An enquiry into nurse educators’ beliefs, understandings and approaches to teaching the concepts of reflection to adult student nurses in UK Higher Education Institutes

The approaches taken in teaching reflection to adult student nurses varies across the UK despite national curriculum outcomes from the professional statutory and regulatory body, The Nursing and Midwifery Council (NMC). This study highlights pertinent aspects of the various approaches to teaching, the inclusion of theory and the roles of the student, mentor and nurse lecturers in the utilisation of reflection to develop professional knowledge from experiences. Ethical approval was gained to conduct the study, utilising a case study approach, including nurse lecturers and curriculum documentation from a range of NMC accredited Higher Education Institutes across the UK. Semi structured interviews were conducted face to face with all participants in their home sites. Curriculum documentation used with students such as lecture notes, slides, module and programme handbooks and practice assessment documents were also collated in order to understand and analyse the approaches taken to teaching reflection. These two main data sources (interviews and curriculum documents) were also complemented by the use of field notes and a researcher journal in order to gain deeper understanding of the detail during data collection. A thematic analysis of the interview data and curriculum documents was undertaken to highlight and explore patterns and assist in the emergence of a theme and subthemes. Following in depth data analysis, the findings of this study detail an overarching theme of safe and caring practices, alongside three subthemes: II Personal and Professional Dimensions of Reflection Dimensions of Reflection in Nurse Education Articulation of Practice Although the publication of the Francis Inquiry (2013) was unanticipated at the inception of this research, it has shown to be a very important factor in analysing the data. The issue of patient safety that arose during data collection and became evident during analysis align closely to the publication of this significant report. The findings from this study are timely as the review of standards for nurse education and mentoring are underway. The findings from this study will also contribute to strengthening the student nurse role in assuring the best standards of care in the practice setting are achieved in order to improve patient safety through thoughtful approaches

Barriers and facilitators to implementation of non-medical independent prescribing in primary care in the UK: a qualitative systematic review

Objectives: To support workforce deficits and rising demand for medicines, independent prescribing (IP) by nurses, pharmacists and allied health professionals is a key component of workforce transformation in UK healthcare. This systematic review of qualitative research studies used a thematic synthesis approach to explore stakeholders’ views on IP in primary care and identify barriers and facilitators influencing implementation.Setting: UK primary/community care.Participants: Inclusion criteria were UK qualitative studies of any design, published in the English language. Six electronic databases were searched between January 2010 and September 2021, supplemented by reference list searching. Papers were screened, selected and quality-appraised using the Quality Assessment Tool for Studies with Diverse Designs. Study data were extracted to a bespoke table and two reviewers used NVivo software to code study findings. An inductive thematic synthesis was undertaken to identify descriptive themes and interpret these into higher order analytical themes. The Diffusion of Innovations and Consolidated Framework for Implementation Research were guiding theoretical anchors.Primary and secondary outcome measures: N/A.Results: Twenty-three articles addressing nurse, pharmacist and physiotherapist IP were included. Synthesis identified barriers and facilitators in four key stages of implementation: (1) ‘Preparation’, (2) ‘Training’, (3) ‘Transition’ and 4) ‘Sustainment’. Enhancement, substitution and role-specific implementation models reflected three main ways that the IP role was used in primary care.Conclusions: In order to address global deficits, there is increasing need to optimise use of IP capability. Although the number of independent prescribers continues to grow, numerous barriers to implementation persist. A more coordinated and targeted approach is key to overcoming barriers identified in the four stages of implementation and would help ensure that IP is recognised as an effective approach to help alleviate workforce shortfalls in the UK, and around the world.<br

Paramedic independent prescribing in primary care – seven steps to success

Paramedic practice is evolving and the number of advanced paramedics in primary care roles in the UK has risen dramatically. A significant milestone for the paramedic profession, recent legislation granting paramedics independent prescribing rights means UK paramedics are the first worldwide to receive this extension in scope of practice. Paramedic prescribing capability is expected to increase autonomy for independent case management and enhance capacity for service development. Local and national success is however likely to depend on skilful implementation and the avoidance of historical barriers. This article aims to raise awareness of potential barriers to early adoption of paramedic independent prescribing in primary care. It identifies common pitfalls prior to training and provides seven practical steps for paramedics considering pursuing non-medical prescribing training