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To identify and synthesize empirical evidence on the role of healthcare leaders in the development of equitable clinical academic pathways for nurses.
Integrative literature review.
Literature was searched using CINAHL, PubMed, ProQuest and Google Scholar databases.
A total of 114 eligible articles published between 2010 and2022 were screened, 16 papers were selected.
Results highlighted the need for consistent national, regional, and organizational policy approaches to developing clinical academic careers for nurses. Government health departments and National Health boards must focus on increasing engagement in research and evidence-based nursing practice for high-quality patient care. Discriminatory practices and attitudes were identified as barriers. Discrimination due to gender was evident, while the impact of race, ethnicity, and other social categories of identity are under-researched. Educational leaders must unravel misconceptions about research, highlighting its relevance to patient care and bedside nurses' work. Academic leaders together with executive nurses, research funders and professional nursing bodies must create appropriately remunerated career structures. Transformative approaches are required to develop the clinical academic nurse role and understand its value in clinical practice.
Multiple elements exist within complex systems that healthcare leaders can navigate collaboratively to develop and implement clinical nurse academic roles. This requires vision, acknowledgement of the value of nursing research and the importance of evidence-based research infrastructures.
Findings highlight the collaborative role of healthcare leaders as critical to the success of critical academic careers for nurses. This review can inform those still to formalize this innovative role for nurses.
The review complies with the PRISMA guidelines for reporting systematic reviews. This paper contributes evidence about the healthcare leader's role in developing clinical academic pathways for nurses to the wider global clinical community.
No patient or public contribution was included in this review.
To explore the work of palliative care from the perspectives of district nurses with a focus on the strategies they use to achieve positive outcomes for patients.
An exploratory descriptive qualitative study.
A combination of group and individual interviews using semi-structured interviewing were used to explore district nurses' views of providing palliative care across two large urban community nursing services.
Sixteen district nurse participants were interviewed. Three key themes were identified: “Getting what was needed” involved finding solutions, selling a story and establishing relationships. District nurses sought ways to “Stay involved” recognizing the benefit of delaying discharge for some patients. “Completing a nursing task” was a way of managing time constraints and a form of self-protection from having difficult conversations.
This study highlights the importance of understanding the contextual nature of the practice setting in relation to the provision of palliative care. In doing so, it has revealed the strategies district nurses use to overcome the challenges associated with providing palliative care within a generalist workload.
District nurses experience a tension between managing high patient workloads and remaining patient centred in palliative care. Being task focused is a way of remaining safe while managing a high volume of work and is not always a negative factor in the care they provide. However, focusing on a task while at the same time addressing other unmet needs requires a set of skills that less experienced nurses may not have.
Palliative care education alone will not improve the quality of palliative care provided by generalist community district nurses. The practice context is an important factor to take into consideration when supporting the integration of palliative care in district nursing.
No patient or public contribution was made to this study.
We have adhered to the relevant EQUATOR guidelines and used the COREQ reporting method.
Investigated the experiences of Māori (the Indigenous peoples of Aotearoa, New Zealand) patients and whānau (extended family network) engaging with acute hospital inpatient services and their priorities for a Māori-centred model of relational care.
A qualitative Māori-centred research design using a Thought Space Wānanga (learning through in-depth group discussion, deliberation and consideration) approach.
Two wānanga were conducted between May 2022 and June 2022, with 13 Māori patients who had been acutely hospitalized within the past 12 months and their whānau members. The first wānanga utilized storytelling and journey mapping to collect data. The second wānanga refined the initial themes. Wānanga were audio-recorded and then inductively coded and developed into themes.
Thirteen patients and whānau attended the first wānanga, while 10 patients and whānau participated in the second wānanga). Four themes were developed: (1) Whakawhanaungatanga (establishing connections and relationships), (2) Whakamana (uplifting the status and esteem of Māori), (3) Whakawhitiwhiti kōrero (the importance of communicating, discussing and deliberating) and (4) Kotahitanga (working together with purpose) all provide insights into the importance of effectively engaging and connecting with Māori patients and whānau when acutely hospitalized.
The experiences and priorities of Māori patients and whānau affirm the international literature, suggesting that Indigenous relational concepts are critical to building relationships, connections and trust. Despite existing healthcare models for working with Indigenous peoples, their poor application contributes to sub-optimal healthcare experiences at all points of their healthcare journey. A relational mode of practice focused on engagement and forming connections better meets the needs of Indigenous peoples engaging with inpatient health services.
Despite the existence of Indigenous models of care, Indigenous peoples consistently report a lack of engagement and connection when accessing inpatient health services. Without establishing relationships, applying models of care is challenging.
What problem did the study address? Internationally, healthcare systems are consistently ill-equipped to deliver culturally safe care for Indigenous and marginalized peoples, evident in ongoing health inequities. Like other reports of Indigenous experiences of health services, Māori express dissatisfaction with care delivery in an acute inpatient setting. This study investigated Māori patients and whānau experiences engaging with acute hospital inpatient services and their priorities for a Māori-centred model of relational care. What were the main findings? Māori patients and whānau recounted negative experiences with healthcare professionals lacking effective relationships and trust. Satisfaction occurred when engagement with health care professionals resembled Indigenous cultural rituals of encounter that considered their holistic, collective and dynamic worldviews. Previous models of relational care, while helpful, are not Indigenous and so do not address their needs, such as engagement as a mode of practice (how) to achieve this. Where and on whom will the research have an impact? This research impacts Indigenous peoples' health outcomes, particularly Māori, and nurses and clinicians working and interacting within acute inpatient and other hospital settings. Indigenous research methods support co-constructing knowledge for translation into practical outcomes through transformational practices, policies and theory development.
We used the Consolidated Criteria for Strengthening the Reporting of Health Research Involving Indigenous Peoples (CONSIDER) statement (see File S2—CONSIDER Checklist) and the Consolidated Criteria for Reporting Qualitative Research (COREQ) guidelines (see File S3—COREQ Checklist).
Māori patients and their whānau interviewed about their experiences were involved in data interpretation.
FreshRSS 