‘Safety First’: Residents, Families, and Healthcare Staff Experiences of COVID-19 Restrictions at an Irish Residential Care Centre

The COVID-19 pandemic and the need to stem the transmission and protect the most vulnerable in society led to infection control restrictions effectively locking down an entire country. These restrictions were also imposed on residential care settings for older people, initially in March 2020, and subsequently at varying times throughout the year that followed. Furthermore, the restrictions led to the suspension in all visiting to residents expect in exceptional circumstances and on compassionate grounds. The purpose of this research study was to develop an understanding of the experience of residents, their families, and carers in an Irish residential care setting during the COVID-19 lockdown. Data were collected in a residential care centre for older people in Ireland, using semi-structured interviews of residents, family members and staff. Interviews were conducted in person for residents and virtually for family members and staff. In total 29 people were interviewed. Data were analysed using Braun and Clarke’s thematic data analysis approach. Four themes and three subthemes were developed from the data. The main themes were ‘difficult but safe’, ‘communication’, ‘staff going above and beyond’, ‘what about the future?’ Residents, families and staff of the residential care setting had to manage and cope with the challenges of the restrictions imposed during COVID-19 lockdown. This study highlighted the negative impacts of visiting restrictions on staff, residents and their family members during the COVID-19 lockdown

Nurse and Midwife Clinical Competency Determination and Competency Development Planning Toolkit.

The Irish health service is driven by policy direction aiming to provide more services within primary, community and continuing care. A programmatic approach to change is being taken by the Health Service Executive with an initial focus on chronic disease. The current healthcare environment within which nurses and midwives now work has intensified working processes and increased patient complexity. Patient populations are ageing, those with chronic diseases are living longer, hospital stays are shorter with increased use of technology and invasive treatments, patients present with co-morbidities and multiple pathologies, patient turnover and subsequent admissions and discharges are increased and care in the community is expanding. Patient safety and risk controls necessitate on-going clinical audit, utilization of evidence-based practice, adherence to clinical guidelines, introduction of care pathways and peer review. This means that processes for determining and attainment of competencies for nurses and midwives building on identified core clinical competencies are required with due regard to scope of practice and service need. Modern developments such as service needs analysis, the maintenance of portfolios, engagement in clinical supervision and clinical audit and other continuing professional development processes provide support for clinical competency determination and attainment. To this end the National Council commissioned the School of Nursing and Midwifery, Trinity College Dublin, through an open tender process to develop and test a toolkit to assist service managers, nurse and midwife managers and nurses and midwives in clinical competency determination and competency development planning. The research team worked in partnership with a clinical team and a National Council steering committee to develop the toolkit. This report details the process involved in developing the toolkit. The development of the toolkit was informed by a literature review, examination of grey literature and piloting of a toolkit. It built upon current competency frameworks for nurses? and midwives? and documents published by the National Council. The final piloted toolkit includes information on: competence determination for service need, identifying and writing clinical competencies for practice; competency development planning and assessment and competency frameworks in Nursing and Midwifery. The toolkit was evaluated using a mixed-method approach in sixteen pilot sites. A purposive sample of 455 registered nurses or midwives, to ensure representation of discipline, profession, grade and area of practice, were recruited to participate in the survey aspect of the pilot. In total 208 questionnaires were returned representing 46% of the total number distributed. The questionnaires sought experiences of using competencies, and opinions on the structure, content, relevance and utility of the toolkit, plus feedback on using the tools provided within the toolkit. Participants were also given the opportunity to provide opinions on how to improve the toolkit in an open response section, a demographic section was also included. In total, 45 people (73% response rate) also participated in six focus group interviews. A semi-structured interview schedule developed by the team was used to guide the discussion

Serenity Spirituality Sessions: A Descriptive Qualitative Exploration of a Christian Resource Designed to Foster Spiritual Well-Being among Older People in Nursing Homes in Ireland

This paper reports on a descriptive qualitative study that explored the value and benefit of Serenity Spirituality Sessions programme for older nursing home residents. The research was carried out in six nursing homes in the Republic of Ireland. The facilitators of these sessions, who worked in the nursing homes, were interviewed about their experiences of delivering the programme and their views on the impact that the programme had on resident participants. Emergent themes revealed benefits of the intervention for clients, including inducing a calming effect, increased sense of belonging and benefits of ritual use. The programme yielded positive results, and appears suited to the predominantly Christian population, and as such is deemed a useful adjunct to holistic and spiritual care in these settings