International perspectives on social media guidance for nurses: a content analysis

Aim: This article reports the results of an analysis of the content of national and international professional guidance on social media for the nursing profession. The aim was to consolidate good practice examples of social media guidelines, and inform the development of comprehensive guidance. Method: A scoping search of professional nursing bodies’ and organisations’ social media guidance documents was undertaken using google search. Results: 34 guidance documents were located, and a content analysis of these was conducted. Conclusion: The results, combined with a review of competency hearings and literature, indicate that guidance should cover the context of social media, and support nurses to navigate and negotiate the differences between the real and online domains to help them translate awareness into actions

Review of the evidence for adolescent and young person specific, community-based health services for NHS managers

Purpose – The purpose of this paper is to provide an overview of the evidence surrounding the design and delivery of adolescent-specific health services for young people aged 14-25. This aims to make recommendations for National Health Service (NHS) senior management teams on the available literature relating to service design for children’s and young people's services within the UK. Design/methodology/approach – This paper presents a mini-review carried out in Spring 2013 using EMBASE, BNI, PSYCHinfo, MEDLINE and Google Scholar to systematically search available published and unpublished research papers. Systematic reviews, meta-analyses and evaluations of service models were included within this review. Adapted “GRADE” criteria were used to appraise the evidence. Findings – Of 70 papers found, 22 met the inclusion criteria. There were five main service designs found within the literature: hospital-based; school-linked or school-based; community based; combination and integrative; and other methods which did not fit into the four other categories. Research limitations/implications – This review is limited to the literature available within the inclusion criteria and search strategy used. It intends to inform management decisions in combination with other parameters and available evidence. Originality/value – There is range of research and evidence syntheses relating to adolescent services, but none of these have been conducted with a focus on the UK NHS and the information needs of managers re-designing services in the current climate within England

What do nurses do in professional Facebook groups and how can we explain their behaviours?

AIMTo explore and explain the causal (mechanisms) relationships between nurse’s actions and behaviours in Facebook groups.BACKGROUNDOnline Social Networks such as Facebook have rapidly diffused through the nursing profession with an estimated 60% using social media every day. There have been a range of concerns linked to unprofessional behaviours on Facebook despite professional guidance being in place. However, there is little evidence that explores the causal and influencing factors that lead to nursing behaviour and actions on Facebook.METHODBhaskarian critical realist ethnography (CRE) employing structured observation and reflective field notes of publicly accessible, groups and profiles on Facebook explicitly relevant to the nursing profession. For ethical approval reasons, these groups and pages will remain anonymous. Observations were conducted over a 6 month period during 2015-2016 by applying a selective case sampling approach to post. Observations occurred at two time points during the 6 month period by a single researcher. This allowed for a range of ‘typical’ and more extreme behaviours to be observed.CRITICAL REALISM & DATA ANALYSISCausal mechanisms are a ‘reality’ that cannot be directly observed (this is not the same as cause-effect; reality is much more complex). However, the components and outcomes of this reality can be observed and measured. Components for coding data were: morphostatic and morphogenic structures, entities, tendencies, events, behaviours and outcomes. These were then ‘mapped’ to explain how they interacted. Theories based on past research and other theoretical models were established and the maps were used to test which of these best explained nurses’ actions and behaviours in the Facebook environment.RESULTSComponents from the data were mapped (e.g. figure.1). This identified that despite having awareness of being professional and being in the domain of the professional group with other nurses a shift from professional-unprofessional seemed to occur. Indicating that awareness (self-efficacy) does not always result in professional behaviours and actions. For example, swearing would be deemed to be unprofessional but heightened emotions in response to politicians and policy changes that affect nursing created resulted in offensive language being ‘accepted’ within the group. Figure.2 provides an example framework illustrating how personal-professional-social values can create conflict and a shift in one may then affect the behaviours of an individual or group in the online environment.CONCLUSIONPersonal-professional-social values overlap in the Facebook environment and triggers in one domain may result in unprofessional or unacceptable behaviours in another. Further research needs to examine the nature of these and methods by which awareness of professionalism translates into action (i.e. the areas where conflicting values may occur)

Professionalism in Social Media: The 3Cs rule

INTRODUCTION The concept of e-professionalism or e-accountability relates to the attitudes and behaviours the reflect professional values in the online environment. Despite professional guidance and organisational policy being in place for several years, literature outlines issues associated with e-professionalism in nursing still remain. AIM To explain the complex relationships that exist between professionalism, accountability and social media and, make recommendations about how this might be managed consistently. METHOD Critical realist ethnography. Use of secondary sources of evidence: professional guidance and published research. Focus groups with registered nurses (n=8) and observation of nursing related, publicly accessible Facebook groups/pages over 3 months. A realist approach to analysis and concept mapping explained the complex interaction of components within social networks: entities, structures, tendencies, actions and events. RESULTS Issues with context, clarity and confirmability: Actions such as. breach of confidentiality, ‘friending’ patients (breach of boundaries) were unanimously ‘unprofessional’. Other behaviours were more subjective, with no consensus about whether individuals should be held to account e.g. being obviously drunk, pole dancing. Differences of opinion were best explained by background, personal values and also the difficulties with ‘confirming context’ in social media (e.g. the currency of the post, the person who actually posted it). Influencing factors: External factors changed behaviours the concept of ‘acceptability’ e.g. there was initially consensus that posting pictures at work and in uniform was unprofessional. However, in response to politician comments nurses were actually doing this publicly; accepting and promoting such behaviour. CONCLUSION Three core considerations for online behaviours and assessing incidents in social media were ‘The 3Cs’: context, clarity and confirmability. These are presented in an ‘Awareness to Action’ (A2A) tool that facilitates 1) reflection about use of social media and, 2) decisions about whether an incident is unprofessional (warranting further action) or simply, unacceptable (warranting less severe or no action)

Professional socialisation, accountability and social media: what’s the relationship and should we care?

BACKGROUND: The rapid diffusion of social network sites such as Facebook have presented a wealth of challenge and opportunity for the nursing profession. A large majority of student nurses have adopted Facebook but [as developing professionals] may not understand the implications and unintended consequences of the information shared in a personal or innocent way.No studies have yet critically analysed [in depth] the underlying factors that influence and determine the relationships between professional accountability and social media or if there is actually a ‘problem’ with social media. AIM: Critically analyse the relationships between professional accountability and Facebook during the journey of professional socialisation.METHOD: Critical realist ethnography employing online observation of three cohort groups, 30 public profiles and professional group discussion topics, focus groups (academic and practicing nursing staff n=8) and semi-structured interviews with student nurses over two sites (n=16).RESULTS: Critical realist retroductive analysis (Bhaskar, 1998) was developed as part of this study. Three relationships were identified and six models were generated to explain and test proposed mechanisms within the data, which cause these relationships: 1) the concept of professional accountability 2) patterns of use 3) behaviours and activities 4) physical versus online reality 5) unacceptable, acceptable, professional or unprofessional behaviours 6) perceived knowledge and awareness versus actual behaviours.Three explanatory theoretical concepts were then confirmed and used to develop three critical realist frameworks: I) Socialisation, Professional Socialisation, Online Socialisation (SPO) II) Unacceptable, Acceptable, Unprofessional, Professional (UAPU) and III) Awareness into Action (A2A).CONCLUSION: I) SPO: This study has indicated a potential ‘tertiary’ or ‘online’ socialisation process and illustrates the factors, context and socialisation informs accountable behaviours; linking the physical and online (personal, public, professional).II, III) UAPU, A2A: The lack of physical context and presence in the online environment causes dissonance between perceived and actual behaviours and confidence versus competence in the online environment. With further research and validation these three frameworks may be used in education and practice, for personal and group assessment, reflection and/or for raising awareness of good practice online. They may also be used by organisations and professional bodies to assess scenarios or incidents

Can the use of a Facebook group in addition to classroom teaching enhance exam success in a Drug Calculations module?

A wide range of literature acknowledges the use of e- and traditional learning in the health professions but further research is frequently recommended to explore perceived benefits (Lahti, Hatonen & Valimaki, 2013; Cook et al, 2010) particularly in the rapidly changing technological environment. Facebook boasts 1.11 billion users; over 61% access this via mobile ‘anytime, anywhere’ (Statistics Brain, 2013). In the United Kingdom an estimated 80% of student nurses may have a Facebook account, with a wide range of informal programme/university specific ‘groups’ available to members for support/advice. As an electronic and mobile learning tool, Facebook offers quick, easy, flexible access, complementing the ‘always on’ behaviours of nursing students today. Aim: To establish if a module specific Facebook group can improve examination success and user satisfaction in a Drug Calculations Examination. Method: Examination scores and feedback questionnaire were used to evaluate exam success and satisfaction of pre-nursing students undertaking a Drug Calculations Module. A 30 student cohort opted in or out of using a Facebook group in addition to classroom teaching. Results: A t-test to the 95% confidence level showed that students who opted in to the Facebook group were more likely to pass on first attempt with a higher mark on their exam; p=0.038. Chi-square testing showed White British students were more likely to opt-in to the Facebook group p=0.000. 90% of group users expressed that it improved their learning experience and would use it again. Conclusion: Facebook groups enhanced student success in their Drug Calculations examination and were a satisfactory option to students who chose to opt in. Students from Black/Black African groups were less likely to use this learning option. Additional research is required into student demographics and use of Facebook groups, along with more robust exploration of student use of Facebook groups for formal/informal educational support/advice

A nurse-led sleep service for children and young people with disability

Aim: To evaluate the outcomes from a nurse-led, community-based sleep hygiene service for children and young people, which was designed and implemented in a community NHS trust. The project aimed to provide evidence for wider implementation of such a service across the trust. Method: The project recruited 22 participants to an eight-week programme over six months and collected quantitative and qualitative data. It included evaluating service costs and collecting information about how the child’s sleep problem affected the carer and family pre- and post-intervention. Findings: There was a significant, positive effect on quality-of-life measures, with two thirds of participants achieving 40% of their expectations by the end of the eight weeks. Parents said they felt ‘less helpless’ and they valued the support given in the home setting. Conclusion: Cost and benefit analysis showed that the service could reduce costs associated with high-cost prescriptions. It could also positively affect community paediatric waiting lists and clinic appointments

Proposed research study into the age at death and cause of death in Gypsies & Travellers

This study will identify the age of death and the major causes of death in Gypsies and Travellers. Reliable information as to the causes of death in this population is not available. This study will provide very valuable data to those working with Gypsies and Travellers, and to the community itself, as to the predominant causes of death. This will then be used to strategically design healthcare interventions. Gypsies and Travellers have poor health status and low life expectancy compared to other English-speaking minority ethnic groups. To inform healthcare service provision and interventions it is important to accurately identify the prevalent causes of death in this population and which causes differ from the general population. Gypsy or Traveller ethnic status is generally not collected on NHS systems and ethnicity is not recorded at death; therefore age and cause of death cannot be accurately determined in this community. This study will link ethnicity and cause of death data. An appropriate funding source is currently being sought

Online social networks and the pre-registration student nurse: a focus on professional accountability

Background & rationale: The rapid diffusion of social network sites such as Facebook have presented a wealth of challenge and opportunity for the nursing profession. A large majority of student nurses have adopted Facebook but [as developing professionals] may not understand the implications and unintended consequences of the information shared in a personal or innocent way. No research has yet critically analysed or explained [in depth] the underlying factors that influence and determine the relationships between professional accountability and social media or if there is actually a ‘problem’ with social media, and if there is explain how we can address it. Aim: Explain the context and relationships between professional accountability and Facebook for the pre-registration student nurse during their journey of professional socialisation. Methods: Critical realist ethnography employing focus groups (academic and practicing nursing staff n=8), semi-structured interviews with student nurses over two geographical sites (n=16) supported by online observation of three cohort groups, 30 public profiles and professional group discussion topics. Results: Six overarching models were explored, 1) the concept of professional accountability, 2) patterns of use, 3) behaviours and activities, 4) physical versus online reality, 5) unacceptable, acceptable, professional or unprofessional behaviours and, 6) perceived knowledge and awareness versus actual behaviours. To explain the relationship between the pre-registration student nurse, Facebook and accountability three frameworks were developed. The first, Socialisation-Professional socialisation-Online socialisation (SPO) explains the journey of socialisation and the relationship between the online and physical world. Unacceptable-Acceptable-Professional-Unprofessional (UAPU) explains the complex nature of Facebook behaviours and how individuals understand the difference between the concept of unprofessional and simply unacceptable. The final framework ‘Awareness to Action’ takes the principles from the previous two frameworks and outlines a proactive tool to raise awareness of online profiles and, a reactive tool using ‘the 3Cs’ (clarity, context & confirmability) to make [professional] decisions about behaviours and incidents in the online environment. Conclusion: The relationships between the accountability, Facebook and the pre-registration student nurse are individual, complex and evolving (ICE). The very nature of socialisation means that this is based on individual background, experiences and values. Society and OSNs are complex environments which are changeable and, them and our relationship with them is continuously evolving. A2A and its ‘3Cs’ provides an assessment of self-efficacy, risk and decision-making tool to proactively [for nursing students] and reactively [for educators, employers and professional groups] manage self-awareness and behaviours in the online environment

Critical realist ethnography: from philosophy to the practice of research analysis.

Background: There are few realist ethnographic studies in nursing and the majority employ traditional approaches to analysis; reflecting the principles of interpretivist or positivist research paradigms. Aim: Present the development and application of a novel approach to realist ethnographic analysis to a research project that sought to explain how student nurses become socialised into online social networks. Method: Realist ethnography sought to explain the relationship between online social networks and professional socialisation. Results: The findings show how this novel approach to analysis led to the proposition of a new and original concept of ‘online socialisation’. Conclusion: This article informs nurse and healthcare researchers how to apply an analysis approach to realist ethnographic study based on the principles of Bhaskarian philosophy