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Background: The documentation of patient data on health records is a vital component of the care process. Accurate and complete recording of this data is a necessary practice. The adoption of electronic health records to improve the quality of nursing documentation is on the rise. Objectives: This study compares the accuracy and completeness of pressure ulcer data documentation between electronic and paper records. Design: A descriptive, comparative design with a retrospective review of patient records. Settings and sample: Two hospitals were chosen purposefully, one using electronic recording of patient data and the other using paper records. Methods: In the first phase, all hospitalised patients aged 18 years and over were inspected for pressure ulcers. In the second phase, the files of patients with pressure ulcers were audited. Results: Of the 52 patients with ulcers found in the hospital that used an electronic system, 43 of their records documented the pressure ulcers (83%). Of the 55 patients with pressure ulcers in the hospital using paper records, 39 files had corresponding documentation of the presence of a pressure ulcer (71%). Conclusion: In terms of accuracy and completeness, more comprehensive documentation practice was found on the electronic health records compared with paper records. However, both types of systems have shortcomings in the practice of pressure ulcer data documentation. [ABSTRACT FROM AUTHOR]

Birth satisfaction relates to women's perceptions of their childbirth experience, with importance placed on the midwife to improve standards of the intranatal care provided. With evaluating intranatal care in mind, this paper aims to educate midwives about one particular method of measuring women's experiences of labour, which involves using the valid and reliable Birth Satisfaction Scale-Revised (BSS-R). The BSS-R is a 10-item self-report valid and reliable measure, which is recommended by the International Consortium for Health Outcomes Measurement (ICHOM) as the 'method of choice' for evaluating women's 'birth experience'. Since the ICHOM began recommending the BSS-R as part of its pregnancy and childbirth standard set, the scale (at time of print) has been used in 39 countries and 134 sites around the world. [ABSTRACT FROM AUTHOR]

Nursing has become an all-graduate profession; as such, student nurses must develop their skills of critical analysis. The need to develop critical analytical thinking has been identified as the single most important skill in undergraduate education and reaching the academic requirements of level six study. In degree-level healthcare programmes, students are frequently asked to complete a structured critical appraisal of research. This paper examines how critical appraisal activities can be an opportunity for students to develop transferable critical thinking skills. Critical appraisal teaches objectivity, reflection, logic and discipline, which encourage students to think critically in both theory and practice. [ABSTRACT FROM AUTHOR]

Objective: To investigate the hypothesis that stereophotogrammetric wound size monitoring shows suitable inter-observer reliability and user acceptance for clinical practice use. Method: Veterans admitted for conservative management of severe pressure ulcers were eligible for inclusion in the study. Three-dimensional (3D) digital wound images were independently captured by two expert and two non-expert nurse-observers using a commercially available stereophotogrammetry system, weekly for 6 weeks. A double-blinded analyst generated 3D wound reconstructions, using software to determine geometry. Clinical opinion of wound progression was provided by an expert physician. Results: Thirteen wounds were assessed with more than 80% of all images being readable. Interclass correlation of 0.9867 (p < 0.0001) was observed. Compared with clinical opinion, 3D wound measurement was sensitive between improving and static wounds for wound perimeter, volume, depth and length. Conclusion: These preliminary findings suggest that 3D wound measurement minimises differences in wound measurement between expert and non-expert observers, suggesting it could be implemented with high reliability in health-care settings where several observers are involved in wound care management. Declaration of interest: This study was funded in part by a grant from the Department of Veterans Affairs VISN10 Research Initiative Program. All study personnel contributed to the paper. AJD's effort was provided in partial fulfilment of the requirements for the MD degree from Case Western Reserve University School of Medicine. The authors declare they have no conflict of interests with regard to the information presented in this paper. [ABSTRACT FROM AUTHOR]

Background: This paper investigates the palliative care competencies (knowledge, behaviours, attitudes) and education needs of nurses and healthcare assistants (HCAs) who provide supportive (Level 2) palliative care. Methods: A mixed-methods study using a sequential exploratory design was used, with findings integrated across sources. Qualitative focus groups were conducted in 2018 with a sample of staff (n=11, all female; nurses=4; HCAs=7) providing supportive palliative care in a single service setting. A quantitative survey, also conducted in 2018, explored the issue with a wider sample within the same setting (n=36; nurses=18; HCAs=18; female=32). Results: Qualitatively, communication was highlighted as an important domain of the competence framework, with many participants acknowledging that the ability to communicate effectively is essential. Quantitatively, participants scored in the lower range for competency variables. A significant difference was observed between HCAs and nurses on measures of knowledge (t= -2.718; df=30; p<.05) and behaviour (t=-3.576; df=30; p<.05), with HCAs scoring significantly higher than nurses. In relation to education, while some participants report being indecisive regarding engaging in education/training, others highlighted the benefit of education, especially its ability to impact on their current practice. Conclusion: This research contributes to understanding palliative care competencies among nurses and HCAs working in palliative care, and has important implications for the education and training of nurses and HCAs working in Level 2 palliative care in Ireland. [ABSTRACT FROM AUTHOR]

International interest in quality of life (QoL) has been affected by patients' prolonged survival, the increasingly aging population, the increase in chronic conditions and the increasing costs of health care. This has also led to the development of QoL instruments that meet the psychometric criteria necessary for reliable and valid outcome measures in research, health policy decision-making and, increasingly, in clinical practice. Despite the proliferation of QoL instruments available to inform best practice, clinicians seldom routinely apply them. One of the barriers to using QoL instruments is the unfamiliarity nurses have with existing instruments. In order to increase community health nurses' familiarity with existing QoL assessments, the aim of this paper is to describe five instruments and modules that have been developed by the World Health Organization's Quality of Life Assessment Group for the assessment of QoL among healthy and ill adults and to describe how their applicability could enhance evidence-based practice in community nursing. [ABSTRACT FROM AUTHOR]

Background: Although it is widely acknowledged that spiritual care is an important component of good palliative care, there remains a lack of confidence about it among healthcare providers. This paper analyses the benefits and drawbacks of using spiritual history-taking tools to address the problem, considering four of the most widely used tools--FICA, FAITH, SPIRITual and HOPE. Method: The authors conducted a literature review to establish the main themes identified as important to spirituality at the end of life. They then applied these findings to the spiritual history-taking tools to determine the extent to which they may be of assistance in identifying the spiritual needs of patients receiving palliative care. Conclusion: The authors conclude that spiritual history-taking tools do have an important role in identifying the spiritual needs of patients at the end of life, with the 'HOPE' tool most comprehensively addressing the spirituality themes identified as important within the healthcare literature. [ABSTRACT FROM AUTHOR]

Background/Aims: Mouth opening is a routine and vital activity of daily life that facilitates ingestion and speech. It is often found to be limited in patients with oral carcinoma. Measuring mouth opening is essential to detect the therapeutic effect of an intervention aiming to improve it. During measurement, the procedure needs to be reliable, simple, inexpensive and safe. This study aimed to determine the intrarater and interrater reliability of a novel method of measuring maximal voluntary mouth opening in patients with oral carcinoma. Methods: Patients aged between 40 and 60 years of either gender with a diagnosis of oral carcinoma and presenting with difficulty in mouth opening were recruited. The distance between incisors was marked on standard sized paper slips as the participants performed maximal voluntary mouth opening. Distance between the markings was measured with a ruler in millimeters. The measurement procedures were carried out by two independent investigators. Results: A total of 15 patients (12 male and 3 female) with a mean age of 52.53 ± 8.28 years participated in the study. Mean maximal voluntary mouth opening measure was <35 mm, indicating restricted mouth opening in these patients. Intrarater reliability of 0.95 (0.87–0.98) and interrater reliability of 0.96 (0.89–0.98) were found for the measurements. Conclusions: The reliability of maximal voluntary mouth opening measurement using this novel technique was found to be excellent. This technique can be used in the routine clinical evaluation of patients with oral carcinoma. [ABSTRACT FROM AUTHOR]

Aims This paper examines: the intra-rater, inter-rater and test-retest reliability of the Five-Times-Sit- To-Stand (FTST5) test administered by experienced and inexperienced assessors; and the correlation of FTSTS test times with lower limb muscle strength and balance performance in healthy older and young people. Method The cross-sectional study investigated reliability using test batteries including: FTSTS times; hand-held dynamometer measurements of hip flexor, knee flexor and extensor, and ankle dorsiflexor and plantarflexor muscle strength; Berg Balance Scale (BBS) scores; and dynamic posturography measurements of the limits of stability (LOS). A convenience sample of 12 healthy older and 12 younger participants was recruited in the local university-based rehabilitation centre. Results The FTSTS test showed excellent intra-rater reliability (intraclass correlation coefficient (ICC) range: 0.914-0.933) and moderate intra-rater reliability (ICC range: 0.644-0.879) in healthy older and young subject groups respectively. Inter-rater reliability between assessors yielded an ICC of 0.990. Test- retest reliability (ICC range: 0.988-0.995) was excellent. FTSTS times were not significantly associated with the older subjects' lower limb muscle strength, BBS scores or LOS results. Conclusion The FTSTS has good intra-rater, inter-rater and test-retest reliability. There is no significant correlation of FTSTS times with lower limb muscle strength or balance performance in healthy older people. The FTSTS test is a reliable measurement tool whether used by experienced or inexperienced assessors. A future study with a larger sample size is required for establishing the validity of FTSTS test times in the older population. [ABSTRACT FROM AUTHOR]

Pain is a common symptom for long-term care residents, particularly those in need of palliative care. However, pain assessment in residents who have communication limitations is challenging. A study was conducted with the aim of developing a pain assessment tool that could feasibly be used by direct care providers in long-term care with minimal training yet demonstrating strong psychometric properties. The study used both qualitative and quantitative methods to develop and test the Pain Assessment in the Communicatively Impaired (PACI) tool. Part I of this paper reported on the development phase; this second part reports on the test results. The validity and reliability results of the PACI tool were acceptable, and the convergent validity was moderately strong. A moderate level of interobserver agreement was evident, with kappas ranging from 0.46 to 0.63 for the individual items and a kappa score of 0.59 for the total tool score. The overall results of this study support the psychometric properties and feasibility of the PACI tool, offering preliminary support for its use in clinical practice. [ABSTRACT FROM AUTHOR]

This UK-based empirical research investigates interprofessionalism and personalization to assess their potential to achieve quality care provision for people with long-term conditions. Governmental policies extol the virtues of interprofessionalism and personalization to drive modernization forward, however, change requires the commitment of health and social care professionals. Therefore the complexity of turning policy into practice requires continual review to ensure policy ideals become practice realities rather than speculative rhetoric. This paper examines interprofessional working (IPW) and interprofessional education (IPE) by analysing the experiences and working relationships of professionals from different professions and their potential impact upon personalization initiatives. The conclusion argues that educational providers and professional awarding bodies need to enshrine interprofessionalism into curricula and qualification accreditation thereby instilling collaboration intrinsically into care provision. [ABSTRACT FROM AUTHOR]

Rowan Clemente, Specialised Dietitian, and Stephen Taylor, Research Dietitian, North Bristol NHS Trust, consider the current UK pH stick threshold and whether it might be putting vulnerable patients at risk [ABSTRACT FROM AUTHOR]

Background: Recent international documents have highlighted the importance of preparing the nursing workforce for end of life care. However, these documents do not make clear what prepared in the context of end-of-life care actually means. Searching the literature failed to retrieve any papers defining prepared in this context. Aim: A concept analysis, using Walker and Avant's model, was conducted to help address this gap in the knowledge base. Results: From this analysis many attributes and antecedents were synthesised. These include that a prepared nurse would be confident to: assess the dying patient, communicate with empathy, identify and manage symptoms, recognise and deal with death and dying, understand the holistic elements of dying, be comfortable with the effects of loss and bereavement on patients and self, and be self-competent. Conclusions: From this analysis, a clearer idea of what is needed to prepare nurses for end-of-life care is offered and suggestions for future research are made. [ABSTRACT FROM AUTHOR]

Demands made on nursing staff are expanding and changing, requiring a broad set of competencies that require evaluation and enhancement in places. This study used the Nurse Competence Scale to measure self-assessed competence among nurses working in three municipal health-care services in Norway. Results indicate that nurses perceive their competence as being satisfactory overall, but there are areas that would benefit from improvement: providing patients' family members with education and guidance, quality assurance, and using research to evaluate and develop services. These competencies could be the focus of departments' future competence plans. The Nurse Competence Scale can be used to assess the impact of training and the efficacy of competence-enhancing actions. [ABSTRACT FROM AUTHOR]

Background: Hospitalised patients receiving intravenous antimicrobial therapy require a reliable device through which this is delivered. Short peripheral intravenous catheters (PIVCs) are the default device for antimicrobial therapy but up to half fail before therapy completion, leading to suboptimal drug dosing, patient distress from repeated insertions, and increased healthcare costs. This study will investigate the use of long PIVCs to determine if they are more reliable at delivering antimicrobial therapy. Methods: A two-arm, parallel randomised controlled trial of hospitalised adults requiring at least 3 days of peripherally compatible intravenous antimicrobials. Participants will be randomised to a short (<4 cm) or long (4.5-6.4 cm) PIVC. After interim analysis (n=70) for feasibility and safety, 192 participants will be recruited. Primary outcome is disruption to antimicrobial administration from all-cause PIVC failure. Secondary outcomes include: number of devices to complete therapy, patient-reported pain and satisfaction, and a cost analysis. Ethical and regulatory approvals have been received. [ABSTRACT FROM AUTHOR]

This paper reports the findings from a Delphi Study undertaken to identify the research priorities in children's palliative care in Ireland. Palliative care for children is a small and highly specialised field of healthcare that focuses on improving the quality of life of children living with, or dying from, a life-limiting condition. Ideally, support for children requiring palliative care begins at the time of diagnosis, which for many children with life-limiting conditions can be from birth. There is a notable overlap between the needs of children requiring palliative care and those with disabilities and other complex care needs, resulting in care being provided by a range of voluntary and statutory agencies. As a new specialty, there is a need to develop an evidence-based approach to providing children's palliative care. In order to do this in a systematic way, identification of the research priorities in children's palliative care within Ireland is required. [ABSTRACT FROM AUTHOR]

Background: An inter-professional education (IPE) workshop centred around newly approved COVID-19 vaccination was attended by 77 nursing and pharmacy students. Aim: To embed and evaluate the implementation of a virtual IPE workshop, and to upskill undergraduate nursing and pharmacy students about the COVID-19 vaccination. Methods: The workshop was evaluated using a questionnaire completed by participants from both disciplines. A focus group was conducted with the IPE facilitators. Results: 77 students out of a potential 400 attended the workshop (19% attendance). Of the 77 participants, 44 (23 nursing, 21 pharmacy) completed the questionnaire (57%), rating the content highly. There was overall positivity toward working interprofessionally, and there was no evidence of significant differences between how the two groups of students rated the workshop. Qualitative findings from students and facilitators corroborated the supposition that the workshop would enhance professional development. Thus, the workshop was successful in facilitating interprofessional interactions, with students all working collaboratively toward the same goal, the ultimate purpose of IPE. It was agreed that such an event should be included as part of the student curricula. Conclusion: Implementing an IPE event that includes real-time healthcare priorities can contribute to optimising students' healthcare education. More high-quality longitudinal research is needed to understand the impact of such sessions on students' competence and confidence. [ABSTRACT FROM AUTHOR]

Background/Aims: This study aimed to translate the perceived insufficient milk questionnaire into the Chinese language, Mandarin, perform cultural adaptation, and evaluate its validity and reliability. Methods: The perceived insufficient milk questionnaire was translated using a forward-backward process. An expert panel evaluated content validity with both item and scale content validity indices. Construct validity was assessed by exploratory and confirmatory factor analysis. Internal consistency reliability was evaluated by the Cronbach alpha coefficient. With a 1-week interval, the test-retest reliability was assessed by intraclass correlation coefficient. Results: A total of 328 participants were recruited. The item-level content validity index was as high (0.83–1.0), and the scale-level content validity index was 0.92, indicating excellent validity. A single-factor model was verified as acceptable with good fit indices. The internal consistency (Cronbach alpha coefficient=0.943) and test-retest reliability (intraclass correlation coefficient range: 0.870–0.974) were good. Conclusions: The Chinese version of the perceived insufficient milk questionnaire had acceptable validity and reliability. It is helpful for healthcare providers to evaluate mother's beliefs about breastmilk quantity and nutritional quality, preventing early cessation of breastfeeding through timely interventions. [ABSTRACT FROM AUTHOR]

* Objective: Physical and psychosocial deficits have been reported in people living with chronic wounds. While the negative impact of these factors on an individual's quality of life (QoL) is well documented, there has been little research into the well-being of those living with chronic wounds, despite recent calls for increased attention to this related, yet distinct construct. This paper introduces the Well-being in Wounds Inventory (WOWI) and provides support for the WOWI as a valid and reliable measure of well-being in patients living with chronic wounds. * Method: A draft questionnaire was administered to a convenience sample of individuals with chronic wounds (n=85) and the resulting data subject to factor analysis in order to refine the structure of the questionnaire. The reliability, validity and responsiveness of the resulting questionnaire were then tested by administration to a second sample of individuals with wounds (n=49). Socio-demographic data, issues affecting patient well-being and well-being factors, such as, emotions; perceived coping skills; social support; personal control; hope for the future, were measured. * Results: Results confirmed the WOWI as a reliable and valid measure of well-being. Items loaded onto two subscales, 'personal resources' and 'wound worries'. Analysis revealed the WOWI to be highly feasible measure of well-being, with good test-retest reliability and responsiveness to changes in health status. * Conclusion: The current study highlights the importance of assessing well-being factors in individuals living with chronic wounds. It introduces the WOWI as a valid and reliable measure of well-being in chronic wound patients. The authors recommend health-care practitioners take account of well-being as part of a holistic treatment plan in order to maximise patient outcomes. * Declaration of interest: This project was funded by Urgo Medical. The authors have no conflict of interest to declare. [ABSTRACT FROM AUTHOR]

Background: Patient and public involvement (PPI) is increasingly important in healthcare research. Although this is accepted at the level of individual research studies, it has been less well used in scoping fundamental research priorities. It has been suggested that patients with long-term conditions (LTCs) are well placed to influence research priorities in this area due to their accumulated experience of illness over time. Aims: To obtain PPI in research-priority setting for a group with a special interest in LTC research. Discussion: PPI representatives provided views on issues they thought required further research. The facilitators were able to move from the specifics of these ideas to identify cross-cutting research priorities. Conclusion: It was possible to determine broad research themes despite PPI representatives initially articulating identified issues in very specific terms. Facilitating a better understanding of the research process for PPI representatives would allow their contribution to be more effective. Implications for practice PPI should be considered at the beginning of the process when broad research priorities are considered and before the study design. This is particularly so for broad, non-specialty-focused research themes such as LTCs. More work is required to ensure the views of harder-to-reach groups are included in this type of PPI. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic has placed increased strain on many aspects of the NHS. Dentists have been identified as having skills transferable to support community nursing teams as part of the redeployment response. This article aims to explore the roles dentists have undertaken within the community setting and reflect on dentists' transferable skills, training and personal experiences during redeployment. Despite differences in healthcare delivery, both professions share skills surrounding professionalism, communication, raising concerns and consent. Community nurses have supported dentists through specific training and competencies so that the latter are equipped with skills to support roles including wound care, catheter care and medication administration. Dentists have been well-received by community nursing colleagues and patients during redeployment. This experience has enabled redeployed dentists to establish new skillsets while improving their appreciation for the fundamental role that community nurses play within society. [ABSTRACT FROM AUTHOR]

The article discusses the author's views with regards to the growing popularity and global implementation of patient-centered healthcare. Topics covered include the evolving role of patients in medical research, the establishment of the INVOLVE initiative by the National Institute for Health Research (NIHR), and the highlights of the author's published paper titled "Establishing Priorities for Oncology Nursing Research: Nurse and Patient Collaboration."

Attitudes toward ageing have powerful influences and impact older adults' own perception of health, quality of life and utilisation of health and social care services. This study describes attitudes to ageing among 490 Norwegian older adults living in the community who responded to The Attitudes to Ageing Questionnaire. Results showed that in spite of physical changes and psychological losses, the attitudes of older adults support life acceptance with gained wisdom in feeling that there were many pleasant things about growing older and that their identity was not defined by their age. They demonstrated the ability to incorporate age-related changes within their identities and at the same time maintain a positive view of self. Although they acknowledged that old age represented a time of loss with decreasing physical independence, they meant that their lives had made a difference, they wanted to give a good example to younger persons and felt it was a privilege to grow old. [ABSTRACT FROM AUTHOR]

Aims: The aim of this study was to examine perceived barriers to assessment of delirium for critical care nurses, and the impact of education on their knowledge and practice. Background: Delirium is a significant problem in critical care, leading to increased morbidity and mortality. Many authors have found variations in assessment by critical care nurses, but there has been limited analysis of the reasons for this. Education on the topic improves knowledge and practice, but the best approach has not been examined. Design: A questionnaire survey design. Methods: A self-reported questionnaire was distributed to critical care nurses (n=31) at a district general hospital. Data were analysed with descriptive statistics. Results: Knowledge and practice were variable, but correlation was seen between nursing band and years of experience with better scores. Any type of education led to significantly improved scores. Several barriers to assessment were found, with the most common being lack of knowledge and difficulty in assessing intubated patients. Conclusion: It is essential to improve practice in delirium assessment and management. Education is vital to improve the knowledge and practice of critical care nurses regarding delirium. [ABSTRACT FROM AUTHOR]

Shifts in demographic profiles and in the understanding of how to best deliver health care have seen nurses increasingly caring for non-acute client groups outside traditional clinical settings. Evidence suggests that this does not always sit well with nurses, or with nurses in training. This study sought to investigate the influences on student nurse perceptions of the worth of working with various client groups. Thematic analysis of a focus group discussion led to the identification of several themes suggesting that unhelpful opinions are present in some students on entry to the programme; however, programme-related influences also contribute towards unhelpful attitudes. To create a more positive framing of working within such specialisms will require significant focus across nursing, nurse education and society in general. [ABSTRACT FROM AUTHOR]

The purpose of this secondary data analysis (SDA) was to review a subset of quantitative and qualitative paired data sets from a returned postal screening tool (PST) completed by patients and compare them to the clinical letters composed by elderly care community nurses (ECCN) following patient assessment to ascertain the tool's reliability and validity. The aim was to understand to what extent the problems identified by patients in PSTs aligned with actual or potential problems identified by the ECCNs. The researcher examined this connection to establish whether the PST was a valid, reliable approach to proactive care. The findings of this SDA indicated that patients did understand the PST. Many appropriate referrals were made as a result of the ECCN visit that would not have occurred if the PST had not been sent. This article focuses specifically upon the physiotherapy section as this was the area where the most red lags were identified. [ABSTRACT FROM AUTHOR]

Enquiry-based learning (EBL) is an approach to education that generally involves students working in groups, forming their own questions and solving scenarios formulated from an initial 'trigger' presented by tutors. EBL entails specific demands but is believed to effectively apply theory to practice and enhance deep learning. In 2012, the midwifery programme at the University of Worcester was reapproved to run as an EBL curriculum. The research summarised here is an evaluation of students' perceptions and experiences of the first year of the new curriculum. A mixed-methods design was employed, using questionnaires and interviews. The students were most likely to perceive the benefits of EBL as increasing critical thinking (73%), problem-solving (68%), and leadership skills (66%). Concerns were voiced about the teaching of anatomy and physiology, and consistency of approach among tutors. All the students stated that their perceptions of EBL and its outcomes became increasingly positive over time. This evaluation suggests that EBL has potential to enhance the key skills of students who will be required to practise within increasingly complex maternity services. Further research is needed to explore the views of mentors as key stakeholders in midwifery education. [ABSTRACT FROM AUTHOR]

Background/Aims: UK occupational therapists are recognised as having key skills in work rehabilitation, but there is limited evidence to underpin this. In order to use research resources to best effect, it is vital to identify the research priorities of occupational therapists in work rehabilitation. This study aims to gather the views of those with a special interest in the field in order to identify their research priorities. Methods: An online survey was developed and administered electronically to members (n=173) of the College of Occupational Therapists Specialist Section-Work (COTSS-Work). Respondents were asked to: i) prioritise and comment on research areas; ii) propose research questions. A final sample of 42 surveys was collected and analysed thematically Results: Responses reflected the diversity and complexity of work rehabilitation. Identifying a rank order of research priorities proved challenging as the majority (≥62%) of respondents considered all of the topic areas listed a high priority. Research into the following areas were included in the survey: interventions; outcome measurements; assessments; management and/or service delivery; planning and/or commissioning; and education. However, 'interventions' was rated highest overall. Conclusions: Occupational therapists in the UK need more evidence to justify their role in the work and health arena. Greater opportunities are required for occupational therapists in clinical practice, as well as those involved in research, to address areas in which evidence-based practice is lacking and the mechanisms to disseminate this knowledge base. [ABSTRACT FROM AUTHOR]

With the current caesarean section (CS) rate at 25% for England, delivering postnatal wound care is a common element of the midwife's role. Anecdotal evidence suggested CS wound care education was a need within the Trust's midwifery service. A questionnaire was used to investigate midwives' views and the need for education in relation to CS wound care. The results confirm midwives do see wound care education as a need. For the first time, information is available on the topics midwives feel should be the focus of such education and useful methods of delivering it. This information can be used to develop a wound care education package to address midwives' learning needs in this area. [ABSTRACT FROM AUTHOR]

The author discusses the findings of her study on the views of hostel staff in Great Britain on caring for dying homeless residents. They say that patients share their diagnosis with trusted hostel workers. Participants do not have access to medical information that would help them support dying residents. Some of them do not see their job as personal carer of dying homeless patients which affected the latter's dignity.

When co-occurring with psychosis, anxiety can adversely affect social and occupational functioning and can cause debilitating levels of distress. This article describes a single-centre three-phase service development project culminating in the introduction of 1-day anxiety management workshops for service users of an Early Intervention for Psychosis Service (EIPS). The workshops, which were run by a mental health nurse and an assistant psychologist, attracted 12 participants with a first episode of psychosis and co-morbid anxiety. Quantitative and qualitative measures demonstrated a statistically significant reduction (p<0.0005) in subjective anxiety levels following the intervention, and that participants felt they were likely to make use of the skills in the future. It can be concluded that such workshops are not only time- and cost-effective, but also valuable in delivering brief interventions based on cognitive behavioural therapy (CBT) to service users with a first episode of psychosis. [ABSTRACT FROM AUTHOR]

Despite being preventable and treatable, undernutrition remains a problem for many older people in tertiary healthcare settings. Nurses have a crucial role in assisting people who are unable to eat independently and are uniquely positioned to implement solutions that will lead to better nutritional care. However, what is known about the management of undernutrition is not informing nursing practice. This study used action research, underpinned by the ‘participatory world view', to address the theory-practice gap. Data and between-method triangulation were used to collect and analyse qualitative non-participant observations and action research group data. Set Up Ready For Dining (SURFD) was developed and implemented by nurses to improve patient mealtimes. Findings show that nursing practice in nutritional care is influenced by technique within the healthcare context that emphasises operational efficiency, and by the choices that nurses made around being the patient advocate during mealtimes. [ABSTRACT FROM AUTHOR]

Background: Recent worldwide economic events have forced an examination of the nurse’s contribution to high-quality, effective, person-centred care. Since the role of specialist nurses is considered one of the least understood or valued developments in nursing, specialist nurses must demonstrate their contribution to quality, person-centred health care. Aim: To develop a questionnaire which aims to measure the quality of care provided by palliative care specialist nurses from the patients’ perspective and to undertake initial validation. Method: The process of questionnaire development involved six phases including systematic literature reviews, patient advisory groups and expert panel reviews, each of which contributed to the questionnaire face and content validity. Johnston’s Expert Palliative Care Nurse Model (2002; 2005) provided an evidence-based framework for the development of the questionnaire, and enabled the identification of the key attributes of the palliative care specialist nurse role, thereby providing the themes on which to base the questionnaire. Results: The Quality Measure for Palliative Nursing, a questionnaire, was developed. The themes identified in the questionnaire—personal characteristics, communication skills, knowledge, relationship with patient and providing comfort—aim to facilitate measurement of the quality of care provided by palliative care specialist nurses. Designed for use by palliative patients the Quality Measure for Palliative Nursing is a one-page questionnaire comprising of 15 questions. Conclusions: The Quality Measure for Palliative Nursing is unique since it aims to measure the quality of care provided by community palliative care specialist nurses, and could also be used to measure patient satisfaction with the quality of care provided. Further testing is recommended to ensure that this questionnaire can provide reliable and valid results. [ABSTRACT FROM AUTHOR]

The establishment of an integrated research culture in medicine has contributed to the ongoing success of medical science in treating disease. Research examining the effectiveness of services and care is of increasing priority, and is a branch of research open to all health professionals. This article provides an overview of the research process aimed at health professionals with novice research skills. It will provide tools and resources to guide health professionals in the development of research concepts leading to a feasible protocol. [ABSTRACT FROM AUTHOR]

Aim: To translate and validate a European Portuguese version of the Rapid Assessment of Physical Activity (RAPA) questionnaire. Methods: The original English version of RAPA was translated into Portuguese following standardized procedures. Fifty-five Portuguese older adults were assessed in two sessions, approximately one week apart Test-retest reliability was evaluated by weighted kappa (Κ). Construct validity was evaluated by Spearman's correlation coefficient between the RAPA and the World Health Organization Disability Assessment Schedule (WHODAS 2.0) and the short physical performance battery (SPPB) (gait and chair stands tests, and total score); and by the Mann-Whitney U test between participants with and without depression and able and unable to complete the SPPB balance test. Results: Weighted Κ was 0.67 (95% CI=0.52-0.81) for reliability. A significant correlation was found between the RAPA and WHODAS 2.0 (rs=-0.47, p<0.01), gait test (rs=-0.45, p<0.01) and total SPPB score (rs=0.45, p<0.01). Participants able to complete the SPPB balance test had higher levels of physical activity than those unable (3.25±1.23 vs 2.37±1.30, p<0.05), and those without depression had higher levels of physical activity than those with depression (3.24±1.23 vs 2.50±1.34, p<0.05). Conclusions: The European Portuguese version of the RAPA questionnaire seems valid. However, its reliability requires further investigation. [ABSTRACT FROM AUTHOR]

Aims: To describe the development and test reliability of a new assessment scale for measuring basic mobility and self-care: the Traffic Light System-BasicADL (TLS-BasicADL). Subjects: Eighteen occupational and physiotherapists took part in inter-rater, and 25 in intra-rater, reliability testing. Thirty inpatients admitted to an acute geriatric/orthopaedic unit, aged ≥70 years participated in inter-rater testing, 5 of whom were included in intra-rater testing. Methods: TLS-BasicADL was constructed by members of the interdisciplinary team at a geriatric unit. Items were generated from existing instruments, pilot testing and consensus meetings. Inter-rater testing was performed by two therapists simultaneously. Intra-rater reliability was examined using video-taped films of 5 patients. Therapists viewed and assessed 5 patients, then retested 4 weeks later. For inter-rater testing percentage agreement (PA) and intra-class correlation coefficient (ICC) were used, and for intra-rater reliability, PA. Results: Analysis of reliability showed high inter-rater (PA=86%; ICC=0.90) and fair intra-rater reliability (PA=≥72%) for mobility items. Conclusion: The new interdisciplinary assessment, TLS-BasicADL for measuring function in older persons in the acute hospital setting is shown to have high inter-rater and fair intra-rater reliability. [ABSTRACT FROM AUTHOR]

An abstract is presented of the article "Infusion Phlebitis Assessment Measures: A Systematic Review" by G. Ray-Barruel, D. F. Polit, J. E. Murfield et al., which was originally published in a 2014 issue of the "Journal of Evolution in Clinical Practice".

• Objective: This study aimed to evaluate the internal consistency reliability and construct validity of the Fitzpatrick Skin Type Scale during radiation therapy in a cohort of women receiving treatment for breast cancer. • Method: The assessment of the scale was performed as a nested study within a randomised controlled trial of two creams used for radiation therapy skin care for breast cancer patients. The sample consisted of 244 female patients undergoing radiation therapy for breast cancer. Participants completed a modified version of the Fitzpatrick Skin Type Scale. • Results: Internal consistency as measured by Cronbach’s alpha was 0.505, 0.829 and 0.339 for the Genetic Disposition, Sun Exposure and Tanning Habits subscales respectively. Only the Sun Exposure subscale surpassed the 0.70 cut-off, indicating good internal consistency. Maximum likelihood factor analysis with promax rotation method confirmed the a priori factor structure for the Sun Exposure subscale as well as providing evidence of construct validity for this subscale. Analysis for the other two subscales highlighted issues with internal reliability and construct validity suggesting that not all items on each subscale truly measure the intended trait. • Conclusion: The study findings support reliability and validity of the Sun Exposure subscale of the Fitzpatrick Skin Type Scale in a convenience sample of women receiving radiation therapy for cancer. Despite limitations with two of the three subscales, this tool continues to be used in clinical practice. [ABSTRACT FROM AUTHOR]

Aim: This pilot study aimed to investigate the validity of an assessment for instrumental use of the mind: the Assessment and Intervention Instrument for Instrumentalism in Occupational Therapy (AIIIOT). The AIIIOT is used to guide individuals being assessed in developing personal mission statements to guide their lives. The individuals then assess themselves on perceived frequency, adequacy, satisfaction, and belief in ability to perform occupations that would help them achieve the stated missions. Method: The validity of the AIIIOT in evaluating occupational performance was investigated by comparing it with the Canadian Occupational Performance Measure (COPM). Eleven people, aged 19-58 years, comprising of nine women and two men, participated in this convergent validity study. Data were gathered using the AIIIOT and the COPM. Pearson moment correlation and linear regression analyses were conducted to determine the convergent and predictive validities. Results: The participants' AIIIOT belief scores were correlated with the COPM performance and satisfaction scores, indicating that the AIIIOT belief scale had convergent validity. The AIIIOT belief scores were good predictors for the performance and satisfaction with performance of prioritised occupations as measured on the COPM. The AIIIOT adequacy scores were good predictors for the AIIIOT Frequency scores. Adequacy scores were also good predictors of the AIIIOT satisfaction scores. Conclusion: The above findings suggested that the AIIIOT had reasonable convergent and predictive validities. Further research with larger, more representative samples is indicated to confirm these findings. INSET: Example of an evaluation using the Assessment and Intervention.... [ABSTRACT FROM AUTHOR]

Aims: To consider the views, understanding and training needs of members of a multidisciplinary team (MDT) around 24-hour postural care. These MDT members refer individuals with profound and multiple learning disabilities (PMLD) and postural care needs to a 24-hour postural care service. Methods: This study used a mixed-methods approach, which was undertaken in two phases. The setting for this study was a community healthcare NHS trust in England, which refers patients to physiotherapy for PMLD. Phase 1 involved 57 members of the MDT including: psychologists, psychiatrists, community nurses, health facilitation nurses, speech and language therapists, and occupational therapists. Phase 2 involved a purposive sample of 14 MDT members across three profession-specific focus groups. Findings: Phase 1 identified that around 50% of all MDT members refer to the 24-hour postural care service; the majority (75.4%) of these participants identified that they would be happy to receive more training on 24-hour postural care. Phase 2 suggested that while referrals were being made, MDT members were not able to identify why individuals should be referred to the 24-hour postural care service. Conclusions: This study has revealed that MDT members working in a community trust within learning disability services were lacking an awareness of why individuals should be referred to 24-hour postural care. This study discusses the implications of this finding. [ABSTRACT FROM AUTHOR]

Aims: To investigate whether thoracic exercises result in improved pain, range of movement and health-related quality of life (HRQOL) following open heart surgery (OHS), and to evaluate patient perception of the role of thoracic exercises in recovery. Methods: A single-blinded pilot trial was conducted in a tertiary public hospital in Australia. Thirty-eight participants who underwent OHS were randomly allocated to an experimental (Group 1, n=23), or control (Group 2, n=15) group. All participants were prescribed a twice-daily walking programme postoperatively. The experimental group also completed a progressive, individualised thoracic exercise programme. Baseline pre-operative measures of shoulder and thoracic range of movement, pain and HRQOL were repeated at 4 weeks following discharge and 3 months postoperatively. Participants also rated their perceptions of the role of exercise and its contribution to physical recovery. Findings: At 4 weeks following discharge, the experimental group reported 1.7 cm on the visual analogue scale (VAS) less sternal pain (95% CI of median 2.8-0.0, P=0.03) than the control group. The experimental group reported a trend toward greater perception of the contribution of their physiotherapy programme than the control group (median difference 1.2 cm, 95% CI -2.1- -0.0, P=0.04). There were no other differences between the two groups. Conclusions: Thoracic exercises following OHS may be effective in reducing sternal pain and warrant further investigation. [ABSTRACT FROM AUTHOR]

The purpose of this study was to explore the experiences of long-term care (LTC) residents living and dying with heart failure (HF) and their family members. An exploratory descriptive design was used to collect data from seven LTC residents and seven family members. The data was analysed using thematic content analysis. The main themes that emerged from the data were: limited understanding of the HF diagnosis, living with restrictions and other comorbidities, making decisions about transitioning to end-of-life care, and learning and negotiating the lines of communication. Residents and family members communicated with many health-care providers about managing the HF symptoms but most often worked through the nurse when problems arose or decisions about care needed to be made. The findings from this study contribute to our understanding of residents' and family members' experiences in managing residents' HF in LTC. [ABSTRACT FROM AUTHOR]

Introduction: Pain is a common symptom for patients receiving palliative care, but can be relieved by effective pain management. Nurses play a critical part in implementing pain management effectively and must therefore have a solid foundation of knowledge and a positive attitude toward it. Aim: The purpose of this study was to implement and evaluate an educational pain management programme (PMP) for nurses in Kenya. Methods: The effects of the PMP were measured using a quasi-experimental pre-post test design. Twenty seven nurses from two units in a single health institution in Kenya participated in a baseline assessment using the Nurses' Knowledge and Attitudes Survey Regarding Pain (NKASRP). Nine randomly selected nurses then received 7 hours of focused education. This group completed the assessment again both immediately after and 2 weeks after the PMP. Results: A deficit in knowledge and attitudes related to pain management was prominent at baseline. The nurses who received the PMP scored significantly higher on the NKASRP following the PMP: mean scores were 18.44, 28.00, and 27.56 at baseline, first follow-up, and second follow-up assessment respectively. Conclusion: The PMP appears to be effective in improving nurses' pain knowledge and attitudes. [ABSTRACT FROM AUTHOR]

Acute deteriorations in health occur in all healthcare settings. Every health professional must therefore have the knowledge and skills to recognise and respond effectively to acute illness, in order to avert further deterioration. It is widely acknowledged that a robust understanding of physiological observations, in addition to effective interpretation and clinical decision-making skills, is required for this task (Odell et al, 2009; Steen, 2010). A significant amount of work has been undertaken in one higher education institution (HEI) to ensure that theoretical preparation adequately equips nurses for this aspect of their role. However, it would appear from this evaluative study that some barriers may exist that prevent this essential theoretical knowledge from being embedded into clinical practice. This gap in transformational knowledge is important to highlight as there is an increasingly urgent need for these skills if acutely ill patients are to be successfully rescued (The National Confidential Enquiry into Patient Outcome and Death (NCEPOD), 2005; 2009; 2012; National Institute for Health and Care Excellence (NICE), 2007; Department of Health (DH), 2009). The dissolution of barriers that prevent the development of effective recognition and response skills is an important task for all those involved in acute care education, in both HEI and clinical settings. [ABSTRACT FROM AUTHOR]

Finding ways to make good quality education available to all staff in an expanding and increasingly busy hospice organisation is a real challenge. Constantly providing learning opportunities that are then poorly attended owing to the pressure of work is equally disappointing, and leads to questions of cost-effectiveness. An action research project was undertaken to investigate the reasons for low attendance rates at learning events in one hospice. Having identified time and conflict with patient need as major issues, a second cycle of research using literature review and a survey methodology was conducted to find a contemporary and innovative solution to this problem in an attempt to establish a vibrant learning culture. As a result a virtual learning environment-ORACLE (Online Research and Care Learning Environment)-was created to augment the face-to-face sessions and provide staff with access to appropriate learning materials 24 hours per day, 365 days per year. Although unique to this organisation, ORACLE has potential application to any other work environment. [ABSTRACT FROM AUTHOR]

Background: International expert consensus is that psychosocial intervention is likely to help advanced cancer patients and their family carers affected by weight loss and poor appetite. Purpose: To investigate the potential for a psychosocial intervention, the Macmillan Approach to Weight and Eating (MAWE), to mitigate weight- and eating-related distress in carers of patients with advanced cancer. /Method: A controlled before and after study was conducted with carers of advanced cancer patients living in the community in the South of England in 2006-7. It used mixed methods to compare carers exposed to MAWE (n=12) with a control group (n=14). Results: Weight- and eating-related distress improved in carers exposed to MAWE. Qualitative analysis found that MAWE may help carers by providing information, reassurance, and support for self-management. Conclusion: This preliminary study of MAWE suggests that it provides benefits as a supportive intervention. Further testing is warranted using a more robust experimental design. [ABSTRACT FROM AUTHOR]

Aim: To explore the process employed in the development of a population health framework and documentation for managing community nursing caseloads. Background: No formal structure exists to validate and link local health information collected by Irish public health nurses to a wider epidemiological framework. Neglect of this bottom up information forfeits opportunities to resource and manage public health nursing services. Design: Action research methods guided the development of the framework in one geographic area in Dublin and 34 participants engaged in Stringer's (1996) Look, Think and Act cycle. Results: The framework identified four patient registers: family health, chronic sick/disability, older adults and acute care, which identify public health outcomes for discussion within the caseload analysis process and can predict risk factors in local populations. Conclusions: The use of the developed documentation identified a framework that describes caseloads in primary care and provides nurse managers with an evidence base to allocate resources, match skill mix to need, and estimate future workforce requirements. [ABSTRACT FROM AUTHOR]

Aims/background: Occupational therapy (OT) and physiotherapy (PT) curricula content and preparedness for work-related practice and occupational health and safety (OHS) are not well documented. This study aimed to identify content and other elements of entry-level curricula in 23 OT and 17 PT programmes from Australia and New Zealand, and to identify educators' perceptions of OT and PT graduates' preparedness for work-related practice and OHS topics. Method: A telephone survey collected curricula content as well as teaching and assessment methods from 19 OT and PT work-related practice educators. Educators reported perceptions of new graduate preparedness for 22 topics in the field of work-related practice identified in an earlier study. Results included descriptive statistics and thematic analyses. Findings: Educators reported a high rate of inclusion (81%) of work-related practice topics in curricula. The main teaching method was theory (99.5%) and other methods included hands-on practical work with students and fieldwork with clients. Educators reported similar assessment processes across programmes. New graduates were prepared for practice with minimal supervision in the majority of topics (81%). Conclusions: Work-related practice content was included strongly and consistently in OT and PT entry-level curricula. However, as the majority of content was embedded in other courses, topics may not have been explicit and identifiable to students. New graduates were perceived to be prepared for practice with minimal supervision. This finding will assist employers to understand new graduates' preparedness for practice and needs for further development. Preparedness for practice in this field was similar to expectations of preparedness for other practice areas. [ABSTRACT FROM AUTHOR]

A significant number of people experience pain and cognitive impairment toward the end of life. Assessment of their pain becomes more complex as their cognitive abilities diminish and they lose their ability to express themselves and understand their experience of pain. The rate and pattern of cognitive decline differs between individuals, which makes it difficult to take a standardised approach to pain assessment. Based on a review of the literature, this article describes the development of a pain assessment toolkit consisting of guidelines and a selection of self-report and behavioural assessment tools to support health professionals in tailoring their assessment to meet the needs of an individual with cognitive impairment. [ABSTRACT FROM AUTHOR]

Background/Aims: The purpose of this study was to investigate if a sample of United States occupational therapists: 1) extensively used theoretical conceptual practice models to guide clinical decision-making; 2) combined theoretical conceptual practice models; 3) were interested in learning more about how to use the models and to combine them systematically in practice. Methods: The study was conducted using a survey questionnaire to gather data from 46 occupational therapists who were members of the American Occupational Therapy Association. Findings: The study participants perceived theory to be important as a guide to practice. They tended to combine models in clinical decision-making but the majority did not have a consciously thought-out systematic approach to doing so. Many were interested in learning more about how to use theoretical models and to combine them in clinical decision-making. Conclusions: The findings indicated that the study participants may benefit from and would be willing to participate in learning programmes designed to help them improve their theory application and specifically their theoretical model combination skills. [ABSTRACT FROM AUTHOR]