases were systematically searched in July and August 2024, focusing on literature published since 2014. Studies were screened in Covidence by three team members, with conflicts resolved by additional reviewers. Studies not involving nurses or not set in aged care were excluded. Results: The search identified 13 studies, which included quantitative, qualitative and mixed‐method approaches, conducted in both Australian and international settings, as well as in rural and metropolitan locations. Nurses were often involved as part of an existing virtual care programme, typically located in a hospital setting. The training and credentials of nurses delivering VN varied in terms of specialisation and advanced practice. The model of care in general was ad hoc, though in some cases there were regular, scheduled VN consultations. The time requirements for onsite staff and nurses were not well articulated in any of the studies, and information on the funding models used was also lacking. Conclusion: There is some evidence that VN interventions in aged care may improve communication, enhance person‐centred care and reduce emergency department presentations and hospitalisations. Impact, Patient or Public Contribution: Rigorous, ongoing evaluation of VN interventions is required to ensure their appropriate application in residential aged care.

Objectives: To explore the experiences of older people living in Australian residential aged care facilities (RACFs) and families of older people living in RACFs, regarding the process of Resident of the Day (ROD; sometimes referred to as a resident review) and their knowledge of how these assessments inform care planning.Methods: Semi‐structured interviews were used to engage residents and families in conversations about their experiences and knowledge of the assessment associated with ROD and subsequent care planning. A reflexive thematic analysis was used to generate findings.Results: Twenty‐six interviews were conducted in four RACFs across Victoria, diverse in terms of geographic location and provider type. Those residents who had some awareness of the ROD described the process only in superficial terms. Connections between ROD and care planning were unable to be made by most residents. Family members had a greater level of awareness of the ROD, although they were unable to describe the process or purpose and did not connect it to care planning.Conclusions: Despite being undertaken in all Victorian RACFs, residents and families have little or no knowledge of the ROD process, purpose or what happens to the information collected.

Background: Gambling and gambling-related harm attract significant researcher and policy attention. The liberalisation of gambling in most western countries is strongly associated with a marked rise in gambling activity and increases in gambling-related harm experienced at the population level. Programs to address gambling-related harm have traditionally focused on individuals who demonstrate problematic gambling behaviour, despite clear evidence of the effectiveness of a public health approach to high-risk activities like gambling. Little is known about the availability or efficacy of programs to address gambling-related harm at a population level.Methods: The Victorian Responsible Gambling Foundation commissioned a rapid evidence review of the available evidence on programs designed to reduce gambling-related harm at a population level. The review was conducted using a public health and harm reduction lens. MEDLINE, ProQuest Central and PsychInfo databases were searched systematically. Included studies were published in English between 2017 – 2023 from all countries with gambling policy contexts and public health systems comparable to Australia’s; included primary data; and focused on primary and/or secondary prevention of gambling-related harm or problems.Results: One hundred and sixty-seven articles were eligible for inclusion. Themes identified in the literature included: risk and protective factors; primary prevention; secondary prevention; tertiary prevention; target population group; and public health approach. The evidence review revealed a gap in empirical evidence around effective interventions to reduce gambling-related harm at the population level, particularly from a public health perspective.Conclusions: Addressing gambling-related harm requires a nuanced, multi-layered approach that acknowledges the complex social, environmental, and commercial nature of gambling and associated harms. Moreover, evidence demonstrates community programs to reduce gambling-related harm are more successful in reducing harm when based on sound theory of co-design and address the social aspects that contribute to harm.

Social participation in older age has been positively associated with enhanced health and wellbeing. This project examined key aspects of social participation for older people living in the community to identify what was most important for maintaining social participation in the event they transitioned to living in a nursing home. We conducted interviews and focus groups with 36 older people, aged 65 years or older living in the community in Victoria, Australia, between 2020 and 2022. Interview transcripts were analysed thematically. Participants discussed their understanding of the importance of social participation and what helped maintain it. Findings demonstrated the key importance of relationships, both old and new, in maintaining social participation, and to the preservation of a sense of identity. An important facilitator to maintaining relationships was having a physical place to go to interact. Barriers to social participation included diminishing social networks and life transitions. The impacts of the COVID‐19 pandemic were commonly referred to by all participants, outlining the obvious impediments to maintaining relationships (e.g., social isolation associated with lockdowns) and how that affected social participation. Conversely, some participants outlined the positive impact the restrictions had on their connection with friends and family. These perspectives outline the importance of being able to maintain relationships through life transitions, like a pandemic or moving into a nursing home, to optimise opportunities for social participation. Findings from this study will be relevant for aged care providers as they implement services to optimise social participation for older people who transition to living in nursing homes.

This research sought to explore the meaning of, preferences for, and involvement in social participation for older people living in nursing homes in Victoria, Australia. A qualitative descriptive study using semistructured interviews with twenty older people living in four geographically and ethnically diverse nursing homes was conducted between 2020 and 2022. Interview transcripts were thematically analysed. All the older people had been very socially active before moving into aged care and had participated in leisure and volunteering activities. Five themes emerged from the data analysis related to the meaning of, preferences for, and involvement in activities for social participation. The meaning of social participation among these older people varied. Some participated in group activities to keep active and busy, while others were content with interests of their own. Social participation in group activities provided older people with a connection to others and assisted in maintaining existing, or developing new, relationships. However, the ability to participate in group activities that offered opportunities for social participation was limited by age‐related decline for some older people. The COVID‐19 pandemic restrictions constrained activities, which provided opportunities for social participation for some older people living in nursing homes, but not all. These perspectives highlight the need for individualised person‐centred opportunities for social participation in nursing homes. Group activities should enable older people to remain active and facilitate social connections that provide meaning and purpose. Respect for individual choice is important, as older people are not a homogeneous group, and opportunities to pursue individual activities should be facilitated.