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This paper answers a call from Nordic colleagues for new strategies in education to meet the needs of a new generation of bachelor nursing students regarding the development of clinical skills. We, as they, believe that educational models targeting the development of clinical skills must be customised to meet the learning style of the current and future generations of bachelor nursing students. In this paper we put forward that using a comprehensive, collaborative, student-centred approach will assist younger generations’ learning processes. We describe a pedagogical model of peer learning that combines collaboration, reflection and assessment aligned with learning outcomes. Such an approach, we believe, is likely to be in line with expectations, needs and preconditions of the current and future generations of nursing students.

IntroductionOlder people receiving healthcare in long-term care contexts (eg, home healthcare, sheltered housing and nursing home contexts) are especially vulnerable to developing frailty and functional decline. Considering the negative effects associated with these conditions and the possibility of preventing them from progressing, it is vital that nurses possess a broad knowledge base related to them. Particularly as prevention related to these conditions lies well within their remit. Such knowledge could guide the development of effective models of care, ensuring continuity and, hence, quality of care. Our objective will be to review published literature on existing models of care targeting frailty and/or functional decline and how these conditions are described by older people themselves, significant others and nurses in relation to long-term care.Methods and analysisThe scoping review will be conducted in accordance with Arksey and O’Malley’s methodological framework. Recent methodological developments will be considered. PubMed, CINAHL and PsycINFO will be searched. Eligibility criteria will be peer-reviewed papers and written in English. All types of study designs will be eligible and included papers will be quality and ethically assessed. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA)-Protocol checklist for protocols and the PRISMA for Scoping Reviews checklist were followed in this paper.Ethics and disseminationAs the study outlined in this protocol is a scoping review, no ethics approval was needed for this protocol nor for the upcoming study. The findings will be published in an open-access, peer-reviewed journal. Additionally, the findings will guide a research project following the Medical Research Council’s framework for developing and evaluating complex interventions. Thus, supporting us in developing a model of care related to the detection and prevention of frailty and/or functional decline among older people in a long-term care context.

IntroductionWhat nurses do and how they do it can influence older people’s experiences of the quality of long-term care. In addition, a clear role definition for nurses supports them in giving patients appropriate basic care. Despite this, there is a lack of a clear role definition regarding policy, work descriptions and expectations. Therefore, the objective of this scoping review is to map the literature on nurses’ role, function and care activities and/or nursing interventions, as well as to identify nursing interventions (as models of nursing care, patient care pathways and/or clinical practice guidelines) in relation to older people in long-term care. Hence, to explore how nurse’s role, function and care activities in relation to older people’s basic care needs are described and understood by key stakeholders (older people, their next of kin, nurses) in long-term care.Methods and analysisArksey and O’Malley’s methodologic framework for scoping studies will be used for this upcoming scoping review. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews checklist will be followed. Search strategies will be developed in collaboration with the research team and an experienced librarian. Search strategies will be adjusted for each of the databases: PubMed, PsycINFO, CINAHL and Scopus. Data will be charted using a pilot extraction sheet. Quantitative data will be described numerically, and qualitative data will be analysed using thematic analysis. The key stakeholders will be consulted for validation.Ethics and disseminationThe upcoming study will follow All European Academies' principles for good research. The findings will be used to inform the design of future studies aiming to develop a nursing intervention targeting older peoples’ basic care needs.

IntroductionKnowledge about long-term care services ability, regardless of if the service is home-based or facility-based, to provide an optimal and comprehensive fundamental nursing care (understood as focusing on physical, relational and psychosocial needs) consistently over time is sparse. Research into nursing indicates the presence of a discontinuous and fragmented healthcare service, and that fundamental nursing care such as mobilisation, nutrition and hygiene among older people (65 years and above) seems to be, regardless of reasons, systematically rationed by nursing staff. Thus, our scoping review aims to explore the published scientific literature on fundamental nursing care and continuity of care targeting older people’s needs while also describing identified nursing interventions with the same foci in a long-term care context.Methods and analysisThe upcoming scoping review will be conducted in accordance with Arksey and O’Malley’s methodological framework for scoping studies. Search strategies will be developed and adjusted to each database, for example, PubMed, CINAHL and PsychINFO. Searches will be limited to the years 2002–2023. Studies focusing our aim, regardless of study design, will be eligible for inclusion. Included studies will be quality assessed and data will be charted using an extraction form. Textual data will be presented through a thematic analysis and numerical data by a descriptive numerical analysis. This protocol adheres to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses protocol checklist.Ethics and disseminationThe upcoming scoping review will take into consideration ethical reporting in primary research as part of the quality assessment. The findings will be submitted to an open-access peer-reviewed journal. Under the Norwegian Act on Medical and Health-related Research, this study does not need ethical clearance by a regional ethical review authority as it will not generate any primary data or obtain sensitive data or biological samples.

BackgroundCritical thinking is an essential skill that nursing students need to develop. Technological tools have opened new avenues for technology-supported guidance models, but the challenges and facilitators of such guidance models, as well as how they stimulate the development of critical thinking, remain unclear.ObjectiveWe developed a protocol for a mixed methods systematic review to investigate the use of technology-supported guidance models that stimulate the development of critical thinking in nursing education clinical practice.MethodsA convergent integrated design following the Joanna Briggs Institute Manual for Evidence Synthesis will be employed. A pair of authors will select the articles by screening titles and abstracts, and the methodological quality of the articles included in the review will be assessed by a pair of authors according to checklists for specific study designs. The data will be extracted using the standardized Joanna Briggs Institute mixed methods data extraction form and following a convergent integrated approach. The thematic synthesis for data transformation will be used.ResultsDevelopment of a comprehensive systematic search strategy was completed in October 2020. The database searches were performed on October 21, 2020. As of January 2021, analysis and synthesis is ongoing. Completion of this review is expected by January 2021.ConclusionsBy combining evidence from studies with varied methodological approaches, the results should provide broad insight into the use of technology-supported guidance models for clinical practice in nursing education with a focus on the development of nursing students’ critical thinking. The results of this mixed methods systematic review can also be used to develop or improve current technology-supported guidance models for clinical practice in nursing education.International Registered Report Identifier (IRRID)PRR1-10.2196/25126

Background Critical thinking is an essential set of skills in nursing education, and nursing education therefore needs a sharper focus on effective ways to support the development of these skills, especially through the implementation of technological tools in nursing education. Objective The aim of this study protocol is to assess the feasibility of a technology-supported guidance model grounded in the metacognition theory for nursing students in clinical practice. Methods Both quantitative (research questionnaires) and qualitative (focus group interviews) approaches will be used to collect data for a feasibility study with an exploratory, flexible mixed methods design to test a newly developed intervention in clinical practice. Results The intervention development was completed in December 2020. The intervention will be tested in 3 independent nursing homes in Norway. Conclusions By determining the feasibility of a technology-supported guidance model for nursing students in clinical practice, the results will provide information on the acceptability of the intervention and the suitability of the outcome measures and data collection strategy. They will also identify the causes of dropout and obstacles to retention and adherence. International Registered Report Identifier (IRRID) DERR1-10.2196/31646

Objective. To explore the first-line leaders’ role in quality work in long-term care in Norway, in order to determine how that work is related to such success characteristics as leadership, staff, patients, performance, information and information technology. Design. Cross-sectional telephone survey. The text was analysed using content analysis. Setting. Thirty-two Norwegian municipalities stratified according to region and population size. Participants. Sixty-four first-line leaders in nursing homes and home-based care. Main outcome measure. The clinical microsystem approach is used as a framework by defining and designing measureable variables. Results. Thirty-six leaders described how they initiated and motivated employees to be active in quality work; the remaining leaders indicated that they played a passive role. The first-line leaders played a key role in implementing national quality policies and regulations. The quantity of other success characteristics was low. Conclusions. The municipalities delegated the responsibility of implanting national policies to the first-line leaders. Missing were key quality success criteria such as macro- and meso-perspectives for the municipality as a whole and co-operation with other leaders in the organization and fostering of relevant learning. Quality work was fragmented rather than comprehensive and systematic.

Aims. The present study explores how community nurses addressed patient care in the EPR and the comprehensiveness of their documentation. Background. The need for comprehensive nursing documentation in home health care is considerable and quality is regarded as a prerequisite for continuity of care. Documentation according to the nursing process is considered to be of good quality due to its logical structure. Nurses in home health care face different challenges than nurses in institutionalised care because of long-term patient situations and a focus on chronic illness rather than acute disease. Design. Retrospective study. Method. The study was performed on a sample of 91 patient records. Data were analysed in three phases: (1) systematising the unstructured text, (2) structuring the text according to the nursing process and (3) assessing the comprehensiveness using a validated instrument. Results. The home care nurses documented patient care chronologically along a time axis rather than using a logical structure according to the nursing process. The documentation reflected today’s overall emphasis on patient participation, as more than 70% of the notes on nursing status were connected to subjective nursing status. Paradoxically, the nurses showed a lack of attention to the patients’ ability to communicate. Only two of 264 documented nursing diagnoses were connected to communication. The comprehensiveness of the documentation, however, was incomplete. Conclusions. Home health care nurses are attentive to patient participation but fail to address patients’ needs with regard to communication. The documentation is incomplete when assessed according to the steps of the nursing process. A question that arises is whether the nursing process may be a limitation for the quality of the nursing documentation. Relevance to clinical practice. The study contributes to identifying areas of improvement in documentation by nurses in home health care.

Progressive loss of hip containment attributable to dysplasia epiphysealis hemimelica of the right proximal femur and macrodactyly of the right second toe was diagnosed and monitored by radiographs and magnetic resonance imaging in a 7-year-old boy. The patient had early surgical correction including shortening osteotomy of the hypertrophic toe and partial resection of the involved superolateral femoral head-neck junction combined with a Pemberton-like acetabuloplasty. This treatment restored containment and function. At 4 years followup, the femoral head remained contained and the patient was participating fully in the activities of daily life for his age-group. A review of the literature suggests monitoring the hip with magnetic resonance imaging may allow early identification of a hip at risk for loss of containment. This treatment may save the hip from severe deformity and early secondary osteoarthritis.

Two spectrophotometric methods for cholinesterase determination which utilize thiocholine chloride esters as substrates were developed. The disappearance of the C-S bond at 229 mμ during the enzymic hydrolysis of the thiocholine chloride esters, permitted the measurement of the rate and activity of the enzyme samples. The reduction of indophenol by the thiocholine liberated during the enzymatic hydrolysis made the evaluation of enzyme activity feasible in the visible spectrum at 600 mμ. These methods are simple, rapid, and accurate in analyzing cholinesterase activity or inhibition. They also serve to measure the cholinesterase activity of as little as 0.01–0.001 ml samples of blood, serum, or tissue extracts.