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Why you should read this article: • To better understand the detrimental effects of domestic violence and abuse on children and young people • To acknowledge the importance of having independent domestic violence advocates in children’s hospitals • To reflect on how you can enhance your practice with regard to domestic violence and abuse. Domestic violence and abuse (DVA) has detrimental effects on the health and well-being of children and young people exposed to it, whether they witness or experience it. The introduction of independent domestic violence advocates in UK hospitals has enhanced the safety of victims of DVA. In 2020-2021 an independent domestic violence advocate post was piloted at a children’s hospital for one year, the advocate’s role being to train hospital staff and support women who had experienced DVA. A service evaluation showed that the training and support provided by the independent domestic violence advocate had benefits for women, children and staff. It also confirmed that the commissioning of services for children exposed to DVA is often underfunded and overshadowed by the provision of support to adults. [ABSTRACT FROM AUTHOR]

Why you should read this article: • To gain a greater understanding of key specialist nursing roles in children’s cardiology • To delve into the guidance and standards on nursing roles and competences in children’s cardiac services • To recognise the need for nursing teams to collaborate across congenital heart disease (CHD) networks. Background: Children’s cardiac nursing roles have changed over the past decade. Royal College of Nursing (RCN) guidance and NHS England standards have been published with the aim of standardising and enhancing nursing care for children and young people with congenital heart disease (CHD) and their families. Aim: To explore the breath of implementation of key nursing roles in children’s cardiac services across the UK and Ireland and to determine whether the roles met the RCN guidance and the NHS England standards. Method: A cross-sectional survey design was used. The 150 members of the Congenital Cardiac Nurses Association (CCNA) were invited via email to participate and were sent a link to an online survey. Findings: Of the 150 potential respondents, 31 completed the survey. Overall, respondents believed that the RCN guidance had been implemented effectively and that children’s cardiac nursing roles matched the RCN’s example job descriptions. Respondents’ comments suggested that implementation of the NHS England standards had been challenging and that progress in setting up key roles such as lead nurse, cardiac nurse educator and children’s cardiac nurse specialist had been slow. Respondents felt that political and financial factors adversely affected recruitment. Conclusion: Since publication of the NHS England standards there has been some progress in the implementation, in children’s cardiac services, of key nursing roles such as lead nurse and innovative nursing roles such as advanced nurse practitioner and research nurse. The findings of this study have informed the latest edition of the RCN guidance, which now includes the role of senior research nurse. [ABSTRACT FROM AUTHOR]

Why you should read this article: • To explore the use and uptake of video group consultations (VGCs) by UK general practice staff during the COVID-19 pandemic • To enhance your awareness of the potential use of VGCs in your clinical setting • To recognise that the use of VGCs is dependent on funding, organisational support, general practice priorities and understanding of the model. Background: Video group consultations (VGCs) are one approach to delivering care using a virtual platform for a group of patients with the same or similar health conditions. However, little is known about the use and uptake of VGCs in the UK. Aim: To describe the use and uptake of VGCs by UK general practice staff during the coronavirus disease 2019 pandemic. Method: A cross-sectional design using an online questionnaire. Data analysis adopted the principles of content analysis and demographic data were analysed descriptively. Findings: A total of 36 participants completed the questionnaire across nine UK regions and representing 36 general practices. A lack of standardisation regarding the use and uptake of VGCs across UK general practices was identified, hindering implementation, scale-up and delivery. Conclusion: While the VGC model looks promising, further research is needed to demonstrate its use and uptake, developing a more robust evidence base for implementation. [ABSTRACT FROM AUTHOR]

People with cancer from ethnically diverse backgrounds are having a poorer experience of NHS care than their non-ethnic background counterparts, the latest National Cancer Patient Experience Survey results show. [ABSTRACT FROM AUTHOR]

Why you should read this article: • To increase your knowledge of the principles of moving and handling the body of a deceased child • To enhance your decision-making about the practical aspects of the care of children after death • To consider the development of policies and training to standardise care after death in children's hospices Background: Children's hospices provide a range of services for babies, children and young people who have a life-limiting or life-threatening condition, including care after death in specialist 'cool bedrooms'. Care after death is a challenging but important element of hospice care. Aim: The aims of the study were to identify the practices of staff providing care after death in UK children's hospices, notably their moving and handling practices and their management of physiological deterioration, and to produce recommendations that promote safe and consistent practice in moving and handling and in managing physiological deterioration after death in UK children's hospices. Method: An electronic survey was sent to all 54 UK children's hospices. Free-text responses were analysed using deductive content analysis and used to add depth to the quantitative findings. Findings: Out of 54 children's hospices, 33 responded to the survey. There were great variations in the way hospices delivered care after death, notably in length of stay, interventions and equipment. The lack of consistent practice grounded in evidence-based policy and training may mean that some staff experience higher levels of stress and anxiety than others and that some staff take risks when providing care after death, particularly to express empathy towards bereaved families. Conclusion: Recommendations are made about moving and handling a child's body after death and managing its physiological deterioration. Hospices can use these recommendations to develop policy and training, standardise what is expected of staff and support practitioners in adequately caring for children after death. [ABSTRACT FROM AUTHOR]

AUTH Why you should read this article: • To understand the clinical reasons for pre-treatment assessment of patients undergoing systemic anticancer therapy (SACT) • To appreciate the benefits of a digital SACT pre-assessment pathway for cancer patients • To familiarise yourself with the challenges of providing a digital service During the coronavirus disease 2019 (COVID-19) pandemic measures have been implemented in healthcare systems to reduce transmission of the infection. People with cancer are immunocompromised and at higher risk of contracting infections, therefore many cancer services have been conducting routine reviews and pre-treatment assessments remotely through telephone and video consultations during the pandemic. Patients who are to receive systemic anticancer therapy (SACT) should have an additional consultation to provide them with specific information about the therapy, including side effects and who to contact for advice if they develop these at home. This article describes the development and implementation of a digital SACT pre-assessment pathway in a large university hospital during the COVID-19 pandemic, which aimed to deliver information to groups of patients remotely. The article explores the challenges to implementation and discusses some of the findings of a patient feedback survey, which suggest that the digital SACT pre-assessment sessions have been successful overall. [ABSTRACT FROM AUTHOR]

Why you should read this article: • To understand the important aspects of competency frameworks for nurses • To learn about a project to develop and evaluate a gerontological competency framework for early career nurses • To recognise the potential benefits of competency frameworks in supporting post-registration nurse education Background: Within gerontological nursing as a postgraduate nursing specialty, there is a lack of consensus regarding the standardised competencies and education development required, particularly in the UK. Aim: To develop and evaluate a competency framework for early career nurses undertaking post-registration education in a UK university in care for older people living with frailty. Method: The competency framework was developed as part of a broader gerontological education-career pathway intervention to improve competence and retention among early career nurses. A four-step process was used to develop the framework guided by a consensus building approach. A mixed-methods approach to the evaluation was adopted, with an online survey, one-to-one interviews and focus group interviews with students and organisational stakeholders. Findings: A total of 33 students completed the competency framework as part of an academic module, 30 of whom took part in the evaluation. There was consensus among interviewees that the competencies confirmed 'what they knew already' and identified areas they needed to develop. Survey respondents reported that the competency framework was a useful part of the education-career pathway. Conclusion: The competency framework was acceptable to students and feasible to complete. It also enabled students to appreciate the unique knowledge and skills that underpin gerontological nursing and to evidence their expertise using a structured approach. [ABSTRACT FROM AUTHOR]

Black and Asian nurses are being prevented from climbing the career ladder because of racism in the NHS. [ABSTRACT FROM AUTHOR]

AUTH Why you should read this article: • To understand that issues with nutrition are common in all stages of dementia • To improve your knowledge of nutritional care for people living with dementia in care homes • To learn how a nutritional guide might improve food and drink intake in this group of people Issues with eating and drinking are common in all stages of dementia but are most prevalent in the middle and late stages of the condition. This can lead to unintentional weight loss and malnutrition. Previous work by the authors has attempted to understand how to improve the nutritional care of people living with dementia, and has resulted in the development of a guide for care staff to improve their knowledge and skills regarding nutrition in people with dementia. The aim of this service evaluation was to investigate how use of the nutritional guide for care staff could improve the provision of nutritional care for people living with dementia in care homes. An online survey questionnaire was emailed to care homes who had received copies of the guide between November 2018 and August 2019. Completion of the survey was sought eight weeks after use of the guide. Forty-seven questionnaires were returned from staff working in care homes. Respondents reported that the guide had supported them to increase the appetite and fluid intake of people living with dementia. The guide prompted staff members to monitor for malnutrition using validated screening tools and provided strategies to encourage people living with dementia to eat more at mealtimes. These findings indicated that the guide has contributed to changes in the practice of care home staff when providing nutritional care for people with dementia. [ABSTRACT FROM AUTHOR]

Background: E-professionalism is a term used to describe the behaviours of healthcare professionals, including nurses, in the online environment. While a range of professional guidance on the use of online social media platforms is available, there has been little research into the perspectives of patients and the public more generally on nurses' e-professionalism. Aim: To explain what, how and why the public make decisions about the acceptability of nurses' online behaviours and e-professionalism, and to make recommendations for nurses on managing the information they share online. Method: This was a mixed-method critical realist study. Participants in a survey (n=53) and two focus groups (n=8) discussed and rated the acceptability of five vignettes related to nurses' online behaviours based on real-life examples. Findings: The participants generally thought that nurses are entitled to have a personal life and freedom of speech and to promote causes they believe to be important, even if these were not aligned with their own beliefs. Participants unanimously considered the use of profane language against any individuals or groups to be unacceptable. Conclusion: The public make decisions on the acceptability of nurses' online behaviours based on a range of complex factors, including social and individual values, attitudes and beliefs, as well as their intent and consequences. Recommendations for nurses on how to manage the information they share online include: using separate platforms for personal, educational and professional purposes; using functions that control who can 'tag' and share their posts; and ensuring any information they share that relates to healthcare or nursing practice is up to date and evidence based. [ABSTRACT FROM AUTHOR]

Mental health nurses are being urged to have their say on job satisfaction, well-being, burnout and care quality in a new survey. [ABSTRACT FROM AUTHOR]

The number of children in the UK with life-limiting conditions and the demand for home-based palliative care is increasing. Children's hospices remain a dominant provider of palliative care. This study aimed to determine the approaches taken by children's hospices across the UK in meeting the planned and unplanned health needs of children and their families who receive palliative care at home. In addition, the survey aimed to identify the professional composition of community teams and the number of children and families supported by each service. An internet-based questionnaire survey was sent to all children's hospices in the UK, comprising ten questions exploring the size of the team, geographical areas covered, workforce composition, services offered and approaches to managing unplanned, out of hours care. Responses were received from 14 (26%) of the hospices. A total of 1,618 children and their families were being cared for by these hospices, of whom 825 received care at home. Registered nurses constituted the greatest proportion of staff and were employed by all teams. Care provided at home was broadly split into two categories: planned short breaks and responsive palliative nursing. The latter comprised advance care planning, anticipatory prescribing and active symptom control. Out of hours care was usually offered in the form of telephone support. Models of community-based care are evolving to include nurses practising at specialist and advanced levels, allowing more children with increasingly complex conditions to be cared for at home. [ABSTRACT FROM AUTHOR]

This article gives an example of a nurse-led service review and explains the process of evaluating a service that includes nurse-led clinics, patient information and patient experience. The aim of the evaluation was to engage with patients to gather information about and understand their experience, to inform the development of quality services and patient pathways. [ABSTRACT FROM AUTHOR]

Aim To identify the views and experiences of emergency nurses and doctors of the presence of family members during invasive procedures and resuscitation events. Methods 84 staff members from three emergency departments in one UK trust responded to a paper-based 22-item questionnaire developed by the authors. Findings Staff expressed positive views about family presence during such traumatic events, but also expressed non-evidenced concerns about negative aspects of family presence. Conclusion Future research should focus on exploring the views of patients and their families in culturally diverse societies or across culturally different countries. Such data could underpin culturally sensitive policies to guide the practice of family presence and identify the education required to support successful development of such policies. Using simulation-based learning methodology integrated with existing advanced life-support/advanced trauma life-support training could support successful implementation of family presence policies. [ABSTRACT FROM AUTHOR]

The UK has a serious shortage of nurses and for the first time in recent nursing history 27% more UK registrants left the register in 2016-2017 than joined it. Emergency nurses are particularly affected as their environment is unpredictable, fast-paced and increasingly crowded. This article reports the results of a study of a successful initiative to retain senior emergency nurses in a London trust. [ABSTRACT FROM AUTHOR]

Aim The aim of this article is to present selected findings from a doctoral study on the subjective well-being and subjective experience of mental health problems in UK mental health nurses. Here the concept of 'nurses' well-being' is explored. Method Data were drawn from a survey of 237 mental health nurses about their mental health and well-being and from interviews with 27 mental health nurses with personal experience of mental health problems and high subjective well-being. Results While nurses' subjective well-being is relatively low, some use strategies to support their well-being in and outside the workplace. Activities outside work that improved their wellbeing were physical exercise, mindfulness practice, spending time in nature and listening to music. Well-being was associated with clear boundaries between home and work life, regular clinical supervision and translating learning from work with patients to nurses' own lives. Conclusion Healthcare employers' staff health and well-being strategies should be informed by nurses' insights into what works for them. This may mean offering opportunities to take part in well-being activities. There are also opportunities to improve staff well-being through shared initiatives open to nurses and patients, and through an inclusive and empowering approach to staff engagement. [ABSTRACT FROM AUTHOR]

The introduction in 2016 of the Nursing and Midwifery Council revalidation process, which involves several standardised steps, has represented a major change for UK nurses and midwives, and is now a compulsory requirement of reregistration. This article presents preliminary results of a survey about revalidation, undertaken in June 2016 at Oxleas NHS Foundation Trust, Dartford, focusing on how nurses and midwives feel about the process. The article considers the effect of different variables, including pay band, seniority and directorate, on nurses' and midwives' perceptions of revalidation, and suggests it is regarded more positively by senior, more experienced staff than by those who are less experienced. [ABSTRACT FROM AUTHOR]

This article examines the findings of a Royal College of Nursing (RCN) survey, The Value and Contribution of Nursing to Public Health in the UK: Final report, on the value of public health nursing and nurses' role in shaping the integration of health and social care. The prevention of ill health is important across all the UK's government health policies as they place an emphasis on improving health and supporting people not just to live longer, but to stay healthy. Integration of care means aligning health and social services and making sure that they are 'person-centred', designed to meet the needs of individuals across care pathways which are 'place-based' where people are living and working. To meet the unprecedented challenges of increasing population demands and financial pressures in health and care services, improving the public's health and better integration of services are fundamental. Nurses and midwives are in a unique position to support and drive this improvement because of the regular and frequent contact they have with people. The survey highlights the value of the contribution they can make to public health and the associated knowledge and skills required to undertake such work [ABSTRACT FROM AUTHOR]

Aim To explore the experiences of children, young people and their families attending their first appointments with a child and adolescent mental health service (CAMHS) clinic. Method Semi-structured interviews were conducted with a sample of 17 family groups who attended an outpatient clinic. Findings Four themes were identified: telling traumatic events, feeling the stigma associated with mental ill health, experience of being in unfamiliar territory and having a therapeutic connection. Conclusion Families attribute significant meaning to their first engagement with CAMHS. Practitioners need to be cognisant of the importance of this first encounter for families and offer clear information for children and young people before their first appointments. [ABSTRACT FROM AUTHOR]

The new system of Nursing and Midwifery Council revalidation comes into effect in April 2016, from which time all nurses and midwives will be required to demonstrate their ability to practise safely and effectively. This article describes how one emergency department has incorporated evidence collection for revalidation into its regular continuing professional development opportunities, and outlines the benefits of this for individual nurses, employers and patients. [ABSTRACT FROM AUTHOR]

A short series of articles in Nursing Older People, starting in September, presents case study examples of the positive work achieved by trusts that participated in the RCN's development programme to improve dementia care in acute hospitals. This introductory article reports on the independent evaluation of the programme. The programme included a launch event, development days, site visits, ongoing support by the RCN lead and carer representatives and a conference to showcase service improvements. The evaluation drew on data from a survey, the site visits, trust action plans and a range of self-assessment tools for dementia care. The findings highlight substantial progress towards programme objectives and learning outcomes and suggest that the programme provided the focus, impetus and structure for trusts to make sustainable changes. It also equipped participants with the strategies and confidence to change practice. Recommendations are made for taking the programme forward. [ABSTRACT FROM AUTHOR]

There is a higher prevalence of epilepsy in people with learning disabilities than in the general population. In the authors' trust's catchment area of Bedfordshire, concerns have been raised about the training of carers and family members of people with learning disabilities and epilepsy in the use of emergency epilepsy rescue medication. This article describes how a specialist learning disability healthcare service in Bedfordshire completed a survey of the number of people with learning disabilities and epilepsy who were receiving treatment in the area. The results demonstrate that local clinical practice is in line with the relevant National Institute for Health and Clinical Excellence standard, and that adequate training for family and paid carers in the use of emergency epilepsy rescue medication is available. However, it also shows that trainers should be assessed regularly and more topics should be covered in their training programmes. Awareness of each person's epilepsy triggers and careful monitoring of antiepileptic medication ensure effective management of seizure activity, and reduce the need for rescue medication. [ABSTRACT FROM AUTHOR]

This article reports on an analysis of patient and carer free-text comments received in response to the first National Mesothelioma Experience Survey conducted in the UK. It provided people affected by mesothelioma with an opportunity to give feedback on the management and support they received from healthcare services. The findings highlight the relevance of the chief nursing officer for England's Compassion in Practice strategy and the 6Cs initiative, in particular the core values of compassion, communication and competence, to the delivery of high quality services and excellent health and wellbeing outcomes. [ABSTRACT FROM AUTHOR]

The article discusses a report by Great Britain's Department of Health (DH) that little has been done in response to the findings by the Confidential Inquiry into Premature Deaths of People with Learning Disabilities (CIPOLD) that a significant portion of people with learning disabilities die much earlier as compared to the rest of the population. Topics include the lack of training and awareness of healthcare workers, and allocation of learning disability teaching in the nursing course.

This study aimed to evaluate nurses’ knowledge, perceptions and opinions of double-checking medication administration in a UK children’s hospital. Of 119 questionnaires distributed, 48 were returned. Only 30 respondents had seen a written version of the hospital double-checking policy. More than half stated that they had not received formal training in double-checking medications. Of 35 nurses providing a definition of double-checking, one gave a response that reflected hospital policy. Most respondents thought that staffing, workloads and interruptions affected adherence to double-checking; 15 reported that double-checking was easier to do at night; and the results suggested that lack of knowledge and of clear guidelines contributed to medication errors. [ABSTRACT FROM AUTHOR]

There are concerns that urgent treatment under section 62 of the Mental Health Act 1983 is being used increasingly because of delays in getting a second opinion. It is therefore of paramount importance that section 62 is used and recorded appropriately. The Mental Health Act code of practice recommends that it should be the approved clinician in charge of treatment who decides what treatment is appropriate and completes the form. The authors of this article surveyed trainee and consultant psychiatrists to ascertain their understanding of urgent treatment. Results showed the authorisation of urgent treatment was inconsistent and there was ambiguity about who should complete a section 62 form. These uncertainties highlight the need for a national standardised form. [ABSTRACT FROM AUTHOR]

Complaints can give hospital managers valuable insight into patients' experiences of care delivery, insight that regular service audits may miss. Viewed positively, complaints offer managers an opportunity to develop and improve services. This article shares the findings from a Patients Association survey of complainants across ten pilot trusts from July 2011 to July 2013. The results describe what it feels like to make a complaint and highlight considerable variation in performance by the organisations involved. Overall complainant satisfaction was found to be low, and approaches that senior nurses can take in response are suggested. [ABSTRACT FROM AUTHOR]

This article reports on the results of the National Mesothelioma Experience Survey, which provided people with mesothelioma, and their families and carers, with an opportunity to comment on the management and support they received from healthcare services. The findings highlight a need to improve assistance with the physical, emotional and social effects of mesothelioma, and suggest that those with peritoneal mesothelioma may experience poorer care than those with pleural disease. [ABSTRACT FROM AUTHOR]

A patient survey was conducted to determine satisfaction with information provision during pelvic radiotherapy and identify any unmet information needs. A questionnaire was designed that incorporated questions from the European Organisation for Research and Treatment of Cancer Quality of Life Group information questionnaire. Eligible patients were identified from a database of those who had received treatment at the cancer centre over an 18-month period. Eighty three patients were sent the questionnaire and 58 (70%) responded. Nearly half would have liked more information and none wanted less. More than two thirds of respondents stated they had received written information, which in half of cases was offered by a nurse. Information on potential late effects of radiotherapy was well received, with most indicating a preference to be offered it before treatment. Continuing review of an individual's information prescription throughout the cancer pathway is recommended. [ABSTRACT FROM AUTHOR]

Background Delayed discharge from hospital creates additional pressure on staff and finances. While legal sanctions are in place for acute trusts, the concept of a delayed transfer is generally poorly defined in mental health. Aims To evaluate whether levels of, and reasons for, delayed discharge have changed over a ten-year period. Method Using alternative clinical and social criteria for delayed discharge, a census survey of general adult psychiatry inpatients was taken in June 2011 and compared with a similar survey carried out in October 2001. Results The 2011 sample showed 14 per cent of clients experienced delayed discharge, reduced from 25 per cent ten years earlier. In 2011 there were fewer people awaiting rehabilitation, forensic or respite care, but more waiting to be rehoused. The proportion of new long-stay inpatients was higher in 2011, although several were in hospital for clinical reasons and were not delayed discharges. Conclusion Hospital admission appears to be used for focused treatment purposes. The inconsistent definition and application of 'delayed discharge' can lead to financial consequences for mental health services. [ABSTRACT FROM AUTHOR]

Aim To explore nurse prescribers' approaches to providing medication for users of addiction services and the opportunities for this in the NHS. Method A telephone survey of a self-selected sample of 20 nurse members of the UK group of the National Non-Medical Prescribers in Substance Misuse Forum, working in NHS addictions services. Results Opportunities for nurse prescribing ranged from enhanced key working in community drug and alcohol team (CDAT) clinics, deputising for doctors and CDAT whole team strategies, to non-CDAT prescribing in addictions services elsewhere. Advantages of nurse prescribing are seen by practitioners and service users as far outweighing disadvantages. Conclusion Many healthcare services are in transition and need more nurses to train in independent prescribing. As fewer doctors are employed and commissioners change their requirements, whole systems approaches are starting with nurse prescribers at their centre. Careful evaluation of results should be maintained. [ABSTRACT FROM AUTHOR]

The article focuses on a study which evaluates the care received by older people with diabetes in Great Britain. It notes in the study that financial difficulties such as expensive travel costs and low interest rate on savings affect the diabetes self-care of most participants. It concludes that care of older patients with diabetes should be as individualistic as that provided to young and middle-aged patients.

The article discusses the results of a survey by the Royal College of Nursing (RCN) on the relationship between staffing levels and care delivery for older people in hospital as well as the practical implications for nurse working on older people's wards. It notes that the survey shows that care activities are more likely to become compromised on wards with poorer nurse staffing. It cites the importance of adequate staffing in meeting the challenge of providing care for these patients.

Public policy emphasises the need for cancer patients to have access to information that will help them with choice and decision making. This article discusses the results of a postal survey for telephone users and an online survey for email users carried out to explore the main reasons people seek information from an independent voluntary sector cancer information helpline. Along with needing information to support decision making, respondents cited a fundamental need for information to help them understand their situation. All nurses have a responsibility to provide comprehensive information at every stage of the cancer pathway, regardless of whether patients are facing a choice or decision. Helpline nurses have a specific role to play as an independent, anonymous source of information. [ABSTRACT FROM AUTHOR]

This study aimed to establish which policies are in place for checking medication administration in UK children's units and to discuss evidence to support the use of different checking processes. It involved a questionnaire survey (n=105) in 69 UK hospitals of children's nurses and pharmacists. In the hospitals surveyed, most administrations of oral and intravenous medications were checked by two registered children's nurses. Evidence suggests a role for single and double checking depending on risk assessment. Robust research is needed to further evaluate these processes. [ABSTRACT FROM AUTHOR]

E-health is concerned with promoting the health and wellbeing of individuals, families and communities, and improving professional practice through the use of information management and information and communication technology. In autumn 2010 the RCN, supported by an information technology consultancy, carried out a survey of members' views on e-health to assess their involvement in, and readiness for, e-health developments and their knowledge of its benefits. A total of 1,313 nurses, midwives, healthcare support workers and pre-registration students from across the UK responded. This article describes ways in which nurse managers can influence the successful implementation of the survey recommendations. INSET: UK programmes for IT and e-health. [ABSTRACT FROM AUTHOR]

The Cancer Reform Strategy (Department of Health 2007) states that 'commissioners and providers should ensure that the critical roles of clinical nurse specialists (CNSs) in information delivery, communication and co-ordination of care are supported'. Despite this, CNS roles are increasingly under threat. The British Association of Head and Neck Oncology Nurses conducted a short survey of CNSs in each region to understand better the actual and perceived threats to its members. The results showed that 31 per cent of respondents had been asked to work on the wards and 42 per cent had been asked to perform other managerial duties. The association recommends that strong consideration is given to maintaining and strengthening the CNS workforce. [ABSTRACT FROM AUTHOR]

This article discusses how a bespoke questionnaire for patients admitted to an acute medical unit was developed to assess satisfaction levels. A postal survey was sent to 500 people who had been discharged from the unit between January and March 2010. This article looks at the lessons learnt in developing and undertaking the survey and makes recommendations for anyone considering embarking on a similar project. It does not look at the results of the survey. [ABSTRACT FROM AUTHOR]

Glucagon has been prescribed routinely on diagnosis of paediatric type 1 diabetes. A forum of paediatric diabetes specialist nurses sought to examine whether this practice is evidence based. Forum members audited their own caseloads, including the families and carers, their professional practices and those of other teams nationally. It was found that the prescription of glucagon varies and its use is often limited by lack of confidence. They found little evidence to support routine prescription on diagnosis and recommend that individual case assessment of risk and of the needs and preferences of families and carers would be more cost effective. Families and carers who do acquire a glucagon injection kit should receive regular training in its use. [ABSTRACT FROM AUTHOR]

Aim This paper examines the complex issues of measuring the patient experience and evaluating the quality of health care. It discusses the use of surveys, patient stories and narrative methods of data collection in an attempt to define quality and how it should be measured. Background A recent Department of Health (DH) document insists that patients will be at the heart of decision making in the NHS by having greater control in informing strategic commissioning decisions (DH 2010c). The government aims to improve patient experience, enabling patients to rate services according to the quality of care they receive. This will be carried out using information generated by patients. Review methods This paper discusses the advantages and disadvantages of using surveys in gathering patient satisfaction data. It considers the value of surveys in measuring quality of care and appraises their usefulness in strengthening patients' collective voice. Discussion The paper investigates the use of another source of feedback -- it examines the design of qualitative data collection methods as a means of gaining feedback from service users in encouraging providers of health care to be more responsive to their needs. Too often, patients are expected to fit the services, rather than services meeting the patients' needs. Conclusion The most effective way of exploring and representing the patient's experience is by using a mixed-method approach. In other words, an integrated approach with the use of surveys and more narrative methods, such as patient stories, will effectively define quality and how it should be measured, ensuring that the focus is always on what matters most to patients. [ABSTRACT FROM AUTHOR]

Aim: The aim of the study was to explore how 'new role' and other social carers and stakeholders involved in providing enhanced health and social care for older people perceive the social care support worker's professional status. Method: Three different enhanced care approaches, of which two trained social care support workers to undertake new clinical support roles were studied in three residential homes: a local authority home, a voluntary sector home and a 'not for profit' independent sector home for older people. Participants were staff with national vocational qualifications at level 3 as new role carers with and without additional basic health skills awards. Other participant groups included care staff of other grades, care home managers, their parent organisation managers, and local and national stakeholders. Results: Staff in all three care settings believed themselves to be professionals in the homes in which they worked but were less sure of their status in the wider health and care landscape. Conclusion: If the social carer workforce is to be considered a profession, it requires a professional framework in the form of a representative organisation, a code of conduct for practice and clarity as to how its new role activities interact with those of other established health professionals. [ABSTRACT FROM AUTHOR]

This article discusses the findings of a survey of Breast Cancer Care's helpline users. There is a paucity of data about the effect on patients of using a helpline and the survey aimed to address this. During the evaluation period all relevant callers to the helpline were invited to take part in a postal survey to assess their experience of using the service. Two hundred and thirty two callers completed the questionaires. Analysis of the results shows that respondents were satisfied with the service that provided them with relevant information, emotional support and helped them make informed choices. [ABSTRACT FROM AUTHOR]

There is a growing trend to increase the number of single occupancy rooms for inpatients to support infection control and maintenance of privacy and dignity. In 2008, single rooms accounted for 28 per cent of NHS beds (National Nursing Research Unit (NNRU) 2008), the Department of Health (DH) having advocated at least 50 per cent single patient occupancy in new or replacement facilities (DH 2004). Some units have or are planning 100 per cent single patient occupancy, although this model may not fit the needs of children and young people in hospital in terms of safety, sociability and development, patient satisfaction and demands on the workforce. Considerations in planning healthcare facilities for children and young people include alleviating fear and anxiety, maximising security, safety and sociability, reducing boredom and creating a healing environment (DH 2004). The findings from the National Service Framework for Children, Young People and Maternity Services (DH 2003) reveal that many facilities have been redesigned with little acknowledgement of children's needs. There is evidence to support and to oppose 100 per cent single patient occupancy for adults (Table 1) but little evidence regarding children. For children and young people the recommendations state: 'For best practice a minimum of 50 per cent of cubicles should be provided' (DH 2004), and it is recognised that single rooms offer maximum privacy, flexibility and protection from infection. There is no evidence about whether 100 per cent single patient occupancy would meet the needs of children and young people in hospital in terms of their safety, sociability and development, patient satisfaction, and demands on the workforce. This study explores the feasibility of a 100 per cent single room occupancy model for children and young people. [ABSTRACT FROM AUTHOR]

In response to concerns about a lack of dignity in care raised in the media and several studies, the RCN launched last year its dignity campaign, Dignity: At the heart of everything we do. A major part of this campaign was a dignity survey of more than 2,000 nurses, nursing students and healthcare assistants, making it the largest dignity survey of the UK nursing workforce ever undertaken. This article outlines what some of the survey findings mean for nurse managers and leaders, and discusses the relationship between dignity and nursing. [ABSTRACT FROM AUTHOR]

In December 2008, readers of RCN Publishing's eight specialist nursing journals were surveyed about their careers and asked for their opinions on the state of nursing in the UK. This article examines the responses of readers of Emergency Nurse and compares these with the overall survey results. INSETS: Case study: Vincent Golden;Case study: Gemma Davies. [ABSTRACT FROM AUTHOR]

This article examines the findings of a survey of readers of RCN Publishing specialist nursing journals, which cover fields such as cancer, gerontology and emergency care. The survey provides a snapshot of the profession and highlights differences between nurses in each field: their ages, working practices, concerns and aspirations. The survey found that the cancer nursing specialty has large numbers of well-educated and well-paid staff. INSETS: Media-savvy campaigner;Personal assistant turned nurse. [ABSTRACT FROM AUTHOR]