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Objective: The association between higher registered nurses (RN) staffing (educational level and number) and better patient and nurse outcomes is well-documented. This discussion paper aims to provide an overview of safe staffing policies in various high-income countries to identify reform trends in response to recurring nurse workforce challenges., Methods: Based on a scan of the literature five cases were selected: England (UK), Ireland, California (USA), Victoria and Queensland (Australia). Information was gathered via a review of the grey and peer-reviewed literature. Country experts were consulted for additional information and to review country reports., Results: The focus of safe staffing policies varies: increasing transparency about staffing decisions (England), matching actual and required staffing levels based on patient acuity measurement (Ireland), mandated patient-to-nurse ratios at the level of the nurse (California) or the ward (Victoria, Queensland). Calibration of the number of patients by the number of nurses varies across cases. Nevertheless, positive effects on the nursing workforce (increased bedside staffing) and staff well-being (increased job satisfaction) have been consistently documented. The impact on patient outcomes is promising but less well evidenced., Conclusion: Countries will have to set safe staffing policies to tackle challenges such as the ageing population and workforce shortages. Various approaches may prove effective, but need to be accompanied by a comprehensive policy that enhances bedside nurse staffing in an evidence-based, objective and transparent way., Competing Interests: Declaration of Competing Interest The authors report no declarations of interest., (Copyright © 2020 Elsevier B.V. All rights reserved.)

Thirty-one participants engaged in this oral history research study aimed at exploring the lived experience of intellectual disability nurses and healthcare assistants' knowledge of the trajectory of intellectual disability nursing over the last 30 years in the Republic of Ireland and England. This paper documents some of these experiences offering perspectives on intellectual disability nursing and what is important for the future. Findings from Ireland consider the nature of intellectual disability services and the registered nurse in intellectual disability. Findings from England focus on opportunities and restrictions in intellectual disability nursing, shared visions, the changing context within which work took place and also the internal and external supports that impacted their roles. It is evident that intellectual disability nurses must be responsive to the changing landscape of service provision and also the requirements for contemporary new roles to meet the changing needs of people with intellectual disabilities.

Aim: To identify the barriers and facilitators to seasonal influenza vaccination uptake among nurses., Background: Seasonal influenza causes significant mortality and morbidity among older people and high-risk groups. Vaccinating nurses against influenza is an essential public health measure to reduce the burden of disease. Yet despite annual recommendations, nurses' influenza vaccine uptake rates remain low., Design: An explanatory sequential mixed methods study design., Data Sources: Qualified nurses attending mandatory training in two large acute hospitals in Ireland., Methods: A paper-based questionnaire assessing nurses' knowledge, risk perception, health beliefs and influenza vaccination practices was distributed to a convenience sample of qualified nurses (N = 462) between September 2017 - February 2018. A self-selected sample of 35 nurses who completed the questionnaire participated in five focus groups to explore in depth the barriers and facilitating factors associated with their vaccination practices between September 2018 - October 2018. The questionnaire data were analysed statistically and thematic analysis was applied to the qualitative data. The quantitative and qualitative findings were integrated using the Pillar Integration Process., Results: Seven themes emerged: (a) the influence of nurses' knowledge on vaccine uptake; (b) dissemination of information; (c) vaccine fears and concerns; (d) protection, risk and vulnerability: self and others; (e) influencers; (f) accessibility; and (g) organizational pressure., Conclusion: Achieving high vaccine uptake rates among nurses through voluntary vaccination programmes remains a challenge. Multi-faceted influenza campaigns based on the HBM should be prioritized to address dissemination of evidence-based knowledge, accessibility, and external cues to action., Impact: Low influenza vaccine uptake among nurses compromises patient safety and contributes to a significant burden on health services. This study identified factors associated with vaccine practices among nurses and will inform the development of specific tailored interventions for nurses., (© 2020 John Wiley & Sons Ltd.)

Aim: To explore the differences in perceived importance and actual performance of clinical leadership for all grades of nurses and midwives engaged in clinical practice., Background: Clinical leadership is central to the provision of person-centred care. However, little is known about how nurses and midwives perceive this in practice., Methods: Data were collected on a sample of nurses and midwives in the Republic of Ireland, using a cross-sectional study design (n = 324). The clinical leadership needs analysis instrument was used to measure perceived importance and performance of clinical leadership in practice. Grades of nurses/midwives included; staff, manager, advanced practitioner and senior manager., Results: Senior managers were more likely to report significantly higher scores than staff grades for perceived importance of Technology & Care Initiatives (p < .01) and Financial & Service Management (p = .02). Performance of Staff & Care Delivery was significantly higher for senior managers than staff grades [F(5,309) = 6.06 p < .01]., Conclusion: There was a mismatch between the perceived importance and actual performance of clinical leadership in practice between different grades of staff., Implications for Nursing Management: Leadership training for all grades and mentoring of staff grades can promote the building of confidence and empower staff in leading clinical practice., (© 2019 John Wiley & Sons Ltd.)

Introduction: This debate essay proposes possible remedies to the shortage of nurses in acute inpatient mental health settings and draws inspiration from a Journal of Psychiatric and Mental Health Nursing editorial, Glascott and McKeown (2022, 29, 767). Aim: The aim is to stimulate debate within the profession. The art and science of nursing continues to develop but staffing shortages in key areas undermine practice, leadership, academic and policy efforts to improve the quality of care for people attending services. Method: This is a debate essay which draws on the authors' experience and presents ideas based on extant literature. Results: Organisational, professional and wider societal challenges are explored. Practice‐based solutions as well as recommendations for improving the terms and conditions of employment of nurses are made. Opportunities which may empower the nursing profession are promulgated. Discussion: It is intended that this paper will provoke further discourse and may reflect the 'call to action' advocated by Glascott and McKeown (Journal of Psychiatric and Mental Health Nursing, 2022, 29, 767). Implications for Practice: While the focus is on acute inpatient mental health nursing, the ideas presented may have an application to wider nursing groups or a wider cadre of public sector workers. [ABSTRACT FROM AUTHOR]

Purpose: Only limited published research is available exploring the lifestyle practices of student nurses. The purpose of this paper is to explore the lifestyle behaviours and exercise beliefs of Irish student nurses. Design/methodology/approach: A descriptive survey design was used. First-year and third-year undergraduate student nurses (n=182) studying at one Irish university participated. Data were collected by administering self-report questionnaires. Findings: A total of 20 per cent of the students smoked, 95 per cent consumed alcohol and 19 per cent of the females reported that they exceeded the recommended weekly safe level for alcohol consumption. In total, 73 per cent of the students reported exercising two to five times per week, and walking was the most popular exercise undertaken. The male students reported significantly higher fitness levels and exercised more on a weekly basis than the females. The students identified a range of benefits of and barriers to exercising. Research limitations/implications: There are a number of study limitations, including: only one university setting was used; a descriptive survey approach was employed; and data were collected using self-report questionnaires. Further studies need to be conducted with additional data collection methods to explore students' lifestyle and physical activity behaviours. Practical implications: The university, as a setting for health promotion, must increase awareness, facilitate and encourage student nurses to engage in healthy lifestyle behaviours. Originality/value: This survey revealed the lifestyle and exercise behaviours of Irish student nurses. Lower levels of smoking and higher levels of physical activity were found amongst these student nurses than those reported elsewhere in the literature. (Contains 3 tables and 1 figure.)

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]

Purpose: The aim of this study is to highlight factors influencing the commitment of nurses, and particularly focuses on the role of training, development and career issues. It provides the basis for a HRD framework, outlining policy choices in developing high commitment amongst nursing staff. Design/methodology/approach: A qualitative research design was used, involving 40 semi-structured interviews with nursing staff, from acute and community hospitals. The main themes and sub-themes relating to the drivers of commitment and the role of training, development and career issues were identified and explored employing a grounded theory, constant comparative approach. Findings: The main "fault-line" between nurses and the organization concerned resource management, and the introduction of general management concepts and practices. HRD practitioners should consider using the language and terms of reference familiar to nurses when devising HRD initiatives. Factors positively influencing the commitment of nursing staff included shared values, involving a sense of "vocational" commitment towards patient care and nursing. Strong leadership, particularly concerning the role of line management, was seen as important in influencing commitment. Teamwork and support, from both line management and colleagues, was also important. Training and development were highly regarded by nurses, and could be a useful way of recognizing and acknowledging their contribution to health care delivery. Career progression and greater involvement were viewed favourably by some nurses and unfavourably by others. The main issue concerned the possible substitution of nurse practitioner responsibilities with administrative and managerial responsibilities. Research limitations/implications: The findings are solely based on interviews with nursing staff from two NHS organizations. In exploring the various drivers of commitment and the role of training, development and career issues the study's focus was towards depth, as opposed to breath, of investigation. Practical implications: Valuable information for HRD practitioners and researchers on the drivers of commitment amongst nursing staff and the role played by training, development and career issues is provided. Originality/value: This paper is a useful study on exploring commitment amongst nursing staff and ways in which HRD practitioners and researchers can facilitate and develop commitment. (Contains 8 tables.)

Abstract: Aim: To explore the collaborative nature of an international research project with other advanced practice nurse researchers and critically analyse the process. Background: Research within the nursing community is recognized internationally as important to ensure that nurses participate in cutting‐edge health care and promote evidence‐based practices, yet there is little detail found in literature on how a successful collaborative relationship is initiated and conducted in advanced practice research. Design: Discussion paper: The purpose of this paper is to discuss the process of collaboration on a research study among advanced practice nurses from four countries who are members of an international organization. Implications for Nursing: The collaborative process in international nursing research can be challenging and rewarding. It is important to remember that there is a relationship between the complexity of the study and the time required to complete it. Keys to success include following established guidelines. Conclusion: This project was a valuable experience in developing collaborative relationships as well as creating partnerships for future research to build on the knowledge gained. The authors' linkages to universities facilitated their participation in the research and completion of the ethical review processes. The use of social media and university resources was indispensable. [ABSTRACT FROM AUTHOR]

Public health nurses (PHNs) in Ireland provide preventative child health. An evidence‐based National Healthy Childhood Program (NHCP) has been in development since 2016. The final program implementation, including training all PHNs coincided with the Covid‐19 pandemic. Objective: To describe implementation and evaluation of a blended training program for PHNs Design: The evaluation used quantitative and qualitative methods underpinned by an implementation science framework to assess the training program. The three‐phase blended training was led by a Training and Resources implementation team. Data from a national cohort of PHNs (n = 1671) who completed training were descriptively analysed. Results: The majority of PHNs completed a suite of four online units (phase 1), as well as self‐directed and asynchronous content in phase 2. Results of phase 2 indicated it met participant needs in terms of knowledge but outstanding needs in terms of skills remained. Phase 3 (a modified Face to Face Clinical Skills Review) was completed by 1671 PHNs over a 5‐month period in 2020. Evaluation was very positive in terms of organisation and usefulness for practice. Conclusions: Despite challenges the NHCP training implementation goals were met. A well‐designed blended learning training program met service delivery imperatives and PHN needs. [ABSTRACT FROM AUTHOR]

Aims: This study aims to explore a proposed translational research continuum for nurse practitioners. Background: Nurse practitioners are acknowledged as clinical leaders responsible for transforming health care delivery. It is important that nurse practitioners contribute to health care knowledge using scientific processes for the implementation of evidence‐based practice and evaluation of outcomes of interventions for their patient groups. Evaluation: This paper provides a review of translational research literature including implementation science to align nurse practitioner activities to a modified translational research framework. Key Issues: A translational research framework has the potential to strengthen nursing research in the nurse practitioner role. Adapting an accepted translational research continuum for nurse practitioners places the clinical nursing leaders in an equitable research position with all health care professionals. Implications for Nursing Management: The translational research continuum provides nursing management with a structure to benchmark nursing research. The continuum applies a modern research framework to support research engagement for the nurse practitioner role. [ABSTRACT FROM AUTHOR]

Background: The 2008 financial crisis exacerbated an already mounting workforce challenge faced by most health services in the western world, namely the recruitment and retention of qualified nurses. Aim: This paper examines two additional challenges of relevance to workforce planning in health care, an ageing nursing workforce and reliance upon migrant nurses to solve short‐term workforce issues. Methods: Using Ireland as a case exemplar of these issues, this paper argues that policy makers and service providers should seek not only to address the challenge of retaining trained newly qualified and younger nurses but also focus on supporting older nurses and migrant nurses to remain within the workforce. Findings: The findings of this paper highlight the need for workforce planners, policy makers and service providers to take account of an ageing nursing workforce and reliance on foreign‐trained nurses as a solution to short‐term planning difficulties. Conclusion: Failure to address this need is likely to lead to significant workforce difficulties for health services into the future and undermine current efforts to increase the number and long‐term retention of qualified nursing staff. Implications for Nursing Policy: Policy makers and service providers should focus on the retention of trained older nurses as an important element of workforce planning. [ABSTRACT FROM AUTHOR]

Irish Travellers are a minority ethnic group within the Irish state with a distinct culture and set of traditions. Travellers experience mental health inequalities, high rates of mental ill health, and structural and individual barriers to mental health supports. A Traveller Mental Health Liaison Nurse (TMHLN) was introduced in a healthcare region in Ireland to provide greater mental health‐related support to Travellers. This paper presents a description of the TMHLN role following a multi‐stakeholder evaluation. The research design was descriptive qualitative and the findings are reported using COREQ criteria. Thirty‐four key stakeholders were interviewed individually or as part of focus groups. Thematic analysis generated two broad themes: the role context, and the specific activities of the role. Mental health nursing experience and understanding of local issues and services were key, as was use of language, building trusting relations, creating the metaphorical, and having the physical, space for working. Specific activities involved in‐reach and outreach work, including one‐to‐one mental health support provision, delivery of education/training sessions to Travellers and service providers, (re)establishing links to specialist services, integrated and interagency working, and promoting cultural competency. The findings set out a role with a greater emphasis on the use of recovery technologies, having an emphasis on psychosocial interventions and self‐care, and less focus on biomedical technologies, signs and symptoms, and clinical outcomes. This study contributes to knowledge on the role of a MHLN as this relates to working with marginalized minority groups. [ABSTRACT FROM AUTHOR]

Introduction: Early assessment and management of depression and/or anxiety for patients post stroke is critical. However, suboptimal provision of psychological care is widely reported. Nurses are the largest professional group to care for patients post stroke and have an important role in addressing their emotional wellbeing. Aim: The aim of this paper is to examine nurses’ knowledge, experiences, and perceptions of the provision of psychological care to patients post stroke in Ireland. Methods: A cross-sectional descriptive survey design involving both quantitative and qualitative items was administered to a convenience sample of seventy-four (n=74) nurses working in six Irish community hospital rehabilitation units. Results: Fifty one (n=51) questionnaires were completed and returned which represented a 69% response rate. Findings demonstrate suboptimal psychological care provision for patients post stroke with no formal pre-defined care pathways. Despite nurses’ knowledge of psychological problems and symptomology, participants revealed receiving limited training in psychological monitoring and no systematic allocation of psychological care duties. This research suggests that pre-defined/formal care pathways; access to psychology expertise; further training and support for members of the Multi-Disciplinary-Team has the potential to improve the provision of psychological care for patients post stroke. Conclusions: This study has implications for the reform and development of rehabilitation services in relation to practice, education, and research. It identifies opportunities to support nurses to improve the delivery of psychological care for patients post stroke. [ABSTRACT FROM AUTHOR]

This paper argues that professional regulatory frameworks are shaped by sociocultural factors and prevailing ideologies that stem from society's interactions with and expectations of the regulated professions. Taking a century of Irish nursing and midwifery regulation as a case reflection, the paper highlights five regulatory pivot points to provide a historical narrative of how adopting a sociocultural perspective can enlighten our understanding of the current regulatory form. A form that in early twenty-first-century Ireland resulted in the establishment of a professionally contentious, non-professional (lay) majority on the regulatory board for these frontline professions. The paper concludes by suggesting that when viewed through a sociocultural lens, regulatory change is to be expected. As prevailing ideologies change, power, influence and cultures alter to support and reinforce the new ideology. Professional regulation thereby becomes reflective of society's views on professionalism and professional identity, drawing on society's historical experiences of the professions. [ABSTRACT FROM AUTHOR]

Abstract: Background: There is an increasing recognition that sleep is an important aspect of health and well‐being, and this is particularly the case in infancy and early childhood where sleep behaviours and patterns can result in substantial problems. Methods: This paper draws on Wave 1, 2, and 3 data from Growing Up in Ireland, the national longitudinal study of children in Ireland to provide an overview of sleep patterns in a population of children aged 9 months (n = 11,112), 3 years (n = 9,790), and 5 years (n = 8,996). The anonymised data made available through the Irish Social Science Data Archive were analysed using descriptive statistics. Results: Findings from the analysis show that about two thirds of infants (66.9%; n = 7,433) and just under 3 quarters of children aged 3 years (72.8%; n = 7,127) go to sleep between 7:00 p.m. and 9:00 p.m. and about 3 quarters (78.6%; n = 7,070) of 5‐year‐old children are in bed by 9:00 p.m. Just under half of infants (48.5%; n = 5,000) wake up between 7:00 a.m. and 8:00 a.m. and 13.5% (n = 1,500) wake up between 6:00 a.m. and 7:00 a.m. More than 80% (n = 8,889) of mothers report their 9‐month‐old infant wakes up at least occasionally and 13.8% report it happens every night. Almost all infants nap during the daytime, with the majority (56.0%; n = 6,222) doing so for between 1 and 2 hours. About one third (65.4%; n = 6,402) of 3‐year‐olds take daytime naps, but only 5.0% (n = 449) of 5‐year‐olds do so. Substantial proportions of mothers report children's sleep patterns are at least a small problem for them (ranging from about 30% (n = 3,333) in infancy to 22% (n = 2,444) at 3 years and 12% (n = 1,079) at 5 years). Conclusions: These findings highlight a substantial unmet need, and it is suggested that public health nurses and health visitors have a key role to play in supporting positive sleep patterns in early childhood. [ABSTRACT FROM AUTHOR]

The article presents the authors' reply to comments in response to their article "The relationship between gender role stereotypes and requisite managerial characteristics: The case of nursing and midwifery professional," which appeared in a previous issue. According to the authors, the paper was aimed to investigate to examine the relationship between gender role stereotypes and requisite managerial characteristics within the nursing and midwifery professions in Ireland.

The aim of this paper is to assist the novice researcher in the research ethics application process. The novice researcher in this context refers to any researcher negotiating a research ethics application for the first time. This may be a student or a more experienced registered nurse engaged in research activity. The paper applies ethical principles to the varied elements of a research ethics application form to explain the theoretical basis of the application criteria. The impetus for this paper arose following an internal audit of the decisions made by the research ethics committee of the nursing department at the Institute of Technology in Tralee, Ireland. The audit revealed the common reasons why full approval was not granted following initial review. This information prompted the development of a paper which would assist novice researchers in avoiding common errors and omissions in the research ethics application process. Despite the specific requirements of individual research ethics committees in different jurisdictions, the fundamental elements of research ethics approval remain unchanged. While the paper has local origins, its relevance holds a wider appeal. The paper takes a structured approach using the three ethical principles of respect for persons, beneficence, and justice, as outlined by the Belmont Report (1979) to provide a framework for discussion. Despite the advent of other frequently used frameworks for research ethics, the principles of the Belmont report remain constant as guidance for good practice in the research ethics context. [ABSTRACT FROM AUTHOR]

Irish Travellers are a small indigenous minority group with a distinctive lifestyle and culture which sets them apart from the general population. Travellers are vulnerable to significant mental distress which is exacerbated by the social disadvantage that they experience. A Traveller Mental Health Liaison Nurse (TMHLN) was introduced in one health care region in Ireland to provide support for Travellers and increase their access to mental health services. The aim of this paper is to present the findings from an evaluation which explored Travellers access to and reasons for accessing the TMHLN, the interventions provided and their experiences of and perceptions of the role of the TMHLN. A descriptive qualitative approach was used. Ten Travellers who used the service were interviewed. Following data analysis, three themes emerged: factors affecting Traveller mental health; accessing the TMHLN and the Travellers experiences and perceptions of the TMHLN. The participants were extremely positive about the TMHLN and valued the support provided. The findings highlight how the interpersonal skills associated with mental health nursing set against recovery orientated and culturally congruent practices are suitable approaches when working with Travellers. [ABSTRACT FROM AUTHOR]

The potential of life story work to add quality to dementia care is widely acknowledged. Whether this potential is always realised in practice and under what circumstances is less clear. This paper explores whether knowing the person's life story enhances healthcare professionals' understanding of the person with dementia and whether this understanding impacts on the person's care. In-depth interviews were conducted with 11 registered nurses and 12 healthcare assistants who had used life story work with people with dementia living in long-stay care settings. Data were analysed using the constant comparative technique. Engaging in life story work enabled staff to see the person behind the dementia. Understanding (as opposed to knowing) the person with dementia's life story changed staff's thinking on what is important when delivering care to people with dementia, with staff giving concrete examples of changes in how they delivered care to the person with dementia and what they considered important when delivering that care. It was concluded that life story work can facilitate a shift to person centred dementia care but how it is implemented matters if this outcome is to be achieved. [ABSTRACT FROM AUTHOR]

Background Developed by Blackhall et al. (2011), the Validation, Emotion, Reassure, Activity (VERA) communication framework seeks to provide student nurses with a guide to provide person-centred care to people living with dementia. The framework aims to enable the caregiver to communicate with the person living with dementia in a respectful manner, and accept that there is both value and meaning to the person's speech and behaviour. This paper presents the findings from a small pilot control pre-post study which aimed to explore the impact of the VERA framework to promote person-centred communication between student nurses and older people with dementia in long term care. Methods A control group of six students, received standard communication training and ten students received additional communication training using the VERA framework. Data was collected using the non-participant observational tool Quality of Interactions Schedule (QUIS) and three self-assessment questionnaires to assess student nurses' confidence, dementia knowledge and communication skills. Results The results of this study found that those students who received the additional VERA communication training were observed to have a significantly (Mann-Whitney U test; p = <0.05) reduced number of negative interactions with people with dementia than those students who had received standard communication training alone. In addition, student nurses trained in the VERA framework showed a significant increase (Mann-Whitney U test; p = <0.05) in their confidence to care for people with dementia than those who had received standard communication skills training. Conclusion The study finding need to be interpreted with caution given the small sample size and the pilot nature of the study. Nevertheless, these findings indicate that the VERA framework has the potential to improve (1) person-centred communication between student nurses and older people with dementia and (2) students' confidence to care for people with dementia. [ABSTRACT FROM AUTHOR]

Purpose: This paper aims to investigate nurses' experiences of leadership within health care in the Republic of Ireland. Design/methodology/approach: This mainly qualitative study made use of a mail survey sent to a random national selection of registered nurses. Participants were asked to provide narrative descriptors of good nursing leadership and identify obstacles to such leadership. Findings: Participants mainly provided examples of nursing leadership within a hierarchical context (concentrated leadership), such as meeting organisational goals and decision-making. While elements of distributed leadership were mentioned (good communication, providing help and support), they were mainly described as part of formal management roles, rather than leadership. Observed obstacles to developing nursing leadership included high workload, lack of support from management and peers, limited opportunities to gain experience, lack of education/training and poor work environments. Research limitations/implications: The small sample (n = 72) limits generalisation. A wider interdisciplinary effort to address experiences with nursing leadership in Ireland may be needed to inform health services of the issues from a broader perspective. Practical implications: The findings suggest that development of nursing leadership in Ireland may still be in its infancy, and that several obstacles need to be overcome. Originality/value: Very few studies have addressed narratives from nurses regarding personal experiences with nursing leadership. The examples provided by participants have yielded significant insight into the issues they encounter, which are reflective of health care elsewhere. [ABSTRACT FROM AUTHOR]

Aims and objectives: To report the development, testing and validation of an instrument to assess the stressors experienced by student nurses during their older adult clinical placements. Background: The world's population of older adults is accelerating rapidly, with associated increased healthcare demands and a growing need for skilled nursing staff. However, this sector fails to attract adequate numbers of nursing graduates which is leading to a significant gap between nursing supply and demand. Older adult care is considered to be less attractive than other specialties and accompanied by more sources of stress. Design: A quantitative design was used. Methods: Data were collected from a cohort of Irish student nurses (n = 242) completing older adult clinical placements as part of their undergraduate degree. Exploratory and confirmatory factor analysis examined the instrument's underlying latent structure. Discriminant validity was investigated using a confirmatory factor analysis model with covariates. STROBE guidelines for cross‐sectional studies informed reporting of this paper's research. Results: Factor analyses identified two factors relating to "Knowledge and Workload" and "Resources," which were assessed by nine and six items, respectively. Discriminant validity analyses found a significant relationship between age and the workload and knowledge factor, and between year of programme and the resources factor. The new instrument was labelled the Student Nurse Stressor‐15 (SNS‐15) Scale. Conclusions: The SNS‐15 contained some overlap with stressors from extant general student nurse stress instruments and a number of unique stressors encountered in older adult care. Future research directions are discussed. Relevance to clinical practice: The SNS‐15 may assist stakeholders in nurse education and practice with the development of undergraduate degree programmes and clinical placements, and ultimately, in improving patient care and student retention. [ABSTRACT FROM AUTHOR]

Aim This paper reports on the qualitative findings from a national review of a nursing and midwifery scope of practice framework. Background Scope of professional practice frameworks offers a system of rules and principles to regulate its members and demonstrate its responsibility to society. Key issues in reviewing the scope of practice include notions of specialist and advanced practice, accountability, autonomy, competence, supervision, continuing professional development and delegation. Evaluation of scope of practice frameworks has particular application value to nurses, midwives, regulatory bodies and healthcare employers across the globe. Design A mixed methods approach was used. This included a national survey of nurses and midwives and focus groups and interviews with key stakeholders. The qualitative data are reported in this paper. Methods Focus groups and interviews were conducted among a convenience purposive sample of key stakeholders, including nurses and midwives working in the widest range of services and settings in 2014. The participants contributed to thirteen focus groups and thirteen interviews. Findings Six global themes, as follows: Evolution of the nursing and midwifery professions and practice; Scope of practice: understanding and use; Expanding scope of practice; Professional competence; Practice setting and context; Reflections on the current framework. Conclusion Practitioners understand the scope of professional practice and while some see it as empowering others see it as potentially restrictive. Nurses and midwives are generally willing to expand their scope of practice and see it as resulting in improved patient care, improvement in overall quality of standards and increased job satisfaction. [ABSTRACT FROM AUTHOR]

It is frequently claimed that nursing is vital to the safe, humane provision of health care and health service to our populations. It is also recognized however, that nursing is a costly health care resource that must be used effectively and efficiently. There is a growing recognition, from within the nursing profession, health care policy makers and society, of the need to analyse the contribution of nursing to health care and its costs. This becomes increasingly pertinent and urgent in a situation, such as that existing in Ireland, where the current financial crisis has lead to public sector employment moratoria, staff cuts and staffing deficits, combined with increased patient expectation, escalating health care costs, and a health care system restructuring and reform agenda. Such factors, increasingly common internationally, make the identification and effective use of the nursing contribution to health care an issue of international importance. This paper seeks to explore the nature of nursing and the function of the nurse within a 21st century health care system, with a focus on the Irish context. However, this analysis fits into and is relevant to the international context and discussion regarding the nursing workforce. This paper uses recent empirical studies exploring the domains of activity and focus of nursing, together with nurses perceptions of their role and work environment, in order to connect those findings with core conceptual questions about the nature and function of nursing. [ABSTRACT FROM AUTHOR]

Aim. To identify the barriers and enablers to the implementation of a national policy to increase and develop the advanced nurse practitioner (ANP) workforce in Ireland. Background. The Department of Health (Ireland) introduced a policy to increase the number of ANPs to 2% of the nursing workforce. Evaluation provides information to inform successful policy implementation and development of ANP roles in healthcare services. Methods. Qualitative descriptive design. Twenty candidate ANPs participated in four focus groups. Nine key stakeholders were also interviewed. Results. Analysis identified four barriers: lack of infrastructural resources; delay in releasing and arranging replacements for candidate ANPs; role resistance from administration, allied healthcare professionals and other nurses; and lack of organisational readiness. The five enablers were: supportive physicians; Nursing and Midwifery Practice Development Units; supportive directors of nursing; role awareness and clarity; and educational preparation. Conclusions. This evaluation identifies barriers and enablers to the implementation of a national policy to increase the critical mass of advanced practitioners within the healthcare services. Evaluation at the implementation phase informed the roll-out of future advanced practice initiatives. Implications for Nursing Management. To support advanced practice development, leadership, infrastructure, and resource planning are needed to harness known enablers and address identified barriers to the implementation and sustainability of these posts. [ABSTRACT FROM AUTHOR]

Nurses' household preparedness is critical if they are to avoid role conflict and report for duty during an emergency. To date, the alignment between nurses' perceived and actual household preparedness remains under examined. Investigating one of these variables in isolation fails to consider that perceived and actual household preparedness must be high and aligned. If misaligned, vulnerabilities could surface during emergencies, like concerns about family safety, potentially impacting a nurse's commitment to duty during a crisis, or nurses may lack the actual preparedness to continue working long hours during an emergency. An online questionnaire was distributed to registered nurses in Ireland. The questionnaire was informed by a review of the literature and captured nurses' perceived and actual household preparedness, attitudes towards and exposure to a range of emergencies, and pertinent demographic characteristics. The results showed a relationship between how nurses view their household preparedness and their actual preparedness. Regression analyses indicate that while there is an overlap, the factors associated with how prepared nurses think they are and how prepared they are can differ. This means that strategies to boost actual preparedness may differ from those needed to boost perceived preparedness. This finding underscores the importance of psychosocial preparedness. Feeling prepared is crucial as it can influence how one responds in an emergency. Considering both the perceived and actual aspects of household preparedness can lead to a more effective response during emergencies. [ABSTRACT FROM AUTHOR]

fealy g.m. (2004) Journal of Advanced Nursing 46(6), 649–656 ‘The good nurse’: visions and values in images of the nurse The various ways in which the nurse has been publicly portrayed do not merely reflect the value of nursing in society, but also define the boundaries of nursing, and reveal the ideologies and systems of power-brokerage at work in shaping nursing. Therefore, it is of profound interest to the profession to continue to examine the ways in which the nurse is and has been portrayed. This paper aims to present a historical analysis of the image of the nurse in public discourses in Ireland. Using a framework of critical discourse analysis within the method of historical research, the paper draws on documentary primary sources to present an analysis of discourse concerning the ‘good nurse’. In exposing the diverse ways in which the nurse has been depicted in Irish public discourses, the origins of the ‘good nurse’ ideal are identified, the reasons for its continued promotion are critically examined, and the effects of the ideal on the development of nursing in Ireland are considered. While the ways in which Irish nurses have been depicted in public discourses have similarities with international nursing imagery, the ‘good nurse’ ideal has a uniquely Irish expression, indicating that the image of the nurse is both culture-specific and changes to reflect the underlying sociocultural context, and prevailing system of political power and influence. [ABSTRACT FROM AUTHOR]

Accessible summary What is known on the subject? Nationally and internationally there has been a movement away from the traditional medical model towards a more holistic recovery-oriented approach to mental health care delivery., At every level of service provision the emphasis is firmly on recovery and on facilitating active partnership working and involvement of service users, their carers and family members., What this paper adds to existing knowledge? This is the first study to identify on a national level specific areas of care that are addressed most or least by psychiatric and mental health nurses in care planning for mental health service users in Ireland., In addition, this is the first study to identify nationally how the recovery approach is being implemented by psychiatric and mental health nurses in relation to current recovery-orientated policy., What are the implications for practice? Mental healthcare staff require more education on the recovery concept and this needs to be multidisciplinary team wide. Further research is required to establish how best to develop a shared approach to working with service users and their families within the mental healthcare environment., Further investigation is required to help determine how funding could be allocated appropriately for education and training and service development nationally., Abstract Introduction The restructuring of national mental health policy to an integrated recovery ethos demands a clarification in the psychiatric/mental health nurse's role, skills and competencies. Aim/Question To explore the psychiatric/mental health nurse's role and identify skills, competencies and supports required to adopt recovery-orientated policy in practice. Method An exploratory mixed methods study in multiple health services in Ireland with N = 1249 psychiatric/mental health nurses. Data collection used a survey, focus groups and written submissions. Data analysis used descriptive statistics and thematic analysis. Results The medical profession use a symptom-focused approach to mental healthcare delivery. Nurses viewed this as a primary inhibitor to recovery-orientated practice. Professional development in prevention and earlier intervention within primary care environments requires development. Nurses require research support to measure the effectiveness of the mental health interventions they provide. Implications and conclusion The effective implementation of the recovery approach requires a multitude of strategies and narrative threads in an overall medical assessment. Nurses need support from medics in providing consistency of assessments/documentation of required psychosocial interventions. A greater range of specialist services provided by nurses including psychosocial interventions and health promotion is fundamental to quality care and improving service user outcomes in primary care. [ABSTRACT FROM AUTHOR]

Background: Achieving a sustainable health workforce involves training and retaining sufficient staff to deliver health services. The Irish health workforce is characterised by a high level of emigration of Irish-trained staff and a heavy reliance on internationally trained staff. This paper presents qualitative findings from a mixed-method study of doctors, nurses and midwives who have recently emigrated from Ireland., Methods: Using Facebook, this study elicited 556 (388 completed) responses to an exploratory mixed-method online survey in July 2014. Respondents provided rich responses to two free-text questions, one on health worker return (N = 343) and another on health professional emigration (N = 209) from the source country (Ireland)., Results: Respondents emigrated because of difficult working conditions in the Irish health system (long working hours, uncertain career progression), which compared poorly with conditions in the destination country. Respondents' experiences in the destination country vindicated the decision to emigrate and complicated the decision to return. Their return to Ireland was contingent upon significant reform of the Irish health system and an improvement in working conditions, expressed, for example, as: 'It's not about the money, it's about respect . . . we love working in medicine, but we love our families and health more' (RD283)., Conclusions: This paper highlights that doctors, nurses and midwives are emigrating from Ireland in search of better working conditions, clear career progression pathways and a better practice environment. The question for the source country is whether it can retain and attract back emigrant doctors, nurses and midwives by matching their expectations.

Background/Aims The extension of termination of pregnancy services in the Republic of Ireland represents a significant change to practice. As a result, education was provided to assist midwives and nurses to fulfil their expanded role. Using Kirkpatrick's framework, this study aimed to conduct an in-depth evaluation to ascertain if knowledge gained at a termination of pregnancy education programme was applied to clinical practice. Methods Semi-structured interviews were conducted with a purposeful sample of seven midwives and nurses, 3 months after attending a termination of pregnancy education programme. Results Attendance at the programme prompted reflection on practice, with participants providing examples of how they applied the knowledge gained to the care they provide. The complexities of providing a termination of pregnancy service were highlighted, along with additional educational requirements. Conclusions Knowledge gained from the education programme was applied to practice improving termination of pregnancy care. Additional education and training needs identified will guide the development of future programmes. [ABSTRACT FROM AUTHOR]

Accessible summary People with intellectual disability live within their community and will require services to support them at end of life., Often people with intellectual disability are denied access to essential services., This paper identifies the experiences of community nurses caring for persons with an intellectual disability and palliative/end-of-life care needs., Summary Palliative care services have developed over the years to support all persons with life-limiting conditions. Moreover, services for people with an intellectual disability have moved from the traditional institutional setting to supporting people with an intellectual disability to live in their own community and family home. The expansion of palliative care services and integration of people with intellectual disability into their communities has resulted in an increased demand and greater diversity in the population groups accessing palliative care services. This study aims to describe the provision of community nursing support for persons with an intellectual disability and palliative/end-of-life care needs from the perspective of community nurses. A quantitative descriptive cross-sectional survey was employed. On receipt of ethical approval, data were collected through self-reporting questionnaires and descriptive analysis was conducted to describe frequencies and to identify patterns of the respondents using spss version 18. Only 85 people with an intellectual disability were referred to palliative/end-of-life care services over a 3-year period. Those delivering care expressed challenges including, understanding communication styles, late referrals, lack of time, knowledge and skills. Highlighted within the study were the benefits of liaison between family and professional and nonprofessional carers. Findings provide insight into the importance of teamwork, advance planning, knowing the person and best practice in providing palliative/end-of-life care for people with intellectual disability through collaboration. [ABSTRACT FROM AUTHOR]

Purpose: This paper addresses the conceptual wrangle that occurred during the initial stages of a grounded theory doctoral study into the nature of moral distress within multidisciplinary teams (MDTs) working within the acute mental health services in the Republic of Ireland., Design and Methods: While grounded theory methodology directs that face sheet data (biographical details) are not collected unless they emerge as significant events within the data, practitioners within this study were asked to describe the structure, formulation, and practice of their team prior to interview, in order to establish the field of study., Findings: Early analysis of the responses revealed that of 32 multidisciplinary members interviewed, none agreed on structure, formulation, and practice of their MDT., Practice Implications: This finding suggests that caution needs to be taken in assuming a common understanding of the concept of MDT in research, policy formation, and team development., (© 2012 Wiley Periodicals, Inc.)

Introduction: United Nations Sustainable Development Goals (SDGs) were adopted as a plan of action for people, planet, and prosperity by 2030. SDG 3 aims to ensure healthy lives and promote well-being for all ages, and other goals focus on reduction of inequality, abolition of poverty, decent work for all, and building effective, accountable, and inclusive institutions. A community pediatric clinic, Kidscope, was established in a vulnerable Irish community offering free developmental assessment and onward referral of children 0 to 6 years. The Kidscope model involves multiagency input with local public health nurses (PHNs) acting as fundamental partners in the provision of specialist early years support to vulnerable children and families. This study evaluates PHN involvement in Kidscope in the context of SDGs. Objective: To record and understand PHN roles within Kidscope and to capture their contribution to achieving SDGs in a disadvantaged Irish community. Methods: Qualitative stakeholder analysis and mapping design. Snowball sampling identified participants. Data collection involved scoping interviews, questionnaires, one-to-one interviews, and a focus group. A Stakeholder Matrix Table was developed in line with the guiding framework. Transcripts were thematically analyzed. Results: PHNs are key stakeholders in Kidscope contributing to clinic development, delivery, and sustainability. Six themes were identified: lead referrers, in-clinic support, learning and education, child and family follow-up, specialist early years role, and partnership working. PHNs contribute to six SDGs through the Kidscope model. Conclusion: PHNs are fundamental partners in achieving SDGs in a disadvantaged Irish community through ameliorating childhood developmental delay by intercepting the gap within Ireland's early intervention system and disrupting the impact exclusion to healthcare has on vulnerable children and their families. Findings underscore a shift from the current "cradle to grave" model of working toward a specialist early years PHN role. [ABSTRACT FROM AUTHOR]

Similar to other countries, there have been a number of high-profile reports into past and recent cases of child abuse and neglect in Ireland. The most recent of these have been the Monageer Inquiry, the Ryan Report, the Roscommon Child Care Case and the Report of the Independent Child Death Review Group. An analysis of these reports highlights the critical role played by public health nurses with troubled families. It also makes explicit key issues that consistently emerge as problematic in terms of professional practice. This paper summarises the main findings of the reports as they relate to the public health nursing service and identifies key themes emerging along with recommendations arising. The emerging themes relate to assessment, early intervention, record keeping, communication and interdisciplinary working and the role of public health nursing management. [ABSTRACT FROM AUTHOR]

Aim: This paper is a report of a study measuring critical thinking ability in graduates on completion of a Master's degree in Nursing., Background: Nurse education programmes identify the development of critical thinking capabilities as a central outcome for graduates at Master's level. However, despite the centrality of critical thinking to educational curricula, achievement of this outcome has not been evaluated., Method: A cross-sectional cohort study was conducted in Ireland between 2006 and 2007. Critical thinking was measured using the Watson-Glaser Critical Thinking Appraisal tool. The sample consisted of two cohorts: a control cohort (110 students commencing Master's in Nursing programmes) and an outcome cohort (222 students who had a Master's degree in Nursing). The Watson-Glaser Critical Thinking Appraisal scores of the graduate cohort were also compared to previously published norm reference scores in the area of nursing and other higher education professional groups., Results: Graduates had statistically significantly higher critical thinking scores than commencing graduates. Graduates from Master's in Nursing programmes also had similar critical thinking scores to nurses at undergraduate and postgraduate levels in the United States of America. However, scores were lower than those of occupational and academic groups in education and medicine., Conclusion: Graduates from a Master's degree in Nursing make statistically significant gains in critical thinking scores when compared to students commencing the programme. However, the gains were relatively modest and call into question the effectiveness of pedagogical methods used to facilitate the development of critical thinking at Master's level.

Aim: This paper is a report of a study conducted to examine migrant nurses' perceptions and attitudes of integration into the perioperative setting., Background: Adapting to a new culture can be overwhelming for many nurses working in foreign countries. Currently, the Republic of Ireland appears to rely heavily on migrant nurses because of persistent nursing shortages over the last decade. To date, there is little research on how the integration process affects migrant nurses in Ireland., Method: A quantitative descriptive design was used. Data were collected in 2007 using questionnaires distributed to 220 migrant perioperative nurses working in four hospitals in Ireland., Results: There were communication issues between migrant nurses and their work colleagues. Forty-nine percent of migrant nurses found that work practices were different from those in their home countries. Cultural differences were also an issue. Ninety percent of respondents found the support of preceptors beneficial and 96% found hospital orientation programmes valuable., Conclusion: Workshops and in-service education are needed on key practices and procedures performed in the perioperative setting for all new staff. Specific learning outcomes and an achievement timeframe should be developed for each new nurse, based on their previous experience and level of knowledge. Migrant nurses not accustomed to delegating and being assertive need to be supported and given time to acquire these skills and to gain confidence.

Aim: To determine the current level of job satisfaction among nurses in the Republic of Ireland. To identify the factors that make the greatest contribution to nurses' current level of job satisfaction. To establish the difference between (a) the factors that nurses regard as being important to their job satisfaction, and (b) those factors that actually contribute to nurses' current level of job satisfaction. To enter the findings into a database maintained by Market Street Research in the USA., Background: A review of the literature suggests that (a) job satisfaction among nurses is low, and (b) job satisfaction research in nursing is growing., Methods: This paper represents the descriptive findings of a study that used a mixed-method design. Data collection involved the use of a postal questionnaire survey and the sample was selected using stratified random sampling., Findings: The findings confirmed low to moderate levels of job satisfaction among nurses. Factors such as professional status, interaction and autonomy made the greatest contribution to nurses' job satisfaction., Conclusion: Overall, the findings are consistent with those of previous research on nurses' job satisfaction. The implications are that health service administrators and nursing managers need to design and implement initiatives that will promote professional status, interaction and autonomy among nurses within their organizations and address the reasons why task requirements, organizational policies and pay make less of a contribution to the current level of job satisfaction.

Aim: The aim of this paper is to report findings from a study investigating nurses' experiences of strike in one public general hospital in the Republic of Ireland., Background: October 1999 heralded the first nationwide nurses strike in the Republic of Ireland. The strike reflected an international shift towards industrial action in a profession which had previously viewed such action as the antithesis of professional behaviour., Methods: A focused ethnographic approach studied a group of striking Registered Nurses, not as a culture per se, but as a collection of individuals sharing a common human experience. A purposive sampling approach identified eight information-rich cases from a modified quota structure. Semi-structured interviews were carried out immediately prior to, during and at the end of the 1999 strike. The participants also maintained journals which were explored during the interviews. Data were analysed using a constant comparative approach, seeking to achieve category saturation., Findings: Four strike versions were identified. The anticipatory version is constructed as an inevitable protest, the orientation version as history-making solidarity and the performing version as a job of work. The withdrawal version is constructed as a conspiracy from which nurses are excluded. These versions portray ongoing tension that is experienced between conflicting self-identities of Registered Nurses as nurses and as strikers. The analysis revealed strategies adopted to resolve tensions between these identities within the dimensions of carer, patient advocate, multidisciplinary team member and professional., Conclusions: Debate on such potentially contentious issues by individual nurses, hospital managers and union leaders may facilitate awareness and preparation in advance of any future industrial action. Strategies that may be helpful in the event of a strike include a prestrike orientation programme for the entire organization, a support system for staff during the strike and informal de-briefing among all staff in the context of a social gathering when the strike is over.

Aim: This paper aims to outline the development and results of an instrument that describes the assertive behaviour of nurses., Background: As a largely female dominated profession, nurses are anecdotally regarded to be in traditional subservient roles. In addition, nurses aspire to public images of nurses as "nice". These factors are thought to reduce nurses' capacity to behave in an assertive manner. However, little empirical evidence exists that describes the assertive skills of today's practicing nurse., Methods: A 44-item questionnaire collected data from 27 registered nurses., Results: Items that feature strongly in the respondents reported behaviour are allowing others to express opinions, complimenting others and saying no. These findings suggest that nurses behave in a passive way, conforming to the image of a nice nurse. Nurses were less adept at disagreeing with others opinions and providing constructive criticism. Differences emerged in behaviours between the three groups., Conclusion: Assertive behaviour is a skill, i.e. utilized according to interpersonal and role relationship. Factors within the work environment such as colleagues and atmosphere can support or prevent these behaviours.

Abstract Schools of Nursing have witnessed an increase in the number of nursing students who struggle with learning difficulties. Support and accommodations are available in academic settings. Because nursing is a practice profession students also learn in clinical settings, which may not have similar support and accommodations. The compatibility of the clinical setting for the education of students with learning difficulties has not been studied. Staff nurses responsible for the clinical education of students and new nurses receive little preparation for their role as educator, and may not feel supported to meet the needs of those with learning difficulties. This is part one in a series of articles about the clinical education of nursing students with learning difficulties. This paper provides a framework and literature review for the development of a study (part 2) exploring the issue from the perspective of the nurse preceptors who educate students and new graduates with learning difficulties. Highlights • There is an increase in the number of students in school of nursing with learning difficulties. • The literature on nursing students with learning difficulties can be understood from the perspectives of nursing schools, faculty, and students. • Nurse educators have a role in preparing the learning environments for students with learning difficulties. [ABSTRACT FROM AUTHOR]

coyne i., o'neill c., murphy m., costello t. & o'shea r. (2011) What does family-centred care mean to nurses and how do they think it could be enhanced in practice. Journal of Advanced Nursing 67(12), 2561-2573. Abstract Aim. This paper is a report of the qualitative findings of a multisite survey in seven children's units in Ireland. In this survey, nurses caring for children identified their practice and perception of family-centred care. Background. International research has identified inconsistencies with the provision and application of family-centred care in practice. Existing research studies illustrate barriers to family-centred care including nurses' attitudes to families and a lack of support and resources for the philosophy. Method. A descriptive survey design was employed to collect data in 2008-2009. Questionnaires were distributed to nurses ( n = 750) which yielded a response rate of 33% ( n = 250). The nurses completed a 47-item questionnaire which examined nurses' perceptions and practices of family-centred care, the quantitative findings of this study will be reported in another publication. The questionnaire contained two open-ended questions and the data from these questions are reported here. Findings. While nurses accept family-centred care as an ideal philosophy for the care of children and their families, the implementation of family-centred care in practice would seem to present challenges for nurses. The majority in this study indicated that they required further organizational and managerial support to fully implement family-centred care practices. Two interrelated themes were identified 'the components of family-centred care' and 'enhancing family-centred care'. Conclusion. To provide good quality family-centred care nurses need adequate resources, appropriate education, support for managers and support from other healthcare disciplines. [ABSTRACT FROM AUTHOR]

Public health nurses in Ireland are generalist practitioners with a wide range of roles that address the needs of clients in the community across their lifespan. Child protection is one of many of the roles of Irish public health nurses. However, with increasing caseloads, birth rates and aging populations, their child protection role is becoming more difficult to define and practise safely. This paper presents a key finding of a qualitative study that explored the views of a group of public health nurses (n=10) regarding their role with pre-school children. A significant theme following analysis of the interviews were the nurses' expressed concerns on their role in child protection. There is a need to define the role practised by public health nurses in child protection and to achieve a standard for this nationally. [ABSTRACT FROM AUTHOR]

Aim. This paper is a report of a descriptive study of nurses' and midwives' clinical leadership development needs. Background. Nurses and midwives are expected to fulfil a leadership role at all levels, yet efforts to strategically support them are often unfocused. An analysis of clinical leadership development needs can provide the foundation for leadership initiatives to support staff. Method. A mixed methods design was used. A questionnaire was sent to 911 nurses and midwives and 22 focus groups comprising 184 participants were conducted. Data were collected between March and June 2009 across all promotional grades of nurses and midwives in Ireland. Repeated measures ANOVA with Greenhouse-Geisser adjustment was used for post hoc pair wise comparisons of the subscale dimensions of clinical leadership. ANOVA with Tukey's post hoc method was used for comparison between grades on each individual subscale. Thematic analysis was undertaken on the focus group data. Results. Results reveal that needs related to development of the profession were the highest for all grades. The staff grade expressed a higher need in relation to 'managing clinical area', 'managing the patient care' and 'skills for clinical leadership' than managers. Qualitative analysis yielded five themes; (1) clinical leadership and leaders from a nursing and midwifery perspective; (2) quality service from a nursing and midwifery perspective; (3) clinical leaders' roles and functions; (4) capital and (5) competences for clinical leaders and leadership and the context of clinical leadership. Conclusion. Clinical leadership concerns quality, safety and effectiveness. Nurses and midwives are ideally placed to offer the clinical leadership that is required to ensure these patient care outcomes. Development initiatives must address the leader and leadership competencies to support staff. [ABSTRACT FROM AUTHOR]

To evaluate the learning needs of patients post percutaneous coronary intervention from the perspective of both patients' and cardiac nurses'. Increasing numbers of patients with cardiovascular disease are managed using postpercutaneous transluminal coronary angioplasty. This paper presents findings of a study which explored the cardiac learning needs of these patients. Descriptive survey from one cardiac unit where approximately 30 post percutaneous coronary intervention were performed per month. Self-report data were provided by patients using an adaptation of the Nursing Information and Support scale for health-related quality of life informational needs. This scale includes physical, psychosocial, emotional and disease-specific dimensions. The questionnaire was also provided to cardiac nurses. Statistical tests applied were Spearman's Correlation and the Mann-Whitney U test. Patients ( n = 33) and nurses ( n = 13) completed the questionnaire. Disease-specific items, physical action, psychosocial and emotional information were the categories that patients found most important. Cardiac nurses perceived physical action as least important and focused more on psychosocial and emotional issues. Individual items revealed the patients particularly valued their interaction with the nurses. Patients appear to be more concerned with their immediate state and disease rather than their psychosocial or emotional state. Mean rankings within scales demonstrate the value patients place on the nurse-patient relationship and the time needed for this. Findings may be helpful to nurses who wish to addresses secondary prevention issues with patients' post percutaneous coronary intervention who experience short hospital stays. [ABSTRACT FROM AUTHOR]

Aim. This paper is a report of a study measuring attitudes of primary care nurses towards caring for people with hepatitis C. Background. Hepatitis C is a major public health problem. Attitudes to caring for people with hepatitis C vary and can have an impact on nursing care practices. International literature has identified discriminating practices amongst healthcare professionals including nurses. There is limited research examining primary care nurses' attitudes to caring for people with hepatitis C. Methods. A cross-sectional postal census survey of 981 nurses working in one health board region in the Republic of Ireland was conducted during the period March 2006 to June 2006. Results. A response rate of 57.1% (n = 560) was achieved. Exploratory factor analysis of an attitude scale identified three latent variables: 'infection control behaviour', 'caring' and 'fear'. Attitudes were generally positive towards caring for persons with hepatitis C; however, 51.7% of respondents would use additional infection control precautions if caring for someone with known hepatitis C. Younger nurses and those educated to degree level and above held significantly more positive attitudes to caring. Nurses agreed that they have a central role in managing and treating people with hepatitis C; however, many agreed that they lack the knowledge and skills to care for persons with hepatitis C. Conclusions. Negative attitudes can result in discriminatory experiences for persons with hepatitis C or at risk. Nurses require ongoing education on hepatitis C to improve knowledge, to limit concerns and ensure adherence to infection control guidelines. [ABSTRACT FROM AUTHOR]

Aim. This paper is a report of a study conducted to compare knowledge of hepatitis C virus infection amongst three groups of registered nurses working in primary care, to identify their current sources of information and access to educational resources. Background. Hepatitis C virus infection is a public health problem;no vaccine exists to prevent the disease. Previous studies identified limitations in nurses' knowledge of hepatitis C virus infection and the impact on care. Limited research has been conducted in primary care. Methods. A cross-sectional postal census survey of 981 nurses working in one Irish health board region was conducted March--June 2006. Questionnaires measured knowledge of hepatitis C virus infection. Data were collected on demographics, current working practices, information resources and previous education. Results. The response rate was 57.1% (n = 560). A minority (27.3% 145/531) of respondents agreed they were well informed about the virus. Almost 40% reported having contact with clients with the virus; however, information and service provision differed. Factors influencing higher knowledge included: contact with clients with hepatitis C virus infection (P < 0.0001), working in the addiction services (P < 0.0001), educated to degree level and above (P < 0.010) and previously attending education programmes (P < 0.0001). Only 21.5% (119/553) of respondents had attended any form of education on hepatitis C virus infection. Conclusion. Gaps in nurses. knowledge exist and can limit information and advice. Educational and information resources need to be developed for registered nurses working in primary care; care for clients with hepatitis C virus infection is not the sole remit of the addiction services. [ABSTRACT FROM AUTHOR]