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Aim: To synthesise evidence from studies that explored the impact of electronic and self‐rostering systems to schedule staff on healthcare organisations and healthcare workers. Design: Mixed‐method systematic review. Methods: Studies were screened by two independent reviewers and data were extracted using standardised data extraction tables. The quality of studies was assessed, and parallel‐results convergent synthesis was conducted. Data Sources: Academic Search Complete, CINAHL, ERIC, MEDLINE, PsycINFO and PsycARTICLES were searched on January 3, 2023. Results: Eighteen studies were included (10 quantitative descriptive studies, seven non‐randomised studies and one qualitative study). Studies examined two rostering interventions including self‐rostering (n = 12) and electronic rostering (n = 6). It was found that the implementation of electronic and self‐rostering systems for staff scheduling impacted positively on both, healthcare workers and healthcare organisations. Benefits included enhanced roster efficiency, staff satisfaction, greater control and empowerment, improved work‐life balance, higher staff retention and reduced turnover, decreased absence rates and enhanced healthcare efficiency. However, self‐rostering was found to be less equitable than fixed rostering, was associated with increased overtime, and correlated with a higher frequency of staff requests for shift changes. Conclusion: The impact of electronic and self‐rostering systems to schedule staff on healthcare organisations and healthcare workers' outcomes was predominantly positive. Further randomised controlled trials and longitudinal studies are warranted to evaluate the long‐term impact of various rostering systems, including electronic and self‐rostering systems. Implications for Healthcare: Rostering is a multifaceted responsibility for healthcare administrators, impacting patient care quality, workforce planning and healthcare expenditure. Impact: Given that healthcare staffing costs constitute a substantial portion of global healthcare expenditure, efficient and strategic resource management, inclusive of healthcare staff rostering, is imperative. Reporting Method: The 27‐item Preferred Reporting Items for Systematic Reviews and Meta‐analyses (PRISMA) checklist. Patient or Public Contribution: No Patient or Public Contribution. [ABSTRACT FROM AUTHOR]

Background and Objectives The inability of individuals in the advanced stage of dementia to communicate about preferences in care at the end-of-life poses a challenge for healthcare professionals and family carers. The proven effective Family Carer Decision Support intervention has been designed to inform family carers about end-of-life care options available to a person living with advanced dementia. The objectives of the mySupport study were to adapt the application of the intervention for use in different countries, assess impact on family satisfaction and decision-making, and identify costs and supportive conditions for the implementation of the intervention. Research Design and Methods A multiple-case study design was chosen where the nursing home was the case. Nursing homes were enrolled from six countries: Canada, Czech Republic, Italy, Netherlands, Republic of Ireland, and United Kingdom. Results Seventeen cases (nursing homes) participated, with a total of 296 interviews completed including family carers, nursing home staff, and health providers. Five themes relevant to the implementation of the intervention were identified: supportive relationships; committed staff; perceived value of the intervention; the influence of external factors on the nursing home; and resource impact of delivery. Discussion and Implications There is a commonality of facilitators and barriers across countries when introducing practice innovation. A key learning point was the importance of implementation being accompanied by committed and supported nursing home leadership. The nursing home context is dynamic and multiple factors influence implementation at different points of time. [ABSTRACT FROM AUTHOR]

The recurrence of venous leg ulcers (VLUs) is of concern to both patients and health care systems, with large amounts of resources being consumed by this chronic condition. Self‐management has been recommended to decrease the recurrence of VLUs. However, this concept has not been clearly defined in VLU recurrence prevention. The aim of this concept analysis was to describe self‐management in VLU recurrence prevention, and explore the terms used and their application in preventing VLU recurrence. Using Walker and Avant's method of concept analysis, 19 articles were systematically reviewed. The primary term used was that of self‐care. The defining attributes included (a) completing preventative tasks of compression, elevation and exercise; (b) lifelong compliance with preventative tasks by patients; (c) internal factors of understanding why tasks are needed, and motivation/belief they will help prevent recurrence, hence changing routines/lifestyles; (d) environmental support through local health care systems and support systems, while avoiding risk. Inconsistent terminology use can cause communication issues within wound management as well as multidisciplinary teams. Although self‐management is evolving, its development may have been constrained by the medical model, which emphasises compliance with direct preventative tasks for this chronic condition. There is minimal focus on external or environmental factors that support behaviour change. The use of the term self‐management may be more beneficial to communication between professions as it aligns with the chronic disease research. Presently the concept focuses on concordance of the patient with completing the preventative tasks of lifelong compression, elevation and exercise/mobility. The person's beliefs and understanding that compliance with these tasks will reduce the risk of recurrence, and hence, lifelong changes to routines, habits and lifestyles must be made by the person. [ABSTRACT FROM AUTHOR]

Background the mySupport advance care planning intervention was originally developed and evaluated in Northern Ireland (UK). Family caregivers of nursing home residents with dementia received an educational booklet and a family care conference with a trained facilitator to discuss their relative's future care. Objectives to investigate whether upscaling the intervention adapted to local context and complemented by a question prompt list impacts family caregivers' uncertainty in decision-making and their satisfaction with care across six countries. Second, to investigate whether mySupport affects residents' hospitalisations and documented advance decisions. Design a pretest–posttest design. Setting in Canada, the Czech Republic, Ireland, Italy, the Netherlands and the UK, two nursing homes participated. Participants in total, 88 family caregivers completed baseline, intervention and follow-up assessments. Methods family caregivers' scores on the Decisional Conflict Scale and Family Perceptions of Care Scale before and after the intervention were compared with linear mixed models. The number of documented advance decisions and residents' hospitalisations was obtained via chart review or reported by nursing home staff and compared between baseline and follow-up with McNemar tests. Results family caregivers reported less decision-making uncertainty (−9.6, 95% confidence interval: −13.3, −6.0, P  < 0.001) and more positive perceptions of care (+11.4, 95% confidence interval: 7.8, 15.0; P  < 0.001) after the intervention. The number of advance decisions to refuse treatment was significantly higher after the intervention (21 vs 16); the number of other advance decisions or hospitalisations was unchanged. Conclusions the mySupport intervention may be impactful in countries beyond the original setting. [ABSTRACT FROM AUTHOR]

Suicide and self-harm are widespread yet underreported. Risk assessment is key to effective self-harm and suicide prevention and management. There is contradicting evidence regarding the effectiveness of risk assessment tools in predicting self-harm and suicide risk. This systematic review examines the effect of risk assessment strategies on predicting suicide and self-harm outcomes among adult healthcare service users. Electronic and gray literature databases were searched for prospective research. Studies were screened and selected by independent reviewers. Quality and level of evidence assessments were conducted. Due to study heterogeneity, we present a narrative synthesis under three categories: (1) suicide- and self-harm-related outcomes; (2) clinician assessment of suicide and self-harm risk; and (3) healthcare utilization due to self-harm or suicide. Twenty-one studies were included in this review. The SAD PERSONS Scale was the most used tool. It outperformed the Beck Scale for Suicide Ideation in predicting hospital admissions and stay following suicide and self-harm, yet it failed to predict repeat suicide and self-harm and was not recommended for routine use. There were mixed findings relating to clinician risk assessment, with some studies recommending clinician assessment over structured tools, whilst others found that clinician assessment failed to predict future attempts and deaths. There is insufficient evidence to support the use of any one tool, inclusive of clinician assessment of risk, for self-harm and suicidality. The discourse around risk assessment needs to move toward a broader discussion on the safety of patients who are at risk for self-harm and/or suicide. There is insufficient evidence to support using standalone risk assessment tools. There are mixed findings relating to clinician assessment of risk. Structured professional judgment is widely accepted for risk assessment. [ABSTRACT FROM AUTHOR]