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Aim A discussion on how informatics knowledge and competencies can enable nursing to instantiate transition to integrated models of care. Background Costs of traditional models of care are no longer sustainable consequent to the spiralling incidence and costs of chronic illness. The international community looks towards technology-enabled solutions to support a shift towards integrated patient-centred models of care. Design Discussion paper. Data sources A search of the literature was performed dating from 2000-2015 and a purposeful data sample based on relevance to building the discussion was included. Discussion The holistic perspective of nursing knowledge can support and advance integrated healthcare models. Informatics skills are key for the profession to play a leadership role in design, implementation and operation of next generation health care. However, evidence suggests that nursing engagement with informatics strategic development for healthcare provision is currently variable. Implications for nursing A statistically significant need exists to progress health care towards integrated models of care. Strategic and tactical plans that are robustly pragmatic with nursing insights and expertise are an essential component to achieve effective healthcare provision. To avoid exclusion in the discourse dominated by management and technology experts, nursing leaders must develop and actively promote the advancement of nursing informatics skills. For knowledge in nursing practice to flourish in contemporary health care, nurse leaders will need to incorporate informatics for optimal translation and interpretation. Conclusion Defined nursing leadership roles informed by informatics are essential to generate concrete solutions sustaining nursing practice in integrated care models. [ABSTRACT FROM AUTHOR]

The purpose of this discussion paper is to explore the existing literature from Canada on transitioning from military to civilian life for veterans of recent deployments. A number of topics relating to the transition experience emerged: interpersonal readjustment, emotional including mental health needs, school needs, and social needs. Implications for nursing will be discussed in terms of veterans as a cultural group and culturally competent nursing care. Recommendations for future nursing research include how well current services are meeting the needs of the younger, more recent veterans transitioning to civilian life; conducting longitudinal studies on the impact of transitioning to civilian life for veterans and their families; comparing the transition experience at an international level; developing a transition model that situates the veteran culture as the overarching framework for testing and understanding the experience of transitioning to civilian life. [ABSTRACT FROM AUTHOR]

Aims and objectives: This review aimed to demonstrate the self‐care behaviours of first‐generation Chinese immigrants with cardiovascular disease in western countries and identify related cultural factors. Background: Self‐care is the cornerstone to mitigate disease symptoms and maintain health status. Chinese immigrants to western countries, operating within a cross‐cultural context, may find self‐care to manage their cardiovascular disease challenging. Design: An integrative review was conducted. Methods: Seven databases were searched Scopus, ProQuest Health & Medicine, Medline (Ovid), Embase (Ovid), AMED (Ovid), PsycINFO and CINAHL, with output limited to peer‐reviewed studies published from 2000 to 2020 in English or Chinese. Initially, 2037 papers were screened. Six papers were retained and critiqued using the Joanna Briggs Institute critical appraisal tools. Deductive and inductive approaches were utilised to analyse the findings. The PRISMA 2020 checklist informed review reportage. Result: In general, Chinese immigrants with cardiovascular disease took an active role in management of their cardiovascular disease, including through diet and activity adaptation and adherence to western medication. Families also played a significant role in disease decision‐making and management. However, language and cultural barriers impeded their access to health information and resources in host countries. Relevance to clinical practice: Understanding self‐care behaviours and associated cultural factors among Chinese immigrants with cardiovascular disease is important to improve nurses' culturally sensitive practices and provide tailored health education interventions to promote self‐care behaviours among immigrant populations. The scarcity of literature on self‐care behaviours among Chinese first‐generation immigrants with cardiovascular disease indicates the need for further research in this area. Development of culturally and linguistically sensitive health resources and education programs is urgently needed. [ABSTRACT FROM AUTHOR]

Accessible Summary: What Is Known on the Subject?: Economic and educational opportunities are usually the principal driving forces for migration.There is a large body of quantitative research studies, mainly from the U.K., supporting the high prevalence of psychiatric disorders, mainly psychotic disorders, in Afro‐Caribbean immigrants which increases across generations.The process of migration and acculturation can present significant risk factors for psychiatric disorders in immigrants.Research involving members of the Black community is generally conducted with the perception that Blacks are a homogenous group, ignoring the cultural and ethnic differences among the subgroups. What the Paper Adds to Existing Knowledge?: It provides a broadened understanding of the experiences, thoughts and feelings of Afro‐Caribbean immigrants, and the factors within the processes of migration and acculturation that negatively impacts their mental health.It provides context to the volume of quantitative studies indicating a high prevalence of psychiatric disorders, particularly psychotic disorders, in Afro‐Caribbean immigrants and their offspring. What Are the Implications for Practice?: Nurses conducting mental health evaluations and assessments for members of the Black community should be culturally competent. Cultural competence entails an understanding of cultural beliefs, race, ethnicity and values. Additionally, knowledge of the effects of migration and acculturation as mental health risks is also important to improve mental health outcomes.Cultural competence will help reduce health disparities by increasing trust in the health care system and providers, not only for Afro‐Caribbean immigrants, but all immigrant groups. Introduction: There is evidence to support migration as a significant risk factor for psychiatric disorders in immigrants. Unfortunately, as an immigrant group, little is known about the mental health of Afro‐Caribbean immigrants and the factors that threaten their mental health. Aim: To explore the perceived effects of migration on the mental health of Afro‐Caribbean immigrants. Methods: A qualitative narrative synthesis was employed to interpretively integrate 13 primary qualitative research findings. Eleven of the primary studies were conducted in the U.K., one in the U.S. and one in Canada. Results: The themes gleaned: (1) experiences of racism, (2) generational conflicts, (3) feelings of powerlessness, (4) limited socioeconomic resources, (5) unfulfilled expectations, (6) fragmented family and community and (7) ignoring cultural/ethnic identity. Discussion: The findings broadened the understanding and experiences of Afro‐Caribbean immigrants and their mental health vulnerabilities as they navigate through migration and acculturation. Implications for Practice: Addressing the mental health of Afro‐Caribbeans will require health care providers to: (1) be cognizant of their immigrant status; (2) understand how migration and acculturation influence the mental health of immigrants; (3) be aware of the ethnocultural differences among Black subgroups. [ABSTRACT FROM AUTHOR]

Aim The aim of this paper was to provide a concept analysis of 'pandemic influenza'. Background Pandemic influenza can have a devastating impact as individuals have little to no immunity towards the newly encountered virus. It is a persistent societal threat due to the advancement of multiple technological processes. Nurses work in multiple roles in pandemics. As such, a thorough understanding of the concept and its implications from a nursing perspective is required. Design Rodgers' Evolutionary Method was used to conduct the concept analysis of the term 'pandemic influenza'. Data sources Forty-nine papers were examined from the disciplines of public health, medicine, law, bioethics and healthcare policy. Papers were found from the PubMed, CINAHL and Google Scholar databases all dates up to December 2013. Limits were set to include peer-reviewed, English language articles. Methods Identified papers were critically analyzed to explore the concept's antecedents, attributes and consequences. Surrogate and related terms, and an exemplar, were identified. Results Attributes of pandemic include original viral structure, increased human susceptibility, younger vulnerable populations and unpredictable time frames. Antecedents include processes that enable the increased geographical transmission of a newly created influenza. Consequences include higher morbidity and mortality rates and the need for an efficient pandemic response. Conclusions This analysis identified the attributes of pandemic influenza through a synthesis of the current pandemic literature. However, no articles were identified as specifically nursing in nature. Therefore, more research is required to examine the impact of a pandemic declaration on the nursing profession. [ABSTRACT FROM AUTHOR]

Aims and objectives. This discursive paper explores issues of abuse during smoking cessation counselling. Background. During a training session for a smoking cessation intervention pilot study, nurses expressed concerns about issues of abuse that had previously surfaced during cessation counselling in their practice. Abused women are more likely to smoke. As guidelines recommend integrating cessation interventions into practice, issues of abuse are likely to surface. Methods. A literature review and synthesis of abuse and smoking cessation was undertaken to arrive at recommendations for practice. Results. There are a few suggestions about how to manage abuse within cessation counselling, but none have been studied: (1) integrate stress-management strategies, (2) assess for abuse, (3) provide separate interventions for partners to create a safe environment, and (4) develop interventions that consider the relationship couples have with tobacco. However, coping strategies alone do not address abuse, screening without treatment is not helpful, and partner interventions assume both partners are open to quitting/counselling. In contrast, as with all clinical practice, abuse and cessation would be considered separate but intertwined problems, and following best practice guidelines for abuse would provide the guidance on how to proceed. After care has been taken to address abuse, it is the patient's decision whether to continue with cessation counselling. Conclusion. Guidelines addresses both care planning and the ethical/legal issues associated with the disclosure of abuse and provide a practical tool for addressing abuse that obviates the need to tailor cessation interventions to abuse. Relevance to clinical practice. This paper clarifies a relationship between smoking and abuse and the subsequent implications for smoking cessation interventions and highlights the importance of addressing abuse and smoking cessation separately, even though they are interrelated problems. It provides nurses with appropriate initial responses when abuse is disclosed during an unexpected encounter such as during a smoking cessation intervention. [ABSTRACT FROM AUTHOR]

Aims To report a systematic review of the psychometric properties of self-report instruments to identify the symptoms of anxiety in pregnancy to help clinicians and researchers select the most suitable instrument. Background Excessive anxiety in pregnancy is associated with adverse birth outcomes, developmental and behavioural problems in infants and postnatal depression. Despite recommendations for routine psychological assessment in pregnancy, the optimal methods to identify anxiety in pregnancy have not been confirmed. Design Psychometric systematic review. Data sources A systematic literature search of the multiple databases (1990-September 2014). Review methods Identification of self-report instruments to measure anxiety in pregnancy using COSMIN guidelines to assess studies reporting a psychometric evaluation of validity and reliability. Results Thirty-two studies were included. Studies took place in the UK, Australia, Belgium, Canada, Germany, Italy, Scandinavia, Spain and the Netherlands. Seventeen different instruments were identified. Measures of validity were reported in 19 papers and reliability in 16. The overall quality of the papers was rated as fair to excellent using the COSMIN checklist. Only one paper scored excellent in more than one category. Conclusion Many instruments have been adapted for use in different populations to those for which they were designed. The State Trait Anxiety Inventory, Edinburgh Postnatal Depression Scale and the Hospital Anxiety and Depression Scale have been tested more frequently than other instruments, yet require further assessment to confirm their value for use in pregnancy. [ABSTRACT FROM AUTHOR]

mcinnes e., seers k. & tutton l. (2011) Older people's views in relation to risk of falling and need for intervention: a meta-ethnography. Journal of Advanced Nursing 67(12), 2525-2536. Abstract Aim. This paper is a report of a meta-ethnography of qualitative studies of older peoples' views on risk of falling and need for intervention. Background. Falls and falls-related injuries in older people are worldwide problems. A conceptual understanding of older people's views about falls risk and need for intervention is useful for understanding factors likely to impact on acceptance of risk and recommended interventions. Data Sources. Seven electronic databases were searched 1999-2009. Reference lists of included articles were screened for eligible papers. Review Methods. Assessment of quality was carried out. Themes and concepts were extracted using a meta-ethnographic approach to compare similarities and differences across the retrieved studies. A line of argument was developed to produce an explanatory framework of the extracted themes and concepts. Results. Eleven relevant qualitative research articles of reasonable quality were identified. Six key concepts were identified: beyond personal control; rationalizing; salience; life-change and identity; taking control and self-management. A line of argument synthesis describes how older people approach self-appraisal of falls risk and intervention need, and how they cope and adapt to falls risk and intervention need. Conclusion. In response to having an elevated risk status and perceived associations with frailty and impact on an independent life-style, some prefer to adapt to this reality by taking control and implementing self-management strategies. Healthcare professionals should take into account beliefs about risk and negotiate choices for intervention, recognizing that some individuals prefer to drive the decision-making process to preserve identity as a competent and independent person. [ABSTRACT FROM AUTHOR]

Aim: To address: What are the experiences of 2SLGBTQQIA+ parents using parenting supports and services to meet their children's early childhood development needs (<5 years of age)? Design: Whittemore and Knafl's (2005) integrative review methodology. Methods: Electronic databases were searched from 2000 to October 14, 2022 for empirical studies or reviews addressing the research question. The title and abstract of 12,158 articles were screened for inclusion in the review by two independent researchers; 175 of these articles underwent full‐text review. Studies selected were critically appraised using a Joanna Briggs Institute Critical Appraisal tool. Relevant key findings were extracted from each study and entered into N‐VIVO‐12. Thematic content analysis was employed and PRISMA guidelines were adhered to. Results: A total of 18 articles (15 qualitative and three multi‐method studies) met the inclusion criteria and were selected for the review. Seven themes were revealed from analysis of the studies: (1) 2SLGBTQQIA+ Status kept a secret; (2) Forced to come out; (3) Heteronormative messaging; (4) Feeling excluded; (5) Stigmatised; (6) Parents act as educators; and (7) Positive experiences. Conclusion: This integrative review provides nurses with insight into the experiences of 2SLGBTQQIA+ parents using health care services for their young child. Implications for the Profession: This article highlights what changes nurses need to make to their practice to ensure appropriate, inclusive care for clients of diverse sexual and gender identities and their families. Impact: Health care providers, especially nurses, have an opportunity to improve the experiences of these families and positively impact their health and well‐being. Additionally, there is a need for research with the 2SLGBTQQIA+ parent community and the use of rigorous methodological techniques, including clearly linking participants' gender and sexual identities with study findings, to improve our understanding of 2SLGBTQQIA+ parent experiences. Patient or Public Contribution: Although there was no direct patient contribution to the work since it was an integrative review of the literature, indirectly patient contributions are incorporated from the original research results of studies incorporated into this review. [ABSTRACT FROM AUTHOR]

Aims and objectives This paper aims to investigate the transition experiences of students with previous nursing qualifications (nondegree qualifications) entering a nursing degree program. Background Nurses with professional nursing qualifications (nondegree) are an important pool of professionals to draw on to help address nursing shortages through providing alternative pathways to becoming registered nurses. However, research suggests this cohort need higher levels of support and intervention to be successful. Design An integrative review was conducted, guided by Whittemore and Knafl's framework. A comprehensive search was conducted and 14 studies were included in the review. Methods A five-stage approach was used to conduct the review: problem identification, literature search, data evaluation, data analysis and presentation of results. Constant comparative analysis was used to identify commonalities, differences and themes in the relevant literature. Results Themes emerged that suggested students struggled with academic and institutional challenges, becoming learners, managing conflicting demands of outside life, developing a student identity and experienced threat to their sense of professional identity. Additionally, the cohort did not view themselves as 'the same' as traditional students. Holland's framework provides a useful framework from which to conceptualise these students' experiences. Conclusion There are challenges for this cohort of students as they transition into degree level study. Supportive activities that extend and further develop students' personality orientations may be a useful starting point in addressing some of the challenges and providing a more positive transition to university. Relevance to clinical practice The demand for health care is growing and there remains a shortfall of registered nurses. Nurses with professional qualifications (nondegree) are an important pool of professionals from which to increase registered nurse numbers and address workforce sustainability issues. [ABSTRACT FROM AUTHOR]

Accessible summary Social support has positive and negative dimensions, each of which has been associated with mental health outcomes. Social networks can also serve as sources of distress and conflict., This paper reviews journal articles published during the last 24 years to provide a consolidated summary of the role of social support and social conflict on immigrant women's mental health. The review reveals that social support can help immigrant women adjust to the new country, prevent depression and psychological distress, and access care and services. When social support is lacking or social networks act as a source of conflict, it can have negative effects on immigrant women's mental health., It is crucial that interventions, programmes, and services incorporate strategies to both enhance social support as well as reduce social conflict, in order to improve mental health and well-being of immigrant women., Abstract Researchers have documented the protective role of social support and the harmful consequences of social conflict on physical and mental health. However, consolidated information about social support, social conflict, and mental health of immigrant women in Canada is not available. This scoping review examined literature from the last 24 years to understand how social support and social conflict affect the mental health of immigrant women in Canada. We searched MEDLINE, PsycINFO, CINAHL, Healthstar, and EMBASE for peer-reviewed publications focusing on mental health among immigrant women in Canada. Thirty-four articles that met our inclusion criteria were reviewed, and are summarized under the following four headings: settlement challenges and the need for social support; social support and mental health outcomes; social conflict and reciprocity; and social support, social conflict, and mental health service use. The results revealed that social support can have a positive effect on immigrant women's mental health and well-being, and facilitate social inclusion and the use of health services. When social support is lacking or social networks act as a source of conflict, it can have negative effects on immigrant women's mental health. The results also highlighted the need for health services to be linguistically-appropriate and culturally-safe, and provide appropriate types of care and support in a timely manner in order to be helpful to immigrant women. [ABSTRACT FROM AUTHOR]

Aims and Objectives: To illustrate the scope of different types of transitional, community‐based health interventions for formerly incarcerated women, trans and nonbinary people, the eligibility criteria for these interventions, and associated health outcomes. Background: Meeting the health needs of formerly incarcerated people in community, rather than through the criminal justice system, may prevent further experiences of criminalization. Research is needed to understand what community‐based health interventions have been implemented internationally to inform the design of an intervention in Canada. Design: Scoping review using the Joanna Briggs Institute scoping review methodology. Methods: In consultation with a medical research librarian, key databases and journals were searched for English language articles, from any country, with no specified date range. Three authors independently screened titles and abstracts to identify articles for full‐text review. The study adheres to PRISMA‐EQUATOR guidelines. Results: Thirty‐six studies met the present criteria and were reviewed in full text. Method, setting, participants, sample, relevant outcomes and relevant findings were extracted from each study for synthesis. Included studies had varied methods and were published from 1999 to 2020. Thirty‐one studies were based in the United States, one in Puerto Rico and two each in Canada and the United Kingdom. The most common health issue focus was human immunodeficiency virus and/or hepatitis c virus. The most common outcome was uptake of offered services, such as a transitional clinic. Conclusions: Gaps in the research pertain to a lack of attention to clinical outcomes and patient experience, and a lack of consideration of sexual and reproductive health concerns. Women were the minority population in all studies that included both men and women; transgender participants were mentioned in only four of thirty‐six studies. The specific needs of women, trans and nonbinary people must be taken into consideration. Relevance to clinical practice: Nurses must be conscious of the elevated health risks associated with exposure to correctional institutions and the risks associated with the period of transition. Patient or Public Contribution: A member of the research team brings lived experience expertise with respect to the criminal justice system. [ABSTRACT FROM AUTHOR]

sutcliffe k., caird j., kavanagh j., rees r., oliver k., dickson k., woodman j., barnett-paIge e. & thomas j. (2012) Comparing midwife-led and doctor-led maternity care: a systematic review of reviews. Journal of Advanced Nursing 68(11), 2376-2386. Abstract Aims. A report of a systematic review of reviews which examines the impact of having midwives-led maternity care for low-risk women, rather than physicians. Background. A rising birth rate, increasing complexity of births, and economic constraints pose difficulties for maternity services in the UK. Evidence about the most effective, cost-effective, and efficient ways to give maternity services is needed. Data sources. Searches were carried out in August-September 2009 of ten electronic databases, 16 key nursing and research websites, and reference lists of 56 relevant reviews. We also contacted 38 experts for information. No date restrictions were employed. Review methods. A narrative review of systematic reviews or 'meta review' was conducted using transparent and systematic procedures to limit bias at all stages. Systematic reviews that compared midwife-led care during pregnancy and birth with physician-led care were eligible for inclusion. Results. Three meta-analytic reviews were included. Midwife-led care for low-risk women was found to be better for a range of maternal outcomes, reduced the number of procedures in labour, and increased satisfaction with care. For some maternal, foetal, and neonatal outcomes reviews found no evidence that care led by midwives is different to that led by physicians. No adverse outcomes associated with midwife-led care were identified. Conclusions. For low-risk women, health and other benefits can result from having their maternity care led by midwives rather than physicians. Moreover, there appear to be no negative impacts on mothers and infants receiving midwife-led care. [ABSTRACT FROM AUTHOR]

brereton l., gardiner c., gott m., ingleton c., barnes s. & carroll c. (2011) The hospital environment for end of life care of older adults and their families: an integrative review. Journal of Advanced Nursing 68(5), 981-993. Abstract Aim. This article is a report of an integrative review to identify key elements of the physical hospital environment for end of life care of older adults and their families as reported by patients, relatives, staff and policy makers. Background. Globally ageing populations and increases in long-term illness mean that more people will need palliative care in the future. Despite policy initiatives to increase end of life care in the community, many older adults prefer, and will require, end of life care in hospital. Providing an appropriate physical environment for older adults requiring end of life care is important given concerns about hospital environments for this group. Data sources. Thirteen databases from 1966 to 2010 were searched including ASSIA, BNI, Cochrane Library, CINAHL, EMBASE, MEDLINE, PsycINFO, Social Science Citation Index, the Science Citation Index, HMIC and the National Research Register. Reference and citation tracking was performed on included publications. Review methods. An integrative review was conducted. Two reviewers independently screened titles and abstracts for inclusion and completed data extraction. Study quality is not reported as this poses methodological difficulties in integrative reviews. Data synthesis involved thematic analysis informed by the findings of included literature. Results. Ten articles were included. Four themes were identified: privacy as needed; proximity (physically and emotionally) to loved ones, home and nature; satisfaction with the physical environment; and deficiencies in physical environment. Conclusion. Little evidence exists about physical hospital environments for end of life care of older adults and their families. More research is required in this field. [ABSTRACT FROM AUTHOR]

The article presents a study on non-clinical interventions that help increase the success rate of vaginal birth after caesarean section. Vaginal birth after caesarean section in a subsequent pregnancy reportedly poses the risk of uterine rupture. Non-clinical interventions may reportedly have a significant impact on the success of vaginal birth after caesarean section. These interventions include national and local guidelines, individualized information, and feedback on mode of birth rates.

The article analyzes measures in nursing and health-related literature in relation to evaluating patient spirituality as more than religiosity. It is said that nursing and health-related disciplines agree that spirituality and religiosity are two distinct concepts and that the former is a broader concept. However, the concept of spirituality is reportedly used interchangeably with the concept of religion in terms of evaluating patient spirituality.

Aim. To review the literature about the Canadian experience with nurse practitioner role implementation and identify influencing factors. Background. Although nurse practitioners have been in existence for more than 40 years, their integration into healthcare systems has been challenging. While frameworks exist to guide implementation of these roles, clear identification of factors influencing role implementation may inform best practices. Given that Canada has witnessed considerable growth in nurse practitioner positions in the past decade, an exploration of its experience with role implementation is timely. Data sources. A review of Canadian literature from 1997 to 2010 was conducted. Electronic databases including CINAHL, Cochrane Database of Systematic Reviews, Health Source: Nursing Academic Edition, Medline, Social Science Index, PubMed, Web of Science and PsychINFO and government and professional organization websites were searched. Methods. An integrative review was performed guided by Whittemore and Knafl's method. Results. Ten published studies and two provincial reports were included. Numerous facilitators and barriers to implementation were identified and analysed for themes. Three concepts influencing implementation emerged: involvement, acceptance and intention. Involvement is defined as stakeholders actively participating in the early stages of implementation. Acceptance is recognition and willingness to work with nurse practitioner. Intention relates to how the role is defined. Conclusion. This integrative review revealed three factors that influence nurse practitioner role implementation in Canada: involvement, acceptance and intention. Strategies to enhance these factors may inform best practice role implementation processes. [ABSTRACT FROM AUTHOR]

Aim and objectives. To identify the theories and concepts related to building age-friendly rural communities. Background. Global population is rapidly ageing. Creating environments that support active ageing was a catalyst for the World Health Organization to develop Global Age-Friendly Cities guidelines. Although the age-friendly movement has captured the attention of some countries, little is known about the participation of older people in rural settings. Method. An integrative review approach was employed to summarise the research literature on this topic. Using a systematic search strategy, databases including Discover (EBSCO's electronic database system), Web of Science, Scopus, PubMed, CINAHL, PsycINFO, Medline and Google Scholar were searched. Primary, peer-reviewed studies were included if published during 2007-2014 in the English language. Results. Nine studies were eligible for inclusion. The studies were set predominantly in Canada, with the exception of one from Ireland. The findings were summarised and clustered into main topics which included: theoretical perspectives; geographic and demographic characteristics; collaboration and partnerships; sus-tainability and capacity; and finally, future research agendas. Conclusions. Rural communities are changing rapidly and are becoming increasingly diverse environments. Community characteristics can help or hinder age-friendliness. Importantly, the fundamental starting point for age-friendly initiatives is establishing older peoples' perceptions of their own communities. Relevance to clinical practice. It is important for nurses, working in primary health care settings, to understand the needs of older people in the communities in which they practice. This includes the community characteristics that can be enablers and barriers to older people being able to remain and age within their own communities. [ABSTRACT FROM AUTHOR]

Aims and objectives. To determine, from a systematic literature review, the experience of living with heart failure and to propose some practice guidelines and research questions. Background. Chronic heart failure has been one of the fastest growing illnesses in recent decades, with almost 23 million people affected worldwide. This complex syndrome has multiple causes and appears when underlying heart disease is advanced. Currently, heart failure has no cure and leads to a significant deterioration in patients' quality of life. Design. Qualitative meta-synthesis. Methods. A qualitative meta-synthesis was conducted to extract and analyse qualitative research from the Cochrane, PubMed, CINAHL, PsycINFO, Web of Science and Cuiden databases. Snowball sampling and a manual search were performed to identify other relevant studies. Results. Twenty-five qualitative studies were selected. The findings indicate that there are three main themes that describe the phenomenon. The first theme refers to the experiences related to the beginning of the process. The second theme is connected with the effects on the person: physical, emotional, social and spiritual changes. The third theme is linked with how to live with heart failure despite the illness, including the adjustment and coping process and how external resources can help them to manage. Conclusions. Heart failure has a major impact on the entire person, but some areas have not been addressed. By creating new tools to understand and evaluate the impact of this illness and interventions that prevent or improve some situations, we can promote the well-being and the quality of life of this population. Relevance to clinical practice. Nurses must have a personal knowledge of the experiences and needs of the patients. To do this, nurses should create care environments that promote an exchange of experiences and knowledge between the nurse and the patient and family. [ABSTRACT FROM AUTHOR]

Aims To compare nurse turnover rates and costs from four studies in four countries ( US, Canada, Australia, New Zealand) that have used the same costing methodology; the original Nursing Turnover Cost Calculation Methodology. Background Measuring and comparing the costs and rates of turnover is difficult because of differences in definitions and methodologies. Design Comparative review. Data Sources Searches were carried out within CINAHL, Business Source Complete and Medline for studies that used the original Nursing Turnover Cost Calculation Methodology and reported on both costs and rates of nurse turnover, published from 2014 and prior. Methods A comparative review of turnover data was conducted using four studies that employed the original Nursing Turnover Cost Calculation Methodology. Costing data items were converted to percentages, while total turnover costs were converted to US 2014 dollars and adjusted according to inflation rates, to permit cross-country comparisons. Results Despite using the same methodology, Australia reported significantly higher turnover costs ($48,790) due to higher termination (~50% of indirect costs) and temporary replacement costs (~90% of direct costs). Costs were almost 50% lower in the US ($20,561), Canada ($26,652) and New Zealand ($23,711). Turnover rates also varied significantly across countries with the highest rate reported in New Zealand (44·3%) followed by the US (26·8%), Canada (19·9%) and Australia (15·1%). Conclusion A significant proportion of turnover costs are attributed to temporary replacement, highlighting the importance of nurse retention. The authors suggest a minimum dataset is also required to eliminate potential variability across countries, states, hospitals and departments. [ABSTRACT FROM AUTHOR]

Aim To analyse critically the barriers and facilitators to new graduate nurse engagement in interprofessional collaboration. Background The acculturation of new graduate nurses must be considered in strategies that address the global nursing shortage. Interprofessional collaboration may support the transition and retention of new graduate nurses. Design Whittemore and Knafl's revised framework for integrative reviews guided the analysis. Data sources A comprehensive multi-step search (published 2000-2012) of the North American interprofessional collaboration and new graduate literature indexed in the CINAHL, Proquest, Pubmed, PsychINFO and Cochrane databases was performed. A sample of 26 research and non-research reports met the inclusion criteria. Review methods All 26 articles were included in the review. A systematic and iterative approach was used to extract and reduce the data to draw conclusions. Results The analysis revealed several barriers and facilitators to new graduate engagement in interprofessional collaboration. These factors exist at the individual, team and organizational levels and are largely consistent with conceptual and empirical analyses of interprofessional collaboration conducted in other populations. However, knowledge and critical thinking emerged as factors not identified in previous analyses. Conclusion Despite a weak-to-moderate literature sample, this review suggests implications for team and organizational development, education and research that may support new graduate nurse engagement in IPC. [ABSTRACT FROM AUTHOR]

Lowe G., Plummer V., O'Brien A.P. & Boyd L. (2012) Time to clarify - the value of advanced practice nursing roles in health care. Journal of Advanced Nursing 68(3), 677-685. Abstract Aim. This article presents a discussion of the importance of providing meaningful advanced practice nursing role definition and clarity to improve international standards of nursing titles and scopes of practice. Background. A plethora of international literature exists discussing advanced practice nursing roles and their contribution to healthcare delivery in various countries. However, lack of consistency around title, role definition and scope of practice remains. Data sources. CINAHL and Medline databases were searched using 'nurse practitioner', 'nurse practitioner role', 'nurse practitioner practice', 'nurse practitioner in public health', 'advanced practice nursing roles' and 'development of new nursing roles' with articles limited to years 1995-2010. Citations used in those articles were also explored. All cited articles were in the English language. Discussion. This article supports the need to strengthen the Nurse Practitioner role in health care and professional clarity is identified as a strategy to enhance this. Themes around role clarity, professional identity, ability to enhance healthcare provision and inter-professional issues are examined. The need to more clearly articulate advanced nursing roles in light of the evolution of the Nurse Practitioner role is highlighted. Much work has already occurred in this domain and a means of adapting and broadening these developments for a wider, more global audience whilst maintaining local context is discussed. Conclusion. Although evidence exists that advanced practice nursing roles are increasing internationally, uncertainty around role clarity remains. This is problematic because the valuable contribution of nursing roles is lost, if the ability to clearly express their function does not exist. [ABSTRACT FROM AUTHOR]

wulff k., cummings g.g., marck p. & yurtseven o. (2011) Medication administration technologies and patient safety: a mixed-method systematic review. Journal of Advanced Nursing 67(9), 2080-2095. Abstract Background. Healthcare leaders need evidence-based information on nursing medication administration technologies to guide the design of improvements to patient safety. Aim. The aim of this study was to evaluate the research evidence on relationships between the use of medication administration technologies and incidence of medication administration incidents and preventable adverse drug events to inform decision-making about existing technology options. Data sources. Thirteen electronic databases and seven relevant patient safety websites were searched for the years 1980-2009. Review methods. A mixed-method systematic literature review of research on medication administration technologies and associated links to patient safety, operationalized as medication administration incidents and preventable adverse drug events, was conducted. Results. Twelve studies (two qualitative, five pre- and postinterventions and five correlational) met the inclusion criteria. All were assessed as medium quality with low generalizability of study findings. Only two studies sampled more than one hospital and none of the studies was driven by an explicit theoretical framework. The studies included in this review are generally positive towards medication administration technologies and their potential benefits, yet the level of evidence overall is equivocal. The majority of studies pointed to the development of workarounds by nurses following medication administration technology implementation that could compromise patient safety. Conclusion. More theoretically driven research is needed to determine which medication administration technologies should be implemented in what ways to most effectively reduce medication administration incidents and preventable adverse drug events and minimize the development of potentially unsafe workarounds. Further evidence is required to accurately assess the actual contribution of medication administration technologies for improving patient safety. [ABSTRACT FROM AUTHOR]

To determine current evidence about the use of complementary and alternative medicine in the context of highly active antiretroviral therapy. The following objectives included identifying the risks and benefits of using complementary and alternative medicine when living with the human immunodeficiency virus (HIV) and taking such medications. In Canada and the USA, HIV/AIDS service organisations recognise that people affected or infected by HIV are increasingly choosing to use complementary and alternative medicine to cope with this disease. These same organisations advocate for increased access to complementary and alternative medicine and more information about the safe use of complementary and alternative medicine to make informed decisions. Based on the increased integral use of complementary and alternative medicine and conventional medicine in Canada and the USA, the literature review was limited to these two countries. Systematic review. Available full-text abstracts published in English from 2000-2009 were retrieved by electronic searches of selected databases, including the websites of Health Canada and American National Center for Complementary and Alternate Medicine (NCCAM). Forty studies were examined and were categorised by referring to the NCCAM (2007) four types of complementary and alternative medicine. Insufficient evidence exists to support the use of a particular complementary and alternate therapy to enhance the management of HIV disease. Decisions about using complementary and alternative medicine in conjunction with highly active antiretroviral therapy are often poorly informed. Safety risks and potential drug interactions are frequently ignored as people who use highly active antiretroviral therapy prefer to focus on the physical and mental benefits of using selected complementary and alternate therapies to promote their quality of life. As life expectancy increases, from the use of highly active antiretroviral therapy, it is important for health professionals like nurses to be knowledgeable about the prevention, assessment and treatment of HIV symptoms and treatment side effects. Given the increased trend of using complementary and alternative medicine by the general population, it is also important to understand the appropriate use of complementary and alternative medicine for symptom management in HIV/AIDS care. [ABSTRACT FROM AUTHOR]