Enablers of the successful implementation of simulation exercises: a qualitative study among nurse teachers in undergraduate nursing education

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The construction of a subset of ICNP® for patients with dementia: a Delphi consensus and a group interview study

BACKGROUND: The International Classification for Nursing Practice (ICNP®) 2013 includes over 4000 concepts for global nursing diagnoses, outcomes and interventions and is a large and complex set of standardised nursing concepts and expressions. Nurses may use subsets from the ICNP as concepts and expressions for research, education and clinical practice. The objective of this study was to identify and validate concepts for an ICNP subset to guide observations and documentation of nursing care for patients with dementia. METHOD: The process model for developing ICNP subsets was followed, according to the guidelines adopted by the International Council of Nursing (ICN). To identify relevant and useful concepts for the subset, a modified form of the Delphi method was used. Six nurses working in healthcare services in three municipalities in Norway with postgraduate education in geriatric psychiatry and dementia care participated in two Delphi sessions. The participants reviewed and scored the concepts included in the suggested subset and had an opportunity to rewrite them and offer alternatives. To validate the subset after the Delphi study, a group interview was conducted with six other nurses with postgraduate education in geriatric psychiatry and dementia care. The group interview was recorded and transcribed, and summative content analysis was used. RESULTS: Suitable concepts for an ICNP subset to guide observations and documentation of nursing care for patients with dementia were identified. In total, 301 concepts were identified, including 77 nursing diagnoses, 78 outcomes and 146 nursing interventions. An increased focus on concepts to describe basic psychosocial needs such as identity, comfort, connection, inclusion and engagement was recommended by nurses in the validation process. CONCLUSIONS: Relevant and pre-formulated nursing diagnoses, goals and interventions were identified, which can be used to develop care plans and facilitate accuracy in the documentation of individuals with dementia. The participants believed that it may be difficult to find formulations for all steps of the nursing process. In particular, nursing diagnoses and psychosocial needs are often inadequately documented. The participants highlighted the need for the subset to contain essential information about psychosocial needs and communication

An Analysis of the Work System Framework for Examining Information Exchange in a Healthcare Setting

Lack of communication is a leading root cause of sentinel events (any unanticipated event in a healthcare setting resulting in a patient’s death or serious physical or psychological injury and not related to the natural course of the patient\u27s illness). Deficits in communication of essential information when patients transfer between different healthcare services can cause interruptions in the continuity of care, inappropriate treatment, and potential harm to the patient. Research has shown that providing the right information about the right patient to healthcare providers at the right time could eliminate up to 18 percent of the general adverse events. In this paper, we assess the applicability of the work system framework (WSF) to evaluate the health information-exchange processes that occur when patients are transferred from home healthcare services and nursing homes to hospitals. From our analysis, we identify possible improvements in both work practices and the flow of health information among healthcare providers. Further, we propose a modified work system snapshot template tailored for evaluating the health information-exchange process. The proposed modifications include changing the WSF terminology to healthcare terms (including patient safety indicators) and adding new performance measurement indicators that are relevant to healthcare

Peer Support for People Living With HIV: A Scoping Review

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Prosjekt utdanningspost : et samarbeid mellom Fjeldberg sykehjem og Høgskolen i Østfold Undervisningssykehjemprosjektet

Rapporten beskriver resultatene fra en praksisperiode der 18 studenter hadde praksisstudier i en korttidsavdeling ved Fjeldberg sykehjem i Fredrikstad våren 2002. Prosjektet er et delprosjekt under det nasjonale Undervisningssykehjemsprosjektet. I løpet av praksisperioden overtok studentene den daglige driften, samt pleie- og omsorgsoppgavene i avdelingen på dag og kveld i to uker, i nært samarbeid med to lærere (delprosjektlederne). De ansatte ved sykehjemmet var i disse periodene på kompetansehevende kurs i et selvvalgt tema, dokumentasjon, ved Høgskolen i Østfold. Noen hospiterte ut fra faglige interesseområder, både i overtakelsesuke og ellers i løpet av prosjektperioden. Studentene svarte på et spørreskjema før og etter praksisperioden. Resultatene fra undersøkelsen etter praksisperioden viste at studentene var spesielt fornøyd med overtakelsesperiodene. Da fikk studentene mer ansvar for arbeidet ved posten. De uttrykte tilfredshet i forhold til å få mer ansvar, blant annet gjennom å fungere som gruppeleder. Resultatene fra undersøkelsen viser at planleggingen var svært viktig for gjennomføringen av praksisperioden. Studentene oppga at det hadde vært svært nyttig å samarbeide med andre studenter. Noen ansatte opplevde at ansvarsfordelingen mellom ansatte og studenter var litt uklar. Dette ble tatt opp underveis, og var viktig for å få til et godt samarbeid. Kommunikasjon gjennom et omfattende opplegg med så mange aktører er utfordrende. Det hadde vært nyttig å ha flere deltakere i prosjektplanleggingen fra avdelingen. Ansatte ved avdelingen hospiterte, deltok på kurs med mer i overtakelsesukene. Resultatene fra undersøkelsen viser at flere av de ansatte opplevde at de gjennom prosjektet fikk mulighet til å oppdatere seg faglig En gruppe ansatte mente prosjektet hadde vært belastende for avdelingen, mens flere pekte på at det hadde vært avlastende å ha studentene i avdelingen. Formen for prosjekt anbefales. Spesielt positivt er det at studentene føler at de oppøver selvstendighet og ansvar gjennom denne formen for praksisstudier. Studentene lærer veldig mye av hverandre. For pasientene innebar det at hjelperne hadde bedre tid til dem, kunne iverksette flere sosiale tiltak og at studentene gjerne ville utøve god, individuelt tilpasset sykepleie. Lærerollen gir god mulighet til å gå sammen med studentene og reflektere sammen over situasjoner som studenter og lærer sammen har erfart

It Is Not That Simple nor Compelling! Comment on “Translating Evidence Into Healthcare Policy and Practice: Single Versus Multi-faceted Implementation Strategies – Is There a Simple Answer to a Complex Question?”

Healthcare decisions are often made under pressure, with varying levels of information in a changing clinical context. With limited resources and a focus on improving patient outcomes, healthcare managers and health professionals strive to implement both clinical and cost-effective care. However, the gap between research evidence and health policy/clinical practice persists despite our best efforts. In an attempt to close the gap through behaviour change interventions, there has been a strong held belief that ‘ more is better ,’ without understanding the mechanisms and circumstances of knowledge translation (KT). We argue that even a single intervention or strategy in translating evidence into healthcare policy or practice is rarely simple to implement. Nor is the evidence compelling on the best approach. As Harvey and Kitson argued, designing and evaluating KT interventions requires flexibility and responsiveness. If we are to move forward in translation science then we need to use rigorous designs such as randomised controlled trials to test effectiveness of interventions or strategies with embedded process evaluations to understand the reason interventions do or do not work

“They make a diference”: a qualitative study of providers’ experiences of peer support in outpatient clinics for people living with HIV

This study contributes to knowledge on how peer support can meet the needs of people living with HIV. Incorporating people living with HIV in the co-production and distribution of healthcare services may improve the knowledge and perspectives in healthcare services. However, the skill standards of peer supporters should be addressed when implementing peer support in usual care.publishedVersio

“They make a diference”: a qualitative study of providers’ experiences of peer support in outpatient clinics for people living with HIV

Background Although the life expectancy of people living with HIV has increased, they are still often disconnected from society through stigma and discrimination. Peer support has been found to increase social support. Given the limited research on peer support from the providers’ perspective, this study explored how peer supporters experience their roles and contributions in outpatient clinics (OPCs). Additionally, healthcare professionals’ perceptions of working with peer supporters in OPCs were examined. Methods This qualitative study included purposively selected peer supporters (n = 10) and healthcare professionals (n = 5) from five OPCs in Norway in 2020. In-depth interviews and focus group discussions were conducted in Norwegian or English, using interview guides. Interview transcripts were analysed in NVivo 12 using reflexive and collaborative thematic analysis. Results The results show that peer supporters experience mutual support through emotional and honest interactions. Further, the peer supporters found it essential to negotiate with the service users about their preconception of HIV, confront their views through dialogue, and replicate positive experiences by being credible role models. The participants expressed that integrating peer support in the OPCs’ usual care processes increased the prospect of equitable services. Quality of peer support and role clarity were identified as critical components. The results demonstrate that emotional and honest conversations promote support between peers and that peer supporters identify a need for a reframed understanding of HIV by modelling plausible alternative interpretations and coping experiences. Conclusions This study contributes to knowledge on how peer support can meet the needs of people living with HIV. Incorporating people living with HIV in the co-production and distribution of healthcare services may improve the knowledge and perspectives in healthcare services. However, the skill standards of peer supporters should be addressed when implementing peer support in usual care

Simulations with standardized patients for nursing students in preparation for clinical placements in mental health care

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