Economic evaluation of CPD activities for healthcare professionals: A scoping review.

CONTEXT: Continuing professional development (CPD) activities for healthcare professionals are central to the optimisation of patient safety and person-centred care. Although there is some evidence on the economics of healthcare professionals training, very little is known about the costs and benefits of CPD. METHODS: This study aimed to review the research evidence on economic evaluations of CPD activities for healthcare professionals. CINAHL, MEDLINE/PubMed, Scopus, Econlit and Web of Science databases were used to identify articles published between 2010 and 2021. RESULTS: Of the 6791 titles identified, 119 articles met the inclusion criteria and were included in this scoping review. The majority of articles were partial economic evaluations of CPD programmes (n = 70); half were from the USA. Studies that included multiple professions were most prevalent (n = 54), followed by nurses (n = 34) and doctors (n = 23). Patient outcomes were the most commonly reported outcome (n = 51), followed by change in clinical practice (n = 38) and healthcare professionals' knowledge gain (n = 19). CONCLUSIONS: There is an urgent call for more evidence regarding the economic evaluations of CPD. This is particularly important in view of the rising costs of healthcare globally. The majority of studies included in this review did not provide detailed information on the evaluations and many focused exclusively on the cost of CPD activities rather than outcomes.

Are mentors failing to fail underperforming student nurses? An integrative literature review.

AIM:: this review aimed to identify and review primary research to address the question: 'Is there evidence that mentors are failing to fail underperforming student nurses?' Design: this was an integrative literature review. METHODS:: online databases (Medline, Scopus, PsycINFO, and the Cumulative Index to Nursing and Allied Health Literature (CINAHL)) were searched using specified inclusion and exclusion criteria to focus the review. Critical appraisal was undertaken and key findings, outcomes and emergent concepts were identified from each study. These were then collated and synthesised into themes. RESULTS:: five articles met the criteria and review aim. Three main themes were identified. These were the mentors' relationship with the university, documentation when failing a student, and psychological and emotional impacts. CONCLUSION:: the phenomenon of failing to fail continues to concern the nursing profession but there is limited primary research evidence to inform contemporary discussions in the UK regarding the management of this in practice.

Why undertake a pilot in a qualitative PhD study? Lessons learned to promote success.

Background Pilot studies can play an important role in qualitative studies. Methodological and practical issues can be shaped and refined by undertaking pilots. Personal development and researchers' competence are enhanced and lessons learned can inform the development and quality of the main study. However, pilot studies are rarely published, despite their potential to improve knowledge and understanding of the research. Aim To present the main lessons learned from undertaking a pilot in a qualitative PhD study. Discussion This paper draws together lessons learned when undertaking a pilot as part of a qualitative research project. Important methodological and practical issues identified during the pilot study are discussed including access, recruitment, data collection and the personal development of the researcher. The resulting changes to the final study are also highlighted. Conclusion Sharing experiences of and lessons learned in a pilot study enhances personal development, improves researchers' confidence and competence, and contributes to the understanding of research. Implications for practice Pilots can be used effectively in qualitative studies to refine the final design, and provide the researcher with practical experience to enhance confidence and competence.

Correction: Supported: Supporting, enabling, and sustaining homecare workers to deliver end-of-life care: A qualitative study protocol.

[This corrects the article DOI: 10.1371/journal.pone.0291525.].

Exploring nurses' use of language with older people.

The authors discuss ways in which nurses speak to older people. Research shows that the words nurses use can have a powerful effect on the wellbeing of older people. An experimental project developed at the University of Hull is described in which creative writing techniques were used to increase nursing students' and staff's sensitivity to the importance of language in care. The project enabled participants to co-create a body of work that was subsequently displayed in the faculty reception, and it showed how trusting relationships could be developed between participants. The authors are working to extend the project by finding ways to embed creative writing in the undergraduate nursing curriculum.

Development of a European Centre of Excellence (Coe) for Research in Continuing Professional Development (UPGRADE).

The European Centre of Excellence (CoE) for Research in Continuing Professional Development (UPGRADE) is a pan-European network of researchers, clinicians, regulators, educators, and professional bodies, established in 2020 through a consensus group of experts, who defined its mission, vision, values, aims and objectives. The Centre's aim is to advance the science of Continuing Professional Development (CPD) for healthcare professionals through research and dissemination of best practices for CPD. Debate among UPGRADE partners and interchange of research data will yield best practices across countries to optimise quality CPD programmes. Collaboration, information exchange and communication among CPD experts will be facilitated through UPGRADE via an online Community of Inquiry (CoI). UPGRADE aims to evolve as a driving force network of academics and health professional leaders in research, education, professional regulation, and clinical practice whose collaborative work ensures quality and safe person-centred care. UPGRADE members are from 22 European countries, represented by strategic leaders in diverse sectors of health, policy, academia, and professional organisations. Three research-working groups constitute the pillars of UPGRADE, which addresses gaps in research, collect and create critical databases, and solidify the effectiveness of CPD.

Supported: Supporting, enabling, and sustaining homecare workers to deliver end-of-life care: A qualitative study protocol.

BACKGROUND: Homecare workers provide essential care at home for people at end-of-life but are often poorly trained and supported. AIM: To explore the experiences and needs of homecare workers and the views of homecare clients and carers, and other community-based health and social care staff about the homecare worker role, including identification of good practice. METHODS: In this qualitative exploratory study, we will conduct 150 semi-structured interviews with homecare workers within three geographic English localities chosen for maximum socio-demographic variation. Eligible participants will be consenting adults providing care services (workers [n = 45], managers [n = 15] community practitioners [n = 30]), receiving care (clients thought to be in the last 6 months of life [n = 30], family carers [n = 15], or commissioners of homecare services supporting end-of-life care [n = 15]. Interviews may adopt a Pictor-guided or standard semi-structured approach according to their preference. Managers and commissioners can contribute to an online focus group if preferred. A range of recruitment strategies will be used, including through homecare agencies, local authorities, local NHS services, charities, voluntary sector groups and social media. Interviews and focus groups will be recorded, transcribed, anonymised, and analysed adopting a case-based approach for each geographic area within-case and then comparison across cases using reflexive thematic analysis. The design and analysis will be informed by Bronfenbrenner's Adapted Ecological Systems theory. This study is registered on the Research Registry (No.8613). CONTRIBUTION: We will provide evidence on ways to improve the experiences and address the needs of homecare workers in relation to caring for people nearing end-of-life. It will offer insight into good practice around supporting homecare workers including responding to their training and development needs. Findings will inform subsequent stages of an evaluation-phase study of a training resource for homecare workers.

Approaches used to enhance transition and retention for newly qualified nurses (NQNS): A rapid evidence assessment.

AIM: To undertake a rapid evidence assessment of approaches used to enhance nurse transition and retention for newly qualified nurses and to evaluate the strength of the evidence for specific approaches to nurse transition and retention. DESIGN: A rapid evidence assessment was undertaken. Electronic databases were searched, and the full texts of relevant papers were retrieved. Studies were appraised using relevant Critical Appraisal Skills Programme and Mixed Methods Assessment Tools and a single descriptor of quality: high; medium; or low was assigned to each output. Given the disparity in methods, the lack of randomised trials, results could not be combined; therefore, a descriptive approach was used to synthesise and present the data. DATA SOURCES: The search was undertaken using: specific database searching; and secondary searching of relevant websites. Electronic databases (CINAHL complete, Academic search premier, Open Grey, ERIC* (Education), Web of Science-Social Science Citation Index and PubMed) were searched during February 2018. RESULTS: Orientation and creating supportive environments were frequently reported as being effective in enhancing transition across a range of studies. A range of methods: quasi-experimental, survey and qualitative were used. Generally, the quality of most studies was poor. CONCLUSIONS: Despite decades of research into the experiences of newly qualified nurses and development of schemes and frameworks to support them during this period, there is little substantive or robust evidence in terms of impact on retention. Further research into the longer-term retention of newly qualified nurses is recommended. Longitudinal studies would be beneficial in assessing the efficacy of approaches to enhancing retention.

'A fifty mile round trip to change a lightbulb': An exploratory study of carers' experiences of providing help, care and support to families and friends from a distance.

While the role of carers has been widely investigated, the experiences of those who care from a distance have been little explored, especially in the United Kingdom. However, contemporary patterns of family life suggest that this may be a significant experience for many. This exploratory study employed an anonymous online survey, conducted April-November 2017, to collect data about specific issues (experiences, challenges and satisfactions) faced by carers living at a distance requiring at least 1 hr travel time (each way) from the person they support. One hundred and twenty-eight participant responses were analysed. Qualitative (thematic) analysis identified that 'distance carers' carry out multiple care tasks, both when with, and apart from, the person they care for. Distance creates specific challenges for carers who have to work to 'bridge the distance gap' and who cannot 'just drop in' and see the person they support. Distance further exposes carers to emotional, financial and temporal demands. The use of technologies or the availability of a wider support network may support distance carers, and some explore the viability of relocation. However, these potential support strategies were identified as 'fragile' and at risk of breaking down. Despite the challenges identified, distance carers also reported satisfactions derived from supporting their relative/friend. While the numbers of those providing distance care are unknown, this research suggests that this is a significant carer group, whose needs should be recognised in health and social care policy, practice and research.

Education and training for learning disability practice: key messages from contemporary literature.

Over the last quarter of a century, much attention has justifiably been given to the closure of long-stay hospitals and the subsequent community-based experiences of people with learning disabilities. This has inevitably led to debate regarding how best they might continue to be supported, and by whom. Having identified a range of accredited provision currently available to prepare or develop staff working with adults with learning disabilities in the United Kingdom, this article reviews a range of contemporary literature relating to education in learning disability health and social care that is typically produced and viewed in isolation. Four themes are identified: training social carers, user involvement, (inter)professional practice and work-based learning. Key messages emerge from these themes to form recommendations for the future education of learning disability practitioners across the workforce.

Involving carers in risk assessment: a study of a structured dialogue between mental health nurses and carers.

BACKGROUND: Involving carers is a key priority in mental health services. Carers report the sharing of service users' safety information by mental health nurses is problematic and seldom takes place. AIMS: The impact of an intervention on consensus between nurses and carers on perceptions of risk was investigated. METHODS: Carer-nurse risk consensus scores were measured pre- and post-introduction of a structured dialogue (paired t-test/ANOVA). Carer experience with involvement was surveyed pre-test (n = 60) and compared with the post-test intervention group (n = 32) (chi-square tests of linear-by-linear association). RESULTS: Consensus and perceptions regarding type and severity of risk did not change significantly for carers or nurses after engaging in a structured dialogue. Statistically significant differences were found with carers reporting higher levels of satisfaction with services in four out of six areas surveyed. CONCLUSIONS: Findings provide support for increasing carer contribution to discussions regarding risk. Further work to embed carer involvement in clinical practice is warranted.

Student nurses' attitudes to vulnerable groups: a study examining the impact of a social inclusion module.

BACKGROUND: Front line health care professionals have a responsibility to ensure that excluded groups and vulnerable people have equitable access to health care services. This obligation is stated explicitly in the Nursing and Midwifery Council Code of Professional Conduct (2004). Consequently, educationalists involved in the delivery of nurse education have sought to promote the principles of socially inclusive and anti-oppressive practice throughout the curriculum. METHOD: This quantitative study, conducted with a group of nursing and midwifery university students, aimed to examine student attitudes prior to and on completion of a module on social inclusion/exclusion. RESULTS: The data demonstrated that the majority of students surveyed held views that were generally positive and inclusive. Yet, a small group of respondents held stereotypical views potentially compromising their ability to provide health care. CONCLUSION: This study identified important gaps within the current curriculum and the need for educators in the field of Health and Social Care to concentrate efforts throughout the curriculum on challenging stereotypical views and attitudes rather than assuming that students can understand the complex concepts of social inclusion in a stand alone module. The students who took part in the study generally held positive views and values and the module was to some extent able to shape their perspective on vulnerable people.

Employment experiences of older nurses and midwives in the NHS.

AIM: To examine the employment experiences of older nurses and midwives working in the NHS. METHOD: A total of 27 semi-structured telephone interviews were conducted with nurses and midwives to identify positive and negative aspects of their working lives in the NHS. The interviewees were selected from a potential pool of 87 nurses and midwives who had consented to be involved in an earlier part of the study. Data were analysed using QSR NVivo 7.0. FINDINGS: Positive and negative issues were identified as having an impact on the quality of working life. These included: access to training, change and Agenda for Change (AfC), quality of management, work demands, patient/colleague contact and nursing and midwifery as a career. CONCLUSION: This study highlighted a number of issues relevant to older nurses and midwives that warrant further study and attention. These include access to training and continuing professional development, issues relating to change and AfC, and general work demands including workload, resources and morale. The ability of staff to remain healthy, committed and able to deliver quality care can be compromised in cases where the staff experience is negative.