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BackgroundFalls have implications for older adults’ health and well-being. Strength and balance interventions significantly reduce the risk of falls. However, patients do not always perform the unsupervised home exercise needed for fall reduction. ObjectiveThis study aims to develop motivational smartphone apps co-designed with health professionals and older adults to support patients to perform exercise proven to aid fall reduction and to explore the apps’ usability and acceptability with both health professionals and patients. MethodsThere were 3 phases of app development that included analysis, design, and implementation. For analysis, we examined the literature to establish key app components and had a consultation with 12 older adults attending a strength and balance class, exercise instructors, and 3 fall services. For design, we created prototype apps and conducted 2 patient and public involvement workshops, one with 5 health professionals and the second with 8 older adults from an exercise group. The apps were revised based on the feedback. For implementation, we tested them with one fall service and their patients for 3 weeks. Participatory evaluation was used through testing, semistructured interviews, and focus groups to explore acceptability and usability. Focus groups were conducted with the service that tested the apps and two other services. Qualitative data were analyzed using the framework approach. ResultsOn the basis of findings from the literature and consultations in the analysis phase, we selected Behavior Change Techniques, such as goal setting, action planning, and feedback on behavior, to be key parts of the app. We developed goals using familiar icons for patients to select and add while self-reporting exercise and decided to develop 2 apps, one for patients (My Activity Programme) and one for health professionals (Motivate Me). This enabled health professionals to guide patients through the goal-setting process, making it more accessible to nontechnology users. Storyboards were created during the design phase, leading to prototypes of “Motivate Me” and “My Activity Programme.” Key changes from the workshops included being able to add more details about the patients’ exercise program and a wider selection of goals within “Motivate Me.” The overall app design was acceptable to health professionals and older adults. In total, 7 patients and 3 health professionals participated in testing in the implementation phase, with interviews conducted with 6 patients and focus groups, with 3 teams (11 health professionals). Barriers, facilitators, and further functionality were identified for both apps, with 2 cross-cutting themes around phone usability and confidence. ConclusionsThe motivational apps were found to be acceptable for older adults taking part in the design stage and patients and health professionals testing the apps in a clinical setting. User-led design is important to ensure that the apps are usable and acceptable.

This article provides an overview of the wound healing process, outlining the four distinct phases of the healing cascade: haemostasis, inflammation, proliferation, and maturation. The different types of closure method are described and, specifically, the various types of surgical suture that can be used for wound closure, as well as the strengths and limitations of each. The article explains aspects of patient care that need to be considered such as obtaining informed consent, and the importance of nurses maintaining appropriate clinical skills. It concludes with a step-by-step outline of best practice on how to remove sutures. [ABSTRACT FROM AUTHOR]

Nursing programmes were flexible during the COVID-19 pandemic, offering simulation to replace clinical hours and adjusting supervision and assessment. However, second-year students in two modules had lower results despite no changes to the material, team or delivery. Objectives: A retrospective cohort study was conducted, on second-year adult nursing students who submitted written assignments, to analyse recurring patterns that could explain the failure rate. Method: Data were analysed from 265 university students to identify patterns of association in demographics, module results and student engagement indicators. Results: A positive correlation was found between age and assignment results, with older students achieving higher grades. Clustering identified three patterns of student engagement. Students demonstrating engagement with all aspects of the course (30.2%) performed significantly better than those in other clusters (P<0.001). Students with disabled student support recommendations performed notably worse than those without. All sizeable differences were resolved following the return to campus and the implementation of additional writing support. Discussion: Age, cross-medium engagement and preparation were all shown to have an impact on marks. These findings can influence how higher education institutions drive and monitor engagement, as this study suggests that all parts of a blended learning approach are equally important. [ABSTRACT FROM AUTHOR]

This article will provide clinical guidance on carrying out venepuncture on an adult. It will discuss site, equipment selection and aseptic non-touch technique. The aims are to increase knowledge of the anatomical structures associated with venepuncture, demonstrate the clinical procedural technique of venepuncture, and provide an awareness of the dangers and complications of this invasive technique. [ABSTRACT FROM AUTHOR]

This article provides clinical guidance on performing cannulation on an adult. The site, equipment selection and aseptic non-touch technique will be discussed. The clinical procedural technique of cannulation will be explained and the article will also provide an awareness of the dangers and complications of this invasive technique for both the patient and the health professional. [ABSTRACT FROM AUTHOR]

Supplemental Digital Content is Available in the Text. Paging and text messaging to request new orders remain common means of communication between clinicians and nurses in the hospital setting. However, sending and triaging multiple pages can lead to interruptions in other clinical duties. A medication order delegation protocol allowing for nurse-driven ordering of low-risk medications was developed with an objective of decreasing potentially avoidable pages. The aim of this study was to evaluate the impact of implementing this protocol on nurse and clinician perceptions of clerical burden and satisfaction. A survey assessing satisfaction with the process of obtaining medications in this protocol and the perception of clerical burden associated with ordering them before and after delegation protocol implementation was completed by over 160 clinicians and nurses. Survey respondents reported increased satisfaction and decreased clerical burden associated with the implementation of the delegation protocol. These results suggest the potential for delegation protocols to limit clerical burden associated with paging. [ABSTRACT FROM AUTHOR]

Older adults often have health complexities and higher levels of attrition. Even though they are the main users of healthcare, they are often not included in health research because the health research may not be well designed to accommodate their evolving health needs. One research area in which participation of older adults is essential focuses on improving physical function. In this field, there are many innovations and new technologies developed. Barriers and facilitators to recruit older adults to research that improves physical function by using technology are not well explored yet. This study aims to explore barriers and facilitators regarding recruitment and retention of older adults living in Assisted Living Facilities to a randomised controlled trial study that aimed to improve physical function by using technology. Nine semi‐structured interviews were conducted with four Scheme Managers, three therapists and two researchers. The interviews were transcribed. After open, axial and selective coding, the codes were thematic analysed in ATLAS.ti. Scheme Managers, therapists, researchers and older adults' peers appear to play an important role in the recruitment and retention of older adults living in Assisted Living Facilities. Additionally, the technology itself and the presentation of the research appear to influence recruitment. Creating a social setting, inviting people face‐to‐face, demonstrating the technology, showing the benefits by presenting results from a pilot study and alleviating people's fears were experienced as important factors for recruitment. The results from this study can help other researcher to improve recruitment and retention strategies so evidence‐based practice in care for older adults can be improved to enhance quality of life of older adults. [ABSTRACT FROM AUTHOR]