Sunday, 20 December 2015

Mobile technologies improve healthcare

Roger Watson, Editor

The aim of this UK study by Guo et al. (2015) was to provide evidence of the impact of mobile technologies among healthcare professionals in education and practice settings.  An integrative literature review was conducted to capture all studies evaluating mobile technologies used by healthcare professionals in education and practice settings.

Twenty studies were found and the authors concluded: 'The development of mobile technologies for healthcare professionals is expanding rapidly and benefits of mobile technologies in the education and practice of healthcare professionals have been articulated in the literature. This review suggested that mobile technologies in healthcare potentially improve access to information, enhance productivity and quality of care, reduce medical errors, increase engagement with learning in different contexts and promote evidence-based decision making at the point of care.'

Reference

Guo P, Watts K, Wharrad H (2015) An integrative review of the impact of mobile technologies used by healthcare professionals to support education and practice Nursing Open doi: 10.1002/nop2.37

How do different health professionals use research?

Roger Watson, Editor

Do different health professionals use, or intend to use, research differently to change their clinical practice?  This is a question well worth asking because, if they differ on this, then we cannot assume that simply publishing research and producing evidence-based guidelines is sufficient strategy to get research into practice.

This question was asked by Appleby et al. (2015) in their article titled: 'What are health professionals' intention towards using research and products of research in clinical practice? A systematic review and narrative synthesis' and published in Nursing Open.  The aim of the study was: 'To explore health professionals’ intentional behaviour and what determines their intention to use products of research in clinical practice' and rigorous systematic review methods were used to find 18 relevant studies.

It transpires that different health professionals do differ in their adoption of research into practice.  In brief - although this hardly does justice to this extensive and detailed study - doctors are more likely to be influenced by peers than nurses who are more easily influenced by guidelines.  In their conclusions the authors say: 'Healthcare professionals responsible for implementing new guidelines should be aware of the dominant influences on health professionals’ intentions when recommending a guideline-driven change in clinical practice. This review has established professional role of the clinician in clinical practice as important, particularly in regard to nurses and physicians. Findings have indicated that nurses’ intentions are mostly influenced by their ability to carry out the guideline-driven behaviour in the realities of the practice environment, whereas physicians’ intentions are often influenced by the usefulness and relevance of the guideline and the perceptions of peers.

Reference

Appleby B, Roskell C, Daly W (2015) What are health professionals' intention towards using research and products of research in clinical practice? A systematic review and narrative synthesis Nursing Open doi: 10.1002/nop2.40

Thursday, 19 November 2015

Self care in heart failure and the role of caregivers

Roger Watson, Editor

The aim of the study from Canada was to develop an instrument that measures caregiver (CG) contributions to HF patients’ self-care because there are no reliable and valid tools for measuring such contributions.


The authors used a systematic literature review and interviews with 14 caregivers to derive items and produced a 34-item scale with good content validity.  As the authors explain: 'With further psychometric testing and refinement, the CACHS questionnaire may equip clinicians to assess and quantify the overall impact of the CGs on patient self-care and target specific self-care decisions or behaviours.' They conclude: 'The CACHS questionnaire should undergo validation in larger studies involving diverse populations to assess whether it remains to demonstrate robust and stable psychometric properties.'

Reference

Harkness K, Buck HG, Arthur H, Carroll S, Cosman T,  McGillion M, Kaasalainen S, Kryworuchko J, O’Keefe-McCarthy, Sherifali D, Strachan P (2015) Caregiver Contribution to Heart Failure Self-Care (CACHS) Nursing Open doi: 10.1002/nop2.35

Violence in the workplace for ambulance personnel

Roger Watson, Editor

Workplace violence (WPV) for healthcare workers is common and ambulance personnel are, literally, at the 'front line' for this kind of abuse. A study from The Netherlands by van der Gelden et al. (2105) and published in Nursing Open titled: 'Predictors of workplace violence among ambulance personnel: a longitudinal study' aimed to: 'examine predictors of repeated confrontations with workplace violence among ambulance personnel, the proportion of exposure to potentially traumatic events that are aggression-related and to what extent personnel was able to prevent escalations.'  The study took place over 6 months with over 100 ambulance personnel.

One of the predictors of events in this study was internal conflict among staff, specifically conflict with superior staff whereby the junior member of staff could not compromise and de-escalate the confrontational situation.  As the authors say: 'our findings suggest that measures (training, procedures, rules) to prevent repeated verbal aggression and being on guard, should especially target
facilitating or improving the ability to compromise very easily and diminishing or solve problems with superiors' and 'ambulance personnel should not only be viewed as ‘victims’ but also should receive recognition for their apparently successful interventions to prevent escalations during WPV.'

Reference

van der Velden PG, Bosmans MWG, van der Meulen E (2015) Predictors of workplace violence among ambulance personnel: a longitudinal study Nursing Open doi: 10.1002/nop2.38



Thursday, 8 October 2015

Cardiac rehabilitation in Australia

Roger Watson, Editor

Not all patients are able to attend hospital after a myocardial infarction for rehabilitation, and programmes have been designed to enable them to undertake rehabilitation at home.  This study from Australia by Frohmader et al. (2015) titled: 'Patient perceptions of nurse mentors facilitating the Aussie Heart Guide: A home-based cardiac rehabilitation programme for rural patients' and published in Nursing Open was designed to: 'To explore and describe long-term thoughts and perceptions of the Aussie Heart Guide Programme including the role of the mentor, held by patients recovering from myocardial infarction.'

The research was carried out by interviewing 13 patients at home by telephone once they had completed the programme.  Views were generally positive and, in the words of one participant: 'I live a long way from the city. I do not go to the local doctor much. I am very isolated. The mentor helped me cope after being discharged from hospital.'  In terms of support, one patient said: 'I was really down in the dumps for about 3 months after my heart attack. I’m not sure if it was because I went through a lot in hospital or because of my age but I found the mentor phone calls to help somewhat.'

In conclusion the authors say: 'The findings from this study support the provision of the Aussie Heart Guide Programme as a home-based self-help programme for patients recovering from MI who find it geographically difficult to attend hospital-based cardiac rehabilitiation programs'  and: 'Mentors were perceived to be integral to the success of the programme through the provision of timely information, ongoing psychosocial support and lifestyle advice to patients during their recovery from myocardial infarction.'

Reference

Frohmader TJ, Lin F, Chaboyer W (2015) Patient perceptions of nurse mentors facilitating the Aussie Heart Guide: A home-based cardiac rehabilitation programme for rural patients. Nursing Open doi: 10.1002/nop2.34

Mary Seacole's place in the development of modern nursing

Roger Watson, Editor

In the history of modern nursing two figures emerge: Mary Seacole and Florence Nightingale.  Florence Nightingale's place in this history is well documented and well known and her legacy, especially in the UK, is obvious.
Mary Seaciole
 However, in recent decades another figure - Mary Seacole - has emerged both as an important figure in the history of nursing and for her work in the Crimea but also because she is championed and has largely been adopted by black nurses the world over.  The campaign to have a Seacole statue erected as a permanent memorial in London would represent one of the first statues of an important black figure in the UK.

Florence Nightingale
However, as she has done before (McDonald 2013), the Canadian Nightingale scholar Lynn McDonald has questioned the place and contribution of Seacole in the pages of Nursing Open in an article titled: 'Mary Seacole and claims of evidence-based practice and global influence.'  McDonald's initial article in JAN drew an indirect response from some European Seacole scholars Staring-Derks et al. (2015) and, essentially, the most recent article by McDonald is a response.

Clearly, I don't expect that many will agree with McDonald's arguments and may question their publication.  In my view her points are well made and supported by credible sources and she has a right - provided that due processes are followed - to be heard.  As with the 2013 in JAN, I would welcome any rejoinders either on this blog or on JAN interactive or in the pages of either journal.  

References

McDonald L. (2014Florence Nightingale and Mary Seacole on nursing and health care Journal of Advanced Nursing 70(6), 14361444. doi: 10.1111/jan.12291

McDonald L (2015) Mary Seacole and claims of evidence-based practice and global influence Nursing Open doi: 10.1002/nop2.32

Staring-Derks C.Staring J. & Anionwu E.N. (2015Mary Seacole: global nurse extraordinaire Journal of Advanced Nursing 71(3), 514525. doi: 10.1111/jan.12559

Pain management in children

Roger Watson, Editor

Pain in children needs particular attention as some children may have difficulty in describing their pain and may not understand why they are in pain.  Also, there are pharmacological issues to be taken into account with children in terms of dosage and frequency of administration of analgesia.

As this UK study by Beckett et al. (2105) titled: 'A mixed-method study of pain management practice in a UK children’s hospital: identification of barriers and developing strategies to maintain effective in-patient paediatric pain management' and published in Nursing Open states: 'UK paediatric acute pain services vary. Although comprehensive pain management guidelines exist, consensus on the best model of care is lacking.'  And, despite the evolution of specialist acute pain services (APSs), 'their overall efficacy is unknown.'

The study looked at pain management practices over two weeks in one hospital with children who were inpatients and interviews were held with staff.  Referrals and non-referrals to the APS were studied and all were made appropriately.  The authors report that: 'Acute Pain Services cases experienced higher pain levels, were more likely to have long term conditions, longer hospital stay and repeat admissions.'  These data and the interviews suggest that APSs are effective but that they are likely to become overburdened as they are often viewed as a generic pain advise service.  Therefore, despite the success of the APS studied, the authors conclude: 'However, without forward planning and simultaneous investment in training there is a risk that pain becomes increasingly specialized, that responsibility for managing other forms of difficult-to-treat pain becomes blurred and that front-line staff lack the ability to provide timely effective care.'

Reference

Beckett K, Henderson EM, Parry S, Stoddart P, Fletcher M (2015) A mixed-method study of pain management practice in a UK children’s hospital: identification of barriers and developing strategies to maintain effective in-patient paediatric pain management Nursing Open doi: 10.1002/nop2.33

Discharge planning in Japan

Roger Watson, Editor

The aim of this study from Japan by Sakai et al. (2015) titled 'Developing an instrument to self-evaluate the Discharge Planning of Ward Nurses' and published in Nursing Open was 'To develop the Discharge Planning of Ward Nurses (DPWN), a Japanese self evaluation instrument for ward nurses’ discharge planning practices.'  As the authors explain: As part of this shift in the healthcare system, enormous
efforts have been attempted to shorten the average length of hospital stay. As a result of this shortened length of hospital stay, older adult patients often leave the hospital with altered independence levels and vulnerable health conditions. These older adults frequently have difficulty when leaving the hospital.'  For this reason, and especially in Japan where families get very anxious at discharge and feel their relatives have been rushed out of hospital, improved assessment is necessary.

An initial 55 items was reduced statistically to produce a 25-item scale with four dimensions.  The authors conclude: 'The DPWN might be used for various purposes, such as to enable ward nurses to self-evaluate their own practices and to assess the effectiveness of educational programmes for ward nurses. Additionally, it might be useful in creating educational tools aimed at developing nurses’
discharge planning competencies; moreover, new nurses may also be mentored using the tools, thus aiding the development of an educational pathway. Furthermore, assessing discharge outcomes such as patient/family satisfaction might be possible. More studies are needed to further examine the clinical utility of the DPWN both nationally and internationally.

Reference

Sakai1 S, Yamamoto-Mitani N, Takai Y, Fukahori H, Ogata Y (2015) Developing an instrument to self-evaluate the Discharge Planning of Ward Nurses Nursing Open doi: 10.1002/nop2.31

Nursing handovers as a source or error

Roger Watson, Editor


Nursing handovers are the opportunity—between nursing shifts—to share information about patients and to discuss care priorities. They take place collectively and individually, their effectiveness is questionable and they may be one of the ‘rituals’ of nursing. However, if inaccurate information is transmitted then they can, potentially, do great harm. In this study from Switzerland by Mayor and Bangerter (2015) titled: 'Managing perturbations during handover meetings: a joint activity framework’ nursing handovers are investigated.

In the words of the authors: ‘Handovers are joint activities performed collaboratively by participating nurses. Perturbations of handover are frequent and may potentially threaten continuity of care.’ To conduct the study, handovers were videotaped and transcribed over several days. Unfortunately, nurses were the source of ‘perturbations’ which led to mistakes in the handovers. The article is presented with photographs to illustrate one incident and excerpts from the transcripts.

In the discussion, the authors state: ‘Perturbations are managed via a tacit division of labour according to nurses’ temporal status as incoming or outgoing. As outgoing nurses who are not giving the report will subsequently leave, they are thus more available to deal with perturbations. Incoming nurses need to process information discussed during the handover, but can deal with perturbations to some extent because their colleagues can still repeat information to them after the handover. Outgoing nurses giving the report are least likely to handle perturbations.’


Reference

Mayor E, Bangerter A (2015) Managing perturbations during handover meetings: a joint activity framework Nursing Open doi: 10.1002/nop2.29


How useful is pre-nursing experience?

Roger Watson, Editor


Keeping people in nursing is a problem as is keeping nursing students in nursing education in the UK. Dropout from universities is high, many never enter nursing after graduation and many leave early. But how do we attract people into nursing and ensure that the ones who come in are suited to the programme of study and to working as nurses? A Scottish study reported by Smith et al. (2105) in an article titled: 'I know exactly what I’m going into”: recommendations for pre-nursing experience from an evaluation of a pre-nursing scholarship in rural Scotland' reports on the experiences of school pupils undertaking a residential period of experience in some aspects of nursing. In the words of the authors, the aims of the scholarship were 'to inspire school leavers to consider nursing careers, aspire to university-level education and alert pupils to the availability of nurse education closer to home.'

Forty two school pupils (n = 42) completed questionnaires and participated in anecdote circles and 33 student nurses acting as pupil ‘buddies’ participated in focus groups. The programme was successful in increasing the number of pupils who wanted to become nurses and those who did made very positive comments such as: 'I now know for sure I want to be a nurse.' Pupils particularly enjoyed clinical skills experience and liked being treated, educationally, as adults. Some realised how difficult nursing was but also that they were able to speak to patients. Ten specific recommendations for running such schemes are provided in the article by Smith et al. (2015)


Reference

Smith A, Beatttie M, Kyle RG (2015) “I know exactly what I’m going into”: recommendations for pre-nursing experience from an evaluation of a pre-nursing scholarship in rural Scotland Nursing Open doi: 10.1002/nop2.23

Patient repositioning

Seamus Cowman, Associate Editor

Patient repositioning is a frequently implemented pressure injury prevention strategy. The surprising thing is that, little is known about how often it should be implemented, or the frequency of movement among hospitalized patients with reduced mobility. A new study by Latimer et al. 2015: ‘The repositioning of hospitalized patients with reduced mobility: a prospective study’ published in Nursing Open, provides new insights for health professionals in planning care for pressure ulcer, at risk patients. The problem of pressure ulcers represents a serious failing in the delivery of health services and it remains as an enigma to health service professionals and administrators alike as this is largely a preventable problem.


This observational study incorporated two data collection methods: chart audits and semi-structured observations. Using a consecutive sampling plan, 241 participants were recruited from two large Australian hospitals with one of the inclusion criteria being reduced mobility. The results showed that patients were repositioned more frequently than might have been previously believed and were observed to be repositioned on average 15 times over a 24 hour period. A lack of patient understanding about proper positioning for prevention of pressure ulcers is an important finding. Interestingly older patients and males were repositioned less frequently, placing them at greater risk for PI development. Patients were repositioned less at night than they were during the day.

The study has many basic findings which should be of great significance to health professionals in their efforts to tackle a mostly preventable health problem. The authors in their conclusion echo a recommendation that is a recurring theme from the literature on pressure ulcers: ‘Targeted and individualized pressure injury prevention management should be incorporated into clinical practice, however, this can only be achieved with nurses support and concurrent organizational support’.

Reference

Latimer S, Chaboyer W, Gillespie BM (2015) The repositioning of hospitalized patients with reduced mobility: a prospective study Nursing Open doi:





Sunday, 20 September 2015

Patient repositioning

Seamus Cowman, Associate Editor
Professor Seamus Cowman

Patient repositioning is a commonly implemented pressure injury prevention strategy in health care. The surprising thing is that there is little evidence on how frequently patients should be repositioned, there is also a lack of understanding of the frequency of movement among hospitalized patients with reduced mobility. A new study by Latimer et al 2015: ‘The repositioning of hospitalized patients with reduced mobility: a prospective study’ published in Nursing Open, provides new insights for health professionals in planning care for pressure ulcer, at risk patients. The problem of pressure ulcers represents a serious failing in the delivery of health services and it remains as an enigma to health service professionals and administrators alike, as this is largely a preventable problem.

This observational study incorporated two data collection methods: chart audits and semi-structured observations. Using a consecutive sampling plan, 241 participants were recruited from two large Australian hospitals with one of the inclusion criteria being reduced mobility. The results showed that patients were repositioned more frequently than might have been previously believed and were observed to be repositioned on average 15 times over a 24 hour period. A lack of patient understanding about proper positioning for prevention of pressure ulcers is an important finding. Interestingly older patients and males were repositioned less frequently, placing them at greater risk for pressure ulcer development. Patients were repositioned less at night than they were during the day.

The findings of this study should be of interest to health professionals in their efforts to tackle a mostly preventable health problem. The authors in their conclusion echo a recommendation that is a recurring theme from the literature on pressure ulcers: ‘Targeted and individualized pressure injury prevention management should be incorporated into clinical practice, however, this can only be achieved with nurse’s support and concurrent organizational support’.    

Reference
Latimer, S., Chaboyer, W. and Gillespie, B. M. (2015), The repositioning of hospitalized patients with reduced mobility: a prospective study. Nursing Open, 2: 85–93. doi: 10.1002/nop2.20


 July 2015

Friday, 18 September 2015

Calmness and agitation in people with dementia

Roger Watson, Editor

Anyone caring for people with dementia will know how hard mealtimes can be: the noise; movement; and resistance to feeding can all lead to agitation with the result that older people with dementia receive a low food intake with the consequent negative effects of undernutrition.  In a study by Begland et al. (2105) titled: 'A qualitative study of professional caregivers' perceptions of processes contributing to mealtime agitation in persons with dementia in nursing home wards and strategies to attain calmness' professional caregivers were interviewed about this phenomenon.

As the authors explain, the aim of the study was to: 'Describe professional caregivers’ perceptions of factors and processes contributing to mealtime agitation and strategies for attaining and maintaining calm mealtimes.'  Through the interviews the following factors leading to agitation were identified: lack of social interaction; negative social interaction around the table; too many stimuli.

The authors concluded that: 'When PCs perceived agitation as developing from negative emotional reactions to episodes that were happening during the meal, they are able to take actions to prevent these episodes. This approach is different from an attitude that perceives agitation as solely caused by the dementia disease and thus as something that the staff cannot influence or prevent.'  and that 'Head nurses in nursing home wards for persons with dementia should be aware of the need for knowledge about how to conduct positive mealtimes and should ensure that PCs receive adequate support and supervision while participating in mealtimes. Head nurses should communicate to their staff that participating during mealtimes is an essential part of high quality dementia care.'

Reference

Bergland, Å., Johansen, H. and Sellevold, G. S. (2015), A qualitative study of professional caregivers' perceptions of processes contributing to mealtime agitation in persons with dementia in nursing home wards and strategies to attain calmness. Nursing Open. doi: 10.1002/nop2.24

Thursday, 27 August 2015

Nurses' response to infections in older people

Roger Watson, Editor

Infections can be hard to detect in older people and often masked by other symptoms such as confusion which can have other causes.  In nursing homes untrained nursing assistants (NAs) are often responsible for the direct care of older people yet they may be unable to detect the signs of infection in older people and, therefore, unable to respond appropriately.  In a Swedish study titled: 'Nurses’ actions in response to nursing assistants’ observations of signs and symptoms of infections among nursing home residents' and published in Nursing Open Alleman and Sund-Lavander (2105) the issue of how the response to infection in older people relates to who detects it is investigated.

Using nursing records from 205 nursing home residents it appears that action taken in related to who - in terms of which grade of staff - detects the infection.  When NAs suspect an infection it is more common that no action is taken than when a Registered Nurse detects the infection.  Also, it appears that NAs did not feel always safe in conveying information to Registered Nurses.  In the words of the authors: 'As NAs often initiate episodes of suspected infection by observing changed conditions, it seems important to include the NA in the decision-making process as these observations could detect possible early signs and symptoms of infections.'

Reference

Alleman H, Sund-Levander M (2015) Nurses’ actions in response to nursing assistants’ observations of signs and symptoms of infections among nursing home residents Nursing Open doi: 10.1002/nop2.22

Wednesday, 3 June 2015

Breast care nurses in Australia

Roger Watson, Editor

The role of breast care nurses in Australia is examined in a study by Ahern et al. (2105) titled: 'A survey of the breast care nurse role in the provision of information and supportive care to Australian women diagnosed with breast cancer' published in Nursing Open.

A survey of 50 breast care nurses from across Australia showed, as reported in the article: 'Patterns of service indicated higher caseloads in urban areas, with fewer kilometres served. Breast care nurses in outer regional, remote and very remote areas were less likely to work in multi-disciplinary teams and more likely to spend longer consulting with patients. Breast care nurses reported they
undertook roles matching the competency standards related to the provision of education, information and support; however, there were barriers to fulfilling competencies including knowledge based limitations, time constraints and
servicing large geographical areas.'

The authors concluded: 'This was the first Australian study to describe the role of the breast care nurse nationally and the first study to investigate breast care nurses perceived ability to meet a selection of the Australian Specialist Breast Nurse Competency Standards. Important differences were found according to the geographical location of breast care nurses.'

Reference

Ahern T, Gardner A, Courtney M (2105) titled: 'A survey of the breast care nurse role in the provision of information and supportive care to Australian women diagnosed with breast cancerNursing Open doi: 10.1002/nop2.18

Sunday, 17 May 2015

End of life care in ICU

Roger Watson, Editor
Intensive care is designed to save lives but many lives also end there and the environment may not be the best suited to this sensitive time of transition for the dying person and for families. A recent study by Coombs M (2015) titled: 'A scoping review of family experience and need during end of life care in intensive care' and published in Nursing Open explores family experiences at end of life of a relative in ICU in a literature review.



From the many hundreds of articles retrieved and the 16 that were finally reviewed, the author concludes: 'Studies in this scoping review demonstrate the interest
from practitioners and researchers to improve care for patients and families at the end of life. In this body of work on family need and experience in end of life care,
there is broad consensus on key areas in this, for example, information, communication, relationships and support. However, this review has identified areas for further theoretical, empirical and practical exploration with the aim of
improving family outcome in end of life care in critical care. Greater use of prospective and longitudinal studies is required to explore how time influences family perception of their experience and need. There is further opportunity to understand family need at the transition from treatment withdrawal to death in the intensive care setting and the impact of care at this time. As nurses manage care for patients and families at this pivotal time, this is an important area requiring further exploration and review.'

Reference

Coombs M (2015) A scoping review of family experience and need during end of life care in intensive care' Nursing Open doi: 10.1002/nop2.14

Sunday, 19 April 2015

Generation Y nurses



Roger Watson, Editor
This study was to report what factors Generation Y New Zealand Registered Nurses wish to change about nursing.  New Zealand has a shortage of nurses and a growing older population and it is important to see what factors will attract generation Y people into nursing and keep them there.
Generation Y are defined for this study as those born between 1980-1994 and data were collected using an online survey - of course...for generation Y!  Various motivators and de-motivators ('push and pull factors') were identified in the study and, as the authors conclude: 'Given the ageing New Zealand nursing workforce couple with an ageing population and an increasing demand for health services it is clear that the retention of young Generation Y registered nurses in the healthcare workforce is essential. It is imperative that employers of nurses and government organisations responsible for nursing work force planning understand what push or pull factors are motivating these nurses to remain in, or exit from the profession with a view to developing strategies to address their concerns. If Generation Y New Zealand registered nurses are to remain in the workplace then the workplace needs to develop motivators to keep them there. If this does not occur the potential exists for the healthcare workplace to either be overwhelmed by dissatisfied workers which will be detrimental to both the nurses and patients or a workplace that is short of nurses.'

This article is published open access and is free to download.


From Norway to Bangladesh - nursing student experience

Roger Watson, Editor

The purpose of this study by Jørgensen and Hadders (2015) titled: 'The significance of communities of practice: Norwegian nursing students’ experience of clinical placement in Bangladesh' was to gain understanding of Norwegian students’ experience of learning in clinical placement in Bangladesh without formal one to one supervision, by a personal mentor in the ward.  Seven third year bachelor nursing students enrolled in a clinical placement programme in Bangladesh participated in focus group interviews prior to their departure to Bangladesh, during their stay in Bangladesh and after their return to Norway.

The first interview was conducted a few days before students’ travel to Bangladesh. Prior to departure, the students expressed their anticipations about how they expected to be received by the Bangladeshi nurses and how they expected to achieve their learning objectives during their clinical placement.  The second interview was conducted in Bangladesh when the students were about midway through their clinical placement.  Despite the challenges, overall students evaluated their learning outcomes as satisfactory, professionally as well as personally. They considered their obtained knowledge relevant and transferable to the Norwegian nursing context.

In the words of the authors: 'Additional data are needed and follow-up interviews would provide more depth to the understanding of how nursing students reintegrate in Norway. An exploration of how nursing students cope with reintegration coming home and how they managed to incorporate their insights from a clinical placement abroad in their professional nursing practice in Norway needs to be investigated further in a future study.'

Reference

Jørgensen W, Hadders H (2015) The significance of communities of practice: Norwegian nursing students’ experience of clinical placement in Bangladesh Nursing Open doi: 10.1002/nop2.15

Wednesday, 25 February 2015

Why do Chinese nurses leave practice?

Roger Watson, Editor
There is a worldwide shortage of nurses and nurse turnover is an issue facing most health services in most countries and this includes China where the required number of nurses in the years ahead will probably run to tens of millions.  The reasons for nurses leaving practice in China is reported in an article by Zhu et al. (2015) titled: 'A qualitative exploration of nurses leaving nursing practice in China' and published in Nursing Open.  


The study involved in-depth interviews with 19 nurses who had left nursing practice and were theoretically sampled from one provincial capital city in China during August 2009–March 2010.  'Mismatched expectations' described one of the major reasons for leaving and this may be a result of the way people enter nursing in China; in the words of the authors: 'The majority of participants said that they were transferred into nursing studies without true desire to be nurses. While different levels of education between the universities and colleges became fiercely competitive with a market orientation, Chinese students are required to accept the pre-condition for getting a university admission offer ‘I agree to be transferred to other subjects’. Although nursing is an unwelcome career choice in current Chinese society, involuntarily transferring students into nursing studies from other subjects has been taken for granted. As a nursing teacher now, Yuan thought that a lack of proper support for students who involuntarily entered nursing study has a negative impact on students’ learning attitudes and their leaving the nursing practice early.'  Clearly, if more nurses are going to be encouraged to stay in nursing the way that they are
recruited and then the expectations once in practice may have to be reviewed to avoid even bigger problems in future.







Reference

Zhu J, Rodgers S, Melia K (2015) A qualitative exploration of nurses leaving nursing practice in China Nursing Open doi: 10.1002/nop2.11

Machine translation and ethnic diversity

Roger Watson, Editor

When it comes to machine translate there are at least two fundamental questions: does it work? If so is one translator better than the rest?  In the early days of online translators many of us sought amusement in some of the howlers that were generated.  It seems that these machine translators are much better these days and are worth studying, especially on the context of research into ethnic diversity where language can be a facilitator and a barrier. 

 A recent paper by Taylor et al. (2105) titled: ‘A prospective observationalstudy of machine translation software to overcome the challenge of includingethnic diversity in healthcare research’ and published in Nursing Open reports an investigation to compare two online translation packages.  Translation of English into Spanish and Chinese was used to test the translators with some interesting results.

One translator was better than the other and Spanish translated better than Chinese.  However, in the words of the authors: ‘Machine translation software is not currently accurate enough to provide translation of documents used in research or health care and would not recommend its use without the involvement of professional proofreading and editing.’

Which were tested and which was best: read the article!

Reference

Friday, 2 January 2015