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Treballs Finals de Grau d'Infermeria, Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona, Curs: 20122-2023, Tutor: Josefina Goberna Tricas, Introducció: A inicis del segle XX, degut a un fort procés de medicalització i tecnificació de la assistència, els parts s’atengueren a l’hospital. En els últims anys s’està vivint un canvi de model assistencial i apareix el concepte de part humanitzat. Una eina per fomentar-ho i evitar la violència obstètrica és el Pla de Part. La infermera obstètric-ginecològica (llevadora) hi te un rol fonamental. Objectius: Definir el concepte d’atenció humanitzada al part i conèixer el rol de la llevadora en aquest. Metodologia: Revisió́ bibliogràfica a través de les bases de dades PubMed, CINAHL, Scopus i CercaBib. S’han seleccionat 15 articles segons criteris prèviament establerts. S’ha completat amb una anàlisi bibliomètrica mitjançant l’eina VosViewer per observar l’evolució de la literatura sobre aquesta temàtica. Resultats: L’atenció humanitzada va enfocada a apoderar i dignificar les dones, per tal que adoptin un rol actiu i decisiu que permetrà viure el procés de part de forma positiva. El Pla de Part és influeix positivament en aquest procés i en els resultats matern-fetals. Les llevadores són essencials en la seva implantació per aconseguir unes cures humanitzades que evitin situacions de violència obstètrica. Conclusió́: És important que els professionals de la salut tinguin una sensibilitat ètica que contribueixi al respecte de l’autonomia de les dones i eviti situacions de violència obstètrica. Es recomana l’ús dels plans de part. Cal potenciar canvis en la formació dels professionals de la salut perquè es conscienciïn sobre aquest tema i s’adoptin models que tendeixin a la millora de la qualitat assistencial.

Early childhood development (ECD) refers to the physical, motor, socio-emotional, cognitive, and linguistic development of a young child. The 'Countdown to 2030' global distribution of 'children at risk of poor development' indicates the need for urgent action and investment in ECD. Nurturing care enhances ECD, even in the presence of adversities. Strategic actions should exist at multiple levels: the family, community, health care providers and government. Previously, child health related policies and programs of the Government of India functioned in isolation, but have recently started demonstrating multi-sectoral collaboration. Nonetheless, the status of ECD in India is far from optimal. There is strong evidence that parenting programs improve outcomes related to ECD. This is dependent on key programmatic areas (timing, duration, frequency, intensity, modality, content, etc.), in addition to political will, funding, partnership, and plans for scaling up. Each country must implement its unique ECD program that is need-based and customized to their stakeholder community. Barriers like inadequate sensitization of the community and low competency of health care providers need to be overcome. IAP firmly believes that responsive parenting interventions revolving around nurturing care should be incorporated in office practice. This paper outlines IAP's position on ECD, and its recommendations for pediatricians and policy makers. It also presents the roadmap in partnership with other stakeholders in maternal, neonatal, and child health; Federation of Obstetric and Gynaecological Societies of India (FOGSI), National Neonatology Forum (NNF), World Health Organization (WHO), and United Nation Children Fund (UNICEF).

AimsTo highlight the need for the development of effective and realistic workforce strategies for critical care nurses, in both a steady state and pandemic.BackgroundIn acute care settings, there is an inverse relationship between nurse staffing and iatrogenesis, including mortality. Despite this, there remains a lack of consensus on how to determine safe staffing levels. Intensive care units (ICU) provide highly specialised complex healthcare treatments. In developed countries, mortality rates in the ICU setting are high and significantly varied after adjustment for diagnosis. The variability has been attributed to systems, patient and provider issues including the workload of critical care nurses.DesignDiscursive paper.FindingsNursing workforce is the single most influential mediating variable on ICU patient outcomes. Numerous systematic reviews have been undertaken in an effort to quantify the effect of critical care nurses on mortality and morbidity, invariably leading to the conclusion that the association is similar to that reported in acute care studies. This is a consequence of methodological limitations, inconsistent operational definitions and variability in endpoint measures. We evaluated the impact inadequate measurement has had on capturing relevant critical care data, and we argue for the need to develop effective and realistic ICU workforce measures.ConclusionCOVID-19 has placed an unprecedented demand on providing health care in the ICU. Mortality associated with ICU admission has been startling during the pandemic. While ICU systems have largely remained static, the context in which care is provided is profoundly dynamic and the role and impact of the critical care nurse needs to be measured accordingly. Often, nurses are passive recipients of unplanned and under-resourced changes to workload, and this has been brought into stark visibility with the current COVID-19 situation. Unless critical care nurses are engaged in systems management, achieving consistently optimal ICU patient outcomes will remain elusive.Relevance to clinical practiceObjective measures commonly fail to capture the complexity of the critical care nurses' role despite evidence to indicate that as workload increases so does risk of patient mortality, job stress and attrition. Critical care nurses must lead system change to develop and evaluate valid and reliable workforce measures.

Mental stress and illness are common health problems in competitive sports that can reduce performance and have effects beyond the end of a career as sport-specific and unspecific disorders. The promotion of mental health and safe handling of mental problems and illnesses require appropriate education and train-ing. However, child, adolescent and adult psychiatrists with specific expertise in competitive sports (sports psychiatrists) are not yet an integral part of the structure of medical care provision in competitive sports. This position paper gives an overview about existing care structures in competitive sports for the promotion of mental health, and investigated them with proposals for the further development of sports psychiatric care in competitive sports. Sports physicians, sports psychiatrists, as well as interdisci-plinary and interprofessional collaboration, are at the center of mental health efforts in competitive sports. Further aspects that will be discussed are the education and training of athletes and the environment in competitive sports, as well as the promotion of coaches’ health. Key Words: Elite sports, Prevention, Mental health problems and disorders, Sports psychiatry, Sports Medicine

The International Working Group for Patients' Right to Nutritional Care presents its position paper regarding nutritional care as a human right intrinsically linked to the right to food and the right to health. All people should have access to food and evidence-based medical nutrition therapy including artificial nutrition and hydration. In this regard, the hospitalized malnourished ill should mandatorily have access to screening, diagnosis, nutritional assessment, with optimal and timely nutritional therapy in order to overcome malnutrition associated morbidity and mortality, while reducing the rates of disease-related malnutrition. This right does not imply there is an obligation to feed all patients at any stage of life and at any cost. On the contrary, this right implies, from an ethical point of view, that the best decision for the patient must be taken and this may include, under certain circumstances, the decision not to feed. Application of the human rights-based approach to the field of clinical nutrition will contribute to the construction of a moral, political, and legal focus to the concept of nutritional care. Moreover, it will be the cornerstone to the rationale of political and legal instruments in the field of clinical nutrition.

The purpose of this short position paper is to stimulate a community wide discussion on how situation awareness (SA) technologies may best support the decisions made during pandemics. Currently much of SA is directed towards the critical information needed to make epidemiological and public health decisions; as important as this is, an epidemic also requires doctors and front line medical professional to make numerous decisions regarding individualized patient care. The question is how can SA contribute to both the rapid collection, analysis, and sharing of critical patient information among medical personnel, and then across all levels of decision-making from individual patients to public health policy?

Suicide is a major global public health issue, and in recent years, there has been increasing recognition of the problem of physician suicide. This American College of Physicians policy paper examines, from the perspective of ethics, the issues that arise when individuals and institutions respond to physician suicides and when they engage in broader efforts aimed at physician suicide prevention. Emphasizing the medical profession as a unique moral community characterized by ethical and professional commitments of service to patients, each other, and society, this paper offers guidance regarding physician suicide and the role of a healing community. The response to an individual physician suicide should be characterized by respect and concern for those who are grieving, the creation of a supportive environment for suicide loss survivors, and careful communication about the event. Because suicide is a complex problem, actions aimed at preventing suicide must occur at the individual, interpersonal, community, and societal levels. The medical community has an obligation to foster a culture that supports education, screening, and access to mental health treatment, beginning at the earliest stages of medical training.

Background Missed nursing care is a complex healthcare problem. Extant literature in this area identifies several interventions that can be used in acute hospital settings to minimise the impact of missed nursing care. However, controversy still exists as to the effectiveness of these interventions on reducing the occurrence of missed nursing care. Aim This theoretical paper aimed to provide a conceptual understanding of missed nursing care using complexity theory. Methods The method utilised for this paper is based on a literature review on missed care and complexity theory in healthcare. Results We found that the key virtues of complexity theory relevant to the missed nursing care phenomenon were adaptation and self-organisation, non-linear interactions and history. It is suggested that the complex adaptive systems approach may be more useful for nurse managers to inform and prepare nurses to meet uncertain encounters in their everyday clinical practice and therefore reduce instances of missed care. Conclusions This paper envisions that it is time that methods used to explore missed care changed. Strategies proposed in this paper may have an important impact on the ability of nursing staff to provide quality and innovative healthcare in the modern healthcare system.

Background: Professional support in childbearing has beneficial effects on childbirth experience, interactions within the family, breastfeeding and medical outcomes. However, more knowledge is needed about prerequisites for professional support to be valuable and satisfactory during childbearing. Aim: The aim of this discourse paper is to describe and explore prerequisites for professional support that are of value for women and their families during childbearing as well as how healthcare organizations can be formed to facilitate these prerequisites. Design: Discourse paper. Methods: This discourse paper is based on our own experiences and is supported by literature and theory. Results: Well-functioning structures and processes facilitate professional support that leads to safe, secure, calm and prepared parents with the ability to handle the challenges of childbearing and parenting. When organizing care in childbearing, prerequisites for support needs must also be considered. CC BY 4.0© 2021 The Authors. Nursing Open published by John Wiley & Sons Ltd.First published: 06 November 2021CorrespondenceAnette Ekström-Bergström, Department of Health Sciences, University West, SE-461 86 Trollhättan, Sweden.Email: anette.ekstrom-bergstrom@hv.se

There is a need for a paradigm shift across mental health in primary care to improve the lives of millions of Europeans. To contribute to this paradigm shift, the European Forum for Primary Care (EFPC-MH) working group for Mental Health, produced a Position Paper for Primary Care Mental Health outlining 14 themes that needed prioritizing. These themes were developed and discussed interactively during the EFPC conferences between 2012 and 2019. The Position Paper on Mental Health gives direction to the necessary improvements over the next ten years. The themes vary from preferable healthcare model to the social determinants highlighting issues such as inequalities. The Statement of Mental Health in Primary Care will be established in cooperation with fellow organizations. ispartof: Primary Health Care Research And Development vol:21 issue:e56 pages:1-8 ispartof: location:England status: published

The Heart Failure Association of the European Society of Cardiology has published a previous position paper and various guidelines over the past decade recognizing the value of palliative care for those affected by this burdensome condition. Integrating palliative care into evidence-based heart failure management remains challenging for many professionals, as it includes the identification of palliative care needs, symptom control, adjustment of drug and device therapy, advance care planning, family and informal caregiver support, and trying to ensure a good death. This new position paper aims to provide day-to-day practical clinical guidance on these topics, supporting the coordinated provision of palliation strategies as goals of care fluctuate along the heart failure disease trajectory. The specific components of palliative care for symptom alleviation, spiritual and psychosocial support, and the appropriate modification of guideline-directed treatment protocols, including drug deprescription and device deactivation, are described for the chronic, crisis and terminal phases of heart failure. Funding Agencies|Patient Forum of the European Society of Cardiology

Background Over the last number of years, the healthcare system has become more complex in managing increasing costs and outcomes within a defined budget. To be effective through reform, especially moving forward from the COVID-19 pandemic, healthcare leaders, specifically in nursing, have an increased need for business acumen beyond traditional leadership and management principles. Aim This paper examines the concept of business acumen in the profession of nursing, specifically for managers and higher nurse leaders, establishing whether these skills are optional or essential. Discussion Nurses learn and develop broad skills in leadership and management, but less specifically about business or the broader system. With a contemporary Australian health system aiming to be more effective, nurses may require a greater level of business acumen to adequately understand the mechanics of business decision making in the system when designing care models, as well as representing the business potential of nursing in balance with clinical outcomes through reform. Conclusion The modern nurse, in addition to clinical skills, may need a foundational understanding of business evolving throughout their career, to maximise innovative growth across the system, in meeting the healthcare needs of our community now and into the future. Without a foundation level of business acumen and an understanding of the system across the profession, nurses may not be empowered with their full potential of being a strong voice influencing health system reform.

Cardiovascular disease is one of the main causes of morbidity and sick leave in Belgium, imposing a great socio-economic burden on the contemporary healthcare system and society. Cardiac rehabilitation is an evidence-based treatment strategy that not only improves the cardiac patients' health state but also holds promise so as to facilitate vocational reintegration in the society. This position paper was developed and endorsed by the Belgian Working Group of Cardiovascular Prevention and Rehabilitation. It provides an overview of the currently available Belgian data with regard to the role of cardiac rehabilitation in return to work after an initial cardiac event. It identifies the relevant barriers and facilitators of vocational integration of cardiac patients and summarises the contemporary Belgian legal and medical framework in this regard. Cardiac rehabilitation remains a primordial component of the post-acute event management of the cardiac patient, facilitating vocational reintegrating and thereby decreasing the pressure on social security. Despite the availability of a relevant legislative framework, there is a need for well-defined algorithms to assess readiness for return to work that can be used in daily clinical practice. ispartof: ACTA CARDIOLOGICA vol:75 issue:5 pages:388-397 ispartof: location:England status: published

Contains fulltext : 225338.pdf (Publisher’s version ) (Open Access) OBJECTIVES: The number of older people dying in long-term care facilities (LTCFs) is increasing globally, but care quality may be variable. A framework was developed drawing on empirical research findings from the Palliative Care for Older People (PACE) study and a scoping review of literature on the implementation of palliative care interventions in LTCFs. The PACE study mapped palliative care in LTCFs in Europe, evaluated quality of end-of-life care and quality of dying in a cross-sectional study of deceased residents of LTCFs in 6 countries, and undertook a cluster-randomized control trial that evaluated the impact of the PACE Steps to Success intervention in 7 countries. Working with the European Association for Palliative Care, a white paper was written that outlined recommendations for the implementation of interventions to improve palliative and end-of-life care for all older adults with serious illness, regardless of diagnosis, living in LTCFs. The goal of the article is to present these key domains and recommendations. DESIGN: Transparent expert consultation. SETTING: International experts in LTCFs. PARTICIPANTS: Eighteen (of 20 invited) international experts from 15 countries participated in a 1-day face-to-face Transparent Expert Consultation (TEC) workshop in Bern, Switzerland, and 21 (of 28 invited) completed a follow-up online survey. METHODS: The TEC study used (1) a face-to-face workshop to discuss a scoping review and initial recommendations and (2) an online survey. RESULTS: Thirty recommendations about implementing palliative care for older people in LTCFs were refined during the TEC workshop and, of these, 20 were selected following the survey. These 20 recommendations cover domains at micro (within organizations), meso (across organizations), and macro (at national or regional) levels addressed in 3 phases: establishing conditions for action, embedding in everyday practice, and sustaining ongoing change. CONCLUSIONS AND IMPLICATIONS: We developed a framework of 20 recommendations to guide implementation of improvements in palliative care in LTCFs.

Objective The aims of this study were to understand the status quo of authors, collaborations between institutions, research hotspots, and research frontiers of fund-sponsored clinical nursing papers and to provide a reference for Chinese scholars to conduct clinical nursing studies in the future. Methods The visualization software CiteSpace was used to analyze fund-sponsored clinical nursing papers published between 2012 and 2016 in 12 core journals of nursing. Results In the clinical nursing field, there are many cooperative author groups; however, the collaborations between institutions are not close and exist mainly within the same province or city. High-frequency keywords have revealed the four clinical nursing research hotspots of population, diseases, nursing intervention, and others. Chinese medicine nursing, prevention, treatment and nursing, and new technology-aided nursing of ventilator-associated pneumonia are the study frontiers of clinical nursing. Conclusions Clinical nursing studies are rich in content and cover a wide range of areas, and their hotspots and frontiers are closely related to the requirements of clinical nursing. Collaborations across regions, provinces, and cities are not adequate; there is an urgent need to strengthen the cross-regional exchanges and collaborations to promote the further development of clinical nursing.

Bakgrund: Etnisk diskriminering innebär att missgynnas på grund av utseende, språk eller kultur. Diskriminering skapar fysisk och psykisk ohälsa. När sjuksköterskor och hälso- och sjukvården diskriminerar patienter på grund av etnicitet utsätts patienterna för vårdlidande. Vård ska, enligt lag, ges på lika villkor där alla människor, oavsett etnicitet, har rätt till adekvat vård. Syfte: Syftet med studien var att beskriva patienters upplevelser av etnisk diskriminering i hälso- och sjukvården. Metod: Studien är en kvalitativ litteraturöversikt med induktiv ansats vilken baseras på nio vetenskapliga artiklar. Resultat: Patienter upplever etnisk diskriminering i hälso- och sjukvården vilket synliggörs i tre teman; orättvis vård, orättvist bemötande och minskad delaktighet. Konklusion: Patienter riskerar att bli utsatta för etnisk diskriminering i samma stund de söker sig till hälso- och sjukvården. Diskrimineringen kan pågå genom hela vårdkedjan, oberoende situation, vårdinrättning och land. Etnisk diskriminering sker på både organisations- och individnivå. För att undvika orsaka patienterna vårdlidande på grund av etnisk diskriminering bör sjuksköterskan utmana och reflektera över egna fördomar. Background: Ethnic discrimination means being disadvantaged because of appearance, language, or culture. Discrimination creates physical and mental illness. When nurses and the health care system discriminate against patients based on ethnicity, patients are exposed to care suffering. Care must, according to law, be given on equal terms where all people, regardless of ethnicity, have the right to adequate care. Aim: The aim of this study was to describe patients experiences of ethnic discrimination in health care. Method: The study is a qualitative literature review with an inductive approach which is based on nine scientific articles. Findings: Patients experience ethnic discrimination in healthcare, which is made visible in three themes; unfair care, unfair treatment and reduced participation. Conclusion: Patients risk being exposed to ethnic discrimination at the same moment they seek health care. The discrimination can continue throughout the care chain, independent situation, care facility and country. Ethnic discrimination occurs at both organizational and individual levels. To avoid causing the patients suffering due to ethnic discrimination, the nurse should challenge and reflect on their own prejudices.

Open Dialogue is a need-adapted approach to mental health care that was originally developed in Finland. Like other need-adapted approaches, Open Dialogue aims to meet consumer’s needs and promote collaborative person-centred dialogue to support recovery. Need-adapted mental health care is distinguished by flexibility and responsiveness. Fidelity, defined from an implementation science perspective as the delivery of distinctive interventions in a high quality and effective fashion is a key consideration in health care. However, flexibility presents challenges for evaluating fidelity, which is much easier to evaluate when manualization and reproducible processes are possible. Hence, it remains unclear whether Open Dialogue and other need-adapted mental health interventions can be meaningfully evaluated for fidelity. The aim of this paper was to critically appraise and advance the evaluation of fidelity in need-adapted mental health care, using Open Dialogue as a case study. The paper opens a discussion about how fidelity should be evaluated in flexible, complex interventions, and identifies key questions that need to be asked by practitioners working in need-adapted mental health care to ensure they deliver these interventions as intended and in an evidence-based fashion.

BACKGROUND: Previous studies have demonstrated that students who are engaged in learning tasks and make errors before receiving instruction on how to complete them, achieve better learning outcomes than students who first receive instruction and then complete the learning activities with the aim of avoiding errors. Although simulation literature often refers to errors as learning opportunities, to date, there is limited understanding of how pedagogical approaches that promote learning from errors can guide the design of simulation-based learning in healthcare education. AIMS: To (a) present the Learning from Errors conceptual model; and (b) provide an example of how educators can use this model. DESIGN: The Learning from Errors model is drawn from critical elements of two pedagogical approaches, productive failure and error management training and pedagogical features of high-quality healthcare simulations. METHODS: We describe the Learning from Errors model, which emphasises the need for adopting pedagogical methods that explicitly use errors as learning opportunities and ultimately inform simulation design. We then illustrate the application of this model to a simulation example. RESULTS: The model includes the following elements: i) normalisation of errors, ii) challenging simulation scenarios, iii) self-directed learning, iv) collaborative teamwork and v) comparison with best practice. CONCLUSION: This discussion paper presents the Learning from Errors conceptual model, an evidence-based approach that can assist educators in the design of simulations that embrace errors as a catalyst for learning.

BACKGROUND: Empathy development is an integral aspect of nurse education in several countries. Empathy supports person-centred care provision by aiding effective communication and promoting feelings of wellbeing by helping people feel understood. AIM: The development of empathy in nursing students is best facilitated through experiential learning and reflective practice, although to date, there are no reflective models specifically designed for this purpose. It is the aim of this paper to present a model designed to promote reflection on the development of empathy. DESIGN: The authors have developed an approach to empathic reflection based on the philosophy of Edith Stein. METHODS: In this paper we outline the Empathic Reflection model which emphasises the need for educator support and an appreciative approach. We then present a narrative example of the model in action in an acute care setting. RESULTS: We have developed a three-stage model to support experiential learning about the development of empathy for nursing students. CONCLUSIONS: This discussion paper explores an interesting area for future nursing research about empathy development through experiential learning and reflective practice. Educators can contribute to the promotion of empathy by working in partnership with students to explore previously held beliefs which might act as barriers to empathic care provision.

Purpose The purpose of this paper is to contribute theoretical ideas of how peer support workers (PSWs) bring added value to interprofessional learning (IPL) in mental health care teamwork. The question is: How can we theoretically understand the value of PSWs’ expertise for IPL in mental health care teamwork? Design/methodology/approach Initially, the authors formulate a hypothesis. Then, the authors describe the focus and context in IPL and PSWs, respectively, and the PSWs’ and mental health professions’ different roles, expertise and perspectives. The authors also refer to some peer provided programs related to IPL. Finally, the authors construct an outline and apply ideas from Wenger’s Communities of Practice (CoP). Findings Using CoP, the PSWs as newcomers can by their perspectives change mental health professions’ perspectives and stimulate IPL in teamwork. Originality/value The paper gives theoretical insights of how PSWs can facilitate IPL in mental health care teamwork.

In the early stages of the COVID-19 pandemic, physiotherapists (PTs) across the globe were required to rapidly adapt clinical practice to provide safe and effective care for people with HIV/AIDS and cancer and those in hospice and palliative care. These rapid decisions included developing criteria for in-person versus remote care and developing equitable platforms for telehealth and telerehabilitation. Most decisions were made with limited guidelines or evidence for practice related to the pandemic. The purpose of this perspective was to provide a synopsis of the experiences of 25 PTs from 16 countries regarding their clinical decisions for (1) rapid adaptation of patient care delivery, (2) evaluation criteria to treat in-person or remotely, (3) utilization decisions for telerehabilitation, (4) determinations for future practice and research needs, and (5) promotion of health equity in an environment rapidly transformed by a highly infectious and deadly disease.