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Digital health was given impetus by the COVID-19 pandemic and demonstrated its potential for the delivery of safe care in the community. Remote monitoring and virtual wards are becoming mainstreamed across the UK. Artificial intelligence (AI) software has the potential to transform healthcare delivery but its trustworthiness is a key challenge. Positive staff attitudes towards digital health and new ways of working require staff education and engagement. Continued attention is required to meet the needs of those without access to digital technology and its use.

The COVID-19 pandemic has increased workload demands for many NHS staff including those working in the community. Nurse managers can make a difference by being authentic leaders, nurturing a supportive organisation where the workload is managed participatively and self-kindness is legitimate. Unfortunately some staff may experience burnout and this article presents a personal management plan to address the symptoms of burnout and aid recovery, although it cannot promote a total recovery if the cause of the symptoms remains unaddressed.

Vaccine hesitancy is a concern both globally and within the UK. Alison While reviews the evidence relating to vaccine hesitancy, its underlying factors and the sociodemographic variations Vaccination is an important public health intervention, but its effectiveness depends upon the uptake of vaccination reaching sufficient levels to yield ‘herd’ immunity. While the majority of the UK hold positive attitudes about vaccination, some people, including health professionals, decline vaccinations. This article reviews the evidence relating to vaccine hesitancy, its underlying factors and the sociodemographic variations.

Medication is the most frequent treatment intervention, and its success depends on patients taking their medicines in line with their prescribed regimen to yield the full benefit of the treatment. Adherence is especially difficult to ensure in those with multimorbidity, who take multiple medications to manage their conditions. Non-adherence is costly for the health service, both through wastage and increased ill health. Non-adherence may be intentional or non-intentional, and many factors affect an individual's compliance with a medication regimen. There are a variety of aids that may be helpful; however, the interaction with a health professional is very important, both for understanding the reason for non-adherence and for promoting adherence.

Falls among older people are a major public health challenge, because the sequelae of falls can be severe, both in terms of mental and physical health repercussions. Building on an earlier article that discussed the reasons why older people fall, this article describes the interventions that may help reduce falls among older people. Four interventions which could be applied within UK community settings, namely, the Otago programme, the falls management exercise programme, tai chi and home assessment and modification are outlined here. District nurses are well placed to contribute to a reduction in falls among older people by identifying those susceptible to fall risks among their clients and putting in place the necessary interventions to minimise them.

Falls are common among older people and a major public health challenge. This article describes why falls are more common among older people, the potential causes of falls and what assessments should be undertaken to inform preventive interventions. District nurses are well placed to contribute to the understanding of why an older person has had a fall as part of a falls risk assessment.

There is a growing number of people who need access to high-quality endof-life care in the home setting. This requires timely assessments of needs, ensuring good symptom management and recognising the roles undertaken by carers. For some patients, a range of medications may need to be put in place to relieve end-of-life symptoms, using ‘anticipatory prescribing’. District nurses must ensure that they acknowledge the patient's voiced preferences and be mindful of the safety issues that arise with the supply of controlled drugs in the home. This article highlights the challenges faced by district nurses providing or dealing with anticipatory prescribing during end-of-life care.

Background Globally there are mounting concerns about nurses’ job satisfaction because of its pivotal role in nurse turnover and the quality of care of patients. Objectives To identify a more comprehensive and extensive knowledge of the job satisfaction of qualified general nurses working in acute care hospitals and its associated factors drawing upon empirical literature published in the last five years. Design Literature review. Data sources A comprehensive electronic database search was conducted in PubMed (2012–2017), Web of Science (2012–2017), CINAHL (2012–2017), Embase (2012–2017), PsycINFO (2012–2017) and the Applied Social Sciences Index (2012–2017), CNKI (2012–2017), WanFang (2012–2017), SinoMed (2012–2017) and VIP (2012–2017) to retrieve relevant articles published in both English and Chinese between January 2012 and October 2017. Review methods Key terms and phrases associated with job satisfaction, occupational stress, professional commitment, role conflict and role ambiguity were utilized in the subject search in combination with nurses following guidelines for searching the OVID interface. The abstracts or full texts of research papers were reviewed prior to their inclusion in the review according to inclusion criteria and quality assessment using the Strobe guidelines. Results A total of 59 papers were included in this review. The impact of job satisfaction upon sickness absence, turnover intention, as well as the influencing factors of job satisfaction such as working shift and leadership, job performance, organizational commitment, effort and reward style has been identified in a number of research studies yielding equivocal findings. Job satisfaction of hospital nurses is closely related to work environment, structural empowerment, organizational commitment, professional commitment, job stress, patient satisfaction, patient-nurse ratios, social capital, evidence-based practice and ethnic background. Various mediating or moderating pathways have been identified with nurses’ job satisfaction being mediated by various factors. Conclusions It is vital to increase nurses’ job satisfaction because this has the potential both to improve patients' perceptions of care quality and ensure an adequate nursing workforce. The indirect relationships and predictors of job satisfaction contribute to a more comprehensive understanding of the complex phenomenon of job satisfaction, which in turn may aid the development of effective strategies to address the nursing shortage and increase the quality of patient care.

Vaccine hesitancy can undermine a vaccination programme. Alison While looks at the strategies that can be used to promote vaccination uptake The success of a vaccination programme depends upon its coverage so that it provides herd immunity. Vaccine hesitancy has the potential to undermine a vaccine programme. Evidence suggests that some strategies are more effective in promoting vaccination uptake. Nurses should help in the promotion of vaccination uptake using evidence-based interventions and through ‘Making Every Contact Count’.

Social distancing has reduced the amount of touch in everyday life. This article summarises the current state of knowledge regarding the biological underpinnings of touch, varied preferences for touch, including cultural norms, and its potential psychological and physical benefits for recipients. The lack of nursing research and related evidence are noted, and suggestions are made regarding the use of consensual touch as part of non-verbal communication within community nursing practice to express compassion and help build authentic relationships between nurses and their clients.

Globally the number of older people living alone is increasing. Little is known about the life experience of older people living alone in Mainland China. This study aimed to explore older people's experience regarding different components of their lives. A cross-sectional survey of 387 older people aged 60 years and above and living alone in two communities in Shanghai was conducted from April to July 2015. A structured questionnaire including 15-item Geriatric Depression Scale, Activity of Daily Living Scale, UCLA Loneliness Scale version 3, Social Support Rate Scale and Older People's Quality of Life Questionnaire was used to assess the health status, loneliness, social support, quality of life and demographic information. A total of 15.7% of the participants rated their health as poor with 56.8% reporting chronic diseases and 26.9% reporting being depressed. A total of 71.1% of the participants reported a high level of functional ability. However, 54.3% and 21.7% of the participants reported a moderately and moderately high level of loneliness respectively. The median of SSRS was 30 and the mean of Older People's Quality of Life Questionnaire was 120.2, indicating a lower level of social support and quality of life. There were statistically significant differences in health, loneliness, social support and quality of life across the participants with different characteristics. Interventions to improve the health status, reduce loneliness, increase social support and maintain or improve quality of life of older people living alone in Shanghai could be developed and implemented. Potential interventions include providing frequent home care services, early detection of depression, encouraging more contacts from children and other family members, and providing support from other sources.

Parents of young people with cystic fibrosis (YPWCF) play an important role during the transition from paediatric to adult health services. There is limited evidence on parental information needs and the extent to which they are met. An online survey was conducted targeting a finite population of 190 parents of YPWCF in Ireland. Fifty-nine parents responded (31% response rate). Parents reported the need for more general preparation and timing of the transfer, more information regarding the differences between adult and child health services and how their child will self-manage his/her illness in the future. Most parents received information on the timing of transfer and new healthcare providers but reported being insufficiently informed about their legal status relating to medical confidentiality for their adult child and community resources available for their child after transition to adult health services. The findings highlight the importance of information and preparation for caregivers as well as young people to promote successful transition to adult healthcare. Providing parents with clear information and anticipatory guidance are simple changes in practice that may lead to improvements in transition experiences.

Antimicrobial resistance poses a significant health risk. In this article, Alison While discusses the correct use of both antibiotics and infection prevention and control measures to minimise the speed at which resistance emerges, and improve outcomes for everyone

As survival increases worldwide, large numbers of young people will need to transition from child to adult cystic fibrosis (CF) services. Little is known about the best method for transitioning patients with CF and which transition programmes yield better outcomes. This paper provides a systematic review of the empirical literature on the outcomes and experiences of transition for young people with CF. Outcomes data were subject to a narrative synthesis and a thematic synthesis of experiences data. Structured transition programmes were associated with increased satisfaction, discussions about transition, self-care and self-advocacy skills, more independence, lower anxiety, and increased self-management and parent management of physiotherapy and nutritional supplementation. Young people's concerns included leaving behind previous caregivers, differences in care provision and infection risks. Lack of preparation was a consistent theme. The two most useful aspects of transition programmes were meeting the adult doctors/CF specialist nurse/team and visiting the adult centre. Young people want education about the differences between services, implications of their condition and self-care management. Structured transition programmes appear to impact positively on experiences but the contribution of the different components of transition programmes is unclear. The absence of high-quality studies indicates the need for more well-designed research.

Quality of life and life enrichment are important throughout the lifespan and no less during ill-health or later life. The role of the arts and gardens and their potential benefits are not prominent within healthcare practice. This paper outlines the evidence reported in two literature reviews, one addressing the arts and the other focusing on gardens and gardening so that district nurses can understand what art-based and gardening opportunities they may offer their clients and their carers.