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Aims and objectives: The purpose of this study was to examine the extent to which staffing adequacy predicts nursing teamwork, controlling for demographic and background variables. Background: Findings from former studies indicate that hospital, unit and staff characteristics may be related to nursing teamwork, such as type of hospital and unit, role, gender, age, work experience, type of shift worked, shift length, number of working hours per week, overtime and staffing adequacy. Teamwork as well as staffing is identified as significant contributors to patient and staff safety in hospitals. However, the contribution of staffing to the quality of nursing teamwork is scarcely studied. Design: This was a quantitative descriptive cross‐sectional study using the paper‐and‐pencil questionnaire Nursing Teamwork Survey‐Icelandic. Methods: The study was conducted in 27 inpatient units in eight hospitals in Iceland with a sample of 925 nursing staff members. Participants were 567 registered nurses, practical nurses, unit secretaries and nurse unit managers. The Strengthening the Reporting of Observational Studies in Epidemiology checklist was used for this paper. Results: When controlling for unit type, role, experience on current unit and intent to leave, perceived adequacy of staffing alone explains up to 10% of overall teamwork. Unit type, role, years of experience on current unit and perceived staffing adequacy correlated significantly with overall teamwork. Conclusions: The findings of this study indicate that unit and staff characteristics, including perceived adequacy of staffing, are associated with and explain the variability in nursing teamwork on inpatient hospital units. The findings of this study provide important information for clinical nurses, nurse managers, policymakers and instructors in health care. Relevance to clinical practice: The findings underline the importance of adequate staffing for nursing teamwork in inpatient hospital units. [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]

This paper reviews impacts on the nursing workforce of health policy and reforms of the past two decades and suggests reasons for both current difficulties in retaining nurses in the workforce and measures to achieve short-term improvements. Difficulties in retaining nurses in the New Zealand workforce have contributed to nursing shortages, leading to a dependence on overseas recruitment. In a context of global shortages and having to compete in a global nursing labour market, an alternative to dependence on overseas nurses is self-sufficiency. Discursive paper. Analysis of nursing workforce data highlighted threats to self-sufficiency, including age structure, high rates of emigration of New Zealand nurses with reliance on overseas nurses and an annual output of nurses that is insufficient to replace both expected retiring nurses and emigrating nurses. A review of recent policy and other documents indicates that two decades of health reform and lack of a strategic focus on nursing has contributed to shortages. Recent strategic approaches to the nursing workforce have included workforce stocktakes, integrated health workforce development and nursing workforce projections, with a single authority now responsible for planning, education, training and development for all health professions and sectors. Current health and nursing workforce development strategies offer wide-ranging and ambitious approaches. An alternative approach is advocated: based on workforce data analysis, pressing threats to self-sufficiency and measures available are identified to achieve, in the short term, the maximum impact on retaining nurses. A human resources in health approach is recommended that focuses on employment conditions and professional nursing as well as recruitment and retention strategies. Nursing is identified as 'crucial' to meeting demands for health care. A shortage of nurses threatens delivery of health services and supports the case for self-sufficiency in the nursing workforce. [ABSTRACT FROM AUTHOR]

Aims and objectives This paper aims to provide an updated comprehensive review of the research-based evidence related to the transitions of care process for adolescents and young adults with chronic illness/disabilities since 2010. Background Transitioning adolescent and young adults with chronic disease and/or disabilities to adult care services is a complex process, which requires coordination and continuity of health care. The quality of the transition process not only impacts on special health care needs of the patients, but also their psychosocial development. Inconsistent evidence was found regarding the process of transitioning adolescent and young adults. Design An integrative review was conducted using a five-stage process: problem identification, literature search, data evaluation, data analysis and presentation. Methods A search was carried out using the EBSCOhost, Embase, MEDLINE, Psyc INFO, and AustHealth, from 2010 to 31 October 2014. The key search terms were (adolescent or young adult) AND (chronic disease or long-term illness/conditions or disability) AND (transition to adult care or continuity of patient care or transfer or transition). Results A total of 5719 records were initially identified. After applying the inclusion criteria a final 61 studies were included. Six main categories derived from the data synthesis process are Timing of transition; Perceptions of the transition; Preparation for the transition; Patients' outcomes post-transition; Barriers to the transition; and Facilitating factors to the transition. A further 15 subcategories also surfaced. Conclusions In the last five years, there has been improvement in health outcomes of adolescent and young adults post-transition by applying a structured multidisciplinary transition programme, especially for patients with cystic fibrosis and diabetes. However, overall patients' outcomes after being transited to adult health care services, if recorded, have remained poor both physically and psychosocially. An accurate tracking mechanism needs to be established by stakeholders as a formal channel to monitor patients' outcomes post- transition. [ABSTRACT FROM AUTHOR]

Aims and objectives The aim of this paper is to describe how selected demographic characteristics 'explain' the observed variance in the distribution of maternal health literacy estimates in adolescents attending antenatal care in Uganda, as estimated by the 'Maternal health literacy scale'. Background By the age of 20 years, more than 60% of Ugandan females are mothers. In the Busoga region of Uganda, the percentage of pregnant adolescents and adolescent mothers is at its highest (above 30%). Design Validated questionnaire survey. Methods The Maternal health literacy scale was administered to 384 adolescents aged 15-19 years attending antenatal care in Jinja and Iganga districts of the Busoga region during the period of July 2013-December 2013. The Mann-Whitney U test in SPSS21 was used to determine if the two levels of dichotomised person factors, i.e. demographic characteristics, relate to 'significantly' different mean maternal health literacy estimates, not strictly following the normal distribution, as measured by the Maternal health literacy scale. Results The person factors, age, education level, pregnancy order and prepregnancy awareness about conception, explained approximately 12% of the observed variance in maternal health literacy estimates. Conclusions Prepregnancy awareness about conception was the single most contributory factor to the observed variance in estimated maternal health literacy levels. More research on women of childbearing age is warranted to explore the impact of further person factors on the maternal health literacy in pregnant adolescents. Relevance to clinical practice Using the person factors found to show 'significant' impact on maternal health literacy in pregnant adolescents, target-specific interventions aimed at improving maternal health literacy in pregnant adolescents can be formulated. By accounting for these factors in reproductive health policy designs, one might take preventive actions to curb the prevalence of adolescent pregnancies in both developing and developed countries. [ABSTRACT FROM AUTHOR]

Aims and objectives To identify the reported predictors of the practice of restricting a child for a clinical procedure in hospital. Background Previous work in this area is dominated by discussion papers and suggestions for addressing the issue of restriction. This is the first study to explore reported predictors of this practice with a view to implementing change based on research findings. Design A factorial survey was developed, which incorporated the use of vignettes with various scenarios. The factorial design enabled exploration of the interaction of multiple factors on the practice of restriction. Methods One hundred and sixty-six nurses caring for children were each sent 10 vignettes and asked to rate their likelihood to restrict a child based on the vignettes. A total of 105 nurses responded to the survey, representing a response rate of 63%. Hierarchical linear regression was used to identify reported predictors of restriction. Results Nurses were more likely to restrict a child if they had prior instruction on safe holding, if there was no play therapist available, if the nurse was a registered general nurse with no other registration qualification, if the child required cannulation or if the child was less than five years of age. Conclusion This study identified predictors of restriction from the perspective of practicing nurses; the evidence needs to be used in developing clinical guidelines and in multidisciplinary education. Relevance to clinical practice There is a need to move from any presumption of restriction towards more critical consideration of the individual requirements of the child. There is a need to increase the numbers of nurses receiving specialist training on the care of a child in hospital. The importance of a well-resourced play therapy service is supported, and there is a need for multidisciplinary work to explore alternatives to restriction. [ABSTRACT FROM AUTHOR]