Using Rapid Reviews in Nursing and Midwifery Research: An Example From a Study Commissioned to Inform Policy-Making

Aim: To illustrate the potential use of rapid review approaches in nursing and midwifery research by presenting a worked example from a study conducted to inform policy decision making. Background: Rapid reviews, which can be defined as outputs of a knowledge synthesis approach that involves modifying or omitting elements of a systematic review process due to limited time or resources, are becoming increasingly popular in health research. This paper provides guidance on how a rapid review can be undertaken and discusses the strengths and challenges of the approach. Data source and research design: Data from a rapid review of the literature undertaken in 2015 is used as a worked example to highlight one method of undertaking a rapid review. Implications for nursing: Seeking evidence to inform health policy making or evidence based practice is a process that can be limited by time constraints, making it difficult to conduct comprehensive systematic reviews

Developing and sustaining specialist and advanced practice roles in nursing and midwifery: A discourse on enablers and barriers

Aims and objectives To collate, synthesise and discuss published evidence and expert professional opinion on enablers and barriers to the development and sustainability of specialist and advanced practice roles in nursing and midwifery. Background Expanded practice is a response to population health needs, healthcare costs and practitioners’ willingness to expand their scope of practice through enhanced responsibility, accountability and professional autonomy. Design This discursive paper is based on a rapid review of literature on enablers and barriers to the development and sustainability of specialist and advanced practice roles and is part of a wider policy analysis. Methods We analysed and synthesised of 36 research articles, reviews and discussion papers on enablers and barriers in the development and sustainability of expanded practice roles. Results Several factors enable role expansion, including: role clarity; credentialing and endorsement; availability of education for expanded roles; individual practitioners’ dispositions towards role expansion; support from peers, other professionals and the work organisation; and costs. Where limited or absent, these same factors can constrain role expansion. Conclusions Enabling nurses and midwives to practice to their full scope of education and expertise is a global challenge for disciplinary leadership, a national challenge for professional regulation and a local challenge for employers and individual clinicians. These challenges need to be addressed through multistakeholder coordinated efforts at these four levels. Relevance to clinical practice This discursive paper synthesises empirical evidence and expert professional opinion on the factors that enable or hinder the development and sustainability of specialist and advanced practice roles. Providing a critical appraisal of current knowledge, it provides a reference source for disciplinary debate and policy development regarding the nursing and midwifery resource and informs clinicians of the myriad issues that can impact on their capacity to expand their scope of practice

The perceptions of key stakeholders of the roles of specialist and advanced nursing and midwifery practitioners

Aim: To explore the perceptions of key stakeholders of the roles of specialist and advanced nursing and midwifery practitioners. Background: There is evidence that the contribution of these roles to patient care is poorly understood. Design: This research took place over 2 months in 2015 and is part of a larger study involving a rapid review to inform policy development on the specialist and advanced nursing and midwifery practice in Ireland. As an added value, a qualitative element involving thematic analysis was undertaken with key stakeholders. Methods: A phenomenological qualitative study was conducted incorporating semistructured interviews with key stakeholders (n = 15). Purposive sampling with maximum diversity was used to recruit a wide range of perspectives. Findings: Participant’s perspectives led to seven themes: Impact of these roles; role preparation, experience and organizational support; specialist and advanced practice roles in an interdisciplinary context; different folks but not such different roles; impact of specialist and advanced practice roles on patient outcomes; barriers and facilitators to enacting specialist and advanced practice roles; future development of these roles. Conclusion: There is acknowledgement of the positive impact of specialist and advanced practitioners; however, the evidence is currently not conclusive. Preparation for these roles needs to reflect changes in the calibre of today’s professional applicants, and organizational support is paramount to their successful execution. The contribution of their activity to patient outcome needs to be made visible to enhance these roles and to justify the development of new roles across a variety of healthcare areas

The universal, collaborative and dynamic model of specialist and advanced nursing and midwifery practice: A way forward?

Aims and objectives To inform and guide the development of a future model of specialist and advanced nursing and midwifery practice. Background There is a sizable body of empirical literature supporting the unique contributions of specialist and advanced practice roles to health care. However, there is very little international evidence to inform the integration of a future model for advanced or specialist practice in the Irish healthcare system. Design A qualitative study was conducted to initiate this important area of inquiry. Methods Purposive sampling was used to generate a sample of informants (n = 15) for the interviews. Nurses and midwives working in specialist and advanced practice and participants from other areas such as legislative, regulatory, policy, medicine and education were included in the sampling frame. Results Arguments for a new model of specialist and advanced practice were voiced. A number of participants proposed that flexibility within specialist and advanced practitioner career pathways was essential. Otherwise, there existed the possibility of being directed into specialised “silos,” precluding movement to another area of integrated practice. Future specialist and advanced practice education programmes need to include topics such as the development of emotional and political intelligence. Conclusion The contribution of specialist and advanced practice roles to the health service includes providing rapid access to care, seamless patient flow across services, early discharge and lead coordinator of the patient\u27s care trajectory. There was a recommendation of moving towards a universal model to cultivate specialist and advanced nurse and midwife practitioners

Multi-century trends to wetter winters and drier summers in the England and Wales precipitation series explained by observational and sampling bias in early records

Globally, few precipitation records extend to the 18th century. The England Wales Precipitation (EWP) series is a notable exception with continuous monthly records from 1766. EWP has found widespread use across diverse fields of research including trend detection, evaluation of climate model simulations, as a proxy for mid-latitude atmospheric circulation, a predictor in long-term European gridded precipitation data sets, the assessment of drought and extremes, tree-ring reconstructions and as a benchmark for other regional series. A key finding from EWP has been the multi-centennial trends towards wetter winters and drier summers. We statistically reconstruct seasonal EWP using independent, quality-assured temperature, pressure and circulation indices. Using a sleet and snow series for the UK derived by Profs. Gordon Manley and Elizabeth Shaw to examine winter reconstructions, we show that precipitation totals for pre-1870 winters are likely biased low due to gauge under-catch of snowfall and a higher incidence of snowfall during this period. When these factors are accounted for in our reconstructions, the observed trend to wetter winters in EWP is no longer evident. For summer, we find that pre-1820 precipitation totals are too high, likely due to decreasing network density and less certain data at key stations. A significant trend to drier summers is not robustly present in our reconstructions of the EWP series. While our findings are more certain for winter than summer, we highlight (a) that extreme caution should be exercised when using EWP to make inferences about multi-centennial trends, and; (b) that assessments of 18th and 19th Century winter precipitation should be aware of potential snow biases in early records. Our findings underline the importance of continual re-appraisal of established long-term climate data sets as new evidence becomes available. It is also likely that the identified biases in winter EWP have distorted many other long-term European precipitation series

Caring International Research Collaborative: A Five-Country Partnership to Measure Perception of Nursing Staffs’ Compassion Fatigue, Burnout, and Caring for Self

Partnering in research across disciplines and across countries can be challenging due to differing contexts of practice and culture. This study sought to demonstrate how central constructs that have application across disciplines and countries can be studied while concurrently considering context. Groups of nurses from Botswana, Ireland, Israel, New Zealand, and Spain partnered to identify how to measure the constructs of caring for self, burnout, and compassion fatigue, replicating a study by Johnson (2012), who found that caring for self had a moderately strong negative relationship with both compassion fatigue and burnout. While these constructs were of interest to all five groups, the conversation of contextual influences varied. All five groups used the same instruments to measure the central constructs. Levels of burnout and compassion fatigue varied by country but were moderated by caring for self. Partnering across countries made it possible to understand that caring for self moderates the negative impact of burnout and compassion fatigue in all five countries. This study gives insight into methods for partnering across disciplines and contexts

The role of line managers and co-workers in mediating informal flexibility for working family carers

Irish Academy of Management Conference on Sustainable Leadership and Management: Making a Global Impact for the Public Good. University of Galway, 23-25 August 2023Purpose: Our paper identifies the enabling mechanisms through which carer-friendly informal flexibility is enacted in the workplace and explores whether these enabling mechanisms help working carers remain in the workforce and avoid taking leave from employment. Methodology: Twenty-six working carers in Ireland were interviewed. Interviews were semi-structured, and questions were formulated around three broad themes: participants’ caregiving role; their employment situation; and the services and supports available to them. Findings: The findings highlight three mechanisms through which carer-friendly informal flexibility is enacted: reassurance and pre-emptive support; carer advocacy; and idiosyncratic deal making (i-deals). In the absence of informal flexibility, disruption to working arrangements is likely in the form of intermittent periods of leave from the workplace. Research limitations/implications: Greater diversity in the profile of our study participants could be helpful, particularly the inclusion of more male carers and those working in the private sector. Practical implications: A greater emphasis on informal, locally negotiated, flexible working arrangements would facilitate carers to remain in employment. Originality/value: Our research explores the enabling mechanisms through which carer-friendly informal flexibility is enacted. Our study uncovered the pivotal mediating role played by line managers and co-workers in supporting carers to secure access to these informal flexible working arrangements

A Scoping Review to Map the Evidence on Family Carers Who Combine Work with Care

Introduction: Family carers provide a wide range and significant amount of assistance to relatives, friends and neighbours who are ill or disabled. Statistical data from the Organisation for Economic Co-operation and Development (OECD) indicates that at least 1 in 10 adults is involved in informal, and most often unpaid care. About half of the proportion of those who participate in a caring role combine this with paid employment and balancing both roles can be a challenge. Consequently, there is increased demand for the introduction of measures to reconcile paid work and care-provision. Unfortunately, much remains unknown about the lives of family carers who balance work with care. Aim: The present work endeavours to illuminate this topic by scoping the extent, range and nature of available evidence on ‘family carers who are in paid employment’. Methods: Steps followed when carrying out the scoping review included: i) Clarifying the research purpose and question; ii) Identifying relevant research studies from various electronic databases, reference lists of identified studies, and grey or unpublished literature; iii) Selection of studies by two independent reviewers; iv) Collating data using an excel data sheet; and v) Analysing and summarising data using qualitative thematic analysis. Results: Two-hundred-and-sixty-three publications were incorporated, and these comprised a variety of research study designs, which were based in different countries. Six themes were emergent from the scoping review findings. The first was the compound carer’s experience who is a working family carer; subthemes relevant to this group were coping, health outcomes and employment outcomes. A subsequent theme was health outcomes for working family carers; health outcomes were subdivided into mental health, physical health, and health behaviour outcomes. The theme on the profile of characteristics for working family carers comprised of subthemes indicative that caring was largely a gendered activity, with age as another important variant — caring increasing at older ages. The economic impact of caring on working family carers was an eminent theme with a clear personal economic impact and national economic impact. A significant finding was the theme on conflicting priorities among working family carers; subthemes related to this were either work-to-family conflict or family-to-work conflict. The most important theme in the present work was that on employment outcomes among working family carers with subthemes characterised by employment participation, employment-related disadvantages, work-place provisions in place for this group and positive employment impacts. Finally, it was clear that there were support services for working family carers and thus this was an apparent theme; subthemes related to this were the formal services and social support services. Conclusions: Evidence on working family cares is vast and covers a wide range of topics such as compound caring, health, demographic profile, conflicting priorities, finances, employment, and support services. Working family carers face the difficult task of balancing work with care which could lead to negative outcomes related to employment, finances, and health. Implications for applicability: The pressures associated with the dual responsibility can be alleviated via the introduction of support services and policies to support working carers.Health Research Boar

Caring international research collaborative: A five-country partnership to measure perception of nursing staffs' compassion fatigue, burnout, and caring for self

Partnering in research across disciplines and across countries can be challenging due to differing contexts of practice and culture. This study sought to demonstrate how central constructs that have application across disciplines and countries can be studied while concurrently considering context. Groups of nurses from Botswana, Ireland, Israel, New Zealand, and Spain partnered to identify how to measure the constructs of caring for self, burnout, and compassion fatigue, replicating a study by Johnson (2012), who found that caring for self had a moderately strong negative relationship with both compassion fatigue and burnout. While these constructs were of interest to all five groups, the conversation of contextual influences varied. All five groups used the same instruments to measure the central constructs. Levels of burnout and compassion fatigue varied by country but were moderated by caring for self. Partnering across countries made it possible to understand that caring for self moderates the negative impact of burnout and compassion fatigue in all five countries. This study gives insight into methods for partnering across disciplines and contexts