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Aim: The increase in the number of people with chronic obstructive pulmonary disease (COPD) and the disease burden, has prompted concerted efforts to improve healthcare, particularly outpatient services. In line with these attempts the Partnership-Based Nursing Practice Theoretical Framework for People with COPD was developed to guide outpatient nursing care. The principal approach of the framework is a ‘Dialogue’ with the patients, which has four components: ‘Establishing family involvement’, ‘Assisting living with symptoms’ and ‘Facilitating access to healthcare’, with the primary goal being ‘Enhancement of the health experience’. With new knowledge, research on the framework, and extensive experience in using it, a need arose to modify the framework to maximize its clinical utility. Design: Discursive paper. Methods: A narrative review and critical reflection was conducted to revise the nursing practice framework via selected literature search from 2012 to 2022, research on the framework, and the authors' reflections on the clinical experience of using the framework. Results: The nursing practice framework highlights capacities and possibilities that lie in the nurse–patient relationship. The overarching dialogue in the revised framework includes both patients and families. The action-related component ‘Assisting living with the disease’ was added to the framework to underscore the significance of attempting to understand what may lie ahead for patients and families. The other action-related components are as follows: ‘Assisting living with symptoms’ and ‘Facilitating access to healthcare’. The primary goal remains unchanged: enhancing the ‘Health experience’. Conclusion: Using the revised nursing practice framework in outpatient care may help to enhance the lives of people with COPD and their families, particularly at advanced stages of the disease. It may have transferability to other groups of people living with progressive diseases dealing with complicated health problems, and to reduce the usage of costly healthcare resources such as hospital care. Implications for the Profession and/or Patient Care: The partnership-based nursing practice framework assumes an extension of conventional specialized respiratory service and embraces a comprehensive account for that which may influence the patient's health problems. This guidance, which holistically attends to patient-family needs of living with complicated and progressive health predicaments, is fundamental. It contributes to strengthening the disciplinary focus of nursing, interdisciplinary collaboration, person-family-centred quality nursing care and inspires research initiatives. Critical reflections and updates on nursing practice frameworks, such as this revision, are essential to advance nursing and healthcare. [ABSTRACT FROM AUTHOR]

Globally, the nursing profession constitutes the largest proportion of the health workforce; however, it is challenged by widespread workforce shortages relative to need. Strategies to promote recruitment of the nursing workforce are well-established, with a lesser focus on strategies to alleviate the burden on the existing workforce. This burden may be exacerbated by the impact of low-value health care, characterised as health care that provides little or no benefit for patients, or has the potential to cause harm. Low-value health care is a global problem, a major contributor to the waste of healthcare resources, and a key focus of health system reform. Evidence of variation in low-value health care has been identified across countries and system levels. Research on low-value health care has largely focused on the medical profession, with a paucity of research examining either low-value health care or the de-implementation of low-value health care from a nursing perspective. The objective of this paper is to provide a scholarly discussion of the literature around low-value health care and de-implementation, with the purpose of identifying implications for nursing research. With increasing pressures on the global nursing workforce, research identifying low-value health care and developing approaches to de-implement this care, is crucial. [ABSTRACT FROM AUTHOR]

Perioperative nurses must provide culturally competent care to all surgical patients, and understanding gender identity and gender diversity may be the first step to creating an inclusive perioperative practice for transgender and gender diverse patients. In the nurse--patient relationship, limited exposure to and knowledge of diverse populations may negatively affect the health of this important demographic. When nurses are unaware of how care can be affected by explicit (conscious) or implicit (unconscious) bias, they may use transphobic stereotyping behaviours or act with microaggressions, like using excessive protective attire. Such care may invalidate gender identity and impede trust. In contrast, nurses practising gender-affirming care validate the patient's gender identity and life experiences, which supports autonomy and creates trust. The aim of this paper is to provide perioperative nurses with a deeper understanding of factors that may affect gender diverse patient's perioperative outcomes. In addition, understanding the social determinants of health affecting this demographic may result in better health outcomes. As such, the holistic care of the transgender and gender diverse patient is the optimal goal, with clinicians employing a non-judgemental, sensitive and compassionate attitude. [ABSTRACT FROM AUTHOR]

The purpose of this paper is to provide discourse regarding awareness of institutional racism, from a non-Indigenous, Australian nursing student's perspective. The discussion has a focus on the presence of institutional racism in the Australian healthcare system, its impact on the health of First Nation Peoples and a commitment to ensuring culturally safe practice. It will be argued that institutional racism is pervasive in healthcare as a consequence of three factors: exclusion of First Nations Peoples from governance roles, inherent racism impacting on socio-cultural treatment bias, and institutional racism influencing key relationships in healthcare delivery. [ABSTRACT FROM AUTHOR]

Aim: To describe and discuss clinical strategies for nurses working in partnership with substitute decision‐makers for people living with advanced dementia. Background: By providing person‐centred care to patients living with advanced dementia, nurses are positioned to work in partnership with substitute decision‐makers who make healthcare decisions related to advanced care. Because the experience of being substitute decision‐makers is complex and stressful, nurses need skillsets for working in partnership with substitute decision‐makers. Design: In this discursive paper, an innovative framework for working in partnership with substitute decision‐makers is proposed. Method: Evidence‐based findings from a systematic review provided five domain foci for the partnership framework. In each domain, two clinical strategies were discursively proposed. Clinical strategies were hypothesised from research findings and insights from the authors' nursing experiences. Then, topical literature was searched, and findings were used to support the discursively argued strategies. Discussion: To deal with complexities and reduce stress for substitute decision‐makers, an innovative Nurse–Substitute Decision‐Maker Partnership Framework for use in the context of advanced dementia is proposed and discussed. The partnership framework consists of five domains: Building trust, Exploring emotions, Translating quality of life, Encouraging proactivity and Negotiating families. Within these domains, ten strategies to support the practices of clinical nurses to work in partnership with substitute decision‐makers are discussed. Relevance to Clinical Practice: In the framework, the ten clinical nursing strategies are designed to provide targeted care to substitute decision‐makers in areas that are known to cause complexity and stress to them. The Nurse–Substitute Decision‐Maker Partnership Framework has been designed to improve nurse–substitute decision‐maker partnerships and reduce the stress experienced by substitute decision‐makers as they work through the complexities associated with advanced dementia. [ABSTRACT FROM AUTHOR]

Aim: To present the first iteration of the caring life‐course theory. Background: Despite requiring care from birth to death, a person's universal or fundamental care needs and the subsequent care provision, either by self or others, has yet to be presented within a life‐course perspective. Accurately describing the care people require across their lifespan enables us to identify who, what type, how and where this care should be provided. This novel perspective can help to legitimise a person's care needs and the support they require from wider care systems and contexts. Design: Discussion paper outlines theory development. We adopted an inductive approach to theory development, drawing upon existing literature and the team's diverse experiences. Our theoretical insights were refined through a series of collaborative meetings to define the theory's constructs, until theoretical saturation was reached. Discussion: Fourteen constructs are identified as essential to the theory. We propose it is possible, using these constructs, to generate caring life‐course trajectories and predict divergences in these trajectories. The novel contribution of the theory is the interplay between understanding a person's care needs and provision within the context of their lifespan and personal histories, termed their care biography, and understanding a person's care needs and provision at specific points in time within a given care network and socio‐political context. Impact for Nursing: The caring life‐course theory can provide a roadmap to inform nursing and other care industry sectors, providing opportunities to integrate and deliver care from the perspective of the person and their care history, trajectories and networks, with those of professional care teams. It can help to shape health, social and economic policy and involve individuals, families and communities in more constructive ways of talking about the importance of care for improved quality of life and healthy societies. [ABSTRACT FROM AUTHOR]

Open Dialogue is a need‐adapted approach to mental health care that was originally developed in Finland. Like other need‐adapted approaches, Open Dialogue aims to meet consumer's needs and promote collaborative person‐centred dialogue to support recovery. Need‐adapted mental health care is distinguished by flexibility and responsiveness. Fidelity, defined from an implementation science perspective as the delivery of distinctive interventions in a high quality and effective fashion is a key consideration in health care. However, flexibility presents challenges for evaluating fidelity, which is much easier to evaluate when manualization and reproducible processes are possible. Hence, it remains unclear whether Open Dialogue and other need‐adapted mental health interventions can be meaningfully evaluated for fidelity. The aim of this paper was to critically appraise and advance the evaluation of fidelity in need‐adapted mental health care, using Open Dialogue as a case study. The paper opens a discussion about how fidelity should be evaluated in flexible, complex interventions, and identifies key questions that need to be asked by practitioners working in need‐adapted mental health care to ensure they deliver these interventions as intended and in an evidence‐based fashion. [ABSTRACT FROM AUTHOR]

Previous studies have demonstrated that students who are engaged in learning tasks and make errors before receiving instruction on how to complete them, achieve better learning outcomes than students who first receive instruction and then complete the learning activities with the aim of avoiding errors. Although simulation literature often refers to errors as learning opportunities, to date, there is limited understanding of how pedagogical approaches that promote learning from errors can guide the design of simulation-based learning in healthcare education. To (a) present the Learning from Errors conceptual model; and (b) provide an example of how educators can use this model. The Learning from Errors model is drawn from critical elements of two pedagogical approaches, productive failure and error management training and pedagogical features of high-quality healthcare simulations. We describe the Learning from Errors model, which emphasises the need for adopting pedagogical methods that explicitly use errors as learning opportunities and ultimately inform simulation design. We then illustrate the application of this model to a simulation example. The model includes the following elements: i) normalisation of errors, ii) challenging simulation scenarios, iii) self-directed learning, iv) collaborative teamwork and v) comparison with best practice. This discussion paper presents the Learning from Errors conceptual model, an evidence-based approach that can assist educators in the design of simulations that embrace errors as a catalyst for learning. [ABSTRACT FROM AUTHOR]

This original article outlines a theoretical path and posterior critical analysis regarding two relevant matters in modern nursing: patterns of knowing in nursing and commodification contexts in contemporary health systems. The aim of our manuscript is to examine the development of basic and contextual nursing knowledge in commodified contexts. For this purpose, we outline a discussion and reflexive dialogue based on a literature search and our clinical experience. To lay the foundation for an informed discussion, we conducted a literature search and selected relevant articles in English, Spanish, and Portuguese that included contents on patterns of knowing, commodification, and nursing published from 1978 to 2017. Globalization, commodification, and austerity measures seem to have negative effects on nursing. Work conditions are worsening, deteriorating nurse–patient relationships, and limiting reflection on practice. Nurses must develop knowledge to challenge and participate in institutional organization and public health policies. Development of nursing knowledge may be difficult to achieve in commodified environments. Consequently, therapeutic care relationships, healthcare services, and nurses' own health are compromised. However, by obtaining organizational, sociopolitical, and emancipatory knowledge, nurses can use strategies to adapt to or resist commodified contexts while constructing basic knowledge. [ABSTRACT FROM AUTHOR]

Development of the Nurse practitioner role and the specialisation of practice is an increasing focus in healthcare. To date, a bibliometric evaluation of scholarly work referring to Nurse Practitioners, has not been located in the published literature. With the aim of identifying the top 100 cited articles in the Nurse Practitioner domain, the Scopus™ database was searched for Nurse Practitioner studies during 2007–2021. Using bibliometric analysis we identified prolific authors; annual trend; citation rates; countries of origin; and study design. There were 1768 papers identified across 360 peer reviewed journals in 33 countries. Finding from this analysis provides evidence of an evolving research area of inquiry which contributes to knowledge of the Nurse Practitioner role and scope of practice. [ABSTRACT FROM AUTHOR]

Aims A discussion on the case for nurse-led community delivery of health and social care interventions to ex-offenders. Background Ex-offenders re-enter their communities with limited pre-release preparation for the continuity of access to health care once outside prison. Once released, these individuals become hard to reach, do not consider health a priority and consequently use services to address their health and social care needs in a crisis-led way. Nevertheless, how nurses can best support these health-excluded group of individuals in the community remains vague and requires discussion. Design Discussion paper. Data sources Several databases were searched for papers published in English from 1990-2012 using the Population, Intervention and Outcome framework to help structure search. Discussion It is argued that current dominant discourses around equity of care are contradicted in the provision of health and social care services to ex-offenders in the community. Effective engagement with community interventions may be achieved if ex-offenders maintain contact with frontline providers who can support both their structural and health needs. Implication for nursing Nurses are uniquely positioned to initiate and sustain contact with ex-offenders, intervening at points of greatest need in the community to address the socially significant health and social care issues that plague them. Conclusion The use of nurses in the provision of health and social care interventions to ex-offenders is a strategy, which could increase equity in access to health care, reduce reoffending and improve both the health and life chances of these individuals. [ABSTRACT FROM AUTHOR]

An introduction is presented in which author discusses articles on topics including focuses on promoting environmental sustainability and an opportunity to share projects related to improve the environmental footprint of critical care.

This paper describes intervening conditions that might constrain or facilitate the exercise of Legitimate Influence: The Key to Advanced Nursing in Adult Critical Care, the foundation of which is credibility and advanced clinical nursing practice. Constraining conditions are conflict, resistance, gender bias, political awareness and established values. Credibility, advanced clinical nursing practice and strategic activity are required to enhance patient stay in hospital and improve patient outcome. Intervening conditions that facilitate these are overcoming resistance, political awareness and established values. In a previous paper, it was indicated that enhanced patient stay and improved patient outcome were achieved primarily through strategic activity that emphasized restoring patients to a former, or improved, health status. This paper portrays how intervening conditions can impinge upon this and the exercise of legitimate influence. [ABSTRACT FROM AUTHOR]

Kitson A, Conroy T, Wengstrom Y, Profetto-McGrath J, Robertson-Malt S. International Journal of Nursing Practice 2010; 16: 423–434 Defining the fundamentals of care A three-stage process is being undertaken to investigate the fundamentals of care. Stage One (reported here) involves the use of a met a-narrative review methodology to undertake a thematic analysis, categorization and synthesis of selected contents extracted from seminal texts relating to nursing practice. Stage Two will involve a search for evidence to inform the fundamentals of care and a refinement of the review method. Stage Three will extend the reviews of the elements defined as fundamentals of care. This introductory paper covers the following aspects: the conceptual basis upon which nursing care is delivered; how the fundamentals of care have been defined in the literature and in practice; an argument that physiological aspects of care, self-care elements and aspects of the environment of care are central to the conceptual refinement of the term fundamentals of care; and that efforts to systematize such information will enhance overall care delivery through improvements in patient safety and quality initiatives in health systems. [ABSTRACT FROM AUTHOR]

Abstract: The current evidence-based practice (EBP) movement in healthcare emphasizes that clinical decision making should be based on the “best evidence” available, preferably the findings of randomized clinical trials. Within this context qualitative research findings are considered to have little value and the old debate in nursing has been re-ignited related to whether qualitative versus quantitative research findings provides the best empirical evidence for nursing practice. In response to this crisis qualitative scholars have been called upon by leaders in the field to clarify for outsiders what qualitative research is and to be more explicit in pointing out the utility of qualitative research findings. In addition, attention to “quality” in qualitative research has been identified as an area worthy of renewed focus. Within this paper two key problems related to addressing these issues are reviewed: disagreement not only among “outsiders” but also some nursing scholars related to the definition of “qualitative research”, and a lack of consensus related how to best address “rigor” in this type of inquiry. Based on this review a set of standard requirements for qualitative research published in nursing journals is proposed that reflects a uniform definition of qualitative research and an enlarged yet clearly articulated conceptualization of quality. The approach suggested provides a framework for developing and evaluating qualitative research that would have both defensible scholarly merit and heuristic value. This will help solidify the argument in favor of incorporating qualitative research findings as part of the empirical “evidence” upon which evidence-based nursing is founded. [Copyright &y& Elsevier]

Abstract: The aim of this paper is to provide a comprehensive overview of ethnomethodology and explore its usefulness as a methodology for nursing. Ethnomethodology was conceived through the writings of Harold Garfinkel, an American Sociologist in 1967. The influence of phenomenology, sociology and writings of the linguistic philosopher Wittengenstein is evident in this methodology. In the 1970s, it was both heralded by some as a threat to sociology and by others as a welcome development borne out of the dissatisfaction with positivist paradigm research. It is a methodology that has been utilised not only by sociologists but also by many health care disciplines. However, its utilisation by nurse researchers has not been widespread. [Copyright &y& Elsevier]

Presents several papers on nursing outcomes. "Nursing-Sensitive Outcome Implementation and Reliability Testing in a Tertiary Care Setting," by Julia G. Behrenbeck; "Nursing Outcomes Classification (NOC) Implementation and Testing in a Cardiac Surgery ICU," by Kathy Demmer; "Validity Surveys: Selected Nursing Outcomes Classification (NOC) Physiologic Outcomes," by Cindy A. Scherb and Sandra L. Bellinger.

AIM: The goal of this project was to improve unit-based safety culture through implementation of a multidisciplinary (pharmacy, nursing, medicine) teamwork and communication intervention. METHOD: The Agency for Healthcare Research and Quality Hospital Survey on Patient Safety Culture was used to determine the impact of the training with a before–after design. RESULTS: Surveys were returned from 454 healthcare staff before the training and 368 staff 1 year later. Five of eleven safety culture subscales showed significant improvement. Nurses perceived a stronger safety culture than physicians or pharmacists. CONCLUSION: While it is difficult to isolate the effects of the team training intervention from other events occurring during the year between training and postevaluation, overall the intervention seems to have improved the safety culture on these medical units. [ABSTRACT FROM AUTHOR]

Abstract: The British government''s involvement in overseas nurse recruitment originated in its imperial past when the Colonial Nursing Service was established in 1940 by the Colonial Office to unify the administration of British nurse appointments across the Empire. The Colonial Office unified recruitment arrangements for colonial nursing posts, effectively creating an imperial market in nursing labour, which arguably set the historical precedent for the greater flow of international nurse recruitment from and to the United Kingdom (UK). The recent implementation of the Nursing and Midwifery Council''s Overseas Nurses Programme to regulate the registration route for international nurse recruits to the UK is symptomatic of growing international nurse migration. In a globalising marketplace, overseas nurse recruitment remains a significant supply factor in meeting the staffing needs of the National Health Service (NHS) in the UK. The continuities between the historical case of the Colonial Nursing Service and the current prevalence of transnational nurse migration highlight a pervading tension between the professional agenda of nursing and recruiters’ and governments’ responses to market pressures. [Copyright &y& Elsevier]

Global nurse migration has become a major phenomenon, impacting health service delivery in both developed and developing countries. The phenomenon has created a global labor market for health professionals and fueled international recruitment. International migration and recruitment are viewed as solutions to staffing shortages for some countries and as exacerbating problems for others. As a result, migration and recruitment have become prominent features of the international health policy debate. [ABSTRACT FROM AUTHOR]

Explores Orem's self-care model in learning disability nursing in the U.S. Development of nursing knowledge; Use of the nursing theory and conceptual models for the survival of the discipline of nursing; Uses of the Orem's self-care model of nursing practice; Examination of the areas of self-care.

Examines the potential of Orem's self-care model to meet the needs of people with varying degrees of intellectual disabilities and additional physical care needs in hospital, community, and residential setting. Investigation of the benefits and deficits of Orem's self-care model; Analysis of intellectual disabilities, learning disabilities, and mental handicap; Background to the use of conceptual models of nursing.

Management of agitation is an increasingly common duty in the nursing care of older patients. Agitation describes a range of behavioural symptoms including aggressiveness and hyperactivity, and can be a sign of severe illness. In a series of focus groups in a large teaching hospital, nurses’ feelings and actions in regard to nursing agitated older people were recorded and analysed. The results demonstrated that agitation is not well understood and is often not well-managed. Despite recent efforts to provide more supportive staffing structures, nurses felt particularly stressed and unsupported in relation to this phenomenon. Recommendations are made for the instigation of enhanced education programmes as well as ongoing attention to improved workload initiatives. [ABSTRACT FROM AUTHOR]

As nursing has been previously identified as a stressful occupation, sources of job stress and levels of job satisfaction were extensively investigated. However, studies addressing issues of nurses’ mental health are scarce. This work aims to assess psychological well-being of nurses in different job settings in Alexandria and to identify sociodemographic, psychosocial and workplace predictors. A total sample of 412 nurses represented nurses working in five different health organizations in Alexandria. A self-administered questionnaire was used to collect sociodemographic, occupational and health data, and the Standardized Arabic Version of General Health questionnaire (GHQ-30 items), Job Descriptive Index (JDI), and Social Support Scale (SSS) were also used. Results revealed that 21.67% of nurses recorded moderate to severe psychological symptoms on GHQ. Fewer years of experience, negative family and friend support, and negative total work satisfaction were found to be significant predictors of psychological ill health among nurses in a descending rank order. Implications for nursing intervention will be discussed. [ABSTRACT FROM AUTHOR]

Evidence-based nursing is the current fashion. It is being touted as the mechanism to achieve best practice in the clinical setting. But while evidence-based practice (EBP) is being presented in the literature, discussed at nursing practice forums, and evidence-based centres of excellence have developed, there seems to be very little impact in the practice that nurses deliver on a daily basis. The case in point is the collection of vital signs. While not historically a nursing skill, over the last 60 years it has become an integral component of practice in the postoperative general surgical setting. The evidence to support these practices is scant. Policies and text purport traditional routine-regulated practice without substantive evidence to support their claims. These polices are being used to control rather than support EBP. In conjunction with the traditional practice of vital sign collection and the culture of the clinical settings, the policies are limiting opportunities for clinicians to make individual decisions about care delivery based on the unique needs of each patient. Rather than focusing on EBP as the solution to the development of best practice, is it not time to change the focus to real strategies that will assist in achieving best practice? These include the creation of rigorous relevant evidence, the valuing of clinical expertise and the changing of the cultures in which nurses develop and practice. [ABSTRACT FROM AUTHOR]

Spirituality has been the subject of numerous journal articles and books in recent years. Research into this topic has been conducted in many spheres of nursing practice with the notable exception of military nursing. This article goes a small way to addressing the apparent lack of research into spirituality in a military nursing setting by summarizing the findings of one study into this significant area of nursing care. The findings are derived from a mixed method quantitative/qualitative study of registered nurses in the Royal Australian Air Force. The major finding indicated that two distinct concepts of ‘family’ define the way in which this small group of nurses perceive, assess and implement care for the spiritual needs of their patients. These concepts comprise a traditional family structure and an extended military family structure that includes the person's unit and comrades-in-arms. [ABSTRACT FROM AUTHOR]

Explores the role of nurse practitioners (NP) in the emergency department (ED) in Canada. Definition of NP; Special groups commonly referred to as NPs; International perspectives on ED nurse practitioners; Educational requirements for ED service; Benefits and pitfalls of ED nurse practitioners; Real imperative for introducing nurse practitioners in the ED; Barriers to the introduction of NPs into the ED.

A 1997 Institute of Medicine report cited growing public concern about the quality of care in the U.S. health care system for persons at the end of life. The National Institute of Nursing Research (NINR), the lead Institute at the National Institutes of Health for end-of-life research, has conducted a number of public forums to gather information and to assist in identifying research priorities. The complexity of biomedical research requires new methods of discovery, and scientists must use a broad approach and explore new models of team science. In December 2004, NINR and the NIH Office of Medical Applications of Research, along with many co-sponsors, held an interdisciplinary State-of-the-Science Conference on Improving End-of-Life Care. The conference panel identified many gaps in our current state of knowledge and provided suggestions for future research directions. This supplement presents papers from a distinguished group of scientists with a wide range of backgrounds who participated in this state-of-the-science conference. [ABSTRACT FROM AUTHOR]

Aims: This paper explores two critical feminist methodologies for nursing research: feminist political economy and feminist critical discourse analysis. The aim was to appreciate varied methodological approaches available for nurses to understand complexities in healthcare environments, above and beyond socially normative ways of knowing. Design: Discursive paper. Data Sources: Published articles from nursing databases (CINAHL and ProQuest; no date restrictions) and interdisciplinary databases (Women's Studies International, Sociological Abstracts and Ovid MEDLINE; publication dates between 2017 and 2022). Methods: A discursive paper exploring and critically synthesizing the literature on feminist political economy and feminist critical discourse analysis to demonstrate how each methodological approach can be used in nursing. Results: The findings of this discursive paper suggest there is an opportunity to draw on interdisciplinary studies for creative insights into how these methodologies may be helpful for nurses' scholarship and programmes of research. Although few nursing studies explicitly name a feminist political economy or feminist critical discourse analysis approach, several studies apply principles of these methodological approaches. Conclusion: There is an opportunity for these methodologies to be applied within the same project when there is a fit between the research questions and aims of both methodologies (studies where notions of gender and power are considered central and there are potential insights from exploring social progress, structures and the material, along with the social relations of discourses). Implications for the Profession and/or Patient Care: Feminist political economy and feminist critical discourse analysis offer novel options for methodological analyses. Impact: Application of these methodologies may benefit critical nursing scholars looking for diverse critical methodological avenues to explore and to broaden nursing's methodological toolbox towards meeting social justice aims. Patient or Public Contribution: No patient or public contribution. [ABSTRACT FROM AUTHOR]

This article traces the development of Creative Nursing from its origin in 1981 as a newsletter about Primary Nursing to its current position as a quarterly international, interdisciplinary, peer-reviewed, indexed, themed journal that continues to nurture novice authors, welcome international submissions, review articles that other journals won't consider, and address subjects that many journals avoid. Future directions include content in multiple languages, new author guidelines that invite submissions of research methods papers, moving beyond statistical significance based on p-value thresholds, asking authors to make explicit the implications for knowledge translation in their papers, and thinking creatively about how artificial intelligence can be leveraged for research, education, and practice. [ABSTRACT FROM AUTHOR]

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Introduction: Globally, the population is ageing, and more people live in residential care. Best practice in personal hygiene care may reduce distressing and debilitating skin and oral problems and improve resident outcomes. Although there is guidance on personal hygiene care, implementation may be a challenge. Aim: To identify barriers and facilitators to delivering personal hygiene care for older persons in residential care settings. Methods: Systematic review reported according to PRISMA 2020 guidance. Databases MEDLINE, CIHAHL and PsychINFO were systematically searched using terms and synonyms 'barriers', 'facilitators', 'hygiene', 'older adults' and 'residential care'. Only empirical studies, reporting everyday skin and oral care, in English, peer reviewed and published from 2000 to 2021 were included. Due to methodological heterogeneity, a narrative synthesis was conducted. Results: Sixteen papers yielded nine categories of barrier or facilitator. Five related to skin and oral care: (i) knowledge, (ii) skills relating to hygiene care, (iii) skills relating to supporting 'uncooperative' behaviours, (iv) lack of resources and (v) time, workload and staffing levels. The remainder related only to oral care: (vi) resident, family or carer motivation, (vii) dislike of hygiene care, (viii) carer attitudes and beliefs and (ix) social influences and communication. Six papers reported interventions to optimise care. Conclusion: This review highlights the persistent dearth of research into everyday personal hygiene practices, in particular skin hygiene in residential care. Existing literature identifies a range of barriers; however, there is a mismatch between these and reported interventions to improve practice. Relevance to clinical practice: Advances in implementation science to support optimal care have yet to be applied to interventions to support hygiene practices in care homes and it is imperative this is addressed. Future interventions should involve: (i) systematically and theoretically assessing barriers, (ii) application of tailored behaviour change techniques (iii) using these co‐design pragmatic, locally acceptable strategies. [ABSTRACT FROM AUTHOR]

Aims: This study aimed to (i) evaluate the effectiveness of mindfulness‐based interventions in improving self‐efficacy, reducing stress and anxiety among peritoneal dialysis patients, and (ii) compare the most effective method of mindfulness based interventions. Methods: This randomized three‐arm controlled trial recruited first‐time peritoneal dialysis patients from the peritoneal dialysis outpatient clinic in Singapore. Patients were randomly allocated to either video‐assisted mindfulness training, therapist‐assisted mindfulness training or treatment‐as‐usual. All groups received 4.5 days of structured peritoneal dialysis training at the peritoneal dialysis centre, while video‐assisted mindfulness training and therapist‐assisted mindfulness training groups were taught additional mindfulness‐based techniques. The perceived stress scale, self‐efficacy, and anxiety (State and Trait Anxiety Inventory) were measured at baseline, 4‐ and 12 weeks post‐randomization, using reliable and valid instruments. Results: Thirty‐nine patients were recruited (13 in each group). All the therapies showed a significant time trend in anxiety. Only therapist‐ and video‐assisted mindfulness training showed a significant trend in perceived stress scale scores but not treatment‐as‐usual. All Intervention X Time interactions were not significant. Patients in therapist‐ and video‐assisted mindfulness training groups had reduced perceived stress scale scores compared to treatment‐as‐usual at week 12. Conclusion: This study demonstrated the potential of mindfulness‐based interventions in reducing stress among first‐time PD patients. Summary Statement: What is already known about this topic? Mindfulness‐based interventions have been recommended to mediate stressful events.Mindfulness‐based interventions as complementary therapy can be taught to patients who are starting peritoneal dialysis for the first time; however, the best method to guide mindfulness‐based interventions is unknown. What this paper adds? The findings showed that mindfulness‐based interventions can potentially reduce stress and anxiety but have no statistically significant effect on self‐efficacy for patients undergoing peritoneal dialysis for the first time.Video‐ or therapist‐guided mindfulness training is just as effective in teaching mindfulness‐based interventions. The implications of this paper: Nurses hold an essential role in improving the experience of patients undergoing peritoneal dialysis by advocating and facilitating the use of MBI during dialysis, especially those who display high levels of stress and anxiety, as well as signs of coping issues. [ABSTRACT FROM AUTHOR]

Accessible Summary: What is known on the subject: Adult psychiatric services typically focus on the mental health needs of the client but they do not support his or her parenting role.Many authors highlight the importance of a non‐judgmental approach when providing support and care to clients with mental illness who are parents.Assessments frequently focus on the negative aspects while the strengths of these families were often overlooked.There is a lack of scientific literature exploring nurses' experiences when caring for parents with mental illness and their families. What this paper adds to existing knowledge: Trust is the basis that helps clients to be open to receiving care and answering parenting‐related questions. Therefore, without adequate professional‐client trust, some care and interventions addressed to parents with mental illness could be poorly received by the client.Tronto's phases of care facilitated the collection of data and exploration of mental health nurses' experiences of care. What are the implications for practice: Mental health nurses should be aware of the potential needs of these families, as described in the scientific literature, so they can include them in their assessments. They also should consider the need to individualize each care since each situation of a family with parental mental illness is unique.Mental health nurses must take the person's environment into account (family, social and political aspects and different forms of stigma) since all these factors may influence how parents with mental illness receive and provide care. Introduction: Many authors highlight the importance of a non‐judgmental approach when providing care to parents with mental illness. However, assessments frequently focus on the negative aspects while the strengths of such families were often overlooked. Aim: To explore the lived experiences of mental health nurses who care for clients who are parents. Method: We conducted a qualitative phenomenological study. The main data collection technique was in‐depth interviews. Data were analysed according to Colaizzi model, subsequently, the main categories that arised were compared and related to the five phases of Tronto's care. Results: The main categories identified from the analysis of the interviews were: (1) individualized care, (2) continuity of care, (3) psychoeducation and counselling, (4) trust and (5) context of the client. Discussion: Trust is the basis that helps parents with mental illness to be open to receiving care and answering parenting‐related questions. Without trust, some interventions could be poorly received by the client. Implications for Practice: Mental health nurses should be aware of the potential needs of these families, so they can include them in their assessments. They also should consider the need to individualize each care since each situation of a family with parental mental illness is unique. [ABSTRACT FROM AUTHOR]

Background: Brazil is one of the countries with the highest rates of caesarean sections (CS), reaching almost 90% of births in the private sector. A quality improvement project called "Adequate Childbirth Project (PPA)" was conceived to reduce CS in the private sector. This project consisted of four primary components: "Governance", "Participation of Women", "Reorganization of Care" and "Monitoring". This paper aims to evaluate: (1) which specific activities of the PPA had the largest effect on the probability of a woman having a vaginal delivery; (2) which primary component of the PPA had the largest effect on the probability of vaginal delivery and (3) which scenarios combining the implementation of different activities planned in the PPA had a higher effect on the probability of vaginal delivery. Methods: A sample of 12 private hospitals participating in the PPA was evaluated. We used a Bayesian Network (BN) to capture both non-linearities and complex cause-effect relations. The BN integrated knowledge from experts and data from women to estimate 26 model parameters. The PPA was evaluated in 2473 women belonging to groups 1–4 of the Robson classification, who were divided into two groups: those participating or not participating in the PPA. Results: The probability of a woman having a vaginal delivery was 37.7% higher in women participating in the PPA. The most important component of the project that led to an increase in the probability of vaginal delivery was "Reorganization of Care", leading to a 73% probability of vaginal delivery among women in labor. The activity that had the greatest effect on the type of delivery was access to best practices during labor, with a 72% probability of vaginal delivery. Considering the 12 scenarios combining the different activities of the PPA, the best scenarios included: a non-scheduled delivery, access to information about best practices, access to at least 4 best practices during labor and respect of the birth plan, with an 80% probability of vaginal delivery in the best combinations. Conclusion: PPA has been shown to be an effective quality improvement program, increasing the likelihood of vaginal delivery in private Brazilian hospitals. Plain English Summary: Introduction: Brazil boasts one of the highest rates of caesarean sections (CS) globally, with nearly 90% of births in private facilities being delivered via CS. In response, the 'Adequate Childbirth Project – PPA' was launched as a quality improvement initiative aimed at curbing CS rates in private healthcare. Its goal is to improve the quality of childbirth and reduce the number of CS in private healthcare. The project has four main parts: 'Governance', 'Participation of Women', 'Reorganization of Care', and 'Monitoring'. Method: an evaluative study was conducted across 12 private hospitals involved in the PPA, involving 2473 women who were categorized into PPA participants and non-participants. They used a method called a cause-effect network to see which parts of the PPA helped more women have vaginal deliveries. Results: They found that women in the PPA were 37.7% more likely to have a vaginal delivery. Giving women access to good practices during labor and birth was really important. Also, 'Reorganization of Care' was the most important part of the project. It led to a 73% chance of vaginal delivery for women in labor. Conclusion: The PPA is effective in helping more women in private hospitals have vaginal deliveries. This means it's a good program for improving childbirth in Brazil's private hospitals. [ABSTRACT FROM AUTHOR]

Aims. To synthesize the evidence on nurses' experiences of their caring role during the COVID‐19 pandemic and identify emerging concepts that have affected nurses within the caring role in relation to (a) their professional lives and (b) their personal lives. Background. The concept of caring is central to the science and art of nursing practice, and fulfilment of the caring role is fundamental to the profession. The COVID‐19 pandemic imposed unprecedented change globally transforming the caring role of the nurse. The WHO highlights that a well‐supported workforce is paramount to emergency preparedness; therefore, understanding the experiences of the nurse's caring role during the COVID‐19 crisis is paramount to practice in future healthcare crises. Methods. A scoping review. Data Sources. Studies published between January 2020 and November 2023 were identified from the following databases: Cumulative Index to Nursing and Allied Health Literature (CINAHL), Coronavirus Database, PUBMED, PsycINFO, PsycArticles, Scopus, Web of Science, and SocINDEX. Reporting Method. The scoping review adhered to the Joanna Briggs Institute (JBI) Preferred Reporting Items for Systematic Reviews and Meta‐Analysis Extension for Scoping Review (PRISMA‐ScR) checklist. Results. The search identified 1,347 studies, subsequent review of title and abstract, resulted in 117 full‐text papers for further eligibility screening, with a total of 52 studies being included in the scoping review. Findings were grouped thematically using the Braun and Clarke (2006) approach. The five distinctive themes that emerged were (a) emotional turmoil, (b) erosion of care, (c) relationships and solidarity, (d) expansion of role, and (e) professional growth. Conclusion. During the COVID‐19 pandemic, there was an evolutionary shift in the caring role of the nurse, on a trajectory from emotional turmoil to professional growth. The process followed a theoretical framework of transformative learning that could support nurses' capability and preparedness in their caring role for future inevitable extreme events and crisis in healthcare. Implications for Nursing Management. Mapping current knowledge of the unprecedented COVID‐19 crisis from a nurse's professional and personal perspective purposefully aims to highlight gaps for future research, education, and policy and is paramount to emergency preparedness and a well‐supported workforce in future healthcare crisis. [ABSTRACT FROM AUTHOR]

Aim: This paper discusses four main strategies for addressing nursing shortages that have been persistent, widespread and growing. Fallout from the COVID‐19 pandemic might offer valuable impetus to address this tenacious challenge. Background: Nursing shortages are common, widespread and have been persistent for most of a century. Many of the reasons behind these shortages are well known and are themselves enduring, as are the types of strategies put forward for addressing them. These strategies can generally be classified into four main categories: enhancing retention, improving recruitment, encouraging return to practice and drawing on international human resources. The COVID‐19 pandemic is the latest major threat to ensuring a sufficiently sized and skilled nursing workforce. Many nurses have succumbed to burnout as well the plethora of factors that predated the pandemic and have a negative impact on nurse wellbeing, turnover and intention to leave. Sources of evidence: This discussion paper draws on international sources of evidence. Discussion/conclusion: This paper highlights how many of the factors behind and strategies for addressing nursing shortages at the local, national and global levels are widely studied and known. A sustained combination of strategies that focus both within and beyond health and nursing, including on the broader social context, is necessary. While COVID‐19 has been extremely damaging, it might present an opportunity to make sustainable, effective reforms to address nursing shortages. Implications for policy: Knowledge users must recognise that a combination of approaches across the gamut of policies that influence nursing workforces is necessary to address nursing shortages. Attention must also focus on factors beyond nursing and healthcare if shortages are to be remedied. [ABSTRACT FROM AUTHOR]

Introduction: Indonesia is widely recognized as a geographically complex nation which is comprised of an estimated 17,000 islands and with its 264 million inhabitants, it faces a unique combination of having to organize and deliver health care services to a diverse population who speak 724 languages or dialects. Aim: The purpose of this critical reflective narrative is to expand on the challenging structure of healthcare in Indonesia and the corresponding environment for nursing. More specifically we elaborated on health care settings, delivery of care and nursing education in the midst of complex targeted healthcare reforms. Methods: For this paper's needs a review and critical analysis was conducted by a systematic search in PubMed and Google Scholar, including papers from within the last two decades. Following critical taxonomy of the original output (i.e. 553 refs), a final 36 references were selected for inclusion. Results and Discussion: Results have been organized under the broad categories of Health Care structure and delivery followed by Nursing Education and are further elaborated via critical narration under five detailed sub-categories, i.e. The health care system in Indonesia (Specialized health centers and hospitals), Community Nursing, School Nursing, Home Care Nurse, Nursing Education in Indonesia Conclusions: Indonesia's wide geographical expanse of islands and population diversity makes health care delivery a complex task. Thus, the country should be praised for tackling these challenges and initiatives such as the creation of the PUSKESMAS network which increased geographic access and national healthcare coverage. [ABSTRACT FROM AUTHOR]

Aim: With high rates of trauma in the population, known links between trauma and perinatal distress, and the intimate and close nature of the nursing and midwifery roles, ensuring awareness and understandings of trauma is crucial for guiding practice. This paper aims to explore the relationship of trauma to the perinatal period, based on theory and practice, to consider on how nurses and midwives can deliver trauma‐sensitive interactions. Design and Methods: This discursive discussion draws on relevant research from the fields of trauma therapy, attachment theory and nursing and midwifery practice to consider elements of trauma‐sensitive practice in the perinatal period. Results: Nurses and midwives can foster safety for people who have experienced trauma through noticing and responding to triggers, supporting awareness of attachment and its relationships to trauma, undertaking psychosocial screening with care, supporting linearity and cohesion in narratives and developing collaborative care plans that maximise safety and agency. For nurses and midwives, understandings of the relationship between trauma, pregnancy, birth, early parenting and distress is crucial for effective care delivery. Delivering perinatal nursing or midwifery care of any kind, without universal trauma precautions risks reinforcing, misinterpreting or re‐enacting dynamics of trauma. To be trauma‐sensitive in this period requires nurses and midwives to have awareness of the dynamics of trauma in relation to pregnancy, birth and attachment. Implications for the Profession and/or Patient Care: This paper fills a gap in the translation of theory to practice for trauma‐sensitive care in the perinatal period, with a focus on the therapeutic relationship formed by nurses and midwives. The findings highlight that nurses and midwives can foster safety for people who have experienced trauma within their practice, when they hold a robust understanding of the relationship between trauma, pregnancy, birth, early parenting and distress. Patient or Public Contribution: No patient or public contribution. [ABSTRACT FROM AUTHOR]

Background: Choosing Wisely is an international movement that stimulates conversations about unnecessary care. The campaign created five recommendations including a statement that less wound care is sometimes better. Aims: The study aims to evaluate nurses' and physicians' adherence to the Choosing Wisely recommendations for acute wound care in the Netherlands and the barriers and facilitators to improve this. Design: This is a mixed methods study using a survey and interviews. Methods: The survey was completed by 171 nurses and 71 physicians from November 2017 to February 2018. A total of 17 nurses and 6 physicians were interviewed. Results: Awareness of the five recommendations ranged from 62% to 89% for nurses and 46% to 85% for physicians. However, up to 15% of the nurses and 28% of physicians were aware but did not adhere to the recommendations. Barriers to adhering were a lack of knowledge, the work environment and perceptions of patients' preferences. Repeated attention, cost‐consciousness and an open culture facilitated the implementation. Conclusion: Although most nurses and physicians were aware of the recommendations, not all adhered to them. Increasing awareness is not enough for successful implementation. A tailored approach that removes the barriers is necessary, such as increasing knowledge about wounds and changing the work environment. Summary statement: What is already known on this topic? Less wound care is sometimes better: cleaning wounds with tap water only, not bathing wounds, using simple bandages and not using bandages on wounds healing by primary intention leads to better wound care for lower costs.It is unknown to what extent this is known and practiced by nurses and physicians and what barriers and facilitators they experience in practicing this. What this paper adds? Although the majority of nurses and physicians were aware of the Choosing Wisely recommendations for acute wounds, not all adhered to them.Awareness is not always sufficient for successful implementation, which requires a broader approach that targets the barriers. The implications of this paper Implementation of these recommendations can be improved by increasing knowledge about wounds and wound care, changing the work environment, and verifying the patient's presumed preferences regarding wound care. [ABSTRACT FROM AUTHOR]

This discussion paper aimed to reflect on the development of relational connections in the context of a web-based, tailored, asynchronous nursing intervention (VIH-TAVIETM) aimed at empowering people living with HIV in taking their antiretroviral treatment. Our reflection culminates in the Relational Virtual Nursing Practice Model. This paper builds on nurse-researchers and people living with HIV's experiences, nursing theories, and cross-disciplinary work on relational engagement. The model shows the disciplinary principles underpinning VIH-TAVIETM, engagement processes used to create humanistic and supportive relational environment and people's relational experiences and it contributes to the development of conceptual nursing knowledge on how generating meaningful relational nursing care in virtual environments. [ABSTRACT FROM AUTHOR]

Objective: This paper investigates how the public–private partnership (PPP) functions in the care provision for older people in Guangdong, China, particularly for ageing‐in‐place programs. Methods: Three cities with diversified PPP forms of care provision for older people were chosen as case studies. Focus groups were conducted in these cities for the local authorities and care homes involved in the partnerships. Results: Three forms of PPP, including private sector involvement for the ownership, construction, and operation of the facilities delivering care services, were identified. The public–private co‐constructed and privately run model with greater private sector involvement may lead to higher quality care in one specific program. The publicly constructed and privately run program is widely used in many cities, advancing the expansion of ageing‐in‐place programs in more communities. These PPPs reflect flexible and practical collaboration between the public and private sectors at the local level in the Chinese context. Conclusions: PPP have accelerated the development of a better care system for older people, mainly in terms of more affordable and higher‐quality care options for the public. They are also a feasible solution for the local government due to more cost‐effective and sustainable care provisions than previous publicly provided programs. The specific forms adopted are primarily associated with the scale of home care provision for ageing‐in‐place and the local government's financial capacity. Despite increasing private sector involvement, the public sector retains its crucial role in delivering care services targeting ageing in China. [ABSTRACT FROM AUTHOR]

Abstract: Internet health information is rated highly by users and is used to compensate for gaps in health information provided by health professionals. Greater understanding of health issues and changes to personal health management has been reported as a consequence of Internet use. However, there are significant disparities in the access and use of Internet health information linked to income, education and ethnicity. In this paper a case is presented that on-line health information particularly benefits the already privileged in terms of health care; well-educated people with access to economic resources. Several intervention points are suggested to improve Internet health information accessibility and use for all population groups. Interventions at an institutional level include improving equity of Internet access through the provision of free services at strategic sites and improving the readability and cultural acceptability of health information. Individually focused interventions involve skill development to enable effective navigation of Internet sites, identification of patient and families’ information needs and support to develop evaluation skills. The effectiveness of these interventions in reducing disparities is reliant on nurses and other health professionals’ expertise in accessing, evaluating and using Internet health information in their clinical practise. On-line health information is a powerful medium for quick and dynamic knowledge distribution. The challenge for nurses and other health professionals is directing that knowledge to the groups most disadvantaged in the current health care systems, with an agenda of reducing inequalities in access to health information. [Copyright &y& Elsevier]

Healthcare service delivery is fundamentally difficult since it involves nuanced interactions between many different parties, cutting-edge technology, and complex clinical procedures. The vital necessity of patient safety and the reduction of potential dangers are becoming more and more obvious as the healthcare landscape changes. In order to promote a culture of safety within the realm of healthcare and nursing, this review paper critically analyses the function of risk management. In this comprehensive review, we examine the various facets of risk management and how critical it is to patient care. With a focus on patient-centeredness and on-going quality improvement, the transformation of healthcare systems from fragmented and episodic treatment models to integrated and preventative paradigms is the main objective of present study. Given their frontline presence and crucial role in patient care, the review clarifies the essential role of nursing professionals in risk management. It looks at how nurses' roles have evolved to include clinical practice, drug administration, infection control, and communication in detecting, assessing, and managing risks. The paper also emphasizes the need of interdisciplinary cooperation by demonstrating how effective risk management transcends conventional barriers and necessitates a group commitment to patient safety. Ultimately, the delivery of high-quality care is the cornerstone of the environment that healthcare organizations and nursing professionals may jointly establish by adopting a proactive approach to risk management. [ABSTRACT FROM AUTHOR]

Nursing, as a profession in its own right and a discrete health discipline, is responsible for planning, organizing, implementing and evaluating nursing services as a distinct segment of health care, and for educating practitioners to provide these services. The primary responsibility of nursing is to provide care direct to the patient, client, family or community. Like medicine, it is concerned with maintaining, promoting and protecting health, treating the sick and providing rehabilitation. It deals with the psychosomatic and psychosocial aspects of life as these affect health, illness and dying. In modern health services, nursing care is often best given by a nursing care team which usually consists of two or more categories of workers. These workers together make up the nursing personnel subsystem, which is a distinct entity within the overall health personnel system of a country.

Background: Preparing nursing students for practice is supported by developing a global perspective of health care delivery models. However, many schools of nursing and students lack the resources for study abroad. Method: Using a virtual stay-in place model, 42 international students applied an evidenced-based approach to study statistics, research, transitions in care, and elder care models that supported collaboration among peers from Austria, Switzerland, Chile, the United Kingdom, and the United States. Students explored social, economic, and reimbursement factors not encountered in the typical classroom. Results: Student beliefs and perspectives changed after completing a program with global peers. Survey results and themes in reflection papers indicated increased ability to conceptualize content in new ways, including holistic elder care, cultural practices and reimbursement options, and effects on future practice. Conclusion: Virtual international learning experiences are an effective education innovation that allows student to connect and learn from one another using a stay-in place model. [J Nurs Educ. 2023;62(11):647–649.] [ABSTRACT FROM AUTHOR]

Healthcare systems and health professionals are facing a litany of stressors that have been compounded by the pandemic, and consequently, this has further perpetuated suboptimal mental health and burnout in nursing. The purpose of this paper is to report select findings from a larger, national study exploring gendered experiences of mental health, leave of absence (LOA), and return to work from the perspectives of nurses and key stakeholders. Given the breadth of the data, this paper will focus exclusively on the qualitative results from 53 frontline Canadian nurses who were purposively recruited for their workplace insight. This paper focuses on the substantive theme of "Breaking Point," in which nurses articulated a multiplicity of stress points at the individual, organizational, and societal levels that amplified burnout and accelerated mental health LOA from the workplace. These findings exemplify the complexities that underlie nurses' mental health and burnout and highlight the urgent need for multipronged individual, organizational, and structural interventions. Robust and timely interventions are needed to restore the health of the nursing profession and sustain its future. [ABSTRACT FROM AUTHOR]