The Impact of State Dementia Training Requirements for Nursing Homes on Antipsychotic Medication Use.

OBJECTIVES: Nursing home (NH) staff often report not having adequate dementia-specific knowledge to effectively care for these residents. Between 2011 and 2019, 9 states in the United States implemented dementia training requirements for NH staff. This study evaluated whether the state-mandated dementia training for NH staff was associated with improving resident outcomes. DESIGN: Compared trends in antipsychotic medication before and after implementation of state training requirements to trends in states without requirements. SETTING AND PARTICIPANTS: NHs. METHODS: Data from Care Compare for NHs and LTCFocus were linked to state policy data. We excluded 14 states that had implemented training requirements before the start of the study period in 2011. We estimated difference-in-differences models that compared trends in antipsychotic medication use before and after implementation of training requirements in states that have newly implemented requirements to trends in states without requirements. We also investigated whether the impact of training was larger in states with more stringent training requirements (eg, specifying a minimum number of training hours) and in NHs with a special care unit for dementia and examined similar analyses for restraint use and falls. RESULTS: We found that training requirements were associated with a 0.59-percentage point reduction (95% CI -0.91 to -0.27) in antipsychotics use. Effects were larger in NHs with a special care unit for dementia and in states that had stricter training requirements. We also found that training requirements were associated with a 0.17-percentage point reduction (95% CI -0.26 to -0.07) in restraint use measure and had no impact on falls. CONCLUSIONS AND IMPLICATIONS: State requirements for NH staff dementia training were associated with a small, but significant, reduction in the use of antipsychotic medication and physical restraints.

Malnutrition knowledge among nursing staff in four European countries: A cross-sectional study.

BACKGROUND: Nursing staff must have sufficient knowledge in order to adequately prevent and treat malnutrition. However, only a marginal amount of information on this topic is available in the literature. OBJECTIVES: This paper provides a comparison of the malnutrition knowledge among nursing staff in Austria, the Czech Republic, the Netherlands, and Turkey and presents factors associated with the malnutrition knowledge of nursing staff. DESIGN: A cross-sectional study was performed. SETTING AND PARTICIPANTS: Nursing staff from different care settings in Austria, the Czech Republic, the Netherlands, and Turkey participated in the study. METHODS: The KoM-G 2.0 (Knowledge of Malnutrition - Geriatric) questionnaire was used for data collection. RESULTS: In total, 2056 participants from different care settings took part in the study. Between 11.7 % (Turkey) and 32.5 % (Austria) of the participants had high levels of malnutrition knowledge. The country itself was the factor most strongly associated with malnutrition knowledge. The nurses' educational level and specialised training of nursing staff were also significantly (p < 0.001) associated with malnutrition knowledge. Questions about "factors that should be considered during older persons' food intake" were most frequently answered correctly, while questions about "different aspects of nutritional screening" were less often answered correctly in all four countries. CONCLUSIONS: This study was one of the first to describe the rather low level of malnutrition knowledge among nursing staff in different countries. The country itself was identified as the factor most strongly associated with the nurses' knowledge of malnutrition, while the nursing staff's basic education as well as further training were also detected as significant factors. These results indicate that it is necessary to extend and improve (academic) nursing education and to offer specialised training programmes which may improve nutritional care across country borders over the long run.

Staff Training Interventions to Prevent or Reduce Behavioural and Psychological Symptoms of Dementia in Nursing Home Residents: A Mixed Methods Systematic Review.

INTRODUCTION: Nursing home (NH) staff mention knowledge deficits regarding the management of behavioural and psychological symptoms of dementia (BPSDs) in residents with neurocognitive disorders (NCDs). Staff training therefore appears to be necessary. However, existing evidence on best training practices and their outcomes remains scattered. This systematic review aimed to (1) identify the best clinical practices and theoretical bases of staff training interventions on BPSD management in NHs and (2) summarize the effects of these interventions on resident and staff outcomes. METHODS: A mixed methods systematic review was conducted. Two nurse researchers independently searched nine electronic databases to identify studies on the efficacy of staff training interventions aimed at BPSD management in NHs, on a variety of resident and staff outcomes. The search was conducted for articles published between 1996 and 2022, using selected keywords, MeSH terms, and predefined eligibility criteria. The methodological quality of the retrieved studies was assessed using JBI checklists. RESULTS: Overall, 39 studies in 47 articles were included. Ten categories of trainings were identified, of which three demonstrated the most promising results on both residents and staff: (1) structured protocols and models, (2) person-centred bathing, and (3) communication techniques. The methodological quality of the retrieved studies was generally weak. Issues with intervention feasibility and reproducibility were also noted. CONCLUSION: Training interventions incorporating structured protocols and models, person-centred bathing, and communication techniques are associated with better staff and resident outcomes. However, there is a strong need for high-quality research to strengthen existing evidence and ensure feasibility and reproducibility.

"Now I Understand You": Changes in the Communication of Professionals in Nursing Homes After Receiving Training in the Validation Method.

Caring for older persons is a challenge for professionals who work in nursing homes. Problems in maintaining effective communication with a person with dementia in an effort to understand their needs is a major barrier to good care. Therefore, the main goals of this study were to explore communication barriers between professionals and people with dementia and to observe changes in communication patterns between them after completing Naomi Feil's introductory training in the bases of the validation method (BVM). The 11 professionals who worked in nursing homes attended a 16-hour introductory course on BVM. Participants were interviewed individually three times. The goal was to observe qualitatively the changes in relationships and communication patterns with people with dementia. The results were analyzed thematically. The professionals highlighted how, after the training, they had a different understanding of the person with dementia and a more humane perspective. These changes also reflected how the professionals experienced improvements in job satisfaction, security, and confidence. This study concluded that training nursing home staff in BVM for person-centered and human care has positive implications on how the professionals view their daily work and their way of interacting with older residents. [J Contin Educ Nurs. 2023;54(4):157-168.].

Diagnóstico de la superación profesional en el personal de enfermería del Hospital Pediátrico de Camagüey / Diagnosis of professional improvement in the nursing staff at the Pediatric Hospital of Camagüey

Introducción: La superación en enfermería debe estar dirigida hacia los problemas profesionales, lo cual le permite elevar la calidad de su desempeño pedagógico y asistencial. Objetivo: Caracterizar el proceso de superación profesional del personal de enfermería del Hospital Pediátrico Docente Provincial Dr. Eduardo Agramonte Piña de Camagüey. Métodos: Se realizó un estudio observacional descriptivo y transversal en el Hospital Pediátrico Docente Provincial Dr. Eduardo Agramonte Piña entre enero y junio de 2022. La muestra quedó conformada por 272 enfermeros que cumplieron con los criterios de inclusión. Las variables estudiadas fueron: sexo y grupo etario, años de experiencia laboral, categorías de pregrado hasta la licenciatura, actividades de superación de posgrado, profesionales vinculados a la docencia y participación en actividades científicas a los distintos niveles. Los datos se obtuvieron mediante la aplicación de una encuesta y la revisión del registro del personal de la institución, y se procesaron mediante el programa SPSS versión 26.0 en computadora Pentium V. Resultados: Predominaron los profesionales entre 20 y 29 años (29,0 por ciento), del sexo femenino (92,7 por ciento), con menos de 5 años de experiencia profesional (25 por ciento), en su mayoría licenciados (62,1 por ciento), que no contaban con actividades de superación de posgrado (64,3 por cierto). Solo el 3,3 por ciento tenía categoría docente y participación en eventos científicos a nivel de base (9,9 por ciento). Conclusiones: La superación profesional del personal de enfermería analizado es insuficiente, por lo que se deben diseñar e implementar estrategias de capacitación que den respuesta a esta problemática(AU)

Introduction: Professional improvement in nursing should be directed towards professional problems, which allows to raise the quality of its pedagogical and care performance. Objective: To characterize the professional development process of the nursing staff at Hospital Pediátrico Docente Provincial Dr. Eduardo Agramonte Piña, in Camagüey. Methods: A descriptive, cross-sectional and observational study was carried out at Hospital Pediátrico Docente Provincial Dr. Eduardo Agramonte Piña during January and June 2022. The sample consisted of 272 nurses who met the inclusion criteria. The variables studied were sex and age group, years of work experience, categories from undergraduate to bachelor's degree, postgraduate training activities, professionals linked to teaching, and participation in scientific activities at different levels. The data were obtained by applying a survey and reviewing the institution's personnel registry, as well as processed using the SPSS program (version 26.0) on a Pentium V computer. Results: There was a predominance of professionals between 20 and 29 years of age (29.0 percent), of the female sex (92.7 percent), with less than 5 years of professional experience (25 percent), mostly bachelor's graduates (62.1 percent), and with no postgraduate training activities (64.3 percent). Only 3.3 percent had a teaching rank and participated in scientific events at the institutional level (9.9 percent). Conclusions: Professional improvement of the analyzed nursing staff is insufficient; therefore, training strategies should be designed and implemented to respond to this problem (AU)

Educational needs of nursing home staff: does a needs-based palliative care course make a difference?

OBJECTIVE: In Singapore, more elderly are living in nursing homes (NHs), with a resultant increase in deaths occurring in NHs. However, palliative care training is limited in Singapore's core nursing curriculum, and many NHs rely on foreign-trained staff who may not have previous palliative care training. Our study aimed to evaluate whether a needs-based course can improve the palliative care knowledge and attitudes of NH nurses in Singapore. METHODS: Twenty-five nurses participated in the study. The intervention was an 8-week palliative care course developed based on needs assessment and led by a multidisciplinary faculty. A 50-item knowledge test was administered at baseline and 0 day and 3 and 6 months postcourse. Semistructured interviews were conducted at 3 months to assess for changes in attitudes and nursing practices. RESULTS: The mean knowledge score increased significantly from 31.4 (±4.4) precourse to 35.1 (±5.1) at 3 months. Knowledge scores in end-of-life care increased up to 6 months, and scores for pain and symptom management increased significantly at 3 months. Participants reported a positive change with improved communication skills and increased compassion. There was a lack of opportunities to apply some new knowledge and skills due to regulations and perceived residents' preferences to engage more local senior staff. CONCLUSION: The multidisciplinary needs-based palliative care course using various teaching modalities with follow-up knowledge tests helped to increase knowledge and improve communication skills and attitudes of NH nurses towards palliative care. The increase in knowledge and positive change in attitudes was noted to be sustained for at least 3 months postcourse.

Knowledge, Attitude, and Practice of Nursing Home Staff Regarding Physical Restraint in China: A Cross-Sectional Multicenter Study.

Background: Restraint is widely used in nursing homes to address safety concerns. However, many studies have shown that improper restraint can lead to many adverse outcomes. Nursing staff are the main practitioners of physical restraint in nursing homes and play an important role in restraint decision-making and management. In China, there is still a lack of large-scale surveys on the current situation regarding the use of restraint. This study aimed to identify this situation and the influencing factors of the knowledge, attitude, and practice of nursing staff regarding physical restraint in elderly care institutions. Methods: A cross-sectional multicenter descriptive study was conducted. A total of 311 staff in 25 elderly care institutions in Zhejiang Province were recruited using a quota sampling method. A homemade questionnaire was administered to collect general information and information on knowledge, attitude and practice regarding physical restraint. Results: The average scoring rates of the knowledge and attitude dimensions of the 311 staff were 48.7 and 75.6%, respectively. The average scoring rate of the practice dimension of 140 staff who implemented restraint was 80.1%. Educational background and training experience were the influencing factors of restraint knowledge. Training experience, educational background and professional title were the influencing factors of restraint attitude. Restraint knowledge and length of service were the influencing factors of restraint practice. Conclusions: Knowledge of physical restraint among nursing staff is not promising. Their attitude toward restraint was inappropriate or irresponsible in some aspects. Restraint practice is not sufficiently standardized. It is necessary to strengthen restraint training for nursing staff to improve their overall level of restraint knowledge, attitude and practice.

Impacto de una intervención educativa en el conocimiento y manejo de residuos peligrosos biológico-infecciosos / Impact of an educational intervention on the knowledge and management of infectious biological hazardous waste

Introducción: el personal de enfermería tiene una participación fundamental en el manejo de los residuos peligrosos biológico-infecciosos (RPBI) durante la atención en salud, situación que hace indispensable el conocimiento respecto a la peligrosidad y riesgo en el manejo de estos residuos. Objetivo: evaluar el impacto de una intervención educativa acerca del conocimiento y manejo de RPBI, en el personal de enfermería de un hospital general regional. Metodología: estudio cuasi experimental, pretest/postest, prospectivo y longitudinal. Se realizó una intervención educativa, y antes y después de esta se aplicó un cuestionario para evaluar conocimientos relacionados con RPBI y una lista de cotejo del Modelo Institucional para la Prevención de Infecciones Nosocomiales (MIPRIN) para evaluar el manejo de RPBI. Resultados: la intervención educativa demostró un efecto positivo en los conocimientos del personal de enfermería en relación con el manejo de RPBI. En la evaluación pretest se obtuvo un porcentaje de conocimientos de 65.2% y en la postest fue de 78.3% (p < 0.001). Respecto al cumplimiento en el manejo de RPBI, hubo un incremento; sin embargo, no se puede atribuir a la intervención, puesto que se evaluó por servicio y no de manera directa con los participantes. Conclusión: la intervención educativa mostró cambios significativos en los conocimientos y el manejo de RPBI del personal de enfermería.

Introduction: Nursing staff represent an important percentage in the management of biological hazardous waste (BHW) during health care, a situation that makes this knowledge essential regarding the danger and risk in handling these wastes. Objective: To evaluate the impact of an educational intervention about the knowledge and management of BHW in the nursing staff of a regional general hospital. Methods: quasi-experimental, pre-test/post-test, prospective and longitudinal study. An educational intervention was carried out; before and after this intervention, a questionnaire was administered to evaluate knowledge related to BHW and a checklist of the Institutional Model for the Prevention of Nosocomial Infections (MIPRIN, according to its initials in Spanish) to evaluate the management of BHW. Results: The educational intervention showed a positive effect in the nursing staff's knowledge in relation to BHW. In the pre-test evaluation a knowledge percentage of 65.2% was obtained and in the post-test evaluation it was 78.3% (p < 0.001). Regarding compliance in the management of BHW there was an increase; however, it cannot be attributed to the intervention, since it was evaluated by service and not directly with the participants.

Modelo de enfermería: Resignificación / Nursing Model: Resignification

El individuo, en la actualidad, representa una gran responsabilidad para el profesional de enfermería, dada la atención integral y transpersonal que requiere, entendiendo los códigos de creencia que lo limitan para llegar a la autorrealización; pretendiendo establecer en el individuo estándares de salud y de autocuidado, no aplicando para todos los grupos de desarrollo del individuo, ya que cada uno cuenta con una percepción diferente del universo llamada cosmovisión. Estas interpretaciones gestan diferentes arquetipos colectivos que se adquieren en el proceso de enculturación. Para el modelo de resignificación, la relación del individuo, cultura y arquetipos colectivos, son de suma importancia para establecer la autogestión del cuidado, donde el individuo desarrolla sus propias habilidades, destrezas y herramientas para establecer un equilibrio en el medio interno (pensamientos) y el medio externo (conductas), considerando cuatro áreas de desarrollo: biológica, psicológica, social y la que se busca desarrollar, la parte espiritual, llevándolo a la autorrealización.

The individual, nowadays, represents a great responsibility for the nursing professional, given the comprehensive and transpersonal care that he requires, understanding the codes of belief that limit him to reach self-realization; pretending to establish standards of health and self-care in the individual, not applying to all groups of development of the individual, since each one has a different perception of the universe called Worldview. These interpretations generate different collective archetypes that are acquired in the process of enculturation. For the model of resignification, the relationship of the individual, culture and collective archetypes, are of the utmost importance to establish the care self-management, where the individual develops their own abilities, skills and tools to establish a balance in the internal environment (thoughts) and the external environment (behaviors), considering four areas of development: biological, psychological, social and the one that is sought develop, the spiritual part, leading to self-realization.

Intervención educativa de enfermería en pacientes con cateterismo cardiaco / Nursing educational intervention in patients with cardiac catheterization

Introducción: la intervención de enfermería en pacientes sometidos a cateterismo cardiaco constituye el eje articular de las acciones de planeación, desarrollo y evaluación; lo que permite atender el proceso de aprendizaje. Objetivo: evaluar la relación entre el nivel de conocimiento y ansiedad de los pacientes sometido a cateterismo cardiaco, antes y después de aplicar una intervención educativa. Metodología: investigación con enfoque cuantitativo, descriptivo, transversal y exploratorio a 70 pacientes sometidos a cateterismo cardiaco por primera vez, se aplicaron dos instrumentos validados para medir el nivel de conocimiento y ansiedad con un Alfa de Cronbach de 0.90; la recolección fue en dos fases, pretest y postest, la primera antes de la cirugia; la segunda posterior al procedimiento y se compararon los resultados de ambos test en búsqueda de mejores resultados. Resultados: media de edad de 60 - 79 años; 68.6% hombres y 31.4% mujeres; el nivel de conocimientos del pretest fue de 52.9% regular y postest, excelente con un 50%; en cuanto a la ansiedad el pretest el 97.1% reportó grave, mientras que en el postest, el 80% reportó moderado. Conclusiones: el aporte de conocimientos por parte del personal de enfermería a través del rol educador, favorece a los pacientes que son sometidos a un cateterismo cardiaco, que se refleja en disminución de ansiedad e incremento de calidad de vida.

Introduction:The nursing intervention in patients undergoing cardiac catheterization constitutes the articular axis of planning, development and evaluation actions; which allows to attend the learning process. Objective: To evaluate the relationship between the level of knowledge and anxiety of the patient undergoing cardiac catheterization, before and after applying an educational intervention. Methodology: Investigation with a quantitative, descriptive, cross-sectional and exploratory approach to 70 patients undergoing cardiac catheterization for the first time. Two validated instruments were applied to measure the level of knowledge and anxiety with a Cronbach's Alpha of 0.90; the collection was in two phases, pre and post test, the first before surgery; the second after the procedure, the results of both tests were compared in search of better results. Results: Average age of 60-79 years, 68.6% men and 31.4% women; the level of knowledge of the pre-test was 52.9% regular and post-test, excellent with 50%; regarding anxiety, the pre-test 97.1% serious, post-test, 80% moderate. Conclusions: The contribution of knowledges by the nursing staff through the educator role, favors patients who undergo cardiac catheterization, which is reflected in the reduction of seniority and the increase in the quality of life.

Efficacy of a Nasogastric Tube Educational Intervention for Nursing Staff.

AIM: We performed a single-center teaching intervention with nursing providers on nasogastric tube (NG tube) clinical practice. The initial purpose of this study was the validation of whether the training was sufficient enough to be retained at a later time point. METHODS: We performed a prospective pre-post study examining participants' knowledge before, immediately after, and 4 weeks after training in NG tube management. Training was delivered in face-to-face classroom sessions. Knowledge was assessed using a multiple-choice test (pretest, posttest #1and #2). RESULTS: A total of 137 nursing providers participated in the training intervention. Immediately after training (posttest #1) and again 4 weeks later (posttest #2), participants overwhelmingly recalled and retained the knowledge of NG tube management as compared to pretest results. Paired t-tests showed each participant increased their test score from pretest to posttest #1, t (134) = 12.64, P = .0001. Similarly, participants who took posttest #2 significantly improved their scores from the pretest to posttest #2, t (71) = 10.629, P < .0001. Secondary analysis showed that the NG tube management comfort level and age of provider were not significant in predicting test results. However, years of professional experience and frequency of NG tube care were significant predictors for higher test scores. CONCLUSION: To minimize the risk of NG tubes for patients, it is critical to follow clinical guidelines. This study shows that teaching interventions for providers to increase knowledge on NG tubes are beneficial. In addition, the knowledge is retained at later time points.

Role and support needs of nurses in delivering palliative and end of life care.

The coronavirus disease 2019 (COVID-19) pandemic has led to a significant increase in the demand for palliative and end of life care, particularly in the community. Furthermore, palliative and end of life care services face growing pressures due to the increasing number of older people and increasing prevalence of chronic illness. Palliative and end of life care cannot be provided solely by specialists but needs to be integrated into mainstream healthcare. All nurses have a role in supporting patients with life-limiting conditions, and their families, by providing what is termed 'generalist palliative care'. However, some nurses may feel unprepared, unsupported or lacking the confidence and skills for that role. This article explores the definitions of palliative and end of life care, as well as the changes and challenges in service provision brought about by the COVID-19 pandemic. It also considers how nurses who have not specialised in this area of practice can be supported to care effectively for patients with life-limiting conditions, and their families, notably through workforce development initiatives such as training programmes and clinical supervision. This could not only increase the skills of the nursing workforce but also improve patient care.

Implementation of the Evidence Integration Triangle for behavioral and psychological symptoms of dementia (EIT-4-BPSD) in care communities.

BACKGROUND: Federal regulations stipulate that behavioral interventions be used for behavioral and psychological symptoms of distress in dementia (BPSD). Care community staff have difficulty implementing these approaches. PURPOSE: This study tested an implementation strategy, the Evidence Integration Triangle for BPSD (EIT-4-BPSD), for assisting staff in the use of evidence-based behavioral approaches for BPSD. METHODS: About 55 care communities were randomized to EIT-4-BPSD or usual care; 553 residents were enrolled. The implementation strategy was delivered by research facilitators, staff, stakeholders, and champions over 12 months. It involved four components: Environment and policy assessments; Staff education; Establishment of person-centered care plans; and Mentoring and motivating staff. The implementation strategy was evaluated using the Reach, Effectiveness, Adoption, Implementation, Maintenance model. FINDINGS: There was no evidence for resident or care community effectiveness. There was evidence of adoption and implementation. DISCUSSION: EIT-4-BPSD was helpful as an implementation strategy and staff altered how care was provided.

Reimagining care homes: can the COVID-19 pandemic act as a catalyst for enhancing staff status and education?

During the first wave of the coronavirus disease 2019 (COVID-19) pandemic, older people were discharged from hospitals to care homes to release NHS beds. This influx of new residents whose COVID-19 status was largely unknown added to the many challenges already experienced by care homes, with serious consequences including an increased number of deaths among residents. The social care sector has been fragile for several years and the pandemic has brought the challenges experienced by care homes to the forefront, prompting renewed calls for improved funding and reform. This article describes the ongoing challenges and additional challenges caused by the pandemic in the care home sector. The authors argue for urgent reform to enhance the status and education of care home staff, move towards registration of the social care workforce in England, and achieve integration of health and social care services for older people.

Training healthcare providers to respond to intimate partner violence against women.

BACKGROUND: Intimate partner violence (IPV) includes any violence (physical, sexual or psychological/emotional) by a current or former partner. This review reflects the current understanding of IPV as a profoundly gendered issue, perpetrated most often by men against women. IPV may result in substantial physical and mental health impacts for survivors. Women affected by IPV are more likely to have contact with healthcare providers (HCPs) (e.g. nurses, doctors, midwives), even though women often do not disclose the violence. Training HCPs on IPV, including how to respond to survivors of IPV, is an important intervention to improve HCPs' knowledge, attitudes and practice, and subsequently the care and health outcomes for IPV survivors. OBJECTIVES: To assess the effectiveness of training programmes that seek to improve HCPs' identification of and response to IPV against women, compared to no intervention, wait-list, placebo or training as usual. SEARCH METHODS: We searched CENTRAL, MEDLINE, Embase and seven other databases up to June 2020. We also searched two clinical trials registries and relevant websites. In addition, we contacted primary authors of included studies to ask if they knew of any relevant studies not identified in the search. We evaluated the reference lists of all included studies and systematic reviews for inclusion. We applied no restrictions by search dates or language. SELECTION CRITERIA: All randomised and quasi-randomised controlled trials comparing IPV training or educational programmes for HCPs compared with no training, wait-list, training as usual, placebo, or a sub-component of the intervention. DATA COLLECTION AND ANALYSIS: We used standard methodological procedures outlined by Cochrane. Two review authors independently assessed studies for eligibility, undertook data extraction and assessed risks of bias. Where possible, we synthesised the effects of IPV training in a meta-analysis. Other analyses were synthesised in a narrative manner. We assessed evidence certainty using the GRADE approach. MAIN RESULTS: We included 19 trials involving 1662 participants. Three-quarters of all studies were conducted in the USA, with single studies from Australia, Iran, Mexico, Turkey and the Netherlands. Twelve trials compared IPV training versus no training, and seven trials compared the effects of IPV training to training as usual or a sub-component of the intervention in the comparison group, or both. Study participants included 618 medical staff/students, 460 nurses/students, 348 dentists/students, 161 counsellors or psychologists/students, 70 midwives and 5 social workers. Studies were heterogeneous and varied across training content delivered, pedagogy and time to follow-up (immediately post training to 24 months). The risk of bias assessment highlighted unclear reporting across many areas of bias. The GRADE assessment of the studies found that the certainty of the evidence for the primary outcomes was low to very low, with studies often reporting on perceived or self-reported outcomes rather than actual HCPs' practices or outcomes for women. Eleven of the 19 included studies received some form of research grant funding to complete the research. Within 12 months post-intervention, the evidence suggests that compared to no intervention, wait-list or placebo, IPV training: · may improve HCPs' attitudes towards IPV survivors (standardised mean difference (SMD) 0.71, 95% CI 0.39 to 1.03; 8 studies, 641 participants; low-certainty evidence); · may have a large effect on HCPs' self-perceived readiness to respond to IPV survivors, although the evidence was uncertain (SMD 2.44, 95% CI 1.51 to 3.37; 6 studies, 487 participants; very low-certainty evidence); · may have a large effect on HCPs' knowledge of IPV, although the evidence was uncertain (SMD 6.56, 95% CI 2.49 to 10.63; 3 studies, 239 participants; very low-certainty evidence); · may make little to no difference to HCPs' referral practices of women to support agencies, although this is based on only one study (with 49 clinics) assessed to be very low certainty; · has an uncertain effect on HCPs' response behaviours (based on two studies of very low certainty), with one trial (with 27 participants) reporting that trained HCPs were more likely to successfully provide advice on safety planning during their interactions with standardised patients, and the other study (with 49 clinics) reporting no clear impact on safety planning practices; · may improve identification of IPV at six months post-training (RR 4.54, 95% CI 2.5 to 8.09) as in one study (with 54 participants), although three studies (with 48 participants) reported little to no effects of training on identification or documentation of IPV, or both. No studies assessed the impact of training HCPs on the mental health of women survivors of IPV compared to no intervention, wait-list or placebo. When IPV training was compared to training as usual or a sub-component of the intervention, or both, no clear effects were seen on HCPs' attitudes/beliefs, safety planning, and referral to services or mental health outcomes for women. Inconsistent results were seen for HCPs' readiness to respond (improvements in two out of three studies) and HCPs' IPV knowledge (improved in two out of four studies). One study found that IPV training improved HCPs' validation responses. No adverse IPV-related events were reported in any of the studies identified in this review. AUTHORS' CONCLUSIONS: Overall, IPV training for HCPs may be effective for outcomes that are precursors to behaviour change. There is some, albeit weak evidence that IPV training may improve HCPs' attitudes towards IPV. Training may also improve IPV knowledge and HCPs' self-perceived readiness to respond to those affected by IPV, although we are not certain about this evidence. Although supportive evidence is weak and inconsistent, training may improve HCPs' actual responses, including the use of safety planning, identification and documentation of IPV in women's case histories. The sustained effect of training on these outcomes beyond 12 months is undetermined. Our confidence in these findings is reduced by the substantial level of heterogeneity across studies and the unclear risk of bias around randomisation and blinding of participants, as well as high risk of bias from attrition in many studies. Further research is needed that overcomes these limitations, as well as assesses the impacts of IPV training on HCPs' behavioral outcomes and the well-being of women survivors of IPV.

When Crisis Strikes, Handle With CARE.

The decision to continue a career advancement program in midst of our health system's response to the COVID-19 pandemic was made after weighing the pros and cons. At a time when high priority was placed on educating the frontline nurses on rapidly changing protocols and supporting mental health, our organization reallocated resources and ways of doing things in order to maintain some form of normalcy. By doing so, we were able to demonstrate our commitment to professional development even in the face of adversity and highlight the resourcefulness of nursing professional development practitioners. As the COVID-19 crisis has laid bare, we live in an increasingly complex and interconnected world, and agility will be essential to future nursing professional development practice.

Planning and implementing a practice/academic partnership during COVID-19.

Due to the COVID-19 pandemic, nursing programs were challenged to continue educating students at practice sites, and educational institutions limited or eliminated face-to-face education. The purpose of this article is to report on a university and community college nursing program and an academic medical center that implemented an academic-practice partnership with the goal of creating opportunities to continue clinical experiences for nursing students during the pandemic. Principles and implementation of this successful partnership provide direction for other nursing programs and practice settings that may continue to have challenges in returning students to clinical and keeping them in clinical as the pandemic continues.

Children's palliative care: examination of a nursing rotation programme.

BACKGROUND: An 8-month rotation programme was implemented for five nurses employed in two kinds of children's palliative care environments: hospital wards and hospices. This study reports the views of the nurses completing the rotation. The research drew on appreciative inquiry and involved a pre- and post-rotation interview and questionnaire. Thematic analysis of the interviews revealed seven themes: adjusting to the rotation programme; support mechanisms; being safe; new knowledge and skills; knowledge exchange; misconceptions; future plans. These were supported by the questionnaire findings. Although the nurses identified some frustration at having to undertake competency assessments relating to previously acquired skills, as well as being out of their 'comfort zone', all the participants highly recommended the programme. They commented very positively on the support they received and the overall learning experience as well as the new insight into different aspects of care. In addition, they were able to share their newfound knowledge and expertise with others.

Identifying and treating sepsis in older people: a quality improvement project in hospitals and nursing homes in Texas.

Sepsis, if not identified and treated early, can be fatal, particularly in older people. A lack of knowledge and understanding of sepsis among nursing staff can result in a missed or delayed diagnosis, leading to delayed treatment and potentially to patient death. A quality improvement project was conducted in nine hospitals and 200 nursing homes in the Lower and Upper Rio Grande Valley regions of Texas, in the US, to improve the identification and treatment of sepsis by nursing staff. Interventions included educational webinars for hospital staff and train-the-trainer sessions for nurse leaders in nursing homes. All participating hospitals had implemented a sepsis screening tool and sepsis care bundles by the end of the project, and an overall decline in sepsis mortality rates was seen in these hospitals. Among participating nurse leaders in nursing homes, a dramatic improvement in sepsis knowledge was seen. The outcomes of the project support the use of comprehensive nursing staff education on sepsis identification and treatment. Sepsis education needs to be ongoing to maintain optimal levels of knowledge among nursing staff.