To synthesise current evidence on the development and implementation of quality care metrics for nurses working in general practice.
A Scoping review guided by Arksey and O'Malley's framework and the Preferred Reporting Items for Systematic Reviews and Meta-Analysis for Scoping Reviews (PRISMA-ScR).
Articles included peer-reviewed primary research, published in English between 1989 and 2024, reporting on the development, implementation and evaluation of quality care nursing metrics in general practice settings. EndNote was used for citation management, while Covidence facilitated screening and data extraction by four reviewers. The Donabedian model of quality care assessment (2005) and the WHO tool for primary care nurse competencies (2020) were used to synthesise the findings.
A systematic search of PubMed, CINAHL, EMBASE and Web of Science databases was conducted between June 2022 and June 2024. The search strategy was developed using Population, Concept and Context criteria, with keywords including ‘Nurse’, ‘General Practice’, ‘Metric’ and ‘Indicator.’
Eleven studies conducted between 2005 and 2024 met the inclusion criteria. Five studies focused on quality care indicators or measures, and six examined nurse competencies or standards of care.
Quality care metrics are underutilised in general practice. There is ambiguity in metric terminology and nursing roles, education and primary care systems. Quality care metrics must align with nursing values, with digital technology and leadership as core enablers.
Adoption of nursing metrics in general practice provides insights into nursing contributions to patient care. Standardising the definitions of nursing care metrics will enable valid and reliable comparisons.
Quality care nursing metrics will enable the nurse's role to be manifested in general practice settings in relation to patient outcomes.
PRISMA reporting guidelines have been adhered to.
Understanding of the role of the nurse in general practice will support improved quality, safety, policy and governance in general practice settings.
No patient or public contribution.
To assess the care needs of older adults living in poverty in a high-income country and to analyse their relationship with other outcome variables.
A cross-sectional study.
Data were collected between September 2022 and February 2024 from 384 older adults in southeastern Spain. Descriptive statistics were calculated to assess older adults' care needs. A multiple linear regression analysis was carried out to determine the percentage by which the socio-demographic or outcome variables could explain the number of met care needs among older adults in poverty.
Around 20% of the care needs amongst older adults living in poverty were unmet. The most frequently unmet care need was related to money (53.6%). Almost 30% of participants were at risk of malnutrition, 18% felt lonely, and 80% perceived a low level of social support. Age, history of falls, emergency room visits, functionality, perceived social support, quality of life and nutritional status significantly predicted the number of needs met.
The health conditions of older adults living in poverty are suboptimal and may negatively influence their care needs. Nurses should consider these factors when designing, implementing and evaluating interventions to promote the biopsychosocial health of this population.
Nursing interventions to promote health amongst older adults living in poverty should focus on identifying unmet care needs, particularly those related to financial and social support. Interventions should prioritise improving nutritional status, enhancing social support networks and addressing loneliness.
Living in poverty increases older adults' vulnerability due to unmet financial, nutritional and social support needs. These unmet needs can negatively affect older adults' physical and mental health.
The study has been reported following the STROBE guidelines.
The study's participants only participated in the data collection process.
To explore levers and barriers to providing culturally responsive care for general practice nurses (GPNs) using normalization process theory.
A self-administered online cross-sectional survey.
A participatory co-designed adapted version of the normalization of complex interventions measure (NoMAD) validated tool was distributed to a convenience sample of GPNs between December 2022 and February 2023. The sample comprised of GPNs working in general practice services in Ireland (n = 122). Data were analysed using descriptive and analytical statistics (Pearson correlations) and principles of content analysis. This study was conducted and reported in line with the Consensus-Based Checklist for Reporting of Survey Studies (CROSS).
GPNs in this study indicated their familiarity with, acknowledged the importance of and were committed to, providing culturally responsive care. However, implementing culturally responsive care in daily practice was problematic due to insufficient education and training, scarcity of resources and supports and a lack of organizational leadership. Subsequently, GPNs experience difficulties adapting everyday practices to respond appropriately to the care needs of culturally and linguistically diverse (CaLD) patients.
This analysis highlights the necessity of exploring the intricacies of factors that influence capabilities and capacity for providing culturally responsive care. Despite demonstrating awareness of the importance of providing nursing care that responds to the needs of CaLD patients, GPNs do not have full confidence or capacity to integrate culturally responsive care into their daily work practices.
Using normalization process theory, this study elucidates for the first time how GPNs in Ireland make sense of, legitimize, enact and sustain culturally responsive care as a routine way of working. It illuminates the multitude of micro-level (individual), meso-level (organizational) and macro-level (structural) factors that require attention for normalizing culturally responsive care in general practice services.
The study question was identified in a participatory research prioritization for Irish research about migrant health that involved migrants in the process.
Postpartum psychosis is a psychiatric emergency that occurs following childbirth. Women are often cared for in general psychiatric units or in psychiatric Mother and Baby units. Postpartum psychosis is associated with a significant risk of relapse. There is a need to explore how women perceive care to understand what works well or needs further improvement.
This review aimed to explore women's experiences of care and support for postpartum psychosis.
A systematic review using meta-ethnographic methods was conducted.
Comprehensive searches were conducted between 4 March 2024 and 4 March 2025 on five databases (CINAHL, EMBASE, MEDLINE, PsycINFO and Web of Science). Backward and forward chain searching was also undertaken.
Critical appraisal was conducted following screening. Reciprocal and refutational translation were used to form the synthesis, and a line of argument was developed. The eMERGe reporting guidelines were used.
Fifteen studies were included within this synthesis. All the studies were conducted in high income countries and included 235 women. Three main themes were developed. ‘Navigating the unknown’ explored women's perceptions of postpartum psychosis as a less well-known condition, and their informational needs. ‘The double-edged sword of care’ found that there were helpful elements of formal mental health care, but that accessing care was sometimes traumatic, stigmatising and conflicting to women's identities. ‘Seeking consolation and recovery’ explored women's need for psychological support and experiences of peer support.
The findings of this review highlighted women's needs in respect to informational support, medication support, psychological support and in-patient care settings. Mother and baby units were strongly preferred by women.
The findings highlighted a need for specialised care for postpartum psychosis.
There were no patient or public contributions.
Prospero (CRD42024515712)