Nurses as role models in health promotion: a concept analysis

There are national and international expectations that nurses are healthy role models but there is a lack of clarity about what this concept means. This study used concept analysis methodology to provide theoretical clarity for the concept of role models in health promoting behaviour for registered nurses and students. The framework included analysis of literature and qualitative data from six focus groups and one interview. Participants (n=39) included pre-registration students (Adult field), nurse lecturers and registered nurses (RNs), working in NHS Trusts across London and South East London. From the findings, being a role model in health promoting behaviour involves being an exemplar, portraying a healthy image (being fit and healthy), and championing health and wellness. Personal attributes of a role model in health promoting behaviour include being: caring, non-judgemental, trustworthy, inspiring and motivating, self-caring, knowledgeable and self-confident, innovative, professional and having a deep sense of self

Health care staff perceptions of a coaching and mentoring programme: a qualitative case study evaluation

This study aimed to determine the value of the Coaching and Mentoring (C&M) Programme within a large National Health Service (NHS) system (‘Trust’) in London, England. A case study design was utilised with units of analysis: mentors, mentees, coaches, coachees, and line managers. Semi-structured interviews (n=32) took place in 2015. Findings revealed how individuals were able to develop personally and professionally. Findings support the need for more staff opportunities to engage in shared activities. The study also identified the importance of there being strong organisation-wide leadership of the programme, as well as managerial support to enable staff to engage in the programm

Developing the skills to support nursing and midwifery students with specific learning differences in practice: An evaluation of a learning resource

The literature highlights the difficulties that those supporting students with a specific learning difference (SpLD) in practice may have and calls for more education of practice mentors. As a result of concerns locally, nursing and midwifery students who have a SpLD were interviewed to recount their practice experiences. Short films were made from these stories which formed the basis for developing a learning resource to educate novice mentors and develop their skills to support and assess students with SpLDs appropriately. The learning resource was piloted and evaluated, to investigate the effect the learning resource had on novice mentors’ knowledge about SpLDs and their attitudes, feelings and skills. The learning resource was delivered to 72 novice mentors on a mentorship preparation course. Sixty-one completed pre and post session questionnaires and participated in a world café exercise to evaluate the resource. The evaluation results indicated that the resource had a positive effect on novice mentors’ knowledge, skills and attitudes towards students with a SpLD

The role of the practice educator in supporting nursing and midwifery students’ clinical practice learning: An appreciative inquiry

High quality, supportive practice learning experiences are crucial for ensuring that student nurses and midwives develop into competent practitioners who are fit for practice. The practice educator role is one model of practice learning support but the role is relatively new and has been little investigated. This paper reports on an appreciative inquiry that explored the current practice educator role at one university in England, with the aim of reaching a consensus for how the role could be enhanced. The first phase involved in-depth interviews with 18 participants: practice educators (n = 10); student nurse representatives (n= 5) and practice based education leads (n = 3). The interviews were analysed thematically. Three themes related to social processes involved in the role: being a bridge, being there, and social identity. The other themes described contributions to the practice learning environment: safeguarding, support, critical thinking. The second phase used a modified Delphi technique. Participants ranked trigger statements, related to the themes, in order of importance. Two consensus workshops were held where the statements were reviewed by practice educators, students and learning environment leads, following which principles and practices of the practice educator role were agreed. In conclusion, the strength of the practice educator role is that it bridges the worlds of university and practice. This bridging resulted from social processes that required a sustained presence in practice to engage in the reality of everyday practice and gain the shared social identity of a practitioner

Patient dignity in an acute hospital setting: a case study

Abstract Background: Nurses have a professional duty to respect patients' dignity. There is a dearth of research about patients' dignity in acute hospital settings. Objective: The study investigated the meaning of patient dignity, threats to patients' dignity, and how patient dignity can be promoted, in acute hospital settings. Design: A qualitative, triangulated single case study design (one acute hospital), with embedded cases (one ward and its staff, and 24 patients). Setting: The study was based on a 22-bedded surgical ward in an acute hospital in England. Participants: Twenty-four patients, aged 34-92 years were purposively selected. There were 15 men and 9 women of varied socio-economic backgrounds. They could all communicate verbally and speak English. Twelve patients, who had stayed in the ward at least 2 days, were interviewed following discharge. The other 12 patients were observed and interviewed on the ward. The ward-based staff (26 registered nurses and healthcare assistants) were observed in practice. 13 were interviewed following observation. Six senior nurses were purposively selected for interviews. Methods: The data were collected during 2005. The Local Research Ethics Committee gave approval. Unstructured interviews using topic guides were conducted with the 24 patients, 13 ward-based staff and 6 senior nurses. Twelve 4-h episodes of participant observation were conducted. The data were analysed thematically using the framework approach. Findings: Patient dignity comprised feelings (feeling comfortable, in control and valued), physical presentation and behaviour. The environment, staff behaviour and patient factors impacted on patient dignity. Lack of environmental privacy threatened dignity. A conducive physical environment, dignity-promoting culture and other patients' support promoted dignity. Staff being curt, authoritarian and breaching privacy threatened dignity. Staff promoted dignity by providing privacy and interactions which made patients feel comfortable, in control and valued. Patients' impaired health and older age rendered them vulnerable to a loss of dignity. Patients promoted their own dignity through their attitudes (rationalisation, use of humour, acceptance), developing relationships with staff and retaining ability and control. What is already known about the topic? Dignity is complex and multi-faceted, relating to feelings, control, presentation of self, privacy and behaviour from others. Patient factors, the environment and staff behaviour can threaten or promote patients' dignity but their impact in an acute hospital setting has been little studied. What this paper adds The core of patient dignity in an acute hospital setting is feeling comfortable, in control and valued; other components are physical presentation and behaviour. Patients are vulnerable to loss of dignity due to their impaired health, which is further threatened by lack of privacy, and curt or authoritarian staff behaviour. Patients' ability to rationalise their situation, other patients' support, a dignity-promoting culture, and staff interactions making patients feel comfortable, in control and valued, promote dignity when under threat

Preparing student nurses to be healthy role models:A qualitative study

There are national and international expectations for nurses to be healthy role models. This study aimed to investigate student nurses', nurse educators' and registered nurses' experiences and perceptions about being healthy role models and to explore whether nurse education prepares students to become healthy role models. The study used an exploratory qualitative design and was based in the south of England. Participants (n = 39) included student nurses, nurse lecturers and registered nurses. Data collection was conducted through focus groups and data were analysed using thematic analysis. The themes highlighted nurses’ understanding of the key features of being a healthy role model, and perceptions that working as nurses does not support individuals to be healthy. Participants had varied views about whether they should be healthy role models or mirror society and share the same struggles with their health. Students and registered nurses reported inadequate understanding of health promotion and that there was a lack of healthy lifestyle content within undergraduate nurse education. Participants also considered that role modelling healthy behaviour would not in itself influence behaviour change. In conclusion, there needs to be preparation and support for student nurses to be healthy role models from the outset of nurse education.</p

Preparing student nurses to be healthy role models: A qualitative study

There are national and international expectations for nurses to be healthy role models. This study aimed to investigate student nurses', nurse educators' and registered nurses' experiences and perceptions about being healthy role models and to explore whether nurse education prepares students to become healthy role models. The study used an exploratory qualitative design and was based in the south of England. Participants (n = 39) included student nurses, nurse lecturers and registered nurses. Data collection was conducted through focus groups and data were analysed using thematic analysis. The themes highlighted nurses’ understanding of the key features of being a healthy role model, and perceptions that working as nurses does not support individuals to be healthy. Participants had varied views about whether they should be healthy role models or mirror society and share the same struggles with their health. Students and registered nurses reported inadequate understanding of health promotion and that there was a lack of healthy lifestyle content within undergraduate nurse education. Participants also considered that role modelling healthy behaviour would not in itself influence behaviour change. In conclusion, there needs to be preparation and support for student nurses to be healthy role models from the outset of nurse education

The Role and Development of Advanced Clinical Practice Within Allied Health Professions: A Mixed Method Study

Objective: To investigate the profiles of advanced clinical practitioners (ACPs) in the allied health professions (AHPs) and their skills, attributes, experiences and involvement in new models of car

Adjunctive rifampicin for Staphylococcus aureus bacteraemia (ARREST): a multicentre, randomised, double-blind, placebo-controlled trial.

BACKGROUND: Staphylococcus aureus bacteraemia is a common cause of severe community-acquired and hospital-acquired infection worldwide. We tested the hypothesis that adjunctive rifampicin would reduce bacteriologically confirmed treatment failure or disease recurrence, or death, by enhancing early S aureus killing, sterilising infected foci and blood faster, and reducing risks of dissemination and metastatic infection. METHODS: In this multicentre, randomised, double-blind, placebo-controlled trial, adults (≥18 years) with S aureus bacteraemia who had received ≤96 h of active antibiotic therapy were recruited from 29 UK hospitals. Patients were randomly assigned (1:1) via a computer-generated sequential randomisation list to receive 2 weeks of adjunctive rifampicin (600 mg or 900 mg per day according to weight, oral or intravenous) versus identical placebo, together with standard antibiotic therapy. Randomisation was stratified by centre. Patients, investigators, and those caring for the patients were masked to group allocation. The primary outcome was time to bacteriologically confirmed treatment failure or disease recurrence, or death (all-cause), from randomisation to 12 weeks, adjudicated by an independent review committee masked to the treatment. Analysis was intention to treat. This trial was registered, number ISRCTN37666216, and is closed to new participants. FINDINGS: Between Dec 10, 2012, and Oct 25, 2016, 758 eligible participants were randomly assigned: 370 to rifampicin and 388 to placebo. 485 (64%) participants had community-acquired S aureus infections, and 132 (17%) had nosocomial S aureus infections. 47 (6%) had meticillin-resistant infections. 301 (40%) participants had an initial deep infection focus. Standard antibiotics were given for 29 (IQR 18-45) days; 619 (82%) participants received flucloxacillin. By week 12, 62 (17%) of participants who received rifampicin versus 71 (18%) who received placebo experienced treatment failure or disease recurrence, or died (absolute risk difference -1·4%, 95% CI -7·0 to 4·3; hazard ratio 0·96, 0·68-1·35, p=0·81). From randomisation to 12 weeks, no evidence of differences in serious (p=0·17) or grade 3-4 (p=0·36) adverse events were observed; however, 63 (17%) participants in the rifampicin group versus 39 (10%) in the placebo group had antibiotic or trial drug-modifying adverse events (p=0·004), and 24 (6%) versus six (2%) had drug interactions (p=0·0005). INTERPRETATION: Adjunctive rifampicin provided no overall benefit over standard antibiotic therapy in adults with S aureus bacteraemia. FUNDING: UK National Institute for Health Research Health Technology Assessment