Incorporating a service improvement project into an undergraduate nursing programme: A pilot study

Although service improvement projects have been incorporated into some postregistration nurse education modules in the UK, they have not been generally available to pre‐registration students. This paper reports on the implementation and evaluation of a pilot project in pre‐registration nurse education at one university in eastern England. It concludes that the nursing students found the project to be a useful addition to their course. Supportive reactions were obtained from nurse managers, mentors and academics. A need to improve communication with clinical areas through the use of web‐based materials was highlighted.     

Mentors' perceptions and experiences of supporting student nurses in practice

This paper reports on a funded project that explored the perceptions and experiences of mentors regarding student nurse support in practice. The study employed a mixed‐method approach, using questionnaires and focus groups with mentors from one acute Trust and one community Trust. The findings highlighted the multifaceted nature of student learning in practice, with mentors reporting that clinical skills, adjustment to the placement and integrating into the team were the aspects students needed most support with. Mentors were aware of their roles and responsibilities in supporting students and recognized the importance of their own personal attributes. The participants reported a number of challenges, particularly time, competing demands and paperwork, and suggested that a team approach and support groups could help to overcome these. The support for students provided by peers and health‐care assistants was recognized, as was the need to ensure that students are prepared to take responsibility for their learning.     

Cancer patients' perceptions of quality‐of‐care attributes—Associations with age,perceived health status,gender and education

Aims and objectives

The aim of this study was to explore the associations between patients' gender, education, health status in relation to assessments of patient‐centred quality and individuality in care and trust in nurses for those <65 (working age) and ≥65 years (older people).

Background

Patients' assessments of the quality of care they receive are essential for the development of the provision of patient care and services. Previous studies have revealed age of the patient is associated with their assessment of care quality attributes.

Design

The study employed a cross‐sectional, multicultural comparative survey design.

Methods

The data were collected using questionnaires among hospitalised cancer patients (N = 876, n = 599, 68%) in four European countries: Greece, Cyprus, Sweden and Finland. The data were divided into two subgroups based on age (cut point 65 years) and were analysed statistically.

Results

Cancer patients' age, gender and level of education were not related to their assessments of care quality attributes: person‐centred care quality, individuality in care and trust in nurses. Subgroup analysis of the older adults and those of working age showed clear associations with patients' assessments of quality‐of‐care attributes and perceived health status. The lower the perceived health status, the lower the assessment of care quality attributes.

Discussion

The results suggest that the cancer itself is the strongest determinant of the care delivered, rather than any patient characteristics, such as age, education or gender. Perceived health status, in association with cancer patient assessments of care quality attributes, may be useful in the development of patient‐centred, individualised care strategies alongside a stronger focus on people instead of cancer‐care‐related processes and duties.

Conclusions

Health status was the only factor associated with cancer patients' assessments of care quality attributes. Cancer itself may be the strongest determinant of the care quality perceptions, rather than any patient characteristics.

Relevance to clinical practice

The findings of this study have implications for cancer care professionals in terms of patient assessment and care planning. The measures may be useful in assessing quality of cancer nursing care.     

Patients’ experiences of physical limitations in daily life activities when suffering from chronic heart failure; a phenomenographic analysis

Scand J Caring Sci; 2011; 25; 3–11
Patients’ experiences of physical limitations in daily life activities when suffering from chronic heart failure; a phenomenographic analysis The aim of the study was to describe how patients suffering from chronic heart failure conceived their physical limitations in daily life activities. An explorative and qualitative design with a phenomenographic approach was chosen, a total of 15 patients were interviewed. The findings indicate that participants perceived a variety of structural aspects pertaining to physical limitations in activities of daily life which resulted in four referential aspects. Need of finding practical solutions in daily life focused on how life had to be changed and other ways of performing activities of daily life had to be invented. Having realistic expectations about the future was characterised by belief that the future itself would be marked by change in physical functioning, but an incentive to maintain functions and activities ensured good quality of or even increased capacity in daily life. Not believing in one’s own ability included the perception of having no opportunity to improve ability to perform activities of daily life. There were perceptions of undesired passivity, undefined fear of straining themselves or performing activities that could endanger their health in addition to uncertainty about the future. In Losing one’s social role in daily life, participants described losing their social network and their position in society and family because of limited physical capacity. A lack of important issues, mental and physical, occurred when physical capacity was lost. In conclusion, patients suffering from chronic heart failure found new solutions to manage activities in daily life, including willingness to change focus and identify other ways of doing important things. Patients had an incentive to maintain functions and activities to ensure a good quality of and strengthen their physical capacity in daily life. Inability to trust in their physical capacity in combination with experienced limitations in daily life prevented patients from attempting to increase activities.     

Embodied reflection in practice—‘Touching the core of caring’

Ranheim A, Kärner A, Arman M, Rehnsfeldt AW, Berterö C. International Journal of Nursing Practice 2010; 16 : 241–247
Embodied reflection in practice—‘Touching the core of caring’ A study was performed with the aim of clarifying the integration of the caring act of touch with reflection on caring theory. Seven participant nurses in elderly care volunteered as ‘coresearchers’ and performed a caring act called Rhythmical Embrocation, together with reflective dialogues on caring theory. The project lasted for 6 months and at the end qualitative interviews with participants were used to evaluate the study. The findings showed an opening of awareness, embodied moments of presence and an extended ability to act creatively in caring. In this study, the movement between theory and practice was the integration of the caring act with reflection on basic caring concepts. Implications for praxis development are that implementation and reflection by teams over certain caring acts might open the door to an expanded view of one's own caring ability that in the long run will benefit the patient.     

Rapid tranquilization: An audit of Irish mental health nursing practice

Rapid tranquillization is a pharmacological intervention sometimes employed in mental health care for the management of acute behavioural disturbance. It is a form of restrictive practice, which, along with seclusion and restraint, is a conventional and controversial intervention in the therapeutic management of risk in mental health settings. This study surveyed mental health nurses practice in rapid tranquillization. A self‐report questionnaire was utilized which addressed aspects such as definitions of rapid tranquillization, presence of rapid tranquillization policy, types of incidents where it is used and postintervention monitoring. The results demonstrate that rapid tranquillization is an intervention used in the management of acute behavioural disturbance in various mental health settings in Ireland. Respondents showed a basic understanding of rapid tranquillization as an intervention; however, some areas reported not having a specific rapid tranquillization policy. There was some evidence of a variation in postrapid tranquillization monitoring of psychiatric/mental health and physical health. Service user debriefing following rapid tranquillization was reported to be common; however, the content of this was not elaborated on. In the light of variations in practice, specific training and the development of rapid tranquillization policies are recommended.