Exploring the relationship between social identity and workplace jurisdiction for new nursing roles: a case study approach.

BACKGROUND: The introduction of new healthcare roles internationally has had mixed results with some evidence that variations can be accounted for by the manner of their introduction rather than role content. Explanation may be found partly in the ways in which new roles establish a workplace jurisdiction; that is, recognition in the workplace of a role's legitimate rights to undertake a particular scope of practice. OBJECTIVE: To explore the factors that influence the development of workplace jurisdiction of new nursing roles. DESIGN AND SETTING: Critical realist multiple case study design within two NHS Acute Hospital Trusts in England and two new nursing roles as embedded units of analysis in each case (n=4 roles). In Phase 1, data were collected through semi-structured interviews (n=21), non-participant observation of committees (n=11), partial participant observation and shadowing of the role holders' working day (n=9), together with analysis of organisational documents (n=33). In Phase 2, follow up interviews with role-holders (n=4) were conducted. Participants Staff in new nursing roles (n=4) were selected purposively as embedded units according to the theoretical framework and other informants (n=17) were selected according to the study propositions. RESULTS: Qualitative analysis demonstrated that different role drivers produced two different role types, each of whom faced different challenges in negotiating the implementation of the role in the workplace. Negotiation of workplace jurisdiction was shown to be dependent on sharing social identities with co-workers. Four major workplace identities were found: professional, speciality, organisational and relational. CONCLUSION: The current focus on setting legal and public jurisdictions for new nursing roles through national standards and statutory registration needs to be complemented by a better understanding of how workplace jurisdiction is achieved. This study suggests that social identity is a significant determinant.

Nutrition and wound healing.

A review of the role of macro- and micro-nutrients in injury response and wound healing, the effects of nutrient depletion and repletion on healing and recovery, and an examination of the process of nutrient assessment, delivery and evaluation.

Prediction of survival in dementia by cognitive tests: a six-year follow-up.

One hundred and sixteen elderly female in-patients with confirmed diagnoses of senile or arteriosclerotic dementia were tested on the Paired-Associate Learning Test (PALT) and Cognitive Assessment Scale (CAS) of CAPE and were followed up annually for six years. Comparison of those patients who had died by each follow-up date with those who had survived showed that in general the latter had had better PALT and CAS scores.

Prediction of survival by three psychological measures.

One hundred and seven elderly female in-patients with confirmed or suspected diagnoses of dementia were assessed by the Paired-Associate Learning Test (PALT), and the Cognitive Assessment Scale (CAS) and Behaviour Rating Scale (BRS) of CAPE. Eighteen months later, 62 patients were still alive. These had significantly better scores on the 'easy' set of PALT and on BRS than the non-survivors; the differences on the 'mediate' and 'hard' sets, and on CAS, while in the predicted direction, were not significant.

The comparative effectiveness of three versions of 'classroom' reality orientation.

The effectiveness was compared of 'Classroom' Reality Orientation presented (1) once daily, in groups; (2) twice daily, in groups; and (3) once daily, individually. On a questionnaire measure of orientation all three versions produced significantly greater improvement than that found in an untreated control group, but did not differ in their relative effectiveness. Similarly, the three versions did not differ in their effectiveness when used with patients of varying degrees of deterioration.