Search

Aim: To develop a conceptual framework for nurses' protocol‐based care decision‐making. Design: Miles & Huberman's bottom‐up approach to developing conceptual frameworks was followed, using data collected from a multiple embedded case study examining protocol‐based decision‐making by nurses in three hospital wards within a university hospital in northern Spain. Methods: The qualitative data from the case study, obtained through documentary analysis, observations, and interviews, underwent a secondary analysis consisting of four steps: data reduction, data display, comparison, and drawing conclusions. Results: The framework for protocol‐based care decision‐making comprises four components: (1) protocol‐based care, as a balance between standardisation and individualised care, (2) the process, (3) the context, and (4) the elements of protocol‐based care decision‐making. These components and their relationship as a context‐dependent, linear, variable and multifactorial process, directly influenced by the perception of risk, are described and illustrated. Conclusions: This study provides a rigorous bottom‐up framework for nurses' protocol‐based care decision‐making. The framework could be a valuable resource for managers, clinical nurses, educators, and researchers to guide and evaluate nurses' decision‐making, leading to improved care quality and reduced variability in clinical practice. Furthermore, the framework lays a foundation for further research and practical applications. Impact: This study addressed the problem of understanding nurses' protocol‐based care decision‐making and the need for a specific conceptual framework. The main findings of the study contribute to the development of a rigorous bottom‐up framework comprising four components of protocol‐based care decision‐making. The framework has the potential to improve care quality, reduce variability, enhance patient safety, and increase healthcare efficiency by guiding nurses' decision‐making in various healthcare settings. No Patient or Public Contribution: Patient or public contribution was not applicable since the study focused on nurses' decision making. [ABSTRACT FROM AUTHOR]

Aim: To investigate nursing/midwifery students, Clinical Mentors, Link Teachers and Head Nurses experiences within "Dedicated Education Unit" model in 6 European clinical placements and analyse the necessary elements for a powerful clinical learning environment. Design: A multi‐country, phenomenological, qualitative study. Methods: Focus group interviews were performed to identify the personal and organizational factors of importance for students and nurses/midwives. Results: Data analysis produced 4 main themes (1) Clinical placement organization, (2) students' clinical knowledge and skill acquisition, (3) students, and nurses/midwives' experiences within the DEU model and (4) factors for creating an effective learning environment. Conclusions: A close educational‐service collaboration, a realistic clinical placement planning, a focus on student learning process and an investment in professionals' education and development among others, are elements to set up a powerful clinical learning environment. Implications for the profession: It is considered advisable and urgent to improve the working conditions of nurses/midwives and the learning environments of students as a strategy to alleviate the global shortage of nurses and respond to the increasingly demanding health needs of the population. Impact: Due to the close relationship between students' learning and features of the clinical environment nurse educators seek innovative models which allow students to manage patient care and their transition to professional practice. To implement new learning strategies, identifying students, nurses and midwives perceptions and suggestions is a powerful information to evaluate implementation process and outcomes. Public Contribution: Our findings could help academic and clinical managers to meet the human and organizational requirements to create a successful learning environment in every student placement. [ABSTRACT FROM AUTHOR]