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Purpose The COVID-19 lockdowns (2020–2021) disrupted all aspects of usual functioning of the criminal justice system, the outcomes and impact of which are largely still unknown. The pandemic has affected individuals across the wider society, this includes a negative impact on the social circumstances of children and young people involved within youth offending services (YOS) (Her Majesty’s Inspectorate of Probation, 2020; Criminal Justice Joint Inspectorates, 2021). This population frequently represents those from marginalised circumstances and are rarely given the opportunity to participate meaningfully in the services they are involved in. The purpose of this study was to explore the experiences of the young people serving orders with the YOS during Covid19 lockdowns and requirements. Design/methodology/approach This paper outlines a creative methodology and method used to uncover the experiences and perceptions of young people undergoing an order within a YOS during the COVID-19 lockdowns. The arts-based approach entailed a novel and creative method using a lyric artist to engage with young people through a virtual platform, supporting them to create lyrics about their experiences of the YOS during this time. Findings The artist developed a successful rapport with young people based on familiarity with, and passion for, music. He promoted their strengths, improving their confidence which was perceived to elicit more in-depth perspectives that might not have otherwise been obtained using more traditional methods. As such, the method and methodology outlined developed the young people’s social and communicative skills whilst producing meaningful feedback that can contribute to the YOS recovery plan and thus future of the service. Practical implications This paper reports on a novel arts-based research methodology, implemented to capture meaningful data from participants during the COVID-19 pandemic. Originality/value This paper reports on a novel arts-based research methodology, implemented to capture meaningful data from participants during the COVID-19 pandemic.

Purpose This paper aims to explore young peoples’ authentic experiences of youth justice services (YJS) during the Covid-19 pandemic. By adopting the creative arts-based method of lyric writing, the research team sought to empower participants through collaboration and participation and to facilitate them leading the narrative (Deakin et al., 2020). Design/methodology/approach This research adopted a creative arts-based method in which participants worked alongside an artist to generate lyrics that captured their experiences within YJS. Such an approach demonstrated a commitment to participatory, child-first approaches. Findings Two main themes were identified: identity and relationships. The young people vocalised resistance to frequent labelling and their ambitions to move away from past criminal identity and behaviour. Relationships with practitioners could be a source of frustration within this but were also highlighted as valuable and supportive. Research limitations/implications As data collection was remote, owing to the Covid-19 pandemic and associated lockdowns, the opportunity to develop relationships with young people within the YJS prior to conducting the research was restricted. This approach may have also impacted recruitment of participants. The sessions presented short-term interventions and whilst follow-up sessions were offered, many did not take them up. Although the research sample is small and cannot be considered representative, it allows for a valuable insight into the experiences of young people at a particularly challenging time. Practical implications Upon receiving our findings and recommendations, the first YJS research site has sought to further embed a relationship-based practice model and greater creative/participatory socially prescribed psychosocial therapeutic interventions, including music groups and spoken word artists to work with children and young people. Originality value This research adds to the growing literature base surrounding creative arts-based research with children and young people for their value towards communication, pro-social identity and development.

The interventions of pharmacy professionals are considered impactful inputs towards optimised patient care and safety, by rationalising prescriptions, enhancing therapeutic choices and reducing and preventing medication errors and adverse effects. Between October 2020 and October 2021, the community hospitals at Powys Teaching Health Board recorded 158 interventions, corresponding to 0.4 interventions per pharmacy staff per week. Predominantly, only two members of the team were recording these pharmacy interventions (PIs). Poor indicative PIs can result in lost opportunities for medication optimisation and prescribing rationalisation, increased costs and unidentified education and training potentials.The aims of this project were (1) to record 180 interventions between 22/11/2021 and 08/04/2022 (20 weeks), corresponding to an average 3-fold increase, compared to the interventions recorded between October 2020 and October 2021 (52 weeks); (2) to have all hospital pharmacy staff recording at least one intervention during the same period.The number of interventions recorded and the number of pharmacy staff recording each intervention were two process measures. The project was completed through two Plan-Do-Study-Act (PDSA) cycles and applied theory on managing change in healthcare.The most successful intervention influencing positively the process measures was the implementation of a newPharmacy InterventionRecordTool (xPIRT) toolkit that included an online recording tool (xPIRT) and an interactive panel with up-to-date results from all interventions recorded (xPIRT Dashboard). Motivating change was proven to be one of the best determinants of user satisfaction and engagement that contributed to meet the project’s targets. xPIRT Dashboard provided staff the capacity to act on possible personal motivators and the possibility to improving care with medicines on their wards. The implementation of xPIRT toolkit was able to increase the representativity and significance of PIs recorded by the hospital pharmacy team and it is expected to be used for personal professional development, demonstrating team activity and impact, service planning, prescribing practice optimisation, and to identify education/training needs. This toolkit can be easily applied and adapted to other health organisations, settings and services.

Medication errors and omissions can potentially cause harm, prolong a hospital stay, lead to co-morbidities and even death. Pharmacy interventions (PI) ensure that these errors are identified and addressed, leading to improved patient safety and prescriber practice. Particularly in community hospitals, many only having general practitioners and not specialist doctors in their medical teams, PIs assume a strategic role. The PIs recorded throughout 8 months (between November 2021 and June 2022) in the community hospital wards in Powys, Wales, UK, using xPIRT (Pharmacy Intervention Recording Tool), a new pharmacy intervention record toolkit, were subjected to a retrospective analysis. The data were organised by location, drug, severity, acceptance, cost avoidance and intervention type. Significant prescribing errors were identified, which can potentially be different from those recorded in acute settings. Our results also informed on the need for integrated electronic prescribing systems paired with a PI recording tool to address effectively prescribing inaccuracies. Overall, this study was able to identify pharmacy teams as key to improve patient safety and care while contributing to significant cost-savings, through the recording of PI using xPIRT.

Purpose To explore parental experiences surrounding the diagnosis of their child's non-malignant life-limiting condition. Design and methods A qualitative descriptive study design using single-occasion one-to-one semi-structured interviews collected data from twenty-three parents of children diagnosed with non-malignant life-limiting conditions. Findings ‘Starting out in haziness’ was the central concept when parents' recounted the time they learnt of their child's diagnosis. Analysis revealed three main distinct but interconnected themes within this concept helping us better understand the experiences of parents at this particular time, those being: ‘Entering a whole new world’, ‘Acquiring a learner permit’ and ‘Navigating the unknown territory’. Conclusion Learning of their child's diagnosis was highly distressing for parents and was marked with emotional chaos. Parents' process of realization regarding the diagnosis was related to the diagnostic process. Information and communication needs should be individualized accordingly. The findings have implications for service provision, particularly with regard to how supportive care is delivered at this time.

This is the peer reviewed version of the following article: Price, J. (2021). Violence, control and restraint: The harms to young adults particularly upon transition. The Howard Journal of Crime and Justice, https://doi.org/10.1111/hojo.12418, which has been published in final form at https://doi.org/10.1111/hojo.12418. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Self-Archiving

Since 1982, children's hospices in the UK have provided services where families can care for their children at the end of life (EOL) in a less medicalised environment. More recently, the services of many children's hospices have extended to newborn babies and their families. This paper explores the experiences of three families (five parents) who availed of children's hospices services when their babies required a palliative approach to care. Early diagnosis of a life-limiting condition in pregnancy allowed advanced care planning and enabled parental participation in decision-making before birth. A homely environment, as well as constant support and a sensitive approach from expert staff encouraged parental involvement in all aspects of their baby's care whilst in hospice. Extended time with their baby after death enabled parents to feel connected with their infant. The holistic and family-centred approach to care from children's hospices is highly valued by parents of newborn babies.

In this paper, we present insights from the qualitative data collected during a process evaluation of a reading intervention project carried out in primary and secondary schools in West Yorkshire, ...

Drawing on empirical data from two individual research projects, this paper extends the literature on child and youth incarceration and offers a previously unexplored analysis of experiences and tr...

This article explores the experience of transitioning from youth offending services to adult probation services upon turning age 18 years while incarcerated. The significant differences in the level of provision have been described as a ‘cliff-edge’ (Transition to Adulthood Alliance (2009). Drawing upon interviews with young people held in institutions, stakeholders, and survey data from Her Majesty's Inspectorate of Prisons, it is argued that the drop in support is exacerbated by poor communication between institutions and services which has harmful implications for young people during this crucial period of developmental maturity and beyond custody.

BACKGROUND Children with non-malignant life-limiting conditions (NMLLCs) constitute the largest proportion of children requiring palliative care. In part, due to technological advances, growing numbers of such children are experiencing improved survival. Care is mostly provided at home by the family, with significant professional input at different points in the child's life trajectory. This study explored the experience of healthcare professionals caring for this cohort of children. METHODS A qualitative descriptive study design using single-occasion one-to-one semi-structured interviews collected data from 12 healthcare professionals' including nurses, social workers and doctors. Data were analysed using thematic analysis. RESULTS The findings highlighted the unfailing determination and dedication of healthcare professionals who provided care despite challenges with what seemed like 'with every fibre of their being'. Three key themes marked such strength and commitment; those were 'being there', 'being focused' and 'being strong'. 'Being there' explicitly highlighted expert care that was individualized and responsive to the child and family's unique needs. The provision of such care was often threatened and potentially compromised by the intricacies and challenges associated with children's palliative care (CPC) and service provision. 'Being focused' captured the sense that the healthcare professionals remained entirely focused on providing expert care despite these challenges. 'Being strong' epitomized the personal and professional impact on healthcare professionals who are working in this area and the manner in which they sustain themselves in 'being focused' and in 'being there'. CONCLUSIONS The healthcare professionals demonstrated their unwavering commitment to deliver quality care required by children and families, however against a background of issues relating to organizational constraints. The findings have implications for education/service providers such as the need for specific palliative care education at both pre-registration level and continuing professional development.

Hospice has been pivotal to children's palliative care provision in the United Kingdom (UK) for more than 3 decades. Some hospices have recently expanded to include care of infants transferred from neonatal units as well as antenatal referrals. Despite developments evidence suggests hospice care is often not offered to parents in neonatal units (NNU). This study examines perspectives of 17 staff from 3 children's hospices regarding the challenges and opportunities caring for infants in hospice. Data was collected from 3 focus groups and analysed using a thematic approach. Findings suggest that hospice staff juggle many complex issues when caring for infants at the end-of-life. Such issues centre round the referral process from hospital services borne from an apparent reluctance of hospital staff to let go, through involving hospice. Education, partnership working, planning for all possible outcomes seems crucial in further developing quality palliative care for infants and their families.

Parents of children with non-malignant life-limiting conditions frequently accept roles that exceed the conventional activities of parenting in relation to the intensity, complexity and temporal nature of the family caregiver experience. This paper explores the prevalent and all-consuming experiences of parents caring for their children. A qualitative descriptive study design was used. Twenty-three parents (both mothers and fathers) were interviewed. Transcribed interview data were analyzed using thematic analysis. ‘Managing an unexpected life’ was the central concept when parents recounted ongoing efforts to address the emotional and practical effects of their child’s condition on their life and that of their family. Analysis revealed three main distinct but interrelated themes within the concept of ‘Managing an unexpected life’ helping us enhance our understanding of parents’ experiences: ‘Striving for normality’, ‘Becoming the expert’ and ‘Fighting for your child’. Findings suggest that the central concept of ‘Managing an unexpected life’ appeared to be in keeping with a caregiver’s career. Findings likewise suggest the need for improved and focused support and services to enhance parents’ career caregiving.

Over the past 20 years, the number of children and young people with mental health issues has increased. During their clinical placements, children's nursing students often encounter such service users, as well as mothers with mental health issues such as postnatal depression. Many of these students have reported feeling inadequately prepared to meet the needs of these service users.To evaluate a service user-led workshop to improve the knowledge and confidence of children's nursing students in caring for children and young people with mental health issues.One university in the south of England ran an interactive workshop as part of a final-year module for BSc and MSc children's nursing students. The workshop was facilitated by service users who had experienced mental health issues. Questionnaires were administered before and after the workshop to collect data from students who attended, then quantitative and qualitative analyses of the data were conducted.This study found that children's nursing students gained knowledge and confidence in caring for children and young people with mental health issues after attending the workshop. Four themes were identified from the pre-questionnaire data: fear and anxiety; boundaries; mixed experiences; and learning on the job. The themes of boundaries and learning on the job were identified again in the post-questionnaire data, as well as the additional themes of 'being with, rather than doing' and 'further knowledge'.Service user involvement is an essential aspect of nurse education due to its positive and motivating effects on students. Future research could explore the optimal type of service user input required at different stages of nurse education, to ensure that it enhances the development of students' knowledge and confidence.

Death of an infant is acutely stressful for parents and professionals. Little is known about junior nurses' experiences providing end-of-life care in Neonatal units (NNU). This study aimed to better understand junior nurses' experiences providing end-of-life care in NNU. Neonatal nurses (n = 12) with less than 3 years experience participated in a focus group. Nominal Group Technique (NGT) was used to build consensus around the challenges faced, alongside suggested developments in improving future care provision. Primary analysis involved successive rounds of ranking and decision-making whilst secondary analysis involved thematic analysis. All issues, whether environmental, professional or social appeared driven by an awareness on the part of nurses, that there was no ‘second chance' which created a huge pressure to ‘get if right' for the infants and families. Regarding future care 2 areas of improvement identified were ‘Education and Training' and Support. This paper unpacks these findings making recommendations for practice.

Throughout the course of this book, it has been highlighted that palliative care has only recently been applied to the perinatal and neonatal population (TFSL, A guide to children’s palliative care: supporting babies, children and young people with life-limiting and life-threatening conditions and their families, Together for Short Lives, Bristol, 2018). In the developed world, more than 90% of neonatal deaths occur in hospital. Hospice care for infants has not yet been widely or consistently adopted. The reasons for this are not fully understood, but it may be caused by misconceptions about what it is, what it offers, and myths about hospice care. In this chapter, we examine the support available outside the neonatal unit within children’s hospices and how collaboration between hospices and neonatal units (NNUs) can assist in offering parental choice. This chapter will assist the reader to have a greater understanding of what hospice care can offer babies and their families in the strive for quality palliative care for each individual baby and family.

Background: Increasing numbers of young adults with life-limiting conditions are living into adulthood and consequently making the transition from children’s to adult services. A poorly planned transition is associated with adverse outcomes such as non-adherence to treatment and loss to follow-up, together with negative social and emotional outcomes, However, there is little descriptive data on how organisation are currently managing transition.Aim: To obtain an overview of organisational approaches to transition on the island of Ireland, and to explore important organisational factors that may influence the effectiveness of the process.Methods: A cross-sectional questionnaire survey. One of the four Health Services Executive areas in the Republic of Ireland and the whole of Northern Ireland. Participants were service providers in statutory and non-statutory organisations providing transition services to young adults with life-limiting conditions. Results: The survey was distributed to 55 organisations. The overall response rate was 29/55 (53%). The approach to transition most commonly used focused on interagency communication and collaboration. Key factors in an effective transition were reported as: early commencement; effective communication between the young adult, their family, and services; the availability of appropriate adult services; and effective preparation through collaboration with the young adult and their family. However, implementation of these processes was inconsistent.Conclusions: The findings demonstrate that caring for young adults with life-limiting conditions presents a considerable challenge to organisations and that transition from children’s to adult services is an important part of this challenge.

In 2010/12 an innovative children's palliative care interprofessional educational project funded by the Irish Hospice Foundation was undertaken in a University faculty (Trinity College Dublin). This initiative responded to international educational recommendations to meet the palliative care needs of children. The project involved the development and delivery of 3 standalone modules at Master's level and a substantive research evaluation of the project to examine stakeholders and students perspectives to provide an insight into their experiences and to gather data for future developments. The research evaluation was conducted in two parts, part one sought students' evaluation and part two sought stakeholders', curriculum developers and lecturers' feedback. This paper reports the students' evaluation. Findings indicate that students perceived undertaking the modules provided them with the opportunity for improved interprofessional learning and they found modular content and assessment challenging. They also found the modules met their educational needs and also promoted an awareness of interprofessional education and the collaborative teamwork involved in children's palliative care. These students already experienced in children's palliative care indicated that those teaching on programmes at this level need expertise and programme time needs to be available for sharing experiences and for consolidation of learning.

Background: Final-year children’s nursing students evaluated the content of their course and there was strong evidence they would benefit from supplementary teaching of safeguarding before qualification. Aim: To explore the potential for the arts to enable children’s nursing students to think critically and reflectively about the safeguarding of children and young people. Method: An action research approach was used, recruiting final-year children’s nursing students in one university in the south of England. Questionnaires containing open and closed questions were used to collect data after a field trip to see Matilda the Musical, followed by discussion boards. Findings: Data analysis indicated the use of the arts was a departure from traditional pedagogy, which was relished and described by the students as an interesting and exciting way of learning. Students highlighted how ‘seeing’ Matilda aided them later on the discussion boards to identify categories of abuse and correlate this with the effects of abuse. Conclusion: The use of musical theatre and discussion boards was beneficial to acquiring knowledge and bonding when delivering safeguarding teaching to final-year children’s nursing students.

There is a possibility that front-line services, particularly out-of-hours services, are not accessible to some parents. The aim of this service evaluation was to gain a better understanding about visits to one emergency department (ED) in the south of England by children and their parents or carers. The specific focus was to elucidate the reasons behind frequent ED attendance and indicate a potential redesign of services. Semi-structured interviews were conducted with 13 parents. The overarching theme emerging from the transcripts was parents’ complex decision-making to ensure their children’s healthcare needs were addressed. Parents highlighted the absence of consistent specialist community services to support them in caring for their children at home and to act as a resource for decision-making relating to their child’s care. Telephone and online information services such as NHS 111 were perceived as not always helpful. Parents were able to identify models of out-of-hours care which they saw as potentially more accessible and useful, such as the provision of a specialist paediatrician at GP surgeries. Further evaluation is necessary to make it possible to integrate parents’ views and needs into service design and delivery.

Children's nurses require a wide range of skills and knowledge to enable them to provide the best care for children and families, thus nurse educators must continually strive to ensure they create appropriate and meaningful learning for students in their journey to become children's nurses. Museum visits have been utilized previously within nurse education, but no evidence as to any added value of such visits on the learning of children's nursing students has been reported. This article highlights an innovative teaching strategy that was introduced to a group of year 1 children's nursing students-a field visit to the Museum of Childhood in London-and demonstrates the potential value to their learning. Students worked together in small groups within the museum exploring topics relevant to children's nursing. They had an opportunity to reflect and research further and then worked together to present their learning to their peers. Subsequent evaluation of both the visit and the presentation helped unravel the extent of student learning and highlighted that a range of different learning had taken place. Not without its challenges, the museum visit seemed to provide a meaningful learning experience for students, and suggestions for improving the learning for future similar groups have been explored.

Background Improvements in care and treatment have led to more young adults with life-limiting conditions living beyond childhood, necessitating a transition from children's to adult services. Given the lack of evidence on interventions to promote transition, it is important that those creating and evaluating interventions develop a theoretical understanding of how such complex interventions may work. Objectives To develop theory about the interventions, and organisational and human factors that help or hinder a successful transition from children’s to adult services, drawing on the experience, knowledge, and insights of young adults with life-limiting conditions, their parents/carers, and service providers. Design A realist evaluation using mixed methods with four phases of data collection in the island of Ireland. Phase one: a questionnaire survey of statutory and non-statutory organisations providing health, social and educational services to young adults making the transition from children’s to adult services in Northern Ireland and one Health Services Executive area in the Republic of Ireland. Phase two: interviews with eight young adults. Phase three: two focus groups with a total of ten parents/carers. Phase four: interviews with 17 service providers. Data were analysed seeking to explain the impact of services and interventions, and to identify organisational and human factors thought to influence the quality, safety and continuity of care. Results Eight interventions were identified as facilitating transition from children’s to adult services. The inter-relationships between these interventions supported two complementary models for successful transition. One focused on fostering a sense of confidence among adult service providers to manage the complex care of the young adult, and empowering providers to make the necessary preparations in terms of facilities and staff training. The other focused on the young adults, with service providers collaborating to develop an autonomous young adult, whilst actively involving parents/carers. These models interact in that a knowledgeable, confident young adult who is growing in decision-making abilities is best placed to take advantage of services – but only if those services are properly resourced and run by staff with appropriate skills. No single intervention or stakeholder group can guarantee a successful transition. Rather, service providers could work with young adults and their parents/carers to consider desired outcomes, and the range of interventions, in light of the organisational and human resources available in their context. This would allow them to supplement the organisational context where necessary and select interventions that are more likely to deliver outcomes in that context.

The death of a child is a life-altering event for parents, leading to grief that is individual, intense, and long lasting. The grief experienced by parents following the death of their child can affect their relationships and as they sometimes see it, their role within society. Parents can find grief isolating, due to society's lack of understanding of their grief experience. Gendered differences in grief reactions have also been noted. Theoretical understandings of bereavement, now acknowledge parental need "not to let go" but rather to reconstruct relationships with their deceased child in terms of a continuing bond. This narrative literature review draws together theory and research on the topic, highlighting current knowledge and suggesting ways in which children's nurses can support parents as they live through the loss of their child.

Parents caring for a child with a life threatening or life limiting illness experience a protracted and largely unknown journey, as they and their child oscillate somewhere between life and death. Using an interpretative qualitative approach, interviews were conducted with parents (n=25) of children who had died. Findings reveal parents’ experiences to be characterised by personal disorder and transformation as well as social marginalisation and disconnection. As such they confirm the validity of understanding these experiences as, fundamentally, one of liminality, in terms of both individual and collective response. In dissecting two inter-related dimensions of liminality, an underlying tension between how transition is subjectively experienced and how it is socially constructed is exposed. In particular, a structural failure to recognise the chronic nature of felt liminality can impede parents’ effective transition.

Aim To examine the perspectives of children's nurses about parental presence during resuscitation. Methods Semi-structured interviews were used to collect data from nine children's nurses, working in the same emergency department, followed by thematic analysis to identify common themes. Findings Nurses thought that parents had a negative effect on the ability of professionals caring for the child. However, they also recognised the negative effect parental absence can have on the grieving process. During resuscitation nurses struggle personally and professionally to decide whether parents should be present. Conclusion There is a lack of guidance available about how to manage parental presence at the resuscitation of the child. Experienced children's nurses were having to 'gauge it every time'.

This study examines first year children’s nursing students’ anxieties before their first practice placement and their support needs during that time. Strategies to address needs are highlighted. A questionnaire was completed by children’s nursing students (n = 21) before their initial practice placement to establish their expectations and concerns. A subgroup (n = 5) took part in a focus group following placement to establish consensus around the support that helped and what could help future students prepare for first placement. The resultant data indicated the importance of students having a sense of belonging to their practice placement, trusting website information, induction days, and the involvement of a more senior student in their preparation, in addition to facilitative mentors. Using similar methodology to that used with students, a subgroup of professional staff took part in two focus groups (FG1 n = 5, FG2 n = 4) to establish consensus around support initiatives using areas identified by students as priorities that could better facilitate this initial practice placement. Although commonalities existed within both students and professionals, some differences were highlighted. A student’s first practice placement is of utmost importance in affirming their choice to study nursing. Academic and clinical staff play a crucial part in this decision-making.

Aim This paper reports on parent and professional perspectives of step down care in assisting the transition from hospital to home, within one children's hospice in a constituent country of the United Kingdom. Background In recent years increasing numbers of children dependent on long term assisted ventilation have been noted. Meeting the complex physical, emotional and social needs of the child and family is challenging. Many of these children spend extended periods in hospital even when medically stable. Design This was a qualitative study using an inductive, semantic analytic approach within a realist epistemology. Methods Data collection was carried out in 2013. Interviews took place with parents (n=5) and focus groups with professionals (n=26) who had experience of step down care. Results/Findings Multiple benefits of step down in the hospice were clear. Both sets of accounts suggested that for children and families life was ‘on hold’ in hospital. Hospice was considered a home-like environment where the child and family could ‘live again’. Parents reflected that, in hospice they were ‘living, not existing’ while professionals highlighted hospice as nurturing and empowering the whole family, promoting the child's development while safely meeting their clinical needs. Conclusion and implications for practice The study highlights a number of crucial benefits to the child and family both in the immediate and longer terms. The collective perspectives therefore endorse hospice as a potential viable choice for these children and their families during the always difficult, usually protracted transition from hospital to home. This article is protected by copyright. All rights reserved.

BackgroundImprovements in care and treatment have led to more young adults with life-limiting conditions living beyond childhood, which means they must make the transition from children’s to adult services. This has proved a challenging process for both young adults and service providers, with complex transition interventions interacting in unpredictable ways with local contexts.ObjectivesTo explain how intervention processes interact with contextual factors to help transition from children’s to adult services for young adults with life-limiting conditions.DesignSystematic realist review of the literature.Data sourcesLiterature was sourced from four electronic databases: Embase, MEDLINE, Science Direct and Cochrane Library from January 1995 to April 2016. This was supplemented with a search in Google Scholar and articles sourced from reference lists of included papers.Review methodsData were extracted using an adapted standardised data extraction tool which included identifying information related to interventions, mechanisms, contextual influences and outcomes. Two reviewers assessed the relevance of papers based on the inclusion criteria. Methodological rigor was assessed using the relevant Critical Appraisal Skills Programme tools.Results78 articles were included in the review. Six interventions were identified related to an effective transition to adult services. Contextual factors include the need for children’s service providers to collaborate with adult service providers to prepare an environment with knowledgeable staff and adequate resources. Mechanisms triggered by the interventions include a sense of empowerment and agency amongst all stakeholders.ConclusionsEarly planning, collaboration between children’s and adult service providers, and a focus on increasing the young adults’ confidence in decision-making and engaging with adult services, are vital to a successful transition. Interventions should be tailored to their context and focused not only on organisational procedures but on equipping young adults, parents/carers and staff to engage with each other effectively.

Education is viewed as central to improving future palliative care for children and families across all countries. International education initiatives will ensure practitioners are aware of global health issues and can provide culturally sensitive care. Creative and innovative means of meeting such directives are required to achieve meaningful student learning. This paper focuses on one innovation, a children's palliative care workshop using case studies as a teaching method, with nursing students from the USA and nursing and midwifery students from the UK. Key learning points arising from student evaluation were recorded under three main themes, these were: differences across countries, similarities across countries, and making learning fun and memorable. Findings indicated that this joint learning activity was viewed positively by all students and has enabled them to learn with and from each other, potentially impacting on their future practice.

This article presents the findings of a qualitative research study that explored the experiences of part-time students who completed a BSc(Hons) trauma studies program in Northern Ireland. Data collection involved semistructured interviews with seven students. Findings indicated a journey through the program during which students experienced both challenges and opportunities for development. Such challenges included responses to emotive content and barriers to sharing in classroom-based dialogues. Moreover, participants felt the program enhanced their knowledge as well as the supportive services they provided to those who had experienced a trauma. Findings suggest that participants who had experienced a personal trauma appeared to be drawn to this program.

This paper presents a study that examines the potential value of a new and innovative inter-professional education (IPE) experience for final year midwifery and children's nursing students focused on improving awareness of end-of-life care for infants in conjunction with the support of their families. The study uses an action research approach to examine midwifery and children's nursing student experiences of an IPE initiative in developing knowledge regarding perinatal/neonatal palliative care. The setting is a Higher Education Institute in the South of England that included final year midwifery students (n = 39) and children's nursing students (n = 34) taking part in the study. Qualitative and quantitative data indicated that the IPE intervention had proven worth in developing knowledge and confidence in the students as both student groupings felt they lacked knowledge and confidence about perinatal/neonatal palliative care before attending the study day. Students felt that learning with, from and about the other profession represented was important in generating their knowledge. Educators should explore innovative ways to enable the further development of the fledgling speciality of perinatal/neonatal palliative care through education on an interprofessional platform.

Parenting a child with complex health/palliative care needs is wide ranging. Family-centred practices place parents at the heart of the ongoing care of these children, and therefore it makes sense that their views and experiences should be central to research within the field. Despite this assertion, little guidance exists as to how best to involve parents in research and how to address the subsequent complexities that can emerge following involvement. This paper draws on the experiences of two children's nurses who have carried out qualitative doctoral research studies in child healthcare. Each study involved data collection using in-depth interviews with parents who were caring, or had cared, for their child. One study involved caring for a child with complex needs and the other bereaved parents who had cared for their child at the end of life. Based on the experiences of completing these studies, some of the practical and ethical issues inherent in carrying out research with parents will be discussed. ...

This article reports on an empirical study of the expertise that different professionals develop in working together to safeguard children. The research involved three key professional groups who work with children: nursing, teaching, and social work. The methodology used a clinical scenario and critical incident to explore professional perspectives and experiences of collaboration. Data collection was via semi-structured interviews with a sample of 18 practitioners, composed of pre- and post-qualifying practitioners from each professional group. Data analysis was undertaken through an inductive process, with open coding of transcripts followed by the synthesis of themes into a qualitative framework. The findings identified different elements of interprofessional expertise including assessment and decision-making, responsibility, risk and uncertainty, managing relationships, and dealing with conflict and difficulty. Collaborative activity was found to be shaped by the threshold between statutory and non-statutory services and mediated by the relationship between practitioners and parents. The article concludes by exploring constraints and opportunities for addressing potential gaps in interprofessional expertise in this area.

Objective To examine the experiences of bereaved parents concerning the care provided to children who died from cancer compared to those who died from a non-malignant condition.\ud \ud Design An in-depth qualitative study with bereaved parents of children who died as a result of a life-limiting diagnosis, recruited through two regional centres.\ud \ud Results Although parents' accounts displayed commonalities, key differences were discernible. Typically, parents of children with cancer considered care at the end of life as well resourced and responsive to their and their child's needs. In contrast, parents of children with non-malignant conditions reported under-resourced and inadequately responsive services. Although both groups of parents called extensively on military metaphors such as ‘battle’, ‘fight’ and ‘struggle’, the focus of their respective energies was different. In the one case the adversary was disease and illness; in the other it was service providers and service provision.\ud \ud Conclusions Community-based services for children and young people with cancer at the end of life were perceived by parents as responsive to parent and child needs. Conversely, community services for children and young people with non-malignant conditions were experienced as ad hoc and under-resourced. Community services for children with non-malignant conditions may require further development if they are to meet the levels of support offered to parents of children with cancer. If improvement is to be achieved, the need to raise awareness regarding hospice services, hospice referral and eligibility criteria across the entire gamut of service providers is essential.

This article presents a narrative literature review of the psychosocial impact on family life of caring for a child diagnosed with cystic fibrosis. Diagnosis of long-term illness in a child causes major upheaval in the lives of both the child and family. Normal family life is often emotionally, socially, physically and financially disrupted. Amid such disruption, parents attempt to cope by creating a semblance of order in their lifestyle. Within an interdisciplinary approach to caring, the children's nurse plays a pivotal role in supporting families to establish such order and reconstruct their lives, while coming to terms with the knowledge that their child could die prematurely. In addition, the nurse, in his/her role as teacher and educator, empowers parents, children and young people with the knowledge to make informed decisions and assists parents in developing the skills (often technical) to care for their child. Cystic fibrosis is one such condition in childhood, and this article explores the main psychosocial issues experienced by families caring for their child following diagnosis of CF, as raised in the literature.

Palliative care nursing practice can be enhanced if the clinical judgements made in applying palliative care philosophy to individual situations are critically examined and challenged. A model of reflection developed specifically for children's palliative care practice is illustrated here using a critical incident in which the parents of a child with complex disabilities were helped to reduce their caring role and accept increased support. As a result of the structured reflection, the importance of assessing for signs of stress in parents and the wider family was recognised. Additionally, the need for more research specific to the needs of families with more than one child with life-limiting illness was identified as a mechanism for improving the quality of care delivered.

Historically midwives may have not considered palliative care as a part of their professional role. Enhanced technologies and antenatal screening have broadened the boundaries of care. However do midwives truly embrace the philosophy of palliative care into their practice? This paper presents the discussion round a case study that demonstrates the evolving area of advanced practice: perinatal palliative care. What we highlight is that midwives in fact have an important collaborative role to play in ensuring that palliative care for the baby and family starts as soon as a life-limiting condition is recognised, thus ensuring best care and support are provided for those parents and families for whom pregnancy sadly leads to palliative care. Five key lessons for practice are outlined.

To examine the perspectives of children's nurses about parental presence during resuscitation.Semi-structured interviews were used to collect data from nine children's nurses, working in the same emergency department, followed by thematic analysis to identify common themes.Nurses thought that parents had a negative effect on the ability of professionals caring for the child. However, they also recognised the negative effect parental absence can have on the grieving process. During resuscitation nurses struggle personally and professionally to decide whether parents should be present.There is a lack of guidance available about how to manage parental presence at the resuscitation of the child. Experienced children's nurses were having to 'gauge it every time'.