Research Quality-Lessons from the UK Research Excellence Framework (REF) 2021.

Research quality is a term often bandied around but rarely clearly defined or measured [...].

Nursing and Interdisciplinary Research: Phoenix or Dodo?

Interdisciplinary research activities are increasing in health care in terms of amount and quality. It is recognised that the global problems facing humankind will not be solved by individual disciplines working in isolation. The purpose of this paper is to examine the issues facing interdisciplinary research and how it impacts on nursing in particular. Some solutions to engendering cross disciplinary research are offered and a definition of interdisciplinary research is shared.

Fit for Practice: Analysis and Evaluation of Watson's Theory of Human Caring.

The aim of the authors of this paper is to analyze Watson's theory of human caring for its usefulness and worth in education, practice, and research. The reason for undertaking this analysis is to evaluate if Watson's theory would be useful for nursing in those countries where such theories were not an established part of the nursing curriculum. Furthermore, in some European countries, their political past or cultural influences led to an unquestioned adoption of the biomedical model. As their political culture changes, many social structures have had to be revisited, and for nursing, this has meant the introduction of theoretical reasoning, teaching, and practice.

Delegating and supervising unregistered professionals: the student nurse experience.

BACKGROUND: Changing models of healthcare have resulted in the need for registered nurses to be competent in delegating and supervising the unregistered health care assistant. However research evidence suggests nurse education does not prepare students for the practicalities of this role. OBJECTIVES: This paper reports on undergraduate student nurses' level of preparation when working with health care assistants (HCA). It is part of a large scale project, undertaken between 2005 and 2011, which explored pre-registration student nurses' perceptions of the role of the HCA and how this affects their clinical learning. DESIGN: A sequential transformative mixed method research design was adopted. SETTING: One higher educational institution in the United Kingdom. PARTICIPANTS: Forty-five pre-registration nursing students took part in phase one and 662 participated in phase two. METHODS: Phase one used focus groups (n=32) and interviews (n=13) and phase two used a semi-structured questionnaire. RESULTS: Whilst most students reported that they were familiar with the role of the health care assistant, findings showed that nurse training did not initially prepare students for the realities of clinical practice, however as students progressed they became more aware of such issues. For some such skills were learnt on the job and they identified a number of barriers they faced when delegating tasks such as fear of causing conflict. Overall the lack of initial preparation was perceived by participants to be a hindrance to meeting the goals of clinical learning and to understanding the dynamics within the nursing hierarchy. CONCLUSIONS: Students in this study highlighted gaps in their educational programme and clinical experiences regarding their preparation for a delegatory and/or supervisory role. Given the importance of such skills, it is imperative that universities provide pre-registration student nurses with the education necessary to develop delegation strategies and to adapt to their evolving professional role.

Perceptions of the unregistered healthcare worker's role in pre-registration student nurses' clinical training.

AIM: To explore the unregistered healthcare worker's role and influence on student nurses' clinical learning experience. BACKGROUND: Across the developed world, the role of the unregistered worker is exceeding its traditional boundaries. Evidence suggests that this includes the day-to-day mentoring of pre-registration student nurses. However, no research to date has explored reasons as to why this is occurring, what types of tasks are taught, and the consequence of this. DESIGN: A sequential exploratory mixed method research design was adopted. METHOD: Reporting on the final qualitative phase of a mixed method sequential research study, semi-structured interviews were undertaken with 59 unregistered healthcare workers across four hospitals in Northern Ireland. Transcriptions were analysed using a content analysis approach; all data were collected in 2010. RESULTS: Findings show the diversity of the unregistered healthcare workers' roles and confirm that they play a major part in the education of student nurses with regards to basic, clinical, and non-clinical tasks, with and without the approval of registered staff. However, their involvement did not reflect their levels of expertise as evidenced by certified training. Their participation was justified based on mentor unavailability, their closeness to the student and the patient. While some did raise concerns, they recommended that these workers be formally involved in nurse education. CONCLUSION: Mechanisms of workforce planning need to pay particular attention to the expanding role of unregistered healthcare workers as 'role drift' has the potential to alter patterns of work and affect current educational approaches impacting on the acquisition of clinical skills. Further research is recommended in this domain.

A qualitative study exploring the impact of student nurses working part time as a health care assistant.

BACKGROUND: National and international evidence indicates that university students engage in employment whilst studying. Research has suggested that nursing students either enter training with previous care experience or tend to work part time in a health related area whilst undertaking higher education. The impact of this on the socialisation process remains unclear. OBJECTIVES: Based on the symbolic interactionist framework, this paper reports on a theme from a large mixed methods study - the extent and implications of student nurses' work experience on learning and training. DESIGN: One qualitative stage from a sequential exploratory mixed methods design. SETTINGS: One higher education institution in the United Kingdom. PARTICIPANTS: Forty-five pre-registration nursing students. METHODS: Thirty-two students took part in four focus groups and 13 took part in individual interviews. RESULTS: Findings revealed that 27 (60%) of students were in paid nursing related employment. This was reported to be advantageous by most participants with regards to enhancing confidence, skills and time spent in the clinical setting. However, it was also perceived by a small number of participants as being detrimental to subsequent learning resulting in role confusion, influencing placement behaviour, and preferences for future nursing practice. Student participants with no prior work experience believed this placed them at a disadvantage, negatively influencing their learning, ability to fit in, and adjustment on placement. Findings have suggested that student participants desire more recognition of the experience and skills they have gained from their employment. CONCLUSIONS: Whilst care experience among the student nursing population is advocated, the results of this study show that it is perceived to impinged on their learning and educational journey. Policy makers, educationalists and health service providers need to be aware of the students who operate within the dual roles of student and health care worker so as to provide guidance and appropriate direction.

Analysis of international content of ranked nursing journals in 2005 using ex post facto design.

AIM: The purpose of this study was to examine articles in ISI-ranked nursing journals and to analyse the articles and journals, using definitions of international and article content. BACKGROUND: Growing emphasis on global health includes attention on international nursing literature. Contributions from Latin America and Africa have been reported. Attention to ranked nursing journals to support scholarship in global health is needed. METHOD: Using an ex post facto design, characteristics of 2827 articles, authors and journals of 32 ranked nursing journals for the year 2005 were analysed between June 2006 and June 2007. Using definitions of international and of article content, research questions were analysed statistically. FINDINGS: (a) 928 (32·8%) articles were international; (b) 2016 (71·3%) articles were empirical or scholarly; (c) 826 (89·3%) articles reflecting international content were scholarly or empirical; (d) among international articles more were empirical (66·3 % vs. 32·8 %; χ(2) ((1)) = 283·6, P < 0·001); (e) among non-international articles more were scholarly (29·2 % vs. 22·7 %; χ(2) ((1)) = 15·85, P < 0·001; 22·7 %); (f) 1004 (78·0 %) articles were international, based on author characteristics; (f) 20 (62·5 %) journals were led by an international editorial team; and (g) international journals had more international articles (3·6 % vs. 29·2 %; χ(2) ((1)) = 175·75, P < 0·001) and higher impact factors than non-international journals (t = -14·43, P < 0·001). CONCLUSION: Articles with empirical content appear more frequently in international journals. Results indicate the need to examine the international relevance of the nursing literature.

Capacity building in nursing and midwifery research and development: an old priority with a new perspective.

AIM: This paper is a report of a study to identify strategic priorities to inform the development of a regional strategy for nursing and midwifery research and development. BACKGROUND: Research capacity has been highlighted internationally as a crucial element in the advancement of nursing and midwifery research and development. Research capacity has been defined as that which relates to the ability to conduct research. In a strategic context, however, there is a broader perspective that encompasses activities related both to 'using' and 'doing' research. METHODS: A modified nominal group technique was employed. Three rounds were used to identify the main strategic priorities for nursing and midwifery research and development. Round one was based on the Delphi Technique and further rounds were based on the nominal group technique approach. Data were collected during February 2005. Participants (n = 105) were those involved in the research and development agenda for nursing and midwifery in Northern Ireland. FINDINGS: Capacity building was highlighted as a central component from the final 12 priorities, with three key areas identified: (1) the importance of strong and visible leadership; (2) developing research expertise that will enable the profession to deliver programmes of research and (3) increasing the capacity of individuals and organizations to engage in development activity. CONCLUSION: The 12 priorities identified emphasize the need for a broad perspective on building capacity that reflects involvement in a range of activities that span 'research' and 'development'. This has important implications globally if nurses and midwives are to develop the knowledge and skills required to engage in research and development as an integral part of their practice. Embracing this broader perspective has the potential to enhance performance that will contribute to continuous quality improvement.

Stoma coloproctology nurse specialist: a case study.

AIMS AND OBJECTIVES: The aim of this paper is to provide insight into the role of a Stoma Coloproctology Nurse Specialist. This paper presents the findings of an in-depth case study of a stoma coloproctology nurse specialist employed in one health board area in Northern Ireland. This case study was part of a larger study exploring innovative nursing and midwifery roles in Northern Ireland. BACKGROUND: Specialist nursing roles have evolved and developed in response to changing health care needs, patient expectations, changes in professional regulation and government initiatives. DESIGN: A case study approach was adopted. METHOD: Semi-structured interviews with the post holder (PH), her line manager and the human resource manager were undertaken. Non-participant observation of the PH's practice was also carried out. Analysis was undertaken on secondary data such as job specification, annual reports and other documentation relating to the post. RESULTS: Findings illustrate the PH's function and the impact of the role on patient care. Examples of innovative practices relating to providing care, support and guidance for patients and their families were identified; however, limitations to her role were also identified. CONCLUSIONS: The PH provides an invaluable service to patients, demonstrating a positive impact on care. However, the findings suggest the importance of establishing clear role boundaries, which may lead to professional growth and practice development. RELEVANCE TO CLINICAL PRACTICE: Although this study provides a valuable insight into the role of a Stoma Coloproctology Nurse Specialist a number of challenges exist, as the CNS role requires policy and appropriate educational preparation to practice at an advanced level. Further research investigating the development of the CNS role in the clinical setting and its relationship to members of the multi-professional team would be beneficial.

Quality of care: a comparison of perceptions of health professionals in clinical areas in the United Kingdom and the United States.

A tool was developed, using the nominal group and Delphi techniques, to explore healthcare staff's perceptions of the quality of hospital care provided in the United Kingdom compared with a tool from the United States. Similarities were identified in many core areas; however, there were several differences between the UK and US tools. This article identifies the process and findings and discusses possible reasons for similarities and differences between the tools.

The characterisation of selected antidepressant drugs using electrospray ionisation with ion trap mass spectrometry and with quadrupole time-of-flight mass spectrometry and their determination by high-performance liquid chromatography/electrospray ionisation tandem mass spectrometry.

The electrospray ionisation ion trap tandem mass spectrometry (ESI-MS(n)) of selected antidepressant drugs, i.e., citalopram, fluoxetine, mirtazapine, paroxetine, sertraline, and venlafaxine, has been investigated. Sequential product ion fragmentation experiments (MS(n)) have been performed in order to elucidate the degradation pathways for the [M+H](+) ions and their predominant product ions. These MS(n) experiments show certain characteristic fragmentations in that functional groups are generally cleaved from the ring systems as molecules such as H(2)O, amines and phenols. When an aromatic entity is present in a drug molecule together with a nitrogen-containing saturated ring structure as with mirtazapine, fragmentation initially occurs at the latter ring with the former being predictably resistant to fragmentation. Also, when an amine-containing drug molecule such as fluoxetine also contains a functional group, which liberates a phenol with a significantly lower DeltaH(f) (0) value than that of the corresponding amine, the phenol is preferentially liberated. The structures of product ions proposed for ESI-MS(n) can be supported by electrospray ionisation quadrupole-time-of-flight tandem mass spectrometry (ESI-QToF-MS/MS). These molecules can be identified and determined in mixtures at low ng/mL concentrations by the application of high-performance liquid chromatography/electrospray ionisation tandem mass spectrometry (HPLC/ESI-MS(2)), which can also be used for their analysis in hair samples.

Global quality criteria, standards, and indicators for doctoral programs in nursing; literature review and guideline development.

BACKGROUND: Nursing profession has intensified education and training of nurse researchers who could enhance the health of people through the discovery and dissemination of knowledge. This resulted in rapid increase in the number of doctoral programs in nursing in many countries in recent decades, but the guidelines for quality programs are lacking. OBJECTIVES: To develop guidelines for quality criteria, standards, and indicators for doctoral programs in nursing that may be used worldwide. METHODS: The work of the quality criteria, standards and indicators (QCSI) committee of the International Network for Doctoral Education in Nursing formed the basis of this paper and authors supplemented it by a literature review and consultation with international experts. FINDINGS: The major criteria of quality of doctoral program were: the nature of the mission, the quality of faculty, the students, the curriculum, program administration, and resources. Sub-criteria, standards and indicators for each of these criteria were identified in sufficient detail to provide guidance for quality doctoral programs in nursing. Concerns as to whether the QCSI would apply to those countries and doctoral programs that focus on a research thesis only, without formal coursework were addressed. Experts from across the world felt that the QCSI would be applicable for most program types. CONCLUSIONS: Global criteria, standards, and indicators for doctoral programs in nursing presented in this article may serve as guidelines for most doctoral programs in the world as these were developed by experienced nurse scholars representing eight countries from five continents. The degree of detail in these parameters is sufficient to enhance the utility of the QCSI for all doctoral programs worldwide.

Views on the ground: teaching and clinical assessors' views on vocational training for healthcare assistants in Ireland.

AIM AND OBJECTIVES: This paper reports the views of teaching staff and clinical assessors on their experience of programme delivery and assessment. BACKGROUND: In 2001, the Irish Department of Health and Children developed a vocational training programme for healthcare assistants. This programme was piloted nationally across 14 hospital and community sites. Teaching staff and clinical assessors at each site delivered the programme. METHOD: One-to-one semi-structured interviews were undertaken with 16 clinical staff and 26 teaching staff. With consent, all interviews were tape-recorded, from which the transcripts were subject to content analysis. RESULTS: A lack of experience and preparation among teaching staff and clinical assessors was evident. The staff's commitment to their role on the programme while maintaining their normal duties caused frustration and uncertainty. Not withstanding, the value of the programme in terms of increased motivation, satisfaction and knowledge of healthcare assistants and the impact on care delivery, was recognized by respondents. CONCLUSIONS: This programme represents the provision of a national standard training programme for healthcare assistants. It provides an insight into the delivery of such a programme and the educational and training needs of healthcare assistants through the views of staff that taught and assessed on it. RELEVANCE TO CLINICAL PRACTICE: Findings suggest that the development and implementation of a national training programme for healthcare assistants is achievable.

Health care assistants: the views and perceptions of course co-ordinators in the Republic of Ireland.

AIM: A research study was undertaken in Ireland to evaluate a pilot Healthcare Support course. One aim of the study was to obtain the views and perceptions of the course coordinators on a range of issues relating to the training programme. BACKGROUND: From the beginning of formal UK health care, there have always been unqualified or untrained assistants working within hospital and community settings. The provision of relevant training for these staff members has a number of benefits not just to registered nurses but also to patients, managers and health care assistants (HCAs) themselves. METHODS: Semistructured interviews were undertaken with course coordinators in 14 pilot sites across Ireland. RESULTS: The coordinators maintained that the course was too short but acknowledged that this was a pilot programme. The course structure was perceived to be appropriate and with the content relevant to the skills and knowledge required by HCAs. Selection criteria were varied across the pilot sites which led to some difficulties for coordinators. CONCLUSIONS: Overall, coordinators felt that the trainees on the programme were committed and motivated and that the course increased their knowledge and skills and was a rewarding experience.