Search

Background Aims Methods Design Setting Participants Data collection Data analysis Results Conclusion Implications for the Profession and/or Patient Care Reporting Method (EQUATOR) Patient or Public Contribution Strict patient isolation in hospital is associated with adverse health outcomes. However, there is a lack of high‐quality evidence for effective interventions to improve safety and quality of care for these patients.To identify patient reported areas for improvement in the care of patients in hospital isolation and to determine the feasibility of collecting patient reported outcomes using validated tools.An exploratory mixed methods study.A major metropolitan teaching hospital in Melbourne, Australia.Patients in hospital isolation for transmissible infections.Data were collected by (1) phone interviews with patients in isolation and (2) seven validated measurement tools to assess cognition, loneliness, nutritional status, quality of life, anxiety and depression and physical activity. Data were collected between September and December 2021.Interviews were transcribed and analysed using thematic analysis. Quantitative data were analysed descriptively including participant characteristics and outcome data.Participants identified areas for improvement including activities to decrease boredom, more contact with staff to mitigate loneliness and increase comfort care, and formalised communication about clinical treatment and discharge plan. Patients with gastrointestinal symptoms were happier to be alone. There were operational challenges within the health service including delays and miscommunication. Only 70% of the participants completed all questionnaires.This study identified areas for improvement in care of patients in isolation and demonstrated that collecting patient reported outcomes using validated tools was feasible. The results of this research will inform development of an intervention to manage adverse effects.Patients in hospital isolation require additional consideration to ensure that their needs are met to avoid adverse outcomes. The patient experience and comfort can be negatively affected when fundamental care is lacking.EQUATOR guidelines for Mixed Methods Reporting in Rehabilitation & Health Sciences (MMR‐RHS).Thirteen patients in hospital isolation agreed to participate in this study, sharing their experiences through interviews and assessment. [ABSTRACT FROM AUTHOR]

Aims: To investigate the ways that nurses engage with referral letters and discharge summaries, and the qualities of these documents they find valuable for safe and effective practice. Design: This study comprised a qualitative, case‐study design within a constructivist paradigm using convenience sampling. Methods: Interviews were conducted with nurses to investigate their practices relating to referral letters and discharge summaries. Data collection also involved nurses' examination and evaluation of a diverse range of 10 referral letters and discharge summaries from medical records at two Australian hospitals through focus‐group sessions. The data were transcribed and analysed inductively. Results: In all, 67 nurses participated in interviews or focus groups. Nurses indicated they used referral letters and discharge summaries to inform their work when caring for patients at different times throughout their hospitalisation. These documents assisted them with verbal handovers, to enable them to educate patients about their condition and treatment and to provide a high standard of care. The qualities of referral letters and discharge summaries that they most valued were language and communication, an awareness of audience and clinical knowledge, as well as balancing conciseness with comprehensiveness of information. Conclusion: Nurses relied on referral letters and discharge summaries to ensure safe and effective patient care. They used these documents to enhance their verbal handovers, contribute to patient care and to educate the patient about their condition and treatment. They identified several qualities of these documents that assisted them in maintaining patient safety including clarity and conciseness of information. Implications for the Profession and Patient Care: It is important that referral letters and discharge summaries are written clearly, concisely and comprehensively because nurses use them as key sources of evidence in planning and delivering care, and in communicating with other health professionals in relaying goals of care and implementing treatment plans. Impact: Nurses reported that they regularly used referral letters and discharge summaries as valuable sources of evidence throughout their patients' hospitalisation. The qualities of these documents which they most valued were language and communication styles, awareness of audience and clinical knowledge, as well as balancing conciseness with comprehensiveness of information. This research has important impact on the patient experience in relation to encouraging effective referral letter and discharge summary writing. Reporting Method: We have adhered to the relevant EQUATOR guidelines through the SRQR reporting method. Patient or Public Contribution: No patient or public contribution. [ABSTRACT FROM AUTHOR]

Aims: To explore adverse event reporting in the surgical department through the nurses' experiences and perspectives. Design: An exploratory, descriptive qualitative study was conducted with a theoretical‐methodological orientation of phenomenology. Methods: In‐depth interviews were conducted with 15 nurses, followed by an inductive thematic analysis. Results: Themes include motives for reporting incidents, consequences, feelings and motivational factors. Key facilitators of adverse event reporting were effective communication, knowledge sharing, a non‐punitive culture and superior feedback. Conclusion: The study underscores the importance of supportive organisational culture for reporting, communication and feedback mechanisms, and highlights education and training in enhancing patient safety. Implications: It suggests the need for strategies that foster incident reporting, enhance patient safety and cultivate a supportive organisational culture. Impact: This study provides critical insights into adverse event reporting in surgical departments from nurses' lived experience, leading to two primary impacts: It offers specific solutions to improve adverse event reporting, which is crucial for surgical departments to develop more effective and tailored reporting strategies. The research underscores the importance of an open, supportive culture in healthcare, which is vital for transparent communication and effective reporting, ultimately advancing patient safety. Reporting Method: The study followed the Standards for Reporting Qualitative Research and the Consolidated Criteria for Reporting Qualitative Research guidelines. Patients or Public Contribution: No patients or public contribution. [ABSTRACT FROM AUTHOR]

Aims Design Methods Results Conclusions Implications for Patient Care Impact Reporting Methods Patient or Public Contribution Simulation offers a feasible modality to prepare nurses for challenges communicating with patients with dementia. Elderspeak communication is speech that sounds like baby talk and can lead to rejection of care by patients with dementia. However, it is unknown if simulation can be used to capture elderspeak communication in dementia care. The purpose of this mixed‐methods study was to determine if simulation accurately captures elderspeak communication by nursing staff in hospital dementia care.A 3‐part mixed‐methods design in which (1) three dementia care simulations were designed and validated by a panel of experts, (2) communication by nursing staff completing each simulation was quantitatively compared to communication during actual patient care, and (3) views on the realism were explored using within‐ and across‐case coding.Three simulations using different modalities (manikin, role‐play, and standardised patient) were designed and validated with eight experts using the Lynn Method. Ten nursing staff were audio‐recorded and their communication was coded for elderspeak communication. Results for each simulation were compared using Wilcoxon signed‐rank test to recordings taken during actual dementia care encounters. Debriefings were coded for realism and results were converged.The average time using elderspeak during naturalistic care was 29.9% (SD = 20.9%) which did not differ from the average amount of elderspeak used across the three simulations modalities which ranged from 29.1% to 30.4%. Qualitative results suggested a lack of realism with the manikin condition and the nursing staff indicated preference for the simulation with the standardised patient.Communication elicited in the dementia care simulations was congruent to communication produced in actual dementia care but preference was for the standardised patient.Elderspeak communication can be accurately produced in the simulated environment which indicates that simulation is a valid method for person‐centred communication training in nursing staff. Simulation offers a feasible modality to prepare nurses for challenges communicating with patients with dementia. Elderspeak communication is speech that sounds like baby talk and can lead to rejection of care by patients with dementia. However, it is unknown if simulation can be used to capture elderspeak communication in dementia care. Elderspeak communication captured in the simulated environment was congruent to communication nursing staff use during actual patient care to hospitalised persons living with dementia. This study empirically identifies that communication is elicited in similar patterns by nursing staff in the simulated environment compared to the naturalistic care environment which demonstrates that simulation can be used as a valid tool for education and research on person‐centred communication. STROBE.No Patient or Public Contribution. [ABSTRACT FROM AUTHOR]

Background: Healthcare consumers require diverse resources to assist their navigation of complex healthcare interactions, however, these resources need to be fit for purpose. Aim: In this study, we evaluated the utility, usability and feasibility of children, families and adults requiring long‐term intravenous therapy using a recently developed mobile health application (App), intravenous (IV) Passport. Design: Multi‐site, parallel, multi‐method, prospective cohort study. Methods: A multi‐site, multi‐method study was carried out in 2020–2021, with 46 participants (20 adults, 26 children/family) reporting on their experiences surrounding the use of the IV Passport for up to 6 months. Results: Overall, utility rates were acceptable, with 78.3% (N = 36) using the IV Passport over the follow‐up period, with high rates of planned future use for those still active in the project (N = 21; 73%), especially in the child/family cohort (N = 13; 100%). Acceptability rates were high (9/10; IQR 6.5–10), with the IV Passport primarily used for documenting new devices and complications. Thematic analysis revealed three main themes (and multiple subthemes) in the qualitative data: Advocacy for healthcare needs, Complexity of healthcare and App design and functionality. Conclusion: Several recommendations were made to improve the end‐user experience including 'how to' instructions; and scheduling functionality for routine care. Implications for the Profession and/or Patient Care: The IV Passport can be safely and appropriately integrated into healthcare, to support consumers. Impact: Patient‐/parent‐reported feedback suggests the Intravenous Passport is a useful tool for record‐keeping, and positive communication between patients/parents, and clinicians. Reporting Method: Not applicable. Patient Contribution: Consumers reported their experiences surrounding the use of the IV Passport for up to 6 months. [ABSTRACT FROM AUTHOR]

Aims: To define nurse‐led clinics in primary health care, identify barriers and enablers that influence their successful implementation, and understand what impact they have on patient and population health outcomes. Background: Nurse‐led clinics definitions remain inconsistent. There is limited understanding regarding what enablers and barriers impact successful nurse‐led clinic implementation and their impact on patient health care. Design: Scoping review using narrative synthesis. Methods: PubMed, MEDLINE, Web of Science, Scopus, CINAHL and PsycINFO were searched to identify nurse‐led clinic definitions and models of care between 2000 and 2023. Screening and selection of studies were based on eligibility criteria and methodological quality assessment. Narrative synthesis enabled to communicate the phenomena of interest and follows the PRISMA for Scoping Reviews (PRISMA‐ScR) checklist. Results: Among the 36 identified studies, key principles of what constitutes nurse‐led clinics were articulated providing a robust definition. Nurse‐led clinics are, in most cases, commensurate with standard care, however, they provide more time with patients leading to greater satisfaction. Enablers highlight nurse‐led clinic success is achieved through champions, partners, systems, and clear processes, while barriers encompass key risk points and sustainability considerations. Conclusion: The review highlights several fundamental elements are central to nurse‐led clinic success and are highly recommended when developing interventional nurse‐led strategies. Nurse‐led clinics within primary health care seek to address health care through community driven, health professional and policy supported strategies. Overall, a robust and contemporary definition of nurse‐led care and the clinics in which they operate is provided. Relevance to Clinical Practice: The comprehensive definition, clear mediators of success and the health impact of nurse‐led clinics provide a clear framework to effectively build greater capacity among nursing services within primary health care. This, in addition, highlights the need for good health care policy to ensure sustainability. Patient or Public Contribution: No Patient or Public Contribution. [ABSTRACT FROM AUTHOR]

Aim: To reach consensus on the definition and attributes of 'person‐centred handover practices' in emergency departments. Background: Handover practices between emergency care practitioners and healthcare professionals in emergency departments are important and should be conducted meticulously. Person‐centred handover practices may enhance the delivery of person‐centred care in emergency departments. Design: A three‐round online Delphi survey. Methods: Nine experts participated in a three round Delphi survey. The expert panel comprised experts from nine countries. Quantitative data were descriptively analysed, and qualitative data were thematically analysed. A consensus of 80% had to be reached before an attribute and definition could be accepted. Results: Experts reached a consensus of 79% in round one, 95% in round two and 95% in round three. A final set of six attributes were agreed upon and the final concept definition was formulated. Conclusion: Person‐centred handover practices have not been implemented in emergency departments. Yet, person‐centred handover practices may enhance the delivery of person‐centred care, which has multiple benefits for patients and healthcare practitioners. Implications for the profession and/or patient care: Person‐centred care is not generally implemented in emergency departments. Person‐centred handover practices can lead to person‐centred care. Handover practices in emergency departments are a high‐risk activity. Despite numerous calls to standardise and improve handover practices, they remain a problem. Developing a standardised definition could be a first step towards implementing person‐centred handover practices in emergency departments. Reporting method: The study adhered to the relevant EQUATOR reporting guidelines: Guidance on Conducting and Reporting Delphi Studies (CREDES) checklist. Impact (Addressing): Improve handover practices and patient care.Improve person‐centred care in emergency departments. Patient or public contribution: Emergency care practitioners and nurses experienced in handover practices and/or person‐centred care, working in clinical and academic fields, participated in the study by sharing their expert knowledge during each of the Delphi rounds. [ABSTRACT FROM AUTHOR]

Aim Design Methods Results Conclusion Implications for the profession and patient care Patient or Public Contribution This study examines the intricate language and communication patterns of nurse‐to‐nurse handoffs across three units with varying patient acuity levels and nurse–patient ratios, seeking to identify linguistic factors that may affect the quality of information transfer and patient outcomes.A mixed‐methods cross‐sectional design.This study used the Nurse‐to‐Nurse Transition of Care Communication Model to explore the content and meaning of language in nursing handoffs within a large academic medical centre. Data were collected on three units through digital audio recordings of 20 handoffs between June and September 2022, which were transcribed and analysed using the Linguistic Inquiry Word Count programme. Trustworthiness was established by adhering to COREQ and STROBE guidelines for qualitative and quantitative research, respectively.Analysis revealed a preference for casual, narrative language across all units, with ICU nurses demonstrating a higher confidence and leadership in communication. Cognitive processes such as insight and causation were found to be underrepresented, indicating a potential area for miscommunication. Communication motives driven by affiliation were more pronounced in ICU settings, suggesting a strong collaborative nature. No significant differences were observed among the units post multiple testing adjustments. Speech dysfluencies were most pronounced in ICU handoffs, reflecting possible stress and cognitive overload.The study highlights the need for improved communication strategies such as interventions to enhance language clarity and incorporating technological tools into handoff processes to mitigate potential miscommunications and errors. The findings advance nursing science by highlighting the critical role of nuanced language in varied‐acuity hospital settings and the necessity for structured nurse education in handoff communication and standardized handoff procedures.This study underscores the critical role of language in nurse‐to‐nurse handoffs. It calls for enhanced communication strategies, technology integration and training to reduce medical errors, improving patient outcomes in high‐acuity hospital settings.Nurses only. [ABSTRACT FROM AUTHOR]

Aim: To identify, describe and synthesise what is known about family carers' experiences and perspectives of engagement in delirium prevention and care for adults in hospital. Design: Systematic review and synthesis of qualitative evidence. Data Sources: Comprehensive literature search within PubMed, CINAHL, EMBASE, Scopus, Cochrane Central and PsycInfo databases to August 2022. Peer reviewed original qualitative research published in English. Methods: Data were extracted using Covidence systematic review software. Methodological quality was reviewed against the Critical Appraisal Skills Program (CASP) Qualitative Checklist. Thematic synthesis was used to develop analytical themes. Confidence in the Evidence from Reviews of Qualitative Research (GRADE‐CERQual) framework was applied to findings. Results: Of 3429 records identified, 29 met criteria for final inclusion. Studies included a range of settings (intensive care, medical and surgical wards) and family carer types (spouse, daughter, parent and friend). Three primary themes Shared Caregiving, Partnership and Support, Communication for Shared Understanding and three cross‐cutting contextual themes Care Transitions, Family Carer Context and Hospital Context were identified. Family carers have mixed experiences of involvement in delirium care and prevention. Family carer engagement in care impacted perceptions of care quality and their own self‐efficacy. Where person‐centred care expectations were not met, some family carers adopted compensatory or care contingency strategies. Information sharing and timely support from hospital staff who understood the carer context supported carer involvement. Supportive physical environments and addressing power imbalances allowed greater engagement. Conclusion: Family carers often wish to be involved in delirium prevention and care, but need to be recognised as individuals, listened to, informed and supported to optimise their contribution. Impact: The review findings can guide health professional and decision makers to optimise family carer involvement in delirium care programs. Protocol Registration: PROSPERO [CRD42020221854]. Reporting: ENTREQ. No Patient or Public Contribution. [ABSTRACT FROM AUTHOR]

Aim(s): To explore intensive care nurses' (ICN) perceptions of simulation‐based learning (SBL). Design: A systematic review and meta‐synthesis. Methods: The review followed the PRISMA guidelines for reporting a systematic review. A systematic search strategy was developed using a modified PICo framework. A comprehensive search was conducted in July 2023 in CINAHL, OVID Embase, Medline complete, Web of Science, ERIC and Scopus databases for articles published in English between 2013 and 2023. Data were extracted using the Joanna Briggs Institute QARI Data Extraction, with data synthesis guided by Braun and Clark's thematic analysis approach. Quality appraisal was assessed using the CASP tool. Results: Eleven studies providing qualitative data were included for analysis. Analysis and meta‐synthesis led to the construction of two themes: The learning experience and professional growth through collaboration. Conclusion: The review highlights the balance needed in finding the appropriate simulation approach, with the right level of fidelity, conducted at appropriately regular intervals, incorporating the correct makeup of professional team members, conducted in the right environment and facilitated by a skilled facilitator, to ensure best outcomes and return on investment for ICN's education. Implications for Practice: These findings are a valuable resource for educators and organisations considering simulation‐based learning initiatives in the intensive care setting. No Patient or Public Contribution: This review involved analysis of existing literature and as such no unique patient or public involvement occurred. Reporting Method: The systematic review followed the Preferred Reporting Items for Systematic Review and Meta‐Analysis (PRISMA) reporting guidelines. [ABSTRACT FROM AUTHOR]

Aim: To generate, test and refine programme theories that emerged from a rapid realist review investigating practising UK Nurses' and Midwives' experiences of effective leadership strategies during the COVID‐19 pandemic. Background: The realist review of literature generated six tentative theories of healthful leadership practices reflecting, working with people's beliefs and values; being facilitative; multiple means of communication and; practical support. The review yielded little insight into the actual impact of the leadership approaches advocated. Methods: A realist study, informed by person‐centredness using mixed‐methods. Online survey (n = 328) and semi‐structured interviews (n = 14) of nurses and midwives across the UK in different career positions/specialities. Quantitative data analysed using descriptive statistics and exploratory factor analysis. Framework analysis for qualitative data using context (C), mechanism (M), outcome (O) configurations of the tentative theories. Results: Three refined theories were identified concerning: Visibility and availability; embodying values and; knowing self. Healthful leadership practices are only achievable within organisational cultures that privilege well‐being. Conclusions: Leaders should intentionally adopt practices that promote well‐being. 'Knowing self' as a leader, coaching and mentoring practice development is important for leadership development. Implications for Clinical Practice: Nurses who feel valued, heard, cared for and safe are more likely to remain in clinical practice. Job satisfaction and being motivated to practice with confidence and competence will impact positively on patient outcomes. Impact: The study addresses the role of leadership in developing healthful workplace cultures. The main findings were six leadership practices that promote healthful cultures. The research will have an impact on strategic and clinical leaders, nurses and midwives. Reporting Method: This study used EQUATOR checklist, RAMASES II as reporting standards for realist evaluations. Patient or Public Contribution: No patient or public contribution. [ABSTRACT FROM AUTHOR]

Aim: To investigate clients' perspectives about outcomes of a telehealth residential unit (RU) program for families experiencing complex early parenting issues, and to explore facilitators and barriers to positive client outcomes. Design: Qualitative study using semi‐structured interviews. Methods: Semi‐structured interviews were conducted with mothers (n = 18) admitted to a telehealth RU program. Interview transcripts were analysed using thematic analysis. Results: Mothers reported short‐term improvements in their child's presenting issues (e.g. feeding to sleep, night‐time waking, co‐sleeping), increased confidence and increased partner involvement. According to participants, program outcomes were facilitated by a positive parent–clinician relationship, the accessibility of clinicians and being able to take part in the program from their own home. Barriers included difficulties with technical equipment and connecting with the clinician overnight, and challenges with implementing strategies in the longer term. Conclusion: This nurse‐led telehealth program was viewed positively by parents and the study identified a number of areas for improvement. Implications for the profession and/or Patient care: Telehealth early parenting programs provide an important way for parents to receive support with early child sleep, settling and feeding issues. Clinicians working in this area should focus on the development of positive parent–nurse relationships, enhancing communication and availability for parents during overnight periods and supporting parents to develop early parenting skills that will be applicable across the early childhood period. Impact: The study is the first to address client experiences of a telehealth RU program. Facilitators and barriers identified will inform service improvements to the program going forward, and similar telehealth programs for families; to ensure benefits and service outcomes are maximised for parents for such a crucial service. Reporting method: The Consolidated Criteria for Reporting Qualitative Research (COREQ) guidelines for qualitative research were followed. [ABSTRACT FROM AUTHOR]

Background: Gynaecological cancer illness and treatment have a significant impact on women's sexual health and concerns regarding sexual health are known to be an unmet need in survivors. The digital support programme Gynea was designed to enhance women's health, including sexual health, after gynaecological cancer treatment. This study aimed to explore how cancer survivors experienced participation in Gynea. Methodology: This is a phenomenological hermeneutic study. Individual, in‐depth semi‐structured interviews were conducted to explore lived experiences. Twenty women were interviewed after completing the Gynea programme. The transcripts were analysed using Lindseth and Norberg's phenomenological hermeneutic method. Findings: Three main themes (with subthemes) emerged from the analysis: (1) A silent existential trauma; (2) Redefining sexual health; (3) Communicating with a partner about sexuality. The women redefined sexual health rather than just being sexual intercourse, being a rediscovery of the body. The women's increased awareness and understanding of their own sexual health empowered their communication about their sexuality with their partners. This was important for regaining sexual health and intimacy in their relationships. Conclusion: Participation in Gynea helped to strengthen the women's sexual integrity. Knowledge and support empowered them to take care of their sexual needs and communicate these with their partners. Implications for Patient Care: Healthcare services and nurses need to be aware that sexual health is an existential state of being, in which good sexual health does not necessarily equate to sexual function, but rather to sexual empowerment. Digital support with nurse guidance can support women in caring for their sexual health after cancer illness by thematizing sexual health with a holistic approach and should be part of the medical treatment. Patient or Public Contribution: Twenty gynaecological cancer survivors contributed by sharing their experiences from the sexual health module in Gynea. [ABSTRACT FROM AUTHOR]

Aim: To explore the experiences of partnership nursing among nurses when caring for children and young people with long‐term conditions, and their families. Background: Partnership nursing is promoted as a positive model of care among paediatric nurses, where shared roles and decision‐making, parental participation, mutual trust and respect, communication and negotiation are valued to create positive care experiences and enhance patient outcomes. Little is known about how nurses use partnership with both the patient and the parents in this triad to deliver partnership nursing. Design: A qualitative systematic review followed Joanna Briggs Institute meta‐aggregation approach and has been reported according to PRISMA guidelines. Methods: A comprehensive systematic search was conducted in seven electronic databases. Studies were assessed according to a pre‐determined inclusion criteria. Qualitative findings with illustrative participant quotes were extracted from included studies and grouped into categories to inform overall synthesised findings. Methodological quality assessment was conducted. Findings: A total of 5837 publications were screened, and 41 qualitative studies were included. Three overarching synthesised findings were identified: (1) Using education to promote feelings of safety and support, (2) Partnering to develop a strong therapeutic relationship and (3) Optimising communication underpinned by shared decision‐making principles to deliver individualised care. Conclusion: Nurses demonstrated successful partnership in their practice, but focused on developing dyadic nurse–parent and dyadic nurse–child partnerships. Future practice development that creates a three‐way triadic partnership may aid therapeutic relationships and shared decision‐making. Implications for clinical practice: Clinicians can reflect on how dyadic partnerships (focusing on the child or the parent) may exclude opportunities for coherent care. Further exploration in practice, policy and research as to how nurses determine child competency and child and parent level of engagement in triadic partnership may improve the potential of meaningful shared decision‐making. [ABSTRACT FROM AUTHOR]

Aim: To describe the contributing factors and types of reported medication incidents in home care related to the flow of information in different phases of the medication process, as reported by multi‐professional healthcare groups. Design: This descriptive, qualitative study used retrospective data. Methods: An incident‐reporting database was used to collect 14,289 incident reports from 2017 to 2019 in a city in Finland. We used this data to select medication incidents (n = 1027) related to the flow of information in home care and between home care and hospitals. Data were divided into five groups based on the medication phase: (1) prescribing, (2) dispensing, (3) administration, (4) documentation and (5) self‐administration. In addition, the types of medication‐related incidents were described. The data were examined using abductive content analysis. The EQUATOR SRQR checklist was used in this report. Results: Four main categories were identified from the data: (1) issues related to information management, (2) cooperation issues between different actors, (3) work environment and lack of resources and (4) factors related to healthcare workers. Cooperation issues contributed to medication‐related incidents during each phase. Incomplete communication was a contributing factor to medication incidents. This occurred between home care, remote care, hospital, the client and the client's relatives. Specifically, a lack of information‐sharing occurred in repatriation situations, where care transitioned between different healthcare professionals. Conclusion: Healthcare professionals, organisations, clients and their relatives should focus on the efficient and safe acquisition of medications. Specifically, the use of electronic communication systems, together with oral reports and checklists for discharge situations, and timely cooperation with pharmacists should be developed to manage information flows. Relevance to Clinical Practice: These findings demonstrate that healthcare professionals require uniform models and strategies to accurately and safely prescribe, dispense and administer medications in home care settings. No patient or public contributions. [ABSTRACT FROM AUTHOR]

Aims: The aims of the study were to explore the experiences of women with gestational diabetes mellitus (GDM) and their partners and examine the factors influencing partner involvement in GDM management, seeking to inform a targeted couple‐based intervention. Design: A descriptive qualitative study. Methods: We conducted semi‐structured interviews with 14 women with GDM and their partners. Participants were recruited through convenience sampling from a tertiary hospital in Xi'an, China. Data were analysed using thematic analysis. Results: Three themes and 12 subthemes were identified. Theme I: Women's expectations of their partner's involvement in GDM management—practical support and emotional support. Theme II: Partner involvement in GDM management—constructive involvement, unhelpful involvement with good intentions and insufficient involvement. Theme III: Factors that influence partner involvement in GDM—knowledge of GDM, GDM risk perception, health consciousness, attitudes towards the treatment plan, couple communication regarding GDM management, family roles and appraisal of GDM management responsibility. Conclusion: Women desired practical and emotional support from partners. The types of partner involvement in GDM management varied. Some partners provided constructive support, while some partners' involvement was limited, non‐existent or actively unhelpful. By combining these results with the factors influencing partner involvement, our findings may help healthcare professionals develop strategies to involve partners in GDM care and enhance women's ability to manage GDM. Implications for the Profession and Patient Care: Partner involvement in GDM care may help them understand and better attend to women's needs, thus improving their experience and potential outcomes. This study highlights novel factors that need to be considered in developing couple‐based interventions for this population. Reporting Method: The reporting follows the COREQ checklist. Patient or Public Contribution: Some patients were involved in data interpretation. There is no public contribution. [ABSTRACT FROM AUTHOR]

Aims and objectives: To explore collaborative practice and perceptions and attitudes of key stakeholders on collaboration in type 2 diabetes management in a tertiary care setting. Background: Understanding collaborative practice in diabetes care in developing countries helps to design and provide patient‐centred and cost‐effective care. Design: An exploratory qualitative study. Methods: Interviews were undertaken with 30 patients and 18 health professionals and policymakers. Thematic data analysis was undertaken to explore collaborative practice and examine participant perspectives on collaboration in diabetes management. We compared the findings with D'Amour's Collaboration Framework to determine the level of collaboration. Results: Most participants reported a lack of collaborative practice in diabetes management, while they appreciated its importance in improving care. Perceptions varied with respect to what constituted collaborative practice. Three themes were identified: (1) perspectives of key stakeholders on current practice of collaboration; (2) impediments to collaborative practice; (3) strategies to improve collaborative practice. Analyses of the themes using D'Amour's Collaboration Framework indicated a low level of collaboration among physicians, nurses, pharmacists and policymakers, which was attributed to workload and time pressures on health professionals, power dynamics and lack of role clarity of all actors in collaborative action. Participants commented on the need to improve collaboration by establishing strong leadership and governance at different healthcare structure levels, which is committed to coordinating collaboration and developing collaborative frameworks and policies that guide collaborative undertaking. Conclusions: Perceived shortcomings of collaboration were attributed to inadequate resources, power dynamics, a lack of strong team functioning and policies. Participants' positive perceptions provide an opportunity to improve collaborative practice through incorporation of collaborative frameworks and policies. Relevance to Clinical Practice: The findings in this study inform development of tailored and patient‐centred diabetes care in tertiary care settings in sub‐Saharan Africa. Reporting Method: The study was reported in accordance with the COREQ checklist. Patient or Public Contribution: Patients or the public were not involved in the design, analysis or interpretation of the data in this study. However, patients and healthcare providers participated in pilot interviews, which helped refine the interview guides. The summary of the findings of the study was also discussed with patients and healthcare providers, where they provided feedback. [ABSTRACT FROM AUTHOR]

Aim: To explore how patients with Inflammatory bowel disease experienced encounters with healthcare professionals in two gastrointestinal outpatient clinics to demonstrate what matters in the communication between patients and healthcare professionals. Design: This fieldwork study is part of a larger study developing an application for patients with inflammatory bowel disease in a framework inspired by Participatory Design. Participatory design consists of three phases and this study focused on the first phase, needs assessment. A phenomenological hermeneutic approach and qualitative methods were applied to obtain an understanding of patients' needs. Methods: Three weeks of participant observations and three focus groups with 14 subjects were conducted at two university hospitals in Denmark. Field notes and interview transcripts were analysed using condensation of meaning and interpreted based on interactional nursing practice theory. The reporting method adhered to the EQUATOR guideline: COREQ. Results: Four themes emerged: Easy and dependable access to healthcare professionals. Predictability of follow‐up appointments. Importance of privacy during patient exams and Quality of time spent with healthcare professionals. Conclusion: Easy, dependable access, privacy, presence and predictability of follow‐up appointments were important to patients with Inflammatory Bowel Disease. Implications for the profession and patient care: In communication with patients with inflammatory bowel disease, healthcare professionals must be aware of privacy and the importance of predictable follow‐up agreements. They must be aware that presence and easy, reliable access positively affect patients' self‐care skills. Patient contribution: This study is part of a larger project based on Participatory design involving patients and healthcare professionals in the development of technology to support communication. [ABSTRACT FROM AUTHOR]

Aim: A medical emergency team (MET) stand‐down decision is the decision to end a MET response and hand responsibility for the patient back to ward staff for ongoing management. Little research has explored this decision. This study aimed to obtain expert consensus on the essential elements required to make optimal MET call stand‐down decisions and the communication required before MET departure. Design: A Delphi design was utilised. Methods: An expert panel of 10 members were recruited based on their expert knowledge and recent clinical MET responder experience in acute hospital settings. Participants were emailed a consent form and an electronic interactive PDF for each survey. Two rounds were conducted with no attrition between rounds. The CREDES guidance on conducting and reporting Delphi studies was used to report this study. Results: Consensus by an expert panel of 10 MET responders generated essential elements of MET stand‐down decisions. Essential elements comprised of two steps: (1) the stand‐down decision that was influenced by both the patient situation and the ward/organisational context; and (2) the communication required before actioning stand‐down. Communication after the decision required both verbal discussions and written documentation to hand over patient responsibility. Specific patient information, a management plan and an escalation plan were considered essential. Conclusion: The Delphi surveys reached consensus on the actions and communication required to stand down a MET call. Passing responsibility back to ward staff after a MET call requires both patient and ward safety assessments, and a clearly articulated patient plan for ward staff. Observation of MET call stand‐down decision‐making is required to validate the essential elements. Implication for the Profession and Patient/or Patient Care: In specifying the essential elements, this study offers clinical and MET staff a process to support the handing over of clinical responsibility from the MET to the ward staff, and clarification of management plans in order to reduce repeat MET calls and improve patient outcomes. Impact: Minimal research has been focussed on the decision to hand responsibility back to ward staff so the MET may leave the ward with safety plan in place. This study provided expert consensus to optimise MET stand‐down decision‐making and the ultimate decision to end a MET call. Communication of agreed patient treatment and escalation plans is recommended before leaving the ward. This study can be used as a checklist for MET responder staff making these decisions and ward staff responsible for post‐MET call care. The aim being to reduce the likelihood of potentially preventable repeat deterioration in the MET patient population. Reporting Method: The CREDES guidance on conducting and reporting Delphi studies. Patient or Public Contribution: None. [ABSTRACT FROM AUTHOR]

Aims and Objectives: The aim of this study was to determine how much time nurses spend on direct and indirect patient care in acute and subacute hospital settings. Background: Quantifying direct and indirect nursing care provided during inpatient stay is vital to optimise the quality of care and manage resources. Design: Time and motion cross‐sectional observational study and reported the study according to the STROBE guideline. Methods: Nurses working in an acute or subacute medical wards of a single health service participated. Nurses were observed twice for 2 h on the same day with an observer break in between sessions. Real‐time task‐related data were digitally recorded using the Work Observation Method By Activity Timing (WOMBAT) tool by a single research assistant. Frequency and time spent on pre‐determined tasks were recorded and included direct care, indirect care, documentation, medication‐related tasks, communication (professional) and other tasks. Task interruptions and multitasking were also recorded. Results: Twenty‐one nurses (acute n = 12, subacute n = 9) were observed during shifts between 7 AM and 9 PM in May–July 2021. A total of 7240 tasks were recorded. Nurses spent a third of their time on direct patient care (27% direct care and 3% medication administration). A total of 556 task interruptions occurred, mostly during documentation, and medication‐related tasks. A further 1385 tasks were performed in parallel with other tasks, that is multitasking. Conclusions: Time spent on tasks was similar regardless of the setting and was consistent with previous research. We found differences in the distribution of tasks throughout the day between settings, which could have implications for workforce planning and needs to be investigated further. Interruptions occurred during documentation, direct care and medication‐related tasks. Local‐level strategies should be in place and regularly revised to reduce interruptions and prevent errors. Relevance to clinical practice The association between interruption and increased risk of error is well‐established and should be an ongoing area of attention including observations and education provided in local settings. [ABSTRACT FROM AUTHOR]

Aim and objective: To evaluate evidence that examined nurses' work experiences in hospital wards with single rooms. The research question was 'What does the research tell us about nurses' work experiences in hospital wards with single rooms?' Background: In the last decades, new hospital builds have moved towards including a high proportion of single rooms. Yet, single rooms create 'complex environments' that impact the nurses. Design: A structured integrative review was undertaken of empirical evidence. Methods: Original, peer‐reviewed articles, written in English, were sourced from four databases: CINAHL, PubMed, Embase and Web of Science. The initial searches were performed in April 2021 and repeated in December 2022. Quality appraisal was undertaken using the Mixed Methods Appraisal Tool. A narrative synthesis approach was used to analyse the data. Reporting was guided by the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA) statement. Results: Twelve studies, published between 2006 and 2022, with an international origin, and representing n = 826 nurses, were included in this review. The synthesis revealed mixed perspectives about nurses' work experiences in wards with single rooms. Whilst single rooms are 'all good in theory (and) a good idea', the reality was quite different. Synthesised findings are presented in four categories: (i) aesthetics and the physical space, (ii) privacy vs. isolation, (iii) safety, which includes situational awareness and (iv) communication and collaboration. Conclusion: This review describes how single rooms affects nurses' work experience. Whilst nurses shared multiple concerns about single rooms and the challenges they also acknowledged patient preference for the privacy and space afforded by single rooms. Relevance to Clinical Practice: Findings from this review highlight the need for careful planning to maintain and strengthen teamwork, prevent nurses' sense of working in isolation, as well as creating opportunities for mentorship, and collaboration among nurses when working in single‐room settings. [ABSTRACT FROM AUTHOR]

Aim: To explore nurses' and physicians' experiences of simulation‐based training in a crisis resource management quality improvement intervention on intensive care admission. Background: Quantitative studies have documented that staffs' non‐technical skills are improved after simulation‐based training in crisis resource management interventions. Experienced‐based consensus led to development of a quality improvement intervention based on principles of crisis resource management and tested in simulation‐based training to enhance staffs' non‐technical skills. However, the impact on staff is unexplored, leaving little understanding of the relationship between simulation‐based training in crisis resource management interventions and changes in non‐technical skills. Design: A qualitative study with a hermeneutical approach. Methods: Data consisted of semi‐structured interviews with physicians (n = 5) and nurses (n = 15) with maximum variation in work experience. Data were collected 3 months after implementation and analysed using thematic analysis. The COREQ guideline was applied. Results: The analysis revealed three themes: prioritising core clinical activities and patient centredness; transition into practice; and reflection on patient safety. These themes reflected staff's experiences of the intervention and implementation process, which evolved through prioritising core clinical activities that facilitated the transition into clinical practice and staff's reflection on patient safety. Conclusions: Prioritising core clinical activities were facilitated by clear communication, predefined roles and better teamwork. Transition into practice stimulated professional growth through feedback. Reflection on patient safety created a new understanding on how a new structure of intensive care admission could be implemented. Collectively, this indicated a joint understanding of admissions. Implications for Practice: Findings enables health care professionals to understand how the intervention can contribute to improve quality of care in management of intensive care admission. Improving non‐technical skills are vital in high‐quality admissions, which supported a structured process and a collaborative professional standard of admissions. Patient and Public Contribution: None. [ABSTRACT FROM AUTHOR]

Aims: This study examined the perceptions of the SHARE plus intervention and its effects on communication, collaboration, and involvement in day‐to‐day diabetes management in older adults with Type 1 diabetes (T1D) and their care partners. Background: The SHARE plus intervention includes continuous glucose monitoring with a data sharing app that allows care partners to view glucose data on a smartphone and receive alerts. People with T1D and their care partners are educated about communication strategies, problem‐solving strategies, and action planning when using glucose data sharing. Design: Qualitative descriptive design. Methods: Older adults with T1D wore a continuous glucose monitor for 3 months (n = 10). Care partners (n = 10) used a data‐sharing app. The SHARE plus intervention consisted of one 90‐min education session. Semi‐structured interviews were conducted across 10 dyads (person with diabetes and care partner) following the 12‐week study. A qualitative description and a constant comparison approach were used to examine similarities and differences in experiences. Interviews were transcribed, coded, and analysed for common themes. The manuscript adheres to COREQ EQUATOR checklist. Results: The SHARE plus intervention increased diabetes knowledge across the dyads, improving confidence and helping partners understand how to navigate symptoms and behaviours and when to intervene. Dyads worked together to optimise diabetes management through improved communication, collaboration, and management of disagreements. Although the majority of persons with diabetes and their care partners reported no conflictual communication, disagreements about diabetes management remained in some dyads. The SHARE plus intervention impacted care partners in various ways from a psychological perspective. While live‐in‐care partners felt peace of mind, care partners living away from persons with diabetes had some increased worry and concern. Conclusion: The SHARE plus intervention results can help guide future development of diabetes dyadic care and education interventions using diabetes technology. Relevance to Clinical Practice: The SHARE plus intervention is a brief, practical intervention that can help diabetes clinicians improve communication and collaboration among spouses living with older adults with T1D who use continuous glucose monitoring with data sharing. Patient Contribution: A person with diabetes was part of the research team and assisted with design of the intervention and subsequent interviews and analysis. [ABSTRACT FROM AUTHOR]

Objective: To identify and describe the attributes of relational care from an Indigenous Māori healthcare consumer perspective. Data Sources: CINAHL Plus, Ovid MEDLINE, ProQuest Nursing & Allied Health, Scopus, New Zealand Index, the Ministry of Health Library, New Zealand Research and Google Scholar were searched between 23 and 30 May 2022. Methods: This scoping review used the Joanna Briggs Institute methodology for scoping reviews, thematic analysis and the Patterns, Advances, Gaps, Evidence for practice and Research recommendations framework for the synthesis of the findings. Results: A total of 1449 records were identified, and 10 sources were selected for final review. We identified five relational attributes that were most important to Māori: (1) the expressive behaviours and characteristics of healthcare professionals (HCPs), (2) communication to facilitate the healthcare partnership, (3) appreciating differing worldviews, (4) the context in which healthcare is delivered and (5) whanaungatanga (meaningful relationships). Conclusion: The relational attributes identified are inextricably linked. Connecting with HCPs and developing a therapeutic relationship is fundamental to improving consumer experience and engagement with mainstream healthcare services. Whanaungatanga is fundamental to meaningful engagements with HCPs. Future research should explore how relational care is practiced in acute care settings when clinician–consumer interactions are time‐limited, examine how the health system influences the capacity for relational care and how Indigenous and Western paradigms can co‐exist in healthcare. Implications: This scoping review can inform future projects addressing health equity for Indigenous communities by creating environments that prioritise culturally safe relational care and value Indigenous knowledge systems. Reporting Method: We used the Preferred Reporting Items for Systematic reviews and Meta‐Analyses extension for Scoping Reviews (PRISMA‐ScR) Checklist. No Patient or Public Contribution: No patient or public contribution. [ABSTRACT FROM AUTHOR]

Aim: To describe how women perceived relational autonomy for decision‐making during childbirth pain and illuminate influencing factors. Background: Most women report challenging pain during birth. Circumstances can affect their ability to engage in pain management decisions. Design: We used an interpretative description approach to conduct this study. Method: A purposive sample of ten women who reported pain during childbirth participated in semi‐structured interviews. The study was conducted between July 2019 and November 2020 and reported according to the COREQ checklist. Results: Circumstances during childbirth, such as women's expectations and relationships, influenced their efforts to engage in relational autonomy. Care providers dealt with the unpredictability of childbirth and challenges with pain management using decision‐making practices that could disrupt women's expectations, undermine women's trust, demonstrate disrespect for women and rely on inadequate communication. Women who felt dependent on others were less likely to participate in decision‐making. When care providers' perceptions about pain differed from women's reports of pain, participants became distressed because care providers did not acknowledge their subjective pain experiences. Conclusions: Women regarded their relationships and communication with care providers as foundational to relational autonomy in decision‐making about pain management during childbirth. Relevance to clinical practice: Study findings can support care providers' considerations of the complexity of childbirth pain and factors affecting women's relational autonomy in decision‐making about pain. In particular, the findings highlight the importance of women's expectations and care providers' recognition of women's experiences of pain. Patient or public contribution: Women who shared their stories of childbirth pain contributed to the data collected. The chief nursing officers in the data collection setting facilitated the recruitment and data collection. [ABSTRACT FROM AUTHOR]

Aim: To synthesise evidence about informal carers' (carers) experience of their support needs, facilitators and barriers regarding transitional care of older adults with multimorbidity. Background: Carers provide crucial support for older adults during care transitions. Although health practitioners are well positioned to support carers, system factors including limited healthcare resources can compromise the quality of care transitions. Design: Scoping review. Methods: Searches were undertaken of the published literature. Five databases were searched including MEDLINE, CINAHL, EMBASE, PsycINFO and the Cochrane Library. Two reviewers independently screened articles to identify relevant studies. Studies were retrieved from January 2000 to July 2022. Data were extracted and tabulated for study characteristics, support needs, facilitators and barriers. Key themes and patterns were synthesised across the studies. Results: Eighteen studies including N = 3174 participants were retrieved. Most studies (n = 13) employed qualitative designs. Five studies used surveys. Carers reported their need to: be involved in coordinated discharge planning; advocate and be involved in decision‐making; and receive community‐based follow‐up. Carers described facilitators and barriers in four themes: (1) relationships with the older adult and health practitioners, (2) being involved in coordinated discharge planning; (3) communication and information strategies; and (4) community‐based follow‐up. Synthesis of themes across all studies resulted in the identification of five areas of research: carers' health literacy; community‐based care; carers' involvement in transitional care planning; inpatient and community health practitioners' communication skills; and culturally diverse carers' experiences. Conclusion and Relevance to Clinical Practice: The review highlights the importance of quality communication and relationships between carers, older adults, health practitioners and health organisations. Although information and education are important there is a need for further research to examine systems that support communication between carers, older adults and health practitioners and health literacy for all carers including culturally diverse carers. [ABSTRACT FROM AUTHOR]

Aims and Objectives: To determine which factors can be considered protective of ethical conflicts in intensive care unit healthcare professionals during a pandemic. Background: The COVID‐19 pandemic gave rise to new ethical concerns in relation to the management of public health and the limitations on personal freedom. Continued exposure to ethical conflict can have a range of psychological consequences. Design: A qualitative design based on phenomenological approach. Methods: A total of 38 nurses and physicians who were regular staff members of Barcelona and Milan's public tertiary university hospitals and working in intensive care units during the first wave of the COVID‐19 pandemic. Semi‐structured online in‐depth interviews were conducted. A thematic analysis was performed by two independent researchers following the seven steps of Colaizzi's methods. We adhere COREQ guidelines. Results: One theme 'Protective factors of ethical conflict in sanitary crisis' and four subthemes emerged from the data: (1) knowledge of the infectious disease, (2) good communication environment, (3) psychological support and (4) keeping the same work team together. Conclusions: Four elements can be considered protective factors of ethical conflict for healthcare professionals during a sanitary crisis. While some of these factors have already been described, the joint identification of this set of four factors as a single element is, in itself, novel. This should help in ensuring the right mechanisms are in place to face future pandemics and should serve to improve institutional organisation and guarantee safe and high‐quality patient care in times of healthcare crisis. Relevance to Clinical Practice: Future strategies for the prevention of ethical conflict during sanitary crises, pandemics or other catastrophes need to consider a set of four factors as a single element. These factors are the knowledge of the infectious disease, a good communication environment, psychological support and keeping the same work team together into joint consideration. [ABSTRACT FROM AUTHOR]

Aims and Objectives: To explore the perceptions of family‐centred care among nurses and the family members of hospitalised children and investigate the facilitators of and barriers to the implementation of family‐centred care in Malawi. Background: In Malawi, approximately 34% of children have long‐term illnesses that require hospitalisation. Family‐centred care ensures that the delivery of healthcare is grounded in partnerships between healthcare providers, patients and their families, which can improve the psychological well‐being of families. However, there is lack a good understanding of how families and nurses perceive this concept, its facilitators and the barriers. Design: This was an exploratory qualitative study. Data were analysed deductively and inductively using the five‐step qualitative content analysis method. Methods: Twenty‐nine nurses and 31 families were recruited. Data were collected through in‐depth, semi‐structured and face‐to‐face individual interviews. The study was reported using the COREQ checklist. Results: Both nurses and families of hospitalised children recognised the importance of nurse–family partnerships in family‐centred care. Four themes emerged as follows: Perceptions of family‐centred care, elements of family‐centred care, facilitators of family‐centred care and barriers to family‐centred care. Specific information to families and the religious beliefs of families were identified as important facilitator and barrier to family‐centred care, respectively. Conclusion: The implementation of family‐centred care is promising in Malawi, as it is positively perceived by nurses and families, and its implementation is consistent with the Institute for Patient and Family‐Centred Care Framework. Relevance to clinical practice: Our findings present the best practices, gaps and challenges in the context of a low‐income country regrading implementation of family‐centred care. Education programmes on family‐centred care are crucial for sustaining the current gains. [ABSTRACT FROM AUTHOR]

Background: Patient engagement has emerged as a key focus in the research literature to facilitate patients' recovery. The term is commonly used by researchers, yet without working definitions. This lack of clarity is further complicated by the interchangeable use of a few terms. Objectives: This systematic review aimed at identifying how patient engagement was conceptualised and operationalised in perioperative settings. Methods: MEDLINE, EMBASE, CINAHL and the Cochrane Library were searched for publications in English discussing patient engagement during the perioperative phase. Three reviewers conducted study selection and methodological assessment using Joanna Briggs Institute mixed methods review framework. Reflexive thematic analysis was used to analyse qualitative data and descriptive analysis for quantitative data. Findings: Twenty‐nine studies were included with a total sample of 6289. Study types included qualitative (n = 14) and quantitative (n = 15) with different types of surgery. Sample sizes ranged from n = 7 to n = 1315. Only 38% (n = 11) of included studies offered an explicit definition. Four themes associated with operationalisation included provision of information, which was most studied theme, communication, decision‐making and action‐taking behaviours. All four themes were interconnected and co‐dependent on each other. Conclusions: Patient engagement in perioperative settings is a complex and multifaceted concept. The conceptual void in the literature calls for more theoretically informed and comprehensive approaches to researching surgical patient engagement. Future research should aim to better understand the factors that influence patient engagement, as well as the impact of different forms of engagement on patient outcomes through the whole surgical journey of a patient. [ABSTRACT FROM AUTHOR]

Aim: To explore the experiences of women who have had ovarian hyperstimulation syndrome, and healthcare professionals who care for them. Background: Ovarian hyperstimulation syndrome is a side effect of fertility treatment. Little research exists internationally that explores the experiences of women who have had this condition, or the healthcare professionals who manage it. Design: Qualitative study using semi‐structured interviews. Methods: Eighteen interviews with women who had experienced ovarian hyperstimulation syndrome (n = 10) and healthcare professionals (n = 8) in six UK fertility centres. Framework analysis was used. This paper is reported following COREQ guidelines. Results: Women described a range of symptoms and severity, sometimes experiencing worrying physical health problems such as abdominal swelling and shortness of breath. The combination of the symptoms, and their management, on delaying future fertility treatment could cause emotional distress. Healthcare professionals at different centres described variation in practice, which generally involved 'active monitoring' until symptoms became severe, when women would be hospitalised. Women expressed feeling 'left in limbo' while waiting for symptoms to improve or worsen, and described a lack of control during this waiting period. Healthcare professionals felt they provided adequate information about ovarian hyperstimulation syndrome and its management. This, however, did not align with women's perceptions that information, including potential delays to their fertility treatment, was missing. There was similar mismatch between women's and healthcare professionals' views of decision‐making about fertility treatment following ovarian hyperstimulation syndrome, including women's concerns about having to make rushed, unplanned decisions about their fertility treatment when they did not feel adequately informed to do so. Conclusion: Ovarian hyperstimulation syndrome and its management can have a significant physical and emotional impact on women, and influence their fertility treatment. Improvements could be made to the information women receive about this condition, its management and its implications for wider fertility treatment. Implications for the profession and/or patient care: Nurses have the skills and knowledge to support women through the physical and emotional stresses of fertility treatment. Therefore, they are well placed to provide specialist information and support for OHSS and ensure women are fully informed about all aspects of the condition, including how its management might delay fertility treatment. [ABSTRACT FROM AUTHOR]

Aims and Objectives: To investigate the association between perceived nurse–patient interaction and quality‐of‐life among nursing home residents, adjusted for loneliness, anxiety and depression. Background: Symptoms of anxiety and depression are known to residents of nursing homes along with cognitive impairment, physical inactivity and low quality‐of‐life. Anxiety, depression and loneliness are found detrimental to NH residents' quality‐of‐life. The nurse–patient relationship is important for patient's well‐being, both in terms of illness and symptom management. Design: Cross‐sectional design. Methods: Data were collected in 2017 and 2018 from 188 residents in 27 nursing homes resided in two large urban municipalities in Middle and Western Norway. The inclusion criteria were: (1) local authority's decision of long‐term NH care; (2) residential stay 3 months or longer; (3) informed consent competency recognised by responsible doctor and nurse; (4) capable of being interviewed, and (5) aged 65 years or older. This article is executed in accordance with STROBE statement. Results: Adjusting for age, sex, anxiety, depression and loneliness, perceived nurse–patient interaction was statistically significant to quality‐of‐life. While anxiety and depression showed insignificant estimates, loneliness demonstrated a significant relation with quality‐of‐life. Nurse–patient interaction and loneliness explained together 25% of the variation in quality‐of‐life. Conclusion: This study suggests that loneliness is frequent as well as more detrimental to quality‐of‐life among nursing home residents compared to anxiety and depression. Furthermore, the present results show that the nurse–patient interaction represents an essential health‐promoting resource for Quality‐of‐life in this population. Relevance to clinical practice: Staff nurses need to exercise their awareness of loneliness to meet residents' needs. Nursing educations should provide knowledge about nurse–patient interaction, and students as well as staff nurses in NHs should be trained, for instance by simulation, to use the nurse–patient interaction as a health‐promoting resource. Finally, loneliness represents a bigger challenge than depression and anxiety; accordingly, building nurses that are capable of meeting patients' needs and facilitate care that counteracts loneliness is highly warranted [ABSTRACT FROM AUTHOR]

Aims: To examine the existing literature on child–parent‐nurse relationships (in relation to communication, information, and involvement and decision‐making) during postoperative pain management. Background: Pain in children is under‐reported and under‐treated in hospitals and research has continued to report high rates of pain among hospitalised children worldwide. The role of child–parent‐nurse relationships may be a factor and to date, no review has been identified that focus on these relationships during postoperative pain management. Design: A systematic scoping review following Arksey and O'Malley with further adaptations based on JBI. Methods: A systematic search for published primary studies was conducted using the Medline, CINAHL, British Nursing Index, ASSIA, PsycINFO, Science Direct and Web of Science in English from 2000 to 2022. Two reviewers independently carried out data screening and extraction and any differences were resolved with the assistance of a third reviewer. The data were analysed using thematic analysis and presented descriptively. This study followed the PRISMA‐ScR Checklist. Results: A total of 37 studies met the inclusion criteria. The findings mainly demonstrated a focus on the perspectives of parents and nurses with less on children's perspectives and none of the studies explored child‐nurse relationships. The findings were categorised under three themes: communication, information, and involvement and decision making. Conclusion: A prevailing deficiency in child–parent‐nurse relationships significantly contributed to suboptimal postoperative pain care, causing prolonged and untreated postoperative pain in children. Children's hesitation in communicating with nurses, the limited communication skills of nurses, and the weak communication position of parents in a hospital setting all hindered the development of strong relationships between children, parents, and nurses. The unclear definition of the roles of children and parents in postoperative pain management resulted in confusion for both parents and nurses. This was exacerbated by parents' lack of knowledge and inadequate guidance from nurses, ultimately leading to a decreased level of parental involvement in their child's postoperative pain management while in the hospital. Unattended requests for pain management caused children to experience prolonged pain and led to a deterioration in the relationship between parents and nurses, as well as a reduction in the parents' ability to provide pain care to their child. Relevance to Clinical Practice: This study highlights the reasons behind the suboptimal management of postoperative pain in children. The importance of the relationship between children, parents, and nurses in pain management must be acknowledged, and the results of this study may be used to inform improvements in nursing pain management practices. No Patient or Public Contribution: Patient or public contribution is not a necessary stage in a systematic scoping review following Arksey and O'Malley's framework. [ABSTRACT FROM AUTHOR]

Aim: To explore nurses' and family members' perspectives of family care at the end of life, during restricted visitation associated with the COVID‐19 pandemic. Background: To minimise the transmission of COVID‐19, stringent infection prevention and control measures resulted in restricted hospital access for non‐essential workers and visitors, creating challenges for the provision of family‐centred care at the end of life. Design: Qualitative descriptive approach based on naturalistic inquiry. Methods: At a large public hospital in Melbourne, Australia, individual semi‐structured interviews were undertaken with 15 registered nurses who cared for patients who died during restricted visitation associated with the COVID‐19 pandemic, and 21 bereaved family members. COREQ guidelines informed analysis and reporting. Results: Five themes developed from the data: (i) impact of visitor restrictions, which describes uncertain, ambiguous and arbitrary rules, onerous and inconsistent requirements; (ii) nurse‐family communication; (iii) family‐centred care and interrupted connections; (iv) well‐being and negative emotions; and (v) suggestions for a better way, such as moving away from the black and whiteness of the rules, prioritising communication, compassion and advocacy. Conclusions: Negative consequences for communication and the patient‐family connection at the end of life were felt deeply. The evolving COVID‐19 rules that were frequently revised and applied at short notice, and the subsequent consequences for clinical practices and care were felt deeply. Relevance to Clinical Practice: Technology‐facilitated communication, innovation and increased resources must be prioritised to overcome the challenges described in this study. A family‐centred approach to care and emphasising the patient‐family connection at the end of life is fundamental to minimising trauma and distress associated with future public health emergencies. Patient or Public Contribution: Bereaved family members contributed their first‐hand experience. Members of the health service's patient experience team ensured the research was conducted in accordance with health service guidelines for patient and public contribution. [ABSTRACT FROM AUTHOR]

Aim and Objectives: The aim of this study was to explore the sources of ethical conflict and the decision‐making processes of ICU nurses and physicians during the first and subsequent waves of the COVID‐19 pandemic. Background: Depside several studies exploring ethical conflicts during COVID‐19 pandemic, few studies have explored in depth the perceptions and experiences of critical care professionals regarding these conflicts, the decision‐making process or which have analysed the complexity of actually implementing the recommendations of scientific societies and professional/healthcare institutions in interdisciplinary samples. Design: A descriptive phenomenological study. Methods: Thirty‐eight in‐depth interviews were conducted with critical care nurses and physicians from five hospitals in Spain and Italy between December 2020 and May 2021. A thematic content analysis of the interview transcripts was conducted by two researchers. Consolidated criteria for reporting qualitative research (COREQ) were employed to ensure the quality and transparency of this study. Results: Two main themes emerged as sources of ethical conflict: the approach to end of life in exceptional circumstances and the lack of humanisation and care resources. The former comprised two subthemes: end‐of‐life care and withholding and withdrawal of life‐sustaining treatment; the latter comprised three subthemes: the impossibility of guaranteeing the same opportunities to all, fear of contagion as a barrier to taking decisions and the need to humanise care. Conclusions: Professionals sought to take their decisions in line with professional ethics and bioethical principles, but, nevertheless, they experienced moral dilemmas and moral distress when not being able to care for, or to treat, their patients as they believed fit. Relevance to Clinical Practice: Further education and training are recommended on the provision of end‐of‐life and post‐mortem care, effective communication techniques via video calls, disclosure of bad news and bioethical models for decision‐making in highly demanding situations of uncertainty, such as those experienced during the COVID‐19 pandemic. [ABSTRACT FROM AUTHOR]

Aims and Objectives: To provide an overview and synthesis of the current evidence on healthcare aides' involvement in team decision‐making in long‐term care. Background: Healthcare aides provide the most direct care to residents in long‐term care homes and are uniquely positioned to influence the quality of care. Yet, they are not typically included in team decisions for improving resident care. As demand for long‐term care increases, it is essential that we have a comprehensive understanding of ways to support healthcare aides' role on the interprofessional team for decision‐making about resident care. Design: Narrative review. Method: Five electronic databases were searched for articles published in English between 2008 and 2020. Thematic analysis was conducted to synthesise findings using an organising framework. Reporting followed the PRISMA‐ScR. Results: Twelve studies were included. Results indicate that work environment factors that influenced (supported or hindered) healthcare aides' involvement in decision‐making included information access/availability, hierarchical staffing structures and supervisor support/shared governance. Relational processes that influenced team decision‐making included team communication and collaboration, information sharing and exchange, and the quality of work relationships among team members. Strategies are discussed that could address the identified barriers and support healthcare aides' active involvement in team decisions regarding resident care. Conclusions: This review highlights the pervasive underutilization of healthcare aides, who have the most knowledge of residents to support person‐centred care. There remains a paucity of research on healthcare aides' involvement in team decision‐making. Research is needed to examine the effectiveness of interventions to support healthcare aides' participation in decision‐making and the impact on staff and resident outcomes. Relevance to Clinical Practice: It is crucial that healthcare aides are afforded opportunities to be part of the interprofessional team for information sharing and decision‐making for resident care. Managers play a key role in supporting healthcare aides' inclusion in decision‐making. [ABSTRACT FROM AUTHOR]

Background: Tracheostomy dislodgment can lead to catastrophic neurological injury or death. A fresh tracheostomy amplifies the risk of such events, where an immature tract predisposes to false passage. Unfortunately, few resources exist to prepare healthcare professionals to manage this airway emergency. Aim: To create and implement an accidental tracheostomy dislodgement (ATD) bundle to improve knowledge and comfort when responding to ATD. Materials & Methods: A multidisciplinary team with expertise in tracheostomy developed a 3‐part ATD bundle including (1) Tracheostomy Dislodgement Algorithm, (2) Head of Bed Tracheostomy Communication Tool and (3) Emergency Tracheostomy Kit. The team tested the bundle during the COVID‐19 pandemic in a community hospital critical care unit with the engagement of nurses and Respiratory Care Practitioners. Baseline and post‐implementation knowledge and comfort levels were measured using Dorton's Tracheotomy Education Self‐Assessment Questionnaire, and adherence to protocol was assessed. Reporting follows the revised Standards for Quality Improvement Reporting Excellence (SQUIRE). Results: Twenty‐four participants completed pre‐test and post‐test questionnaires. The median knowledge score on the Likert scale increased from 4.0 (IQR = 1.0) pre‐test to 5.0 (IQR = 1.0) post‐test. The median comfort level score increased from 38.0 (IQR = 7.0) pre‐test to 40.0 (IQR = 5.0) post‐test). In patient rooms, adherence was 100% for the Head of Bed Tracheostomy Communication Tool and Emergency Tracheostomy Kit. The adherence rate for using the Dislodgement Algorithm was 55% in ICU and 40% in SCU. Discussion: This study addresses the void of tracheostomy research conducted in local community hospitals. The improvement in knowledge and comfort in managing ATD is reassuring, given the knowledge gap among practitioners demonstrated in prior literature. The ATD bundle assessed in this study represents a streamlined approach for bedside clinicians – definitive management of ATD should adhere to comprehensive multidisciplinary guidelines. Conclusions: ATD bundle implementation increased knowledge and comfort levels with managing ATD. Further studies must assess whether ATD bundles and other standardised approaches to airway emergencies reduce adverse events. Relevance to Clinical Practice: A streamlined intervention bundle employed at the unit level can significantly improve knowledge and comfort in managing ATD, which may reduce morbidity and mortality in critically ill patients with tracheostomy. [ABSTRACT FROM AUTHOR]

Aims and objectives: This study aimed to explore whether an intervention using visual telehealth improves care outcomes for residents in residential aged care facilities during acute illness events from the perspective of the nurses from residential aged care facilities and emergency departments. The intervention was the addition of visual telehealth, to an already existing outreach service called Aged Care Emergency. Background: Older people who are residents of residential aged care facilities commonly experience potentially avoidable visits and hospitalisations. Adopting visual telehealth or telemedicine has emerged as a care transition solution across several domains in health care, including residential aged care. Method: This study used an interpretive descriptive methodological approach and was part of a larger study called the PACE‐IT project that implemented a visual telehealth assisted model of care in four emergency departments and 16 residential aged care facilities to prevent unnecessary resident presentations to emergency departments. We report findings from six focus groups that explored key issues relating to the experiences of emergency department and residential aged care nurses who participated in the PACE‐IT project. This study adhered to COREQ research guidelines. Results: There were four overarching themes that emerged from the six focus groups; facilitated person centred care; built confidence, relationships and trust; enabled bidirectional communication that strengthens decision making, but there were issues with technology access, connectivity and usability between the acute care setting and the residential aged care facility. Relevance to clinical practice: Understanding the experiences of residential aged care facility and emergency nurses' experiences when using visual telehealth will better inform practice development in aged care, in particular enhancing decision making and increasing safe practices using telehealth. The knowledge gained in this study in terms of enhanced assessments for residents will provide policy makers with valuable insights for future health care planning and implementation of telehealth. Trial registration: ACTRN12619001692123. [ABSTRACT FROM AUTHOR]

Aims and objectives: The aim of this study was to explore caller satisfaction with interaction, and the association to overall satisfaction with calls. Background: In the era of expanding healthcare at distance, the telephone remains a common tool for the provision of nursing care. Interaction between telenurse and caller in telenursing is vital for safety, satisfaction and adherence reasons. Few studies have quantitatively explored interaction in calls and how it relates to overall satisfaction with calls. Design: Cross‐sectional survey study with a deductive approach. Methods: A total of 466 callers to the Swedish Medical Advisory Service completed the Telenursing Interaction and Satisfaction Questionnaire. Satisfaction with four theoretically defined components of interaction were compared using repeated measures ANOVA. Associations between satisfaction with interaction and overall satisfaction with calls were evaluated with ordinal logistic regression models with and without adjustment for age, sex, health status, waiting time, time for call, main result of the call and expectations. The study followed the STROBE checklist. Results: Callers were most satisfied with affective support, followed by professional‐technical competence, health information and decisional control—in that order. A summated score of satisfaction with interaction was positively and significantly associated with overall satisfaction with calls before and after adjustment for waiting time, main result of call and variables related to the individual caller. Conclusions: Caller satisfaction with interaction is generally high but can be improved, especially regarding decisional control. Satisfaction with interaction is important for overall satisfaction with calls. Relevance to clinical practice: This study provides support for professionals at all levels in telenursing organisations to pay attention to interactional matters. The development of best practice for telenurses needs to consider all four components of interaction to enhance satisfaction with calls. [ABSTRACT FROM AUTHOR]

Aims and objectives: This study aimed to examine the lived experience of physicians and nurses who underwent hospitalised isolation during the Middle East respiratory syndrome coronavirus outbreak that hit Korea in 2015, and how it may have affected their professional self‐image. Background: Health professionals caring for patients during infectious outbreaks such as the Middle East respiratory syndrome have reported negative psychological effects. However, little is known about how the experience influences their professional self‐image. Design: An interpretive phenomenological approach was applied using individual in‐depth interviews. Methods: Through purposeful and snowball sampling, 11 health professionals who had experienced hospital isolation due to suspicious symptoms of Middle East respiratory syndrome during the outbreak, participated in face‐to‐face interviews (50–90 min). We adhered to the Consolidated Criteria for Reporting Qualitative Research guideline for reporting. Results: Six themes were identified: (a) engulfed in chaos and exhaustion; (b) feeling hurt and constrained by the rejection and blame; (c) anxiety induced by the enclosed environment; (d) dread of this uncertain and critical disease; (e) sustained by family and colleagues; and (f) reflection at this turning point, expanding self‐understanding and seeking a balance. Conclusion: Hospitalised isolation was a "turning point" that appeared to change health professionals' sense of identity and direction. Relevance to clinical practice: Preparedness for infectious epidemics should ensure tangible assistance, protection, and clear communication with health professionals, with careful attention to their psychological needs and affirmation of their self‐image in the aftermath. [ABSTRACT FROM AUTHOR]

Aims and objectives: To outline and to examine the current research and grey literature on aggressive incidents of persons with dementia towards professional caregivers in the home care setting. We intended to identify evidence and research gaps in this field. Background: Worldwide, around fifty million people are living with dementia. Current research indicates that aggressive behaviour of persons with dementia towards professional caregivers occurs frequently in inpatient settings. However, there has been little research on this phenomenon in the home care setting. Design: The design entails a scoping review using the methodological framework of Arksey and O'Malley and PRISMA‐ScR. Methods: A systematic literature search in five databases and a web search in Google Scholar was conducted. Title and abstract screening and a full‐text screening were conducted by two independent authors. A free web search for grey literature was conducted in Google. Results: The search yielded 1,376 hits. A total of seven journal articles met the inclusion criteria. In the free web search, six references were identified for inclusion, resulting in a total of 13 references. We identified the following four themes: (1) aggressive behaviour in the context of dementia, (2) triggering factors of aggressive behaviour in persons with dementia, (3) skills and educational needs and (4) hindrances to solving the problem of aggressive behaviour. Conclusions: There is a lack of literature on aggressive behaviour of persons with dementia in the home care setting, and various hindrances to solving this problematic behaviour have been identified. Relevance to clinical practice: For home caregivers, specific education concerning communication skills and responding to aggressive behaviour may help to deal with the situation. A further approach may involve specific training aimed to improve caregivers' confidence. [ABSTRACT FROM AUTHOR]

Aims and Objectives: To analyse the dimensions of quality of palliative nursing care and to explore the perceptions of professionals for the development and validation of the Palliative Nursing Care Quality Scale. Background: The study of palliative nursing care quality has been approached from analysis of the competencies of palliative care nurses, based on various theoretical models. However, there are fewer qualitative empirical studies that have evaluated what good palliative nursing care is and what its dimensions are. Design: Mixed‐method, Delphi approach and exploratory qualitative study. Methods: Consensus by a panel of experts using the Delphi technique and semi‐structured interviews. The study was reported in a comprehensive manner following COREQ criteria. Data collection took place between January and June 2018. Results: The eight‐person expert panel reached consensus on the following dimensions of the Palliative Nursing Care Quality Scale: control and relief of symptoms, family and/or primary caregiver, therapeutic relationship, spiritual support and continuity of care. Thematic analysis of ten interviews identified four emergent themes related to good nursing care: (1) the patient and family as a whole; (2) finding meaning; (3) responsible communication; and (4) caring for the human element. Conclusions: The quality of palliative nursing care goes beyond providing comprehensive care; it means meticulously looking after every detail of what is important to the patient. The expectations of professionals are not as important. Instead, care should be based primarily on the needs and respect for the wishes of the patient and their family. Relevance to Clinical Practice: Specifying the quality of nursing care in routine practice and reaching a consensus on its dimensions means moving towards excellence in care, as well as improving the professional profile of advanced practice palliative care nurses. Patient or Public Contribution: Two primary caregivers participated in the panel of experts and the semi‐structured interview. [ABSTRACT FROM AUTHOR]

Aims and Objectives: To describe the facilitators and barriers of getting from 'something's not right' to a childhood cancer diagnosis from the perspective of parents living in the United States of America. Background: It is common for families to experience long trajectories from when they first notice symptoms to receiving a childhood cancer diagnosis. Understanding this trajectory within the social and cultural contexts of the United States healthcare system is the first step in developing strategies for reducing this timeframe and mitigating some of the psychosocial impact for parents in receiving a childhood cancer diagnosis. This study examines the interpretations and meanings parents attributed to their child's symptoms, their decisions regarding seeking medical care, interactions with healthcare providers and the time course of events. Design: An inductive qualitative inquiry. Methods: In‐depth, semi‐structured interviews with 55 participants representing 39 unique cases of childhood cancer were conducted. Data were analysed using an inductive thematic approach. COREQ guidelines were followed. Results: Participants described multiple barriers and facilitators in their path to receiving a childhood cancer diagnosis. Facilitators included noticing something 'wasn't right' and physician in agreement that symptoms were unusual; acute symptoms requiring action; advocating for a diagnosis; and obtaining a second opinion. Barriers included parents having to interpret symptoms in the context of daily life; physician dismissiveness even when symptoms persisted; and not feeling they could question their physician's assessment. Conclusion: Families experience multiple facilitators and barriers in their trajectory to receiving a childhood cancer diagnosis. Relevance to Clinical Practice: Understanding the path to diagnosis from the parent perspective may increase opportunities for shared decision‐making. Clinician educational modules that include family perspectives may improve patient/parent–provider relationships. Participant Contribution Participants described their family's cancer journey through narrative storytelling. Participants had the opportunity to review and make edits to their transcript. [ABSTRACT FROM AUTHOR]

Aims and Objectives: This study aimed to comprehensively review the research literature to provide an overview of the effects of Humanitude on people with dementia and their caregivers. Background: Humanitude is a relationship‐centred and compassionate care approach that focuses on improving the communication between people with dementia and their caregivers. There is a lack of updated and comprehensive synthesis on the evidence of the effects of Humanitude in dementia care. Design and Methods: This paper adopted the scoping review framework by Arksey and O'Malley. We searched through the following databases: Pubmed, CINAHL, EMBASE, PsycINFO, ProQuest, Scopus and Web of Science from its inception to 3 September 2021. Three investigators independently screened the titles and abstracts and assessed the full‐text articles for eligibility. The PRISMA‐ScR checklist was included in this scoping review. Results: We retrieved 1317 articles from databases and grey sources. Eleven studies were included after the screening. The synthesised results suggest that Humanitude can reduce agitation and psychological symptoms and improve the general well‐being of people with dementia. Humanitude also has positive effects in improving care communication, empathy, job satisfaction and reducing burnout among caregivers. Conclusion: Humanitude shows the potential for positive effects on people with dementia and their caregivers. However, most studies did not include a comparator group and could not provide rigorous findings as compared to randomised controlled trials. There is a need for randomised controlled studies to demonstrate the effectiveness of Humanitude on people with dementia and their caregivers. Relevance for Clinical Practice: This paper reviewed the literature on all types of publications that examine the use of Humanitude in people with dementia and their caregivers. Thus, it provided an up‐to‐date overview of the effects of Humanitude to inform clinical practice. [ABSTRACT FROM AUTHOR]

Aims: The aim of this concept analysis was to develop a contemporary operational definition of Clinical Judgement in nursing. Design: Concept analysis. Methods: Rodgers' evolutionary method of concept analysis. Throughout the study, the authors followed the SRQR checklist. Results: This concept analysis guided the development of an operational definition of clinical judgement, within the context of nursing, articulated as Clinical judgement is a reflective and reasoning process that draws upon all available data, is informed by an extensive knowledge base and results in the formation of a clinical conclusion. Conclusion: The purpose of this concept analysis was to propose a detailed definition of clinical judgement in nursing, that reflected its theoretical base within today's contemporary healthcare system. Using Rodgers' evolutionary method of concept analysis, surrogate terms, attributes, antecedents and consequences were identified, and a contemporary definition was developed. No patient or public contribution was required to design or undertake this research. [ABSTRACT FROM AUTHOR]

Background: The number of people with chronic and long‐term conditions has increased during recent decades; this has been addressed by leveraging information and communication technology (ICT) to develop new self‐care solutions. However, many of the developed technological solutions have not been tested in terms of impact(s) on patients' quality of care. Objectives: This systematic review aimed to identify the current best evidence on the types of interventions that have been developed to improve the quality of patient care through the clinical application of ICT in primary, tertiary or home care. Design: A systematic review, including a meta‐analysis, was conducted according to the JBI Manual for Evidence Synthesis guidelines. Data sources Relevant data were identified from four electronic databases: CINAHL, PUBMED, SCOPUS and MEDIC. Review methods: The eligibility criteria were formatted according to PICOS inclusion and exclusion criteria. At least two researchers performed the screening process separately, after which they agreed upon the results. The Cochrane Risk of Bias Assessment and JBI Critical Appraisal tool for randomised controlled studies (RCTs) were used to assess research quality. Data were extracted, and a meta‐analysis was performed if the research met quantitative requirements. Results: Of the 528 initially identified studies, 11 studies were chosen for final data synthesis. All of the interventions integrated ICT solutions into patient care to improve the quality of care. Patients across all of the RCTs were educated through direct training, the provision of information relevant to their disease or one‐to‐one educational coaching. The interventions included various interactions, e.g. nurse expert visits and support, and support provided by peers, groups or family members. These interactions occurred through face‐to‐face coaching, virtual human coaching or virtual coaching that relied on an algorithm. The performed meta‐analysis included 6 of the 11 identified studies. The overall effect was nonsignificant, with three studies demonstrating a significant postintervention effect on patients' quality of care and quality of life and three studies a nonsignificant effect. Conclusions: The presented results suggest that ICT‐based care should be developed in collaboration with nurses and other health care professionals, involve patients in decision‐making and combine ICT solutions with human interaction and coaching. ICT education was found to be essential to the success of an intervention. [ABSTRACT FROM AUTHOR]

Aim: To explore mothers' experiences of the EArly Collaborative Intervention. Background: Preterm birth puts a considerable emotional and psychological burden on parents and families. Parents to moderate and late premature infants have shorter stays at the neonatal intensive care unit and have described a need for support. The EArly Collaborative Intervention was developed to support parents with preterm infants born between gestational Weeks 30 to 36. In this study, mothers' experiences of the new intervention were explored. Design: A qualitative design guided by a reflexive thematic analysis according to Braun and Clarke. Interviews were individually performed with 23 mothers experienced with the EArly Collaborative Intervention. Data were identified, analysed and reported using reflexive thematic analysis. The COREQ checklist was used preparing the manuscript. Results: Two main overarching themes were constructed. The first theme, 'mothers' feelings evoked from the EArly Collaborative Intervention' describes the emotions raised by the intervention and how the intervention affected their parental role. Their awareness of the preterm baby's behaviour increased, and the intervention helped the parents to communicate around their baby's needs. The second theme, 'based on the preterm baby's behavior', describes experiences of the provision and the learning process about their preterm baby's needs and communication. The intervention was experienced as helpful both immediately and for future interaction with the baby. Conclusions: Mothers found the intervention to be supportive and encouraging. They came to look upon their baby as an individual, and the new knowledge on how to care and interact with their baby affected both their own and their baby's well‐being. Furthermore, the intervention felt strengthening for their relationship with the other parent. Relevance to Clinical Practice: The EArly Collaborative Intervention can support parents' abilities as well as their relation to their baby and may thereby contribute to infant development, cognition and well‐being. [ABSTRACT FROM AUTHOR]

Background: A three‐phase ethnography was conducted at a paediatric orthopaedic hospital exploring the actual and desired participation of children with Osteogenesis Imperfecta in discussions, decisions and actions in the hospital and community. Phase I and Phase II revealed how childhood ethics are understood and practiced in the hospital using artmaking to engage children in discussions about their health‐related experiences. Children expressed frustration, anger and disappointment when their desired level of participation in care was not actualized due to forgone opportunities for engagement by clinicians or lack of child‐oriented health resources. Objectives: The objective of this study (Phase III) was to specify how childhood ethics ought to be understood and practiced in the hospital by (1) convening hospital stakeholders in a collaborative setting to disseminate findings, identify ethical concerns and generate action steps; and (2) develop a preliminary ethical framework to optimise the participation of children with OI in health care. Design: Focused ethnography reported using the SRQR checklist. Methods: A focus group was conducted with 14 interdisciplinary hospital stakeholders. Data were analysed using qualitative, thematic analysis to understand primary ethical concerns and accompanying action steps. The findings were consolidated into a preliminary ethical framework and worksheet for clinicians. Results: Four main factors impeding children's voices and desired participation were identified: legal and contextual factors; variations in clinicians' skills, practice and knowledge; difficulties incorporating alternative engagement methods into practice; and need for interprofessional collaboration. Five action steps were identified: Recognise, Elicit, Interpret, Act and Optimise. Relevance to clinical practice: The focus group and creation of clinician resources were important steps towards addressing the ethical concerns of children with OI, such as marginalisation or exclusion in their OI care. This study better prepares us to disseminate our findings on a larger scale and create ethical frameworks and resources to improve how vulnerable children's voices are heard, understood and acted upon in healthcare settings. [ABSTRACT FROM AUTHOR]

Aims and objectives: To identify stakeholders' views on inpatient Self‐Administration of Medication and corresponding prerequisites for successful implementation. Background: Self‐Administration of Medication allows capable patients to manage their medication regimen throughout hospitalisation. It is assumed to facilitate continuity of care, increase medication safety and patient empowerment. To enable sustainable implementation stakeholders should support it. Knowledge about stakeholders' views regarding Self‐Administration of Medication is currently lacking. Design: A qualitative study was conducted among stakeholders using semi‐structured interviews. Methods: Using purposive and snowball sampling fourteen representatives from Dutch healthcare associations, organisations and authorities were interviewed between April and July 2019. These stakeholders were asked to reflected on Self‐Administration of Medication and its implementation. Data were examined using inductive thematic content analysis and reported following the COREQ checklist. Results: Most stakeholders were positive towards Self‐Administration of Medication and foresaw benefits in terms of the following: improvements to patient‐centred care, contributions to sustainable use of healthcare assets and the need and opportunity for change. Critical concerns included reflecting potential risks for patient safety, concerns about implementation feasibility and questions regarding implementation necessity. Stakeholders highlighted prerequisites pertaining to the implementation process in which the following two themes emerged: (1) initiate a supported change and (2) perform research for best practices and identification of benefits. Other prerequisites concerned distinct levels within healthcare including individual patients (i.e. adequate communication), hospital organisation (i.e. to establish a workflow to secure medication safety) and healthcare system (i.e. to facilitate multidisciplinary collaboration in healthcare). Conclusion: Stakeholders were predominantly positive about Self‐Administration of Medication. For successful and sustainable implementation of Self‐Administration of Medication, prerequisites identified in this study should be met. Relevance to clinical practice: This study provided knowledge about stakeholders' views which could foster implementation and evaluation of Self‐Administration of Medication, which may, in turn, promote effective deployment and patient empowerment. [ABSTRACT FROM AUTHOR]

Aims and Objectives: This study was designed to examine the contents and methods of patient educational interventions about total knee arthroplasty (TKA) and their effectiveness in reducing postoperative pain and enhancing range of motion (ROM) in the literature. Background: Patient education has been provided to facilitate recovery after TKA; however, little is known about the contents and methods of the interventions and their effectiveness in reducing postoperative pain and enhancing ROM. Design: This is a systematic review and meta‐analysis of randomised controlled trials (RCTs). Methods: Published studies from June 1998–June 2021 were identified from electronic databases. Two independent investigators assessed the quality of the studies by using the revised Cochrane risk‐of‐bias tool. Meta‐analyses with random‐effects models were conducted to assess the effectiveness of the interventions using the Comprehensive Meta‐Analysis Software. The study was performed following the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses guideline. Results: Among 12 articles that met the inclusion criteria, three interventions provided education on pain management and mobility/exercises. The most common educational methods were the combinations of oral explanation, written materials, and audiovisual materials, group discussion, while four studies used information technology (IT) devices. The meta‐analysis demonstrated that the educational interventions using IT devices were effective in improving pain and ROM, but not the interventions that did not use IT devices. Conclusion: Structured education for pain management, communication and/or exercise support programs utilising diverse methods have been provided to patients undergoing TKA. Using IT devices could successfully enhance the effectiveness of educational interventions for patients undergoing TKA. Relevance to clinical practice: Integration of postoperative pain management and mobility/exercises with the use of IT devices should be actively considered in providing patient education in clinical nursing practice. [ABSTRACT FROM AUTHOR]

Introduction: The quality of care for tracheostomy and mechanically ventilated patients in intensive care units (ICUs) has improved considerably. However, the communication barrier attributable to these procedures generates many problems for patients, as they are unable to communicate effectively with family members and ICU healthcare professionals, especially nurses. Aims: To describe (1) tracheostomy patients' needs, emotions and difficulties when communicating with ICU nurses and (2) which strategies nurses and patients have adopted to improve their communication. Methods: A scoping review was completed using the Joanna Briggs Institute method and following the PRISMA‐ScR Checklist. The research question was developed using the Population, Concept and Context framework. Five databases were searched. After screening, two researchers independently analysed the 75 papers, and finally, 19 studies were included in this review. Results: All studies used a qualitative design. Seven adopted a phenomenological and two a hermeneutic approach, involving a total of 265 patients. Two main themes and four subthemes were identified: (1) the tracheostomy patients' needs, emotions and difficulties communicating with ICU nurses (patients' emotions, communication needs, and their content and difficulties) and (2) strategies that nurses and patients adopted to improve communication (communication strategies). Conclusions: It is essential to develop effective communication with tracheostomy patients to ensure they feel relieved, safe and considered. Communication content should focus on information relating to the person's personal condition and active involvement in care. Relevance to clinical practice: It is important to prioritise the communication process in tracheostomised patients and create the organisational conditions that foster effective communication processes. Developing training programmes for new or practising nurses is essential to instil greater awareness about this crucial fundamental need. [ABSTRACT FROM AUTHOR]