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Aim: The utility and uptake of pain management interventions across intensive care settings is inconsistent. A rapid realist review was conducted to synthesise the evidence for the purpose of theory building and refinement. Design: A five‐step iterative process was employed to develop project scope/ research questions, collate evidence, appraise literature, synthesise evidence and interpret information from data sources. Methods: Realist synthesis method was employed to systematically review literature for developing a programme theory. Data Sources: Initial searches were undertaken in three electronic databases: MEDLINE, CINHAL and OVID. The review was supplemented with key articles from bibliographic search of identified articles. The first 200 hits from Google Scholar were screened. Results: Three action‐oriented themes emerged as integral to successful implementation of pain management interventions. These included health facility actions, unit/team leader actions and individual nurses' actions. Conclusion: Pain assessment interventions are influenced by a constellation of factors which trigger mechanisms yielding effective implementation outcomes. Implications: The results have implications on policy makers, health organisations, nursing teams and nurses concerned with optimising the successful implementation of pain management interventions. Impact: The review enabled formation of a programme theory concerned with explaining how to effectively implement pain management interventions in intensive care. Reporting Method: This review was informed by RAMESES publication standards for realist synthesis. Public Contribution: No patient or public contribution. The study protocol was registered in Open Science Framework. 10.17605/OSF.IO/J7AEZ [ABSTRACT FROM AUTHOR]

Aims: The aim of this study was to examine professional identity through the group performances of nurses within a specific work environment. Background: Professional identity and social identity are closely linked. Nurses undertake clinical practice usually within a social group environment. The literature is limited on the development of professional identity within the context of nurses' daily work. Design An integrated ethnographic case context design was adopted, consisting of two clinical wards in one acute health‐care facility in Australia. The application of the social identity theory (SIT) was used to study two specific professional activities to describe the group performance of nurses within this organizational cultural context and how this influenced nurses' professional identity. Method: The research was undertaken between 2012 and 2014. Data collection included observation, interviews and fieldnotes of a convenience sample of nurses and allied health‐care professionals who undertook two professional activities in their normal work environment. Findings The development of group efficacy contributed to the development of the professional identity in the homogenous handover activity. Self‐efficacy was demonstrated in the heterogenous multidisciplinary activity. Conclusion: The results indicated the importance of recognizing core identity‐building activities and understanding the value of these activities to professional identity development. SUMMARY STATEMENT: What is already known about this topic? Outside health care, it is well researched that social identity theory and group performance are important to group development within organizations.Professional identity during the training of undergraduate nurses is well researched.It is known, but under studied, that work contexts are significant arenas where nurses' professional identity is refined and expressed. What this paper adds? Social processes in the work environment sustain the construction of nurses' professional identities.Group efficacy during nurse‐to‐nurse activities contribute to the development of professional identity.Self‐efficacy during multidisciplinary interactions offers insights into the performance of professional identity. The implications of this paper: The findings have implications for informing the development of core identity‐building activities to purposefully enhance professional identity within nursing work contexts.The findings have implications for understanding how nurses self‐categorize their professional identity and how this is expressed differently in a homogenous nursing group from a multidisciplinary group.The findings are relevant to professional leadership, education and service development in the nursing profession and generate important possibilities for further research in other nursing work environments. [ABSTRACT FROM AUTHOR]

ABSTRACT Aim Design Methods Findings Implications for the Profession Impact Reporting Method Patient or Public Contribution To uncover perspectives and refine 12 initial program theories concerning the implementation of pain management interventions in intensive care units. Contexts enabling implementation are delineated, and causal mechanisms within these contexts are described.A realist evaluation approach was employed.Fourteen purposively selected Australian nurses of variant roles were virtually and individually interviewed between July and September 2023. Participants were presented with initial program theory, and their perspectives were collated. Data were analysed using an integrated approach of context (C), mechanism (M), outcome (O) categorisation coding, CMO configurations connecting and pattern matching.Pain management interventions work if perceived to be beneficial, precise, comprehensive and fit for purpose. Nurses should be willing to change attitudes and update knowledge. Unit leaders should nurture the development of nurses' professional identity, access to learning, autonomy and self‐determination. Organisations should change the infrastructure, provide resources, mitigate barriers, develop shared mental models, update evidence and institute quality assurance. Adherence to interventions is affected by the outcomes of implementation and intrinsic merits of interventions. In these contexts, confidence is boosted; feelings of empowerment, self‐efficacy, reflective motivation, trust, awareness and autonomy are developed; and capacity is built. Furthermore, frustration from the variability of practices is reduced, accountability and ownership are augmented, yielding positive implementation outcomes.Findings have implications on nurses, team leaders and organisations concerned with implementation.The findings provided a fortified understanding of conditions favouring successful implementation of pain management interventions. Actions should be undertaken at an individual, unit and organisation level to ensure successful implementation.RAMESES II Reporting Standards for Realist Evaluations informed presentation of study.Intensive care nurses contributed insights to refine the program theory. [ABSTRACT FROM AUTHOR]