What influences a person's willingness to share health information for both direct care and uses beyond direct care? Findings from a focus group study in Ireland.

Background: The sharing of health information is invaluable for direct care provision and reasons beyond direct care, such as for health services management. Previous studies have shown that willingness to share health information is influenced by an individual's trust in a healthcare professional or organisation, privacy and security concerns, and fear of discrimination based on sensitive information. The importance of engaging the public in policy and practice development relating to the use and sharing of health information has been identified as an essential step for countries to take. This study's aim was to examine the factors that influence the Irish public's willingness to share their health information as part of a national public engagement on health information. Methods: A qualitative study using online focus groups was conducted as part of a wider national public engagement on health information. Participants were purposively recruited from a combination of public, patient, and service user groups in Ireland. Focus group interviews were audio-recorded, transcribed verbatim and analysed using inductive content analysis. Results: In total, 85 participants took part in 14 focus groups between January and March 2021. Two major themes were identified, trust and personal and public benefits of sharing health information. The ability to exercise control over personal information, perceived transparency of the process, and the extent to which the healthcare service was viewed as confidential, all influenced the level of trust a person held. Perceived benefits were influenced by the extent to which participants believed information sharing would support improved care or provide broader public benefit, and balanced against the potential for personal harm. Conclusions: The findings allow for new insights into the views of the public on the use and sharing of personal health information and can be used to inform the development of a consent model for health information.

A multi-method quality improvement approach to systematically improve and promote the quality of national health and social care information.

Safe and reliable healthcare depends on access to health information that is accurate, valid, reliable, timely, relevant, legible and complete. National data collections are repositories of health and social care data and play a crucial role in healthcare planning and clinical decision-making. We describe the development of an evidence-informed multi-method quality improvement program aimed to improve the quality of health and social care data in Ireland. Specific components involved: development of guidance to support implementation of health information standards; review program to assess compliance with standards; and educating health information stakeholders about health data and information quality. Observations from implementation of the program indicate enhanced health information stakeholder awareness of, and increased adoption of information management standards. The methodology used in the review program has proved to be a robust approach to identify areas of good practice and opportunities for improvement in information management practices. There has been positive adoption of the program among organisations reviewed and acceptance of the proposed recommendations. Early indications are that this multi-method approach will drive improvements in information management practices, leading to an improvement in health and social care data quality in Ireland. Aspects of this approach may be adapted to meet the needs of other countries.

The nature of advocacy vs. paternalism in nursing: clarifying the 'thin line'.

AIM: This paper is an exploration of the concepts of advocacy and paternalism in nursing and discusses the thin line between the two. BACKGROUND: Nurses are involved in care more than any other healthcare professionals and they play a central role in advocating for patients and families. It is difficult to obtain a clear definition of advocacy, yet the concepts of advocacy and paternalism must be compared, contrasted, and discussed extensively. In many situations, only a thin line distinguishes advocacy from paternalism. DATA SOURCES: A literature search was conducted using PubMed and CINAHL databases (2000-2008) as well as a library catalogue for texts. DISCUSSION: Four case stories were described in order to discuss the 'thin line' between advocacy and paternalism and develop communication strategies to eliminate ambiguity. Weighing the ethical principles of beneficence and autonomy helps to clarify advocacy and paternalism and provides an avenue for discussion among nurses practicing in a variety of settings. IMPLICATIONS FOR NURSING: Advocacy and paternalism should be discussed at interdisciplinary rounds, and taken into consideration when making patient care decisions. It is difficult to clarify advocacy vs. paternalism, but strategies such as knowing the patient, clarifying information, and educating all involved are initial steps in distinguishing advocacy from paternalism. CONCLUSION: Truly 'knowing' patients, their life experiences, values, beliefs and wishes can help clarify the 'thin line' and gain a grasp of these difficult to distinguish theoretical concepts.

Significant prevalence and genetic diversity of norovirus infection in Irish children.

UNLABELLED: Pediatric gastroenteritis places a considerable disease burden on children of the developed world. The national surveillance of gastroenteritis in Ireland is a combined virological and epidemiologic surveillance program. The objectives of this study were to characterize the norovirus (NoV) genotypes associated with viral gastroenteritis in children or=4 mo of age and determined that NoV and adenovirus infection are equally significant in children in the first 5 y of life. This group of pediatric patients reported diarrhea as their most common symptom raising the question whether Kaplan criteria are the most effective method for clinically diagnosing outbreaks of enteric infection in pediatric patients. ABBREVIATIONS: :

Nursing structure, processes, and patient outcomes in army medical centers.

The purpose of this study was to describe patient outcomes in Army Medical Centers, identify differences in outcomes between mixed medical-surgical bed and specialty intensive care units (ICUs), and explore predictive models for outcomes attributable to nursing structure and processes. Data were collected from 138 patients and 103 nurses in four medical-surgical and four ICUs in two Army Medical Centers. Significant differences for unit type were found for length of stay and patient satisfaction with nursing care. Outcome predictive models were modest (adjusted R2 = .16 to .24) and significant for length of stay, satisfaction with nursing care, satisfaction with pain management, and health status following discharge. Exploring differences and commonalities between military and civilian hospitals will ultimately provide insight into ways of improving patient outcomes and bettering the work environment of nurses.

Being refreshed: evaluation of a nurse refresher course.

In light of the current nursing shortage, registered nurses who have been away from clinical practice are a valuable resource. This article examines the effectiveness of a structured nurse refresher course to return nurses to employment and to prepare them for effective clinical practice. This course was successful in returning 78% (n = 37) of the survey respondents to nursing employment and was found to be highly effective in preparing these nurses in the six areas included in the course. This refresher course may serve as a model for the development of more structured refresher courses for inactive nurses.

Determining nursing faculty development needs.

Although faculty members often come to a university school of nursing with little or no experience in teaching, research, or other forms of scholarship, few schools of nursing have a comprehensive, formalized faculty development program. In considering the need to find and retain the best faculty in this competitive market, the University of North Carolina at Chapel Hill School of Nursing appointed a task force to develop a formal faculty development program for the School. After reviewing the literature and contacting 24 schools of nursing, the task force concluded that most do not offer a systematic approach to faculty development. The task force developed and distributed a needs assessment and received responses from 53% of the faculty. Based on the needs assessment the task force made eight recommendations to the faculty for an ongoing, comprehensive faculty development program.

Development of a model of moral distress in military nursing.

The purpose of this article is to describe the development of a model of moral distress in military nursing. The model evolved through an analysis of the moral distress and military nursing literature, and the analysis of interview data obtained from US Army Nurse Corps officers (n = 13). Stories of moral distress (n = 10) given by the interview participants identified the process of the moral distress experience among military nurses and the dimensions of the military nursing moral distress phenomenon. Models of both the process of military nursing moral distress and the phenomenon itself are proposed. Recommendations are made for the use of the military nursing moral distress models in future research studies and in interventions to ameliorate the experience of moral distress in crisis military deployments.

How nurses learn advocacy.

PURPOSE: To describe how nurses develop the skill of advocating for patients. DESIGN & METHODS: Hermeneutic phenomenological research methods. Both reserve and active U.S. Army nurses who cared for patients associated with the military operation in Bosnia were individually interviewed to gain an understanding of their experiences of advocating for patients and how they developed their advocating practices. FINDINGS: The constitutive pattern identified was Developing Advocating Practices. The themes comprising this constitutive pattern were Who I Am, Watching Other Nurses Interact with Patients, and Gaining Confidence. CONCLUSIONS: For the nurses in this study, developing advocating practices was more haphazard and situationally dependent than methodically taught in their nursing education programs. Nurses would have a stronger foundation in advocacy in nurse educators consciously teach advocacy and if nurse administrators support new graduates' advocacy in the work environment.

Characteristics of nurses and hospital work environments that foster satisfaction and clinical expertise.

OBJECTIVE: The purpose of this aspect of a larger study was to describe characteristics of nurses and their work environment at two military hospitals. BACKGROUND: Few studies have explored characteristics among nurses who practice in military hospitals. There is reason to believe that differences exist between nurses who work in military and civilian hospitals, some of which are required educational level, leadership experience, officer status, and career development opportunities. METHODS: A descriptive design was used to address how military and civilian nurses who work in military hospitals describe their autonomy, control over practice, nurse-physician collaboration, and clinical expertise and what relationships exist among these variables. RESULTS: Scores on autonomy, control over practice, and nurse-physician relationships all were above midpoint for all respondents as a group, indicating positive work environments in both of the military hospitals studied. Scores from the clinical expertise instrument were well above midpoint, indicating a desirable level of clinical expertise. These findings all reflect favorably on the military hospital work environment. CONCLUSIONS/IMPLICATIONS: This information will help to make a case for instituting or preserving those nursing processes that are effective and for identifying and working to change nursing processes that are not effective. Nurses will benefit by having a more collaborative work environment.