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• Immunisation nurses (IMNs) feel that HPV education for 15–17 year olds is important. • IMNs are highly motivated to design and deliver HPV education for adolescents. • IMNs are experts in HPV education and feel their skills are underutilized. • IMN barriers include time, resources, parental attitudes and teacher training. • Further collaboration between the PHA and the EA is key to IMN's role development. Human Papilloma Virus (HPV) is responsible for the development of cervical, vaginal, vulvar, penile, oropharyngeal and anal cancers. Throughout the UK, Immunisation nurses (IMNs) deliver school-based HPV vaccinations to students 12–13 years old. Providing HPV education to 15–17 year old students may promote decision-making regarding their sexual health and award opportunity for unvaccinated students to self-consent to the vaccination. This study aims to explore the perceptions of IMNs regarding the value of providing HPV education to 15–17 year old students and to explore whether IMNs feel that the design/delivery of this education should form part of their professional role. Six focus groups were conducted online with IMNs from all five Health and Social Care Trusts in Northern Ireland, UK, between January-June 2021. Data were analysed using the COM-B model to identify factors that might influence IMNs' behaviour towards designing/delivering this education for 15–17 year old students. IMNs were highly motivated to design and deliver this HPV education. Facilitators promoting this behaviour included their specialist training, their previous sexual health teaching experience and their desire to educate young people. Barriers negatively influencing this behaviour included lack of time/resources, parental influences, lack of school support and lack of teaching/presentation skills training. IMNs feel that they are the most appropriate professionals to design/deliver HPV education for 15–17 year old students. National policy change, based on collaboration between the Public Health Agency and Education Authority, is a key factor in facilitating IMNs to implement this school-based HPV education intervention. [ABSTRACT FROM AUTHOR]

Background: Anticipatory care is becoming increasingly important in effectively managing complex multimorbidity in aging populations, preventing further functional decline, and avoiding hospital admissions. This study aimed to elicit the feedback of participating general practitioners, practice managers, nurses and an adjunct pharmacist on the implementation strengths and limitations of a nurse-led, person-centered anticipatory care planning (ACP) intervention for older people at risk of functional decline in a primary care setting. The findings have implications for a full trial and intervention design. Methods: As part of a feasibility cluster randomized controlled trial (cRCT) testing the ACP intervention, we sought feedback from implementing stakeholders: general practitioners (N = 3), practice staff (N = 3), research nurses (N = 5), and adjunct pharmacist (N = 1) in both the Republic of Ireland (ROI) and Northern Ireland (NI), UK. Following written, informed consent, they were interviewed to investigate their experience of participating in the implementation of the ACP intervention as part of the feasibility trial, and elicit any recommendations for a full trial. Using the Consolidated Framework for Implementation Research, thematic analysis was employed to analyze data. The intervention consisted of home visits by specially trained nurses who assessed participants' health, discussed with them their health goals and plans, and devised an anticipatory care plan following consultation with participants' General Practitioners and the adjunct clinical pharmacist. Results: Participating stakeholders indicated that the strengths of the implementation process included the training provided to the nurses, constructive collaboration of the research team, and structure of implementation process. Perceived limitations included the selection process and screening tool, communication between the research team and the nurses, the assessment questionnaire, and the final document left with the patient, as well as lack of access to medical records for the adjunct pharmacist. Recommendations include better communication and team-wide consensus on alterations to procedure and documents, and standardized protocols for patient selection, data collection, and reporting for research nurses. Conclusions: The findings have identified strengths of the implementation process on which to build, and recognized limitations which can now be addressed to ensure improved efficiency and effectiveness in future trials. Trial registration: Clinicaltrials.gov, ID: NCT03902743. Registered on 4 April 2019. [ABSTRACT FROM AUTHOR]

Background: As the population of older adults increases, the complexity of care required to support those who choose to remain in the community amplifies. Anticipatory Care Planning (ACP), through earlier identification of healthcare needs, is evidenced to improve quality of life, decrease aggressive interventions, and prolong life. With patient acceptability of growing importance in the design, implementation, and evaluation of healthcare interventions, this study reports on the acceptability of a primary care based ACP intervention on the island of Ireland. Methods: As part of the evaluation of a feasibility cluster randomized controlled trial (cRCT) testing an ACP intervention for older people at risk of functional decline, intervention participants [n = 34] were interviewed in their homes at 10-week follow-up to determine acceptability. The intervention consisted of home visits by specifically trained registered nurses who assessed participants' health, discussed their health goals and plans, and devised an anticipatory care plan in collaboration with participants' GPs and adjunct clinical pharmacist. Thematic analysis was employed to analyze interview data. The feasibility cRCT involved eight general practitioner (GP) practices as cluster sites, stratified by jurisdiction, four in Northern Ireland (NI) (two intervention, two control), and four in the Republic of Ireland (ROI) (two intervention, two control). Participants were assessed for risk of functional decline. A total of 34 patients received the intervention and 31 received usual care. Findings: Thematic analysis resulted in five main themes: timing of intervention, understanding of ACP, personality & individual differences, loneliness & social isolation, and views on healthcare provision. These map across the Four Factor Model of Acceptability ('4FMA'), a newly developed conceptual framework comprising four components: intervention factors, personal factors, social support factors, and healthcare provision factors. Conclusion: Acceptability of this primary care based ACP intervention was high, with nurses' home visits, GP anchorage, multidisciplinary working, personalized approach, and active listening regarded as beneficial. Appropriate timing, and patient health education emerged as vital. [ABSTRACT FROM AUTHOR]

Background: Advance Care Planning is recommended for people with end-stage kidney disease but evidence is limited. Robust clinical trials are needed to investigate the impact of advance care planning in this population. There is little available data on cost-effectiveness to guide decision makers in allocating resources for advance care planning. Therefore we sought to determine the feasibility of a randomised controlled trial and to test methods for assessing cost-effectiveness.Methods: A deferred entry, randomised controlled feasibility trial, incorporating economic and process evaluations, with people with end-stage kidney disease, aged 65 years or older, receiving haemodialysis, in two renal haemodialysis units in Northern Ireland, UK. A nurse facilitator helped the patient make an advance care plan identifying: a surrogate decision-maker; what the participant would like to happen in the future; any advance decision to refuse treatment; preferred place of care at end-of-life.Results: Recruitment lasted 189 days; intervention and data collection 443 days. Of the 67 patients invited to participate 30 (45%) declined and 36 were randomised to immediate or deferred advance care plan groups. Twenty-two (61%) made an advance care plan and completed data collection at 12 weeks; 17 (47.2%) were able to identify a surrogate willing to be named in the advance care plan document. The intervention was well-received and encouraged end-of-life conversations, but did not succeed in helping patients to fully clarify their values or consider specific treatment choices. There was no significant difference in health system costs between the immediate and deferred groups.Conclusions: A trial of advance care planning with participants receiving haemodialysis is feasible and acceptable to patients, but challenging. A full trial would require a pool of potential participants five times larger than the number required to complete data collection at 3 months. Widening eligibility criteria to include younger (under 65 years of age) and less frail patients, together with special efforts to engage and retain surrogates may improve recruitment and retention. Traditional advance care planning outcomes may need to be supplemented with those that are defined by patients, helping them to participate with clinicians in making medical decisions.Trial Registration: Registered December 16, 2015. ClinicalTrials.gov Identifier: NCT02631200 . [ABSTRACT FROM AUTHOR]

A district nurse is an expert generalist practitioner who uses advanced clinical skills and knowledge to fulfil an ever-evolving role. The district nurse is accountable for the care planning, coordination and management of people with multi-faceted and intricate health care needs. In addition, an interprofessional approach to health and social care is required to enable the district nurse to co-ordinate care and enable patients to be cared for and remain within their homes. As the demand on primary and community services increases, care is further enriched by working in partnership with families, carers and voluntary service providers. The nurse patient relationship is the founding component for person-centred, holistic care. Through holistic assessment and shared decision making, co-produced care planning permits people to fundamentally take ownership of their health and enhances formal care provision. This case study reflects the role of the district nurse in Northern Ireland, through comprehensive assessment in clinical practice and highlights how a therapeutic relationship, being centred on the patient and shared decision-making impact positively on the care process. [ABSTRACT FROM AUTHOR]

This overview provides insight into changes in clinical practice and the implications for nursing staff and clinicians who are involved in the management of patients undergoing primary total hip arthroplasty. The review highlights commonly used surgical approaches, their advantages, their associated risks and how to manage complications if they occur. [ABSTRACT FROM AUTHOR]

Aim To test the Rapid Response Systems programme theory against actual practice components of the Rapid Response Systems implemented to identify those contexts and mechanisms which have an impact on the successful achievement of desired outcomes in practice. Background Rapid Response Systems allow deteriorating patients to be recognized using Early Warning Systems, referred early via escalation protocols and managed at the bedside by competent staff. Design Realist evaluation. Methods The research design was an embedded multiple case study approach of four wards in two hospitals in Northern Ireland which followed the principles of Realist Evaluation. We used various mixed methods including individual and focus group interviews, observation of nursing practice between June-November 2010 and document analysis of Early Warning Systems audit data between May-October 2010 and hospital acute care training records over 4.5 years from 2003-2008. Data were analysed using NiVivo8 and SPPS. Results A cross-case analysis highlighted similar patterns of factors which enabled or constrained successful recognition, referral and response to deteriorating patients in practice. Key enabling factors were the use of clinical judgement by experienced nurses and the empowerment of nurses as a result of organizational change associated with implementation of Early Warning System protocols. Key constraining factors were low staffing and inappropriate skill mix levels, rigid implementation of protocols and culturally embedded suboptimal communication processes. Conclusion Successful implementation of Rapid Response Systems was dependent on adopting organizational and cultural changes that facilitated staff empowerment, flexible implementation of protocols and ongoing experiential learning. [ABSTRACT FROM AUTHOR]

Aim The aim of this paper was to report the process evaluation of facilitators' delivery of a psychosocial intervention (called CONNECT), in a randomized controlled trial, to men with prostate cancer and their partners. Background There is a lack of information on the process of implementing psychosocial interventions in controlled trials and, in particular, on the role and performance of facilitators who deliver them. Yet, this information is crucial in assessing whether these interventions are effective or not and why. Design Qualitative design. Methods Semi-structured qualitative interviews and diaries were used to collect data (January-October 2012) from four facilitators and a co-facilitator. Data were analysed using the Miles et al. framework. Results Five themes were discernible. These were 'difficulties to keep to the structure of the intervention', 'selective coverage of topics', 'partner participation', 'overall impression of the group and telephone sessions' and 'perceived benefits to participants'. Issues such as not keeping to the aim of the intervention, deviating from the content and/or reluctance in discussing sensitive issues such as sexual health may mean that the psychosocial effects of the intervention may not have been fully realized. Conclusions These findings will be useful for further development and evaluation of the intervention. A tentative conceptual framework of factors, related to facilitators, influencing the fidelity of interventions in the context of controlled trials, is offered. This model, which requires further development and testing, will be useful for researchers worldwide who are involved in developing interventions and training facilitators. [ABSTRACT FROM AUTHOR]

Insulin is one of the top ten high-alert medications worldwide. Approximately 30% of people with diabetes in the UK use injectable therapies, most commonly insulin, to manage their condition. With an increasing number of people with diabetes being managed within the community, district nurses play an important role in the safe and effective use of insulin. This study surveyed a convenience sample of 164 district nurses working within one Health and Social Care Trust in Northern Ireland to ascertain their knowledge and practice regarding insulin. Study response rate was 38% (n=63). It was found that district nurses’ knowledge and practice relating to insulin therapy was lacking as indicated by a total mean score of 53.1%. Total knowledge scores were slightly higher (58%) than total practice scores (46%). Nevertheless, 79.4% of district nurses felt secure and 6.3% felt very secure in managing diabetes. Deficits in district nurses’ knowledge and practice were identified in areas relating to insulin action, dosage, storage, injection site technique and rotation, hypoglycaemic/hyperglycaemic management, pharmacological action and prescription format. These deficits highlight the need for workplace-based learning and development programmes, incorporating real time, point of care interventions, to enhance and maintain district nurses’ insulin knowledge and practice. [ABSTRACT FROM AUTHOR]

Approaches to the management of patients with cancer have been revolutionised by the ability to examine tumours at a genetic and molecular level and tailor treatments accordingly. Underpinning this work is the need for large numbers of high-quality human biospecimens for use in translational research studies to identify new biomarkers for the prediction, diagnosis and treatment of cancer . Biobanking has subsequently emerged as a dedicated activity to provide the infrastructure required for the standardised collection, storage and distribution of high quality human biospecimens for research purposes. This article provides an overview of the role of biobanks and the vital contribution they make to the delivery of cancer care for patients now and in the future. [ABSTRACT FROM AUTHOR]

This is a case study of an ethical dilemma concerning the appropriateness of encouraging care-staff, working within a dementia care home, to either wear a clinical uniform or not to wear a clinical uniform in practice. It is proposed that people living with dementia may sustain higher levels of wellbeing if care-staff wear clothes that are more akin to their care home environment, for example, wearing similar clothes to the residents or even wearing pyjamas and nightwear during a night shift. The counter argument is that the practice may lead to greater levels of distress due to disorientation, increased potential for infection and inability to identify nurses when needed. [ABSTRACT FROM AUTHOR]

Occupation segregation is a persistent aspect of the labour market, and scholars have often researched what happens when women and men enter into what are seen to be 'non-traditional' work roles for their sex. Research on men within women's roles has concentrated mainly on the challenges to a masculine identity, while research on workplace language has focused on women's linguistic behaviour in masculine occupations. To date, there has been relatively little research into the linguistic behaviour of men working in occupations seen as women's work (e.g., nursing, primary school teaching). To address this gap, this article focuses on men's discursive behaviour and identity construction within the feminized occupation of nursing. Empirical data collected by three male nurses in a hospital in Northern Ireland is explored using discourse analysis and the Community of Practice paradigm. This paper discusses how the participants linguistically present themselves as nurses by performing relational work and creating an in-group with their nurse colleagues by actively using an inherently 'feminine' discourse style. [ABSTRACT FROM AUTHOR]

Aim To describe the protocol used to examine the processes of communication between health professionals, patients and informal carers during the management of oral chemotherapeutic medicines to identify factors that promote or inhibit medicine concordance. Background Ideally communication practices about oral medicines should incorporate shared decision-making, two-way dialogue and an equality of role between practitioner and patient. While there is evidence that healthcare professionals are adopting these concordant elements in general practice there are still some patients who have a passive role during consultations. Considering oral chemotherapeutic medications, there is a paucity of research about communication practices which is surprising given the high risk of toxicity associated with chemotherapy. Design A critical ethnographic design will be used, incorporating non-participant observations, individual semi-structured and focus-group interviews as several collecting methods. Methods Observations will be carried out on the interactions between healthcare professionals (physicians, nurses and pharmacists) and patients in the outpatient departments where prescriptions are explained and supplied and on follow-up consultations where treatment regimens are monitored. Interviews will be conducted with patients and their informal carers. Focus-groups will be carried out with healthcare professionals at the conclusion of the study. These several will be analysed using thematic analysis. This research is funded by the Department for Employment and Learning in Northern Ireland (Awarded February 2012). Discussion Dissemination of these findings will contribute to the understanding of issues involved when communicating with people about oral chemotherapy. It is anticipated that findings will inform education, practice and policy. [ABSTRACT FROM AUTHOR]

Aim. To explore the use of Facebook by Registered Nurses (RNs) in Italy and the United Kingdom (UK), focusing on the disclosure of personal and professional information. Background. The use of online social network sites among medical students and doctors is posing new ethical challenges to the profession. To date, little research has explored the use of online social networking sites among nurses. Design. A cross-national survey. Methods. Data were assessed on 124 nurses' profile pages, readily available without viewing restrictions. Content analysis and inferential statistics were undertaken to describe usage and identify similarities and differences between the two country-groups of nurses. Data were collected between December 2011-January 2012. Results. Overall, UK and Italian RNs showed a similar use of the online platform, tending to disclose personal pictures, home town and current home location, as well as updates and comments related to personal and work-related activities. A statistically significant higher proportion of nurses in Italy disclosed their sexual orientation. In both groups, a few cases were observed of potentially unprofessional content in relation to the use of alcohol, nudity and material of a salacious nature. Conclusion. Although most of the UK and Italy RNs appear to be aware of the risks posed by their online exposure, their online activity indicates the blurring of their personal and professional lives; this is posing new ethical, legal and professional challenges to members of the nursing profession. Further research and debate is encouraged at national and international level. [ABSTRACT FROM AUTHOR]

More than ever, district nurses require highly developed communication and interpersonal skills to enable and nurture a therapeutic relationship. The 'shift left'—whereby patients are being assessed and cared for in the community at a much earlier stage of their illness or recovery— has significant implications. The complexity of patient care and the need for collaborative working and shared decision making necessitates a focus on fostering person-centred care and improving the patient experience in practice. District nurses are adept communicators with a specialist body of knowledge and skills. In Northern Ireland, the single assessment tool (NISAT) is used by health professionals and follows a person-centred framework. This case study reflects on the assessment process used by a district nursing student in clinical practice and demonstrates how a therapeutic relationship is developed, thereby supporting person centredness. [ABSTRACT FROM AUTHOR]

The article focuses on the Professional Framework for Emergency Care Nursing launched at the Northern Ireland Practice and Education Council (NIPEC) annual conference. Topics covered include the domains under which the career pathways are presented, the range of information linked to each domain and the creation of a project group to develop the framework. Also mentioned is the governance process of NIPEC to ensure modifications are made.

The article reports on the pledge by the government of Ireland to immediately match nurses' salaries to those in England after months of industrial action by nurses and other healthcare professionals over pay inequality and unsafe staffing levels.

A specialist practitioner who transformed care for vulnerable young people leaving custody has been named RCN Northern Ireland nurse of the year 2019. [ABSTRACT FROM AUTHOR]

The article reports on the increasing number of nurses and midwives working in health and care services in Northern Ireland.

The author talks about the role of nurses in implementing reforms for a health and social care system in Northern Ireland. She mentions a commitment set out by Health Minister Michelle O'Neill to address the issues facing the health and social care (HSC) system. She emphasizes the need to develop the role of the advanced nurse practitioner (ANP) across primary and out of hours care. The author also stresses the importance of the role of district nurses.

An interview with Robert Sowney, the recipient of the 2016 Outstanding Achievement Award at the Royal College of Nursing (RCN) Northern Ireland Nurse of the Year Awards, is presented. He discusses his job as a leader of a programme that supports trusts to improve unscheduled patient care. He explains his decision to enter emergency nursing. He cites that he has tried to provide mentorship to others.

The article reports that 60 specialist cancer nurse and support worker posts are to be formed in Northern Ireland by 2021, according to health minister Simon Hamilton, and mentions related topics such as Macmillan Cancer Support, the Health and Social Care Board, and Friends of the Cancer Centre.

The article discusses a social media campaign called #fairpay4NInusus undertaken by the Royal College of Nursing (RCN) Northern Ireland to lobby the health minister Simon Hamilton to implement a pay award for Northern Ireland nurses. The campaign featured emergency nurses across Northern Ireland posting pictures of themselves and colleagues holding signs displaying the #fairpay4Nurses to Facebook and Twitter. Mr. Hamilton asked the National Pay Review to recommend a pay award for 2016/17.

The article offers a career profile of Cherith Semple, a Macmillan head and neck cancer nurse specialist (CNS) at the South Eastern Health and Social Care Trust in Belfast, Northern Ireland. Information regarding her medical education at the University of Ulster, her experience of witnessing the sufferings and vulnerability of cancer patients, and her significant contribution in redesigning the surgical follow-up clinic for cancer patients, are included.

The article announces that Cherith Semple, a cancer nurse specialist (CNS), has received the Royal College of Nursing (RCN) Northern Ireland Nurse of the Year 2015 award.

The authors offer opinions about nursing as a profession in Great Britain. Topics include the role of nurses in providing quality care in the British National Health Service (NHS), the NHS report "Five Year Forward View," available at http://tinyurl.com/20145yfv, and the Triple Aim healthcare improvement innovation in Northern Ireland through the organization Institute of Healthcare Improvement.

A photograph showing Unite members who have taken part in historic National Health Service (NHS) strike action on October 13, 2014 is presented.

Menopause is part of the ageing process for all women. However, the experience of menopause is different for each person. To recognize and manage the menopause properly, healthcare professionals need to be well informed and should have access to the necessary resources. The purpose of this survey was to ascertain whether an educational need and a resource need exist among healthcare professionals in Londonderry, Northern Ireland. One hundred and eight surveys were completed by healthcare professionals. From the responses, it is clearly evident that the desire for more education and the establishment of a local specialist clinic exists., (© The Author(s) 2015 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.)