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Aim: To examine the personal experiences and perceptions of people with dark skin tones and their carers, in relation to pressure injury., Design: Qualitative study using semi-structured interviews., Methods: Twenty-two interviews with people with dark skin tone and/or their family carers, who were known to and visited by community nurses for pressure area management or who had been identified as being at high risk for developing a pressure injury were carried out., Results: Thematic analysis of the interview transcripts revealed that skin discolouration towards a darker hue than usual was the commonest symptom identified by participants as a sign of altered skin integrity and potential pressure damage. Four main overarching themes were revealed through comprehensive analysis of the transcripts: (1) indicators of pressure injury; (2) experienced symptoms of pressure damage; (3) trust in healthcare workers; and (4) improving care for populations with dark skin tones., Conclusion: The findings from this study clearly present how early-stage pressure damage is identified among people with dark skin tones., Implications for the Profession And/or Patient Care: These findings have the potential to reduce health inequality by influencing and informing clinical policies and strategies in practice. Findings could also lead to the development of patient-informed educational strategies for nurses and health workers which will enable the early identification of pressure ulcers among people with dark skin tones. Further research is needed to better understand health disparities in relation to preventable patient safety harm., Impact: The findings demonstrate the importance of engaging with and listening to the stories and experiences of people living with pressure damage to help in the early recognition of pressure injuries., Reporting Method: The Consolidated Criteria for Reporting Qualitative Research (COREQ) guidelines for qualitative research were followed., Patient or Public Contribution: A project steering group reviewed information sheets for participants and checked the interview questions were relevant and suitable., (© 2024 The Author(s). Journal of Clinical Nursing published by John Wiley & Sons Ltd.)

Aim: This study aimed to gain a better understanding of nursing/midwifery students' perspectives on a pedagogy of caring and online learning during the COVID-19 pandemic. In addition, it aimed to determine if the COVID-19 pandemic impacted students' perceptions and experience of online learning and students' desire to enter the nursing/midwifery workforce., Design: Mixed methods., Methods: A multi-centre cross-sectional survey of Australian nursing and midwifery students was undertaken to explore students' experience of learning during the COVID-19 pandemic., Results: There are several key findings from this study that may be relevant for the future delivery of undergraduate health education, students transitioning to practice and healthcare workforce retention. The study found that although students were somewhat satisfied with online learning during COVID-19, students reported significant issues with knowledge/skill acquisition and barriers to the learning process. The students reported feeling less prepared for practice and identified how clinical staff were unable to provide additional guidance and support due to increased workloads and stress. The textual responses of participants highlighted that connection/disconnection, empathy and engagement/disengagement had an impact on learning during COVID-19., Conclusion: Connection, engagement and isolation were key factors that impacted nursing students' online learning experiences. In addition, graduates entering the workforce felt less prepared for entry into practice due to changes in education delivery during COVID-19 that they perceived impacted their level of clinical skills, confidence and ability to practice as new graduate nurses/midwives., Patient or Public Contribution: Not applicable., Impact: Attention must be given to the transition of new graduate nurses and midwives whose education was impacted by pandemic restrictions, to support their professional career development and to ensure retention of future healthcare workforce. Connection, engagement and isolation were key factors that impacted nursing students' online learning experiences. Educators should consider how connection and engagement can be actively embedded in the online learning environment., (© 2024 The Authors. Journal of Advanced Nursing published by John Wiley & Sons Ltd.)

Aim: To systematically review and synthesize primary research on experiences and needs of adult informal caregivers of adults at risk of suicide., Design: Systematic review with a data-based convergent synthesis., Data Sources: MEDLINE, PsychINFO and CINAHL were searched in April 2022 and February 2023. English language research focusing on experiences of adult carers of adults was included., Methods: Articles were screened by title (n = 9077) and abstract (n = 132) with additional articles (n = 6) obtained via citation and hand searching. Thirty-one included studies were quality assessed using the Mixed Methods Appraisal Tool and study data were systematically extracted prior to thematic synthesis., Results: Five interconnected themes resulted: transitions; living with fear and uncertainty; changing relationships; interface with healthcare professionals and services; what carers need and want. Caring impacts mental, physical and social wellbeing. Relationships are affected in ways which might not be evident when caring for a minor. Repeated suicidal behaviour is particularly challenging with ongoing hypervigilance contributing to burden, burnout and interpersonal strain. Poor carer support exacerbates negative effects; carers need to feel informed, educated, involved and holistically supported., Conclusion: Timely support for carers is essential. Interventions should address emotional responses, relational changes and effective care recipient support. Longitudinal research is required to understand effects of ongoing caring where there are multiple suicide attempts., Implications: Nurses can provide carers with early support and information and longer term psychosocial interventions. If carers are adequately equipped and supported patient safety and wellbeing will be improved., Impact: Findings of this systematic review include relational changes due to carer hypervigilance reducing autonomy and living with the possibility of suicide. Clinician awareness of the potential for relational shifts will help them prepare and support carers., Patient or Public Contribution: There was no patient or public contribution., (© 2023 The Authors. Journal of Advanced Nursing published by John Wiley & Sons Ltd.)

Aim: To explore patient experiences of intimacy and sexuality in those living with inflammatory bowel disease., Design: An interpretative phenomenological study guided by van Manen's framework. Thematic analysis was conducted through interpretation and reflection on four existential domains: body, relationships, time and space., Methods: Data were collected during 2019-2021 from 43 participants via face-to-face or telephone interviews, as well as anonymous collection of narratives submitted via Google Forms., Results: Four themes were identified: Sexuality as lived incompleteness was the overarching theme representing the essence of the experiences of intimacy and sexuality. This theme covered the four main themes: Otherness of the body, Interrupted connectedness, Missing out on life fullness and Fragmented openness and each corresponded to an existential domain. Intimacy and sexuality are negatively affected by inflammatory bowel disease, with impact on quality of life. Patients experienced grieving multiple losses, from body image and control, to choice of partners and future opportunities. The four domains were difficult to separate and a close inter-relationship between each domain was acknowledged., Conclusions: A model was developed to draw new theoretical insights to understanding the relationship between sexual well-being and psycho-emotional distress similar to grief., Impact: First qualitative study to explore intimacy and sexuality experiences of those living with inflammatory bowel disease. Illness impact on sexuality has negative psycho-emotional implications as a result of losing the old self and capacity to have the desired relationships/sex life. A theoretical model was developed in an attempt to illustrate the close relationship of intimacy, sexuality and psycho-emotional well-being., Patient or Public Contribution: Patients were involved in the study design., (© 2023 The Authors. Journal of Advanced Nursing published by John Wiley & Sons Ltd.)

Background: The continued use of a deficit discourse when researching Aboriginal and Torres Strait Islander Peoples of Australia is problematic. Understanding and challenging the researchers position and the power of the words they use is important. It will ensure we do not persist in framing Aboriginal and Torres Strait Islander People as a problem to be solved., Design: Indigenist review of the evidence of Aboriginal young people's health and well-being., Methods: This review was conducted using an Indigenist approach to identify texts which amplified the voices of Aboriginal young people of Australia and presents a narrative summary of their accounts. This review is reported in line with the PRISMA-ScR reporting guidelines., Results: Culture and connection are critical components of Aboriginal young people's health and well-being. Aboriginal young people describe feeling of powerlessness to influence health and well-being of their community, and they understood the risks they and their communities faced. Young people identified the importance of connection to culture, community and Elders as crucial to their social and emotional well-being., Conclusion: By harnessing an Indigenous analysis, we were able to reveal a strong counter narrative of strength and resilience within their historical, social, and political contexts through the storied accounts of Aboriginal young people., Relevance to Clinical Practice: Most of the currently available evidence about Aboriginal health and well-being is immersed in deficit discourse. Literature reviews being the foundation of research and informing nursing practice, we call for a purposeful shift towards the adoption of an Indigenist strength-based approach which emphasises the strength and resilience of Aboriginal young people., (© 2022 The Authors. Journal of Clinical Nursing published by John Wiley & Sons Ltd.)

Aim: The study aimed to measure and describe the mental health impact of COVID-19 on Australian pre-registration nursing students., Background: The COVID -19 pandemic has had a swift and significant impact on nursing students across the globe. The pandemic was the catalyst for the closure of schools and universities across many countries. This necessary measure caused additional stressors for many students, including nursing students, leading to uncertainty and anxiety. There is limited evidence available to identify the mental health impact of COVID-19 on Australian pre-registration nursing students currently., Design: A cross-sectional study was conducted across 12 Australian universities., Methods: Using an anonymous, online survey students provided demographic data and self-reported their stress, anxiety, resilience, coping strategies, mental health and exposure to COVID-19. Students' stress, anxiety, resilience, coping strategies and mental health were assessed using the Impact of Event Scale-Revised, the Coronavirus Anxiety Scale, the Brief Resilience Scale, the Brief Cope and the DASS-21. Descriptive and regression analyses were conducted to investigate whether stress, anxiety, resilience and coping strategies explained variance in mental health impact. Ethical Approval was obtained from the University of New England Human Research Ethics Committee (No: HE20-188). All participating universities obtained reciprocal approval., Results: Of the 516 students who completed the survey over half (n = 300, 58.1%) reported mental health concerns and most students (n = 469, 90.9%) reported being impacted by COVID-19. Close to half of students (n = 255, 49.4%) reported signs of post-traumatic stress disorder. Mental health impact was influenced by students' year level and history of mental health issues, where a history of mental health and a higher year level were both associated with greater mental health impacts. Students experienced considerable disruption to their learning due to COVID-19 restrictions which exacerbated students' distress and anxiety. Students coped with COVID-19 through focusing on their problems and using strategies to regulate their emotions and adapt to stressors., Conclusion: The COVID-19 pandemic has considerably impacted pre-registration nursing students' mental health. Strategies to support nursing students manage their mental health are vital to assist them through the ongoing pandemic and safeguard the recruitment and retention of the future nursing workforce., Impact Statement: This study adds an Australian understanding to the international evidence that indicates student nurses experienced a range of negative psychosocial outcomes during COVID-19. In this study, we found that students with a pre-existing mental health issue and final-year students were most affected. The changes to education in Australian universities related to COVID-19 has caused distress for many nursing students. Australian nursing academics/educators and health service staff need to take heed of these results as these students prepare for entry into the nursing workforce., Patient or Public Involvement: The study was designed to explore the impact of COVID-19 on the mental health of undergraduate nursing students in Australia. Educators from several universities were involved in the design and conduct of the study. However, the study did not include input from the public or the intended participants., (© 2022 John Wiley & Sons Ltd.)

Background: Antibiotics savelives and have been effectively and reliably used for decades to treat infections and improve health outcomes. This trust in antibiotics has contributed to over prescribing and the emergence of antimicrobial resistance. Significant amounts of antibiotics are still widely prescribed and taken, especially in young children. However, there is a paucity of existing literature relating to how mothers, who are the main carers of young children, may be influenced by their trust in antibiotics., Aims: To explore what factors influence mothers' decisions to seek antibiotics for their young children., Design: Qualitative case study using postcode boundaries., Methods: Thematic analysis of qualitative data from mothers of children under 5, recruited via community playgroups within the case. Data were collected between October 2018 and May 2019, from six focus groups (n = 19) and one-to-one interviews (n = 14). Thematic analysis of the data consisted of six phases: data familiarization; generating initial codes; searching for themes; reviewing themes; defining and naming themes; and producing the report., Results: Mothers were influenced by their belief and trust in antibiotics. Antibiotics were identified as symbolic of recovery, healing and of providing protection and safety., Conclusion: By understanding the symbolic power of antibiotics on maternal decision making, all antibiotic prescribers may be able to offer and provide reassuring alternative and acceptable treatment options to mothers, rather than using antibiotics., Impact: This paper introduces the concept of antibiotics as powerful symbols which influence antibiotic seeking behaviour. This in turn may result in inappropriate use of antibiotics which contributes to the risk of antimicrobial resistance developing. Although the majority of antibiotics are still prescribed by doctors, the number of nurse prescribers has been increasing. Therefore, an increased awareness of antibiotic symbolism, in all prescribing clinicians, is important to enable future local and national strategies to be developed, to support maternal decision making and reduce antibiotic seeking behaviour., (© 2022 The Authors. Journal of Advanced Nursing published by John Wiley & Sons Ltd.)

Aim: This study aimed to understand the lived experience of rural mothers caring for a child with a chronic health condition and to understand their perspectives on the support, services and resources they identify as necessary to effectively manage caregiving., Background: Maternal caregivers in rural areas experience difficulty accessing specialist health care for their child and can also experience geographical and social isolation. Understanding the factors that enable these maternal caregivers to overcome the challenges and adversities faced is crucial to help nurses identify and facilitate avenues for support and resources., Design: This study employed a phenomenological design. The study is reported in line with Consolidated criteria for reporting qualitative research guidelines (COREQ)., Methods: Semi-structured interviews were conducted with 17 maternal caregivers in rural New South Wales, Australia, who had at least one child with a chronic health condition aged between 2-18 years. Data were collected from March to June 2018. Thematic analysis was used to develop a thematic framework. This paper reports on one of the major themes identified in this research, specifically maternal resilience., Results: Participants demonstrated maternal resilience by creating meaningful social connections, cultivating networks, developing problem-solving skills, enhancing their self-efficacy and finding a sense of purpose through hope and optimism. These strategies provide nurses insight into how some rural women overcome adversities associated with their maternal labour required in caring for a child with a chronic health condition., Conclusion: This study found that participants overcame the challenges related to their caregiving work, emerging as resilient caregivers. Understanding maternal resilience assists nurses to provide the services rural mothers in Australia need to care for their child with a CHC., Relevance to Clinical Practice: Findings from this study provide insight into the experiences of rural maternal caregivers of children with a chronic health condition and identify the strategies they adopt to overcome caregiver challenges. Understanding these strategies allows nurses to improve care and support for rural mothers using a strength-based approach to build maternal resilience., (© 2021 John Wiley & Sons Ltd.)

Aim: To explore the views and experiences of nurse academics about their professional work life., Design: A qualitative exploratory interview study., Methods: Data were collected during 2018/2019 using a semi-structured interview method with 19 experienced academic nurses from a range of academic levels in Australia. All interviews were audio recorded, transcribed verbatim and thematically analysed using a narrative approach. Ethics approval was granted by the relevant University Human Research Ethics Committee., Results: Participants provided detailed insights into the type of daily job stressors they faced. They shared narratives about their personal job experiences and how, at times, they chose to remain silent to maintain a cordial working relationship with some of their senior colleagues and leaders. The main themes were identified included a lack of work-life balance, incivility towards staff, increasing workloads and inequitable distribution, lack of recognition, negative workplace culture, lack of awareness of the importance of political astuteness and lack of leadership skills., Conclusion: To ensure a sustainable academic nursing workforce and provide a clearer understanding of job stress and what contributes to faculty decision to leave, areas of priority and strategies that needed attention were identified. These included effective mentoring of less-experienced staff and leadership styles that promote greater inclusiveness, being heard, valued and recognized, improved work-life balance and the need to have a sense of belonging., Impact: The study explored the job experiences of nurse academics and identified occupational stressors that directly influenced their daily work life. The findings have global implications for the recruitment and sustainability of nurse academics. This also impacts on their professional and work-life balance., (© 2022 John Wiley & Sons Ltd.)

Aims: To explore pre-registration nursing students' understandings and experience of intentional rounding in education and clinical sectors. Intentional rounding is a patient safety intervention used in clinical settings to regularly check and document patients' welfare and environment throughout the course of a shift., Design: An explanatory sequential mixed methods design using convenience sampling was used for this study, with an underlying pragmatic paradigm. Integration occurred in the design, methods, implementation and reporting phases of the study., Methods: Data were collected between August 2017 and August 2018 using a previously validated Nursing Perceptions of Patient Rounding quantitative online survey followed by individual qualitative interviews using the same cohort., Results: Using the Pillar Integration Process, this paper displays and discusses the final results. The integration and mixing throughout the study generated insights into the perceived benefits of intentional rounding for nursing students and patients but also indicated a theory-practice gap that affects nursing students' confidence in undertaking this intervention., Conclusion: Students find this patient safety intervention helpful, but further clarity in the education surrounding it is required., Impact: This study addresses pre-registration nursing students' understanding and perceptions of intentional rounding. Intentional rounding benefits nursing students as a patient safety strategy and organization tool. Educational opportunities around the topic could be enhanced, reducing the ongoing theory-practice gap. Clinicians, academics and educators who support pre-registration nursing students in clinical and tertiary education settings can benefit from this work., (© 2022 John Wiley & Sons Ltd.)

Aim: To explore how compassion is received by patients in a hospital setting and how compassion is expressed by health professionals in a hospital setting., Background: Compassion is important to health professionals and patients. Perceived deficits in compassion in healthcare have led increasing concerns about the quality of care for patients. To better understand compassionate practice in a hospital setting we used narrative inquiry to explore the expression of compassion by health professionals and the experience of receiving compassion by patients., Design: Narrative Inquiry. Reported in line with Consolidated Criteria for Reporting Qualitative Research (COREQ)., Methods: Qualitative interviews were conducted with 24 patients and health professionals in Australia. Data were collected between August 2018 and August 2019. Narrative analysis processes were used to develop a thematic framework., Results: Compassionate practice is presented as an overarching theme and comprises of three themes: (1) Amalgamation of various knowledges and skills (2) Delivery of meaningful actions which alleviate suffering and (3) Meeting individual needs and prevention of further preventable suffering. The expression of compassion by health professionals involved the fusion of many skills and knowledges. Patients received compassion through the actions of the health professional which alleviated their suffering., Conclusion: Compassionate practice is both important, and complex. Presence, skilled and purposeful action and the alleviation of suffering are essential to the expression and receipt of compassion in the hospital setting., Impact: Findings from this study contribute to the growing body of literature on compassionate practice in health settings, specifically in how it is expressed and received in a hospital setting. The complexity of compassion is explained for health professionals. Compassion was shown to be embedded in the caring moments between health professionals and patients. This paper explains the different elements that comprise compassion which can guide health professional practice. The importance of seemingly small acts has a big impact on patients, families and health professionals. There is a need for greater stakeholder value and recognition of this aspect of practice., (© 2021 John Wiley & Sons Ltd.)

Aim: This study aimed to explore the experiences of individuals discussing sexual well-being with healthcare professions within the context of their cardiac illness to determine their sexual health information needs., Background: Cardiovascular disease is the leading cause of morbidity and mortality worldwide and known to have a detrimental impact on sexual health. Despite sexual health being recognised as a fundamental component of well-being, it may be a neglected aspect of care within the context of cardiovascular disease., Design: A qualitative exploratory study conducted in accordance with COREQ guidelines., Methods: We conducted semi-structured interviews with participants (n = 13) aged between 30-77 years who had been diagnosed with a cardiovascular disease. Data were transcribed and subject to thematic analysis., Results/findings: Analysis revealed two major themes-Sexual healthcare information and expectations: I expect them to tell me and Experiences of sexual adversity: it's really scary. Although participants expected and welcomed information in relation to their illness and sexual health, this was rarely received. Subsequently, when some participants experienced sexual adversity including erectile dysfunction, they felt anxious and distressed which impacted their intimated relationships. It was often when participants sought information associated with adversity that information was provided and this was primarily in relation to medication associated with assisting dysfunction., Conclusion: Individuals who have cardiovascular disease may require sexual health care. Nurses are well placed to provide information and education associated with cardiovascular disease and associated sexual well-being to promote positive outcomes for individuals and minimise distress around sexual adversity., Relevance to Clinical Practice: Findings highlight the importance of providing clear and accurate information about sexual well-being and function to patients experiencing cardiovascular disease. Provision of information should be considered an essential and routine aspect of care with patients being afforded opportunities to discuss concerns associated with their sexual well-being., (© 2021 John Wiley & Sons Ltd.)

Aims: To, firstly, explore student and academic nurse perceptions of classroom content about the assessment and identification of pressure injuries across skin tone diversity and, secondly, to describe the impact of classroom content on student nurse understanding of pressure injury in people with dark skin tones., Design: Qualitative case study employing focus groups and semi-structured interviews., Methods: Five higher education institutions in the United Kingdom were purposively chosen. At each of the five-case sites, one focus group with student nurses and one semi-structured interview with a nurse academic were conducted between May 2018 and April 2019. The participants' narratives were transcribed verbatim and analysed via thematic analysis., Results: Classroom learning was predominately framed through a white lens with white normativity being strongly reinforced through teaching and learning activities. This reinforcement of white normativity was evidenced through two main themes: (i) dominance of whiteness in the teaching and learning of pressure injuries in undergraduate nurse education and (ii) the impact and implications for student nurses of whiteness as the norm in pressure injury teaching., Conclusion: Nurses responsible for the design and delivery of teaching and learning experiences for nursing students need to ensure meaningful teaching and learning experiences. This learning should assist future nurses to interrogate their complicity in a system of white dominance., Impact: Nurse education delivered today influences and shapes nurses of the future. Nurses are the cornerstone of healthcare and play a significant role in the delivery of equitable healthcare. Nurse academics have a duty of care to inform and highlight health inequities in nursing and ultimately to enhance equity in care., (© 2021 The Authors. Journal of Advanced Nursing published by John Wiley & Sons Ltd.)

Aims and Objectives: To assess formative and summative milestones in a digital course and the reach to low- and middle-income countries of a Massive Open Online Course focussing on supporting nurses dealing with an emerging pandemic., Background: The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has ravaged the globe and increased the need for timely and accurate information from reliable sources. Access to reliable and accurate information, as well as support, is important in achieving health systems strengthening. Using a Massive Open Online Course format, an educational resource aimed at large-scale interactive participation via the Internet, and participants were engaged in a course focussing on nursing in a time of crisis and involved using social learning principles., Design: Observational descriptive study., Method: Routinely collected data were collated during the period of 18 May-18 July 2020 focused on both formative and summative milestones in the course. Data were separated and classified by income in accordance with the publicly accessible 2020 World Bank Open Dataset., Results: During the 2-month period of observation (18 May-18 July 2020), 10,130 individuals from 156 countries enrolled in the course. More than 51% of participants were Active Learners. Thirty per cent completed over 90% of the course content by the end. There was widespread distribution of learners in low- and middle-income countries across Asia, Africa and Latin America., Conclusion: The COVID-19 pandemic has underscored the importance of reliable and valid information sources. The use of Massive Open Online Course format can facilitate dissemination., Relevance to Clinical Practice: In the context of a dynamic global pandemic, leveraging digital resources to allow access to reliable information and resources is important. Incentivising participation through recognition of learning is important. Engaging in a social learning platform also has the power for reflection, promotion of resilience and capacity for health systems strengthening., (© 2021 John Wiley & Sons Ltd.)

Aims: To highlight the need for the development of effective and realistic workforce strategies for critical care nurses, in both a steady state and pandemic., Background: In acute care settings, there is an inverse relationship between nurse staffing and iatrogenesis, including mortality. Despite this, there remains a lack of consensus on how to determine safe staffing levels. Intensive care units (ICU) provide highly specialised complex healthcare treatments. In developed countries, mortality rates in the ICU setting are high and significantly varied after adjustment for diagnosis. The variability has been attributed to systems, patient and provider issues including the workload of critical care nurses., Design: Discursive paper., Findings: Nursing workforce is the single most influential mediating variable on ICU patient outcomes. Numerous systematic reviews have been undertaken in an effort to quantify the effect of critical care nurses on mortality and morbidity, invariably leading to the conclusion that the association is similar to that reported in acute care studies. This is a consequence of methodological limitations, inconsistent operational definitions and variability in endpoint measures. We evaluated the impact inadequate measurement has had on capturing relevant critical care data, and we argue for the need to develop effective and realistic ICU workforce measures., Conclusion: COVID-19 has placed an unprecedented demand on providing health care in the ICU. Mortality associated with ICU admission has been startling during the pandemic. While ICU systems have largely remained static, the context in which care is provided is profoundly dynamic and the role and impact of the critical care nurse needs to be measured accordingly. Often, nurses are passive recipients of unplanned and under-resourced changes to workload, and this has been brought into stark visibility with the current COVID-19 situation. Unless critical care nurses are engaged in systems management, achieving consistently optimal ICU patient outcomes will remain elusive., Relevance to Clinical Practice: Objective measures commonly fail to capture the complexity of the critical care nurses' role despite evidence to indicate that as workload increases so does risk of patient mortality, job stress and attrition. Critical care nurses must lead system change to develop and evaluate valid and reliable workforce measures., (© 2021 John Wiley & Sons Ltd.)

Aims and Objectives: To examine what was known about disaster preparedness in residential care and to consider this in the light of the current COVID-19 pandemic., Background: Care homes provide long-term care to vulnerable, frail older people, as well as to young people with profound disabilities. The COVID-19 pandemic has shown that the residential care sector has been seriously affected in many parts of the world and has exposed major flaws and vulnerabilities in infection control and other processes that have resulted in considerable loss of life of residents of these facilities., Design: Discursive paper informed by a systematic literature. Review was carried out in line with PRISMA reporting guidelines. The review protocol was registered with PROSPERO on 2020 [CRD42020211847]., Results: The review identified six papers meeting inclusion criteria across care residential facilities in different countries. Several prevention and mitigation strategies were identified to manage and reduce the spread and severity of viral respiratory infection pandemics. These strategies include isolation, restriction of movement, personal protective and hygienic measures, health education and information sharing, monitoring and coordination, and screening and treatment. Preparedness strategies identified were contingency planning such as reporting/communication, leadership, human resource, insurance, occupational health and resource availability. The prevention/mitigation and preparedness strategies helped to achieve decline in disease severity, reduced prevalence, reduced spread of the disease, improved readiness criteria, resource usefulness and increased intervention acceptability. This paper presents a conceptual framework exploring the interconnectedness of preparedness and prevention/ mitigation strategies and associated outcomes. We discuss areas of concern in the context of workforce employment patterns in the sector. Concerns related to the unintended consequences of strategies placed on aged care facilities, which may worsen mental health outcomes for residents, are discussed., Conclusions: Persons in residential care settings are at greater risk of infection during a pandemic, and therefore, strict measures to protect their safety are warranted. However, they are also a group who already experience social isolation and so any measures involving restrictions to visiting and social interaction, particularly over the longer term, must be accompanied by strategies to mitigate potential loneliness and mental health sequelae arising from long-term pandemic restrictions., Relevance to Clinical Practice: Though there was evidence of activity in preparedness for disasters within the residential care sector, various contextual factors affecting the sector were clearly not adequately considered or addressed in pre-pandemic disaster planning, particularly in the areas of staff movements between care homes and the length of time that social isolation and restriction measures would need to be in place. Future pandemic planning should consider the nature of the workforce model in the care home sector, and factor in strategies to better support the mobile and highly casualised workforce., (© 2021 John Wiley & Sons Ltd.)

Aim: To investigate and understand how compassion is expressed by nurses and received by patients in a hospital setting., Background: Concerns regarding the absence of compassion in a healthcare setting has necessitated further research in the field. To define and measure compassion is difficult and problematic. Compassion is subjective and in the contemporary literature the views of patients are under-represented. Touch is an important component of nursing practice and can also be considered problematic., Design: Secondary analysis of narrative interviews., Methods: Secondary analysis of 12 participant interviews with nurses (n-4) and patients (n-8). Data were collected between August 2018 and August 2019., Findings: Compassion was expressed and received through touch for nurses and patients. Patients receive compassion through the touch of the nurse and this touch conveyed comfort and safety. Touch allowed for the establishment of an authentic connection between nurse and patient. Nurses used touch to express compassion and patients received compassion when they were comforted with touch. Compassion was present in incidental touch and deliberate comforting touch. Nurses were respectful of the meanings of touch. Patients describe nurses knowing when to touch and using touch appropriately., Conclusions: Nurses in our study were respectful of the meaning of touch for their patients and described using touch to convey compassion. Patients in our study perceived compassion through the touch by the nurse. Through these narratives, touch is revealed as an essential part of compassionate practice conveying safety, authenticity and connection., Impact: Patients in this study describe receiving compassion through the use of touch which made them feel safe. Nurses in this study used touch to create an authentic connection with patients and were aware of the different meanings of touch. Avoiding touch, being wary of touch, or considering touch taboo robs patients of compassion moments., (© 2021 John Wiley & Sons Ltd.)

Aims and Objectives: Given the importance of doctoral training to the future of the discipline, we sought to gain insight into nurse doctoral supervisor's experiences of supervision training and preparation and their views on what quality training for doctoral supervisors in nursing would look like., Background: Doctorally prepared nurses have been found to contribute significantly to improvements in knowledge to inform patient care; yet there is little focus on the development of this aspect of the nursing workforce, and little evaluation of supervisor training, confidence and competence., Design: Qualitative storytelling, semi-structured interviews were conducted via a videoconferencing programme, audio-recorded and thematically analysed with twenty-one experienced nurse doctoral supervisors. Findings are reported in line with the COREQ guidelines., Results: Thematic analysis revealed four themes: 'I had a great mentor': the importance of mentorship and role modelling; 'Sometimes it's just trial and error': learning through experience; 'It's like tick a box': strengths and limitations of formal supervisor training; and 'The training should be more holistic': what should be in supervisor training., Conclusions: We recommend doctoral supervisors be encouraged to seek mentoring for supervision, formal mentoring and clinical supervision for the first five completions and the formation of discipline-based supervisor learning groups in nursing as an adjunct to generic mandatory supervisor training., Relevance to Clinical Practice: Further development of clinical nursing is inextricably linked to quality nurse-led research, and doctorally prepared nurses are essential to the continued development of nursing as an evidence-informed practice discipline. Quality doctoral supervision for and by nurses is crucial and we argue that focus must be given to ensuring the development of a skilled doctoral supervision workforce in nursing., (© 2021 John Wiley & Sons Ltd.)