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The article offers information on how research is defined as a systematic inquiry using orderly disciplined methods to answer questions or to solve problems. Topics include the research requires academic discipline has coupled with specific research competencies so that an appropriate study is designed and conducted, and leading to the drawing of relevant conclusions relating to the explicit aim/s of the study.

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]

Aim: this article proposes a radical new approach to the monitoring and governance of services, and the education and training of nurses to meet ‘failure to rescue’ requirements. Background: healthcare policy in the UK that seeks to ensure safe and effective services for the acutely ill has largely failed, resulting in adult patients dying unnecessarily. Despite grand rhetoric, UK governments have distanced themselves from implementation, resulting in patchy localised developments and creating inconsistent service responses. Design and data sources: this article draws on a review of research and UK policy literature and best international practice to propose a new national framework approach that combines competency development, governance and performance monitoring to address ‘failure to rescue’ shortcomings. Implications for nursing: paramount is a nationally agreed and fit-for-purpose competency tool using simulation to assess staff in order to improve recognition of the deteriorating patient. Service improvements should include increased investment in telemedicine; service performance should be communicated through publicly available ratings and overseen by patient panels; and governance will require strengthening through enhanced Care Quality Commission/Monitor input, which should be linked to the maintenance of foundation trust status. Conclusion: health professional bodies, regulators, providers and the Government must work together to strengthen the safety and effectiveness of acute services. This will require investment in staff competency and enhancement of the governance to ensure services consistently meet public expectations and reduce unnecessary deaths. [ABSTRACT FROM AUTHOR]

Background/aim: The aim of this scoping review was to summarise the current evidence for peer-to-peer support and its impact on quality of life (QoL) in head and neck cancer (HNC). Methods: Five search engines were used—PubMed, CINAHL, APA PyscInfo, Web of Science and HaNDLE-on-QoL—to look for publications between 1981 and 2020. Adapted PICO (population, intervention, comparator and outcome) and Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) methodology was used. Results: Of the 1408 papers identified, 10 met the inclusion criteria: five qualitative, two cross-sectional, one case-control, one cohort and one quasi-experimental design. There were four common themes: patient experience of peer-to-peer support, delivery of peer-to-peer support, engagement with peer-to-peer support and impact on QoL. Conclusion: This review highlights the paucity of evidence with regard to QoL and peer-to-peer support in HNC. It provides a summary of the literature and identifies considerations for clinical practice and future research. [ABSTRACT FROM AUTHOR]

Venous leg ulcer treatment is frequently discontinued in hospitals in contravention of national guidance, significantly affecting patient outcomes and increasing NHS costs. Aim: To identify, from the published literature, reasons for variable implementation. Method: Systematic review with narrative synthesis, including full papers in English with empirical qualitative data. Synonyms for venous leg ulcer, compression therapy and secondary care were searched across a range of health-related databases. The Critical Appraisal Skills Programme (CASP) checklist determined study quality, and meta-ethnography was used for data synthesis. Results: 7040 titles and abstracts and 41 full-text papers were screened with four papers selected. Three key themes were generated: educational needs surrounding implementation of compression therapy, patient factors regarding adherence and organisational resources including availability of appropriate equipment and trained staff. Conclusion: Barriers at the ward level were identified. There is a need to better understand why hospitals are not addressing them. [ABSTRACT FROM AUTHOR]

Aim: Rapidly evolving roles in nursing require exploration and description. This review aims to examine the role of the clinical nurse specialist (CNS) in stoma care from the UK perspective. Design: A scoping review was undertaken using the Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines. Data were synthesised using content analysis to derive meaning units and themes. Data sources: Three electronic databases were used to conduct the search: Embase, AMED and Ovid Medline. Additional sources identified through the reference lists of included studies and guidelines were also included. Methods: Two reviewers undertook the search for articles that described the role of the stoma care CNS in the UK. Any disagreements were to be resolved through discussion. Results: Seven papers met the eligibility criteria. Analysis resulted in 184 unique meaning units. Meaning units were grouped into themes reflecting the four pillars of advanced practice: advanced clinical practice; leadership; facilitation of education and learning; and evidence, research and development. The fewest meaning units were attributed to the evidence theme (n=13) and the most related to advanced clinical practice (n=107) such as having specialist knowledge and skills to manage complications. Conclusion: The stoma care CNS role reflects the four pillars of advanced practice. These practitioners are valuable, carrying out a complex role that involves high-level, specialist decision-making skills. The results from this scoping review could be useful in service development; they will be used to inform the Association of Stoma Care Nurses UK modified Delphi consensus to examine the views of stoma care CNS practitioners. [ABSTRACT FROM AUTHOR]

This article is designed to help authors write scholarly articles for publication in science and healthcare journals. A comprehensive model based on 11 steps and detailing the structure expected for a journal is suggested for the writing of a range of papers. This is in keeping with the recognised style of a number of academic journals. The article encourages authors to submit their papers for publication with the intention of enhancing the quality and safety of care provided to patients, clients and service users. [ABSTRACT FROM AUTHOR]

Background: Female genital mutilation (FGM) is a cultural practice with numerous negative health consequences. Due to migration from countries where FGM is prevalent into high-income countries, there is increased awareness within non-practising communities, with emphasis on FGM's illegal nature and the negative impacts on women. It is therefore vital for health professionals to be knowledgeable to provide adequate patient care. Aim: This review aimed to synthesise literature to report the understanding and experiences of health professionals caring for females affected by FGM in high-income countries. Methods: A systematic search was conducted on three databases: Medline, Embase, and the Cumulative Index to Nursing and Allied Health Literature (CINAHL). Inclusion and exclusion criteria were applied to select the papers. Findings from included papers were synthesised using thematic synthesis. Findings: Eight articles met the criteria. Four themes were generated: FGM knowledge, training, attitudes and caring for FGM patients. Conclusion: Health professionals' knowledge and experiences of FGM tend to be varied. This review highlights the need of training for health professionals in high-income countries to strengthen their FGM knowledge. [ABSTRACT FROM AUTHOR]

Writing for publication is often seen as an arduous, daunting task reserved mainly for those in academia. This paper represents the first author’s experience over the past 2 years of working on writing papers for publication in the context of personal and academic development. The aim is to reflect on the first author’s journey towards publication with the intention of encouraging nursing staff to make their work visible and validate their practice through publication. This personal journey was made easier by the encouragement, help and support of the second author, a university lecturer acting as a mentor, advisor and critical friend. This paper is also intended to assure and give courage to those who have considered writing about their practice but are reluctant to do so. [ABSTRACT FROM AUTHOR]

The article discusses the British government's July 2012 report "Caring for our future: reforming care and support" which examines health and social policy. The White Paper or report outlines a strategy for reforming the health care system so it will be focused on preventive measures as well as on promoting independence and wellbeing,

Background: While nursing education has been forecast to continue to grow, placement capacity is now the key factor precluding growth in supply. Aims: To provide a comprehensive understanding of hub-and-spoke placements and their ability to increase placement capacity. Method: A systematic scoping review and narrative synthesis were used (Arksey and O'Malley, 2005). PRISMA checklist and ENTREQ reporting guidelines were followed. Findings: The search returned 418 results. After a first and second screen 11 papers were included. Results suggest that hub-and-spoke models were generally evaluated favourably by nursing students, with a range of benefits reported. However, many of the studies included in the review were small and of low quality. Conclusion: Given the exponential increase in applications to study nursing, hub-and-spoke placements appear to have the potential to better meet these increased demands, while also providing a number of benefits. [ABSTRACT FROM AUTHOR]

In modern society, people engage in social interactions and activities outside their own home. When in public settings people may need to eliminate bodily waste, so public toilets are required. Accessibility, availability and adaptability are essential principles for safe, private, and purposeful visits to public toilets. A diverse range of individuals use public toilets: various age profiles, all gender groups, vulnerable individuals and people with additional needs. Public toilets essentially need to be a place of privacy, safety and cleanliness to facilitate elimination of urine, evacuation of faeces, management of menstruation, and changing/disposing of continence wear products in a secure environment. [ABSTRACT FROM AUTHOR]

There is an increasing expectation that nurses, whether they work in clinical practice management, education or research, will publish. At the same time there remains a mystique about the best way to go about this. This article provides a simple commentary suggesting ten steps to help you publish in a professional journal. [ABSTRACT FROM AUTHOR]

The article focuses on electronic patient records and the role that they can play in helping health care facilities become paper-light. In the article the author offers his opinions on the benefits of electronic medical records and on an electronic health program policy statement which was released in June of 2008 by the Royal College of Nursing.

Background: Early warning scores (EWS) are an integral part of the care of acutely ill patients. Unfortunately, in the few studies where the accuracy of EWS has been tested it has been found to be lacking, with serious implications for quality of care. Aim: to determine if the provision of computer-aided scoring could increase the accuracy and efficiency of EWS calculations, when compared with the traditional pen-and-paper method, and to determine if it was acceptable to users. Design: 26 nurses from two surgical assessment wards in two hospitals were studied. The study was conducted in three phases. Phase 1 -- a classroom-based exercise where nurses were given ten patient vignettes and asked to derive EWS using traditional pen-and-paper methods; Phase 2 -- the same as phase 1, but using a hand-held computer to derive EWS; Phase 3 -- the same as phase 2, but was a follow-up exercise undertaken in the ward environment, 4 weeks after computer-aided scoring was implemented in the two wards. Each phase closed with a user perception/attitudes questionnaire. Results: Accuracy and efficiency -- phase 1 was associated with a significantly lower overall accuracy (152/260, 58%) compared with phase 2 (96%; difference in proportions 38%, 95% confidence interval 31--44%, P<0.0001). There was a small but significant reduction in accuracy from phase 2 (96%) to phase 3 (88%) (8% difference, P=0.006). The mean time to derive an EWS reduced from 37.9 seconds in phase 1 to 35.1 seconds in phase 2 (P=0.016), down to 24.0 seconds in phase 3 (P<0.0001). User acceptability: in phase 1, nurses favoured the pen-and-paper method in all respects except accuracy. In phase 2, nurses' views shifted significantly in favour of the hand-held computer, with little deterioration in the follow-up phase 3. Conclusions: a hand-held computer helps to improve the accuracy and efficiency of EWS in acute hospital care and is acceptable to nurses. [ABSTRACT FROM AUTHOR]

Background: New treatment options have significantly improved the life expectancy of myeloma patients such that their cause of death is increasingly likely to be from something other than myeloma. Furthermore, the adverse effects of short- or long-term treatments as well as the disease are impacting on quality of life (QoL) for longer periods of time. Understanding people's QoL and what is important to them, is part of providing holistic care. Although QoL data has been collected for many years in myeloma studies, they have not been used to inform patient outcomes. There is growing evidence that supports the assessment of 'fitness' and consideration of QoL as part of routine myeloma care. A national survey was carried out to discover which QoL tools are currently being used in the routine care of myeloma patients, by whom and at which time point. Methods: An online survey using SurveyMonkey was adopted for flexibility and accessibility. The link to the survey was circulated via Bloodwise, Myeloma UK and Cancer Research UK contact lists. Paper questionnaires were circulated at the UK Myeloma Forum. Results: Data about practices in 26 centres were collected. This included sites across England and Wales. Three out of 26 centres collect QoL data as part of standard care. QoL tools used include EORTC QLQ-My20/24, MyPOS, FACT-BMT and Quality of Life Index. Questionnaires were completed by patients before, during or after a clinic appointment. Clinical nurse specialists calculate the scores and create a care plan. Conclusion: Despite growing evidence to support an holistic approach to management of myeloma patients, there is a lack of evidence to confirm that health-related QoL is being addressed in standard care. This is an area that needs further research. [ABSTRACT FROM AUTHOR]

HIGHLIGHTS: What we know about the topic: Recommendations for the use of vascular access care bundles to reduce infection are followed for different devices. The risk of arterial catheter-related infection is comparable with short-term, non-cuffed central venous catheters. There are practice concerns for clinicians inserting and caring for peripheral arterial catheters. What this paper adds: The selected studies had a theme of decreased infection after using bundled strategies for all devices. Few studies addressed use of bundles for care of peripheral arterial catheters. High-quality research should be performed about using care bundles for insertion and care of arterial catheters. Introduction: A scoping review of the literature was performed. Aims/objectives: To find information on the use of care bundles for care of arterial, central, and peripherally inserted venous catheters. Methods: Data was extracted by 2 independent researchers using standardized methodology Results: Results of 84 studies included 2 (2.4%) randomized controlled trials, 38 (45.2%) observational studies, 29 (34.5%) quality projects, and 15 (17.9%) reviews. Populations had more adults than pediatric patients. All studies had the most prominent theme of decreased infection in all devices after using bundle strategies. Discussion and conclusions: The mapping of available evidence strongly supports the use of care bundles to reduce infection in the care of all intravascular devices. However, deficiencies regarding practice concerns about insertion and care of arterial catheters highlight areas for future research with the aim to eliminate the gap in the evidence of studies of care bundles for peripheral arterial catheters. [ABSTRACT FROM AUTHOR]

Background: Vitamin D is associated not only with effects on calcium and bone metabolisms but also with many chronic diseases. Low vitamin D levels in patients with Alzheimer's disease have been widely reported in the literature. Aim: The purpose of this study was to critically review the potential benefit of vitamin D supplementation in individuals with Alzheimer's disease living in the community. Methods: A systematic literature search was conducted in PubMed, CINAHL, EMBASE and the Cochrane Library for papers published 2011–2018. Results: Seven papers were selected, consisting of one clinical trial, five cohort studies and one systematic review. Studies showed an association only between vitamin D deficiency and lower attention in older people. None of the reviewed studies provided evidence of a positive impact of vitamin D supplementation on cognitive function in older people with Alzheimer's disease. Conclusion: There was no evidence that vitamin D supplementation has a direct benefit for Alzheimer's disease. The review synthesised the existing body of knowledge and concluded that optimum levels of vitamin D (neither too low nor too high) do appear to have positive effects on patient outcomes and quality of life. It is still unclear why vitamin D intake is inadequate as people age. Further research is needed to clarify vitamin-D-related aspects of Alzheimer's disease. [ABSTRACT FROM AUTHOR]

This article discusses how to transform material worthy of dissemination into a form that leads to successful publication. It focuses on publication of systematic and literature reviews, empirical studies and conceptual analyses undertaken as part of a course of academic study. An increasing number of nurses and midwives are undertaking healthcare-related courses at BSc, MSc, MPhil and PhD level. Many of their theses are ultimately left to gather dust on library shelves, and are only read by examiners. The authors have worked with many novice writers whose attempts to write up their theses have been unsuccessful for a number of reasons. These are explored in this article. Suggestions for avoiding the many pitfalls that can prevent publication are offered. [ABSTRACT FROM AUTHOR]

This article discusses how to transform material worthy of dissemination into a form that leads to successful publication. It focuses on publication of systematic and literature reviews, empirical studies and conceptual analyses undertaken as part of a course of academic study. An increasing number of nurses and midwives are undertaking healthcare-related courses at BSc, MSc, MPhil and PhD level. Many of their theses are ultimately left to gather dust on library shelves, and are only read by examiners. The authors have worked with many novice writers whose attempts to write up their theses have been unsuccessful for a number of reasons. These are explored in this article. Suggestions for avoiding the many pitfalls that can prevent publication are offered. [ABSTRACT FROM AUTHOR]

The Productive Ward: Releasing time to care (PW) initiative is predominantly a nurse-led quality improvement (QI) offering, designed to streamline ward work processes and clinical environments in an attempt to 'release time to care'. It has been implemented widely in the UK, recently attracting international interest. This paper systematically reviews the literature relating to the PW initiative, highlights and ranks the reported effects and impacts from a nursing perspective. Nine themes emerged from our content analysis. This paper examines the three most reported themes--empowerment, leadership and engagement--exploring how they may influence the opportunities for implementing and sustaining the initiative. This study brings some experience, learning and insight from the PW initiative to those currently involved in implementation. It also highlights some elements of change not being delivered by PW. The comprehensive list of reported impacts and effects, from a nursing perspective, adds value to senior nurses attempting to cultivate a culture of QI. [ABSTRACT FROM AUTHOR]

Electronic assessment is gaining popularity in clinically based elements of pre-registration nurse education. In this study, the authors explored student nurse and mentor experiences during transition from a paper to an electronic system. Mixed research methods used included survey questionnaires and focus groups. Student nurses and their mentors (both n=5) discussed and rated their confidence and skills in information technology and their experience of an electronic assessment document before and after two successive clinical placements. Students’ self-reported confidence increased after both placements; mentors’ confidence fell after the first placement. Students reported the fewest needs for additional support, while mentors expressed anxieties about system navigation and time required. The main barrier was lack of access to computers connected to the internet in the practice environment. Nevertheless, students and mentors were receptive to the change. Training and support was seen as essential. Serious challenges in up-scaling this system for complete student cohorts lie in wait if computer availability is not addressed. [ABSTRACT FROM AUTHOR]

The article presents the discussion on raising the age of the sale of tobacco by one year. Topics include smokefree generation' by phasing out the sale of tobacco by bringing forward legislation that would make it an offence to sell tobacco products to anyone born on or after 1 January; and Vaping is less harmful than smoking as vapes do not contain tobacco, and they are used to support people.

Background: Cancer-related pain is a complex multidimensional experience that affects all aspects of life. To support those impacted by cancer-related pain it is essential that health professionals have adequate knowledge in its assessment and management. Aims: To explore the knowledge of health professionals regarding cancer-related pain. Methods: A scoping review methodology was used to systematically search the literature published between 2010 and 2020. Databases CINAHL, Medline and PsycINFO were searched using terms 'cancer pain', 'healthcare professional', 'knowledge', 'attitudes' and 'barriers'. Findings: The search identified 38 articles. They focused on nursing knowledge with minimal involvement of allied health professionals. Knowledge levels were variable with the majority demonstrating poor knowledge. Common knowledge gaps included around fear of addiction, principles of cancer-related pain assessment and management, and interventional techniques. Conclusion: Knowledge of cancer-related pain is variable with several knowledge gaps. More work is needed to ensure health professionals have adequate knowledge regarding the complexity of cancer-related pain. [ABSTRACT FROM AUTHOR]

Introduction: Hospitals had to create new practices and training due to the severe acute respiratory syndrome Coronavirus 2 (SARS-CoV-2) pandemic. An increase in patient acuity and the need for peripherally inserted central catheters (PICC) across the hospital required an urban community hospital to educate and support in-patient nurses to manage PICCs in acute and complex care units. Traditionally, these skills were performed by specialized registered nurses (RNs) from the Vascular Access Team (VAT). This paper highlights the education plan, implementation, and evaluation of a hospital-wide training for RNs and registered practical nurses (RPNs) in in-patient units during the SARS-CoV-2 pandemic. Methods: Clinical Resource Leaders (CRLs) created a modular approach to upskill existing nurses and train new hires. Various education strategies, such as the use of competency assessments, creating practice supports, and incorporating specialists as a resource, were utilized to ensure knowledge transfer, application, and guidance of evidence-informed clinical practices. Vascular Access Team documentation was utilized to obtain Kirkpatrick's (2021) level 4 evaluation. Results: This training program was implemented after the second wave of the pandemic and was also embedded into nursing orientation. This structured approach ensured that nurses were competent to support the increased acuity and needs of patients. Eighty percent of full-time and part-time nurses were trained to manage PICC lines. Conclusion: Education evaluation results show a decrease in PICC-related VAT assistance requests with a baseline of 570 calls down to 149 six months after education was implemented. Leaders are encouraged to ensure teams have role clarity, policies, and practice supports to be successful. [ABSTRACT FROM AUTHOR]

The article discusses the significant safety and health risks posed by the manufacture and handling of hazardous medicinal products (HMPs) to workers. Topics include the health risks associated with HMP exposure, the importance of implementing closed systems for protection, and the role of regulatory bodies in promoting safer handling practices.

In order to fully understand and appreciate today's drug problem in the UK, the foundations of drug legislation and the history of drug evolution require exploration. This paper critically examines the history of drug policy and the growth of heroin addiction from the perspective of a novice researcher who works closely with intravenous drug users in relation to leg ulceration and wound care in the acute setting. Today's drug policy has come a long way in understanding the problems of heroin addiction and establishing services to meet intravenous drug users' needs and the needs of society. This paper highlights the early warning signs of drug addiction and growth within the UK from an early stage with key areas such as who the early users were and how addiction grew so rapidly between 1920 and 1960. Current policy and decision makers as well as clinicians and researchers in this field must understand the impacts of past policy and embed it within their decisions surrounding drug policy today. [ABSTRACT FROM AUTHOR]

Aim: The purpose of the project was to encourage and support nurses to write papers for publication in a peer-reviewed journal. Background: Writing for publication is an important nursing role as it is a means of communicating knowledge, skills and experiences to improve patient outcomes. Despite the importance, nurses have limited confidence and experiences with publishing nursing developments. Methods: A comprehensive development programme was designed to provide direction and leadership on how to write for publication. Fifty participants attended the programme and it was led and supported by two experienced facilitators. Results: A multi- method approach to evaluation was undertaken including attendance, an evaluation questionnaire, a focus group and a review of writing outcomes. By one year from commencement of programme, 25% had submitted a paper for peer review publication. The programme created and sustained motivation to write and participants valued the taught focused sessions as well as the unstructured group discussion sessions. Conclusion: The writing for publication programme for nurses, midwives and allied health professionals was successful. [ABSTRACT FROM AUTHOR]

Early diagnosis and intervention, and the use of targeted cancer treatments, have significantly reduced mortality from breast cancer. Emotional distress following a diagnosis of cancer is a normal and anticipated, but it may manifest in some individuals at some point as a level of anxiety or depression that significantly affects quality of life and coping. In extreme cases, these feelings can move from physical symptoms of low energy and an inability to complete basic tasks to despair and hopelessness. Confronting a cancer diagnosis is a life-changing experience, bringing a sense of vulnerability. This may create or precipitate a crisis that threatens to overwhelm a person, resulting in a negative impact on established coping mechanisms. There appears to be a paucity of literature on suicide or suicide attempts by people living with and beyond a cancer diagnosis. A literature search identified 19 papers on suicide and or suicide ideation in patients who had had a cancer diagnosis, which were included in the review. Two clear themes emerged from the literature: that a cancer diagnosis with or without pre-existing mental health comorbidities is a risk factor for suicide; and that there is a significant incidence and prevalence of anxiety and depression in cancer patient populations. The literature identifies multiple variables that impact on prevalence of mental health disorders after a breast cancer diagnosis. Despite this, there appears to be a lack of guidance at national level for screening for mental health comorbidities in patients with a cancer diagnosis. [ABSTRACT FROM AUTHOR]

Background: The use of technology in health care, including nursing, is growing, owing in part to the COVID-19 pandemic and in response to national policy. Aims: To investigate nurses' perceptions of digital nursing (DN). Methods: Community and primary care nurses from across Wales were recruited (n=249) through a survey comprising open and closed questions. This was supplemented with semistructured interviews (n=25). Thematic analysis was used to analyse qualitative data. Findings: Nurses had a broad range of perspectives on what DN meant, with four main themes being identified: access; impact on care; technology; and digital future. The positive impacts of DN on ways of working and patient outcomes were supported by answers to closed survey questions. Conclusion: Many nurses understand the value of digital tools within nursing and are clear about their benefits for patients, nurses and multiprofessional teams. However, there is a need for a clear definition and increased awareness of DN. [ABSTRACT FROM AUTHOR]

Patients with spinal cord injuries (SCIs) often have complex needs that require multidisciplinary support in specialist centres. Optimal management depends on seamless transitions between service providers. Delays at any point potentially compromise clinical outcomes and efficient resource utilisation. The Spinal Advisory Working Group aims to develop and implement practical initiatives to improve SCI care, initially focusing on admission and discharge. A literature review identified few relevant papers. In addition, the generalisability of the findings of these papers to SCI centres in the UK is unclear. Therefore, further research is needed to, for example: establish best practice in the UK; quantify the associations between admission criteria and clinical and economic outcomes from a UK perspective; and determine the extent and impact of barriers that influence the transition of SCI patients between NHS care providers. Such research would enable the development of evidence-based strategies to overcome or minimise these barriers. In the meantime, pragmatic consensus guidelines would help standardise management, aid service optimisation, overcome inequities and, potentially, reduce bed blocking. The working group agreed that the robust inclusion and exclusion criteria developed by the Welsh Spinal Cord Injury Rehabilitation Centre could form the basis of a consensus guideline, to be piloted across the five SCI centres represented by members of the group. [ABSTRACT FROM AUTHOR]

Indwelling medical devices, including vascular access and urinary catheters, pose a risk for infection, and therefore daily assessment and consideration of their continued need is a patient safety priority. The I-DECIDED® device assessment and decision tool is an evidence-based checklist, designed to improve the assessment, care and timely removal of invasive devices in acute hospitalized patients. This paper explains each step of the tool, with rationale for inclusion. [ABSTRACT FROM AUTHOR]

Needlestick injuries are a serious concern for nurses and other healthcare workers. One of the main clinical risks from needlestick injury is the possible infection by blood-borne diseases, such as hepatitis and HIV. A number of different measures have been introduced to minimise the risk and impact of needlestick injuries, including the use of fixed-needle safety syringes. However, some healthcare workers refuse to use such devices, for reasons that include the perceived need to change syringe needles between drawing up a medicine and its administration to a patient. This paper will explore the literature relating to needlestick injuries and the reasons commonly given for not using fixed-needle safety syringes. [ABSTRACT FROM AUTHOR]

The purpose of this literature review was to examine current evidence on how student nurses and nursing faculty members perceived the integration of patient safety education in preregistration/undergraduate nursing training. Databases searched from January 2000 to April 2011 included CINAHL, PsycINFO, British Nursing Index, PubMed, AMED, Academic Science, Midline, Cochrane Library Database, Web of Knowledge, Ovid Nursing Database, Wiley Online Library and Science Direct. In total, 77 articles were initially found, although only 15 were included in the author's review. Of these, 5 papers were research-based articles that examined aspects of patient safety education in undergraduate/pre-registration nursing training, and 9 papers were literature review and discussion based, which provided insight into the experience, assessment, evaluation or implementation of patient safety education curriculum in nursing education. The author's literature review highlights the continuing lack of research on patient safety education in undergraduate/preregistration nursing training and, in particular, outlines areas in nursing education which need to be addressed to develop patient-safety-friendly nursing curricula. [ABSTRACT FROM AUTHOR]

Background: metastatic spinal cord compression (MSCC) is an oncology emergency. Prevalence is increasing. Treatment and care are complex and those diagnosed may be faced with life-changing challenges. Aims: to review the impact and management of MSCC in patients with cancer, in order to analyse nursing considerations for supporting patients. Methods: a literature review and thematic analysis of five primary research papers, published between 2009 and 2014. Findings: two themes of prognosis/survival time and independence versus dependence were discovered. Conclusions: the onset of MSCC may result in paralysis and associated loss of independence, impacting on a patient's quality of life. Understanding individuals' prognosis and treatment/care preferences is fundamental for the sensitive, individualised support of patients with MSCC. The findings reinforce the nurses' role in health education, in order to raise awareness of MSCC and promote early diagnosis so that patients maintain function and independence as long as possible. The findings support the need for nurses to be equipped with appropriate communication skills to initiate and engage in sensitive, difficult and proactive conversations with patients and their families, supporting the delivery of humanised care. [ABSTRACT FROM AUTHOR]

Stroke is a life-threatening event that has a devastating impact on young adults and their families. The author conducted a systematic review of the qualitative literature to explore the experience of stroke from the perspective of young adults. Four primary research 'papers' were analyzed using the Qualitative Assessment and Review Instrument; 60 findings were extracted from the papers and merged into 13 categories, from which three synthesized findings were developed -- disorientation, disrupted sense of self, and roles and relationships. Many of the effects of stroke are 'invisible' but have significant impact on social participation, including the ability to return to work and to enjoy an active social life. Young adults feel the same and yet different following stroke, which may have a profound effect on relationships. Effective communication between patients, families and health professionals is crucial to all aspects of recovery. [ABSTRACT FROM AUTHOR]

The article discusses a position paper on advanced nursing practice by the chief nursing officer Dame Christine Beasley of Great Britain's Department of Health (DH). An overview and discussion of the paper's main themes, including clinical/direct care practice, leadership and collaborative practice, and the development of self, are presented.

Background: Over the past 50 years there have been significant advances in both the clinical techniques and equipment used in the intensive care environment. One traditionally used point-of-care test is activated clotting time (ACT), a coagulation test primarily used during cardiopulmonary bypass surgery to monitor the anticoagulation effects of heparin. The ACT test has since emerged into the intensive care environment to guide clinical assessment and management of haemostasis in postoperative cardiac patients. Objectives: The aim of this integrative systematic review was to critique the available research evaluating the effectiveness of ACT point-of-care testing in the intensive care unit for adult patients following cardiopulmonary bypass and cardiac surgery and any impacts this may have on nursing care. Methods: A systematic search of Medline, CINAHL and PubMed was undertaken. Results: The search identified five research papers reporting on the use of ACT point-of-care testing in the intensive care unit for adult cardiac surgical patients. Meta-analysis was not performed due to the lack of homogeneity between the papers included. Conclusions: There was a lack of clear evidence for the use of the ACT point-ofcare test after cardiac surgery in the intensive care environment. This review has highlighted that conventional laboratory tests are generally more accurate and reliable than this point-of-care test in guiding nursing care management. [ABSTRACT FROM AUTHOR]

Background: Incontinence is a common disorder among older adults with a higher prevalence in nursing home settings than in community dwellings. There is a wide variety of absorbent continence products on the market used to manage continence. Aim: The study aimed to investigate the experience of caregivers of residents with incontinence in care home settings using the new MoliCare Premium Form design and to compare some of the product features with the previous design. Method: A questionnaire focusing on the key performance characteristics of the product was developed and administered to 74 nurses in Germany to obtain their opinions on the use of MoliCare Premium Form products. Findings: More than 90% of respondents rated each key performance aspect of the new product design as 'good' and 'OK'. More than 60% of the caregivers found the new product design to be better performing and 93% preferred the new design to the previous version. Conclusion: The newly redesigned continence pad performed very well on each of the individual performance features, indicating the high quality and optimised design of the product. The new design was found to be suitable and effective for individuals with incontinence. [ABSTRACT FROM AUTHOR]

The article presents the efforts of the Lymphoedema Wales (LW) Clinical Network in providing high-quality care to individuals at risk of or diagnosed with lymphoedema. They have implemented the Lymphoedema-specific Patient Reported Experience Measure (LYMPREM) to capture patients' experiences and ensure patient-centered care.

The impact of racism on health is undeniable. However, undergraduate nurse education in the UK is not adequately addressing the racism within the profession. Literature on anti-racist nursing education was reviewed to uncover the most effective strategies for nurse educators to develop this approach. The literature describes a climate of denial and defensiveness among nurse educators. It urges nurse educators to develop racial literacy, and explores nursing curricula, recommending intersectionality as a way to teach about health disparities, with a move away from a culturalist perspective. There is growing recognition that institutions need to address issues around the retention of Black students, and robust reporting systems are required to respond to allegations of racism. Institutions also need to provide evidence-based anti-racist training for staff. The conclusion here is that, without institutional support, there is little nurse educators can do alone to change the culture of racism in nurse education. Thus, this review is a starting point for nurse educators interested in anti-racist nursing education. [ABSTRACT FROM AUTHOR]