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Aim: To explore barriers and enablers of recognition and response to signs of patient deterioration by nursing staff in an acute hospital. Design: A theory‐driven interview study underpinned by the Theoretical Domains Framework of behaviour change. Methods: Between 07/01/2019 and 18/12/2019 a purposive sample of registered nurses and healthcare assistants was recruited to participate in a semi‐structured (audio‐recorded) interview, to explore the determinants of seven specified behaviours of the afferent limb. Anonymised transcripts were deductively coded (using the 14 Theoretical Domains Framework domains as coding categories) and then extracts within each domain were inductively analysed to synthesise belief statements and themes. Prioritisation criteria from published literature were applied. Results: Thirty‐two semi‐structured interviews were conducted. From 1,888 quotes, 184 belief statements and 66 themes were synthesised. One hundred and forty‐six belief statements, represented by 58 themes, met prioritisation criteria. Nine domains of the Theoretical Domains Framework were of high importance: Knowledge; Social, Professional Role and Identity; Beliefs about Consequences; Reinforcement; Intentions; Goals; Memory, Attention and Decision Processes; Environment, Context and Resources and Social Influences. Conclusions: Barriers and enablers most likely to impact on nursing staff afferent limb behaviour were identified in nine domains of the Theoretical Domains Framework. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Advanced Nursing (John Wiley & Sons, Inc.) is the property of John Wiley & Sons, Inc. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

gallagher k., marlow n., edgley a. & porock d. (2011) The attitudes of neonatal nurses towards extremely preterm infants. Journal of Advanced Nursing 68(6), 1768-1779. Abstract Aim. The paper is a report of a study of the attitudes of neonatal nurses towards extremely preterm infants. Background. Alongside advancing survival at extremely preterm gestational ages, ethical debates concerning the provision of invasive care have proliferated in light of the high morbidity. Despite nurses being the healthcare professionals who work closest with the infant and their family, their potential influence is usually ignored when determining how parents come to decisions about future care for their extremely premature infant. Methods. A Q methodology was employed to explore the attitudes of neonatal nurses towards caring for extremely preterm infants. Data were collected between 2007 and 2008 and analysed using PQMethod and Card Content Analysis. Results. Thirty-six nurses from six neonatal units in the United Kingdom participated. Although there was consensus around the professional role of the nurse, when faced with the complexities of neonatal nursing three distinguishing factors emerged: the importance of parental choice in decision-making, the belief that technology should be used to assess response to treatment, and the belief that healthcare professionals should undertake difficult decisions. Conclusion. Neonatal nurses report unexpected difficulties in upholding their professionally defined role through highly complex and ever varied decision-making processes. Recognition of individual attitudes to the care of extremely preterm infants and the role of the family in the face of difficult decisions should facilitate more open communication between the nurse and the parents and improve the experience of both the nurse and the family during these emotional situations. [ABSTRACT FROM AUTHOR]

Aim. This paper is a report of a descriptive study of understanding of breast cancer and experiences of breast mammography among women with an intellectual disability. Background. Despite the efforts of government policies and documents to ensure equal access to improve health screening for people with intellectual disability, the uptake for breast mammography in this population still remains lower than that of the general population. Method. A qualitative approach using four focus groups was undertaken with 19 women identified as having a borderline to moderate intellectual disability all of whom had received a breast mammography. Data collection took place in 2009. Analysis of the data was undertaken using thematic content analysis. Results. The women's knowledge of breast cancer including associated risks, preventative factors and signs and symptoms were extremely limited with their sources of knowledge primarily coming from carers or nursing staff on receipt of an invitation for mammography. Although these women expressed a positive attitude towards their experiences of breast mammography, they also described negative feelings of fear and anxiety, attributed to a lack of understanding about the screening process. A lack of information and embarrassment were identified as the main barriers to screening for this group. Conclusion. This study highlights the need for accessible multi-format information in order to facilitate health promotion and education in women with intellectual disability, their family carers and healthcare staff working with this target group in order to enhance the knowledge and awareness of breast cancer and screening. [ABSTRACT FROM AUTHOR]

Aims: To use nurses' descriptions of what would have improved their working lives during the first peak of the COVID‐19 pandemic in the UK. Design: Analysis of free‐text responses from a cross‐sectional survey of the UK nursing and midwifery workforce. Methods: Between 2 and 14 April 2020, 3299 nurses and midwives completed an online survey, as part of the 'Impact of COVID‐19 on Nurses' (ICON) study. 2205 (67%) gave answers to a question asking for the top three things that the government or their employer could do to improve their working lives. Each participants' response was coded using thematic and content analysis. Multiple response analysis quantified the frequency of different issues and themes and examined variation by employer. Results: Most (77%) were employed by the National Health Service (77%) and worked at staff or senior staff nurse levels (55%). 5938 codable responses were generated. Personal protective equipment/staff safety (60.0%), support to workforce (28.6%) and better communication (21.9%) were the most cited themes. Within 'personal protective equipment', responses focussed most on available supply. Only 2.8% stated that nothing further could be done. Patterns were similar in both NHS and non‐NHS settings. Conclusions: The analysis provided valuable insight into key changes required to improve the work lives of nurses during a pandemic. Urgent improvements in provision and quality of personal protective equipment were needed for the safety of both workforce and patients. Impact Failure to meet nurses needs to be safe at work appears to have damaged morale in this vital workforce. We identified key strategies that, if implemented by the Government and employers, could have improved the working lives of the nursing and midwifery workforce during the early stages of the COVID‐19 pandemic and could prevent the pandemic from having a longer‐term negative impact on the retention of this vital workforce. Patient or Public Contribution: No Patient or Public Contribution, due to the COVID‐19 Pandemic, urgency of the work and the target population being health and social care staff. [ABSTRACT FROM AUTHOR]

Abstract: Aim: The aim of this study was to seek views of UK children's and adult hospices on the availability and challenges of providing services for young adults with life‐limiting conditions. Background: Internationally, there are a growing number of young adults with life‐limiting conditions and/or complex needs which are degenerative, progressive and diverse and involve complex life‐long symptom, medication management as well as palliative care. There are 55,721 young adults, aged 18–40 in England, which continues to increase. The hospice sector is experiencing demands to extend services for this population despite concerns about the appropriateness of adult hospices and their nursing staff to provide care for the complex and unfamiliar conditions of this patient group. Evidence is needed of hospices’ views and the main challenges faced providing services for young adults. Design: Descriptive cross‐sectional survey. Methods: xChildren and adult hospices completed an online survey exploring service provision and their views of respite care for young adults with life‐limiting conditions from 18 years old and onward. Data were collected between October 2015 ‐ February 2016. Findings: Respondents (N = 76 hospices) reported that children's hospices predominantly provided short breaks and end‐of‐life care; adult hospices provided mainly symptom management, end‐of‐life care and day services. Main challenges were lack of existing adult respite services; lack of funding and capacity; lack of a skilled workforce in adult hospices; and the need for better integrated service provision. Conclusion: Examples of good collaborative working were reported. With an increasing population of young adults and pressure on families, it is vital that services work together to find sustainable solutions to the challenges. [ABSTRACT FROM AUTHOR]

Aims The aim of this study was to provide deep insights into the pain associated with pressure injuries in home-dwelling individuals using narrative accounts. Background Pressure injuries or pressure ulcers are burdensome and costly. Prevalence data, surveys and systematic reviews demonstrate that pain associated with pressure injury is widespread, but voices of home-dwelling patients have remained largely unheard. Design Concurrent mixed methods case study of a UK community of approximately 50,000 adults. Methods Qualitative interviews, conducted in 2016, of 12 home-dwelling adult participants with a current pressure injury ( n = 10), or a recently healed pressure injury ( n = 2). Findings Pain had an adverse impact on activities of daily living, mobility and sleep. Participants described days that were clouded in pain; a pain they felt was poorly understood and often out of control. Thematic content analysis revealed two major themes; these are: Poorly controlled pain: 'I just want the pain to go away'; and, Uncertainty for the future: 'it almost seems insurmountable.' Conclusion Findings of our study support the need to develop an appropriate assessment tool for pressure injury patients in the community to enable healthcare professionals and patients to recognize and manage pressure injury-related pain effectively. [ABSTRACT FROM AUTHOR]

Aim The aim of this study was to explore and compare the experiences of nurses in Australia and the UK as they moved from clinical practice into higher education institutions. Background When nurse education moved from hospitals into higher education institutions, the roles and career pathways of nurse educators changed. Design The design method used in this study was qualitative interview study. Methods Semi-structured interviews were undertaken with 14 nurse educators, seven in Australia and seven in the UK, in 2011-2012. Thematic analysis of the transcripts was undertaken and triangulated with automated content and thematic analysis by Leximancer© software. Findings Nurse academics in Australia and the UK voiced similar enthusiasms and concerns. These coalesced around four emergent themes: adapting to change, external pressures, teaching and progress up the academic ladder. The Leximancer© analysis for both sites ranked 'research' as the primary theme, linked with 'time', 'University' and 'nursing' on both sites. Respondents were aware of the importance of research to career progression in universities, but most prioritized their teaching and clinical commitments for the sake of their organizations. Most respondents were supported in their doctoral studies, but the absence of postdoctoral research teams, mentors and role models was striking. Conclusion Additional support is needed to ensure that nurse academics are able to pursue research beyond doctoral level. [ABSTRACT FROM AUTHOR]

Aims To investigate student nurses' and midwives' knowledge, confidence and educational needs regarding recognition and responses to domestic abuse. Background Domestic abuse is a serious global problem and has greater, negative effects on long-term health than more obvious diseases, such as diabetes. Nurses and midwives are well-placed to recognize and respond to domestic abuse but many lack confidence in this area. There is firm evidence that training can increase the confidence of Registered Nurses and midwives in responding to domestic abuse. But the issue of undergraduate preparation is significantly under-investigated. Design A qualitative study. Methods Nursing and midwifery students were recruited using purposive sampling. We facilitated eight focus groups with a total of 55 students (student midwives N = 32; student nurses n = 23). Data were collected between May-November 2014. Findings Students in the study viewed the issue of domestic abuse as important and they possessed sound theoretical knowledge of its nature and consequences. However, they lacked confidence in recognizing and responding to abuse and were concerned about the implications of this for their future practice as registered practitioners. Interactive learning opportunities that engaged with service users and involved experts from practice were viewed as important educational requirements. Conclusion Most students in the study felt insufficiently prepared to deal with the issue of domestic abuse. They perceived this as a cyclical state of disempowerment that would impact negatively on their practice and on their own ability to support nursing and midwifery students of the future. [ABSTRACT FROM AUTHOR]

baker j. (2011) Multi-disciplinary perceptions of patient group directions as a replacement for the pro re nata prescribing of antipsychotic medications in acute mental health settings. Journal of Advanced Nursing 67(9), 2191-2199. Abstract Background. Patient group directions have been used in the NHS for 10 years. Despite high levels of reported use, few studies have examined staff perceptions or evaluated them in practice. In mental health services, pro re nata prescriptions continue to contribute to high doses and polypharmacy of antipsychotics. Replacing pro re nata with patient group directions might improve the quality and safety of care associated with this practice. Aims. This study aimed to explore the acceptability of patient group directions in acute mental health services. Method. Qualitative methods were used. Data were analysed using thematic content analysis. Twenty-six members of the multi-disciplinary team (doctors, nurses and pharmacists) participated in either focus groups or individual interviews in 2009. Results. A broad range of benefits were suggested, including improved safety and access to treatments, and the professional development of nurses. However, concerns also emerged about the need for a culture shift in thinking, and the danger of multiple systems for the supply of medicines. Conclusion. Despite the widespread use of patient group directions in clinical settings in the last 10 years, limited research has examined their development and potential. Patient group directions can potentially give a rigorous means of supplying or administering medicines. However, their development requires careful consideration. [ABSTRACT FROM AUTHOR]