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AnteayerInternacionales

Nurses' Experience of Redeployment to a New Intermediate Care Unit for Respiratory Patients: A Qualitative Study

ABSTRACT

Aim

To explore the experiences of nurses transitioning from a clinical ward to a newly established respiratory intermediate care unit (IMCU).

Design

A qualitative descriptive approach was adopted to capture the lived experiences of redeployed nurses. This design was selected to address the research question: What are the initial experiences of nurses transitioning from general ward settings to a newly established IMCU for respiratory patients?

Methods

Two focus groups were conducted in June 2024, involving 14 purposefully selected registered nurses. Data were analysed using Braun and Clarke's thematic analysis framework, with the study reported in line with the Standards for Reporting Qualitative Research.

Results

The analysis revealed two interconnected themes reflecting the complexity of the redeployment experience. The first theme, ‘The introspection of waiting amidst change and readiness’, captures the emotional ambivalence nurses felt, characterised by anticipation, uncertainty and a perceived lack of preparedness. This phase was marked by concerns over clinical competence, fear of errors and the weight of new legal and ethical responsibilities. The second theme, ‘The road to organizational change with both driving forces and obstacles’, highlights nurses' concerns about physician readiness, feeling undervalued and limited involvement in planning. At the same time, nurses emphasised the importance of teamwork, structured preparation, experiential training and having the right equipment.

Conclusion

The study underscores the complexity of role transitions for nurses moving into semi-critical care settings like IMCUs. It reveals the need for targeted support strategies to reduce uncertainty and enhance role readiness.

Implications for the Profession and Patient Care

To improve the redeployment experience and patient outcomes, healthcare organisations should prioritise structured training, tailored preceptorship programmes and inclusive decision-making processes. These measures can strengthen nurses' resilience, support workforce sustainability and ensure the delivery of high-quality, patient-centred care in intermediate care environments.

Impact

This study highlights the significant impact of inadequate preparation and communication on redeployed nurses' experiences in respiratory IMCUs, emphasising the need for structured training and supportive team dynamics. These findings can guide healthcare leaders, nurse managers and policymakers in developing evidence-based redeployment strategies that reduce anxiety, strengthen team cohesion and ultimately improve nurse adaptation and patient care in semi-critical settings.

Reporting Method

We used the SRQR guidelines for reporting qualitative studies.

Patient or Public Contribution

No patient or public contribution.

Factors Associated with Advance Care Planning Engagement Among Community‐Dwelling Older Adults: A Cross‐Sectional Study

ABSTRACT

Aim

To explore the associations between depression, anxiety, decisional conflict and advance care planning engagement and the potential mediating role of decisional conflict in the associations between depression, anxiety and advance care planning among community-dwelling older adults.

Design

A cross-sectional study was conducted with 262 community-dwelling older Australians across metropolitan, regional and rural communities between August and October 2022.

Methods

Validated self-reported questions were used to collect data on anxiety, depression (Hospital Anxiety and Depression Scale), decisional conflict (Decisional Conflict Scale), advance care planning engagement (Advance Care Planning Engagement Survey) and covariates (demographic characteristics, health literacy [Health Literacy Screening Questions]), overall health status (Short form 36). Data analysis included descriptive statistics, bivariate association analysis, general linear modelling and path analysis.

Results

Anxiety and decisional conflict were directly associated with advance care planning engagement even after controlling for potential effects of demographic characteristics, health literacy and overall health status. The model, including age, gender, country of birth, language spoken at home, education, overall health status, anxiety, depression, decisional conflict and interaction between anxiety and decisional conflict, explained 24.3% of the variance in their advance care planning engagement. Decisional conflict mediated the association between anxiety and advance care planning engagement.

Conclusion

Increased anxiety and decisional conflict were associated with reduced advance care planning engagement directly, even among community-dwelling older adults with higher levels of education and health literacy. Increased anxiety was associated with reduced advance care planning engagement indirectly via increased decisional conflict. Healthcare professionals should assess community-dwelling older adults' anxiety and implement interventions to manage their anxiety and decisional conflict, as these may facilitate their engagement in advance care planning.

Impact

Understanding factors associated with advance care planning engagement among community-dwelling older adults may inform strategies facilitating their future engagement in advance care planning. Findings from this study may be used as evidence for future implementation to facilitate the engagement of community-dwelling older adults in advance care planning.

Reporting Method

The STROBE statement checklist was used as a guide to writing the manuscript.

Patient or Public Contribution

The study was advertised publicly through social media (e.g. Twitter and Facebook) and newsletters (e.g. Advance Care Planning Australia, Centre for Volunteering, Palliative Care Australia and a large home care service provider with approximately 7000 older clients receiving support or services) to recruit participants. People aged 65 years and older living independently in the Australian community who could communicate in English were invited to participate and answer the questionnaire.

Nurse‐Led/Involved Home‐Based Interventions for Older Adults With Chronic Obstructive Pulmonary Disease (COPD): A Mixed‐Methods Systematic Review

ABSTRACT

Aims

To determine the effectiveness of nurse-led/involved home-based interventions for older people with COPD and to explore the experiences of older people and nurses with the interventions.

Design

A mixed-methods systematic review following the JBI methodology for mixed-methods systematic reviews.

Data Sources

The search included relevant and peer-reviewed studies published from January 2010 to December 2023 in CINAHL, MEDLINE, Cochrane Central Register of Controlled Trials, PsycINFO, EMBASE, JBI, EMCARE and ProQuest.

Review Methods

English-language reports of nurse-led/involved home-based interventions for people with COPD were included based on authors’ consensus. Three reviewers performed independent quality appraisal using JBI tools. A convergent segregated approach was used for data synthesis and integration.

Results

Seven interventions were identified in two mixed-methods, two qualitative, two quasi-experimental studies, and one secondary analysis from a randomised control trial. The effectiveness of the interventions was measured with various outcomes and was effective to some extent, with reduced hospitalisation, hospitalisation days, hospitalisation cost and all-paid claims. However, the outcomes were not statistically significant, and the effectiveness was inconclusive. While patients appreciated support and resources, some perceived them as a double-edged sword.

Conclusions

Patients preferred more holistic interventions over extended periods. The inconclusive findings and limitations warrant further research with larger sample sizes and comparable measurement tools and outcomes.

Impact

This is the first mixed-methods systematic review on the effectiveness of home interventions for people with COPD with a clear definition of ‘nurse-led’. Nurses felt highly valued by patients and other health professionals; however, they reported a lack of support from management. The lack of interventions led by nurses challenges them to lead, deliver and evaluate what matters to people with COPD.

Reporting Method

This systematic review was reported in accordance with the Referred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.

Patient or Public Contribution

Not applicable.

Nurse Educators' Background, Education, and Experience in Digital Competence Profiles: A Descriptive Comparative Cross‐Sectional Study in Four Countries

ABSTRACT

Aim

To identify and compare the digital competence profiles of nurse educators, the background variables associated with profiles, and the self-assessed level of digital competence in four European countries.

Design

A descriptive comparative cross-sectional study.

Methods

Data were collected from nurse educators (n = 263) in 36 nursing education organisations in Finland, Malta, Slovakia and Spain. Partitioning around medoids (PAM) clustering was used to identify competence groups, and descriptive and inferential statistics were used to examine the association of nurse educators' background variables.

Results

The clustering analysis resulted in two nurse educator digital competence profile groups: high and moderate. The profiles differed based on completed pedagogical studies and teaching experience, with an emphasis on the high competence profile. Educators in the high competence profile group showed greater interest in using educational technology and self assessed their digital competence at a higher level compared to educators in the moderate competence profile group. Nurse educators' lowest digital competence was in the safe and responsible use of technology, such as knowing copyright laws.

Conclusion

Despite the heterogeneous background of nurse educators, international continuing professional development needs in digital competence are identified. Nurse educators' continuing education should support the utilisation of technology through pedagogical approaches, and educators' competence in the safe and responsible use of technology (e.g., how to protect digital materials) must be enhanced in nursing education organisations.

Implications for the Profession

This study highlights the need to further develop nurse educators' digital competence. Continuing professional development should target preparation in safe and responsible technology use and include pedagogical studies and mentoring from experienced peers.

Reporting Method

The STROBE checklist was adhered to in reporting the results.

Patient or Public Contribution

Each participating educational organisation assigned a contact person to distribute the survey to the nurse educators.

Thriving in Nursing Work: The Association Between Self‐Reports and Biomarkers of Stress, Inflammation and Neuroplasticity

ABSTRACT

Aim

To examine whether self-reported thriving at work is associated with biomarkers of stress, inflammation, neuroplasticity and neurodegeneration in nurses.

Design

A cross-sectional study.

Methods

An online questionnaire measuring thriving at work was administered to nurses in a teaching hospital in Michigan, U.S. over 5 weeks in 2024. A subsample of 100 questionnaire respondents provided blood samples for biomarker analysis. Multiple regression was used to identify self-reported and biomarker predictors of nurse thriving. Cluster analysis was used to distinguish between nurses with high and low levels of thriving based on a combination of self-report and biomarker data.

Results

Higher self-reports of individual and work-related resources predicted higher thriving. Cortisol, a stress hormone, was significantly and inversely associated with thriving. No blood-based biomarkers of inflammation or neuroplasticity predicted thriving. Neurofilament light chain, a marker of neurodegeneration, was not a direct predictor but modified the effects of interpersonal and work resources on thriving.

Conclusion

Biological markers do play a role in nurses' thriving at work and may contribute important complementary information to that provided by nurse self-reports.

Implications for the Profession and/or Patient Care

Nurses thrive in a work situation characterised by positive reports of individual, interpersonal and work resources and lower levels of stress. Efforts to enhance thriving could positively impact nurses' well-being and conditions for providing high-quality patient care.

Impact

This study addressed the question of whether self-reported thriving at work among nurses is reflected in biomarkers of stress, inflammation, and neurocognitive health. A profile of high self-reported work-related resources and low cortisol distinguished higher levels of nurses' thriving from lower levels. Organisational efforts to enhance nurses' thriving can positively impact nurses' health, their work environment, and patient care.

Reporting Method

We followed the STROBE checklist in reporting this study.

Patient or Public Contribution

No Patient or public contribution.

Nursing Perspectives on Factors That Influence Provision of Patient‐Centered Care for Autistic Patients in a Large Urban Hospital System: A Qualitative Study

ABSTRACT

Aim

To characterise nurses' perspectives on factors that influence their ability to provide patient-centered nursing care for autistic patients in a large urban hospital setting.

Design

Qualitative exploratory study.

Methods

We conducted semi-structured interviews via Zoom with nurses from a large urban hospital serving primarily adult patients. We analysed interviews using codebook/template analysis. Two researchers coded each interview and resolved discrepancies through discussion.

Results

Twelve nurses (3 males) with 2–20 years of professional experience across research, management, and patient care roles were interviewed. Three primary themes were generated: (1) barriers to patient-centered care, including lack of formal autism education, factors related to the hospital setting, and specific nurse characteristics, such as inflexible adherence to care routines; (2) facilitators of patient-centered care, including experiential autism knowledge, caregiver involvement, and specific nurse characteristics, such as showing respect for all patients; and (3) missed opportunities for patient-centered care, including underuse of behavioural care teams, inadequate time for planning and preparation, and reliance upon restraints and security personnel for behaviour management.

Conclusion

Nurses identified several areas where consistent implementation of existing processes could improve care. A key finding was the need to explore more patient-centered alternatives to the use of restraints and security personnel in response to aggressive or self-injurious behaviour. Overall, our results support the need for competency training to facilitate increased nursing comfort and ability to provide patient-centered care for autistic patients.

Implications for the Profession

This work suggests nurses gain much of their autism-related knowledge through patient care experiences. Despite providing the majority of hands-on care, nurses receive little to no formal training about caring for the growing autistic population.

Impact

This work has identified targeted areas to improve education and processes in caring for autistic patients.

Patient or Public Contribution

No patient or public contribution.

A Primer of Data Cleaning in Quantitative Research: Handling Missing Values and Outliers

ABSTRACT

Aims

This paper discusses data errors and offers guidance on data cleaning techniques, with a particular focus on handling missing values and outliers in quantitative datasets.

Design and Methods

Methodological discussion.

Results

This paper provides an overview of various techniques for identifying and addressing data anomalies, which can arise from incomplete, noisy, and inconsistent data. These anomalies can significantly affect data quality, leading to biased model parameter estimates and evidence-based decisions. Data cleaning, particularly the appropriate handling of missing values and outliers, is essential to improving data quality before analysis. Data cleaning includes screening for anomalies, diagnosing errors, and applying appropriate corrective measures.

Conclusion

Proper handling of missing values and the identification and correction of outliers are crucial aspects of data cleaning in ensuring data quality and the reliability of statistical analyses. Effective data cleaning enhances the validity and accuracy of research findings for evidence-based decision making that leads to optimal patient outcomes.

Implications for the Profession

The quality of study results depends on how a dataset and its complexities are processed or handled before the analysis. Nursing researchers must use a framework to identify and address important data anomalies and produce reliable results.

Impact

This paper describes data cleaning, often overlooked during the data mining process, as a crucial step before conducting data analysis. By addressing missing values and outliers, identifying and fixing data anomalies, and enhancing data quality prior to analysis, data cleaning techniques can produce precise research findings for evidence-based decision making.

Reporting Method

In this methodological paper, no new data were generated.

Patient or Public Contribution

No patient or public contribution.

Challenges of Cross‐Cultural Validation of Clinical Assessment Measures: A Practical Introduction

ABSTRACT

Aims

This paper explores the methodological challenges associated with cross-cultural validation of clinical assessment measures and proposes strategies to enhance the validity and reliability of these assessments.

Design and Methods

Methodological discussion.

Results

Three main phases require consideration in the cross-cultural validation of assessment instruments: (1) Linguistic translation of the assessment instrument and confirmation of its equivalence, which includes conceptual, item, semantic and operational equivalence; (2) Empirical validation of the translated version's accuracy; (3) Adjusting the scores to fit the cultural context.

Conclusion

Achieving cross-cultural equivalence of assessment instruments is a complex and challenging process that can only be achieved through methodological rigour. It requires interdisciplinary collaboration of both linguistic and subject experts with strong statistical knowledge and a willingness to explore the nuances of the target population. By enhancing methodological rigour, we can improve the validity of clinical assessment measures across cultures, ultimately leading to better health outcomes for diverse populations.

Implications for the Profession

The implications of cross-cultural validation of clinical assessment measures/tools for nursing are significant and multifaceted. Overcoming challenges to cross-cultural validation contributes to the professional growth of nurses by equipping them with greater cultural awareness and confidence in the tools' reliability for patient assessment and evaluation. This not only aids in their clinical practice but also fosters a commitment to evidence-based practice, enhancing their overall effectiveness as healthcare providers. Reliable and valid assessment tools enable nurses to confidently engage in research literature that reflects the realities of diverse populations. This can inform healthcare policies and practices, ensuring they are inclusive and equitable.

Impact

While researchers endeavour to reach a consensus on the definition of cross-cultural equivalence and how it should be determined, this practical introduction discusses challenges and proposes strategies to enhance the validity and reliability of these measures/tools.

Patient or Public Contribution

No patient or public contribution.

Investigating Person‐Centred Care Planning in Care Homes Across England: An Exploratory Study of Practices and Contextual Factors

ABSTRACT

Aims

To report how person-centred care principles are applied to care planning and to explore the contextual factors affecting their implementation in older adult care homes in England.

Design

A combined framework analysis and quantitative content analysis study.

Methods

Using a semi-structured questionnaire, we interviewed 22 care home managers in England, exploring topics around care planning processes. Audio recordings were transcribed verbatim. Transcripts were analysed through a combined framework approach and content analysis.

Results

Most care home managers discussed person-centred care planning in terms of understanding residents' values and preferences and their engagement in decision-making. Factors facilitating person-centred planning implementation included accessible planning tools, supportive care home leadership, effective communication and collaborative partnerships. Inhibiting factors included regulatory and care practice misalignment, time constraints and adverse staffing conditions.

Conclusion

Differences between care home practitioners' understanding and practice of person-centred care planning require further examination to improve understanding of the sector's complexity and to develop suitable care planning instruments.

Implications for the Profession

Findings demonstrate a need for improved staff access to specialised person-centred care training and an opportunity for care home nursing practitioners to lead the co-development of digital person-centred care planning tools that reflect the reality of long-term care settings.

Impact

Identifying factors influencing the implementation of holistic approaches to care planning makes clear the need for modernising long-term care policy and practice to adapt to the contemporary challenges of the care home sector.

Reporting Method

Study reporting was guided by the Standards for Reporting Qualitative Research.

Patient or Public Contribution

Two public involvement advisors with lived experience of caring for a relative living in a care home contributed to the development of the interview guide, advised on care home engagement, guided the interpretation of the findings and commented on the drafted manuscript.

Development and Psychometric Evaluation of the Thriving in Nursing Questionnaire (THINQ)

ABSTRACT

Aim

To develop and evaluate a questionnaire for measuring factors that contribute to thriving at work among nurses.

Design

A cross-sectional study.

Methods

An online questionnaire was administered in March 2024 to nurses in a community teaching hospital in Michigan, US. Questionnaire content was based on a literature search and was pilot tested among nursing professionals within the hospital system. Questionnaire factor structure was examined with exploratory and confirmatory factor analyses with split-half sample validation.

Results

Based on exploratory and confirmatory factor analysis, a three-factor solution presented the best model, with factors comprised of 15 items measuring individual resources (3 items), work resources (6 items) and interpersonal aspects of the nursing work environment (6 items). Reliability estimates for all three factors exceeded 0.80, indicating good internal homogeneity. The questionnaire also demonstrated acceptable split-half validity and reliability.

Conclusion

The questionnaire presented here provides a potentially useful tool for measuring and evaluating thriving at work among nurses.

Implications for the Profession and/or Patient Care

A better understanding of factors that enhance nurse thriving would lay the foundation for targeted interventions aimed at improving the nursing work environment and nurse well-being. Enhancing nurse thriving could have a potentially positive impact on patient care.

Impact

This study addressed the need to understand factors that contribute to thriving in nursing work. The questionnaire that was developed revealed a three-factor solution measuring individual nurse resources, work environment resources and work interpersonal resources. By measuring thriving among nurses, hospitals and other healthcare organisations are taking an important first step in identifying interventions to enhance the nursing work environment, nurse well-being and potentially the quality of patient care.

Reporting Method

We followed the STROBE checklist in reporting this study.

No patient or public contribution.

Dyadic Patterns of Patient and Caregiver Engagement in Type 2 Diabetes Mellitus Care: A Multicenter Observational Study

ABSTRACT

Aim

To identify patterns of dyadic engagement in type 2 diabetes care, describe their characteristics, and explore their association with glycated haemoglobin.

Background

In chronic conditions, patient self-care and caregiver contribution should be considered a dyadic phenomenon. However, patterns of dyadic engagement in type 2 diabetes care have not yet been identified.

Design

Multicentre observational cross-sectional study.

Methods

Patient self-care and caregiver contribution were assessed using the Self-Care of Diabetes Inventory and the Caregiver Contribution to Self-Care of Diabetes Inventory. Patterns of dyadic engagement in type 2 diabetes care were identified by latent class analysis. Associations between patient-caregiver characteristics and class membership were estimated using multinomial regression. The association between classes and glycated haemoglobin levels was assessed using linear regression.

Results

251 dyads of patients with type 2 diabetes and their primary informal caregivers were enrolled. Patients were mostly male (55%, median age 72) and caregivers mostly female (71%, median age 64). Three patterns of dyadic engagement were identified: ‘equally engaged-low care’ (14%), ‘mostly patient engaged-middling care’ (25%), and ‘equally engaged-high care’ (61%). Patient characteristics (sex, education, self-efficacy) and caregiver characteristics (burden, chronic diseases) were associated with pattern membership. Membership in the ‘mostly patient engaged-middling care’ and ‘equally engaged-high care’ patterns was associated with decreased glycated haemoglobin compared to ‘equally engaged-low care’.

Conclusion

The three identified patterns of dyadic engagement in type 2 diabetes showed differences in patient and caregiver characteristics and were associated with glycated haemoglobin.

Impact

The study identified and described patterns of dyadic engagement in type 2 diabetes care. The three identified patterns showed differences in characteristics and in patient glycemic control. Healthcare professionals should consider these patterns for tailoring interventions focused on both dyad members.

Reporting Method

STROBE checklist was followed.

Patient Contribution

Patients and their informal caregivers were recruited to participate in the study.

Examining Stroke Symptom Messages Implemented Globally: A Need for Contextually Relevant Stroke Symptom Messaging

ABSTRACT

Background

Stroke is a global health concern. A timely response to a stroke can help reduce morbidity and mortality. However, barriers to timely response include poor recognition of stroke symptoms. Stroke symptom messages are designed to increase stroke recognition and encourage individuals to seek urgent medical assistance. The Face, Arm, Speech, Time (FAST) and Balance, Eyes, Face, Arm, Speech, Time (BE FAST) are commonly used stroke symptom messages shown to improve stroke symptom recognition and response. However, cultural factors and language differences may limit the effectiveness of stroke symptom messages and their acceptability in different countries and contexts. There has not been a comprehensive examination of the stroke symptom messages used worldwide and how these messages have been adapted in various settings.

Aims

We explored what stroke response messages are being used globally, and the contextual factors that influence the adoption of a stroke response mnemonic in different settings.

Methods

A 14-item survey was disseminated by the World Stroke Organization to its networks. The survey contained open- and closed-ended questions and allowed uploading relevant stroke symptom campaign materials. The survey was analyzed using descriptive statistics and a content analysis.

Results

All except one survey respondent used a stroke symptom message. Fifteen respondents (27%) reported they did not translate their stroke awareness messaging. Of these 15 respondents, they used the English versions of FAST (n = 8), BE FAST (n = 4), and both FAST and BE FAST (n = 3). Forty respondents (71%) reported that they/their organization used an acronym to raise public awareness of the signs/symptoms of stroke that was different from FAST or BE FAST (English), many of which were direct or indirect translations or influenced by FAST and BE FAST. Survey responses shared insights and recommendations related to the content, tailoring and dissemination of stroke symptom messages.

Conclusions

Study findings highlight the global use of stroke symptom messages and their contextual adaptations to fit diverse settings and contexts. The challenges in applying universal or commonly used stroke symptom messages to different contexts were highlighted.

Clinical Relevance

Nurses could have a key role in raising awareness of stroke symptoms and the development of locally adapted stroke symptom messages.

Co‐Designing Storyboards for Multimedia Resources With Informal Carers to Support Hospital‐to‐Home Transitions for Older Adults From Culturally Diverse Backgrounds

ABSTRACT

Aim

To co-develop storyboards and scripts for multimedia resources to support the information needs of informal carers (carers) of older adults from Greek, Italian and Chinese (Cantonese- and Mandarin-speaking) Australian backgrounds during hospital-to-home transitions.

Methodology

A modified experience-based co-design methodology was used to co-develop four storyboards and scripts with Greek, Italian and Chinese Australian carers and advocates from multicultural community-aged care organisations. To promote relevance, a Carer Advisory Group guided the research. The Carer Advisory Group, comprising 10 people, included carers and advocates from participating multicultural community-aged care organisations, a social worker from a large public health service, and policy representatives. Twenty-nine participants took part from June 2023 to April 2024. Data collection involved two rounds of co-development including 2 workshops, 9 small group interviews and 11 individual interviews. Round 1 focused on understanding participants' experiences of older adult care transitions, information needs and advice for other carers. This information was used to develop categories and example quotes to draft four storyboards reflecting participants' descriptions of the carer and patient journey during care transitions. Round 2 involved draft storyboards being presented to the same participants who advised on their acceptability. Certified interpreters and translators were used throughout data collection.

Findings

The co-developed categories, four storyboards and scripts are presented. Participants and the Carer Advisory Group agreed that the findings would be used to develop multimedia resources to support the information needs of carers and older adults from Greek, Italian and Chinese Australian backgrounds in care transitions.

Conclusions and Implications

The storyboards and scripts for multimedia resources are expected to improve access to information and services for carers and older adults from culturally and linguistically diverse backgrounds. The storyboards and scripts are examples to guide policymakers and leaders in improving transitional care in Australia and internationally.

Reporting Method

The reporting of the study has adhered to the COREQ guidelines.

Patient or Public Contribution

Informal carers were involved in the Carer Advisory Group which provided guidance and consultation to each phase of the project. Their contributions included reviewing the ethics application prior to submission for ethical review, and reviewing storyboards and scripts to optimise the relevance for informal carers and older adults.

Placement Poverty and the Politics of Nursing Education

Journal of Advanced Nursing, Volume 82, Issue 2, Page 980-983, February 2026.

Beyond clinical trials: Extending the role of the clinical research nurse into social care and homeless research

Abstract

Aim

Clinical research nurses work at the fulcrum of clinical trials with clearly defined roles and responsibilities. In England, the National Institute for Health Research (the main funder of health research) has broadened its scope to encompass social care research. The expectation is that clinical research nurses will expand their skill set to support these new studies, many of which will employ qualitative and mixed methods. This discussion paper explores the challenges of facilitating this clinical academic workforce development through a case study of a homeless health and social care research project. This was one of the first studies to engage clinical research nurses in this new and expanded role.

Background

Much of what is known about the research nurse workforce has been generated through studies of clinical trials in oncology. The ‘caring-recruiting’ dichotomy has been used as a heuristic device for identifying workforce issues that can impact on study delivery such as how intense pressure to recruit study participants leads to low job satisfaction.

Design

This case study reflects on the authors' experiences of employing a clinical research nurse in a social care research project concerned with the discharge of homeless people from hospital. The ‘caring-recruiting’ dichotomy is used to generate new information about the relationship between workforce development and the successful delivery of social care research.

Conclusion

The case study illuminates how social care research can generate different pressures and ethical challenges for research nurses. The time and skill it took to recruit study participants identified as ‘hard to reach’ was suggestive of the need to move beyond performance measures that prioritise recruitment metrics. The need for different types of staff supervision and training was also warranted as supporting study participants who were homeless was often distressing, leading to professional boundary issues.

Relevance to workforce development

This study highlights that performance management, training and supervisory arrangements must be tailored to the characteristics of each new study coming onto the portfolio to ensure research nurses are fully supported in this new and expanded role.

COVID‐19 preparedness in aged care: A qualitative study exploring residential aged care facility managers experiences planning for a pandemic

Abstract

Aims and Objectives

The study aims to understand the changing context of RACFs and the role of RACF managers in preparing to confront the COVID-19 pandemic and to provide insights into how the use of visual telehealth consultation might be incorporated to assist with managing whatever might arise.

Design

An interpretive descriptive study design was employed, and data were collected using semi-structured interviews conducted via telephone or videoconference. Purposive recruitment targeted clinical managers responsible for the COVID-19 response in RACFs.

Methods

RACF clinical managers were invited to discuss their responses to COVID-19 including the management of RACF and staff. Semi-structured interviews explored the COVID-19-related challenges, the response to these challenges and how telehealth might assist in overcoming some of these challenges. This study followed Thorne's (2008) three-stage process of interpretive description. The COREQ checklist was used in preparing this manuscript.

Results

Two main themes were identified. The first theme ‘keeping people safe’ was comprised of three subthemes; fear and uncertainty, managing the risks and retaining and recruiting staff. The second theme was ‘keeping people connected’, had two subthemes; being disconnected and isolated and embracing technology.

Conclusion

Findings from this study provide valuable insight into understanding the context and the challenges for RACFs and the staff as they attempt to keep residents safe and connected with healthcare providers and the outside world.

Relevance to Clinical Practice

Understanding the experiences of RACF managers in preparing to respond to the pandemic will better inform practice development in aged care in particular the use of telehealth and safe practices during COVID-19. Increased awareness of the challenges faced by RACFs during a pandemic provides policymakers with valuable insights for future planning of pandemic responses.

Magnetism in Nursing Education: A Qualitative Embedded Case Study of High‐Applicant Nursing Programs Amid a National Decline

ABSTRACT

Aims

To describe the factors that characterise nursing programs that continue to attract a high number of applicants even though the total number of applicants is declining.

Design

A qualitative embedded case study in Italy on 2025.

Methods

A purposive sample of four undergraduate nursing programs for which there were more applicants than places in the last three academic years, compared to the rest of the macro-region, where an average ratio of 0.8 applicants/place was documented. Key informants (dean, clinical practice coordinator, nurse educators, students) from each program were involved. A semi-structured, open-ended interview was conducted focusing on the factors that make the identified nursing programs attractive. The recorded interviews (n = 19) were analysed thematically by triangulating the data. A member check was also conducted.

Results

Five factors make a nursing program attractive: (1) the strategic location of the university, (2) the reputation and influence of the nursing program, (3) the structured, innovative, and open-oriented nursing curriculum, (4) the quality of the tutorial system and (5) the program's commitment to student support and development.

Conclusion

Even in times of declining enrollment and fewer applicants, certain factors can make a nursing program magnetic.

Implications for the Profession and/or Patient Care

The map of emerging factors can serve as a strategy to help nursing programs attract students and improve their overall appeal.

Impact

What problem did the study address? ○

In some countries, there is a downward trend in applicants to the nursing profession, raising serious concerns about the growing global nursing workforce gap.

With the decline in applicants, the long-term sustainability of nursing programs is also at risk.

No study has investigated the factors that characterise nursing degree programs, which attract even more applicants in a context of declining attractiveness.

What were the main findings? ○

Five magnetic factors have emerged, one of which is external and the others internal to the nursing program.

The external factors relate to the program itself—and are embedded in the social, civic and academic environment of the host university and the city.

The internal factors relate to the strong leadership and commitment of the nursing programme to promote its quality.

Where and on whom will the research have an impact on? ○

Findings may inform actions at the policy, university and individual nursing program levels.

Reporting Method

COnsolidated criteria for REporting Qualitative Research Checklist.

Patient or Public Contribution

Data collection and validation involved citizens (students) attending the identified nursing programs.

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