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The long-awaited NHS England workforce plan
The first comprehensive workforce plan for the NHS, putting staffing on a sustainable footing and improving patient care. It focuses on retaining existing talent and making the best use of new technology alongside the biggest recruitment drive in health service history.
This is a laudable aim, but can this ambitious plan really deliver the actions needed to transform the long-term future of this critical workforce?
Workforce planning is crucial to the success of the National Health Service (NHS) and has been notable by its absence in recent decades. The publication of this plan could be seen as a step in the right direction. Workforce planning requires
Data analysis of the current workforce and...
Commentary on: Tucker G, Urwin C, Unsworth J. The impact of unsuccessful resuscitation and manikin death during simulation on nursing student’s resuscitation self-efficacy: A quasi-experimental study. Nurse Educ Today. 2022 Dec;119:105587. doi: 10.1016/j.nedt.2022.105587. Epub 2022 Oct 4.
A well-structured resuscitation simulation can improve nursing students’ self-efficacy, whether or not it ends with the death of the manikin. Future research should examine the impact of manikin death on other essential factors that contribute to nursing students’ learning.
Simulation is widely used to train nursing students in assessing and managing cardiac arrest. However, considerable debate has been about whether the manikin should die due to unsuccessful cardiopulmonary resuscitation in simulation. Some believe that it could cause undue stress and interfere with learning.
Commentary on: Collaco N, Gamble A, Morgan JE, Phillips B, Culliford D, Darlington AS. Experiences and support needs of parents/caregivers of children with cancer through the COVID-19 pandemic in the UK: a longitudinal study. Arch Dis Child. 2023 Mar;108(3):198–203. doi: 10.1136/archdischild-2022-324905. Epub 2022 Nov 30.
To teach paediatric oncology nurses how to provide child-family-centred care based on specific needs. To spark research ideas on nursing interventions for anxiety in children with cancer and their families.
The study based on literature mentions that parents/caregivers of children with cancer have additional worries about the potential impact of COVID-19 on their children’s health. It was conducted to identify the experiences, information and support needs of parents/caregivers of children with cancer throughout the different stages of the COVID-19 pandemic in the UK.
The study used an online survey including...
Commentary on: Roland D, Gardiner A, Razzaq D, Rose K, Bressan S, Honeyford K, Buonsenso D, Da Dalt L, De T, Farrugia R, Parri N, Oostenbrink R, Maconochie IK, Bognar Z, Moll HA, Titomanlio L, Nijman RGG; in association with the REPEM network (Research in European Paediatric Emergency Medicine) as part of the EPISODES Study. Influence of epidemics and pandemics on paediatric ED use: a systematic review. Arch Dis Child. 2023 Feb;108(2):115–122. doi: 10.1136/archdischild-2022-324108. Epub 2022 Sep 26.
Healthsystems must be prepared for paediatric emergency department (ED) volume shifts during epidemics and pandemics. Two interventions to increase efficient paediatric ED use include: (1) parental education about home care and (2) real-time remote advice.
Epidemics and pandemics have major impacts on ED care. Studies examining the COVID-19 pandemic noted large early US ED visit declines.
Commentary on: Monforte J, Davis C, Saleem S, Smith B. Moving on From the Delphi Study: The Development of a Physical Activity Training Programme Prototype Through Co-produced Qualitative Research. Qual Health Res. 2022 Nov;32(13):1952–1964. doi: 10.1177/10497323221126535. Epub 2022 Sep 14.
Dialogical inquiry, which aims to facilitate people hearing themselves and others in collaborative and non-hierarchical settings, is compatible with the practice of coproduction. A Delphi study alone may be insufficient for informing the design of educational programmes, curriculum or policy agenda. Additional follow-up qualitative interviews should be conducted to rectify, improve and expand on consensus-based knowledge.
Regular physical activity is critical to the health and well-being of people living with disabilities (PLWD).
Commentary on: Toprak FÜ, Erenel AS. The effect of kangaroo care practice after caesarean section on paternal-newborn interaction: A mixed-methods study in Turkey. Midwifery. 2022 Dec; 115:103489. doi: 10.1016/j.midw.2022.103489. Epub 2022 Sep 15.
Turkish fathers should be encouraged to hold their infants by kangaroo care (KC) after maternal caesarean section. Future research in Turkey could focus on the facilitators and barriers to paternal skin-to-skin holding.
Newborns, when consoled with skin-to-skin holding, or KC, are better able to adapt physiologically after caesarean delivery. KC in Turkey is a desired practice, but when the mother has caesarean section, this delays the practice. In Turkey, fathers are not routinely offered KC. Since there is a high rate of caesarean sections in Turkey, the nursing staff do not offer KC to many infants. There are two hypotheses in this study: (1) newborns...
Commentary on: Madeley AM, Earle S, O'Dell L. Challenging norms: Making non-normative choices in childbearing. Results of a meta ethnographic review of the literature. Midwifery. 2023 Jan;116:103532. doi: 10.1016/j.midw.2022.103532. Epub 2022 Oct 30
Nurses should strive to understand women’s needs, past experiences and sociocultural background as a basis for discussing their choices in a non-judgemental way. Research on non-normative choices in childbearing should include ethnic and sexual minorities, and evaluate protocols for sensitive, women-centred discussion of birthing choices.
Preferences about childbirth range along a wide continuum from physiological, sometimes even unassisted births, to caesarean sections by maternal request. Despite this wide range, most births in the western world take place in medical settings, making it in practice a medical event, reflecting society’s and health professionals’ views of risk and safety that define birth choices which are considered normative....
Commentary on: Ulupınar F, Erden Y. Intention to leave among nurses during the COVID-19 outbreak: A rapid systematic review and Meta-Analysis. J Clin Nurs. 2022 Nov 27. doi: 10.1111/jocn.16588. Epub ahead of print.
During COVID-19, nurses experienced stress, anxiety and fear. Psychological support will help retain staff. Further longitudinal studies on the long-term psychological impacts of the pandemic are needed.
The impact of the COVID-19 pandemic on nurses was unprecedented with high volumes of critically ill patients. This strain on direct care nurses included an increased workload, long hours, separation from family, potential exposure and patient death.
Commentary on: Todhunter-Brown A, Hazelton C, Campbell P, Elders A, Hagen S, McClurg D. Conservative interventions for treating urinary incontinence in women: an Overview of Cochrane systematic reviews. Cochrane Database Syst Rev. 2022 Sep 2;9(9):CD012337. doi: 10.1002/14651858.CD012337.pub2.
Pelvic floor muscle training is an effective conservative treatment option for managing all types of urinary incontinence (UI) in women in isolation or combined with other measures and should be considered first-line treatment in women with UI. Further research is needed on long-term outcomes of conservative interventions and their impact on quality of life.
Urinary incontinence (UI) is a highly prevalent condition affecting nearly 25% of women, especially in older age groups.
Commentary on: Veli N, Martin CA, Woolf K, Nazareth J, Pan D, Al-Oraibi A, Baggaley RF, Bryant L, Nellums LB, Gray LJ, Khunti K, Pareek M; UK-REACH Study Collaborative Group. Hesitancy for receiving regular SARS-CoV-2 vaccination in UK healthcare workers: a cross-sectional analysis from the UK-REACH study. BMC Med. 2022 Oct 10;20(1):386. doi: 10.1186/s12916-022-02588-7.
Understanding the sources of information as drivers of acceptance toward a regular COVID-19 vaccine could allow for targeted messaging to improve uptake. Further research is needed to assess if the trends in intended hesitancy toward potential regular vaccines translates to vaccination behaviour.
Mass vaccination against COVID-19 has been one of the key measures to combat the spread of COVID-19. Initial vaccines have been highly efficacious in reducing infection prevalence and mortality. However, the emergence of variant strains and waning of immunity from initial vaccination...
This is a summary of See et al. Newly registered nurses experience high levels of emotional exhaustion, stress and burnout, with high attrition rates in the first-year post-qualification. The purpose of this review was to consolidate the available evidence on the experiences of newly registered nurses transitioning from the role of student nurse to that of registered nurse.
Thirty-one studies were included in the review, comprising thirty qualitative and one mixed-method study. A total of 452 newly registered nurses were enrolled across the studies from Australia, Canada, Singapore, England, Nepal, Netherlands, Pakistan and Taiwan. Four themes were identified: knowledge deficit, overwhelming clinical practice, importance of workplace support and the meaning of ‘being a nurse’. Twenty-four studies discussed how newly graduated registered nurses experienced anxiety,...
Commentary on: Mazalová L, Gurková E, Štureková L. Nursing students' perceived stress and clinical learning experience. Nurse Educ Pract. 2022 Oct;64:103 457. doi: 10.1016/j.nepr.2022.103457. Epub 2022 Sep 24.
Clinical nursing supervisors may be unfamiliar with the demands and challenges students encounter in the clinical environment, and the amount of encouragement and assistance they require to be successful in the nursing profession. Further research should focus on intervention studies examining how clinical nursing supervisors control nursing student clinical stressors to improve student outcomes.
The clinical environment is the prevailing source of stress during nursing students’ educational experience. Although clinical supervisors are predominantly supportive to students in the clinical environment, current literature recognises certain clinical nursing supervisor actions and behaviours as causes of nursing student clinical stress.
Commentary on: Shaqiqi W, Innab A. Attitude and preparedness of nursing students in Saudi Arabia concerning the managing of intimate partner violence. J Adv Nurs. 2022 Sep 5. doi: 10.1111/jan.15424. Epub ahead of print.
Nurses’ competency to recognise and respond to women exposed to intimate partner violence (IPV) should be facilitated during undergraduate nursing training. Research needs to generate evidence for the best educational strategies to facilitate and integrate these competencies into nursing education curricula.
International guidelines
Commentary on: Yanbei R, Dongdong M, Yun L, Ning W, Fengping Q. Does perceived organization support moderate the relationships between work frustration and burnout among intensive care unit nurses? A cross-sectional survey. BMC Nurs. 2023 Jan 23;22(1):22. doi: 10.1186/s12912-023-01180-5.
Providing intensive care unit (ICU) nurses with organisational supports by showcasing that the organisation cares about their well-being, gives importance to their opinions, is proud of their achievements will decrease their work frustration. Future research and auditing of programmes and events to monitor organisational support to ICU nurses in reduction of work frustration and burn-out. Such monitoring systems could translate into better patient outcome.
The psychological strain of caring for very ill patients causes significant mental stress for all ICU healthcare professionals. When stress is prolonged, it might eventually cause burn-out and deterioration of patient...
Commentary on: Iyasere CA, Wing J, Martel JN, et al. Effect of increased interprofessional familiarity on team performance, communication, and psychological safety on inpatient medical teams: a randomized clinical trial. JAMA Intern Med. 2022 Nov 1;182(11):1190–1198. doi: 10.1001/jamainternmed.2022.4373.
Team member familiarity has a positive impact on teamwork and interprofessional communication. Organisational design should consider team member familiarity.
Interprofessional teamwork matters for patient and workforce outcomes. Familiarity of team members is associated with improved teamwork and communication, safety and quality of care, utilisation and patient outcomes. However, much of the existing research is observational in nature. This study evaluated the impact of a team member familiarity intervention on the quality of nurse and resident interactions, perceptions of organisational climate and care outcomes.
This single site randomised clinical trial evaluated the effect of a resident scheduling intervention designed to...
Commentary on: Gros-Navés S, Contreras-Higuera W, Canet-Vélez O, Torralbas-Ortega J, Taló M, Roca J. The effect of writing a bachelor thesis on attitudes towards nursing research and development: A cross-sectional comparative study between students and professionals. Nurse Educ Today. 2022 Nov;118:105 532. doi: 10.1016/j.nedt.2022.105532. Epub 2022 Aug 31.
Promoting research development early in nursing education improves perceptions and use of research findings among practising nurses. Future research is essential to identify strategies that contribute to developing clinical inquiry skills leading to optimal patient outcomes.
Research is essential for nursing practice and must be duly enhanced during university training. There is considerable evidence linking research and evidence-based practice to improved nursing practice.
Commentary on: Schuengel C, Cuypers M, Bakkum L, Leusink GL. Reproductive health of women with intellectual disability: antenatal care, pregnancies and outcomes in the Dutch population. J Intellect Disabil Res. 2022 Sep 27. doi: 10.1111/jir.12982. Epub ahead of print.
There is a need for accessible and inclusive reproductive healthcare for women with intellectual disability (ID). Further research is required to identify factors explaining reproductive health disparities in women with ID.
Reproductive health is an important aspect of the human rights of women with ID. Described as ‘the forgotten generation’, many women with ID were institutionalised or sterilised following eugenic practices that prevailed for much of the 20th century.
Commentary on: Norman G, Bennett P, Vardy ERLC. Virtual wards: a rapid evidence synthesis and implications for the care of older people. Age Ageing. 2023 Jan 8;52(1):afac319. doi: 10.1093/ageing/afac319.
While virtual wards are now an accepted model of care delivery for older people further research and evaluation of this model specifically focused on patient selection, the use of technology, impact on carers, and patient and carer satisfaction is needed. The use of virtual modalities of care for older people can be a viable alternative to face to face assessment and care.
Since the COVID-19 pandemic, there has been increased interest in Virtual Wards as a viable and cost-effective alternative to hospital-based care. Applying this model of care for frail elderly people has become more common but there remains confusion about the difference and/or overlap in the models of...
Commentary on: Chirico I, Giebel C, Lion K, Mackowiak M, Chattat R, Cations M, Gabbay M, Moyle W, Pappadà A, Rymaszewska J, Senczyszyn A, Szczesniak D, Tetlow H, Trypka E, Valente M, Ottoboni G. Use of technology by people with dementia and informal carers during COVID-19: A cross-country comparison. Int J Geriatr Psychiatry. 2022 Sep;37(9). doi: 10.1002/gps.5801.
Consider patient and caregiver preferences for using technology. Offer training on the use of technology. Provide the most suitable schedule for caregivers. More multicentre randomised controlled trials are needed to assess the feasibility of telehealth in different stages of dementia.
The COVID-19 pandemic brought to light the need to adopt technology in healthcare systems worldwide due to the need for physical distancing and isolation measures, especially in the older adult group.
Commentary on: Cuzco C, Castro P, Marín Pérez R, Ruiz García S, Núñez Delgado AI, Romero García M, Martínez Momblan MA, Benito Aracil L, Carmona Delgado I, Canalias Reverter M, Nicolás JM, Martínez Estalella G, Delgado-Hito P. Impact of a Nurse-Driven Patient Empowerment Intervention on the Reduction in Patients' Anxiety and Depression During ICU Discharge: A Randomized Clinical Trial. Crit Care Med. 2022 Dec 1;50(12):1757-1767. doi: 10.1097/CCM.0000000000005676. Epub 2022 Sep 30.
Critical care nurses are advised to implement a nurse-driven patient empowerment intervention (NEI) in their daily practice to aid discharged patients. The long-term effects of NEI on patients with varying diseases need further evaluation.
Several studies have indicated that a significant proportion of patients who have been admitted or discharged from an intensive care unit (ICU) experienced high levels of anxiety and depression.
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