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Why you should read this article: • To explore the legal and ethical dimensions of prescribing practice with reference to a contemporary prescribing model • To appreciate that duty of care is integral to professional standards and underpins common ethical principles • To recognise that familiarity with professional and ethical principles supports nurses to examine their clinical decisions This is the second of two articles exploring the core professional, legal and ethical dimensions of prescribing. Part one presented a contemporary prescribing model, RAPID-CASE, devised by the authors to demonstrate the application of key professional principles to prescribing practice. This second article examines pertinent legislation and underpinning ethical principles that guide decision-making in prescribing. [ABSTRACT FROM AUTHOR]

Prescribing by a variety of professionals continues its progression in response to the growing demands for health care. Prescribing by nurses was initiated in the 1990s and supported by the National Prescribing Centre's 'prescribing pyramid' or seven steps or principles for good prescribing (NPC, 1999). This article explores a new prescribing consultation model (RAPID-CASE), which is composed of elements from the prescribing pyramid and the Competency Framework for all prescribers (Royal Pharmaceutical Society [RPS], 2021). The RAPID-CASE consultation model is applied to a clinical scenario to illustrate how it can guide a systematic approach to decision-making, using the example of a lower limb skin tear injury. [ABSTRACT FROM AUTHOR]

A need for people‐centred health and social support systems is acknowledged as a global priority. Most nations face challenges in providing safe, effective, timely, affordable, coordinated care around the needs and preferences of people who access integrated health and social care (IHSC) services. Much of the current research in the field focuses on describing and evaluating specific models for delivering IHSC. Fewer studies focus on person‐centred experiences, needs and preferences of people who use these services. However, current international guidance for integrated care sets a precedence of person‐centred integrated care that meets the health and well‐being needs of people who access IHSC services. This integrative literature review synthesises empirical literature from six databases (CINAHL; MEDLINE; AMED; TRIP; Web of Science and Science Direct; 2007–2019). This review aims to better understand the experiences and health and well‐being needs of people who use IHSC services in a community setting. Twenty studies met the inclusion criteria and results were thematically analysed. Three overarching themes were identified, including relationships, promoting health and well‐being and difficulty understanding systems. Findings of this review indicate that relationships hold significance in IHSC. People who access IHSC services felt that they were not always involved in planning their care and that there was a lack of clarity in navigating integrated systems; subsequently, this impacted upon their experiences of those services. However, service user and informal carer voices appear to be underrepresented in current literature and studies that included their views were found to be of low quality overall. Collectively, these findings support the need for further research that explores the person‐centred experiences and needs of people who access IHSC. [ABSTRACT FROM AUTHOR]

Accessible Summary: What is known on the subject?: People diagnosed with "BPD" often experience crisis and use services"BPD" is a controversial diagnosis, and the experience of crisis and crisis intervention is not well understood What this paper adds to existing knowledge?: People diagnosed with "BPD" have different experiences of crisis, and using the diagnosis alone as a basis for deciding care and treatment is not appropriateThere are many human factors which can influence how professionals deliver care to people diagnosed with "BPD" What are the implications for practice?: The education of staff, views on responsibility, team conflicts and access to clinical supervision can have an impact on how care is delivered, and should be addressed by organizations providing crisis care.Access to care often occurs when a person is self‐harming or suicidal, but does not address underlying distress. Crisis care should go beyond managing behaviour and address any underlying needs. Introduction: "Borderline personality disorder" ("BPD") is associated with frequent use of crisis intervention services. However, no robust evidence base supports specific interventions, and people's experiences are not well understood. Aim: To explore the experiences of stakeholders involved in the crisis care of people diagnosed with "BPD." Method: Integrative review with nine databases searched January 2000 to November 2017. The search filtered 3,169 titles and abstracts with 46 full‐text articles appraised and included. Results: Four themes were constructed from thematic analysis: crisis as a recurrent multidimensional cycle, variations and dynamics impacting on crisis intervention, impact of interpersonal dynamics and communication on crisis, and balancing decision‐making and responsibility in managing crisis. Discussion: Crisis is a multidimensional subjective experience, which also contributes to distress for family carers and professionals. Crisis interventions had limited and subjective benefit. They are influenced by accessibility of services, different understandings of "BPD" and human dynamics in complex decision‐making, and can be experienced as helpful or harmful. Implications for practice: Subjectivity of crisis experiences shows limitations of the diagnostic model of "BPD," emphasizing that interventions should remain person‐centred. While thresholds for intervention are often met after self‐harm or suicidality, professionals should review approaches to care and support people with underlying distress. [ABSTRACT FROM AUTHOR]

Aims and objectives: To analyse the experiences of older people with a diagnosed functional mental illness and their carers in relation to mental health service delivery and analyse the experiences of health and social care professionals who care for and treat older people who have a diagnosed functional mental illness. Background: The prevalence of functional mental illness in older adults is notable but to date has received less research attention than dementia. Older adults with functional mental illness have life expectancy of up to 20 years less than the rest of the population. Therefore, the experiences of older adults with functional mental illness, their carers and healthcare professionals, in relation to mental health services, need further exploration. Design: Integrative literature review. Methods: A five‐stage process was informed by Whittemore and Knafl. MeSH was used. Keyword searches of MEDLINE, CINAHL, Cochrane Library, PsycINFO, EMBASE and AMED were conducted between January 2000–October 2017. Titles were screened, and data were extracted manually and analysed using narrative synthesis. The PRISMA checklist was used. Results: A total of 342 articles were deemed potentially relevant to this review. Once inclusion and exclusion criteria were applied, 28 articles were included. The literature presented an overarching theme "determinants influencing older people with functional mental illness use of services." The overarching theme is supported by two main themes: inevitable consequences of ageing and variations of the availability of healthcare services for older people with functional mental illness. Conclusion: Several determinants influence use of services by older people with functional mental illness. Older people with functional mental illness often perceived they did not have a mental health need. Within the literature, there was little acknowledgement of the experiences of older people with functional mental illness regarding their support needs. Relevance to clinical practice: This integrative review has highlighted that some older people with functional mental illness do not seek mental health support because they believe that functional mental illness is an inevitable consequence of ageing; this is mirrored at times by healthcare professionals and carers. In addition to this finding, different views prevail regarding the impact that ageless and age‐defined mental health service delivery models have on the needs of older people with functional mental illness. Further research is required to understand these findings. [ABSTRACT FROM AUTHOR]

Introduction Safe, people-centred, effective, affordable, and coordinated health and social support systems are a global priority. Current research in the field focuses on evaluation of services and models of integrated health and social care (IHSC)(1). This qualitative multi-case study was designed with key stakeholders to explore the experiences and needs of people who use and deliver IHSC at home, in a regional area of Scotland (UK). Methods Eighteen participants were recruited (service user [n=6]; informal carer [n=5]; IHSC staff [n=7]). Service users identified an informal carer and IHSC staff member (who helped them at home) to take part with them, creating a 'case' [n=7]. Qualitative data were collected via semi-structured interviews (December 2019 - March 2020). Principles of thematic analysis were employed to synthesise data and findings. Findings Service users' and informal carers' community connections appeared more cohesive and collaborative than statutory services because of personal connections with individual community members. Supportive relationships, maintaining functionality, and social contacts helped participants feel as though they were coping with their changing health and social care (HSC) needs and roles. Not having supportive relationships and connections negatively impacted service users' experience of IHSC. Discussion Community-delivered care can be undervalued by statutory IHSC services. Findings of this study highlight that promoting compassionate communities and caring for one another, is important to participants. The power of connection is important when designing IHSC services; therefore, services should aim to promote meaningful relationships between people who use and deliver them(1). Conclusions Supportive relationships and personal connections were instrumental in helping all participant groups feel able to cope with their changing HSC needs and roles, promoting reassurance, information sharing, and reduced anxiety. Cohesive, supportive, relationships with members of the community helped people to meet their HSC needs. Connections between and with IHSC providers appeared less cohesive and collaborative. Lessons learned This study offers insight into indicators for improved IHSC. It offers IHSC organisations the opportunity to explore service redesign using co-designed research evidence. Co-produced, community-driven, IHSC services that meet the needs of the people who use them, as defined by those people themselves, should be encouraged. Limitations One of the seven cases had only staff member data, and a second had service user and IHSC staff member data only. Successful recruitment of all three participant groups to each case may have further enriched the data. Although this study's findings are transferrable to other locations, the regional context of data collected could be observed as a limitation. Suggestions for future research Further research into the impact and perceived value of community-led health and social care support is recommended. Further research that explores the impact of personal connections between people who receive and provide HSC (statutory and non-statutory) is warranted. [ABSTRACT FROM AUTHOR]

Standardized achievement scores and academic locus of control were investigated in 28 father-absent (FA) and 28 father-present (FP) third-grade children of similar IQ characteristics. Father-absent children performed significantly worse than FP children in reading achievement. There were no differences between the two groups for spelling and arithmetic, but FA males performed significantly worse than FA females, whose achievement level was closer to that of the FP males and females. For academic locus of control, FA children, compared with FP children, tended to perceive successful achievement outcomes as being related to external sources of control such as task ease or teacher assistance. On the other hand, the two groups took similar responsibility for their failures. Together, the results of this study suggest that for FA and FP groups of similar IQ characteristics, there is already some evidence of the detrimental effects of father absence on cognitive development by the third grade. Further, the academic locus of control characteristics of the one-parent children suggest that their achievement deficits may become more marked in later grades. [ABSTRACT FROM PUBLISHER]