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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. [ABSTRACT FROM AUTHOR]

Aim: To explore how nurses' use of electronic health records impacts on the quality of nurse–patient interactions and communication. Design: An integrative review. Data sources MEDLINE®, CINAHL®, PscyINFO, PubMed, BNI and Cochrane Library databases were searched for papers published between January 2005 and April 2022. Review methods: Following a comprehensive search, the studies were appraised using a tool appropriate to the study design. Data were extracted from the studies that met the inclusion criteria relating to sample characteristics, methods and the strength of evidence. Included empirical studies had to examine interactions or communication between a nurse and patient while electronic health records were being used in any healthcare setting. Findings were synthesized using a thematic approach. Results: One thousand nine hundred and twenty articles were initially identified but only eight met the inclusion criteria of this review. Thematic analysis revealed four key themes, indicating that EHR: impedes on face‐to‐face communication, promotes task‐orientated and formulaic communication and impacts on types of communication patterns. Conclusion: Research examining nurse–patient interactions and communication when nurses' use electronic health records is limited but evidence suggests that closed nurse–patient communications, reflecting a task‐driven approach, were predominantly used when nurses used electronic health records, although some nurses were able to overcome logistical barriers and communicate more openly. Nurses' use of electronic health records impacts on the flow, nature and quality of communication between a nurse and patient. Impact The move to electronic health records has taken place largely without consideration of the impact that this might have on nurse–patient interaction and communication. There is evidence of impact but also evidence of how this might be mitigated. Nurses must focus future research on examining the impact that these systems have, and to develop strategies and practice that continue to promote the importance of nurse–patient interactions and communication. Patient or Public contribution: Studies examined within this review included patient participants that informed the analysis and interpretation of data. [ABSTRACT FROM AUTHOR]

Background: Antimicrobial stewardship (AMS) has traditionally been the domain of doctors and pharmacists but there is a growing recognition that successful stewardship incorporates a multidisciplinary approach that includes nursing staff. This literature review explores nurses' perceptions of their role in antimicrobial stewardship within the hospital environment and provides new insights to inform future practice. Methodology: An integrative literature review was undertaken. Five academic databases were searched, which identified six relevant studies. Whittemore and Knafl's method for conducting an integrative review was followed. ENTREQ guidelines have been adhered to. Findings: Two themes were identified: nurses' working in partnership with other professionals and engagement in education. Discussion: Antimicrobial stewardship illustrates the role of the nurse within the wider multidisciplinary team regarding wider patient safety issues and the need for education to enhance this role. Relevance to clinical practice: Nurses have a clear role to play in antimicrobial stewardship but need to be fully cognisant of the issues involved. Further clarity on how nurses should enact this role in their complex working environments is required. It is essential that both student and qualified nurses are able to speak up in order to maximise patient safety, fulfil their professional duty and promote the overall effectiveness of AMS if they witness poor antibiotic management practices. [ABSTRACT FROM AUTHOR]

This literature review was conducted to describe the range of organisations and informal groups providing peer support to personal budget users in the United Kingdom between the launch of direct payments in 1997 and 2016. Forty-five research reports included relevant evidence. This has been aggregated to show how peer networks supported individual users, as well as to describe their wider role in policy development and implementation. Despite their diversity, the support they provided often had common characteristics. Peer networks fostered collaboration, enhanced communication, built confidence amongst people who were entitled to a personal budget, and applied specialist knowledge that was often derived from the lived experience of network members. None of these characteristics was exclusive to peer networks. However, they may have been more deeply culturally embedded here than in other settings, which perhaps accounts for the positive experiences of support reported in the research literature. It is now more than 20 years since direct payments first enabled UK residents to take the money used to pay for their social services as personal budgets. Early research showed that support provided through peer networks including disabled people's organisations had particular advantages. Despite this, the proportion of support commissioned from peer networks has subsequently reduced. This review of the research literature details the helpful support provided by peer networks at each stage of obtaining and managing a personal budget. The approaches taken by peer networks were often innovative and original, and this article summarises their characteristics. [ABSTRACT FROM AUTHOR]

Aims and objectives: To review patients’ and healthcare professionals’ perceptions of patient involvement in promoting hand hygiene compliance in the hospital setting. Background: Initiatives continue to emphasise the importance of involving patients in their safety at the point of care. A patient‐centred care approach aimed to empower patients to become active members of the healthcare team. However, understanding the perceptions of patients and healthcare professionals of patient involvement in promoting hand hygiene compliance among healthcare professionals has yet to be fully explored. Design: Integrative literature review. Methods: A five‐stage review process informed by Whittemore and Knafl's methodology was conducted. MEDLINE and CINAHL were searched for papers published between January 2009–July 2017. Data were extracted manually, organised using NVivo 11 and analysed using thematic analysis. Results: From an identified 240 papers, 19 papers were included in this review. Thematic analysis revealed two main themes with three related subthemes. Patients were willing to remind healthcare professionals (especially nurses) to wash their hands, healthcare professionals perception towards patients’ involvement varied from one study to another. However, an overall positive attitude towards patient involvement was related to how patients asked and how healthcare professionals responded to being asked. Conclusion: There is limited evidence regarding patients’ actual intention to ask healthcare professionals to wash their hands, and some evidence that patients are reluctant to do so. Further research is required to understand this area thoroughly, including which situations patients would feel more empowered to speak up. Relevance to clinical practice: Simple messages promoting patient involvement may lead to complex reactions in both patients and healthcare professionals. It is unclear, yet how patients and staff react to such messages in clinical practice. There is a need for a deeper understanding of how they can work together to support harm free care. [ABSTRACT FROM AUTHOR]

Aims and objectives To explore the way in which sexual health care is perceived and experienced by students in clinical practice. Background Student nurses understand the need to learn about sexual health but report a variety of learning needs and experience challenges acquiring skills to deliver such care in part due to varied clinical experience. Furthermore, there is a paucity of data exploring clinical competence of sexual health care among student nurses. Design and methods A literature review of the published literature was conducted following a search of online databases. Articles were selected for analysis according to inclusion and exclusion criteria. Eight articles were critically appraised and thematically analysed. Results The following themes were identified: student nurses report having a positive attitude towards sexual health care; however, many felt uncomfortable about addressing sexual health and are reluctant to initiate a conversation; many student nurses lack knowledge about sexual health; they also lack role models at university and on clinical placement. Student nurse caregiving in relation to sexual health was also noted. Conclusions It is encouraging that student nurses have some knowledge, but their knowledge assessed is narrow. Their attitude is generally positive although many feel uncomfortable discussing issues of sexual health and sexuality. Very few student nurses report delivering sexual health care. There is a lack of positive role models both on clinical placement and at university. Relevance to clinical practice The reasons behind a lack of sexual health care delivery by student nurses should be understood. Student nurses should be supported to assess patient need and provide holistic care. Positive role models should be established in clinical and educational environments along with a focus on wider sexual health knowledge and skills. [ABSTRACT FROM AUTHOR]

Aim: To explore the experience of readmissions to hospital from the perspective of older adults. Methods: A systematic review with an interpretative approach was conducted. CINAHL, Embase, and Medline were consulted in October 2016. Results: Six studies with data collection between 2004 and 2013 fit the relevant criteria and included a total of 68 older adults. Two overarching themes were developed with relevant subthemes: Experience during initial hospital stay distinguished by exclusion (Feeling powerless; Feeling disregarded; Perception of readiness for discharge); Patients experience uncertainty following discharge (Perception that community-based services are not available or adequate; Perception that hospital is the only safe place; Difficulty in adapting to a "new normal"). Conclusions: A cycle of exclusion exists during the initial hospital stay and beyond. The experience of being readmitted to hospital is challenging, mostly perceived as negative and existential, emotional and psychological well-being is not satisfactorily addressed by healthcare professionals. [ABSTRACT FROM AUTHOR]

Abstract Background Inflammatory Bowel Disease is a chronic, untreatable condition represented by two illnesses, Crohn's and Ulcerative Colitis. Despite high incidence in well-developed industrialised countries, and the significant impact of symptoms on patient's quality of life, little is known about living with Inflammatory Bowel Disease. Aim To explore the patients' experiences of living with Inflammatory Bowel Disease. Design A qualitative systematic review. Data sources CINAHL, Medline, British Nursing Index and PsycINFO were searched using the following keywords: Inflammatory Bowel Disease AND experiences. We have limited the search to studies published in English from 2000 to 2017. Review method Thematic synthesis. Results Data from 23 studies, identified that fatigue, incontinence and uncertainty about future, body image, and lack of information from healthcare professionals dominated the experiences of those living with Inflammatory Bowel Disease. Also, patients living with Inflammatory Bowel Disease were reluctant to disclose their illness due to lack of public awareness and stigma surrounding symptoms. From these, an overarching theme has been identified: Living in isolation and exclusion. Conclusion Patients with Inflammatory Bowel Disease face a variety of problems, often their priorities and those of healthcare professionals differ greatly. Healthcare professionals have little evidence needed to provide adequate, holistic care to this group. With a rise in the Inflammatory Bowel Disease population in newly industrialised countries it is estimated that the condition is turning into a global disease, potentially making long term care unsustainable. More evidence is needed to understand the concerns of this group. [ABSTRACT FROM AUTHOR]

Abstract Aim The aim of this integrative literature review was to explore the quality of the dying and death experience in the Emergency Department from the perspective of staff and carers. Background Death in the Emergency Department is common. Understanding the quality of the death and dying experience of patients and their family members is crucial to building knowledge and improving care. Design Systematic integrative literature review reported following the PRISMA guidelines. Data sources Pubmed, Cumulative Index to Nursing and Allied Health Literature, Magonline (internurse), and the Cochrane library. Articles used were published in English during 1990- 2017. Review method Appraisal and thematic analysis. Results Sixteen articles are included. Eight themes emerged from the literature: care in the Emergency Department is about living not dying, staff perceive that death is a failure, staff feel underprepared to care for the dying patient and family in this environment, there is limited time for safe standards of care, staff stress and distress, staff use of distancing behaviours, the care of the dying role is devolved from medics to nurses at the end of life, and patients and staff perceive that the Emergency Department is not the preferred place of death Conclusion There are areas of concern about end of life care in the Emergency Department. To improve practice and to ensure that a good death occurs, further research is needed. There is a need to understand more about the experience of caregivers when a relative or friend dies in the Emergency Department. [ABSTRACT FROM AUTHOR]