What's my line? A narrative review and synthesis of the literature on Registered Nurses' communication behaviours between shifts.

AIM: To describe, appraise and synthesize the seminal and empirical literature around Registered Nurses' communication behaviours between shifts in acute hospital settings. BACKGROUND: Effective communication between shifts (at nursing handover) is acknowledged as a prerequisite to safe and high-quality patient-centred care. However, gaps and inconsistencies continue to prevail. DESIGN: Narrative review and synthesis. DATA SOURCES: The electronic databases PubMED, CINAHL and Scopus were used. REVIEW METHODS: English language, peer-reviewed papers published between 1970-April 2012 were considered for review. Criteria included Registered Nurses' communication during handovers in adult hospital settings. RESULTS: Twenty-nine papers were reviewed. The research lacks a clear conceptual framework to define the core purposes of Nurses' communication behaviours between shifts. Seven themes were identified: overall purpose; report givers and receivers; seeing the whole picture; teaching and education; language; patient-centred care; and social cohesion. Two main communication processes are required - one articulating the whole picture and the other detailing information about patients. CONCLUSION: This area of research is challenged by lack of consistency in terminology and methodological rigour. While recent research has confirmed the findings from the seminal work, it has not been able to elaborate on some of the key challenges to refine the knowledge base. A more integrated approach is required to understand the complex process of improving nursing communication behaviours, particularly around the nursing handover. A neglected area of study is the role of the unit lead in determining the communication standards of the whole nursing team.

Working memory performance of older adults with insomnia.

Older individuals suffering insomnia typically report declines in their cognitive performance beyond what they consider to be normal changes due to the aging process. Recent neuro-imaging studies have demonstrated frontal lobe hypo-activation among insomniac populations when compared with healthy, good sleepers. However, research is yet to confirm whether frontal lobe hypo-activation translates into objective declines when performing tasks hypothesized to draw upon this brain region. This study aimed to investigate whether older insomnia sufferers demonstrate significantly impaired performance on a challenging working memory task when compared with age-matched good sleepers. Forty-nine older individuals (mean age = 69.43 years, SD = 4.83) suffering from sleep maintenance insomnia were compared with 49 age-matched good sleepers. Cognitive performance was assessed using the Double Span Memory Task, a computer-based working memory task that requires participants to indicate the names and/or spatial locations of increasingly longer sequences of visually presented objects. After controlling for general intelligence, the individuals suffering from insomnia did not perform differently when compared with the good sleepers on either the simpler or more cognitively demanding components of the task. Older individuals with insomnia did not display an observable impairment of working memory in this study relative to good sleepers. Despite the mixed results from previous research, this study adds weight to the absence of objective impairment in insomniacs, at least while performing short-term demanding cognitive tasks.

A preliminary assessment of the reliability and validity of a computerized working memory task.

The aim of the current study was to evaluate the psychometric properties of a recently developed measure of working memory: the Double Span Task. The Double Span Task is the first experimental task designed to assess all three components of Baddeley's (1992) model of working memory. The reliability of the Double Span Task was assessed in a sample of 105 older adults (M age = 64.3 yr., SD = 6.4). The internal consistency and test-retest reliability of the Double Span Task were good. The validity of the Double Span Task was assessed using a different sample of 49 older adults (M age = 70.0 yr., SD = 9.3). Performance on the Double Span Task was positively correlated with performance on a well-established measure of working memory, the Letter Number Sequencing Task. The Double Span Task also showed good discriminant validity. The Double Span Task is a reliable and valid measure of all three components of the working memory system.