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Aim To explore nurses' archived accounts of Matron Muriel Powell's management and leadership style and the impact of this on the implementation and sustainability of innovation in the workplace. Background In popular discourse, the matron has become an emblem of leadership. Although the title disappeared in the UK in the late 1960s as part of the re-organization recommended by the Salmon Report, it re-appeared in 2002 in an attempt to improve care standards by reasserting a strong nursing presence and clinical leadership role. Design Secondary data analysis using qualitative thematic analysis. Methods This paper draws on interview data held in the 'Nurses Voices' archive. The interview transcripts of 132 nurses who trained or worked at St George's hospital in 1920-1980 were analysed in depth between March 2011-January 2012 and themes were generated inductively by grouping together emergent codes in the data with similar meaning. Results Looking back, the nurses recalled strong memories of the leadership of Matron Powell. Her presence emerged as a significant influence throughout the interviews. Two resonant themes were identified: innovation and open communication. Conclusions Through her visibility and direct access with patients and staff, Dame Muriel Powell showed what we would now call transformative leadership qualities. Her leadership created a culture of open communication and innovation that initiated change in the organization and the nursing workforce. Looking back and learning from historical figures can deepen understanding and provide pointers for the nurse leaders of today. [ABSTRACT FROM AUTHOR]

Accessible summary What is known on the subject? Learning disability nursing in the area of people with a learning disability and an offending background has developed considerably over recent years, particularly since the publication of the Bradley ()., There has been limited work into the competencies nurses require to work in this area, and even less about the personal attributes of learning disability nurses., What this paper adds to existing knowledge? Learning disability nursing's specific contribution to the care of this population lies in their knowledge of the interaction between the learning disability, an individual's, sometimes abusive, personal history and an understanding of the subsequent offending behaviour., The knowledge base of nurses working with people with learning disabilities and an offending background needs to reflect the changing service user group. This is particularly in relation to substance misuse, borderline personality disorder, and mental health and the way such factors inter-relate with the learning disability., What are the implications for practice? Further research is required into the relationship among decision making, risk taking or reluctance to do this, and the personal attributes required by nurses to work in secure learning disability care., Learning disability secure services are likely to continue to undergo change as circumstances alter and the offending population demonstrate greater complexity; nursing competencies and personal attributes need similarly to adapt to such changes., Mental health nursing has a great deal to contribute to effective working with this population, specifically with regard to developing strong relationships when concerns around borderline personality disorder or substance misuse are particularly in evidence., Abstract Aim To identify and discuss the personal attributes required by learning disability nurses to work effectively with people with an offending background in secure and community settings. Background This study was part of a larger research investigation into the nursing competencies required to work with people with an offending background. There are few existing studies examining the personal attributes necessary for working with this group. Design A qualitative study addressing the perceptions of nurses around the personal attributes required to work with people with learning disabilities and an offending background. Methods A semi-structured interview schedule was devised and constructed, and 39 individual interviews were subsequently undertaken with learning disability nurses working in high, medium, low secure and community settings. Data were collected over 1 year in 2010/11 and analysed using a structured thematic analysis supported by the software package MAXqda. Findings The thematic analysis produced three categories of personal attributes, named as looking deeper, achieving balance and connecting, each of which contained a further three sub-categories. Conclusion Nursing of those with a learning disability and an offending background continues to develop. The interplay among personal history, additional background factors, nurses' personal attributes and learning disability is critical for effective relationship building. [ABSTRACT FROM AUTHOR]

Aim To identify and discuss the competencies required by learning disability nurses to work effectively with people with an offending background in low, medium, high secure and community settings. Background Research into the competencies required by nurses working with individuals with an offending background, particularly those with a learning disability, is limited. There is some uncertainty as to whether there should be differentiation according to specific setting. Design A qualitative study addressing the perceptions of nurses on the knowledge, skills and competencies required to effectively work with people with learning disabilities and an offending background in different settings. Methods Seven focus groups were conducted across the four settings to inform the construction of the semi-structured interview schedule. Thirty-nine interviews were subsequently undertaken with nurses across settings to develop a fuller understanding of the competencies and ascertain if these were influenced by the specific setting where the nurses worked. Data were collected over 1-year in 2010 and analysed using a structured thematic analysis supported by the software package MAXqda. Findings The thematic analysis produced four over-arching competencies: knowledge assimilation and application; team working; communication skills; and decision-making. A further competency around personal attributes constitutes the basis of a future paper. Conclusion The first three competencies combine well to inform the work of nurses and appear transferable across settings, but the fourth appears more complicated, specifically in terms of the role of risk in supporting or detracting from decision-making capacity. [ABSTRACT FROM AUTHOR]

Tame S.L. (2013) The effect of continuing professional education on perioperative nurses' relationships with medical staff: findings from a qualitative study. Journal of Advanced Nursing 69(4), 817-827. doi: 10.1111/j.1365-2648.2012.06065.x Abstract Aims. To report perceived changes to UK perioperative nurses' relationships with medical staff following periods of formal, university-based study. Background. Continuing professional development is considered important for nursing internationally; however, practice changes may not result following formal study. The literature did not describe perioperative nurses' experiences of formal study, and it was believed differences may exist due to hierarchical interprofessional relationships in the operating theatre. Design. Descriptive, qualitative. Methods. Unstructured interviews ( N = 23) were conducted between 2006-2007 with a purposive sample of perioperative nurses who had recent experience of continuing professional education. All participants were employed by one National Health Service Trust in the North of England, UK. Audio-taped interviews were transcribed fully into the ethnograph computer-assisted qualitative data analysis programme and data coded and analysed to identify themes. Findings. The findings indicated that whilst continuing professional education did not have a direct impact on practice, development of increased knowledge and confidence facilitated participants' collaboration with and questioning of medical colleagues. Such increased interprofessional collaboration was attributed to indirectly enhancing patient care. Conclusion. Continuing professional education appeared to lead to intrinsic changes to practitioners rather than direct behavioural change. Nurses' increased knowledge and confidence affected the balance of power in the doctor-nurse relationship in British perioperative environments. This paper is of significance to perioperative nursing and may be transferable to other areas of care. [ABSTRACT FROM AUTHOR]

Aims and objectives. To explore the experiences of secondary care nurse prescribers to establish how prescribing is employed and what its benefits and disadvantages are perceived to be. Background. Nurse prescribing has developed rapidly since it inception almost 20 years ago and there is a significant body of research evaluating its implementation in primary care. Recent expansion of non-medical prescribing rights has prompted nurses in secondary care establishments to become prescribers. Evaluation of nurse prescribing in this new environment is required, if practice is to be informed and advanced. The lack of such evaluations in the published literature was the impetus for this study. Design. A cross-sectional qualitative study. Methods. A convenience sample of nurse prescribers was interviewed using a single broad question to prompt elaboration. Transcribed interviews were analysed using Colaizzi's procedural steps. Results. Three main themes emerged from the analysis: motivations behind becoming a nurse prescriber; benefits and limitations of prescribing education and continuing professional development and prescribing in practice. Conclusion. Nurses felt nurse prescribing offers clear benefits in relation to patient care. Where nurses were not prescribing, finance arrangements between different NHS trusts appear to be a significant barrier to its successful implementation of prescribing in practice. Nurse prescribing is strongly believed to be the domain of the experienced nurse. There is a clear need for ongoing evaluation of all aspects of nurse prescribing. Relevance to clinical practice. This paper makes key recommendations on the future development and delivery of programmes of education for nurse prescribers and for the delivery of safe and effective prescribing in practice. [ABSTRACT FROM AUTHOR]

This paper presents findings from a small piece of interpretive research into the lived experience of trained nurses who fulfilled the role of workplace mentors for Foundation degree students. The interprofessional landscape of workplace learning is also examined. The participants were all employed in acute care settings in a large UK National Health Service hospital and provided mentorship to Healthcare Assistants studying the adult pathway of a Foundation degree in Health and Social Care; in preparation for the role of the Assistant Practitioner. A purposive sample of eight workplace mentors (who had supported at least one Foundation degree student) were interviewed using a semi-structured questionnaire. All interviews were audio recorded and subsequently transcribed. A hermeneutic phenomenological approach was used to uncover the lived experience of workplace mentors and 10 major themes were generated from the data. The findings suggest that the mentorship of work-based learners presents mentors with a range of challenges that are quite different from pre-registration students given the situatedness of the learner in their clinical team. While the mentorship of work-based learners in busy clinical environments is challenging, the relationship between mentor and mentee appears to have greater equality due to the situatedness of the student in the clinical team. As a result workplace mentors seem to benefit from a relationship lacking in the hierarchical features that characterise traditional mentoring. Awareness of the unique experience of work-based learners and mentors needs to be raised, particularly where students are seeking to complete their Foundation degree to emerge as Assistant Practitioners. Trained nurses undertaking the role of workplace mentor in support of Foundation degree students, do so to provide coaching that (in a developmental relationship), places them in the vanguard of an emerging professional group; the Assistant Practitioner. [ABSTRACT FROM AUTHOR]

kwong e.w.-y., pang s.m.-c., choi p.-p. & wong t.k.-s. (2010) Influenza vaccine preference and uptake among older people in nine countries. Journal of Advanced Nursing 66(10), 2297–2308. Aim. This paper is a report of a study delineating factors that influence older people’s preferences and uptake of the influenza vaccine in nine countries. Background. Vaccination uptake for the aging population in many countries still remains below the World Health Organization recommended rate. Older people who perceive higher susceptibility to and severity of influenza, and more benefits from vaccination and action cues prompting vaccination, tend to accept the vaccine, but those with more perceived barriers to vaccination are less likely to accept it. Method. A total of 208 older people from China, Indonesia, Turkey, Korea, Greece, Canada, the United Kingdom, Brazil and Nigeria were recruited to 14 vaccinated and 12 unvaccinated focus groups. They shared their experiences of influenza, and influenza vaccination, and promotion of influenza vaccination in focus groups. The data were collected in 2007. Findings. We identified five themes and generated a hypothetical framework for in-depth understanding of vaccination behaviour among older people. Participants’ vaccine preferences were determined by their behavioural beliefs in vaccination, which were based on their probability calculation of susceptibility to and severity of influenza and vaccine effectiveness, and their utility calculation of vaccine, healthcare and social costs. Action cues prompting vaccination and vaccine access further affected the vaccine uptake of participants with vaccine preferences. Vaccination coverage was likely to be higher in the countries where normative beliefs in favour of vaccination had formed. Conclusion. The hypothetical framework can be used to guide healthcare providers in developing strategies to foster normative beliefs of older people in vaccination, provide effective action cues and promote vaccine access. [ABSTRACT FROM AUTHOR]

Objectives: The aim of this study was to understand how people living with Parkinson's and healthcare professionals perceived their care management and interactions with health services were affected during the COVID‐19 pandemic. Background: During the COVID‐19 pandemic, many governments introduced restrictions and services that support Parkinson's care management had to cease or be delivered remotely. These changes may have had an impact on the well‐being of people living with Parkinson's. Methods: A qualitative exploratory UK study was carried out. Semi‐structured individual interviews with people living with Parkinson's and health professionals were recorded, transcribed verbatim and analysed using Braun´s and Clarke´s thematic analysis. Eleven patients and 10 health professionals were recruited between April and September 2020. The study was reported using the COREQ. Results: Two main themes were identified. In the first theme, many patients and professionals reported that the COVID‐19 pandemic made some people living with Parkinson's feel isolated and vulnerable due to disruptions to their social networks and usual activities related to Parkinson's disease care. However, other patients remained connected with their networks. In the second theme, patients and most professionals mentioned that some clinical practices were cancelled, delayed or transformed to remote consultation. Conclusion: The COVID‐19 restrictions had an impact on how people living with Parkinson's managed their care and in their interactions with healthcare services. Health professionals should assess the risk of vulnerability, social isolation, physical inactivity and confidence with remote consultations in people living with Parkinson's. This might inform a rethinking of existing clinical interactions with people living with Parkinson's towards a flexible, sustainable, person‐centred care model. Relevance to clinical practice: This study has shown that Parkinson's care management and interactions with healthcare services should provide personalised and flexible support. To meet this challenge, the design of the organisation of health services should include greater involvement of patients and person‐centred care models. [ABSTRACT FROM AUTHOR]

Aims: The overall aim of this evaluation was to look at the impact of the changes in working practices during the pandemic on nurses. This secondary analysis provided an evaluation of virtual care and being able/required to work from home. Design: This was secondary analysis of an evaluation using semi‐structured interviews. Methods: Conducted at a single National Health Service (NHS) university hospital in the United Kingdom between May and July 2020. Forty‐eight operational leads and nurses participated in semi‐structured interviews which were digitally recorded, transcribed verbatim and analysed using a framework analysis. Results: Two overarching themes emerged relating to the patient experience and nursing experience. There were both positive and negative elements associated with virtual care and remote working related to these themes. However, the majority of nurses found that virtual clinics were useful when proper resources were provided, and managerial strategies were put in place to support them. Participants felt that virtual care could benefit many but not all patient groups moving forward, and that flexibility around working from home would be desirable in the future. Conclusion: Virtual care and remote working were implemented to accommodate the restrictions imposed because of the pandemic. The benefits of these changes to nurses and patients support these being business as usual. However, clear policies are needed to ensure that nurses feel supported when working remotely and there are robust assessments in place to ensure virtual care is provided to patients who have access to the necessary technology. Impact: This was a study of the move to virtual care and remote working during the COVID‐19 pandemic. Telemedicine and flexible working were not common in the NHS prior to the pandemic but the current evaluation supports the role out of these as standard care with policies in place to ensure that nurses and patients are appropriately supported. [ABSTRACT FROM AUTHOR]

Aims: To, firstly, explore student and academic nurse perceptions of classroom content about the assessment and identification of pressure injuries across skin tone diversity and, secondly, to describe the impact of classroom content on student nurse understanding of pressure injury in people with dark skin tones. Design: Qualitative case study employing focus groups and semi‐structured interviews. Methods: Five higher education institutions in the United Kingdom were purposively chosen. At each of the five‐case sites, one focus group with student nurses and one semi‐structured interview with a nurse academic were conducted between May 2018 and April 2019. The participants' narratives were transcribed verbatim and analysed via thematic analysis. Results: Classroom learning was predominately framed through a white lens with white normativity being strongly reinforced through teaching and learning activities. This reinforcement of white normativity was evidenced through two main themes: (i) dominance of whiteness in the teaching and learning of pressure injuries in undergraduate nurse education and (ii) the impact and implications for student nurses of whiteness as the norm in pressure injury teaching. Conclusion: Nurses responsible for the design and delivery of teaching and learning experiences for nursing students need to ensure meaningful teaching and learning experiences. This learning should assist future nurses to interrogate their complicity in a system of white dominance. Impact: Nurse education delivered today influences and shapes nurses of the future. Nurses are the cornerstone of healthcare and play a significant role in the delivery of equitable healthcare. Nurse academics have a duty of care to inform and highlight health inequities in nursing and ultimately to enhance equity in care. [ABSTRACT FROM AUTHOR]

Aims: To explore processes used by qualified nurses in assessing mental capacity of acutely and critically ill hospitalised adult patients. Background: Mental capacity is the ability to understand, reason and make decisions. Acute and critical illness may impact upon the decision‐making abilities of hospitalised adult patients but little is known about how qualified nurses across a range of acute settings assess the capacity of such patients in their care. Design: A qualitative grounded theory approach informed by the Corbin and Strauss (Basics of Qualitative Research (Third Edition). London, UK: Sage, 2008) methodological pathway. Methods: Data were collected through digitally recorded, semi‐structured interviews to explore assessment of capacity processes used by 13 registered nurses employed in acute and critical care environments in a district general hospital in South Wales, UK. Data were analysed using iterative constant comparative processes leading to a core category and grounded theory. The study is presented in accordance with the COREQ checklist. Results: Informal, intuitive, holistic nurse‐led processes were used to assess the mental capacity of patients which combined processes for the assessment of their physiological and mental capacity status, recognising the need to support their rights, dignity and autonomy. The assessment of mental capacity was not a lone process but one that contributed to a cyclical process in which multi‐professional assessment was necessary and ongoing, and in which qualified nurses had a co‐ordinating role. This led to the development of the theory, Nurse Managed Patient Focused Assessment and Care. Conclusion: This theory provides a framework to explain processes and strategies used by qualified nurses in assessing mental capacity of, and caring for, adult patients with acute and/or critical illness. Relevance to clinical practice: This framework may inform related clinical practice and can serve as a basis of an assessment tool in what has been identified as a fundamental role of the qualified nurse. [ABSTRACT FROM AUTHOR]

Aims and objectives To explore the experiences of patients with advanced Chronic Obstructive Pulmonary Disease (COPD) and lung cancer, their carers and healthcare professionals following emergency admission to acute care hospital. Background Emergency admissions of people with lung cancer and COPD have increased and there is global concern about the number of patients who die in hospital. The experience of patients with advanced lung cancer and COPD admitted to hospital as an emergency when nearing the end of life has not previously been investigated. Design Qualitative critical incident case study. Methods Semistructured interviews were conducted with 39 patients (15 with COPD and 24 with lung cancer), 20 informal carers and 50 healthcare professionals, exploring patients' experiences of emergency hospital admission. Interviews took place after admission and following discharge. Participants nominated relatives and healthcare professionals for interview. Data were analysed thematically. Results Patients were satisfied with their 'emergency' care but not the care they received once their initial symptoms had been stabilised. The poorer quality care they experienced was characterised by a lack of attention to their fundamental needs, lack of involvement of the family, poor communication about care plans and a lack of continuity between primary and secondary care. A conceptual model of 'spectacular' and 'subtacular' trajectories of care was used to relate the findings to the wider context of health care provision. Conclusion The complex nature of illness for patients with advanced respiratory disease makes emergency hospital admissions likely. Whilst patients (with COPD and lung cancer) were satisfied with care in the acute 'spectacular' phase of their admission, more attention needs to be given to the continuing care needs of patients in the 'subtacular' phase. Relevance to Clinical Practice This is the first study to explore the patient experience of acute care following an emergency admission and identifies where there is potential for care to be improved. [ABSTRACT FROM AUTHOR]

Aim. To explore carers' experience of caring during a mental health crisis. Background. Community mental health care including crisis care relies increasingly on carers. The relationship between carers and professionals is at times fraught due to issues of what constitutes a crisis, confidentiality and a perception of lack of empathy. The caring experience can lead carers to feel isolated and neglected. Design. A qualitative study with a phenomenological approach. Eight carers participated and were interviewed individually using a semi-structured approach. Method. Analysis used the Interpretive Phenomenological Analysis method including transcribing of interviews, initial noting, searching for connections and patterns across the transcripts and cases. The themes were checked with the participants for their views on the emerging themes. The data were collected from November 2011-May 2012. Findings. Carers experienced 'double deprivation' by not receiving support from professionals and protecting their social network from the trauma of the crisis. The caring in crisis invoked complex feelings of guilt and loyalty which made discussing aggression difficult. Caring was described as a terrifying experience not just because of the aggression but also because of the perception of abandonment by professionals. Conclusion. The experience was an overwhelmingly negative one with a wish for acknowledgement of the crisis and support from mental health services. For most of the participants the caring during crisis was traumatic which left the carer feeling isolated and unsupported. The study should be used to help educate professionals on the complexities of caring during a crisis. [ABSTRACT FROM AUTHOR]

Aims and objectives To evaluate the application of a Multidimensional Model of Clinical Leadership on the community healthcare leader and on transforming community services. Background Healthcare policy advocates clinical leadership as the vehicle to transform community and healthcare services. Few studies have identified the key components of an effective clinical leadership development model. Design The first two stages of Kirkpatrick's ( Personnel Administrator 28, 1983, 62) Four/Five Levels of Evaluation were used to evaluate the application of the multidimensional model of clinical leadership. Methods Eighty community healthcare leaders were exposed to this multidimensional clinical leadership development model through attendance of a community clinical leadership development programme. Twenty five leaders participated in focus group interviews. Data from the interviews were analysed utilising thematic content analysis. Results Three key themes emerged that influenced the development of best practice principles for clinical leadership development: Personal leadership development, Organisational leadership, The importance of multiprofessional action learning/reflective groups, Conclusions Emergent best practice principles for clinical leadership development include adopting a multidimensional development approach. This approach encompasses: preparing the individual leader in the role and seeking organisational leadership development that promotes the vision and corporate values of the organisation and delivers on service improvement and innovation. Moreover, application of the Multidimensional Model of Clinical Leadership could offer the best platform for embedding the Six C's of Nursing ( Compassion in Practice - Our Culture of Compassionate Care, Department of Health, Crown Copyright, 2012) within the culture of the healthcare organisation: care, compassion, courage, commitment, communication, and competency. This is achieved in part through the application of emotional intelligence to understand self and to develop the personal integrity of the healthcare leader and through supporting a culture of lifelong leadership learning. Relevance to clinical practice Embedding the best practice principles of clinical leadership development within a multidimensional model of clinical leadership provides a promising approach to: equipping the healthcare leader with those transferable leadership skills required to help them embark on a journey of lifelong leadership learning; and producing the healthcare leader who is caring, compassionate and can confidently and effectively transform community services. [ABSTRACT FROM AUTHOR]

Aims and objectives To understand how patients experience compassion within nursing care and explore their perceptions of developing compassionate nurses. Background Compassion is a fundamental part of nursing care. Individually, nurses have a duty of care to show compassion; an absence can lead to patients feeling devalued and lacking in emotional support. Despite recent media attention, primary research around patients' experiences and perceptions of compassion in practice and its development in nursing care remains in short supply. Design A qualitative exploratory descriptive approach. Methods In-depth, semi-structured interviews were conducted with a purposive sample of 10 patients in a large teaching hospital in the United Kingdom. Interviews were digitally recorded and transcribed verbatim. Thematic networks were used in analysis. Results Three overarching themes emerged from the data: (1) what is compassion: knowing me and giving me your time, (2) understanding the impact of compassion: how it feels in my shoes and (3) being more compassionate: communication and the essence of nursing. Conclusion Compassion from nursing staff is broadly aligned with actions of care, which can often take time. However, for some, this element of time needs only be fleeting to establish a compassionate connection. Despite recent calls for the increased focus compassion at all levels in nurse education and training, patient opinion was divided on whether it can be taught or remains a moral virtue. Gaining understanding of the impact of uncompassionate actions presents an opportunity to change both individual and cultural behaviours. Relevance to clinical practice It comes as a timely reminder that the smallest of nursing actions can convey compassion. Introducing vignettes of real-life situations from the lens of the patient to engage practitioners in collaborative learning in the context of compassionate nursing could offer opportunities for valuable and legitimate professional development. [ABSTRACT FROM AUTHOR]

Aim To examine how a major Clostridium difficile outbreak in the UK was represented in the media. Background Clostridium difficile is a serious health care-associated infection with significant global prevalence. As major outbreaks have continued to occur worldwide over the last few decades, it has also resulted in increasing media coverage. Newspaper journalists are, however, frequently criticized for sensationalized and inaccurate reporting and alarming the public. Despite such criticisms, nothing is known about how the media frame Clostridium difficile related coverage. Design Qualitative interpretive descriptive study. Method An interpretive analysis of newspaper articles from the national press that reported about the outbreak from the first day of coverage over 3 weeks (12 June-3 July 2008). Findings Twenty-eight newspaper articles were included in the study from tabloids, broadsheets, a regional and a Sunday newspaper. Monster and war metaphors were frequently adopted to portray the severity of Clostridium difficile and the impact it can have on patient safety. In addition, the positioning of the affected patients, their families, healthcare professionals and the Government produced representations of victims, villains and heroes. This subsequently evoked notions of vulnerability, blame and conflict. Conclusion The media are and will remain critical convectors of public information and, as such, are hugely influential in risk perceptions and responses. Rather than simply dismissing media coverage, further understanding around how such stories in specific contexts are constructed and represented is needed so that it can help inform future communication and management strategies. [ABSTRACT FROM AUTHOR]

Aim To report a study of an intermediary programme in infection control practice in one hospital in the UK. Background Promoting best evidence in everyday practice is a constant problem in infection control. Intermediaries can influence the transfer and use of evidence in health care, but there remains a lack of evidence and theory about the specific actions and change processes, which can be successful in improving infection control practices. Design An in-depth mixed methods case study. Methods The study was undertaken in 2011. Participants were recruited through purposive sampling and included frontline staff, managers and nurses in intermediary roles in infection control. Results For frontline staff, intermediary presence triggered a modification in behaviour. Different reactions were noted from the intermediaries' high level of physical presence in clinical areas, the facilitative approaches they used to give feedback and the specific teaching strategies they employed to meet frontline staff needs. The specific intermediary actions uncovered in this study were contingent on the prevailing systems for performance management, organisational commitment and efforts in clinical areas to foster a collegiate environment. Conclusions The study provides theoretical threads of how intermediaries can be successful in promoting evidence use under certain contextual conditions. Further testing of the specific intermediary mechanisms uncovered in this study will contribute to understanding different approaches that work in infection control in embedding evidence in practice. [ABSTRACT FROM AUTHOR]

Aim. To explore the perceptions and work experiences of internationally recruited neonatal nurses. Background. Neonatal nursing and health care are global issues facing developing and developed countries. In the UK, the recruitment of international nurses to address the labour shortage is not a new phenomenon. Methods. A purposeful sample was drawn from internationally recruited neonatal nurses, working at two teaching hospitals in London. Husserl's phenomenological approach underpins this study. Thirteen nurses, (all female) participated in the study and semi-structured face-to-face interviews were conducted to capture the unique perceptions and experiences of neonatal nurses at two hospital sites. A qualitative approach was adopted and this study used Colaizzi's analytical framework to analyse the data. Results. The analysis of the data resulted in four themes namely the support mechanisms, unfamiliarity with family centred care, feelings of being treated like a child and coping strategies. Conclusion. It can be concluded that in recruiting internationally recruited neonatal nurses to work in the NHS, there is a need to support them, encourage them to become familiar with family centred care and they should be treated as qualified nurses. Therefore, there is a need to consider these findings in any recruitment process involving neonatal nurses. Relevance to clinical practice. Internationally recruited neonatal nurses play an important role in caring for neonates in the NHS in the UK however meeting their needs have not always been addressed in the health care setting. [ABSTRACT FROM AUTHOR]

To explore the experience of student support prior to the implementation of a new structure for supporting students and mentors in practice placements (Placement Development Teams) for health care professionals. This study reports findings relating to acute sector adult nursing students and staff. Clinical practice is essential in pre-registration health care professional education programmes. The English Model National Partnership Agreement for health care education gives a new impetus to Strategic Health Authorities, Higher Education Institutions and National Health Service Trusts to evaluate and redesign their strategies for student support. This study was phase one of a large longitudinal qualitative evaluation of Placement Development Teams' introduction. The design for this phase was cross-sectional. Data were collected using telephone interviews with key educational stakeholders in trusts and Strategic Health Authorities and focus groups with third-year adult nursing students working in six acute sector trusts. Five themes emerged from the nursing students' focus group data. These were (1) Supportive and unsupportive behaviour of staff. (2) Mentor allocation. (3) Placement allocation. (4) Benefits of students to the placement area. (5) Perceived control over the learning experience. Four themes emerged from data analysis of the staff telephone interview data. These were (1) Vision of support services. (2) Proactive versus reactive support. (3) Barriers to achieving proactive support. (4) Bridging the gap between education and the trusts. Supporting students in practice is multifaceted and interpersonal and structural factors are important. This study illustrates how student support activity can be redesigned to meet the needs of the Model National Partnership Agreement. Good mentoring is particularly important for student support. Where there are high student numbers in placement, this can adversely affect students' placement learning. [ABSTRACT FROM AUTHOR]