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

A broad range of health professionals can obtain the authority to prescribe in the UK upon successful completion of an accredited non-medical prescribing programme. Since the Covid-19 pandemic, many approved education institutions have adopted more permanent blended approaches to their programmes. This literature review aims to explore blended approaches to delivering postgraduate education to health professionals, with a view to improving the performance and satisfaction of students undertaking non-medical prescribing programmes. Seven papers were selected from a database search; five were research literature and two practice literature. The results suggest that social constructivism and laying a 'foundation' for effective study are key to student satisfaction. Advising students to engage with the provider's Virtual Learning Environment before a programme commences, dividing students into small groups that are designed to create communities of practice, scheduling face-to-face activities to provide early opportunities for social interaction and further research are recommended to enhance education for non-medical prescribers. [ABSTRACT FROM AUTHOR]

Background: Women of non-white British ethnicity have a higher maternal mortality risk for reasons not yet fully understood, and report significant concerns about stereotypes, racism and overall dissatisfaction in care. This study aimed to examine what midwives perceive to be contributing factors to ethnic disparity in maternity care. Methods: A systematic search of the literature was conducted to find contemporaneous, relevant studies which were appraised for inclusion and quality. Four qualitative studies were included. Results: Midwives spoke about practical, cultural and logistical concerns that contribute to health inequalities; none mentioned racism. Three themes emerged: relationship barriers, logistical barriers and a sense of us vs them. Three areas of us vs them were explored: 'incongruent expectations', 'structural racism, stereotypes and implicit bias' and 'culture vs professional accountability'. Conclusions: Further research into the impact of implicit bias is needed to adequately address health inequalities for non-white British women. A national strategy could be used to set expectations for women accessing UK maternity services early in pregnancy. Midwives need to be empowered and supported to thoroughly document women's choices so that their professional responsibilities are met. [ABSTRACT FROM AUTHOR]

Objective: Leg ulcers are common, distressing and painful for patients, and are a significant financial burden to healthcare providers. Compression therapy is the mainstay of treatment for venous leg ulceration. Several studies have evaluated leg ulcer management and compression therapy in the community. However, little is known about the prevalence of leg ulceration and use of compression therapy in acute hospitals. The aim of this study was to explore the published literature on the use of compression therapy for inpatients with leg ulcers in UK National Health Service hospital settings. Method: A literature search was undertaken to identify published papers reporting on inpatient leg ulcer populations and the use of compression therapy in hospitals using the following databases: CINAHL, MEDLINE Complete, Embase and PubMed. Results: The literature review identified 364 articles, of which three met the eligibility criteria. These studies reported on the prevalence of leg ulceration, the number of Doppler assessments conducted for patients and the use of compression therapy. Conclusion: This review confirmed a lack of information on the prevalence of hospital inpatients with leg ulcers, and identified the need to conduct prevalence audits, establish leg ulcer services to streamline inpatient leg ulcer care and provide staff and patient education programmes. [ABSTRACT FROM AUTHOR]

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

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

Background: Many women in prison are mothers and an increasing number are pregnant. These women face the harsh reality of potentially being separated from their babies or children, which can have detrimental effects on both the mother and the child. Aims: To review the literature surrounding the impact of mothers and children staying together in a prison environment. Method: The review focused on papers from the past 9 years and included mothers whose children resided with them in prison, and mothers who had been separated from their babies after giving birth in prison. Three articles were identified: two qualitative studies based on interviews with imprisoned mothers, and one quantitative study into re-offending rates of women who had been released from a prison nursery programme. Findings: Keeping their babies and mother together in a prison environment resulted in a positive outcome, particularly for the mothers. However, when thinking about the welfare of the child, there need to be sufficient opportunities to allow for their physical, social and emotional development. The common themes that emerged during this literature review were: low re-offending rates, motherhood producing motivation for change, and the effect of staying together on maternal and child wellbeing. Conclusions: This review highlighted the need for further studies, especially focusing on prisons in the UK. [ABSTRACT FROM AUTHOR]

Background: In spite of ongoing UK Government recommendations for integrated health and social care, the implementation has been slow. While there are pockets of integration happening across England, many services remain isolated and fragmented. Aim: This review aims to critically review existing evidence to identify if there are any factors enabling successful implementation of integrated health and social care for people with long-term conditions in the community. Method: A review was conducted following the principles of a systematic review. Relevant data was extracted from the identified papers and the papers were quality appraised. Results: A total of seven studies were included in the review. Data analysis and synthesis identified a number of themes in relation to enablers of integrated care, including co-location of teams, communication, integrated organisations, management and leadership, capacity and resources, and information technology. Conclusion: There is a limited amount of evidence regarding integrated health and social care teams. Although there are some consistencies within the findings, further research is needed to enhance the validity of the body of evidence available. [ABSTRACT FROM AUTHOR]

Aim: To explore the role of UK district nurses in providing care for adult patients with a terminal diagnosis by reviewing qualitative research. Design: Meta-ethnography was used to conduct the synthesis. Data sources: CINAHL, MEDLINE and British Nursing Index (BNI) were searched comprehensively for primary research relating to the role of UK district nurses in palliative care. Review methods: The abstracts and titles of 700 papers were screened against inclusion criteria, of these 97 full papers were appraised. Some 24 studies reported in 25 papers were selected for inclusion in the synthesis. Findings: In total, five key themes were identified: valuing the role; practical role; relationships with patients and families; providing psychological support; and role uncertainty. Further synthesis yielded two ‘lines of argument’. The concept of the ‘expert friend’ argues that the atypical relationship district nurses cultivate with patients underpins district nurses’ provision of palliative care and profoundly influences the nature of psychological support given. Secondly, the concept of ‘threat and opportunity’ encapsulates the threat district nurses can feel to their traditional role in palliative care through changing health and social policy, while recognising the benefits that access to specialist knowledge and better training can bring. Conclusion: The findings have implications for understanding the motivators and barriers experienced by district nurses delivering palliative care in a time of unprecedented change to community health services [ABSTRACT FROM AUTHOR]

Background: Poor perinatal mental health, in particular depression, affects at least 10% of new mothers in the UK. Current best practice recommends the use of talking therapies or medication; however, many women choose not to use medication or are deterred from accessing NHS services. Those who can access NHS treatment often face a long waiting list to see a clinician or therapist. Untreated perinatal depression has an impact on the health and wellbeing of women and babies, so it is essential to consider alternative psychosocial interventions delivered by non-clinicians. Aims: This review aims to explore the effects of psychosocial interventions on maternal perception of perinatal depression. Methods: A systematic review was conducted on seven quantitative studies examining the effect of psychosocial interventions in reducing maternal symptoms of depression. Interventions focused either on physical activity or peer support, measuring depression scores with a validated screening tool. Findings: The seven reviewed studies considered either physical activity or peer support-based interventions. There is some evidence that antenatal group peer support may benefit women in the antenatal period and that postnatal peer telephone support may be helpful for primiparous women. Conclusions: Further large-scale research is required to ascertain the effectiveness of a range of interventions in improving maternal perception of perinatal depression. [ABSTRACT FROM AUTHOR]

Background/Aims Asylum-seeking women face higher rates of maternal and neonatal mortality as a result of multiple barriers to accessing maternity care. Midwives are currently experiencing short staffing and high rates of burnout. Complex cases can add additional workload and stress. There is an evidence gap concerning midwives' experiences of caring for asylum-seeking women in the UK. This study's aim was to examine the existing literature on this topic and consider the findings against the current realities of working within the NHS maternity system. Methods Literature was screened using the Critical Appraisal Skills Programme qualitative article checklist and the preferred reporting items for systematic reviews and meta-analyses flow diagram. Eight studies were included and analysed for thematic similarities. Results The results of the systematic review were categorised into three themes: racism and resentment, structural difficulties and systematic problems. Conclusions Midwives lacked the time to appropriately care for asylum-seeking women. A lack of time and resources may negatively impact midwives' attitudes towards asylum-seeking women. [ABSTRACT FROM AUTHOR]

Aim: this review aimed to identify and review primary research to address the question: 'Is there evidence that mentors are failing to fail underperforming student nurses?' Design: this was an integrative literature review. Methods: online databases (Medline, Scopus, PsycINFO, and the Cumulative Index to Nursing and Allied Health Literature (CINAHL)) were searched using specified inclusion and exclusion criteria to focus the review. Critical appraisal was undertaken and key findings, outcomes and emergent concepts were identified from each study. These were then collated and synthesised into themes. Results: five articles met the criteria and review aim. Three main themes were identified. These were the mentors' relationship with the university, documentation when failing a student, and psychological and emotional impacts. Conclusion: the phenomenon of failing to fail continues to concern the nursing profession but there is limited primary research evidence to inform contemporary discussions in the UK regarding the management of this in practice. [ABSTRACT FROM AUTHOR]

Background: Non-medical prescribers (NMPs) are perceived as a complement to busy general practice in primary care. Aim: To conduct an overview of the literature available on the role and impact of non-medical prescribing (NMP) on primary care patients. Method: The search was conducted using multiple databases to find articles published between January 2015-January 2021. Inclusion criteria: NMPs in primary care in the United Kingdom, written in English language. Exclusion criteria: research conducted in secondary care or outside the UK. Findings: 285 studies were identified; 15 were eligible for critical appraisal. Key themes were: NMP's positive perceptions were autonomy, job satisfaction and colleague support; negative perceptions included risk, lack of continuous professional development (CPD), organisational support. Conclusion: By reviewing the perceptions of NMPs in primary care, organisations can ensure when employing new NMPs that the adequate CPD and support is in place. Thereby reducing NMPs concerns about the ligation risk of prescribing. [ABSTRACT FROM AUTHOR]

Background: Advanced clinical practice roles, usually filled by nurses, have had positive effects on clinical effectiveness, including in patient satisfaction, but their benefits for other stakeholders (such as employers, health professionals, education providers and commissioners and professional/regulatory bodies) are less clear. Aim: This study aimed to identify UK research on the potential benefits of advanced clinical practice and evaluate the evidence base for key stakeholders in this field. Method: A mixed-methods systematic literature review was carried out to inform a narrative interpretive synthesis. Findings: 44 articles of mixed quality were identified. Consensus was found regarding the definition of and barriers and facilitators to advanced clinical practice. This role is split into substitution (eg, of doctors) and supplementation (eg, adding value) aspects, and the clinical practice element dominates. Training for the role varies, as do scope of practice and regulation. Conclusion: There are several barriers to the implementation of advanced clinical practice and therefore the realisation of its benefits for key stakeholders. Areas requiring attention include training, support from others for role expansion and organisational issues. [ABSTRACT FROM AUTHOR]

A diagnosis of medically unexplained symptoms (MUS) is made when a person reports a complaint for which no organic disease can be detected. People with MUS commonly present to primary care services in the UK; however, there is no consensus regarding the evidence base for care. This literature review explores the experiences of these patients when they interact with health services. The following themes emerged: experience of diagnosis; expectations; communication; and healthful relationships. People with MUS report negative experiences of health care. Nurses in primary care have an opportunity to provide person-centred care to support these patients, and research could explore the potential contribution of nurses working in primary care in the UK to support them and enhance the evidence base for practice. [ABSTRACT FROM AUTHOR]

Contemporary health care is increasingly being located in the community. From the evident changes in demographics and general health, it can be derived that the people whom student nurses care for are likely to have multiple comorbidities and be vulnerable to clinical deterioration. These nurses are required to develop a range of transferrable skills to meet the demands of the population. The challenge for educators of preregistration student nurses is to develop educational strategies to prepare them with the skills, knowledge, and confidence necessary to recognise and manage deterioration appropriately in any context. This article is the first of two papers discussing the stimulus, design, and delivery of an educational innovation that focuses on the recognition and management of the deteriorating patient. The article explores current literature about community-focused simulation highlighting the potential learning opportunities resulting from contextualising simulation scenarios specific to the community setting. [ABSTRACT FROM AUTHOR]

Background: Newborn screening for congenital heart disease (CHD) forms part of the newborn physical examination (NPE) in the UK. However, research has shown that up to 50% of cases of CHD can be missed by this examination. The purpose of this literature review is to investigate the significance of hearing an asymptomatic heart murmur at the NPE in relation to the presence of CHD. Methodology: A critical literature review was conducted to answer the research question. The findings were discussed using a narrative synthesis approach. Findings: There was considerable heterogeneity of results. The prevalence of murmur in newborns ranged between 0.6%–10.7%. Between 13%–67% of those newborns had some form of CHD, although many had clinically insignificant lesions. Between 2%–9% of newborns with murmurs had a form of critical CHD (CCHD). The ability to discern whether a heart murmur relates to pathology or not improves with experience. No single optimal timing for the NPE was identified. Pulse oximetry was shown to increase sensitivity of screening for CCHD. Conclusion: There is a significant increase in the prevalence of CHD when a newborn has a heart murmur, hence referral for diagnostic echocardiography is required when a heart murmur is identified. Pulse oximetry is an important adjunct to newborn screening for CCHD. Some newborns affected by CCHD will not present with murmur at the NPE. Therefore, those caring for newborns during the early days must know the signs and symptoms of CHD so that appropriate medical assistance can be sought. [ABSTRACT FROM AUTHOR]

This literature review aimed to answer the focus question: are district nurses well placed to provide equitable end of life care (EOL) for homeless individuals? It focused on 10 primary research studies, from which two themes emerged and subsequently formed the basis of the discussion: (1) the difficulty in predicting disease trajectory in people who are homeless and (2) the gaps in existing systems. The main findings from these themes were a lack of education on the recognition of the dying and a general lack of knowledge of the complex challenges faced by and health needs of homeless people, which cause stigma from both the general public and health professionals towards these marginalised individuals. Further, there is certainly a lack of suitable places to deliver palliative and EOL care for people who are homeless. Available services are inflexible and have no tolerance for substance misuse, which creates an access barrier for homeless people in need of EOL care. [ABSTRACT FROM AUTHOR]

Background: Intramuscular (IM) injection practice is an essential nursing skill. Current practice relies on clinical judgement to determine needle length (unless specified in the medicine’s product licence). Obesity is increasing in the global population, but guidelines have largely ignored how to select needle length to meet individual patient need. Aim: The aim of this review was to systematically review the skin-to-muscle depth required to achieve injection into muscle in adults. The objectives were to identify any implications of obesity status when selecting an appropriate needle length and site in clinical practice.Search and review methodology: Studies of subjects above the age of 18 years using observational or experimental designs where the distance from the skin to muscle had been measured at any IM injection site, and obesity status was reported, were included in the search strategy. The primary outcome of interest was the distance from skin surface to muscle penetration. Findings: 14 studies were identified that investigated the dorsogluteal, ventrogluteal, deltoid and vastus lateralis sites, all used cross-sectional observational designs. Ten used ultrasound, three used computed tomography (CT) and one used magnetic resonance imaging. Obesity status was reported as BMI or hip-to-waist ratio. In all studies there was a correlation between obesity status and the distance from skin surface to muscle. In females this exceeded 37mm at both gluteal sites, independent of obesity status. Conclusions: There should be an assessment of obesity status before selecting needle length for IM injections in both genders. Needles longer than the standard 37mm are recommended for all females, whatever their obesity status, for any gluteal site. Injections into gluteal sites should be avoided in females who are obese. Deltoid injections are more likely to achieve muscle penetration in both genders, and in patients who are overweight or obese. Further research is required. [ABSTRACT FROM AUTHOR]

Background: Teleconsultations were introduced for cancer surgery follow-up to ease pressure on hospital services and facilitate patients' access to those services. There is limited evidence on patients' perceptions of this swift shift in service provision. Aims: The purpose of this qualitative systematic review was to explore patient experiences of teleconsultations within NHS cancer surgery follow-up services to better understand patient perceptions, satisfaction and acceptability of teleconsultations within cancer services. Methods: Medline, Embase, PubMed and Google Scholar were searched up to 1 July 2022. Qualitative studies were synthesised using the Braun and Clarke framework. Findings: There were three overarching themes: accessibility; patient experience; and consultation. Conclusion: Teleconsultations were widely accepted among cancer surgical patients. However, there were reports of a lack of rapport building and emotional support because of the absence of visual cues and patient camaraderie. [ABSTRACT FROM AUTHOR]

In the UK, dressings are categorised as medical devices and manufacturers only have to provide limited evidence of effectiveness before dressings are used in clinical practice. Therefore, evidence based on clinical trial methods is scant. As a direct result, governing bodies in the UK are now recommending that decisions to select one dressing over another could mainly be made on price. Placed within the movement critiquing evidence-based practice (EBP), this paper summarises the main issues surrounding the generation of evidence in selecting dressings for wound care, which is immersed in a context that lacks resources, legislative clarity and freedom to choose methodological alternatives. Dressings are therapeutic medical devices rather than consumables and any rationalisation based on costs may have far-reaching implications for wound care clinicians through purchasing decisions and thus may limit their ability to manage wounds effectively. [ABSTRACT FROM AUTHOR]

Background: Non-medical prescribers are perceived as a complement to busy general practice in primary care. Aim: To conduct an overview of the literature available on the role and impact of non-medical prescribers on primary care patients. Method: A search was conducted using multiple databases to find articles published between January 2015-January 2021. Inclusion criteria: non-medical prescribers in primary care in the UK, written in the English language. Exclusion criteria: research conducted in secondary care or outside the UK. Findings: 285 studies were identified; 15 were eligible for critical appraisal. The key themes were: non-medical prescriber's positive perceptions were autonomy, job satisfaction and colleague support. The negative perceptions included risk, lack of continuous professional development and organisational support. Conclusion: By reviewing the perceptions of non-medical prescribing in primary care, organisations can ensure when employing new non-medical prescribers that adequate continued professional development and support is in place. Thereby reducing the concerns of non-medical prescribers about the ligation risk of prescribing. [ABSTRACT FROM AUTHOR]

Background: Recruitment and retention of nursing staff is the biggest workforce challenge faced by healthcare institutions. Across the UK, there are currently around 50 000 nursing vacancies, and the number of people leaving the Nursing and Midwifery Council register is increasing. Objective: This review comprehensively compiled an update on factors affecting retention among hospital nursing staff. Methods: Five online databases; EMBASE, MEDLINE, SCOPUS, CINAHL and NICE Evidence were searched for relevant primary studies published until 31 December 2018 on retention among nurses in hospitals. Results: Forty-seven studies met the inclusion criteria. Nine domains influencing staff turnover were found: nursing leadership and management, education and career advancement, organisational (work) environment, staffing levels, professional issues, support at work, personal influences, demographic influences, and financial remuneration. Conclusion: Identified turnover factors are long-standing. To mitigate the impact of these factors, evaluation of current workforce strategies should be high priority. [ABSTRACT FROM AUTHOR]

Background: Black, Asian, and minority ethnic (BAME) women have significantly higher morbidity and mortality rates in the UK as well as poorer experiences of care. To date, a systematic literature review has not been undertaken in the UK to explore ethnicity based health inequalities. Aim: To explore the maternal health inequalities encountered by BAME women in the UK in relation to their experiences and use of services. Method: A systematic literature search was conducted via five databases (PubMed, MEDLINE, CINAHL, MIDIRS and BNI). Inclusion-exclusion criterion and a keyword strategy were implemented to screen for literature published between 2013–2018. Findings: A total of eight studies with various ethnicities and geographical locations were included. Five themes emerged following thematic analysis: communication, midwife-woman relationship, healthcare services and systems, culture and social needs. Conclusion: The review identified consistency within and across the five themes. Maternity services and systems is a predominant theme that has a residual effect on the remaining four themes. [ABSTRACT FROM AUTHOR]

Background: The World Health Organization recommends exclusive breastfeeding for the first 6 months of life; however, UK breastfeeding rates are some of the lowest worldwide. As such, various interventions have been trialled, aiming to increase breastfeeding rates. Aims: To evaluate the effectiveness of interventions to increase breastfeeding rates in the UK and determine the features of successful interventions. Methods: A literature search was performed, using four databases. The results were refined by applying inclusion and exclusion criteria. Two additional articles were recognised by scanning the references sections of identified studies, resulting in 12 articles for review. Findings: Support-based interventions had predominantly insignificant effects upon breastfeeding rates. Incentives were associated with increases in rates, while combined interventions had mixed success. The interventions were well received by mothers and clinicians and may help to normalise breastfeeding. Conclusions: Future interventions should provide targeted, personalised support to overcome breastfeeding difficulties, and reward mothers for their efforts. [ABSTRACT FROM AUTHOR]

Background: There have been assumptions made in maternal mortality reports that culture is a relevant quality in determining black African women's use of antenatal services in the UK, but these cultural qualities are not defined. It is therefore important to explore the association between cultural qualities and the use of antenatal care for these women. Aims: To examine cultural qualities relevant in antenatal care for black African women. Methods: A literature review was conducted on the CINAHL Plus, Medline, POPLINE, PubMed, Cochrane and Scopus databases with a timeframe from January 2000 to August 2017, to capture the first noted increase in mortality for black African mothers in the UK. Findings: A subjective, complex mix of several factors intertwined with culture may impact on adequate use of antenatal care by black African women, resulting in an increased risk of maternal mortality and morbidity. Conclusion: The need to consider black African women's cultural beliefs and practices during antenatal care provision has been highlighted in this literature review. It is noted that there are other factors that may affect black African women's access and engagement with antenatal care, and women themselves have highlighted a lack of cultural sensitivity and valuing of sociocultural norms when asked about their experiences of antenatal care. [ABSTRACT FROM AUTHOR]

Introduction: The aim of this literature review is to identify the most common tools used to measure burden in carers of people with Parkinson's disease (PD), heart failure (HF), multiple sclerosis (MS) and chronic obstructive pulmonary disease (COPD). Method: Databases such as Medline, PsycINFO, CINAHL and Academic Search Complete were searched. Studies in which carer burden was measured were included. Results: Zarit Burden Inventory and Caregiver Reaction Assessment were most commonly used to measure carer burden, regardless of the chronic condition. A wide range of other instruments were also used. Conclusions: Even though a range of tools are available, further improvements are necessary in order to enable healthcare professionals to identify carers experiencing high burden. [ABSTRACT FROM AUTHOR]

Evidence suggests that black and minority ethnic (BME) midwives are more likely to face fitness to practise hearings than white registrants and BME NHS staff are less likely to be in senior positions. This literature review critically evaluates the literature published since a systematic review on the topic was conducted in 2005. It found that BME nurses and midwives, especially those who registered abroad and subsequently came to live and work in the UK are ‘underemployed’ and consequently expressed feelings of loss of self-confidence. This was further compounded by accounts of excessive scrutiny and punishment. Many felt excluded from white networks of power and opportunities for staff development and promotion. The literature also describes experiences of covert as well as overt racism between the white majority and BME staff as well as ‘horizontal racism’ between BME staff of differing ethnicities. [ABSTRACT FROM AUTHOR]

The Queen's Nursing Institute (QNI) is leading a project to improve young people's experience of transitioning from children's services to adult community health services. To gain an understanding of the current evidence, the QNI conducted a review of relevant UK literature from the last 10 years, focusing on community and primary care nursing. Despite the lack of evidence relating to effective practice in community and primary care settings, the literature search suggested that nurses could play a significant role in coordinating the transition process and working with the young person to prepare them for adult services. The review highlights that further work is required to translate current policy recommendations into practice, and the QNI will be supporting health and care professionals to improve transition by developing learning resources for district nurses, general practice nurses and educators, and promoting the sharing and application of best practice. [ABSTRACT FROM AUTHOR]

Background: acute medicine units (AMUs) are part of acute hospital care, where length of patient stay is short and turnover is high. Expediting patient discharge safely is a major function of AMUs, which need up-to-date bespoke guidance. Aim: to carry out a scoping review of UK discharge policy to critically consider, compare and contrast the relevant discharge policies and guidance that underpin the assessment of acute patient discharge. Objectives: to inform the production of bespoke patient discharge guidance for AMUs. Design and stages: identify the review questions; identify relevant studies; select the studies; chart the data; collate, summarise and report the results. Findings: 28 patient discharge policy guidelines were identified that had no specific guidance for patient discharge from AMUs. New bespoke principles for AMUs were created through a pragmatic interpretation of current relevant policies. Conclusion: there is a gap in specific patient discharge guidance for AMUs. New guidance should contribute in practice to improve patient discharge. [ABSTRACT FROM AUTHOR]

Effective and efficient caseload management requires extensive skills to ensure that patients receive the right care by the right person at the right time. District nursing caseloads are continually increasing in size and complexity, which requires specialist district nursing knowledge and skills. This article reviews the literature related to caseload management with the aim of identifying the most effective method for district nursing teams. The findings from this review are that there are different styles and methods of caseload management. The literature review was unable to identify a single validated tool or method, but identified themes for implementing effective caseload management, specifically caseload analysis; workload measurement; work allocation; service and practice development and workforce planning. This review also identified some areas for further research. [ABSTRACT FROM AUTHOR]