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Aim A discussion which aims to explore the diversity of decision-making during teenage and young adult cancer treatment. The discussion will be related to the concepts of autonomy, dependence and decision-making in this age group. Background The experience of cancer involves a significant series of treatment decisions. However, other non-treatment decisions also have to be made which can relate to any aspect of everyday life. These decisions occur against the backdrop of young people's disease experience. Design Discussion paper. Data sources A literature search for the period 1990-2013 was undertaken. This included searching the following databases: Cumulative Index for Nursing and Allied Health Literature ( CINAHL), SCOPUS, Medline, DARE, Applied Social Sciences Index and Abstracts ( ASSIA), (Psych Info) and The Cochrane Library. Implications for nursing There is a lack of evidence into the experience of everyday decisions made by young people during cancer treatment. This may affect them in the form of unmet needs that nurses, or other professionals, fail to appreciate. Conclusion Further exploration of how teenagers and young adults experience the range and process of decision-making during cancer treatment could be useful in helping to provide effective supportive care for this age group. [ABSTRACT FROM AUTHOR]

Aim. This article presents a discussion on how to maximize nursing students' learning about research for evidence-based practice in undergraduate, preregistration programmes. Background. Evidence-based practice may use information from many sources, including research. Research utilization concerns the translation of research findings into practice. Thus, while evidence-base practice may not be solely research-based and hence more than research utilization, research remains an important ingredient in ensuring quality and cost-effective care and an academic requirement for nursing students undertaking a science degree-level qualification. Nevertheless, how educators can best support research-related learning and application remains uncertain and requires discussion. Data sources. MEDLINE, CINAHL, Social Science Citation Index, British Nursing Index, and Intute were searched for papers published 1980-2011 using the following search terms: research, research utilization, evidence-based practice, learning, teaching, education, training, nursing, health, and social care. Discussion. Nursing students need to be able to value the relevance, authority, and utility of nursing research for patient care through embedding research learning in both academic and practice-based settings. Students can be supported in learning how to access, understand, and appraise the authority of research through weaving these skills into enquiry-based learning. Furthermore, encouraging students to undertake research-based practice change projects can support research utilization and development skills. Conclusion. Research should be fully embedded throughout nursing curricula beyond the confines of 'research classes', integrating learning in academic and practice-based settings. Although this requires synergistic and integrated support of student learning by nurse educators, managers, clinical practitioners, researchers and policymakers; nurse educators have a pivotal role. [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 scoping review is to synthesise current evidence around the clinical skill development of preregistration registered nurses (RNs) in Australia, United Kingdom (UK), Ireland, United States (US), Canada and New Zealand, to inform nurse education, policy and clinical practice. Background: Nursing is a practical profession, and registered nurses require specific skills, knowledge and attributes in order to care for patients safely. The context for health care delivery is shifting, and the education of nurses must adapt to effectively equip the registered nurse of the future. Design: A scoping review was conducted of clinical skill development in preregistration nurses. CINAHL Plus, MEDLINE, Health Source (Nursing/Academic edition) and Scopus were searched. Included studies were primary Australian studies and international literature reviews, which focussed on preregistration nursing education. Papers were written in the English language and focussed on clinical skill development. Results were synthesised narratively. The review is reported here in accordance with the Preferred Reporting Items for Systematic Review and Meta‐analyses Scoping Review extension (PRISMA‐ScR) guidelines. Results: One hundred fifty‐five Australia studies and 89 international reviews were included in the review. Six key themes were identified, namely clinical skills, approaches to teaching and learning, interprofessional education, assessment of learning, clinical placement and simulation. Conclusion: There is substantial variation in strategies and programmes to facilitate clinical skill development both within Australia and internationally, indicating a genuine shift away from traditional didactic pedagogy. New graduate registered nurses were expected to be "work‐ready," albeit at a novice level, when they enter the workplace. Future research should consider measures of impact on actual clinical practice and focus on developing work‐ready graduates for the range of clinical settings in which they may practice. Educators, policymakers and educational institutions can use these findings to inform curriculum developments to ensure that clinical skill development is evidence‐based. [ABSTRACT FROM AUTHOR]

Accessible Summary: What is known on the subject?: Many studies have investigated the attitudes of mental health nurses towards a range of targets. These targets are person‐oriented (for example groups of people with a similar mental health diagnosis) or practice‐oriented (for example practices such as seclusion or restraint).It is thought that attitudes contribute to the practice of mental health nurses because research suggests attitudes have a role in shaping behaviour. What the paper adds to existing knowledge?: To date, research about mental health nurses' attitudes has examined different attitudes in isolation from one another. By demonstrating a lack of connectedness across studies this paper highlights the need for new theory‐informed approaches to attitudinal research.By standardizing measurements across different studies this review demonstrates that the most negatively appraised attitudinal targets—indicated by large proportions of respondents who appraise negatively—concern people with diagnoses of borderline personality disorder, substance misuse, and acute mental health presentations. What are the implications for practice?: Significant numbers of mental health nurses may have attitudes, especially towards people with borderline personality diagnoses and those who misuse substances, that may not be concordant with good practice.There is insufficient evidence about what the actual implications this has for practice because the body of relevant research lacks coherence, interconnectedness and a grounding in contemporary theoretical developments.Training programmes that focus on attitudinal change need to be more rigorously evaluated. Introduction: Attitudes are considered integral to mental health nursing practice. Aims: To comprehensively describe the (i) measured attitudes of UK mental health nurses towards people and practice; (ii) effectiveness of interventions to change attitudes; and (iii) relationships between their attitudes, other variables/constructs and practice. Methods: Using systematic review methodology, multiple databases (CINAHL, Scopus, PsycINFO, Web of Science Core Collection, Google Scholar) were searched. Eligible studies involved measurement of UK‐based mental health nurses' attitudes with multi‐item scales. Studies were quality appraised, mean (SD) attitudinal data were standardized, and other results converted to standardized effect sizes. Results: N = 42 studies were included. Negatively appraised attitudinal targets were people with a borderline personality disorder diagnosis, substance misuse, and acute mental health presentations. Educational interventions were associated with immediate increases in positive appraisals but sustainability was poorly evidenced. There was very limited study of attitude‐practice links. Discussion: This review identifies priority attitudinal targets for action but also demonstrates that future work must consider the interconnectedness of attitudes and their relationship with practice. Implications for Practice: Priority areas for consideration are attitudes to borderline personality disorder, substance misuse and mental health co‐morbidity. Addressing disparities between nurses' attitudes and those of service users is important. More robust research is required into the effectiveness of interventions to change attitudes and into attitude‐practice links. [ABSTRACT FROM AUTHOR]

Aims and objectives: To review relevant literature that addresses the challenges of the biosciences in nurse education. More precisely, the review aims to explore the literature, concerning students’ learning, learning contexts and methodological issues and identify any significant gaps. Background: Knowledge of anatomy, physiology and biochemistry is essential for the understanding of human beings and for full appreciation of the concepts of illness and disease. The current status would seem to be that the required competencies within bioscience subjects are difficult to acquire and students have high rates of failure. Design: Integrative review. Methods: The research was performed on CINAHL, ERIC, Medline and British Nursing Index databases in a period from 2013–2017. Descriptive analytical methods were used for the initial research trawl. Findings: The search strategy resulted in 23 papers. The results of this review shed light on certain deficiencies in the research field looking at the biosciences in nurse education. There is a distinct lack of intervention studies and, thereby, knowledge of how best to support students’ learning in effective ways. Of note is that there are no field study approaches identified in the review sample. Conclusion: Many of the papers are single studies and course evaluations which may be seen as too narrow and inadequate as perspective. Students appear satisfied with the courses in the biosciences, but there seems to be no correlation between satisfaction and achievement. Relevance to clinical practice: Understanding and being able to give coherent rationales for the bioscience content in the nursing curricula are crucial and must be established in relation to its relevance to the dynamic nature of patient care, technological advances and demographic realities. Only on that basis can the primacy of this content be seen as relevant to the aspiring student nurse. [ABSTRACT FROM AUTHOR]

Aim: To examine how school nurse practice evolved as a result of the Covid‐19 pandemic. Design: A scoping review of international literature, conducted and reported in line with Arksey and O'Malley's (2005) framework. Data Sources: Searches were conducted in September 2021. Ten databases were searched: The British Nursing Database, CINAHL, Cochrane Library, Consumer Health Database, Health and Medicine, Nursing and Allied Health, Public Health, PsycINFO, PubMed and Web of Science. Relevant grey literature was identified through hand searching. Review Methods: A minimum of three reviewers independently screened articles and two reviewers independently undertook data extraction, with any decisions made collaboratively with the wider team. Much of the literature was not empirical work and so it was not possible to apply a traditional quality appraisal framework. Results: Searches identified 554 papers (after deduplication) which were screened against title and abstract. Following the full‐text review, 38 articles underwent data extraction and analysis. The review findings highlighted that school nurses adapted their practice to ensure they were able to continue providing their formal and informal school health offer to children, young people and their families and continued working closely with the multidisciplinary team. In addition, the expanded public health role generated by Covid‐19 for school nurses' work was considerable, multi‐layered and added to their routine workload. School nurses displayed resilience, adaptability and creativity in their response to delivering services during Covid‐19. Conclusion: School nurses took on a leading public health role during the Covid‐19 pandemic. Some developments and practices were highlighted as beneficial to continue beyond the pandemic. However, formal evaluation is needed to identify which practices may merit integration into routine practice. Continued investment in staff and infrastructure will be essential to ensuring school nurses continue to expand their practice and influence as public health experts. [ABSTRACT FROM AUTHOR]

Aims and objectives To examine the literature related to a large-scale quality improvement initiative, the 'Productive Ward: Releasing Time to Care', providing a bibliometric profile that tracks the level of interest and scale of roll-out and adoption, discussing the implications for sustainability. Background Productive Ward: Releasing Time to Care (aka Productive Ward) is probably one of the most ambitious quality improvement efforts engaged by the UK- NHS. Politically and financially supported, its main driver was the NHS Institute for Innovation and Improvement. The NHS institute closed in early 2013 leaving a void of resources, knowledge and expertise. UK roll-out of the initiative is well established and has arguably peaked. International interest in the initiative however continues to develop. Methods A comprehensive literature review was undertaken to identify the literature related to the Productive Ward and its implementation (January 2006-June 2013). A bibliometric analysis examined/reviewed the trends and identified/measured interest, spread and uptake. Results Overall distribution patterns identify a declining trend of interest, with reduced numbers of grey literature and evaluation publications. However, detailed examination of the data shows no reduction in peer-reviewed outputs. There is some evidence that international uptake of the initiative continues to generate publications and create interest. Conclusions Sustaining this initiative in the UK will require re-energising, a new focus and financing. The transition period created by the closure of its creator may well contribute to further reduced levels of interest and publication outputs in the UK. However, international implementation, evaluation and associated publications could serve to attract professional/academic interest in this well-established, positively reported, quality improvement initiative. Relevance to clinical practice This paper provides nurses and ward teams involved in quality improvement programmes with a detailed, current-state, examination and analysis of the Productive Ward literature, highlighting the bibliometric patterns of this large-scale, international, quality improvement programme. It serves to disseminate updated publication information to those in clinical practice who are involved in Productive Ward or a similar quality improvement initiative. [ABSTRACT FROM AUTHOR]

Aim and objective: To identify training strategies and determine how registered health and social care practitioners change their practice after Mental Capacity Act training. Design: Narrative literature review. Data sources: Seventeen databases were searched up to December 2019: CINAHL, Social Care Online, PubMed, Social Policy and Practice, Discover, MEDLINE, Science Direct, Ovid, 0of Science, British Nursing Index, DH‐Data and King's Fund Library Catalogue. Review Methods: Empirical studies of any design investigating Mental Capacity Act training were searched and screened. Data were extracted to a bespoke spreadsheet and quality assessed. Reporting followed the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA). Results: Of 162 papers identified, 16 were included comprising qualitative, quantitative and mixed‐methods studies. Trainees valued interactive training with close alignment to practice. Training did not lead to demonstrable practice change. Barriers in the context and cultures of care environments were identified. Conclusion: To facilitate application of Mental Capacity Act legislation, identified barriers should be addressed. Future training should be interactive, scenario‐based and relevant to trainees' practice. Relevance to Clinical Practice: The Mental Capacity Act is widely misunderstood and implemented poor. Training is proposed as a solution, but the nature of training that will positively affect practice remains unknown. This review aims to address this gap in the evidence base. Interactive training, using scenarios that reflect practice complexities, has the most positive impact. Cultural norms in care environments may impede application of this legislation. The review has international relevance as there is a global imperative to adhere to the United Nations Convention on the Rights of Persons with Disabilities. The review will inform training design and delivery to ensure that people with impaired capacity to make decisions are given the best opportunity to act autonomously. [ABSTRACT FROM AUTHOR]

Accessible summary In this paper we review past research that suggests video conferencing (VC) can be successfully used in a number of ways in mental health services. These ways include holding staff meetings remotely, conducting assessment and treatment when it is not easy for the clinician and service user to be at the same location, and running staff training remotely., We also present some guidance regarding issues to be considered when introducing VC into mental health settings, such as the importance of staff and service user consultation, the necessity for training in VC and advice about how to conduct meetings by VC., Beginning to use VC can represent a significant cultural change for staff and service users. We hope that this paper will provide a useful summary of things that may help support this change., Abstract The aim of this paper is to provide an overview of the evidence base regarding the use of video conferencing (VC), implementation issues, policies, procedures, technical requirements and VC etiquette. The paper is based on a literature review of VC within the mental health sector and the authors' experience in implementing VC. Six themes emerged from the literature review: applications of VC, VC assessments, treatment, training and supervision, practitioner anxiety, and VC administrative processes. The results of the review support the use of VC in mental health services. Guidelines for the implementation of VC are discussed, including the importance of staff and service user consultations, training in the use of VC, clear guidance for staff with regards to usage, confidentiality and data protection policies, and VC etiquette. Challenges that can arise when implementing VC in a mental health context are also discussed. Arguably, it is not the technology, but the cultural change it represents to staff which seems to be the most important factor regarding successful implementation. [ABSTRACT FROM AUTHOR]

Aim. This paper is a review of the effectiveness of non-surgical, non-pharmaceutical interventions designed to promote weight loss in people with a learning disability and how qualitative evidence on people's experiences and motivations can help understanding of the quantitative research outcomes. Background. The health risks of obesity underline the importance of effective evidence-based weight loss interventions for people with learning disabilities as they are at increased risk of being overweight. Data sources. Papers published from 1998 to 2009 were identified through searches of the Cumulative Index for Nursing and Allied Health Literature, Proquest, Medline (PubMed), PSYCHINFO databases, and the Cochrane Library. Review methods. An integrative review method was used. Studies included were non-surgical or non-pharmaceutical interventions aimed at weight reduction for people with a learning disability. Synthesis of the findings related to study design, participants, types of interventions, outcome measures and participant perspectives. Results. Twelve studies met the inclusion criteria. The most common research design was quasi-experimental pretest and post-test. Few researchers used a clinical trial approach, and there was only one predominantly qualitative study. Interventions were mainly focused on energy intake, energy expenditure or health promotion. Only a few studies incorporated behaviour modification approaches. Conclusion. Nurses who work with clients with learning disabilities have a key role to play in the management of obesity. Future research needs to focus on qualitative studies of the perceptions of clients and their families, controlled trials investigating the effectiveness of interventions and their costs and sustainability, and longitudinal studies examining weight loss over time. [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]

Accessible summary Anorexia nervosa (AN) affects many young people but they can be reluctant to accept treatment. If we understood the views of young people with AN we might be able to develop more acceptable treatments. At the moment, most of what we know about their views is taken from studies of girls and young women., For some young people, having AN means being able to control something, but AN can also be an illness that controls the person. Confusion about control is one of the things that make AN hard to treat., It is difficult to find the right combination of treatments for the physical and psychological symptoms of AN. The research evidence we have does not offer enough guidance for clinicians., Good relationships with clinicians can be difficult to achieve. Young people with AN want clinicians to look after them but at the same time they may resent it when clinicians tell them what to do. However, once they have recovered they often say that they needed firm treatment in order to get better., Abstract This paper reviews current literature in which adolescents with anorexia nervosa (AN) were consulted about their views of their treatment. Published research was systematically retrieved and interrogated during 2009-2010 and analysed using a four-stage model. Eleven studies met the inclusion criteria. Three core themes were identified. AN was perceived as a means of taking control and also something that controlled the individual. Tensions were recognized between client preferences for psychological interventions and treatments that prioritized physical care. Therapeutic alliance emerged as a strategy for overcoming these difficulties but was challenged by client ambivalence towards treatment. Most included studies were qualitative. Young males and individuals who dropped out of treatment were underrepresented in the studies. Adolescents' perspectives on treatment for AN were characterized by paradoxes and tensions. Egosyntonic theory was used as a theoretical construct to interpret findings. [ABSTRACT FROM AUTHOR]

hoare k.j., mills j. & francis k. (2011) The role of government policy in supporting nurse-led care in general practice in the United Kingdom, New Zealand and Australia: an adapted realist review. Journal of Advanced Nursing 68(5), 963-980. Abstract Aim. This article is a report on a review that examined the role of Government policy in primary care and its association with nurse-led care in the United Kingdom, New Zealand and Australia between 1998 and 2009. Background. The United Kingdom, New Zealand and Australia share a similar model of first point access to the healthcare system via general practitioners. General practice is synonymous with the term primary care. Data sources. Medline, CINAHL, EMBASE, Scopus, PsychInfo, Google, Department of Health, England (United Kingdom), Ministry of Health, New Zealand, Department of Health and Ageing, Australia. Searches of electronic databases from 1998 to December 2009 and hand searches of identified leads and key journals. Historical papers accessed to describe the genesis of practice nursing and historical Government policy documents prior to 1998, were examined. Review methods. A modified realist review was used to synthesize research and policy documents relating to government policies pertaining to nurse-led care. In addition, a systematic review was used to identify literature that described practice nurse-led care. Results. Nurse-led primary care services are well described in the United Kingdom with a total of 45 studies meeting the inclusion criteria for the second review. There are no published studies from New Zealand, and only two from Australia describing nurse-led primary care. Conclusion. New Zealand and Australia lag behind the United Kingdom in practice nurse development. Implementation of clinical governance was fundamental to the development of nurse-led care in the UK. [ABSTRACT FROM AUTHOR]

kennedy f., mcdonnell a., gerrish k., howarth a., pollard c. & redman j. (2011) Evaluation of the impact of nurse consultant roles in the United Kingdom: a mixed method systematic literature review. Journal of Advanced Nursing 68(4), 721-742. Abstract Aim. This paper reports a mixed methods systematic review examining the impact of nurse consultant roles in adult healthcare settings, with a view to identifying indicators for demonstrating their impact on patient and professional outcomes. Background. Nurse consultants were introduced in England in 2000 with the intention to achieve better outcomes for patients by improving quality and services. Previous studies have investigated the impact of nurse consultants, but attempts to amalgamate this evidence have been methodologically limited. Since these reviews were published, the importance of demonstrating the contribution of nurse consultants has prompted new research. A robust review of the evidence is now required. Data sources. A broad search strategy was adapted for eight databases. Grey literature was sought from various sources. Review methods. Quantitative and qualitative studies were included. Study quality was assessed using appropriate instruments. Cross-study synthesis combined the quantitative and qualitative findings in relation to the dimensions of impact identified. Measures of impact were mapped against a framework for assessing clinical and professional outcomes. Results. Thirty-six studies were included. The findings suggest a largely positive influence of nurse consultants on a range of clinical and professional outcomes, which map onto the proposed framework of impact. However, there was very little robust evidence and the methodological quality of studies was often weak. Conclusion. Further robust research is required to explore nurse consultants' impact on patient and professional outcomes. The proposed framework for assessing impact could be used to guide future research and assist nurse consultants assess their impact. [ABSTRACT FROM AUTHOR]

desborough j., forrest l. & parker r. (2012) Nurse-led primary healthcare walk-in centres: an integrative literature review. Journal of Advanced Nursing 68(2), 248-263. Abstract Aims. This paper is a report of an integrative review of the international literature examining established nurse-led primary healthcare walk-in centres and their outcomes to understand whether they are effective in improving access to primary health care. Background. Reviews of nurse-led primary care walk-in centres have included centres staffed by family physicians and general practitioners. There is a paucity of evidence about walk-in centres staffed solely by nurses. Data sources. Studies were identified through an electronic search using the databases Medline, Cinahl and EBSCO from 1990 until July 2010. Papers were included if they examined walk-in centres providing nurse-led primary care for the general community. Only peer reviewed studies published in English were included. Review methods. An integrative approach utilizing Bowling's checklist facilitated a systematic appraisal of studies in regard to clarity of aims, objectives, methods and appropriate analysis of data. Results. Thirteen publications were categorized into five themes: 'users of walk-in centres', 'quality of care provided at walk-in centres', 'impact on other healthcare providers', 'perceptions of walk-in centres' and 'satisfaction with walk-in centres'. Conclusion. The possibility that walk-in centres create demand highlights the need for clearer evidence of the drivers of demand for health care in walk-in centres. Innovations in healthcare provision need to be matched with adaptation to nursing education to ensure an adequately prepared nursing workforce. Improvement in access to primary healthcare needs to be measured in terms of equity and the capacity this access has to fill identified gaps in primary healthcare provision in the community. [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]

Aims. This paper presents a discussion on the role of the nurse, teachers in mainstream education and nurse educators, reviewing theories of professional identity and how these theories have had an impact on practice. Background. The professional identity of both the teacher and nurse aspect of the nurse educator role is reviewed using historical perspectives to define the role of a nurse from doctor's handmaiden to autonomous practitioner, and determine society's idea of a teacher. Data sources. The literature reviewed for this paper has been drawn from the Cumulated Index Nursing And Allied Heath Literature, Educational Resources Information Centre, Professional Development Collection and Education-line. The period of literature publications taken up for review was 1960-2009 to gain a historical view and the main phrases used were Nurse Education and Educators, Nurse Roles, Professionalism and Professional Development. Discussion. Issues of role complexity were considered, highlighting tensions, supposed or actual and ethical obligation in healthcare education. The apparent need to gain professional status is discussed. Implications for nursing. Tensions and complexities in the nurse educator's role combine, causing problems in their practice. Opinions are that nurse educators are expert nurses and teachers. Published authors believe that there is a need for the nurse educator to maintain specialist knowledge in nursing practice, yet there is little discussion relating to specializing in teaching practice. Conclusions. Combining the roles of nurse and teacher removes each concrete identity. A role crisis occurs when nurse educators may be unable to prove their professional ability in nursing or establish their professional position as a teacher. [ABSTRACT FROM AUTHOR]

Aims: Black, Asian and minority ethnic women are at higher risk of dying during pregnancy, childbirth and postnatally and of experiencing premature birth, stillbirth or neonatal death compared with their White counterparts. Discrimination against women from ethnic minorities is known to negatively impact women's ability to speak up, be heard and their experiences of care. This evidence synthesis analysed Black, Asian and minority ethnic women's experiences of UK maternity services in light of these outcomes. Design: We conducted a systematic review and qualitative evidence synthesis using the method of Thomas and Harden. Data Sources: A comprehensive search in AMED, Cinahl, Embase, Medline, PubMed and PsycINFO, alongside research reports from UK maternity charities, was undertaken from 2000 until May 2021. Eligible studies included qualitative research about antenatal, intrapartum and postnatal care, with ethnic minority women in maternity settings of the UK NHS. Review Methods: Study quality was graded using the Critical Appraisal Skills Programme tool. Results: Twenty‐four studies met the inclusion criteria. Our synthesis highlights how discriminatory practices and communication failures in UK NHS maternity services are failing ethnic minority women. Conclusion: This synthesis finds evidence of mistreatment and poor care for ethnic minority women in the UK maternity system that may contribute to the poor outcomes reported by MBRRACE. Woman‐centred midwifery care is reported as positive for all women but is often experienced as an exception by ethnic minority women in the technocratic birthing system. Impact Ethnic minority women report positive experiences when in receipt of woman‐centred midwifery care. Woman‐centred midwifery care is often the exception in the overstretched technocratic UK birthing system. Mistreatment and poor care reported by many ethnic minority women in the UK could inform the inequalities of outcomes identified in the MBRRACE report. [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]

Aims and objectives This systematic review aims to synthesise the existing research on how patients participate in patient safety initiatives. Background Ambiguities remain about how patients participate in routine measures designed to promote patient safety. Design Systematic review using integrative methods. Methods Electronic databases were searched using keywords describing patient involvement, nursing input and patient safety initiatives to retrieve empirical research published between 2007 and 2013. Findings were synthesized using the theoretical domains of Vincent's framework for analysing risk and safety in clinical practice: 'patient', 'healthcare provider', 'task', 'work environment', 'organisation & management'. Results We identified 17 empirical research papers: four qualitative, one mixed-method and 12 quantitative designs. All 17 papers indicated that patients can participate in safety initiatives. Conclusions Improving patient participation in patient safety necessitates considering the patient as a person, the nurse as healthcare provider, the task of participation and the clinical environment. Patients' knowledge, health conditions, beliefs and experiences influence their decisions to engage in patient safety initiatives. An important component of the management of long-term conditions is to ensure that patients have sufficient knowledge to participate. Healthcare providers may need further professional development in patient education and patient care management to promote patient involvement in patient safety, and ensure that patients understand that they are 'allowed' to inform nurses of adverse events or errors. A healthcare system characterised by patient-centredness and mutual acknowledgement will support patient participation in safety practices. Further research is required to improve international knowledge of patient participation in patient safety in different disciplines, contexts and cultures. Relevance to clinical practice Patients have a significant role to play in enhancing their own safety while receiving hospital care. This review offers a framework for clinicians to develop comprehensive practical guidelines to support patient involvement in patient safety. [ABSTRACT FROM AUTHOR]

Accessible summary Some mental health nurses have now been prescribing for their clients for several years. When suitably qualified they can prescribe the same range of medication as medical staff. Concern was expressed that nurse prescribers might become more like doctors and as a result would sacrifice their nursing skills., The views of those who have their medication prescribed by mental health nurses as well as views of nurse prescribers, pharmacist prescribers, nurse managers and doctors were explored by using interviews and focus groups. Most participants saw the inclusion of prescribing in the nursing role as a benefit to clients. Rather than detracting from the nurse patient relationship, results from this study suggest that the nurse patient relationship was improved and more holistic care was provided., Nurse prescribing is well received by those who have experienced it., As nurse prescribing effects a change of power dynamics this could result in the need for less involvement of the medical profession in clients' care. As clients found nurses easier to talk to about their medication than doctors, medication concordance could be increased. Medication reconciliation could also be increased as medications no longer required by clients were more likely to be reduced or stopped by nurse prescribers. Discontinuing medication may indicate a new culture around mental health nurse prescribing. It may be that this trend has an impact on future service provision to clients. Results suggest that clients prefer to have their medication prescribed by nurses., Abstract Mental health nurse prescribing has been established in some areas in the UK for quite some time. Other than speculation that nurse prescribing would have a detrimental effect on the nurse-patient relationship, little has been written about the impact of nurse prescribing to date. Bradley and Nolan found that prescribing allowed nurses to overcome difficulties in the health-care system which would have previously delayed clients' access to medicines. Prescribing was believed to compliment many aspects of nursing and integrated previously diffuse aspects of the nursing role. Latter and Courtenay found that clients were generally satisfied with nurse prescribing. The aim of this study was to explore the impact mental health nurse prescribing has had on those involved. The views of clients, nurse prescribers, pharmacist prescribers, nurse managers and doctors were investigated. Questionnaires were used to gather demographic data and basic qualitative data. Focus groups and interviews were undertaken with 57 participants. The study was undertaken within one National Health Service Foundation Trust in England. Data analysis was guided by a framework approach. The majority of participants believed that the inclusion of prescribing in mental health nurses' roles improved the nurse-patient relationship, and five themes including the relationship, concordance, power, treatment approach and 'unprescribing' emerged. Trust was highly valued, and clients found nurses easier to talk to about their medication than doctors. Rather than detracting from the nurse-patient relationship, results from this study suggest that nurse prescribing enables mental health nurse prescribers to provide more holistic care than previously. [ABSTRACT FROM AUTHOR]

Aim To report a novel review to develop a health systems model of successful transition of children with complex healthcare needs from hospital to home. Background Children with complex healthcare needs commonly experience an expensive, ineffectual and prolonged nurse-led discharge process. Children gain no benefit from prolonged hospitalization and are exposed to significant harm. Research to enable intervention development and process evaluation across the entire health system is lacking. Design Novel mixed-method integrative review informed by health systems theory. Data sources CINAHL, PsychInfo, EMBASE, PubMed, citation searching, personal contact. Review methods Informed by consultation with experts. English language studies, opinion/discussion papers reporting research, best practice and experiences of children, parents and healthcare professionals and purposively selected policies/guidelines from 2002-December 2012 were abstracted using Framework synthesis, followed by iterative theory development. Results Seven critical factors derived from thirty-four sources across five health system levels explained successful discharge (new programme theory). All seven factors are required in an integrated care pathway, with a dynamic communication loop to facilitate effective discharge (new programme logic). Current health system responses were frequently static and critical success factors were commonly absent, thereby explaining ineffectual discharge. Conclusion The novel evidence-based model, which reconceptualizes 'discharge' as a highly complex longitudinal health system intervention, makes a significant contribution to global knowledge to drive practice development. Research is required to develop process and outcome measures at different time points in the discharge process and future trials are needed to determine the effectiveness of integrated health system discharge models. [ABSTRACT FROM AUTHOR]

Accessible summary Staff and relative perspectives on patient aggression in dementia care units are seriously under researched in the UK., We interviewed a number of nursing staff and relatives in four UK care homes in the North West of England., Using a combined approach of one-to-one interviews (for staff) and focus groups (for relatives) we explored their views as to the reasons for and ways of responding to aggressive behaviour., Using thematic analysis we found similar results from both staff and relatives and as such their views were categorized into two broad areas: causation and management., The results indicated that staff in the participating units embraced a person-centred approach to aggression management. They predominantly respond to aggressive incidents with interpersonal strategies, such as distraction as opposed to medication or restraint., Relatives were clear in their perceptions of aggression as an interpersonal challenge, which is compounded or mediated by the illness of dementia. Consequently they were positive in their views of staff using non-coercive interventions., Abstract Staff and relative perspectives on patient aggression in dementia care units are seriously under researched in the UK. Any work that has been conducted has relied upon quantitative studies. Qualitative research on aggression management in older peoples services are rare. In-depth views that can offer insights into causation and management strategies are therefore under represented in the literature. In order to investigate this issue further we interviewed a number of nursing staff and relatives in four UK care homes in the North West of England. Using a combined approach of one-to-one interviews (for staff) and focus groups (for relatives) we explored their views as to the reasons for and ways of responding to aggressive behaviour. This was part of a larger study reported upon elsewhere. Using thematic analysis we found similar results from both staff and relatives and as such their views were categorized into two broad areas: causation and management. In regards to causation we noted three sub-themes; internal, external and interpersonal factors which are further subdivided in the paper and for management two broad categories: the compassionate approach and 'don't go in strong'. The results indicated that staff in the participating units embraced a person-centred approach to aggression management. They predominantly respond to aggressive incidents with interpersonal strategies, such as distraction as opposed to medication or restraint. Overall they adopt a person centre approach to patient care. Relatives were clear in their perceptions of aggression as an interpersonal challenge, which is compounded or mediated by the illness of dementia. Consequently they were positive in their views of staff using non-coercive interventions. While the results of this and our earlier study are promising suggesting a less invasive approach to this aspect of dementia care, given the limitations of a small sample, more research of a similar nature is warranted. Findings from multidimensional studies can then provide a sounder basis for health and social care education, and person centred informed practice to reduce the incidence of aggression through preventative strategies. [ABSTRACT FROM AUTHOR]

Accessible summary Nurse prescribing was launched in the UK in the 1990s, but was introduced to psychiatric/mental health nursing within the last 7 years. Information is available about nurse prescribing in general practice and adult nursing, but there is little research relating to mental health. Most mental health nurses choose not to qualify to prescribe and many who have qualified to prescribe choose not to., As more than half of mental health nurse prescribers in this study were not prescribing, they were asked what they thought prevented them from doing so., The majority of prescribers in the study did not feel adequately supported in their role and considered that the additional responsibility of the role should be recognized., Nurse prescribing has the potential to improve care provided to service users and to enhance access to services. However, in order for this to happen the barriers which prevent prescribing need to be identified and then removed. This study identified many of these barriers to prescribing and these will be discussed. It is hoped that this study's findings will serve as a catalyst to prompt the removal of barriers to prescribing in mental health nursing and ultimately to enable independent nurse prescribing. Awareness about mental health nurse prescribing needs to be raised so that health care professionals, service users, carers and the general public become more familiar with the role. This should help the role to become more accepted and established in everyday practice., Abstract This paper reports a pilot study exploring mental health nurse prescribers' perceptions of barriers to prescribing independently but also includes perceptions of barriers to supplementary prescribing. Current prescribing practice as experienced by mental health nurses suggests a need to identify and highlight these barriers. A mixed methodology explanatory sequential study was carried out over 3 months in Scotland in 2008 as part of a Master's degree. A questionnaire was completed by 33 mental health nurse prescribers. A focus group was conducted with 12 mental health nurse prescribers. Participants' views exposed a number of barriers to prescribing previously unidentified in a review of the relevant literature, and concurred with some previously documented barriers. Sixty per cent of mental health nurse prescribers in the study were not prescribing. Barriers identified in the study included concern about how prescribing impacts on the therapeutic relationship, role conflict, lack of support, inappropriateness of prescriber training, remuneration, qualifying to prescribing time, supervision, prescribing policies, clinical governance and nurse management. Nurse prescribing involves increased accountability and responsibility which is not currently recognized in job status or pay banding. Mental health nurse prescribing has the potential to enhance service provision, but until barriers to prescribing have been identified and addressed as part of the process of organizational change, nurse prescribing cannot achieve its maximum potential. [ABSTRACT FROM AUTHOR]

The purpose of this integrative review of the literature was to find and review international research studies that explored student attrition to determine what is known about the topic and to identify gaps in the research with a view to addressing the situation in the UK. Attrition from nursing programmes is a serious problem in the UK. It is recognised as a complex phenomenon, not attributable to a single cause. Regardless of actual attrition rates and trends, departments of nursing are challenged to perform in a business-like manner. Consequently, every student lost to a programme of study equates to a financial penalty for the department and to the future workforce and community. Integrative review of the literature. Using electronic databases and specific search terms, 18 articles were identified and reviewed. Findings from the identified international research literature were analysed using qualitative content analysis. Four broad themes that accounted for factors of relevance to attrition were identified: Social, Prediction, Programme and Personal. Retention studies are fraught with methodological problems. These include incomplete or inaccurate data and low response rates. Attrition early in programmes may be attributed to a failure to understand the roles of nurses in contemporary societies. This has led to dissatisfaction with programmes and academic failure, as students may underestimate the intellectual demands of their programmes. Attrition later in the programme may be attributed to a combination of personal factors that culminate in a personal crisis. The research literature suggests that stereotyping of nurses is a major factor in attrition. Both professions need to find ways of communicating contemporary roles to wider society. [ABSTRACT FROM AUTHOR]

Introduction: Preconception care promotes better maternal outcomes, may assist in preventing birth defects and improves fertility awareness among healthy childbearing couples. Yet, the significance of preconception care for infertile couples is undeveloped area of practice in Europe. Aims and objectives: To discuss the importance of nurses and midwives in providing preconception care to infertile couples in the United Kingdom and Spain. Design: Discursive paper. Method: A comparison of different midwifery and nursing approaches to preconception care for infertile couples in two European countries. Findings: At present, infertile couples' needs for preconception care are not routinely identified or understood. There is an opportunity for these needs to be considered and identified by nurses at the time of investigation for infertility or when planning pregnancy with assisted conception. Conclusions: We argue that, by providing preconception care, nurses and midwives have an opportunity to deliver important advice to infertile couples in both primary care and specialist infertility services. [ABSTRACT FROM AUTHOR]

Aim The aim of this study was to systematically review evidence relating to clinical supervision for nurses, midwives and allied health professionals. Background Since 1902 statutory supervision has been a requirement for UK midwives, but this is due to change. Evidence relating to clinical supervision for nurses and allied health professions could inform a new model of clinical supervision for midwives. Design A systematic review with a contingent design, comprising a broad map of research relating to clinical supervision and two focussed syntheses answering specific review questions. Data sources Electronic databases were searched from 2005 - September 2015, limited to English-language peer-reviewed publications. Review methods Systematic reviews evaluating the effectiveness of clinical supervision were included in Synthesis 1. Primary research studies including a description of a clinical supervision intervention were included in Synthesis 2. Quality of reviews were judged using a risk of bias tool and review results summarized in tables. Data describing the key components of clinical supervision interventions were extracted from studies included in Synthesis 2, categorized using a reporting framework and a narrative account provided. Results Ten reviews were included in Synthesis 1; these demonstrated an absence of convincing empirical evidence and lack of agreement over the nature of clinical supervision. Nineteen primary studies were included in Synthesis 2; these highlighted a lack of consistency and large variations between delivered interventions. Conclusion Despite insufficient evidence to directly inform the selection and implementation of a framework, the limited available evidence can inform the design of a new model of clinical supervision for UK-based midwives. [ABSTRACT FROM AUTHOR]

Accessible summary Section 5(4) (nurse's holding power) of the Mental Health Act 1983 permits nurses of the 'prescribed class' to detain an informal inpatient. The patient must already be receiving treatment for mental disorder. The section lasts for up to 6 h., Section 5(4) is over 30 years old; however, there is relatively little literature exploring its use., Existing literature has limited itself to surveys and audits investigating: nurses' opinions of Section 5(4); nurses' knowledge of Section 5(4); and trends associated with the implementation of Section 5(4)., The literature review suggests that what is known about the implementation of Section 5(4) is incomplete. For example, there are no accounts of how and why the holding power is implemented from both a nursing and patient perspective., Abstract Section 5(4) (nurse's holding power) of the Mental Health Act 1983 in England and Wales accounts for 10% ( n = 1714) of all detentions after admission to hospital. It is followed by further detention in 66% of cases and may require nurses to restrain, seclude or closely observe the patient to prevent them harming themselves and/or others. To conduct a literature review of empirical articles concerning the implementation of Section 5(4), a literature search was undertaken in ASSIA, British Nursing Index, Medline, Psyc INFO and Lawtel, using a combination of the keywords ' Section 5(4)', 'nurse's holding powers', 'holding powers', ' Mental Health Act 1983', ' MHA', 'compulsory detention', 'formal detention', 'emergency psychiatric interventions', 'containment interventions' and 'involuntary commitment'. Twenty-five articles were included in the review. Existing literature has focused on surveys and audits investigating: nurses' opinions of Section 5(4); nurses' knowledge of Section 5(4); and trends associated with the implementation of Section 5(4). While this literature has provided some insights into the implementation of Section 5(4), it is clear that what is known about its use is incomplete. Further research is required to examine a number of areas, for example, how and why the section is implemented. [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]

Aim. This article presents a discussion of three contemporary approaches to transforming care: Transforming Care at the Bedside, Releasing Time to Care: the Productive Ward and the work of the Studer Group®. Background. International studies of adverse events in hospitals have highlighted the need to focus on patient safety. The case for transformational change was identified and recently several approaches have been developed to effect this change. Despite limited evaluation, these approaches have spread and have been adopted outside their country of origin and contextual settings. Data sources. Medline and CINAHL databases were searched for the years 1999-2009. Search terms included derivatives of 'transformation' combined with 'care', 'nursing', 'patient safety', 'Transforming Care at the Bedside', 'the Productive Ward' and 'Studer Group'. Discussion. A comparison of the three approaches revealed similarities including: the foci of the approaches; interventions employed; and the outcomes measured. Key differences identified are the implementation models used, spread strategies and sustainability of the approaches. The approaches appear to be complementary and a hybrid of the approaches such as a blend of a top-down and bottom-up leadership strategy may offer more sustainable behavioural change. Implications for nursing. These approaches transform the way nurses do their work, how they work with others and how they view the care they provide to promote patient safety. Conclusion. All the approaches involve the implementation of multiple interventions occurring simultaneously to affect improvements in patient safety. The approaches are complementary and a hybrid approach may offer more sustainable outcomes. [ABSTRACT FROM AUTHOR]

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.

This systematic literature review aimed at addressing two questions: first, what evidence exists regarding intermediate care in the UK; and what interventions have been used to develop interprofessional working in intermediate care in the UK? A systematic review of the literature from 2000-2006 resulted in a total of 104 full-text articles describing research into intermediate care in the UK. The review was the first stage of a large, national project evaluating and developing interprofessional working among health and social care staff, particularly in relation to the intermediate care of older people. Systematic literature review. All the literature was reviewed by one reviewer, and a second review was carried out by a team of reviewers to ensure each article was reviewed twice, independently. One article was reviewed by all the reviewers to ensure inter-rater reliability; finally, all the reviews were amalgamated, which resulted in one summary per article. The main findings drawn from this systematic literature review are that research carried out on intermediate care in the UK has a diverse set of aims, for example economic evaluations, delivery of intermediate care and exploring the views and perceptions of those involved in intermediate care. Although several articles include discussions about the importance of interprofessional working in intermediate care, no article specifically focused on the interprofessional focus of intermediate care, and there was no research about interventions used to develop interprofessional working. Intermediate care as a policy has been interpreted very differently across the four countries of the UK; there is no one preferred or consistent interpretation to its delivery. [ABSTRACT FROM AUTHOR]

Aim Review of intervention studies of associated factors with incontinence as the primary outcome in older people in care homes to identify and inform practice and future research. Background Incontinence is highly prevalent among care home populations. Previous reviews of descriptive and intervention studies have used urinary incontinence as the primary outcome. Design Systematic review and narrative summary. Data sources Electronic searches of English empirical studies undertaken using MEDLINE and CINAHL from January 1966-May 2010. All relevant empirical designs were selected from MEDLINE highly sensitive search strings from the Cochrane Incontinence Review Group, modified to exclude surgical and pharmacological studies Review methods The PRISMA statement was followed and established methods for systematic review to produce a narrative summary. Results Nine studies identified relating to associated factors with the management of incontinence in care homes. Factors included economic data, skin care, exercise studies, staff quality and prompted voiding adherence and the promotion of continence by the management of dehydration and incontinence. Conclusion Managing incontinence and promoting continence in care homes is complex, requiring time and cost-efficient management procedures to contain the problem and deliver quality, achievable care. When developing and designing systems of care in care homes, it is important to also recognize the impact of associated factors. As with any healthcare intervention programme, resources are required to implement the protocols. Economic evaluation studies are limited, with further studies warranted alongside preventative studies to maintain long-term continence in these populations. [ABSTRACT FROM AUTHOR]

The aim of this review is to explore the literature relating to the delivery of cervical screening by practice nurses ( PNs) in the United Kingdom and Australia. Research relating to PNs began in earnest approximately 15 years ago in the UK context, and more recently, c.2005, in Australia. Although there is scant literature devoted specifically to the role of PNs in cervical screening, literature relating to the role of PNs provides evidence of the extent to which PNs in the United Kingdom and Australia are involved in the provision of cervical screening services. Findings from this review indicate that the role of PNs in the provision of cervical screening differs substantially between the United Kingdom and Australia. PNs in the United Kingdom provide a high percentage of cervical screening services, whereas in Australia general practitioners provide around 80% of all cervical smears, which account for only 0.6% of all procedures undertaken by PNs. Employment and funding models and inadequate multidisciplinary collaboration are contributing to the underutilization of PNs in Australia. [ABSTRACT FROM AUTHOR]

lafond c.m. & van hulle vincent c. (2012) A critique of the National League for Nursing/Jeffries simulation framework. Journal of Advanced Nursing 00(0), 000-000. doi: 10.1111/j.1365-2648.2012.06048.x Abstract Aims. To present a critique of the National League for Nursing/Jeffries simulation framework. Design. Fawcett's criteria for theory analysis and evaluation are used. Background. Use of simulated learning experiences in nursing education is widespread; a sound framework to guide educators across the globe in implementing these experiences effectively is essential. The basic assertion of the National League for Nursing/Jeffries simulation framework is that student-learning outcomes are influenced by the concepts of teacher, student, educational practices, and simulation design characteristics. Data sources. A literature search was performed using Cumulative Index to Nursing and Allied Health Literature, PubMed and Google Scholar to identify studies published in the English language, between 2005-June 2011, where the National League for Nursing/Jeffries simulation framework was tested or used as a theoretical framework for research. Discussion. Sixteen publications (two articles in press) from the USA and UK were identified using the framework to guide research; outcomes included increased student satisfaction, confidence, and improved skill performance. Implications for nursing. As a newer theoretical framework, the National League for Nursing/Jeffries simulation framework offers promise to guide the construction and implementation of simulation experiences resulting in positive student outcomes. Conclusion. Empirically supported definitions of concepts would strengthen the framework and help educators to consistently produce and identify positive outcomes. Additional rigorous research is necessary to further test relationships among concepts and the associated concept variables in the framework. More studies outside of the United States are needed to confirm the framework is relevant to nursing programs in other countries. [ABSTRACT FROM AUTHOR]

Accessible summary A review of the concept of motivational interviewing (MI) encompassing what is MI and the development of MI will be provided. Additionally, focus on the spirit, guiding and philosophical principles of MI will be explored prior to reviewing the specific skills and strategies required to work in a MI manner., A critical appraisal of the evidence base for MI in the field of alcohol misuse will be provided., Furthermore, Government health policy and clinical guideline recommendations relating to MI will be highlighted., Conclusions regarding these links will be drawn upon with potential future research implications identified., Abstract A critical appraisal of the evidence that supports efficacy of the brief intervention, motivational interviewing (MI), within the field of alcohol misuse, was made. In order to undertake this appraisal the author will focus on a review of the concept of MI prior to considering the efficacy for MI within the specific field of alcohol misuse. [ABSTRACT FROM AUTHOR]

Aim. To report a review and narrative synthesis conducted to analyse and evaluate nurses' preparedness to respond to a bioterrorist event. Background. The anthrax attack on the USA in 2001 resulted in the development of global response strategies for future bioterrorist events. However, despite these actions, it remains unclear whether nurses are prepared to respond to such events. Data sources. A search for relevant research articles was conducted using the MEDLINE, CINAHL, BNI, and EMBASE databases to locate articles published in the period 1996-March 2010. Design. Narrative Synthesis Review methods. A narrative synthesis of qualitative and quantitative studies was undertaken and the articles reviewed using Greenhalgh's critical appraisal criteria. The review was conducted with inclusion and exclusion criteria applied to ensure the studies examined focussed on the hospital nurse's role in responding to a bioterrorist event. Results. Seven original research studies were included in the review. Four themes were identified as affecting nurses' preparedness for a bioterrorist attack. These were perceptions of bioterrorism, the role of formal knowledge, the role of institutional plans and policies, and personal factors. The overarching theme centred on nurses' willingness to respond to a bioterrorist event. It was clear that, although nurses were willing to respond to a bioterrorist attack, they felt unprepared to do so. Conclusions. Existing nurse education in areas such as infection control can incorporate bioterrorism training to improve preparedness, yet nurses must also prepare themselves personally for a bioterrorist attack. [ABSTRACT FROM AUTHOR]

Accessible summary This study investigated the perspectives of mental health nurses working in a medium secure unit, regarding the impact of the security procedures used to manage patient substance misuse on nurse-patient relationships., Data from the interviews were analysed and revealed that the participants perceived that the intrusive nature of the procedures was detrimental to their relationship with patients. Both the relative degree of intrusion posed by the procedure, and the communication skills of nurses were important factors in determining the extent and duration of negative effects on relationships., A number of recommendations were made to improve policy and practice in relation to the application of the procedures. Firstly, that the use of partial strip searching should be minimized. Secondly, that unit managers should ensure consistent application of urine drug screening policies and that responsibility for undertaking the procedures should be spread evenly throughout nursing teams to avoid patients 'splitting' teams into 'good' and 'bad' nurses; Finally, that staff should receive further training in both substance misuse and communication skills., Abstract The role conflict experienced by forensic psychiatric nurses between their therapeutic responsibilities and their responsibility to operationalize security procedures is well established in the literature. There has been less investigation into how this role conflict is played out specifically in the management of inpatient substance misuse in forensic units. This study, therefore, aimed to explore the views of nurses working in one medium secure unit of the impact of the procedures used to manage substance misuse (partial strip searching, room searching, canine searching, 'pat' (or 'rubdown') searching, urine drug screening) on their relationships with patients. Ten interviews of registered mental health nurses working in a medium secure unit in the Northwest were carried out. The interview data were transcribed verbatim and framework analysis used to identify emergent themes. The impact of the procedures on nurse-patient relationships was reported as largely negative by the participants. They reported that the intrusion of the procedures had a detrimental effect on their relationships with patients. The relative degree of intrusion posed by each of the procedures was an important factor in determining the extent and duration of damage to nurse-patient relationships, as was the communication skills of the nurse conducting the procedure. [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]

To identify models used as local initiatives to build capability and capacity in clinical nurses. The National Health Service, Nursing and Midwifery Council and the United Kingdom Clinical Research Collaboration all support the development of the building of research capability and capacity in clinical nurses in the UK. Narrative review. A literature search of databases (including Medline and Pubmed) using the search terms nursing research, research capacity and research capability combined with building, development, model and collaboration. Publications which included a description or methodological study of a structured initiative to tackle research capacity and capability development in clinical nurses were selected. Three models were found to be dominant in the literature. These comprised evidence-based practice, facilitative and experiential learning models. Strong leadership, organisational need and support management were elements found in all three models. Methodological issues were evident and pertain to small sample sizes, inconsistent and poorly defined outcomes along with a lack of data. Whilst the vision of a research ready and active National Health Service is to be applauded to date, there appears to be limited research on the best approach to support local initiatives for nurses that build research capability and capacity. Future studies will need to focus on well-defined objectives and outcomes to enable robust evidence to support local initiatives. To build research capability and capacity in clinical nurses, there is a need to evaluate models and determine the best approach that will provide clinical nurses with research opportunities. [ABSTRACT FROM AUTHOR]

Aim. This review explores the experiences of international nurses recently recruited to the UK nursing workforce (1995-2007) and the implications for retention. Background. An acute shortage of nurses in the mid 1990s, combined with policy initiatives to increase the number of qualified nurses working in the NHS, resulted in an active campaign to recruit nurses from overseas. Since 1997, approximately 100,000 international nurses have been admitted to the nursing register from more than 50 countries worldwide. Many practice areas are now dependent on overseas nurses as an essential part of their workforce. Design. An integrative review. Method. The review was conducted using a range of electronic databases to capture the experiences of this cohort of migrant nurses. Conclusion. Much literature has been generated over the past decade in relation to the experiences of international nurses recruited during this campaign. Five main themes emerged from the review: motivation for migration, adapting to British nursing, experiences of first world healthcare, feeling devalued and deskilled and vectors of racial discrimination. Although some positive experiences are described, significant numbers of nurses describe not feeling personally or professionally valued by the UK nursing establishment, common emotions expressed are disappointment and unmet expectations. This will have implications for job satisfaction and intention to leave or stay. Relevance to clinical practice. If overseas nurses choose to leave the UK in large numbers, the health services could face a severe staffing shortage. It is important that we listen carefully to their experiences to help identify priorities for policy and practice aimed at improving job satisfaction for migrant nurses and articulating the value that they bring to UK nursing. [ABSTRACT FROM AUTHOR]