What is the existing evidence base for adult medical Same Day Emergency Care in UK NHS hospitals? A scoping review.

Introduction: This scoping review focuses on acute medical Same Day Emergency Care (SDEC), as medical patients represent a significant proportion of emergency admissions in the NHS. Methods: This scoping review has been conducted in accordance with the JBI methodology and as detailed in the published scoping review protocol. Results: Identified papers included two observational cohort studies, four audits, four review articles, two opinion pieces, a paper on potential future developments, three policy documents, one strategy paper and a position statement. Key themes were extrapolated and discussed in a narrative. Conclusions: The scarcity of literature in relation to the quality, safety, and effectiveness of SDEC highlights the need for further study. Therefore, there is a pressing need for SDEC specific research within the UK.

Insights from the pandemic: an autoethnography of nursing clinical placement teams.

BACKGROUND: Designated placement staff, including academics, professional clinical support teams and stakeholder clinical teams, are responsible for organising students' clinical placements. Disciplines have reported sustained innovations in the way placement staff work following the pandemic. There are few published reports from nursing placement staff. Aim: Understand how challenges during the pandemic, may have led to disrupting the status quo for nursing placement staff. DESIGN: Nine academic, professional and industry nursing placement staff reflected on their daily work practices and team culture post the pandemic disruptions. The reflections were analysed using a descriptive thematic approach. RESULTS: Staff described "a double-edged sword" balancing fatigue from the dynamic situation increasing their workloads with wanting to seize opportunities to challenge the status quo. Three themes were identified. CONCLUSION: Clinical placement staff shared reflections are useful for identifying workplace initiatives that may enhance nursing and other disciplinary placement staff team culture and ways of working.

What is the existing evidence base for adult medical same day emergency care in UK NHS hospitals? A scoping review protocol.

OBJECTIVES: Same day emergency care (SDEC) is a new model of care, which has emerged over the past 5 years, building on prior ambulatory care services. The National Health Service (NHS) England National Strategy for SDEC suggests SDEC can meet local health needs by providing alternatives to emergency department attendance or hospital admission, for people with an urgent healthcare need, beyond the limited scope of an urgent treatment centre. This review focuses on acute medical SDEC, as medical patients represent a significant proportion of emergency admissions. The planned scoping review aims to map the existing evidence base. METHODS AND ANALYSIS: This is a protocol for a scoping review to be conducted in accordance with the format of the Joanna Briggs Institute (JBI) methodology for scoping reviews. The databases to be searched will include EMBASE, MEDLINE and CINAHL, via EBSCOhost. Sources of unpublished studies, policies and grey literature will include Google Scholar, the Cochrane Library, TRIP database, ProQuest Dissertations and Theses Open, and the Health Management Information Consortium. Papers relating to acute medicine adult patients attending NHS SDEC services in the UK will be included. International papers will be excluded, as will those over 5 years old, and those where full text is not available. The results of the search and study inclusion/exclusion process will be reported and presented in a Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) flow diagram. Data will be extracted from papers included in the scoping review by two reviewers, using a JBI data extraction tool. Any differences of opinion will be discussed until consensus is reached. If needed, a third reviewer will be asked to join the review team to achieve consensus. Data and themes extracted will be summarised and presented in tables. A narrative thematic summary will accompany the presented results, describing how the results relate to the review objective. Literature gaps will be identified and recommendations for future research made. ETHICS AND DISSEMINATION: There is no requirement for ethical approval for this scoping review. On completion, it will be published in a peer-reviewed academic journal and presented at a conference.

Patient perspectives of positive messages from clinicians: a qualitative secondary analysis and conceptual model.

Background: A review and meta- analysis of empathic communication and patients' expectations of interventions has shown that if positive messages are delivered there is a small but measurable reduction of pain and anxiety and some improvements in physical outcomes. Aim: To identify elements of health messages that may have a positive impact on patient health outcomes to guide effective nurse-patient- communication. Methods: Data were extracted from each study in a qualitative analysis of a systematic review investigating the health effects of positive messages, and analysed following the principles of thematic analysis. Findings: Central to effective positive messages were good communication skills. Five key features were identified. Discussion: The non-treatment care categories such as cognitive care and emotional care can significantly influence health outcomes across a range of interactions. Conclusion: Strategies to facilitate positivity can be incorporated into nursing education programs designed to improve patient outcomes.

Iranian nursing students' experiences of workplace violence: a qualitative study.

BACKGROUND: Workplace violence against nursing students is a common phenomenon. This study aimed to investigate Iranian nursing students' experiences of workplace violence, including their reaction to violence and the consequences and the effects of such violence on the students. METHODS: The study participants were undergraduate nursing students. The data were collected using semi-structured, in-depth face-to-face interviews. Data analysis was carried out with qualitative approach using conventional content analysis. RESULTS: Four categories were extracted from the analysis of the interview transcriptions: vertical violence, horizontal violence, reaction to violence and consequences of violence. Nurses were the major imposers of violence against students and psychological and verbal violations were the most of used forms of violence. The students reacted to violence in the forms of counteracting, reporting, disregarding and considering as commonplace. CONCLUSIONS: Workplace violence is a common phenomenon experienced by nursing students in this study, which causes devastating individual, educational, and professional impacts. Action plans including providing safe environment and appropriate support from nurses and educators should be developed in clinical settings to intervene and to prevent workplace violence.

Nursing education, virtual reality and empathy?

An empathic approach to patient-centred care is a core of nursing practice. One of the methods to develop empathy, which is gaining currency is the use of virtual reality simulations in education. This paper posits some questions, does it simply reinforce a 'type' of patient, neglecting caring for the patient as unique, is empathy what results or is it pity, does it result in a greater distance being created between the patient and the health care provider? Can we ever really know what it is like to walk in a patient's shoes when what we experience through virtual reality provides a small snapshot of the vicissitudes of living with an illness or disability. We suggest that what matters most in simulations using virtual reality is how the student exits the experience and if they leave knowing just what patients 'like that' feel, or whether they leave with humility and curiosity.

Effective Characteristics of Iranian Nursing Students in Their Relationship with Clinical Nurses.

Introduction: The purpose of this study was to explore the characteristics of undergraduate nursing students, which may determine the nature of their relationship with clinical nurses. Relationships between nursing students and clinical nurses are critical to maximize student learning outcomes and produce skilled graduates for the future health workforce. Methods: This qualitative content analysis study was conducted from January to August 2016. Twenty nine semi-structured in-depth interviews were conducted with 20 undergraduate nursing students in Tabriz nursing and midwifery faculty. Interviews were recorded and transcribed verbatim (in Persian), and analyzed using conventional content analysis to identify themes. Results: Four key themes emerged: educational factors (cognitive knowledge and practical skills, and learning motivation); communication skills; perceived support (perceived support from nurses and educators); and psychological state (fear of the relationship and self-confidence). Self-confidence is an emphasized concept in nursing students' willingness and ability to relate with clinical nurses. Conclusion: The results of the study showed that educational, communicative and psychological factors are important determinants of student communication with nurses. However, self-confidence is the most important factor in establishing such relationship. Self-confidence could be further assessed to identify nursing students who need greater support or would benefit from greater educational interventions to achieve relational skills.

Practising on plastic people: Can I really care?

PURPOSES: This study evaluated the experiences of undergraduate student nurses with high-fidelity Human Patient Simulation Mannequins (HPSMs) and their perceptions of empathy. METHODS: An exploratory case-study method was used to investigate the literature on empathy and the use of high-fidelity mannequins in nurse education. Two focus groups were conducted with eight third-year undergraduate nursing students in order to elicit responses to their experiences with HPSMs in their learning, especially in relation to empathy. FINDINGS: Undergraduate nurses found it challenging when using HPSMs in the learning environment to relate to the mannequins as real. Students reported that in their experience, the use of mannequins was not conducive currently to the development of skills necessary for positive interpersonal development of the nurse-patient relationship. CONCLUSIONS: Focus group data and the empirical literature suggest that more research needs to be conducted into the use of mannequins in the development of nurse-patient interpersonal skills. Educators need to make evidence-based and pedagogically sound decisions about the use and limitations of HPSMs in undergraduate nursing.

Supporting parents and parenting: An overview of data-based papers recently published in Contemporary Nurse.

Abstract Nurses have a crucial role in play in supporting parents and in delivering and referring parents to family-support services. In this editorial, we reflect on papers recently published in Contemporary Nurse. We sought to consider data-based papers on parenting published between 2008 and 2012 and elucidate the role/s and potential roles of nurses in enhancing and supporting parenting. Parenting is recognised as a crucial variable for achieving positive outcomes for children (Dawson et al 2012). Poor, inconsistent or abusive parenting is linked to poor outcomes (Griffin et al. 2000, Holt et al.2008, Patterson et al.1989), while consistent and effective parenting is associated with enhanced child outcomes (Lamb 2012, Landry et al.2001). In addition to being important to outcomes for children, perceived parenting quality is also important to parents themselves. Disrupted relationships between parents and their children have been identified as distressing and potentially damaging to both parties (Jackson 2000; East 2006, 2007; Power 2012).

Comparison of two single-platform ISHAGE-based CD34 enumeration protocols on BD FACSCalibur and FACSCanto flow cytometers.

BACKGROUND AIMS: Enumeration of viable CD34(+) cells provides critical information for the bone marrow (BM) transplant physician. The single-platform ISHAGE protocol is the most reliable method currently available to quantitate accurately this important subset of cells. Previous studies have shown that 5 CD34(+) cells/microL blood predicts the collection of at least 0.5x10(6) CD34(+) cells/kg patient weight. From the apheresis product, infusion of 2.5x10(6) viable CD34(+) cells (measured pre-cryopreservation)/kg patient weight will reliably permit engraftment of the hematopoietic system (as measured by the time to 20000 platelets/microL) by day 12-14 post-infusion. METHODS: We compared the CD34(+) cell numbers derived from Flow Count-based Stem-Kit; (Beckman Coulter) and Trucount tube-based stem cell enumeration (SCE) kit (BD Biosciences) ISHAGE templates on BD FACSCalibur and BD FACSCanto cytometers on 12 granulocyte-colony-stimulating factor (G-CSF)-mobilized peripheral blood (MPB) and 10 peripheral blood stem cell (PBSC) samples. RESULTS: Comparison of results showed that there was no statistical difference between samples run with Stem-Kit on the FACSCalibur versus SCE kit-based assays on either the FACSCalibur or FACSCanto. Mean results for the Stem-Kit/Calibur combination were 137, for SCE kit/Calibur 140 and for SCE kit/Canto 137 cells/microL. Pair-wise comparison of data based on rank order showed no statistically significant difference and all correlation coefficients had an R(2)>0.98. CONCLUSIONS: The two kits generated very similar data on a range of fresh samples regardless of instrument platform. These results confirm and extend the utility of the single-platform ISHAGE protocols with a variety of reagent kits and instrument platforms.