British journal of nursing (Mark Allen Publishing)最新文献

Background: Palliative and end-of-life care (EoLC) education is available to all community and hospital healthcare staff in one NHS trust in the north-east of England. It is also available to care home and domiciliary care staff within the geographical area of the trust.

Aims: This service evaluation assessed the effect of current in-house education on staff confidence levels in delivering palliative and EoLC. It also examined staff perceptions of how attendance at these courses impacted on the palliative and EoLC patients receive across the locality.

Method: A mixed-methods approach was undertaken. Anonymous data were collected via surveys (n=238) sent out in March 2023 covering educational courses that were delivered from 1 January to 31 December 2022 with a 13% response rate. Quantitative data were analysed using descriptive statistics. Qualitative data were explored using Braun and Clarke's (2012) six-stage approach to thematic analysis. A second staff member was asked to review the data to increase the trustworthiness of the study.

Findings: Staff confidence levels in delivering palliative and EoLC increased by 19% (somewhat confident) and 23% (extremely confident) following attendance at trust education. Staff perceived that those patients received better palliative and EoLC as a result their attendance at these courses. The qualitative data identified five main themes: symptom control, psychological support, holistic care, patient advocacy, and advance care planning. Limitations of the study included the low survey response rate and lack of exploration of patient/carer perceptions directly.

Conclusion: Palliative and EoLC education can increase staff confidence levels in care delivery and, as perceived by staff, results in better care for patients receiving palliative and EoLC. These findings provide evidence for the trust to consider making palliative and EoLC training mandatory, which could also be considered more widely regionally and nationally.

Background: The Recommended Summary Plan for Emergency Care and Treatment (ReSPECT) is a care plan to guide emergency treatment when the person cannot contribute. ReSPECT is important in supporting adults at risk of decline.

Aim: To implement, evaluate and embed ReSPECT conversations to improve patient safety out of hours and support involvement of patients and their families.

Methods: A quality improvement design underpinned by normalisation process theory (NPT) undertaken in a 35-bed community hospital ward between May 2022 and September 2023. Organisational prioritisation, facilitators, and champions supported the plan. Evaluation analysed ReSPECT plans, observations and a follow-up focus group.

Results: ReSPECT conversations increased by 43% over 1 year (23 to 32 patients), and in quality (from 15/23 patients with a do not attempt cardiopulmonary resuscitation decision recorded and no ReSPECT plan to 32/35 with an individualised ReSPECT plan).

Conclusions: ReSPECT could be implemented in community hospitals with facilitators and champions to deliver and embed change. The implementation plan is informing wider rollout across community hospital wards for adults with frailty and multiple conditions.

Recent shifts in nursing education towards generic proficiencies pose challenges to the unique demands of mental health nursing education. Student mental health nurses at the authors' higher education institution (HEI) have provided service feedback that has expressed the difficulties they have encountered. This article examines the issues faced by students, assessors and educators in interpreting and applying the proficiency standards set by the Nursing and Midwifery Council. Addressing the complexities of mental health nursing education, as well as the barriers to learning and attainment, requires a collaborative effort and innovative solutions if HEIs are to successfully prepare future mental health nurses to meet the evolving demands of their role. The proposed solution is a 'Proficiency Directory', which provides structured resources for mental health nursing students to align learning experiences with assessment criteria, facilitating a more comprehensive and meaningful learning journey.

Claire Urwin, Principal Lead for Pre-Registration Developments in London/Programme Leader M Nurse, University of Sunderland (claire.urwin@sunderland.ac.uk), reviews the development of the registered nursing associate role and considers factors relating to professional development for role holders.

Sam Foster, Executive Director of Professional Practice, Nursing and Midwifery Council, considers the latest annual insight report and what it can tell us about when and why people may raise complaints or concerns.

John Tingle, Associate Professor, Birmingham Law School, University of Birmingham, discusses a new report and consultation on NHS patient safety culture development.