Developing an oral healthcare assessment strategy to enhance patient care.

The promotion of oral healthcare is an integral part of nursing care. However, research has shown that staff in hospitals and community care settings often lack oral healthcare skills. This article details a quality improvement project in which a scoping exercise was undertaken in one NHS trust to assess whether ward-based oral healthcare provision was adequate. The scoping exercise identified that there was a need to address the lack of oral healthcare provision in the trust. Subsequently, a multidisciplinary working group developed an oral healthcare assessment tool and rolled this out across the trust. The authors also provided online training for nurses in the trust to assist them in using the new tool. At the same time, an audit of the oral healthcare products used in the trust, and their appropriateness, was undertaken.

Evaluation of the effect of a Nursing System Framework on Nurse Sensitive Indicators, mortality and readmission in an NHS Trust.

In 2018, an NHS Trust (UK) implemented an innovative Nursing System Framework (NSF). The NSF formalized a two-year strategy, which provided teams with clear aims and measurable objectives to deliver care. Failures of coordination of nursing services are well-recognized threats to the quality, safety and sustainability of care provision. AIM: To evaluate the efficacy of introducing a NSF in an NHS Trust, using nursing sensitive indicators and pre-selected mortality, data outcome measures. DESIGN: A before and after implementation, observational study. METHODS: 105,437 admissions were extracted at an admission record level. Data was extracted from 1st September 2018 through to the 31st August 2019. RESULTS: Using SQUIRE guidelines to report the study, insufficient evidence was found to reject a null hypothesis with a chi-squared test of association between in-hospital death and the NSF intervention period, with a p-value of .091. However, trends were seen in the data, which suggested a positive association. CONCLUSION: The NSF is a complex intervention, which provides direction for improvements but requires further research to understand the benefits for nurses, Midwives, Health Visitors and patients.

Measuring nursing movements using real time tracking data at the Royal Wolverhampton Hospital Trust.

BACKGROUND: Real time location systems (RTLS) are increasingly used in healthcare with applications that include contract tracing and staffing. However, their potential to provide organizational insights requires staff compliance with the system. MATERIALS AND METHODS: Our goal is to assess how many nurses are using the RTLS correctly (i.e. complying to the system). We collect RTLS data on the movements of nurses at the Royal Wolverhampton NHS Trust. We identify the number of RTLS active nurses and compare it to what expected from the nurses' rotas. RESULTS: We find that a significant number of nurses appear not to be active from the RTLS data. For approximately 15% of the active users, RTLS records below 10 movements per day. Nevertheless, most of the active users have daily RTLS times consistent with the average shift length. CONCLUSION: Applications of RTLS data may need to account for imperfect compliance of staff to the system.

The feasibility and validity of using a real time location system (RTLS) to measure bedside contact time.

Background: The association between the nurse-to-patient ratio and patient outcomes has been extensively investigated. Real time location systems have the potential capability of measuring the actual amount of bedside contact patients receive. Aims: This study aimed to determine the feasibility and accuracy of real time location systems as a measure of the amount of contact time that nurses spent in the patients' bed space. Methods: An exploratory, observational, feasibility study was designed to compare the accuracy of data collection between manual observation performed by a researcher and real time location systems data capture capability. Four nurses participated in the study, which took place in 2019 on two hospital wards. They were observed by a researcher while carrying out their work activities for a total of 230 minutes. The amount of time the nurses spent in the patients' bed space was recorded in 10-minute blocks of time and the real time location systems data were extracted for the same nurse at the time of observation. Data were then analysed for the level of agreement between the observed and the real time location systems measured data, descriptively and graphically using a kernel density and a scatter plot. Results: The difference (in minutes) between researcher observed and real time location systems measured data for the 23, 10-minute observation blocks ranged from zero (complete agreement) to 5 minutes. The mean difference between the researcher observed and real time location systems time in the patients' bed space was one minute (10% of the time). On average, real time location systems measured time in the bed space was longer than the researcher observed time. Conclusions: There were good levels of agreement between researcher observation and real time location systems data of the time nurses spend at the bedside. This study confirms that it is feasible to use real time location systems as an accurate measure of the amount of time nurses spend at the patients' bedside.

How a better understanding of nursing research roles may help to embed research into clinical structures.

BACKGROUND: Despite efforts to build research capacity within nursing there are growing concerns about the lack of funding and support for nurses who wish to pursue a career in research. AIM: To explore how research capacity within the nursing profession can be increased. DISCUSSION: The disparity in opportunity and support for such roles is a barrier to the growth of nursing research. This article examines the nomenclature that exists around nursing roles in research, including those of clinical research nurse, nurse researcher and clinical nurse academic, and the challenges associated with each of these roles. The authors reflect on their career paths, specifically the transition from clinical research nurse to nurse researcher. CONCLUSION: To grow research capacity within the nursing discipline, organisations must provide opportunities for research at all career stages, promote the fundamental role that research plays in the quality of patient care and highlight career pathways and roles in nursing research.

The experiences and perceptions of newly qualified nurses in the UK: An integrative literature review.

AIM: This integrative review aimed to develop an understanding of the experiences and perceptions of newly qualified nurses in the United Kingdom (UK). BACKGROUND: In the transitional period following registration, newly qualified nurses may feel socially isolated and overwhelmed by increases in accountability, workplace pressures and the psychological demands of the role. Despite this, the experiences and perceptions of newly qualified nurses remains an under-researched area in the UK, with much of the existing research having been conducted internationally. METHOD: An integrative framework methodology was used as a basis for the literature review. The methodology comprised of five stages: problem identification, literature search, data evaluation, data analysis and presentation of the findings. 20 papers were assessed for quality and analysed thematically. RESULTS: Data were synthesised under four themes: Preparation for real-world practice, the transition experience, growing into the role and preceptorship and support from the wider team. CONCLUSION: The review suggests that newly qualified nurses require on-going support post qualification. Workplace culture appears to have a significant impact on the transition experience. The review provides further evidence in relation to the experiences of newly qualified nurses in the UK context. The review may help to inform the development of strategies to support and retain newly qualified nurses in an ever-changing health care environment.

The scope and variance of clinical nurse specialist job descriptions.

Specialist nurses have been part of the nursing workforce for decades but articulating the scope of such roles, educational requirements, professional expertise and levels of pay is still widely debated within the workplace. This article reports on a study that examined a sample of clinical nurse specialist (CNS) job descriptions from across the UK. One hundred job descriptions were sourced, originating from various healthcare settings, and audited to explore their scope and content. In conclusion, the job descriptions showed a high level of agreement of the scope domains of a CNS role but were less consistent when considering the experience and educational requirements of CNSs.